Think that the scientific method is something eggheads use to tell you what to do? That attitude could be bad for your health. So writes Ben Goldacre in his engaging, and often hilarious book Bad Science. He writes that people’s poor understanding of statistics and the dumbing down of science reporting in the mainstream media has had tragic consequences. The MMR (measles, mumps and rubella) immunization scandal is just one of the examples he uses.

Goldacre is a doctor. It’s in his professional interest to know whether the interventions he prescribes—the medicines, surgeries, and other therapies—are actually doing any good. He says too much of his time is spent disabusing his patients of notions that have been peddled to them by the latest evidence-free medicine show in the press. He has no lack of examples: foot baths that claim to remove ‘toxins,’ herbal pills that claim to boost immunity, mystical ear candles that promote general wellbeing. So many claims of miracle cures are easily shown to be fabrications or gross exaggerations. No one is immune from his hilariously savage attacks except medicine backed by good, hard evidence.

In his book, he walks the reader through the principles of evidence-based medicine: trial design, how trials go wrong, how placebo effects work and why people tend to overestimate the efficacy of pills. He uses real-world examples. Homeopathic treatments, for instance, takes some especially brutal barbs. On first glance, the research appears to produce a mixed picture. Some trials have found homeopathy works better than a placebo. But on deeper inspection, Goldacre learned that the better the quality of the trial, the less likely it was to show positive results. In other words, when trials skip an important step like blinding (when information is withheld to prevent bias in the results), they tend to overestimate benefits.

A meta-analysis of those studies by Shang and others was not well received within the homeopathic community. Reluctant to accept the negative findings, they alleged that the review was not fair because it had omitted positive studies. Goldacre points out that these happened to be the poorer quality studies and were left out for this reason.

Homeopathy is unlikely to do any harm, so why the fuss? Goldacre argues that it is the same inability to understand the evidence against homeopathy that has led to other, more serious crises, most notably, the ongoing vaccination scare.

In 1998, a now discredited doctor published a study that suggested a link between the MMR (Measles, Mumps, and Rubella) jab and autism. Although the study was methodologically flawed and has since been partially retracted, there was nothing in and of itself wrong with this. The act of publishing meant that the study was open to academic scrutiny. At the time, there was little media interest in the story. Then, in 2001, the same doctor published a new paper using the same old questionable data. But this time, he questioned the safety of MMR. The study was grist to the mill of the anti-vaccination lobby, which carefully targeted journalists to get the ‘news’ spread far and wide. The result was predictable. Parents were now afraid to immunize their child with MMR.

The seeds of doubt took deeper root when then Prime Minister Tony Blair refused to state whether or not his young son had received the MMR jab. By 2002, the MMR scare was out of control. There were 1200 MMR stories in the press in that year alone, most of which were critical of the immunization.

The Daily Mail and Telegraph turned the scare into a political campaign, demanding that the immunizations be made available in single source injection. Maverick academics, happy to share their thoughts with the media but less keen to submit their research to academic scrutiny through publication, helped to fan the flames.

So, Goldacre asks, was MMR safe? All the big institutions – the Royal Colleges, the NHS –came out in support of MMR. The NHS created www.mmrthefacts.nhs.uk to let the general public have full access to every published study on MMR. The Cochrane Collaboration published a systematic review concluding there was no evidence that MMR was unsafe. The evidence was conclusive, as far as science goes.

But this was not sufficient for the press. There was very little reporting on the overwhelming evidence of MMR safety. Parents responded. MMR vaccination rates were at 92% in 1996. In 2007 they had dropped to 73%, with rates in the low 30s in some urban areas. As a result, measles, mumps and rubella rates have shot up in the UK’s children. In some rare cases, children are dying. Goldacre argues that these deaths could and should have been prevented with immunization.

So, to the question ‘Does ignorance about science cost lives?’ The answer, sadly, according to Goldacre, is ‘Yes’.

For anyone interested in science and how it is abused in the pursuit of profit, this book is a must-read. You don’t have to take Prevention Action’s word for it. Sir Iain Chalmers, founder of The Cochrane Library, says, colorfully, ‘Bad Science introduces the basic scientific principles to help everyone become a more effective bullshit detector’.

See Goldacre, B. (2008) Bad Science, London, Harper Collins

See also Shang, A., HÜwiler-MÜntener, K., Nartey, L., JÜni, P., DÖrig, S., Sterne, JA., Pewsner, D and Egger M. (2005) Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy. Lancet 27.8.05-2.9.05; 366, (9487): 762-32