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Pietrus/Taller/Sala 2

Mala ciencia (título original: Bad Science) es un libro de Ben Goldacre que critica la forma en la que los medios de comunicación cubren las noticias sobre sanidad y ciencia. Publicado originalmente en septiembre de 2008,​ el libro contiene versiones extendidas y revisadas de muchas de sus columnas en The Guardian. Obtuvo muy buenas críticas del Daily Telegraph​ y la British Medical Journal​, entre otros, y alcanzó la lista de los 10 libros más vendidos en Amazon. Fue nominado para el premio Samuel Johnson en 2009. Bad Science es también el título de la columna de Goldacre en The Guardian y de su página web.

Contenidos

Introducción

Una breve introducción (de Goldacre) exponiendo los temas de los que hablará en otros capítulos. Se lamenta de la falta de cultura científica actual.

Capítulo 1. La base de la cuestión

Habla de metodos de "detoxificación" (Aqua Detox, velas de oído, etc.) cuya falsedad se puede demostrar con experimentos bastante simples. Analiza el "fenómeno detox", esa obsesión por librar nuestro cuerpo de supuestas "toxinas" mediante métodos espurios. También se discuten los rituales de purificación.

Capítulo 2. La gimnasia cerebral

La "gimnasia cerebral" es un programa de ejercicios que, según sostienen sus creadores sin ninguna base científica, puede crear nuevas conexiones en el cerebro. En este capítulo el autor discute cómo muchas escuelas públicas de Reino Unido adoptaron este programa sin previo análisis crítico.

Capítulo 3. El complejo Progenium XY

Este capítulo versa sobre los cosméticos, y las afirmaciones engañosas y pseudocientíficas de sus fabricantes.

Capítulo 4. La homeopatía

Se parte de la homeopatía para emprender un ensayo sobre la natureleza de la evidencia científica, con referencias al efecto placebo, regresión a la media y la importancia de hacer estudios a doble ciego y de tomar muestras aleatorias en el diseño de ensayos clínicos objetivos. Finalmente, el autor expone que las pastillas homeopáticas no tienen un efecto diferente al de las plastillas placebo.

Capítulo 5. El efecto placebo

Examples of the power of the mind over pain, anxiety and depression are presented with studies showing how higher prices, fancy packaging, theatrical procedures and a confident attitude in the doctor all contribute to the relief of symptoms. In patients with no specific diagnosed condition, even a fake diagnosis and prognosis with no other treatment helps recovery, but ethical and time constraints usually prevent doctors from giving this reassurance. Exploiting the placebo effect is presented as possibly justifiable if used in conjunction with effective conventional treatments. The author links its use by alternative medicine practitioners with the diversion of patients away from effective treatments and the undermining of public health campaigns on AIDS and malaria.

Chapter 6: The Nonsense du Jour

Nutritionists are accused of misusing science and mystifying diet to bamboozle the public. Misrepresentations of the results of legitimate scientific research to lend bogus authority to nutritionist theories, while ignoring alternative explanations are cited in evidence. The use of weak circumstantial associations between diet and health found in observational studies as if they proved nutritionist claims is criticised. The unjustified over-interpretation of surrogate outcomes in animal (or tissue culture) experiments as proving human health benefits is explored. The cherry picking of published research to support a favoured view is contrasted with the systematic review designed to minimise such bias. The supposed benefits of antioxidants are questioned with studies showing they may be ineffective or even harmful in some cases. The methods used by the food supplement industry to manufacture doubt about any critical scientific reports are likened to those previously used by the tobacco and asbestos industries.

Chapter 7: Dr Gillian McKeith PhD

The Scottish TV diet guru and self-styled "doctor" Gillian McKeith and her scientific claims are dissected. Statements exemplifying her scientific knowledge include that the consumption of dark-leaved vegetables like spinach "will really oxygenate your blood" as they are high in chlorophyll, and that "each sprouting seed is packed with the nutritional energy needed to create a fully-grown, healthy plant". She is described masquerading as a genuine medical doctor on her TV reality/health shows. Her publications are compared with a Melanesian cargo cult; superficially correct but lacking any scientific substance. Her belief in the special nutritional value of plant enzymes (which are broken down in the gut like any other proteins) is ridiculed. The general problems involved in establishing any firm links between diet and health are examined.

Chapter 8: 'Pill Solves Complex Social Problem'

The claim that fish oil capsules make children smarter is examined. The book probes the methodological weaknesses of the widely publicised "Durham trial" where the pills were given to children to improve their school performance and behaviour, but without any control groups and wide open to a range of confounding factors. The failure to publish any results and backtracking on earlier claims by the education authorities is slated. The media's preference for simple science stories and role in promoting dubious health products is highlighted. Parallels are drawn between the Equazen company behind the Durham fish oil trials and the Efamol company's promotion of evening primrose oil.

Chapter 9: Professor Patrick Holford

The influence of the best-selling author, media commentator, businessman and founder of the Institute for Optimum Nutrition (which has trained most of the UK's "nutrition therapists") is acknowledged. Holford's success in presenting nutritionism as a scientific discipline in the media, and forging links with some British universities is also noted. The book judges that his success is based on misinterpreting and cherry-picking favourable results from the medical literature, in order to market his vitamin pills. His promotion of vitamin C in preference to AZT as a treatment for AIDS, vitamin E to prevent heart attacks, and vitamin A to treat autism are all condemned as lacking in sound evidential support. His reliance on the work of discredited fellow nutritionist Dr. R.K. Chandra is likewise slated. The Universities of Luton and Teesside are criticised for their past associations with Holford and the ION.

Chapter 10: Is Mainstream Medicine Evil?

The book remarks on the relatively low percentage of conventional medical activity (50 to 80%) which could be called "evidence-based". The efforts of the medical profession to weed out bad treatments are seen to be hampered by the withholding or distortion of evidence by drug companies. The science and economics of drug development are outlined, with criticism of the lack of independence of industrial research and the neglect of Third World diseases. Some underhand tricks used by drug companies to engineer positive trial results for their products are explored. The publication bias produced by researchers not publishing negative results is illustrated with funnel plots. Examples are made of the SSRI antidepressants and Vioxx drugs. Reform of trials registers to prevent abuses is proposed. The ethics of drug advertising and manipulation of patient advocacy groups are questioned.

Chapter 11: How the Media Promote the Public Misunderstanding of Science

The misrepresentation of science and scientists in the media is attributed to the preponderance of humanities graduates in journalism. The dumbing-down of science to produce easily assimilated wacky, breakthrough or scare stories is criticised. Wacky "formula stories" like those for "the perfect boiled egg" or "most depressing day of the year" are revealed to be the product of PR companies using biddable academics to add weight to their marketing campaigns. Among other examples, the speculation by Dr. Oliver Curry (a political theorist at the LSE) that the human race will evolve into two separate races, presented as a science story across the British media, is exposed as a PR stunt for a men's TV channel. The relative scarcity of sensational medical breakthroughs since a golden age of discovery between 1935 and 1975, is seen as motivating the production of dumbed-down stories which trumpet unpublished research and ill-founded speculation. An inability to evaluate the soundness of scientific evidence is seen to give undeserved prominence to marginal figures with fringe views.

Chapter 12: Why Clever People Believe Stupid Things

This chapter is a brief introduction to the research on cognitive biases, which, Goldacre argues, explain some of the appeal of alternative medicine ideas. Biases mentioned include confirmation bias, the availability heuristic, illusory superiority and the clustering illusion (the misperception of random data). It also discusses Solomon Asch's classic study of social conformity.

Chapter 13: Bad Stats

This chapter covers the cases of Sally Clark and Lucia de Berk, in which the author says poor understanding and presentation of statistics played an important part in their criminal trials.

Chapter 14: Health Scares

In this chapter, the author claims that the press selectively used a "laboratory" that gave positive MRSA results where other pathology labs found none. Creating an "expert" from Chris Malyszewicz who worked from a garden shed.

Goldacre notes how the Daily Mirror once managed to combine "three all-time classic bogus science stories" into one editorial:​ the Arpad Pusztai affair of GM crops, Andrew Wakefield and the MMR vaccine controversy and Chris Malyszewicz and the MRSA hoax. On the other hand journalists were very poor in uncovering or reporting on the thalidomide tragedy​ - only covering well the ultimate political issue of compensation.

Chapter 15: The Media's MMR Hoax

Andrew Wakefield and the MMR vaccine controversy. continues to discuss the lab results in previous chapter and discusses the MRSA mix up in hospitals wrong patients get wrong results.

Index

The hardback and first paperback editions did not include an index. Several indexes were prepared by bloggers, including one prepared by Oliblog.​ The latest paperback issue includes a full index.

Previously unpublished chapter: The Doctor Will Sue You Now

Further to the release of this book a resolution of the legal status of one of the chapters has come about since Goldacre won a libel case filed against him by Matthias Rath.​ The post dated 9 April 2009 states: This is the “missing chapter” about vitamin pill salesman Matthias Rath. Sadly I was unable to write about him at the time that book was initially published, as he was suing my ass in the High Court.

The full chapter has been made universally available under a Creative Commons license with the title The Doctor Will Sue You Now.​ Additionally, this full chapter is included as chapter 10 in the New Paperback Edition.​

In this chapter the author explains its origin, its reasons for being excluded and describes his personal reasons and tribulations in the said legal resolution. Being his personal point of view it contains an account of his anger at being gagged due to legal/financial restrictions, his support by the Guardian (whom he writes for) and his now encyclopedic knowledge of the subject in question.

See also

• Bad Pharma (2012) by Ben Goldacre

External links

• Goldacre's website badscience.net
• "Bad Science", Goldacre's column for The Guardian