Skepticism about science and medicine

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Archive for the ‘conflicts of interest’ Category

Science is broken

Posted by Henry Bauer on 2017/11/21

Science is broken: Perverse incentives and the misuse of quantitative metrics have undermined the integrity of scientific research is the full title of an article published in the on-line journal AEON . I learned of it through a friend who was interested in part because the authors are at the university from which I retired some 17 years ago.

The article focuses on the demands on researchers to get grants and publish, and that their achievements are assessed quantitatively rather than qualitatively, through computerized scoring of such things as Journal Impact Factor and numbers of citations of an individual’s work.

I agree that those things are factors in what has gone wrong, but there are others as well.

The AEON piece is an abbreviated version of the full article in Environmental Engineering Science (34 [2017] 51-61; DOI: 10.1089/ees.2016.0223). I found it intriguing that the literature cited in it overlaps very little with the literature with which I’ve been familiar. That illustrates how over-specialized academe has become, and with that the intellectual life of society as a whole. There is no longer a “natural philosophy” that strives to integrate knowledge across the board, from all fields and specializations; and there are not the polymath public intellectuals who could guide society through the jungle of ultra-specialization. So it is possible, as in this case of “science is broken”, for different folk to reach essentially the same conclusion by extrapolating from quite different sets of sources and quite independently of one another.

I would add more factors, or perhaps context, to what Edwards and Roy emphasized:

The character of research activity has changed out of sight since the era or “modern science” began; for example, the number of wannabe “research universities” in the USA has tripled or quadrupled since WWII — see “Three stages of modern science”; “The science bubble”; chapter 1 in Science Is Not What You Think [McFarland 2017].

This historical context shows how the perverse incentives noted by Edwards and Roy came about. Honesty and integrity, dedication to truth-seeking above all, were notable aspects of scientific activity when research was something of an ivory-tower avocation; nowadays research is so integrated with government and industry that researchers face much the same difficulties as professionals who seek to practice honesty and integrity while working in the political realm or the financial realm: the system makes conflicts of interest, institutional as well as personal, inevitable. John Ziman (Prometheus Bound, Cambridge University Press) pointed out how the norms of scientific practice nowadays differ from those traditionally associated with science “in the good old days” (the “Mertonian” norms of communality, universality, disinterestedness, skepticism).

My special interest has long been in the role of unorthodoxies and minority views in the development of science. The mainstream, the scientific consensus, has always resisted drastic change (Barber, “Resistance by scientists to scientific discovery”, Science, 134 [1961] 596–602), but nowadays that resistance can amount to suppression; see “Science in the 21st century”; Dogmatism in Science and Medicine: How Dominant Theories Monopolize Research and Stifle the Search for Truth [McFarland, 2012]). Radical dissent from mainstream views is nowadays expressed openly almost only by long-tenured full professors or by retired people.

I’m in sympathy with the suggestions at the end of the formal Edwards and Roy paper, but I doubt that even those could really fix things since the problem is so thoroughgoingly systemic. Many institutions and people are vested in the status quo. Thus PhD programs will not change in the desired direction so long as the mentoring faculty are under pressure to produce more publications and grants, which leads to treating graduate students as cheap hired hands pushing the mentor’s research program instead of designing PhD research as optimum for neophytes to learn to do independent research. The drive for institutional prestige and status and rankings seems the same among university leaders, and they seek those not by excelling in “higher education” but by winning at football and basketball and by getting and spending lots of grant money on “research”. How to change that obsession with numbers: dollars for research, games won in sports?

That attitude is not unique to science or to academe. In society as a whole there has been increasing pressure to find “objective” criteria to avoid the biases inherent inevitably in human judgments. Society judges academe by numbers — of students, of research expenditures, of patents, of magnitude of endowment , etc. — and we compare nations by GDP rather than level of satisfaction among the citizens. In schools we create “objective” and preferably quantifiable criteria like “standards of learning” (SOLs), that supersede the judgments of the teachers who are in actual contact with actual students. Edwards and Roy cite Goodhart’s Law, which states that “when a measure becomes a target, it ceases to be a good measure”, which was new to me and which encapsulates so nicely much of what has gone wrong. For instance, in less competitive times, the award of a research grant tended to attest the quality of the applicant’s work; but as everything increased in size, and the amount of grants brought in became the criterion of quality of applicant and of institution, the aim of research became to get more grants rather than to do the most advancing work that would if successful bring real progress as well as more research funds. SOLs induced teachers to cheat by sharing answers with their students before giving the test. And so on and on. The cart before the horse. The letter of every law becomes the basis for action instead of the human judgment that could put into practice the spirit of the law.

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Can truth prevail?

Posted by Henry Bauer on 2017/10/08

Recently I joined the Heterodox Academy, whose mission is to promote viewpoint diversity :

We are a politically diverse group of social scientists, natural scientists, humanists, and other scholars who want to improve our academic disciplines and universities.
We share a concern about a growing problem: the loss or lack of “viewpoint diversity.” When nearly everyone in a field shares the same political orientation, certain ideas become orthodoxy, dissent is discouraged, and errors can go unchallenged.
To reverse this process, we have come together to advocate for a more intellectually diverse and heterodox academy.

My personal focus for quite some time has been the lack of viewpoint diversity on scientific issues — HIV/AIDS, global warming, and a host of less prominent topics (see Dogmatism in Science and Medicine: How Dominant Theories Monopolize Research and Stifle the Search for Truth). But earlier I had been appalled — and still am — over political correctness, by which I mean the dogmatic assertion that certain sociopolitical views must not only prevail but must be enforced, including by government action.

I became aware of political correctness when it came to my university in the late 1980s (distinctly later than elsewhere) and led to the resignation of Alan Mandelstamm, a nationally renowned teacher (of economics) who had for more than a decade attracted more students to his classes than any other teacher of any subject, as well as having a variety of faculty members from other fields sit in on his classes purely for the learning experience. I’ve described the circumstances of Al’s resignation in a couple of articles (The trivialization of sexual harassment: Lessons from the Mandelstamm Case; Affirmative action at Virginia Tech: The tail that wagged the dog). Al passed away some years ago; his obituary has been funded to be permanent and the contributors to it testify to what a marvelous instructor Al was, to the benefit of untold numbers of individuals: 4 years after Al died, former students and associates who learn of his passing continue to add their recollections. Al and I had both participated in the Virginia chapter of the National Association of Scholars (NAS), which stands for traditional academic ideals:
NAS is concerned with many issues, including academic content, cost, unfairness, academic integrity, campus culture, attitudes, governance, and long-term trends. We encourage commitment to high intellectual standards, individual merit, institutional integrity, good governance, and sound public policy.

What that involves in practice is illustrated in the newsletter I edited until my retirement.

Common to NAS, the Heterodox Academy, and dissenting from dogmatism on HIV/AIDS, global warming, and many other issues is the belief that views and actions ought to be consonant with and indeed formed by the available evidence and logical inferences from it — by the truth, in other words, at least as close as humans can come to it at any given time.

Ideologies and worldviews can make it difficult for us even to acknowledge what the evidence is when it seems incompatible with our beliefs. Since my interest for many decades has been in unorthodoxies, I’ve looked into the evidence pertaining to a greater number of controversial issues, in more detail and depth, than most people have had occasion to, with the frustrating consequence that nowadays many of the people with whom I share the preponderance of sociopolitical preferences are not with me regarding HIV/AIDS or global warming; I’m the rare example of “A politically liberal global-warming skeptic”; and I wish that those who seem to agree with me did not include people whose sociopolitical views and actions are abhorrent to me (say, Ted Cruz or Jeff Sessions).

At any rate, in science and in the humanities and in politics, in all aspects of human life, the thing to aim for is to find the best evidence and to be guided by it. Through the Heterodox Academy I learned recently of the Pro-Truth Pledge; see “How to address the epidemic of lies in politics: The ‘Pro-Truth Pledge,’ based on behavioral science research, could be part of the answer”.

The badge of that pledge is now on my personal website, and I encourage others to join this venture.

 

I don’t expect quick results, of course, but “The journey of a thousand miles begins with one step” (often misattributed to Chairman Mao, but traceable more than a millennium further back to Lao Tzu or Laozi, founder of Taoism).

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

American Medicine Needs Reform — or perhaps revolution

Posted by Henry Bauer on 2017/09/10

Dozens of books and myriad articles have been published over the last few decades about What’s Wrong With Present-Day Medicine.

A recent addition is An American Sickness: How Healthcare Became Big Business and How You Can Take It Back by Elisabeth Rosenthal, lauded in a lead review  in the New York Times (4 & 9 April 2017) and with 250 customer reviews on amazon.com, >80% of them 5-starred.

The New York Times review is titled “Why an open market won’t repair American health care”, which indicates clearly enough why it may take a revolution, and perhaps a President Bernie Sanders, and certainly a squashing of the Republican Party’s free-market-above-all ideology, to bring American citizens the guaranteed and affordable heath care that is enjoyed by the citizens of every other major country on Earth.

It is far from only the political left that recognizes this need. Angus Deaton, 2015 Nobel Prize for economic science, wrote: “I would add [to possible ways of reducing income inequality] the creation of a single-payer health system; not because I am in favor of socialized medicine but because the artificially inflated costs of health care are powering up inequality by producing large fortunes for a few while holding down wages; the pharmaceutical industry alone had 1,400 lobbyists in Washington in 2014. American health care does a poor job of delivering health, but is exquisitely designed as an inequality machine, commanding an ever-larger share of G.D.P. and funneling resources to the top of the income distribution” (review of The Crisis of the Middle-Class Constitution — Why Economic Inequality Threatens Our Republic by Ganesh Sitaraman, New York Times, 20 March 2017)

 

 

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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 Margulis, 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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