Bad Science by Ben Goldacre

After being so thoroughly intrigued and impressed with Goldacre’s Bad Pharma, I went back to the library to get his first book, Bad Science. But alas, the library did not have it requiring an interlibrary loan.

While Goldacre’s barbs are directed solely at the pharma industry in Bad Pharma, his targets in Bad Science include the media (a most noble andn worthy target for most any expose) and statisticians (those hit a little too close to home), his sharpest arrows are lasered on homeopathic claims and nutritionists whom he considers to border of quackery. Notice he discusses ‘nutritionists’ and not ‘registered dieticians.’ He really blasts some fad nutritionists (not in general, he really has a bone to pick with one UK woman in particular) whose many false claims (about their training, research history, science knowledge, interpretation of the literature) are almost laughable if there weren't so many of the public who buy into their nonsense.

His most enlightening, and longest, section is about the MMR and autism scare of the last 10-ish years that just won’t seem to go away. In some detail, Goldacre discusses how the scare started (using now-dismissed data), was perpetuated by an agenda-driven media (hmmm, can you spell “global warming”?), the seeming inability of the media to admit after the fact that they were fooled and mislead and finally the mishandling of retorts by a medical establishment was most adept at tripping over its own tongue.

Despite being a legendary cheapskate and getting my books almost exclusively from the library, my highest recommendation for a book is if I then go out and buy it.  I just did get Naked Statistics and will now order both Goldacre books. If you want to test drive Goldacre, see his Ted Talks online. I'm wondering if my primary society, the American College of Sports Medicine, would consider him for a keynote? Maybe I'll drop the hint to a guy I know on the program committee.

East Coast Don

Bad Pharma by Ben Goldacre

The subtitle to this discussion is ‘How drug companies mislead doctors and harm patients”.

When you go to your doctor, “you want the treatment that has been shown, overall, in fair tests, to be better than all others.” The question is, how does your doctor decide what medicine to use? This book tells you, unfortunately, that doctors must make decisions despite being denied access to all the investigative data by trial sponsors and a failed regulatory process in the face of overwhelming marketing pressure.

I think this book is mistitled. While it focuses on big pharma, it really outlines just how badly the medical research-corporate-government complex has failed patients. The doctor-patient relationship has devolved to the doctor being a figurative personal shopper who has to sift through incomplete information to find the best buy when it comes to treatments.  That’s hard to do when, say, 50 trials for a drug are conducted, maybe half get registered at ClinTrials.gov, of which only 25% find results favorable to the sponsoring company while the other 75% of the studies never end up in print. Why? Who’s to blame? Journal editors? Ghostwriters? The peer review process? Marketing arms of big pharma? Academic reward systems? Payers?

There is more than enough blame to go around.

The problem is that everyone involved knows that the system is broken, but no one seems willing to take responsibility and certainly no one is in control.

For people outside of medicine, this book will probably cause the blood of many to boil. To those inside medicine, it’s probably just business as usual that, unfortunately, can be fatal leading to unnecessary premature death. This copiously referenced book lays out hundreds of breadcrumbs for the reader to dig further.

Dr. Goldacre is a UK general practitioner who also wrote Bad Science, which I will find a way to read. Found this book on the same table as Naked Statistics, recently reviewed here at MRB. Check out Goldacre’s blog at www.BadScience.net. Sure looks like big pharma, government, and other stakeholders in this mess aren"t all that keen to fix things as they have too much invested in the status quo. Goldacre advocates a ground up swell by patients to make demands of the people they pay. A well informed person when it comes to healthcare should sprint to a store (or Amazon.com) and get this. And make sure to have a ready supply of omeprezole (Prilosec) on hand, not Nexium. Get the book to find out why Thomas Scully, the head of Medicare/Medicaid, says, "Any doctor who prescribes Nexium should be ashamed of himself."

East Coast Don