Please feel free to post your views on the book or the review. I'm going to go to my local library and check it out.
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Review by Deb RobinsI have just finished an interesting popular science book, “Snake Oil Science” (2007, Oxford Uni Press) by R. Barker Bausell, a research methodologist and once a director of research at the University of Maryland. He presents a very convincing argument by analysing a wide array of research papers purporting positive results in the field of alternative medicines and treatments. He has discovered that very few, even popular and widely accepted supplements and treatments, employed good science methodology or controlled their investigations for a myriad of effects, bias etc., particularly the placebo effect. He alludes more than once, that bad science is not the preserve of alternate medicine either.
It’s a very systematic, lucid and sometimes witty path to understanding, which he guides us along, and whilst most examples referred to general pain relief and acupuncture, it is pretty clear to me now that I applied a reasonable amount of snake oil to my son in my time, including acupuncture. I sometimes even felt guilty that our family budget could not stretch to some therapies or in some cases cope with the quantities recommended.
Amongst other explanations, Bausell looks critically at the business of medical journals, the professional pressures of scientists, the Hawthorn effect (a short-term improvement caused by observing worker performance. (Wikipedia)), an overall lack of statistical understanding, the tendencies of journals and mass media to prefer positive results and the lack of attention given by researchers to the natural history of pain or disease.
Of course he focuses on the placebo effect and when I think back to the temporary surges in Doug’s strength or other temporary positive reactions to this or that supplement, although of course there were not too many of those, I realize that I didn’t do a meta-analysis of supporting “scientific” studies and I certainly was no scientist conducting my own badly conceived trial with one participant. Although this is a pretty big factor in the development of our brains - the ability to see cause and effect but there just also happens to be a fair amount of coincidence involved, when we don't use the proper scientific method.
My one compensation is that the effects of placebo are very real physiologically, albeit for very different reasons than the chemical efficacy of the supplement for instance…and none of these things probably did any harm. I don’t feel alone in my stupidity when the author cites the majority of intelligent people including physicians and researchers who are likewise fooled. Why, Americans recently spent $500 million on magnets alone – imagine the spending upon more popular therapies? No wonder, when it is such good business to promote bad science!
Science as a subject has not been mandatory throughout a student's secondary education in Australia for at least the past couple of years. What hope have future generations against the bad science inspired by commercial interests and so many other factors? In fact, I don’t think Bausell is at all happy that the NIH recognizes alternate medicine at some level.
One nice thing about Prof Bausell, is his humanity and this tempers his criticism more than once. At the close of the book, he actually writes a procedure for choosing the best sham therapy in order to optimize the real benefits from the placebo effect! Now that’s a balanced guy. If I had to do it all over again, even today with very few efficacious medicines at hand apart from my son’s steroids and heart meds to boast about, it would still be essential for me to keep doing things that might improve my son or make him generally healthier. I probably wouldn't stretch the budget so far again perhaps? Hope is a good thing after all and it is anathema for any parent to do nothing.
I realize this was not a volume which even mentioned Duchenne, but it resonated with me and I have nearly (but not quite) accepted that perhaps double-blinded randomized clinical trials are not as heinous as I believed, but pretty necessary, especially in research that might only involve self-reporting or functional measurements. In my opinion, this is a really interesting read for laypersons who read a lot of medical articles, as many of us parents do.
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