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Book Review: Bad Science by Ben Goldacre
Connie Davis | November 29, 2010
I've been following evidence-based medicine for many years and I have to admit I've been appalled by the way it is playing out. We have pay-for-performance that does not understand that the reliability we are after is not in reliably (read blindly) applying a guideline to a patient population, but rather reliably considering how the evidence applies to the individual in a health care interaction, we have guidelines that are based on expert opinion, often influenced by drug company funding, or based on bad science, and we have a news media that seems unable to present medical findings in a balanced and understandable way. So we are left with a public that is confused and lacks trust in medical evidence. (Case in point: in the recent past, the diabetes guidelines championed lower BP targets for people with diabetes (and I parroted the party line), inferring a benefit from studies that have now been cast in doubt and actually seemed to have been causing harm.)
Ben Goldacre steps into this mess and endeavors to help the average person understand how to recognize bad science when you see it.'' Through chapters that pick apart homeopathy, nutritionists and their wild claims, and the whole MMR debacle, Dr. Goldacre points out where we have gone astray. He writes, We get our information from the very people who have repeatedly demonstrated themselves to be incapable of reading, interpreting, and bearing reliable witness to the scientific evidence.'' He has the amazing ability to make statistics understandable and point out where the common errors in interpreting studies lie. His anecdotes and misadventures (being sued for exposing a nutritionist who is featured on British television shows, rousing conversations with homeopaths) make the point that this isn't all innocuous. How many children have been harmed by the bad science (actually, it was beyond bad, it was fraudulent) regarding autism and the MMR vaccination? Ben Goldacre helps us understand how positive bias affects our conclusions, what regression to the mean is (and how it can be used to create the appearance of an effect that isn't there) and what the placebo effect is.
This is the kind of book that would make great required reading in high school health classes. Or medical and nursing school. The ability to critically review evidence is sorely lacking in health care professionals, and this book is much more fun to read than any of the statistics books I struggled through.
More Blog Posts by Connie Davis
Connie Davis MN, ARNP is a geriatric nurse practitioner, health care consultant and William Ziff Fellow at the Center for Advancing Health. This blog was originally posted on Connie’s website where she blogs about improving the patient experience. You can read Connie’s blogs and subscribe to her RSS feed here and follow her on twitter at @ConnieLDavis.
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