“I just don’t care!” the doctor said, in response to a query on a personal health-related issue during a recent New Zealand television interview.
I certainly had never heard a doctor speak in this way – and it made me curious to hear more in his live talk.
I was not disappointed. The thought-provoking comments kept coming: “The right way to build public trust is to earn public trust, and to share data” and, “The paradigm of medicine has somewhat shifted”.
In his unique and energetic style, Dr. Ben Goldacre got his message across to the audience at the Mercury Theatre in Auckland this September. A British physician, researcher, columnist, and author, Dr. Goldacre has made it his mission to tackle “bad science”, whether it is used by drug companies, politicians, journalists, or researchers.
Dr. Goldacre explained the misrepresentation of the research life cycle (objective – data collection – data analysis – publication – evaluation), showing the audience the easiest way to mispresent science and the shortcomings of medicine.
Using statistical data taken from newspapers, advertisements, and the research reports, the audience learned how so-called “in-depth scientific research” can be used as a clever marketing tool and how defined research objectives can often by driven by profit.
One telling example of misrepresented data is the sudden drop in the number of tonsillectomies carried out on children in Hornsey, North London. There was a big discrepancy before and after 1929 – that is, from a few hundred cases down to almost nothing. After some investigation, it was revealed that the decline in the number of tonsil operations coincided with the retirement of one individual medical officer at a particular school, replaced by someone with a different opinion as to the merits of the treatment. Such a case reveals the power of doctors’ choices, rather than patients’ needs. It also shows that how unreliable the data will be if the full picture is not disclosed.
Sharing a more recent case, Dr. Goldacre explained the use of statins, a medicine to lower cholesterol in the blood. Many treatment options are available to lower cholesterol against a placebo, but these have not been tested against one another to determine “real world effects”, including death. Dr. Goldacre and his team approached the UK National Health Service (NHS) to collect patient information. If patients agreed, doctors would be able to randomize the treatment options, ultimately finding the optimal treatment for considerably less resource compared to the traditional “door knocking” data collection method. Nevertheless, this was thwarted by opposition from ethics groups arguing that patients should have a choice.
Dr. Goldacre’s presentation led me to wonder; what role does the general public play in formulating bad science? Surely it is not just the domain of motivated organisations, unreliable researchers, and sensationalist media. Bad science can, and often is, disseminated by all walks of life.
How can we stop its spread? Transparency may be the answer – including that of research objectives, processes, and publication. If research objectives are set for the benefit of all, or purely for the improvement of a company’s bottom line, the public should know – and in a language they can understand. Let consumers make up their own minds.
Unfortunately, providing scientific data to the wider public and expecting people to reach their own conclusions may not be sufficient. Effective communication is also a critical element in combatting bad science. Nowhere is this more eloquently stated than in Professor Shaun Hendy’s timely book, Silencing Science: “The job of the scientist is not just to deliver the facts, but also to engage democratically to assist the community to weigh the full breadth of evidence” (p96).
Indeed, scientists and research providers should communicate well, working together in the best interests of the public.
As a consumer and a citizen in a world of information overload, it can be easy to be misled by a well-packaged data snapshot. We need to embrace a reliable and complete picture, and in terms we can understand. This will allow us to make our own choices in areas as broad as health, education, career, life-style, and more.
As a student of science and maths, I am beginning to grasp the moral imperative of the scientific community. Scientists should not only be answerable to their fund providers, but to everyone. A good start would be the publication of research findings representing the whole truth.
14-year-old Tristan Pang is a maths and physics major at the University of Auckland. He is also the creator of Tristan’s Learning Hub, producer and broadcaster of Youth Voices, founder and webmaster of several community websites, frequent speaker at schools, organizations and conferences, and tutors students from primary school level through to university. He aspires to make a difference in the world.