I Think You'll Find It's a Bit More Complicated Than That (31 page)

An
international petition
against the BCA has been signed by professors, journalists, celebrities and more, with Ricky Gervais and Stephen Fry alongside the previous head of the Medical Research Council and the last government Chief Scientific Adviser. There have been public meetings, with stickers and badges. But it is a ragged band of science bloggers who have done the most detailed work. Fifteen months after the case began, the BCA finally released the academic evidence it was using to support its specific claims. Within twenty-four hours this was meticulously taken apart by bloggers, referencing primary research papers and looking in every corner.

Professor David Colquhoun
of UCL pointed out, on infant colic, that the BCA cited weak evidence in favour of its claims, while ignoring strong evidence contradicting them. He posted the evidence and explained it. LayScience flagged up the
BCA selectively quoting
a Cochrane review.
Every stone was turned
by
Quackometer
,
APGaylard
,
Gimpyblog
,
EvidenceMatters
,
Dr Petra Boynton
,
MinistryofTruth
,
Holfordwatch
, legal blogger
Jack of Kent
, and many more. At every turn they have taken the opportunity to explain the principles of evidence-based medicine – the sin of cherry-picking results, the ways a clinical trial can be unfair by design – to an engaged lay audience, with clarity as well as swagger.

Then the formal complaints began. There have been successes with the
Advertising Standards Authority
, including one in which the ASA concluded that the BCA’s claims to treat colic
breached the guidelines
on ‘truthfulness’ and ‘substantiation’. This interested many, since treating colic was one of the claims over which the BCA sued Singh when he called it ‘bogus’.

Professional complaints followed in May, mostly about
individual chiropractors’ claims
. Then, in June,
blogger Simon Perry
found the BCA database of 1,029 members online, containing four hundred website URLs. He wrote a quick computer program to automatically identify all the chiropractors in the UK who claimed to treat colic, locate their local Trading Standards office, and report them (more than five hundred in total) automatically, followed up with printed letters.

Chiropractic is a profession regulated by the General Chiropractic Council, supervised by the Health Professional Council, which is obliged to investigate all complaints. So Perry reported over five hundred chiropractors to them, alleging that they had made claims without adequate evidence. The GCC rejected his letter, saying that it only considered individual complaints. A pile of individual complaint letters was instantly generated, printed, stuffed into envelopes, and delivered to its door. Astonishingly, ZenosBlog had done
exactly the same thing
. These thousand complaints are now being investigated.

You may view this as bullying individuals, and initially I had some sympathy for them. But my heart was hardened as a result of reading commentary from the chiropractic and alternative-therapy community saying that Singh must expect six-figure consequences for criticising them, and transgressing the letter of the law, even in just one article.

Some clue as to whether chiropractors feel able to defend these complaints about the evidence for their practices came a few days later. On 8 June the McTimoney Chiropractic Association sent a confidential email to its members, which has been obtained and is available in full
on Quackometer
. ‘If you have a website,’ this email begins, ‘take it down NOW … REMOVE all the blue MCA patient information leaflets, or any patient information leaflets of your own that state you treat whiplash, colic or other childhood problems in your clinic … IF YOU DO NOT FOLLOW THIS ADVICE, YOU MAY BE AT RISK FROM PROSECUTION. Finally, we strongly suggest you do NOT discuss this with others’ – and on this it was clear – ‘especially patients.’

The MCA says the complaints are a ‘vexatious campaign against the profession’, that it has nothing to hide, and that it believes its members have not intentionally breached any rules regarding their websites’ content. The entire MCA website disappeared on the same day, and continues to be nothing more than a holding page (it is ‘currently being updated’), but its former site, along with every single chiropractor’s website, has been archived in full online by the science blogging community, for anyone who is interested to look.

We could go on, but there are lessons from this debacle – beyond the ethical concerns over suing in the field of science and medicine – and they are clear. First, if you have more reputation and superficial plausibility than evidence to support your activities, then it may be wise to keep under the radar, rather than start expensive fights. But more interestingly than that, a ragged band of bloggers from all walks of life has, to my mind, done a better job of subjecting an entire industry’s claims to meaningful, public, scientific scrutiny than the media, the industry itself, and even its own regulator. It’s strange that this task has fallen to them, but I’m glad someone is doing it, and they do it very, very well indeed.

Science Is About
Embracing Your Knockers

Guardian
, 13 November 2010

If science has any credibility, it derives from transparency: when you make a claim about how something works, you provide references to experiments, which describe openly and in full what was done, in enough detail for the experiment to be replicated. You explain what was measured, and how. Then people can freely discuss what they think this all means in the real world.

Maria Hatzistefanis
is a star of lifestyle pages and the owner of Rodial, a cosmetics company which sells a product called ‘Boob Job’, which it claims will give you a ‘fuller bust’, ‘increase the bust size’ and ‘plump up the décolleté area’ with ‘an instant lifting and firming effect’, and an increase of half a cup size in fifty-six days. Or rather, an increase of ‘8.4 per cent’. It’s all very precise.

Now, I’m not going to lose a great deal of sleep over anybody who buys a magic cream to make their breasts grow bigger. What worries me is that Maria Hatzistefanis’s company is now threatening a doctor with a libel case, simply for daring to voice doubts over these claims.

This is her crime
. Dr Dalia Nield told the
Mail
it was ‘highly unlikely’ that the cream would make your breasts bigger, and questioned the amount of information provided by Rodial. ‘The manufacturers are not giving us any information on tests they have carried out. They are not telling us the exact ingredients in the product and how they increase the size of the breast.’

That’s fair. I don’t trust claims without evidence, especially not unlikely ones about a magic cream that makes your breasts expand. Maybe it does work – I don’t particularly care either way – but when I asked the company to send me any evidence it had, or any information on ingredients, it flatly refused to send me anything at all.

This is odd, since I’ve seen the letter that Rodial’s lawyers sent, and they tell Dr Nield: ‘Our client on request would have provided all information required on clinical assessment and product ingredients.’

Apparently not.

Dr Nield went on to speculate that the gel could be ‘potentially dangerous … it may even harm the skin and the breasts – we need a full analysis’. Again, this is perfectly reasonable: anything that has real effects on the body may also have unintended side effects. That is an entirely uncontroversial statement, especially when important information is being withheld.

But then the story gets stranger. When Sense About Science, which has helped drive the campaign for libel law reform in the UK, put out a press release about Rodial threatening Dr Nield with libel, they themselves were contacted by Hegarty LLP, solicitors acting for Rodial Limited. This time they seemed to be trying to stop people from even daring to talk about the existence of their libel threat.

People often ask if there are short cuts in spotting nonsense. In reality, it’s not easy to
do in a checklist
, because there are so many elaborate ways to distort evidence, but for me there is one very clear risk factor. The entirety of science is built on transparency, on giving your evidence and engaging with legitimate criticism. If you hear of a company refusing to hand over the evidence it says supports its claims – whether it is a drug company, or some dismal cosmetics firm – all you know is that you are being deprived of information, and that vital parts of the picture are missing. If you hear that someone is threatening to sue their critics, again, all you know is that people will be intimidated from raising legitimate concerns, and again, you are being deprived of information.

Meanwhile, Dr Nield is now one individual facing a large company. Individual doctors and scientists are commonly asked for their opinion on whether or not medical interventions work. It’s plainly in our collective interest that they give honest answers, without fear that their lives will be taken over for years on end by a major company with money and a distorted sense of reputation. It’s obviously unhelpful, for society, that people risk losing a house’s worth of money even if they successfully defend a libel case, as has happened so many times recently.

With the law in its current state, doctors and scientists might be wise simply to stop giving any view about any drug or other health-related product that is marketed for commercial purposes, in any forum, and make it clear that from now on, decisions about efficacy should be made solely by the manufacturers. Good luck with that.

The Return
of Dr McKeith

Guardian
, 19 July 2010

What do you do, as a campaigner for libel reform, when a litigious millionaire calls you a liar? This ethical quandary was presented to me last week when the Twitter account of Gillian McKeith – or to give her full medical title,
‘Gillian McKeith’
– called my book
Bad Science
‘lies’.

Now, firstly, there is little doubt that this is actionable, and probably undefendable. ‘Lies’ – from personal experience of trying – is one word you can never use in England. Even if you can show that someone is obviously wrong, even if you can show that they probably knew they were wrong, you still need to show that they deliberately distorted the truth, and that’s almost always impossible, without direct access to their thoughts. They might just have been mistaken, after all. Or sloppy. Or stupid.

So, for my pleasure, I have a strong case against the litigious millionaire. And I have a reasonably good reputation for honesty to defend. And although I believe libel laws stifle debate in science at great risk to public health, there’s no issue of science here.

But I’ve always believed that in most cases a simple correction, with the same prominence as the initial libel, should be sufficient. That’s why I contacted
@gillianmckeith
, firstly to explain that I’d be happy to debate my concerns about her work, and secondly, to make a simple request: could she please just tweet ‘Bad Science by Ben Goldacre is not lies’. That would be fine with me.

But by now all hell had broken loose.
@gillianmckeith’s
Twitter feed was filled with abuse to a random passing tweeter, and rambling, detailed tweets from McKeith explaining how her PhD from a non-accredited correspondence-course college was entirely valid. Then they all disappeared. Then the tone shifted: instead of first-person stuff about Gillian’s life, lots of third-person PR tweets appeared. Then they disappeared. Then, as over a thousand people were tweeting about her, making it the top trending topic on Twitter,
@gillianmckeith
announced, ‘Do you really believe this is real twitter site for the GM?’

Yes, replied the geeks. Well, the Twitter account
@gillianmckeith
is
linked to from
gillianmckeith.info, explained some. Then that link was deleted. But, explained others, only half-deleted. If you look at the ‘source code’ for the page, the link is still there, just temporarily inactivated. And that Twitter account is
still linked from
gillianmckeith.tv, Gillian’s YouTube page, and in fact her whole empire. Yes, we really do believe this is the real Twitter site for the real Gillian McKeith. If you’re going to play silly buggers online, at least do it competently. And really, very seriously, don’t call investigative journalists liars. You never know: we might sue too.

QUACKS

The Noble and Ancient
Tradition of Moron-Baiting

Guardian
, 29 May 2010

This week a man called
Martin Gardner died
, aged ninety-five. His popular maths column in
Scientific American
(and fifty books on the subject) spanned the decades, but in 1952 he published a book,
In the Name of Science
, on pseudoscience, quacks and credulous journalists. How much do you think has changed over sixty years?

Immanuel Velikovsky had just published his best-selling book
Worlds in Collision
, explaining how a comet which flew out of Jupiter, and zipped past the earth twice, had then caused the earth to stop spinning, so that the Red Sea would part at precisely the moment when Moses held out his hand. Cars and planes, he explained, are propelled by fuel refined from ‘remnants of the intruding star that poured fire and sticky vapour’ on the earth. Several years later the comet returned: a precipitate of carbohydrates that had formed in its tail fell to earth in the form of Manna which kept the Israelites fed for forty years.

The science editor of the
New York Herald Tribune
called this book ‘a magnificent piece of scholarly research’. But while the correspondents of
Reader’s Digest
and
Harper’s
Magazine
heaped praise upon Velikovsky, his publishers received a flood of letters from scientists. A boycott was organised of all their academic textbooks, the editor who commissioned the book was sacked, and Velikovsky moved to Doubleday, which had no textbook imprint to worry about (and was delighted to have a best-seller).