Jamie Morton is the NZ Herald's science reporter.

Declaring war on bad science: Q&A with Dr Ben Goldacre

British physician, academic, writer, Guardian columnist and self-proclaimed "nerd evangelist" Dr Ben Goldacre has earned a reputation as one of the world's most outspoken science commentators - and a sworn enemy of pseudo-science. He talked to Herald science reporter Jamie Morton this morning, before his first visit to New Zealand in September.

Q. So what will be the theme or flavour of your talk?

A. It's mostly Q&A - because that's how Think Inc people (company Goldacre presents for) do things. I am an equal opportunities quack-buster, so I go after people who misrepresent statistics, regardless of who they are.

I go after quacks like homeopaths and nutritionists and herbal remedy peddlers, but I also go after big drug companies, I go after bad journalists.

I also go after the dodgy politicians who mislead them, and I go after academics and doctors as well, despite being one.

So wherever the conversation takes us, I'm happy to go.

Just recently, I've been running a bunch of campaigns that are really at the kind of hard, nerd-end of things.

I've been running a campaign on trying to stop drug companies and academics from withholding the results of clinical trials from doctors, researchers and patients, so I hope that will come up.

And also I've been running something called the COMPare Trials Project, which is trying to take on academic journals when they mis-report the results of clinical trials, which we know they do an awful lot of the time. Lots of academic papers published show that they do.

But with the COMPare Trials Project, we are holding their feet to the fire. We are identifying individual journal editors who are responsible for mis-reporting clinical trials and we are taking them to task on a named basis.

I've got high hopes and I think that's likely to be effective -- not because I'm an unkind person, but I just think feedback and individual accountability really help to fix problems.

Q. Lately in New Zealand there has been an outbreak of measles in one of our provinces. With the weight of evidence today, how depressing do you find it that many people still refuse to vaccinate?

A. It's depressing and it's miserable.

But I think it reflects a huge number of problems caused by a huge number of people.

It's very easy to point the finger at the quacks, who set themselves up as anti-vaccine conspiracy theorists, and who are often alternative therapists trying to sell alternative treatments to patients, or who are trying to profit from the fear that they can elicit among their patients.

I think it's easy, also, to blame irresponsible journalists who are at the kind of shadier end of our shared profession, if you like, and who I think maybe get off a little bit on it.

There's something grandiose about driving a health scare -- you can see that a journalist might have a sense of rather pompous pleasure, that they are giving important health advice to people, even if it is completely misleading.

But I think it's too easy to just blame those two camps.

I think also the medical profession and the regulators and the drug companies have to take some responsibility here.

Because the reality is there are terrible problems and shortcomings in the way that we deal with medical data.

We know that the results of clinical trials are routinely withheld from doctors, researchers and patients.

And that's perfectly legal -- we don't have proper regulations and laws to stop that from happening.

We know that important information on side effects is regularly withheld from the public by regulators, quite unnecessarily, because they keep various important documents secret.

So there are all of these problems in medicine and, to cap it all off, doctors and academics are very bad at giving the public an account of what it is that we actually do.

I think even though we've moved towards an era of evidence-based medicine, where we conduct good-quality clinical trials and gold-standard, thorough tests of which treatment is best, we've been very bad at communicating that to patients and to the public.

And it's not enough for us to gather good data behind closed doors, we also have to get out there and explain to the public how medicine works -- how we do trials, how we turn evidence into action and how we use that information to make decisions.

Because academics and doctors and regulators and drug companies have failed in so many ways, we've left the door open for these quacks to walk in and exploit all of those vulnerabilities.

So although I would blame the quacks and the dodgy journalists for the MMR vaccine hoax, as it will undoubtedly come to be known, still, you know, the blame needs to be spread around.

Especially because I can't change the behaviour of quacks and conspiracy theorists, but I can change the behaviour of doctors, researchers, regulators and drug companies.

Q. From vaccination to water fluoridation, almost every area of science seems to have its own anti-movement. A survey last year found that less than half of New Zealanders feel certain climate change is happening -- and 28 per cent disagreed it was. What do you think causes some people to swim against the consensus of evidence?

A. It's difficult, isn't it?

I guess it's going to be different for each individual.

Everybody knows, from having arguments in the pub, or over dinner, that there are people who just don't care what the facts are.

They will put their hands over their ears and they are people who just have a different relationship to the truth than you or I do.

And that's just part of life, I guess.

We have to accept that there are people who actually don't care about facts.

They would make the rest of our lives a little bit easier, or less frustrating, if they could at least acknowledge that fact openly, and obviously none of them ever do.

I think, in the half-way space of people who want to get involved in evidence, but seem to repeatedly get the wrong end of the stick, clearly people have a tendency to believe what they want to believe.

But that's not just in the general public -- there's also pretty good data from researchers that shows, that, if you show researchers a piece of evidence that they agree with, then they'll just go, oh, that's great, that looks like a really useful and interesting piece of evidence.

If you give them a piece of evidence that conflicts with their prejudices, then suddenly, they'll start looking in detail at the methods of the study.

They'll start getting involved in the mechanics of exactly what measurements were taken, how they were taken, what statistical tests were used, and they'll start to find methodological flaws, or design flaws, in the study to try to pick holes in it.

So I guess it's important to recognise that, for all that we can laugh at everyday folk, with little scientific training, for choosing what to believe, the evidence shows that scientists themselves can be just as vulnerable to all of those biases.

There's a further question, of what do you actually do about all of that?

Because, when you are presented with people who are making bad choices that go against the evidence on things that really matter, then you have to start to worry.

It's an interesting question with things like climate change, because, at least when you make a stupid decision about your own healthcare, because you've decided to ignore medical evidence and buy the services of a quack, you're only harming yourself.

But when it comes to things like climate change, what you have is a middle-aged person who chooses to ignore the scientific evidence on climate change, and who is inflicting harm on people they will never meet, 50, 100, or 150 years from now.

Q. One of our most prominent scientists, Professor Shaun Hendy, has just published a book arguing that many scientists in New Zealand are being silenced, either because of workplace policy or fear of losing funding. Do you see this problem happening around the world? And it is a big worry when there is such a large amount of bad science out there?

A. Stories like this pop up all around the world.

I'm sorry, I don't know the story with Shaun Hendy, but I'm just Googling him and I'm going to read about it when we finish this call.

In the UK, we've had a similar problem recently, where the Government has proposed a new policy on all science funding, where scientists won't be allowed to lobby politicians or Government with the results of their scientific research, which is obviously deranged.

And obviously there are lots of individual stories of scientists having pressure put on them by funders.

I think, again, there is a problem with the culture of science around whether it's legitimate to talk to the public at all.

Because it would be much more difficult to silence individual scientists who have something important to speak up on.

As always, I think these problems aren't just about individual episodes where people have been silenced, and it's not just about where somebody's got something that might be a little bit difficult for their funder to hear, I think it's because of a wider problem and a wider lack of respect for the importance of communicating science to the public.

Q. Professor Hendy also proposes that we establish a politically independent body -- a commission for science that would represent evidence in policy. Do you think this would be an answer to that problem?

A. I think it's a great idea, but there's always a problem when you try to set up just an organisation everybody has to trust.

Because big organisations, inevitably, are vulnerable. They can become captured.

They can become captured by their funders and become part of the establishment, just like the people they think they are going to come out and fight against.

Also, time and again, what you see is people saying, well actually getting involved in the mechanics of exactly how all of this complicated scientific evidence works is very, very difficult.

So the solution that they always reach for first is, we need a bunch of bigwigs, a bunch of usually old men, to sit around a table, have a really big think, and just tell us all what to think.

And just summarise it for everybody.

Even if they are the best people in the world, even if they are purer than pure, I think that's still something of a risky strategy because it builds in this notion that authority and trust are the way to work around people misrepresenting science, rather than transparency and openness.

To be honest, I'm sure that somebody like Shaun Hendy wouldn't particularly disagree with what I'm saying.

But also, there's a second risk, which is that, as soon you set up a big organisation, no matter what great intentions you go into it with, you are at risk of being captured. You are at risk of becoming like the establishment you claim to be in opposition to, or at least apart from.

Q. Our Government, and our Prime Minister's chief science advisor, Professor Sir Peter Gluckman, have been leading efforts to make society more science-literate. This includes dozens of programmes involving school children interacting directly with scientists. What do you think is the benefit of a more science-literate public?

A. I think it's absolutely enormous.

It's one of our greatest and most neglected responsibilities as doctors and as researchers.

When somebody understands how to critically appraise, how to critically review, a piece of scientific research or a claim that is being put in front of them, then they can make much better, informed choices themselves as a citizen, about their own healthcare, about the policies around them.

It's also incredibly important because, where is the interesting stuff happening in culture right now?

It's in science.

And if you don't understand science, then you are denying yourself access to all of the most significant intellectual achievements of the past two centuries of human history.

And just for the sheer, interesting, nerdy joy of it, everybody should be given the opportunity to learn, not just about science in a boring school way, where you have to learn a load of laws about how balls bounce off each other in physics, but you also want people to have the opportunity to learn about the science that's all around us.

How do you know if something's good for you or bad for you?

How do you decide whether a policy is working or not?

These are all really important and interesting scientific issues, and it's not just the answers that are important, it's also the methods.

It's how do you know if something works, or doesn't work, that is so interesting and important.

Q. In regard to science and the media, where do you see it going so horribly wrong most of the time?

A. I think it's very rarely down to individuals.

Obviously there are bad apples -- there are journalists who don't care if what they write is true or not, they just want a sensational story.

But as with all of these problems, it's the structural problems that drive it.

Right at the top of news organisations you generally have editors, who might know a little bit about politics or sport, and they'll have a high respect for politics and sport, but they'll normally know nothing at all about science.

They won't have any kind of cultural allegiance to getting things wrong -- so they won't have the skills to be able to tell if the story that is being brought to them is nonsense.

And then you see a story like an MMR vaccine hoax making it on to the front page.

Anybody who really understands science, who can go and look at the evidence, can generally see that the evidence behind these stories is on a par with somebody claiming that the problem with the cricket umpire at the night before was that they let the batsman score too many tries, with an oval-shaped ball, in the second set.

It's just gibberish.

And if people had been allowed to communicate such gibberish on the topic of sport or politics, they would have been called out.

I think it's those structural problems that really drive things and those are harder to work around, because if you are the person in a news organisation who is trying to help your editor report science properly, most of the time what you are probably going to be doing is saying, 'I'm sorry, you can't run that really eye-catching story'.

That's the last thing an editor wants to hear.

I think the problem though is there is something unique about science when it comes to newspapers.

We see bigger howlers -- bigger, more lurid and ridiculous errors -- in science coverage than you do in sports or politics coverage.

We don't see errors on the same scale.

But I think actually one of the biggest problems of having a relatively science-illiterate set of editors in newspapers is that, as a consequence, newspapers and TV miss the important stories in science because they are just a little bit too technical.

For example, you often get newspapers covering an individual story about one crap surgeon who harms a handful of individual people, or one crap drug that harms a handful of individual people.

But you don't get people writing proper in-depth detailed stories about how there is this massive systemic flaw throughout the whole of medicine, where the results of clinical trials are routinely and legally withheld from doctors, researchers and patients, which undermines the evidence base for the entirety of medicine.

You don't get people writing stories about that huge structural problem because it's not as simple as going out and finding one grieving widow who can talk about the death of one person who was harmed by one doctor or one drug.

But the death toll is much bigger from these systemic problems and the opportunity to do good is much, much greater.

I might be bringing my own prejudices from being a doctor to bear here, but I think a lot of journalists want to do good, they want to identify problems, talk about them, speak truth to power, and get those problems fixed.

But in terms of medicine, unfortunately the coverage tends to be a lot of very lurid coverage about quite easy, simple stories, when people are neglecting these really big structural issues.

Q. And what of the role of public relations in science, especially those representing companies making lots of claims. Do you often see these getting fed straight into printed copy or TV news?

A. Oh yes, for sure.

I mean, it's where, instead of peer-reviewed science, it's PR-reviewed science.

And in particular it's sort of like an insult because it exploits weaknesses -- and I assume it's the same in New Zealand -- where you'd get an incredibly weak online survey being turned into a press release, and then reported as if it's an authoritative finding by scientists.

When you see PR people using science as a gimmick to create a fake news story to get their brand into the paper, what you are really seeing is what the PR profession has correctly identified: that if you want to get a bulls**t story into the newspapers, the most vulnerable target in the newspaper in science coverage.

That's disturbing and that's what the market is telling us.

Because that's what PR companies do.

They exploit, not just dodgy statistics and dodgy surveys, but they also do those things like stupid equations, like "scientists have found the equation to the perfect shape for a rugby ball", as sponsored by a beer company that is also sponsoring a rugby match.

My books are out in maybe 20 or 30 places, and it's really interesting, because all of the structural problems are the same, but the faces are a little bit different.

Every country around the world has its own cast of nutrition gurus and they've all got dodgy PhDs and they've all got books where they make lurid and un-evidenced claims about science.

And they're all fundamentally identical in their demeanour in the way they misuse science -- so there's a different person in every town, in every country, and there's something fascinating and beautiful and brilliant and incredibly depressing about that.

It's a bit like when you hear crappy eastern European pop trance music, and you say, 'this is exactly the same as Italian pop trance, and French trance - it's just that the words are a little bit different, in a different language'.

It's exactly the same with quacks and dodgy journalism -- the tune is the same but the singer's a little bit different.

*Dr Ben Goldacre will be speaking at The Mercury Theatre in Auckland on September 24. For tickets, visit www.eventfinda.co.nz

- NZ Herald

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