Skepticism about science and medicine

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Archive for the ‘conflicts of interest’ Category

Has all academic publishing become predatory? Or just useless? Or just vanity publishing?

Posted by Henry Bauer on 2017/06/14

A pingback to my post “Predatory publishers and fake rankings of journals” led me to “Where to publish and not to publish in bioethics – the 2017 list”.

That essay brings home just how pervasive has become for-profit publishing of purportedly scholarly material. The sheer volume of the supposedly scholarly literature is such as to raise the question, who looks at any part of this literature?

One of the essay’s links leads to a listing by the Kennedy Center for Ethics of 44 journals in the field of bioethics.  Another link leads to a list of the “Top 100 Bioethics Journals in the World, 2015” by the author of the earlier “Top 50 Bioethics Journals and Top 250 Most Cited Bioethics Articles Published 2011-2015

What, I wonder, does any given bioethicist actually read? How many of these journals have even their Table of Contents scanned by most bioethicists?

Beyond that: Surely the potential value of scholarly work in bioethics is to improve the ethical practices of individuals and institutions in the real world. How does this spate of published material contribute to that potential value?

Those questions are purely rhetorical, of course. I suggest that the overwhelming mass of this stuff has no influence whatever on actual practices by doctors, researchers, clinics and other institutions.

This literature does, however, support the existence of a body of bioethicists whose careers are tied in some way to the publication of articles about bioethics.

The same sort of thing applies nowadays in every field of scholarship and science. The essay’s link to Key Journals in The Philosopher’s Index brings up a 79-page list, 10 items per page, of key [!] journals in philosophy.

This profusion of scholarly journals supports not only communities of publishing scholars in each field, it also nurtures an expanding community of meta-scholars whose publications deal with the profusion of publication. The earliest work in this genre was the Science Citation Index which capitalized on information technology to compile indexes through which all researchers could discover which of their published work had been cited and where.

That was unquestionably useful, including by making it possible to discover people working in one’s own specialty. But misuse became abuse, as administrators and bureaucrats began simply to count how often an individual’s work had been cited and to equate that number with quality.

No matter how often it has been pointed out that this equation is so wrong as to be beyond rescuing, this attraction of supposedly objective numbers and the ease of obtaining them has made citation-counting an apparently permanent part of the scholarly literature.

Not only that. The practice has been extended to judging the influence a journal has by counting how often the articles in it have been cited, yielding a “journal impact factor” that, again, is typically conflated with quality, no matter how often or how learnedly the meta-scholars point out the fallacies in that equation — for example different citing practices in different fields, different editorial practices that sometimes limit number of permitted citations, the frequent citation of work that had been thought important but that turned out to be wrong.

The scholarly literature had become absurdly voluminous even before the advent of on-line publishing. Meta-scholars had already learned several decades ago that most published articles are never cited by anyone other than the original author(s): see for instance J. R. Cole & S. Cole, Social Stratification in Science (University of Chicago Press, 1973); Henry W. Menard, Science: Growth and Change (Harvard University Press, 1971); Derek de Solla Price, Little Science, Big Science … And Beyond (Columbia University Press, 1986).

Derek Price (Science Since Babylon, Yale University Press, 1975) had also pointed out that the growth of science at an exponential rate since the 17th century had to cease in the latter half of the 20th century since science was by then consuming several percent of the GDP of developed countries. And indeed there has been cessation of growth in research funds; but the advent of the internet has made it possible for publication to continue to grow exponentially.

Purely predatory publishing has added more useless material to what was already unmanageably voluminous, with only rare needles in these haystacks that could be of any actual practical use to the wider society.

Since almost all of this publication has to be paid for by the authors or their research grants or patrons, one could also characterize present-day scholarly and scientific publication as vanity publishing, serving to the benefit only of the author(s) — except that this glut of publishing now supports yet another publishing community, the scholars of citation indexes and journal impact factors, who concern themselves for example with “Google h5 vs Thomson Impact Factor” or who offer advice for potential authors and evaluators and administrators about “publishing or perishing”.

To my mind, the most damaging aspect of all this is not the waste of time and material resources to produce useless stuff, it is that judgment of quality by informed, thoughtful individuals is being steadily displaced by reliance on numbers generated via information technology by procedures that are understood by all thinking people to be invalid substitutes for informed, thoughtful human judgment.

 

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How to interpret statistics; especially about drug efficacy

Posted by Henry Bauer on 2017/06/06

How (not) to measure the efficacy of drugs  pointed out that the most meaningful data about a drug are the number of people needed to be treated for one person to reap benefit, NNT, and the number needed to be treated for one person to be harmed, NNH.

But this pertinent, useful information is rarely disseminated, and most particularly not by drug companies. Most commonly cited are statistics about drug performance relative to other drugs or relative to placebo. Just how misleading this can be is described in easily understood form in this discussion of the use of anti-psychotic drugs.

 

That article (“Psychiatry defends its antipsychotics: a case study of institutional corruption” by Robert Whitaker) has many other points of interest. Most important, of course, the potent demonstration that official psychiatric practice is not evidence-based, rather, its aim is to defend the profession’s current approach.

 

In these ways, psychiatry differs only in degree from the whole of modern medicine — see WHAT’S WRONG WITH PRESENT-DAY MEDICINE  — and indeed from contemporary science on too many matters: Dogmatism in Science and Medicine: How Dominant Theories Monopolize Research and Stifle the Search for Truth, Jefferson (NC): McFarland 2012.

Posted in conflicts of interest, consensus, media flaws, medical practices, peer review, prescription drugs, scientific culture, unwarranted dogmatism in science | Tagged: , | Leave a Comment »

Superstitious belief in science

Posted by Henry Bauer on 2017/05/16

Most people have a very misled, unrealistic view of “science”. A very damaging consequence is that scientific claims are given automatic respect even when that is unwarranted — as it always is with new claims, say about global warming. Dramatic changes in how science is done, especially since mid-20th century, make it less trustworthy than earlier.

In 1987, historian John Burnham published How Superstition Won and Science Lost, arguing that modern science had not vanquished popular superstition by inculcating scientific, evidence-based thinking; rather, science had itself become on worldly matters the accepted authority whose pronouncements are believed without question, in other words superstitiously, by society at large.

Burnham argued through detailed analysis of how science is popularized, and especially how that has changed over the decades. Some 30 years later, Burnham’s insight is perhaps even more important. Over those years, certain changes in scientific activity have also become evident that support Burnham’s conclusion from different directions: science has grown so much, and has become so specialized and bureaucratic and dependent on outside patronage, that it has lost any ability to self-correct. As with religion in medieval times, official pronouncements about science are usually accepted without further ado, and minority voices of dissent are dismissed and denigrated.

A full discussion with source references, far too long for a blog post, is available here.

Posted in conflicts of interest, consensus, denialism, politics and science, science is not truth, scientific culture, scientific literacy, scientism, scientists are human, unwarranted dogmatism in science | Tagged: | Leave a Comment »

The banality of evil — Psychiatry and ADHD

Posted by Henry Bauer on 2017/04/25

“The banality of evil” is a phrase coined by Hannah Arendt when writing about the trial of Adolf Eichmann who had supervised much of the Holocaust. The phrase has been much misinterpreted and misunderstood. Arendt was pointing to the banality of Eichmann, who “had no motives at all” other than “an extraordinary diligence in looking out for his personal advancement”; he “never realized what he was doing … sheer thoughtlessness … [which] can wreak more havoc than all the evil instincts” (1). There was nothing interesting about Eichmann. Applying Wolfgang Pauli’s phrase, Eichmann was “not even wrong”: one can learn nothing from him other than that evil can result from banality, from thoughtlessness. As Edmund Burke put it, “The only thing necessary for the triumph of evil is for good men to do nothing” — and not thinking is a way of doing nothing.

That train of thought becomes quite uncomfortable with the realization that sheer thoughtlessness nowadays pervades so much of the everyday practices of science, medicine, psychiatry. Research simply — thoughtlessly — accepts contemporary theory as true, and pundits, practitioners, teachers, policy makers all accept the results of research without stopping to think about fundamental issues, about whether the pertinent contemporary theories or paradigms make sense.

Psychiatrists, for example, prescribe Ritalin and other stimulants as treatment for ADHD — Attention-Deficit/Hyperactivity Disorder — without stopping to think about whether ADHD is even “a thing” that can be defined and diagnosed unambiguously (or even at all).

The official manual, which one presumes psychiatrists and psychologists consult when assigning diagnoses, is the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association, now (since 2013) in its 5th edition (DSM-5). DSM-5 has been quite widely criticized, including by such prominent psychiatrists as Allen Frances who led the task force for the previous, fourth, edition (2).

Even casual acquaintance with the contents of this supposedly authoritative DSM-5 makes it obvious that criticism is more than called for. In DSM-5, the Diagnostic Criteria for ADHD are set down in five sections, A-E.

A: “A persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development, as characterized by (1) and/or (2):
     1.   Inattention: Six (or more) of the following symptoms have persisted for at least 6 months to a degree that is inconsistent with developmental level and that negatively impacts directly on social and academic/occupational activities
           Note: The symptoms are not solely a manifestation of oppositional behavior, defiance, hostility, or failure to understand tasks or instructions. For older adolescents and adults (age 17 and older), at least five symptoms are required.
a.     Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or during other activities (e.g., overlooks or misses details, work is inaccurate)
b.     Often has difficulty sustaining attention in tasks or play activities (e.g., has difficulty remaining focused during lectures, conversations, or lengthy reading).”
and so on through c-i, for a total of nine asserted characteristics of inattention.

Paying even cursory attention to these “criteria” makes plain that they are anything but definitive. Why, for example, are six symptoms required up to age 16 when five are sufficient at 17 years and older? There is nothing clear-cut about “inconsistent with developmental level”, which depends on personal judgment about both the consistency and the level of development. Different people, even different psychiatrists no matter how trained, are likely to judge inconsistently in any given case whether the attention paid (point “a”) is “close” or not. So too with “careless”, “often”, “difficulty”; and so on.

It is if anything even worse with Criteria A(2):

“2.    Hyperactivity and Impulsivity:
Six (or more) of the following symptoms have persisted for at least 6 months to a degree that is inconsistent with developmental level and that negatively impacts directly on social and academic/occupational activities
       Note: The symptoms are not solely a manifestation of oppositional behavior, defiance, hostility, or failure to understand tasks or instructions. For older adolescents and adults (age 17 and older), at least five symptoms are required.
a.    Often fidgets with or taps hands or feet or squirms in seat.”
and so on through b-i, for again a total of nine supposed characteristics of inattention. There is no need to cite any of those since “a” amply reveals the absurdity of designating as the symptom of a mental disorder a type of behavior that is perfectly normal for the majority of young boys. This “criterion” makes self-explanatory the reported finding that boys are three times more likely than girls to be diagnosed with ADHD, though experts make heavier weather of it by suggesting that sex hormones may be among the unknown causes of ADHD (3).

A(1) and (2) are followed by
“B. Several inattentive or hyperactivity-impulsivity symptoms were present prior to age 12 years.
C. Several inattentive or hyperactivity-impulsivity symptoms are present in two or more
settings  (e.g., at home, school, or work; with friends or relatives; in other activities).
D. There is clear evidence that the symptoms interfere with, or reduce the quality of, social,
academic, or occupational functioning.
E. The symptoms do not occur exclusively during the course of schizophrenia or another
psychotic disorder and are not better explained by another mental disorder (e.g., mood
disorder, anxiety disorder, dissociative disorder, personality disorder, substance
intoxication or withdrawal).”

It should be plain enough that this set of so-called criteria is not based on any definitive empirical data, as a simple thought experiment shows: What clinical (or any other sort of) trial could establish by observation that six symptoms are diagnostic up to age 17 whereas five can be decisive from that age on? What if the decisive symptoms were apparent for only 5 months rather than six; or five-and-three-quarters months? How remarkable, too, that “inattention” and hyperactivity and impulsivity” are both characterized by exactly nine possible symptoms.

Leaving aside the deplorable thoughtlessness of the substantive content of DSM-5, it is also saddening that something published by an authoritative medical society should reflect such carelessness or thoughtlessness in presentation. Competent copy-editing would have helped, for example by eliminating the many instances of “and/or”: “this ungraceful phrase … has no right to intrude in ordinary prose” (4) since just “or” would do nicely; if, for instance, I tell you that I’ll be happy with A or with B, obviously I’ll be perfectly happy also if I get both.
Good writing and proper syntax are not mere niceties; their absence indicates a lack of clear substantive thought in what is being written about, as Richard Mitchell ( “The Underground Grammarian”), liked to illustrate by quoting Ben Jonson: “Neither can his Mind be thought to be in Tune, whose words do jarre; nor his reason in frame, whose sentence is preposterous”.

At any rate, ADHD is obviously an invented condition that has no clearly measurable characteristics. Assigning that diagnosis to any given individual is an entirely subjective, personal judgment. That this has been done for some large number of individuals strikes me as an illustration of the banality of evil. Countless parents have been told that their children have a mental illness when they are behaving just as children naturally do. Countless children have been fed mind-altering drugs as a consequence of such a diagnosis. Some number have been sent to special schools like Eagle Hill, where annual tuition and fees can add up to $80,000 or more.

Websites claim to give information that is patently unfounded or wrong, for example:

“Researchers still don’t know the exact cause, but they do know that genes, differences in brain development and some outside factors like prenatal exposure to smoking might play a role. … Researchers looking into the role of genetics in ADHD say it can run in families. If your biological child has ADHD, there’s a one in four chance you have ADHD too, whether it’s been diagnosed or not. … Some external factors affecting brain development have also been linked to ADHD. Prenatal exposure to smoke may increase your child’s risk of developing ADHD. Exposure to high levels of lead as a toddler and preschooler is another possible contributor. … . It’s a brain-based biological condition”.

Those who establish such websites simply follow thoughtlessly, banally, what the professional literature says; and some number of academics strive assiduously to ensure the persistence of this misguided parent-scaring and children-harming. For example, by claiming that certain portions of the brains of ADHD individuals are characteristically smaller:

“Subcortical brain volume differences in participants with attention deficit hyperactivity disorder in children and adults: a cross-sectional mega-analysis” by Martine Hoogman et al., published in Lancet Psychiatry (2017, vol. 4, pp. 310–19). The “et al.” stands for 81 co-authors, 11 of whom declared conflicts of interest with pharmaceutical companies. The conclusions are stated dogmatically: “The data from our highly powered analysis confirm that patients with ADHD do have altered brains and therefore that ADHD is a disorder of the brain. This message is clear for clinicians to convey to parents and patients, which can help to reduce the stigma that ADHD is just a label for difficult children and caused by incompetent parenting. We hope this work will contribute to a better understanding of ADHD in the general public”.

An extensive detailed critique of this article has been submitted to the journal as a basis for retracting that article: “Lancet Psychiatry Needs to Retract the ADHD-Enigma Study” by Michael Corrigan & Robert Whitaker. The critique points to a large number of failings in methodology, including that the data were accumulated from a variety of other studies with no evidence that diagnoses of ADHD were consistent or that controls were properly chosen or available — which ought in itself be sufficient reason not to find publication.

Perhaps worst of all: Nowhere in the article is IQ mentioned; yet the Supplementary Material contains a table revealing that the “ADHD” subjects had on average higher IQ scores than the “normal” controls. “Now the usual assumption is that ADHD children, suffering from a ‘brain disorder,’ are less able to concentrate and focus in school, and thus are cognitively impaired in some way. …. But if the mean IQ score of the ADHD cohort is higher than the mean score for the controls, doesn’t this basic assumption need to be reassessed? If the participants with ADHD have smaller brains that are riddled with ‘altered structures,’ then how come they are just as smart as, or even smarter than, the participants in the control group?”

[The Hoogman et al. article in many places refers to “(appendix)” for details, but the article — which costs $31.50 — does not include an appendix; one must get it separately from the author or the journal.]

As usual, the popular media simply parroted the study’s claims, illustrated by headlines cited in the critique:

And so the thoughtless acceptance by the media of anything published in an established, peer-reviewed journal contributes to making this particular evil a banality. The public, including parents of children, are further confirmed in the misguided, unproven, notion that something is wrong with the brains of children who have been designated with a diagnosis that is no more than a highly subjective opinion.

The deficiencies of this article also illustrate why those of us who have published in peer-reviewed journals know how absurd it is to regard “peer review” as any sort of guarantee of quality, or even of minimal standards of competence and honesty. As Richard Horton, himself editor of The Lancet, has noted, “Peer review . . . is simply a way to collect opinions from experts in the field. Peer review tells us about the acceptability, not the credibility, of a new finding” (5).

The critique of the Hoogman article is just one of the valuable pieces at the Mad in America website. I also recommend highly Robert Whitaker’s books, Anatomy of an Epidemic and Mad in America.


(1)  Hannah Arendt, Eichmann in Jerusalem — A Report on the Banality of Evil. Viking Press,
1964 (rev. & enlarged ed.). Quotes are at p. 134 of PDF available at
https://platypus1917.org/wp-content/uploads/2014/01/arendt_eichmanninjerusalem.pdf
(2)  Henry H. Bauer, “The Troubles With Psychiatry — essay review of Saving Normal by Allen
Frances and The Book Of Woe by Gary Greenberg”, Journal of Scientific Exploration,
29  (2015) 124-30
(3)   Donald W. Pfaff, Man and Woman: An Inside Story, Oxford University Press, 2010: p. 147
(4)   Modern American Usage (edited & completed by Jacques Barzun et al. from the work of
Wilson Follett), Hill & Wang 1966
(5)    Health Wars: On the Global Front Lines of Modern Medicine, New York Review Books,
2003, p. 306

 

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Speaking Truth to Big Pharma Power

Posted by Henry Bauer on 2017/03/18

Some time ago I recommended the newsletter of Mad in America, a diligent and reliable commentary on the flaws of modern psychiatric medicine.

A recent issue had links to a superb series of articles by David Healy, a psychiatrist who has spoken truth to Big Pharma and to the conventional (lack of) wisdom, at considerable personal cost. Healy also founded a website with information about dru side effects, RxRisk:
Tweeting While Psychiatry Burns
Tweeting while Medicine Burns (Psychopharmacology Part 2)
Burn Baby Burn (Psychopharmacology Part 3)

Also useful in this newsletter, link to a report of a meta-analysis confirming the Minimal Effectiveness and High Risk of SSRIs

Posted in conflicts of interest, medical practices, politics and science, prescription drugs, science is not truth, scientific culture, scientists are human | Tagged: , , | Leave a Comment »

How Science Has Changed — notably since World War II

Posted by Henry Bauer on 2017/01/01

The way science is usually mentioned, including its history, seems to imply a fundamental continuity in the development of modern science from its origins around the 16th-17th centuries (Galileo, Newton) to the present time, via the understanding of heredity (Mendel, much later DNA), of evolution (Darwin, Lynn Margolis, many others), of atomic structure and chemical bonding, of relativity and quantum mechanics, and much else.

One can certainly discern a continuity in these discoveries and accumulations of facts and the development of ever-better, more encompassing explanations. But the nature of scientific activity — who does science and how they do it — is best understood not as a continuum over this period but as three clearly distinguishable stages in which the interaction of science with society as a whole is significantly different: what the social place of scientists is, how their work is supported, how the fruits of science are disseminated and how they are accepted (or not accepted) outside science itself.

To understand the role of science in today’s worlds it is essential to understand this history.

The birth of “modern” science is credited uncontroversially to “The” Scientific Revolution of the 17th century, but there is not equally general recognition that there have been three distinctly and significantly different stages of scientific activity since then.

In the first stage, a variety of people — clergy, craftsmen, aristocrats, entrepreneurs —were seeking to satisfy their curiosity about how the world works; truth-seeking was effectively in the hands of amateurs, people doing it for the sake of doing it, truth-seeking was their chief controlling interest. Missteps taken at this stage resulted chiefly from the inherent difficulty of making discoveries and from such inherent human flaws as pride and avarice.

The second stage, roughly much of the later 19th century and first half of the 20th, saw science becoming a career, a plausible way to make a living, not unlike other careers in academe or in professions like engineering: respectable and potentially satisfying but not any obvious path to great influence or wealth. Inevitably there were conflicts of interest between furthering a career and following objectively where evidence pointed, but competition and collegiality served well   enough to keep the progress of science little affected by conflicting career interests. The way to get ahead was by doing good science.

In the third and present stage, which began at about the middle of the 20th century, science faces a necessary change in ethos as its centuries-long expansion at an exponential rate has changed to a zero-sum, steady-state situation that has fostered intensely cutthroat competition. At the same time, the record of science’s remarkable previous successes has led industry and government to co-opt and exploit science and scientists. Those interactions offer the possibility for individual practitioners of science to gain considerable public influence and wealth. That possibility tempts to corruption. Outright fraud in research has become noticeably more frequent, and public pronouncements about matters of science are made not for the purpose of enlightenment on truths about the natural world but largely for self-interested bureaucratic and commercial motives. As a result. one cannot nowadays rely safely on the soundness of what authoritative institutions and individuals say about science.

For a full discussion with pertinent citations and references, see my article “Three Stages of Modern Science”, Journal of Scientific Exploration, 27 (2013) 505-13.

Posted in conflicts of interest, fraud in science, funding research, politics and science, science is not truth, scientific culture, scientists are human | Tagged: | 2 Comments »

Trust medical science at your peril (2): What is the evidence, especially in psychiatry?

Posted by Henry Bauer on 2016/07/15

All too often, the evidence turns out to be nothing more than statistical association: “Trust medical science at your peril: Correlations never prove causation”.

A particular example of confusing association with causation is the reliance on biomarkers:

“The Institute of Medicine Report, Evaluation of Biomarkers and Surrogate Endpoints in Chronic Disease (IOM 2010), finds that none of the commonly used biomarkers is a valid measure of the illness it supposedly tracks. As to subsequent treatment, Järvinen et al. have pointed out that ‘There are no valid data on the effectiveness . . . [of] statins, antihypertensives, and bisphosphanates’ (the last, e.g. Fosamax, are prescribed against osteoporosis) — British Medical Journal, 342 (2011) doi: 10.1136/bmj.d2175.
That last quote is surely an astonishing assertion, given that innumerable individuals are being fed statins and blood-pressure drugs and bisphosphanates not because they feel ill in any way but purely on the basis of levels of biomarkers (bone density in the case of bisphosphanates)” (Everyone is sick?)

Supporting evidence is sadly lacking for a wide range of accepted, standard medical practices. For at least a couple of decades, insiders and well-informed observers have described and documented the failings of modern medicine: “What’s wrong with present -day medicine”.

Bad as things are with the treatment of physical illnesses, they are much worse where psychiatry is involved. This blog post was stimulated by the informative article, “In Search of an Evidence-based Role for Psychiatry” by John Read, Olga Runciman, & Jacqui Dillon.

I had learned of it through the Newsletter of Mad in America, an excellent website dedicated to disseminating reliable information about psychiatric matters. One can sign up for the Newsletter at http://www.madinamerica.com/mia-newsletter-signup/.

 

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Trust medical science at your peril: Correlations never prove causation

Posted by Henry Bauer on 2016/06/28

It was a long-known empirical fact that poverty, vagrancy, criminality, and apparently deficient intelligence all correlated with heredity to a considerable extent; they all ran in families and clans. The scientific confirmation that characteristics of animals are passed on from generation to generation, and the Darwin-Wallace explanation of evolution by natural selection of the fittest, made it possible to understand those aspects of human society. It was an obvious, scientifically sound conclusion that human societies could be steadily improved by restricting reproduction of the less fit and expanding the fertility of the fittest. Hence the eugenics movement, promoted by the most progressive, liberal people who were also the best educated, with an apparently justified faith in the reliability of what was at the time the most up-to-date the scientific knowledge (Trust science at your peril: Beware of scientism and political correctness). Those circumstances led to forced sterilization of tens of thousands in America and reinforced Nazis in their doctrines and practices of mass killing of the unfit — Jews, gypsies, homosexuals (Edwin Black, War Against the Weak, 2003).

Only in hindsight did the flaws and errors of the earlier scientific consensus become clear. We now appreciate that environmental and developmental influences can modify heritable traits quite dramatically. “Ill-bred” can be the result of social, economic, environmental factors as much, perhaps even more than any pre-ordained verdict of genetics; and “well-bred” individuals can spring from what might seem the least promising hereditary stock. In other words, the observed correlation between undesired social characteristics and clans was misinterpreted through neglecting the variable of environmental effects.

One lesson to be drawn is that bad science, wrong science, what some even call pseudo-science, can remain the accepted scientific consensus for decades, even in quite modern times, say, the middle of the 20th century. It is unlikely that a mere half-a-century later our societies have become immune from assuming that a mainstream scientific consensus must be true to Nature. Nothing guards our times from treating unjustified, misguided scientific claims as good science.

Unwarranted claims coming from scientists continue to be accepted if they appear minimally plausible and if they are consistent with world-views and vested interests of financial, social, or political powers.

The most sweeping lesson that remains to be learned is that correlations must never be taken as demonstrating a cause-and-effect relationship: there might always be in play an unsuspected variable. One of the earliest axioms taught in Statistics 101 is that correlations never prove causation. The evident correlation between biological kinship and undesirable behavioral traits was not a cause-and-effect relationship.

Many or most people have never learned that basic truth that correlations are not causes. Many others “know” it as a generalization but fail to apply it in specific instances, when an evident correlation could plausibly reflect cause and consequence — just as a genetic basis for undesirable characteristics seemed quite plausible to educated and expert people not so long ago.

Indeed, a large swath of modern medical practices is based on mistaking mere correlations for evidence of causation (“Correlations: Plausible or implausible, NONE prove causation”). For example:

HPV and cervical cancer

The National Cancer Institute offers a great deal of information about this:

Human papillomaviruses (HPVs) are a group of more than 200 related viruses. . . Sexually transmitted HPV types fall into two categories:
— Low-risk HPVs, which do not cause cancer but can cause skin warts (technically known as condylomata acuminata) on or around the genitals, anus, mouth, or throat. For example, HPV types 6 and 11 cause 90 percent of all genital warts. HPV types 6 and 11 also cause recurrent respiratory papillomatosis, a less common disease in which benign tumors grow in the air passages leading from the nose and mouth into the lungs.
— High-risk HPVs, which can cause cancer. About a dozen high-risk HPV types have been identified. Two of these, HPV types 16 and 18, are responsible for most HPV-caused cancers. . . .
>> Cervical cancer: Virtually all cases of cervical cancer are caused by HPV, and just two HPV types, 16 and 18, are responsible for about 70 percent of all cases . . . .
>> Anal cancer: About 95 percent of anal cancers are caused by HPV. Most of these are caused by HPV type 16.
>> Oropharyngeal cancers (cancers of the middle part of the throat, including the soft palate, the base of the tongue, and the tonsils): About 70 percent of oropharyngeal cancers are caused by HPV. In the United States, more than half of cancers diagnosed in the oropharynx are linked to HPV type 16 (9).
>> Rarer cancers: HPV causes about 65 percent of vaginal cancers, 50 percent of vulvar cancers, and 35 percent of penile cancers (. . . .) Most of these are caused by HPV type 16.

The Centers for Disease Control & Prevention offer advice on avoiding HPV cancers:

— Bivalent, quadrivalent and 9-valent HPV vaccines each target HPV 16 and 18, types that cause about 66% of cervical cancers and the majority of other HPV-associated cancers in both women and men in the United States. 9-valent HPV vaccine also targets five additional cancer causing types (HPV 31, 33, 45, 52, 58) which account for about 15% of cervical cancers. Quadrivalent and 9-valent HPV vaccines also protect against HPV 6 and 11, types that cause anogenital warts.
— Quadrivalent and 9-valent HPV vaccines are licensed for use in females and males; bivalent HPV vaccine is licensed for use in females.
What percent of HPV-associated cancers in females and males are caused by the 5 additional types in the 9-valent HPV vaccine?
— About 14% of HPV-associated cancers in females (approximately 2800 cases annually) and 4% of HPV-associated cancers in males (approximately 550 cases annually) are caused by the 5 additional types in the 9-valent HPV vaccine.

What evidence is there for these extremely specific claims of causation?

None, actually. The cited facts are merely that the stated strains of HPV have been detected in those proportions of those cancers. Those correlations don’t begin to indicate causation.

It may be worth recalling that the Centers for Disease Control & Prevention in the early 1990s had officially stated, on the basis of the same sort of data (epidemiology, i.e. correlations), that cervical cancer was an AIDS disease, caused by HIV.

One may sympathize with medical researchers for the impossibility of conducting experiments that would be capable of proving cause-and-effect; ethical, legal, and moral restraints make it unfeasible to use human beings as experimental guinea pigs. There would also be practical barriers: To determine whether a given treatment, in this case a vaccine, actually prevents cancer, a clinical trial would be necessary that spanned over decades and enrolled large numbers of human guinea-pigs, some of whom (controls) would not get potentially-cancer-preventing vaccine.

However, the inability to obtain proof does not justify proclaiming as fact, as these official agencies do, causative relations that are no more than speculation based on statistical correlations.

[The vaccines] “Gardasil and Cervarix have not been shown to be of any significant health benefit. They have been demonstrated to cause serious injuries. It’s scandalous that they were ever approved, and it’s scandalous that they remain on the market.

And they are far from alone on those scores among new prescription medications introduced in the last couple of decades” (Deadly vaccines, 2013/04/17 http://wp.me/p2VG42-24).

Alzheimer’s Disease

Sleep disorders may raise risk of Alzheimer’s, new research shows
Sleep disturbances such as apnea may increase the risk of Alzheimer’s disease, while moderate exercise in middle age and mentally stimulating games, such as crossword puzzles, may prevent the onset of the dementia-causing disease, according to new research to be presented Monday

A daily high dose of Vitamin E may slow early Alzheimer’s disease

Again, these are correlations speculated to be possible causes.

Semantics no doubt plays a role. One could report that sleep disorders, and lack of vitamin E, seem to be associated with a risk of Alzheimer’s. Medical jargon puts it like this: “sleep disorders, and lack of vitamin E, are risk factors for Alzheimer’s”. Then the media and public conclude that “risk factor” means something that tends to cause the associated effect.

See also “60 MINUTES on aging — correlations or causes?

Biomarkers

It is not feasible to test treatments for chronic conditions by actual outcome, because one would have to wait a couple of decades to determine whether regimen A or drug B reduces morbidity and mortality apparently associated with high blood pressure, or high cholesterol, or high blood sugar, or low bone density, etc. All those are statistically correlated with increased morbidity and mortality. They are risk factors.

Present-day medical dogma makes them biomarkers for cardiovascular disease, diabetes, bone fracture, in other words indicators of whether the disease is present. But that is tantamount to making those quantities measures of actual risk, in other words regarding them as measures of what causes those ailments, in other words equating risk factors with causes.

Official reports, however, as well as the many studies on which those reports are based, find that biomarkers are not proper measures of risk after all. See:

“Everyone is sick?”

“‘Hypertension’: An illness that isn’t illness”

“Cholesterol is good for you”

 

Unfortunately, they were not joking

“Magical statistics: Hearing loss causes dementia”

 

The overall lesson:

“Don’t take a pill if you’re not ill”

The ignorant acceptance of correlations as capable of demonstrating causation is greatly reinforced in medical matters by the pharmaceutical industry, which sells drugs as palliatives and preventatives based on nothing more than correlations with biomarkers.

Posted in conflicts of interest, consensus, media flaws, medical practices, prescription drugs | Tagged: , , , , , , , | 5 Comments »

Trust science at your peril: Beware of scientism and political correctness

Posted by Henry Bauer on 2016/06/25

Science is, ideally, a quest for authentic understanding of the world, of everything in the universe. Scientism is a religious faith which preaches that only science is capable of gaining such authentic understanding and that contemporary scientific claims are for all practical purposes true.

In reality, science is a perpetually unfinished quest. The history of science tells of false trails followed, of errors made, of misguided theories held dogmatically long after the evidence had turned against them, of researchers motivated by self-interest and influenced — corrupted, in a sense — by conflicts of interest.

Science has progressed marvelously, but the progress has not come steadily and linearly, it has come through continual correction of minor errors as well as periodic scientific revolutions in which former dogmas were discarded and replaced by different theories, different beliefs, different dogmas, sometimes to an extent capable of changing world-views.

Those realities have been described and documented in many articles and books over many decades (1), yet the conventional wisdom seems ignorant of them. In the popular view, science deploys the scientific method which guarantees getting things right through scrupulous adherence to facts, so that the scientific consensus on any given topic at any given time can supposedly be relied on quite safely to guide personal and public actions.

People who question the mainstream view, the official positions disseminated by such bodies as the National Academy, the Royal Society of London, the National Science Foundation, the National Institutes of Health, the Food and Drug Administration, the World Health Organization, etc., are dismissed as ignoramuses on a par with those who still believe that the Earth is flat, and they are denigrated, attacked, and suppressed as “denialists” — for example, the eminently qualified scientists who question whether HIV really causes AIDS (2), or whether carbon dioxide is the prime cause of global warming (3), or whether the universe began in a Big Bang about 13 billion years ago (4).

In other words, the officially accepted conventional wisdom functions as an exercise of scientism, proclaiming as true — as not to be questioned — any contemporary claims that have the imprimatur of a prevailing scientific consensus.

The most common popular, mass-media-disseminated beliefs about science fall in line with the official scientistic conventional wisdom. Prominent popularizers of the scientistic faith include people sometimes described as the “New Atheists” — see for instance Curtis White in The Science Delusion (Melville House, 2014), who names among others Richard Dawkins, Daniel Dennett, Sam Harris, Bill Mahler. Self-styled “Skeptics” (for instance Michael Shermer and the late Martin Gardner) are also apostles of scientism, as illustrated in associated publications (Skeptic, Skeptical Inquirer).

But promiscuously indiscriminate faith in currently accepted scientific knowledge is unwarranted. One does not need the immense scholarly literature (1) to recognize that, it is already obvious from first principles and fundamental logic:

–>      Science is carried out by human beings and is therefore inherently fallible.

–>      Scientific theories are neither uniquely determined nor proved by any amount of factual evidence. The proverbial black swans demonstrate that no matter how comprehensive or long-standing any given body of evidence and associated explanations may be, no matter that an hypothesis may have been thoroughly tested and accepted via the scientific method, there may remain lurking in the unknown unknown some bits of data that can disprove the accepted theory instantly and devastatingly.

The popular adherence to scientistic dogmas is immensely dangerous because it may support public policies that cause tangible damage, sometimes on a large scale. Historical examples are fairly well known, but their lesson has not been learned; perhaps because a corollary of contemporary scientistic faith seems to be the notion, implicit if not explicit, that even if science was fallible in earlier times, today’s science is so advanced, so sophisticated, that it is no longer dangerously fallible. That and similar corollaries are acts of faith unsupported by evidence, thereby confirming that scientism is a quasi-religious faith: it is unshakeable, embraced as absolutely and self-evidently true.

A couple of recent books (5) describe the considerable damage done by public policies based on a scientific consensus which remained active during something like half of the 20th century: the policies of forced sterilization of purportedly feeble-minded individuals. This was an exercise in eugenics, a program intended to improve the national genetic stock, and it was supported and justified by the prevailing scientific consensus.

In reviewing these books, David Oshinsky focuses on the Supreme Court’s 8-to-1 decision in 1927, written by the revered Oliver Wendell Holmes Jr. and agreed to by the “liberal” Jewish Louis Brandeis as well as by 6 other Associate Justices, upholding the forced sterilization of those judged to be mentally defective: “Was it an isolated misstep or something more: an indictment of Justice Holmes and the Progressive movement he appeared to embrace?” (6).

Oshinsky describes the IMBECILES book by Cohen as “a superb history of eugenics in America, from its beginnings as an offshoot of social Darwinism — human survival of the fittest — to its rise as a popular movement, advocating the state-sponsored sterilization of ‘feeble­minded, insane, epileptic, inebriate, criminalistic and other degenerate persons’.”

The point I want to make here is that the forced sterilization of tens of thousands of Americans, which continued in some States into the 1960s, is nowadays described as an outrage based on pseudo-science, yet it had relied on what was regarded at the time as perfectly sound science supported fervently by individuals whose reputation remains that of progressive reformers: as well as Justices Holmes and Brandeis, strong advocates of this eugenic program included other “progressive icons like Theodore Roosevelt and the birth control champion Margaret Sanger . . . . people who combined ‘extravagant faith in science and the state with an outsized confidence in their own expertise.’ . . . Science didn’t lie” (6).

This notion that science doesn’t lie, that it can always be believed, is a tenet of scientism, and it is baseless, quite wrong, as already noted. Yet this notion, this subconscious scientism continues to corrupt public discourse. Scientism is a faith held unwittingly by most popular media, including such elites as the New York Times; and it is held, again unwittingly, by today’s sociopolitical progressives or liberals.

When some claims by some scientists seem plausibly consistent with liberal, progressive programs, activists seize on them, make dogmas of the claims, and denigrate and attack those who disagree as unscientific denialists.

This circumstance is what has come to be called in recent decades “political correctness”: certain views are to be accepted as so self-evidently correct, objectively true — and by the way ethically and morally sound — that disagreeing with them is virtually a criminal act; and indeed actions that are politically incorrect may bring sanctions. Contemporary illustrations of such sanctions are the penalties imposed by colleges and universities on students and faculty who make politically incorrect statements, including the mere use of a word or a phrase that acts as a “trigger”, a “micro-aggression” that makes some individual belonging to a certified-discriminated-against minority feel uncomfortable (7).

That something is politically correct is shown when people who have no direct specific knowledge about a topic express with certainty a dogmatic opinion about it. They have obviously taken this opinion on faith, from sources congenial to them on ideological grounds, which may be based religiously, socially, politically — at any rate, not on actual evidence about the matter.

Contemporary scientific claims that have attained the status of politically correct include that HIV causes AIDS and that human-caused liberation of carbon dioxide is the prime cause of climate change. The manner in which media and individuals refer to these matters is an immediate proof that opinions about them are politically correct, not evidence-based.

For example, the vigilantes who most assiduously and viciously attack those who question whether HIV causes AIDS include an economist (Nicoli Nattrass), a graduate student (Ken Witwer), a psychologist (Seth Kalichman), a lawyer (Jeanne Bergman), an activist (Nathan Geffen) and others, all of whom feel qualified, despite their lack of appropriate qualifications, to denigrate eminent molecular biologists with deep knowledge of the subject, and even to demand that the National Library of Medicine remove a journal from MEDLINE (8).

Left-leaning media (say, MSNBC) treat HIV=AIDS as indisputable settled science; right-leaning media (say, Fox News) doubt that HIV causes AIDS.

Left-leaning media treat as indisputably settled science that human activities are responsible for global warming and climate change; right-leaning media doubt or deny that.

Nature, however, will not be mocked, and the truth is not determined by human ideologies. Public policies (and also private actions, of course) had best be based on the soundest, most probing and skeptical assessment of current knowledge-claims in light of the indisputable fact that no contemporary scientific consensus represents guaranteed truth.

If the present scientistic, politically correct beliefs about HIV/AIDS and about climate change are as misguided as were the scientistic, politically correct beliefs about mental deficiency and eugenics, then immense harm is being done and will continue to be done. Unfortunately, the plain evidence is that HIV does not cause AIDS (9, 10), and the notion that human activities are responsible for global warming and climate change is suggested only by highly complicated, sophisticated, and fallible computer programs that have already been wrong about the global cooling in the 1940s to 1970s and the lack of appreciable warming since about 2000 (4).

Forced sterilization as part of a eugenic program to improve the fitness of the population was supported by progressive reformers and by eminent medical and scientific experts. That physical traits are transmitted from one generation to another was known, scientifically as well as popularly. That behavioral characteristics are similarly transmitted was not obviously wrong, and when sanctioned by experts it became the conventional wisdom. So feeble-minded-ness, epilepsy, poverty, criminality and other socially undesirable characteristics came to be targets for elimination, by quarantining or sterilizing people and families where such characteristics had been noted (11). There was not sufficient dissent within expert communities to prevent what is now recognized as pseudo-science from becoming accepted as settled science, during the early decades of the 20th century: “Less than 100 years ago, America’s finest minds were convinced the nation was threatened by sexually insatiable female morons” (12). Those finest minds included, as well as the earlier mentioned progressive reformers, David Starr Jordan, a biologist specializing in ichthyology, an activist for peace, an eminent educator — president of Indiana University and later founding president of Stanford University — and moreover so concerned with distinguishing good science from bad science and pseudo-science that he had written a book about it (13), as well as works about eugenics (14).

So policy makers might be excused for succumbing to the “scientific” evidence supporting eugenics — a century ago. Nowadays, though, there is no similar excuse for sticking with the theory of HIV/AIDS or with the claim that it is indisputably settled science that global warming and climate change are humanly caused. Competent, qualified experts have published and spoken copiously, pointing to the deficiencies of the present scientific consensuses on these matters. It is past time that these whistle-blowers, these “denialists”, be attended to; that the actual evidence be attended to.

 

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(1)    For example, among dozens or hundreds of worthwhile works:
Bernard Barber, “Resistance by scientists to scientific discovery,” Science, 134 (1961) 596-602
Henry H. Bauer, Scientific Literacy and the Myth of the Scientific Method (University of Illinois Press, 1992)
Michael Crichton, “Aliens cause global warming” (Caltech Michelin Lecture), 17 January 2003
Daniel S. Greenberg, Science, Money and Politics: Political Triumph and Ethical Erosion (University of Chicago Press, 2001) & Science for Sale: The Perils, Rewards, and Delusions of Campus Capitalism (University of Chicago Press, 2007)
Paul R. Gross & Norman Levitt, Higher Superstition: The Academic Left and Its Quarrels with Science (Johns Hopkins University Press, 1994)
Susan Haack, Manifesto of a Passionate Moderate (University of Chicago Press, 1998) & Defending Science — within Reason (Prometheus, 2003)
Ernest B. Hook, (ed). Prematurity in Scientific Discovery: On Resistance and Neglect (University of California Press, 2002)
David Knight, The Age of Science: The Scientific World-View in the Nineteenth Century (Basil Blackwell, 1986)
Thomas S. Kuhn, The Structure of Scientific Revolutions (University of Chicago Press, 1970, 2nd ed., enlarged)
Derek J. de Solla Price, Little Science, Big Science … and Beyond (Columbia University Press, 1963/1986; the 1986 edition contains additional chapters)
Gunther Stent, “Prematurity and uniqueness in scientific discovery,” Scientific American, December 1972, pp. 84-93
John Ziman, Real Science—What It Is, and What It Means (Cambridge University Press, 2000)

(2)   Henry H. Bauer, The Origin, Persistence and Failings of HIV/AIDS Theory (McFarland, 2007)

(3)    Henry H. Bauer, “A politically liberal global-warming skeptic?”, 25 November 2012

(4)    Henry H. Bauer, Dogmatism in Science and Medicine: How Dominant Theories Monopolize Research and Stifle the Search for Truth (McFarland, 2012)

(5)      IMBECILES: The Supreme Court, American Eugenics and the Sterilization of Carrie Buck by Adam Cohen (Penguin Press, 2016)
ILLIBERAL REFORMERS: Race, Eugenics and American Economics in the Progressive Era by Thomas C. Leonard (Princeton University Press, 2016)

(6)    David Oshinsky, review of (5), New York Times Book Review, 14 March 2016

(7)    A rather random selection of pieces about micro-aggression:
“Microaggression theory”“21 Racial Microaggressions you hear on a daily basis”;
“Ten things you didn’t know were racist”“Microaggression”“Microaggression Theory: An assault on everyday life”“Microaggressions: Power, privilege, and everyday life”

(8)    Letter of 5 August 2009

(9)    Henry H. Bauer, The Origin, Persistence and Failings of HIV/AIDS Theory (McFarland, 2007)

(10) Henry H. Bauer, The Case against HIV

(11) Edwin Black, War against the Weak, Thunder’s Mouth Press (2003)

(12) Farhad Manjoo, “Progressive genocide”, reviewing Better for All the World: The Secret History of Forced Sterilization and America’s Quest for Racial Purity by Harry Bruinius

(13) David Starr Jordan, The Higher Foolishness, Bobbs-Merrill (1927)

(14) David Starr Jordan, The human harvest; A Study of the Decay of Races through the Survival of the Unfit (American Unitarian Association, 1907); The Heredity of Richard Roe; A Discussion of the Principles of Eugenics (American Unitarian Association, 1911)

Posted in conflicts of interest, consensus, denialism, global warming, media flaws, politics and science, science is not truth, science policy, scientism, scientists are human | Tagged: , , , , , , | 6 Comments »

All vaccines are not the same; some are worse than useless

Posted by Henry Bauer on 2015/07/02

I am not among those who question the value of all vaccines on principle. I don’t doubt the value of vaccines in controlling smallpox, measles, polio. I do question the use of adjuvants and preservatives in vaccines, and I do think it makes sense to vaccinate babies against measles and the rest in single shots administered over a period of time instead of all at once in multiple vaccines.

But it gets difficult not to over-react as Big Pharma concentrates on generating vaccines that do more harm than any good that has ever been proven.

It seems that Big Pharma has been running out of new diseases to invent (see Moynihan & Cassels, Selling Sickness: How the World’s Biggest Pharmaceutical Companies Are Turning Us All Into Patients and other works listed in “What’s Wrong with Present-Day Medicine”) and has been turning increasingly to inventing vaccines supposed to guard against old or new infections.

The expected but not forthcoming “swine flu” epidemic led to rapid invention and marketing of a vaccine that turned out to have nasty “side” effects, for example, “How a swine flu shot led to narcolepsy”.

Gardasil and Cervarix, anti-HPV vaccines claimed to prevent cervical cancer, are a scandalous illustration; see for example “Merck Dr. Exposes Gardasil as Ineffective, Deadly, Very Profitable”  and related links. The only suggestion that HPV causes cervical cancer — or rather, that 4 out of four or five times that number of strains of HPV cause cervical cancer — comes from a correlation: those strains have often been found in women who have cervical cancer.

But correlations never, never, never prove causation, no matter that too many medical “experts” ignore this well established, long established fact.

I’ve become all too cynical about Big Pharma, lack of regulation, conflicts of interest, and the like. Yet I was taken aback to find that the National Institutes of Health profit from royalties from sales of Gardasil, and that there are exemptions to the Freedom of Information Act that enable them to hide that fact and the amounts involved.

Posted in conflicts of interest, fraud in medicine, funding research, legal considerations, medical practices, politics and science, prescription drugs | Tagged: , , | 7 Comments »