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There Is This Peculiar Blind Spot In The Culture Of Academic Medicine Around Whether Withholding Trial Results Is Research Misconduct. People Who Work In Any Industry Can Reinforce Each Others' Ideas About What Is Okay.

-Ben Goldacre

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There Is This Peculiar

Ben Goldacre

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There Is This Peculiar Blind Spot In The Culture Of Academic Medicine Around Whether Withholding Trial Results Is Research Misconduct. People Who Work In Any Industry Can Reinforce Each Others' Ideas About What Is Okay.

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I Spend A Lot Of Time Talking To People Who Disagree With Me - I Would Go So Far As To Say That It's My Favourite Leisure Activity.

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I Write About Misuses Of Evidence In Plenty Of Different Spheres: Scaremongering Journalists, Obvious Quacks And Naturopaths, And Flaws In The Way That Evidence Is Used In Mainstream Academia, Medicine And In (government) Policy. One Of The Things I Always Found Interesting Is The Same Tricks Are Used To Distort Medicine In All Of Those Domains.

I'd Like To Submit To Bad Science My Teacher Who Gave Us A Handout Which Says That 'water Is Best Absorbed By The Body When Provided In Frequent Small Amounts.' What I Want To Know Is This. If I Drink Too Much In One Go, Will It Leak Out Off My Arsehole Instead? Thank You. Anton.

The Plural Of Anecdotes Is Not Data

If I Was Writing A Lifestyle Book It Would Have The Same Advice On Every Page, And You’d Know It All Already. Eat Lots Of Fruit And Vegetables, And Live Your Whole Life In Every Way As Well As You Can: Exercise Regularly As Part Of Your Daily Routine, Avoid Obesity, Don’t Drink Too Much, Don’t Smoke, And Don’t Get Distracted From The Real, Basic, Simple Causes Of Ill Health. But As We Will See, Even These Things Are Hard To Do On Your Own, And In Reality Require Wholesale Social And Political Changes.

And If, By The End [of This Book], You Reckon You Might Still Disagree With Me, Then I Offer You This: You'll Still Be Wrong, But You'll Be Wrong With A Lot More Panache And Flair Than You Could Possibly Manage Right Now.

Science Has Authority Not Because Of White Coats Or Titles, But Because Of Precision And Transparency: You Explain Your Theory, Set Out Your Evidence, And Reference The Studies That Support Your Case.

You Cannot Reason People Out Of A Position That They Did Not Reason Themselves Into.

Yes. I'm A Doctor, An Epidemiologist, And Lots Of My Professional Colleagues Flip Back And Forth Between Industry And Medical Roles. I Know Them; They Are Not Bad People. But It Is Possible For Good People In Bad Systems To Do Things That Inflict Enormous Harm.

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Most Bloggers Have No Institutional Credibility, And So They Must Build It, By Linking Transparently, And Allowing You To Easily Double Check Their Work. But More Than Anything, Because Linking Sources Is Such An Easy Thing To Do, And The Motivations For Avoiding Links Are So Dubious, I've Detected Myself Using A New Rule Of Thumb: If You Don't Link To Primary Sources, I Just Don't Trust You.

Real Science Is All About Critically Appraising The Evidence For Somebody Else's Position.

You Are A Placebo Responder. Your Body Plays Tricks On Your Mind. You Cannot Be Trusted.

In The Past, [medicalization]has Been Portrayed As Something That Doctors Inflict On A Passive And Un-suspecting World - An Expansion Of The Medical Empire. But In Reality, It Seems That These Reductionist Bio-medical Stories Can Appeal To Us All, Because Complex Problems Often Have Depressingly-complex Causes, And The Solutions Can Be Taxing, And Unsatisfactory.

I Agree, The World Would Be A Better Place If Doctors Were Less Enthusiastic About Adopting Very New Drugs.

Positive Findings Are Around Twice As Likely To Be Published As Negative Findings. This Is A Cancer At The Core Of Evidence-based Medicine.

I Hope That You Will Be Asked To Participate In A Trial At Some Stage In Your Disease

Amazing Things Happen When You Pull Individual Pieces Of Information Together Into Larger Linked Datasets: Meaning Emerges, As You Produce Facts From Figures.

The Placebo Effect Is One Of The Most Fascinating Things In The Whole Of Medicine. It's Not Just About Taking A Pill, And Your Performance And Your Pain Getting Better. It's About Our Beliefs And Expectations. It's About The Cultural Meaning Of A Treatment.

Doctors And Patients Need As Much Data As Possible To Make An Informed Decision About What Treatment Is Best.

Teaching Needs An Ecosystem That Supports Evidence-based Practice. It Will Need Better Systems To Disseminate The Results Of Research More Widely, But Also A Better Understanding Of Research, So That Teachers Can Be Critical Consumers Of Evidence.

Data Is The Fabric Of The Modern World: Just Like We Walk Down Pavements, So We Trace Routes Through Data, And Build Knowledge And Products Out Of It.

If You Put Me In Charge Of The Medical Research Budget, I Would Cancel All Primary Research, I Would Cancel All New Trials, For Just One Year, And I Would Spend The Money Exclusively On Making Sure That We Make The Best Possible Use Of The Clinical Evidence That We Already Have.

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There Is This Peculiar Blind Spot In The Culture Of Academic Medicine Around Whether Withholding Trial Results Is Research Misconduct. People Who Work In Any Industry Can Reinforce Each Others' Ideas About What Is Okay.

Homeopathy Pills Are, After All, Empty Little Sugar Pills Which Seem To Work, And So They Embody [..] How We Can Be Misled Into Thinking That Any Intervention Is More Effective Than It Really Is.

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I Think You'll Find It's A Bit More Complicated Than That.

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