Оглавление
Ben Goldacre. Bad Science
BEN GOLDACRE. Bad Science
1. Matter
Detox and the theatre of goo
Ear candles
Detox patches and the ‘hassle barrier’
If it’s not science, what is it?
2. Brain Gym
3. The Progenium XY Complex
4. Homeopathy
What is homeopathy?
The dilution problem
I demand a fair trial
‘Miracle’ Cures Shown to Work
Blinding
Randomisation
Meta-analysis
5. The Placebo Effect
The placebo on trial
What the treatment looks like
What the doctor says
‘Placebo explanations’
More than molecules?
An ethical placebo?
6. The Nonsense du Jour
The four key errors. Does the data exist?
Observation, or intervention?
From the lab bench to the glossies
Cherry-picking
Problematising antioxidants
The antioxidant dream unravels
7. Dr Gillian McKeith PhD
Dr McKeith puts a cabbie straight
8 ‘Pill Solves Complex Social Problem’ Medicalisation—or ‘Will fish-oil pills make my child a genius?’
Why you have a placebo group
Durham defend themselves
The fish-oil evidence
The power is in the pill?
Calming down: the apothecary industrial complex
The wheels of time
9. Professor Patrick Holford
AIDS, cancer and vitamin pills
A vaguely systematic review
Professor?
10. The Doctor Will Sue You Now
APPROPRIATE CRIMINAL SANCTION
11. Is Mainstream Medicine Evil?
The pharmaceutical industry
The journey of a drug
Ignore the protocol entirely
Play with the baseline
Ignore dropouts
Clean up the data
‘The best of five … no … seven … no … nine!’
Torture the data
Try every button on the computer
How can this be possible?
Publication bias and suppressing negative results
Duplicate publication
Hiding harm
Vioxx
Authors forbidden to publish data
The single cheap solution that will solve all of the problems in the entire world
Adverts
12. How the Media Promote the Public Misunderstanding of Science
Wacky stories—money for nothing
‘All men will have big willies’
‘Jessica Alba has the perfect wiggle, study says’
Stats, miracle cures and hidden scares
‘Research has shown…’
13. Why Clever People Believe Stupid Things
Randomness
Regression to the mean
The bias towards positive evidence
Biased by our prior beliefs
Availability
Social influences
14. Bad Stats
The biggest statistic
Choosing your figures
Cocaine floods the playground
OK, back to an easy one
Beating you up
Locking you up
The ecological fallacy
The prosecutor’s fallacy
Losing the lottery
15. Health Scares
The Great MRSA Hoax
Epilogue
16. The Media’s MMR Hoax
Vaccine scares in context
Andrew Wakefield and his Lancet paper
The story behind the paper
The press coverage begins
Autism
Leo Blair
What was in these stories?
The evidence on MMR
Scientific ‘evidence’ in the media
What they didn’t tell you
Old diseases return
Chapter 1: Matter
Chapter 5: The Placebo Effect
Chapter 6: The Nonsense du Jour
Chapter 7: Dr Gillian McKeith PhD
Chapter 8: ‘Pill Solves Complex Social Problem’
Chapter 9: Professor Patrick Holford
Chapter 10: The Doctor Will Sue You Now
Chapter 11: Is Mainstream Medicine Evil?
Chapter 12: How the Media Promote the Public Misunderstanding of Science
Chapter 13: Why Clever People Believe Stupid Things
Chapter 14: Bad Stats
Chapter 15: Health Scares
Chapter 16: The Media’s MMR Hoax
And Another Thing
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There is a long history of upset being caused by trials, in medicine as much as anywhere, and all kinds of people will mount all kinds of defences against them. Archie Cochrane, one of the grandfathers of evidence-based medicine, once amusingly described how different groups of surgeons were each earnestly contending that their treatment for cancer was the most effective: it was transparently obvious to them all that their own treatment was the best. Cochrane went so far as to bring a collection of them together in a room, so that they could witness each other’s dogged but conflicting certainty, in his efforts to persuade them of the need for trials. Judges, similarly, can be highly resistant to the notion of trialling different forms of sentence for heroin users, believing that they know best in each individual case. These are recent battles, and they are in no sense unique to the world of homeopathy.
So, we take our group of people coming out of a homeopathy clinic, we switch half their pills for placebo pills, and we measure who gets better. That’s a placebo-controlled trial of homeopathy pills, and this is not a hypothetical discussion: these trials have been done on homeopathy, and it seems that overall, homeopathy does no better than placebo.
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