Wednesday, March 11, 2015

Bad Science

Ben Goldacre's Bad Science is your guide to debunking "hacks, quacks and big pharma flacks". I thought it was an excellent book that exposes a big part of the healthcare industry for what it is: nonsense.

Each chapter explores a portion of the industry (e.g. homeopaths, big pharma) and examines how they mislead us into forking over huge chunks of our paychecks. Goldacre isn't taking aim at strawmen here; he is unafraid to name and shame certain individuals, in order to expose them for the medical frauds that they are.

I found a good chunk of the book to be illustrative and informative. While I didn't know a lot of the "quacks" Goldacre tore down (he is based in England so they are probably mostly famous there rather than here), the concepts are clearly at work here and all over the world.

I particularly benefited from the chapter on the pharma industry. Before this book, I probably placed a little too much confidence in the medical-study gold standard: double-blind controlled trials. But having read the book, I now realize those too are gamed to a large extent by the pharmaceutical industry despite strict regulations. Some techniques for gaming this include: only publishing studies with positive results, using surrogate outcomes that may or may not apply to the outcome we actually care about, altering timelines based on results, changing outcomes midstream, among others.

A combination of these techniques has resulted in 56 "trials" of painkiller drugs each showing that the sponsoring manufacturer's drug is better than the others in the trial. In other words, each of the 56 drugs is better than the rest. Transitive property be damned! I think the book is worth its price for this chapter alone.

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