Leaving the Land of Woo

There are a great many people who react to campaigns urging vaccination with hostility to those who are trying to get them to act.  They are suspicious of any organisation that is trying to get them to do anything that they wouldn't do by choice.  In the US, they are suspicious of government actions which affect them, and they are suspicious of big corporations who use their lobbying power to promote vaccines.

It is understandable that there is massive suspicion of big pharma because whenever there is some perceived danger, such as bird flu, the pharmaceutical companies move into action, developing and promoting their highly profitable products.  And where there are connections with government however tenuous, such as the ownership of Gilead shares by Donald Rumsfeld, public suspicion rises further.

And of course, the alt-med community go to town on the idea that government is interfering in private choice because of the commercial interests of its members.  What then happens is rather curious because instead of looking at the evidence of risk, the nature of the actions being suggested, the likely benefits and costs, in other words rationally evaluating the situation, many alt-med enthusiasts decide to reject any and every aspect of the science.  It's all tarred with the same broad brush.

All vaccines become the tainted offerings of corrupt Big Pharma, every government health warming becomes a covert attempt to boost personal wealth, and every suggestion to take health precautions is rejected out of hand.  Instead of assessing the scientific evidence, alt-med takes advantage of the confusion to promote their alternative therapy.

They exploit the links between government and business to create a widespread rejection of the science itself, and in the process expand the market for their own untested and unevidenced products.

But it's not just the alt-med promoters who confuse the issue.  There are those who distrust medical opinion to the extent of challenging the effects of vaccines themselves, producing videos arguing that vaccines are dangerous, and that the potential effects should be weighed against any possible benefit.  They argue that the benefits are only potential, but the risks are real.  Of course, the statement could be reversed and still be as valid: the benefits are real and the risks are only potential.

It is important to be able to sort out the science from the marketing but these days it is increasingly difficult because those with political agendas also operate within science.  They create their own institutes, publish their own journals, teach their own courses, issue their own qualifications, and often manufacture their own evidence.  Sometimes the quality science is there, but often it is not.

For the lay person, the people with only high-school science behind them, it can be very confusing.  And when people reject government warnings because they no longer believe the government about anything, and when they can't inspect the science for themselves, they are easy prey to marketers.

Material from drug companies medicalising every trivial complaint through to government information about vaccines is rejected en masse.  Health warmings are seen as marketing and are therefore dismissed out of hand.  And the alt-med peddlars are ready in the wings to redirect the confused into their own market.

They use words like "natural" and "non-invasive" to persuade customers to not even think about the science.  They position their own irrational theories against those of some perceived monolithic science entity and argue that the whole of science is unable to help maintain human health.  And since science is now used as a marketing tool, scientific results are corrupted to conform to the required marketing message.  As a result, alt-med sounds as credible as anything else.

Of course it's not.  But it can sometimes be very difficult to refocus attention on the science itself.  As companies debase science and control the appearance of results which support their sales effort, confidence in the objectivity of clinical science falls and this serves to undermine public understanding of their own biology and the natural world.  A clinical trial sounds like some company finding the results it wants instead of a technique of basic clinical research.  As a result, many people are not even interested in considering the results themselves because they just don't believe them.

For the alt-med peddlars, this confusion is an excellent opportunity to appear radical and to ride the wave of public rejection of Big Pharma and disaffection from governments.  Politicians too struggle to deal with the confusion: witness the UK government's recent rejection of the evidence against homeopathy on the grounds that any voice in favour of homeopathy must represent some credible evidence.

Privately owned medical and scientific journals, alt-med institutes issuing their own bogus qualifications, commercially controlled trials, and the medicalisation of trivial complaints to boost product sales, all serve to undermine the objectivity of science.  We have to persuade people to recognise the value of the science whatever their view of politicians and the big medical companies might be.

One of the ways in which we can judge the seriousness and authenticity of scientific research is if it has been peer-reviewed and published in a reputable scientific journal.  The peers doing the reviewing uphold strict scientific standards in which the evidence has to be completely independent  of the views of the researchers, the methodology has to be sound, and the conclusions have to be reasonably drawn from the presented evidence.

This filter mechanism performs a number of very positive functions.  It catches methodological errors and poor experiment design, it questions unreasonable conclusions, it highlights omissions in the data, it checks the statistical processing of results, and it ensures that the results as far as possible are free from bias.  That's why we take results published in reputable journals seriously.

But what happens when a journal accepts poor papers for publication which don't uphold those standards?  Sometimes poor work slips through and people write responses which identify the weaknesses, challenge the results, correct the mistakes, etc.  But by then, the poor quality paper is already in publication, being cited far and wide by those who have a vested interest in those biased conclusions.

PZ Myers, the man behind the absolutely excellent Pharyngula website, recently identified one such shoddy piece of work apparently being published in the Southern Medical Journal.  It claims to have trialled the effects of Proximal Intercessionary Prayer or PIP (that's praying nearby in common language) on vision and hearing.  Now there's nothing wrong with designing a trial to do this and testing the results.

We'd obviously need a group in which no PIP had occurred so that we had something to compare the results with.  We call that a control group and it's an absolutely fundamental part of any scientific trial. Without one, we can't conclude anything.   We'd also choose subjects at random so they didn't know if they were getting the real prayer or a fake, and we'd make sure the experimenters didn't know which was which either.  We call that double-blinding and it's an essential way to prevent bias.  All scientists know about these techniques and why they are essential.

But as PZ Myers shows in his assessment of the paper, it wasn't double-blind and didn't even have a control.  Instead, it was a self-selected group of devout Christians all of whom were biased in their belief in faith healing.  Normally such a paper would not even be considered for publication in a reputable journal so why is it due to appear in the September issue of the Southern Medical Journal?  Indeed, the authors were not scientifically trained at all but were theologians and the work was funded by the evangelical Templeton Foundation.  And yet the Southern Medical Journal is apparently publishing it.

When Woo marketers gain influence over the editorial decisions of reputable scientific journals, they are gaining a form of endorsement.  Of course, in the past Woo merchants have set up their own institutions, printed their own certificates, and teach their own Woo courses, and with a suitable "journal" title for their own publications, they try to project some appearance of academic respectability.

But a cheaper alternative for them is to persuade members of editorial boards of reputable journals, via their religious beliefs, to relax their scientific standards and permit utterly worthless papers to be published.  That gives them a means of piggy-backing on the scientific reputation of the journal built up over a long period of time by the genuine scientific standards previously followed.  Corrupting the journal editorial board is a cheap means of trying to get academic approval for work which even a high school student would have thrown out.

Shame on the Southern Medical Journal for allowing its standards to be lowered to such a derisory level!  If any of you are interested in getting in touch with them, there are two email addresses associated with the Southern Medical Journal:

This e-mail address is being protected from spambots. You need JavaScript enabled to view it   - Wendy Erhart who is also responsible for Corporate Relations

This e-mail address is being protected from spambots. You need JavaScript enabled to view it - Kathy Mclendon

I've written to them to ask about the paper and its likely effect on their journal's reputation given the appallingly bad methodology and questionable results of the faith-healing paper.  We'll see what they say.