Pharmageddon: The Vaccine Pseudo-Controversy

The Vaccine hysteria has run for more than a decade

This is one of those  ‘banker topics’ in that you can bank on the fact that it will come up again and again on this blog. Like the Creationism/Evolution debate, the Science has now taken a back seat to what has essentially become a political/culture war. So recently, I was embroiled in a massive argument on  a Public Health Ethics forum over whether vaccines cause Autism. At first I noticed some slightly dubious comments by someone about vaccine inefficiencies in the developing world. Initially, I didn’t think this was anti- vax conspiracy theory stuff, merely professional criticism of healthcare systems in general and perhaps how the vaccine schedule needs to improvements (..yada yada yada). Still, I was sufficiently uncomfortable with them to direct their attention to this article which looked at how vaccines have been a phenomenal Public Health tool around the world and the  adverse side-effects of which haven’t been substantively demonstrated.

I was expecting people to take it on board and enlighten me with various criticisms of the structures and how the Institutions involved with Immunization processes need to improve in the developing world. Instead what I got was the most verbatim regurgitation of the standard anti vaccine conspiracy theories that are out there (especially in popular media  with Jenny Mccarthy, Jim Carey and Robert Kennedy Jr being quite prominent in promoting this hoax in North America). So I will briefly attempt to go over this (pseudo) controversy and how it has developed over the years.

The Plural of Anecdote is Anecdotes, NOT Data

Perhaps the most infamous of these Vaccine scares is the claim that  Measles Mumps and Rubella (MMR) Vaccine causes Autism. This kicked off when in 1998 Andrew Wakefield (along with others) published this paper in the Medical Journal The Lancet. This was a case-series study looking at 12 kids who had the Vaccine and had later gone on to develop Autism. Now it has to be acknowledged that the conclusion of that particular study merely posited an ‘association between MMR and Autism’. But subsequent to its publication, Mr Wakefield decided to hold press conferences whipping up the frenzy in the media and the press about the ‘link’ between the Autism and the MMR vaccine. [It has since emerged that Andrew Wakefield was found in breach of ethics and conflicts of Interest by the British General Medical Council and the Lancet also retracted that paper based on that investigation — But be that as it may] Even if this was not the case, one has to look at the evidence-base and the strength of the study. And that was essentially based on 12 Clinical Anecdotes which is not enough to establish the link between MMR and Autism.  The reason for this is because firstly this is NEITHER a rare risk exposure (i.e about 93% of the population get vaccinated)  NOR is this a rare outcome (from 1 in 50 to 1 in 200 children develop Autism). For example if an Astranaut developed a third eye, you would count that as both rare risk exposure and rare outcome. In that case 12 anecdotes would be very compelling evidence to take the hypothesis ‘space travel gives you a third eye’ seriously . In this case however, 12 anecdotes don’t tell us anything. What we need is a big study involving a large sample size. That should be the basis of the evidence that ultimately judges this claim. Hence this wasn’t a particularly useful study (again that’s putting all the breaches aside) to begin with.

The Danish Study

And that large study was published  in 2002, in Denmark called “Madsen et al” which looked at a cohort study of more than 500,000 children (as opposed the 12 anecdotes) …400,000 of which received MMR and 100,000 didn’t. And then they looked at the rates of Autism in both groups. The conclusion they found was the rates of Autism on both group were the same. Again when more rigor was applied to this hypothesis, it failed to check out. Of course the Anti-Vax lobby do not acknowledge this and are hell-bent on discrediting that study not by scientific evidence but ad hominem attacks on authors and secret cabals behind the scenes siphoning money here there and everywhere. Respectful Insolence tackles that in detail. The thing to remember is, the scare was started by a study that looked at 12 cases. When it was examined in much more detail (Large sample size always good for accuracy) the claims failed to meet the emprical standard. That is the bottom line in Science.

Thimerosal Mercury Preservative 

Thimerosal (Mercury preservative in Vaccine) causing Autism is now the latest of the conspiracy theories  trotted out by the same crowd. So much so, that the pressure generated from these groups got the Center for Disease Control (CDC) to take it out of their vaccine schedule. Now what would you expect to see after Thimerisal was taken out of the vaccines if it actually caused autism?. You would undoubtedly see a plateauing of the rates of autism, followed by a decrease, wouldn’t You? If it is indeed the Thimerosal. In reality what was observed was that the rates of autism remained the same. In fact, the real rates of Autism may have even increased.  So it could not possibly have been the Thimerosal. But that inconvenient fact does not seem satisfy the anti-vax lobby.

In itself, the CDC backing down and ditching Thimerosal is not a big issue because in the US  there are more efficient ways to implement Vaccine distribution. However in the developing world, places like Uganda where such distribution infrastructures aren’t available; these Preservatives are of much greater importance. But governments over there look at the US  taking it out of their vaccines, inevitably reach the conclusion that they must lead to autism. And that misunderstanding prompts the to compromise their Immunization Infrastructure – something much more important over there than in the West.

The “Big Pharma = Pure Evil” Mantra

Jim Carrey & Jenny Mccarthy: Celebrity Anti-Vaccine Activists

The Philosophical underpinning of these claims usually stems from a politically charged belief that big pharma is basically conspiring to make you and your kids sick so that they can take your money selling you their pills. Certainly, the Pharmaceutical Industries are no angels.(I wrote a post already in which I was critical of them in passing). However, the ant-vax view of them doesn’t even amount up to be Cartoon-ish. Sure you can expect a level of bias to creep in if studies are funded by Big Pharma. But ultimately you have to review the methodologies involved. Just because there is a profit motive involved doesn’t mean that the study therefore will be bogus. It should be fully disclosed and taken into consideration (publication-bias) but there are ways to evaluate the strengths and weaknesses of studies no matter who funds them.

As it happens, if you visit the websites of the anti vax  groups such as Age of Autism or Generation Rescue you will be bombarded with products claiming to cure Autism.  One could make the argument that there is a financial element to their opposition to vaccines (and peddling of their own autism products/services). Valid though this maybe, ultimately it is the horrific lack of scientific peer reviewed evidence that should take precedence when both debunking their claims about vaccines and evaluating their ‘quack-remedies’. (and not who advertises on their site). That is really a side-issue designed to dumb down the debate on the evidence (at least in the Vaccine issue).

The Dangerous Circularity

There seems to be a dangerous circularity of arguments from people when they oppose vaccines. They say ‘why do we need vaccinations for things like Polio, Measles, Mumps etc when these diseases are so rare?’. And you cant help but wanting shout out at them “Well why the f*** do you think they ARE very rare”. Sure there are other factors that have aided the decline of these infectious diseases, but their ‘rarity’ is chiefly due to the Vaccines. Unfortunately this circularity post the MMR hoax has led to a decline in Vaccination rates in the past decade which low and behold saw an uptick in Whooping cough and Measles in parts of the UK and USA in the decade just finished. If we let these  childish notions about vaccinations go unchallenged they can have pretty dire consequences.

The Diagnosis Effect

Another argument often trotted out about this is, that the rates of Autism have increased post 1990. Why is it so? Could it be that our understanding of Autism has increased since that period. When previously it was labelled something else, it is now classified under Autism. It is not beyond the realms of possibility that we have a more nuanced understanding of this disease now. But this doesn’t necessarily mean the rates of Autism have increased from prior to 1990 and the only cause of that are vaccinations. That is pretty tenious claim and requires well controlled large-scale studies and not circumstantial innuendo- as seems to be the mode of operation of many of these Anti-Vaccine groups.

The Opportunity Cost of Self-Indulgent Nonsense

Perhaps the saddest thing about this unicorn-chasing, is the diversion of resources away from the trying to discover the real causes of Autism. So much energy and capital has already been spent trying to debunk this, yet these groups remain on the offensive, still. And the press and media have fanned the flames giving them the credence they never deserved. All this creates an element of doubt among parents as to whether to vaccinate their kids or not – and that is a potentially harmful development for us all.

I haven’t really done this topic justice in this one post, however I will be revisiting it from time to time.

Posted in Conspiracy Theories, Quacks, Science, Vaccines | Tagged , | 4 Comments

Winston Zulu: Zambia’s Man of Deeds

Winstone Zulu (1964 - 2011)

This is going to be a short post. Short – yet probably the most somber – one to date. It is about Winstone Zulu, a prominent AIDs and TB activist and campaigner from Zambia. He was diagnosed with HIV in 1990 and was the first person in Zambia to make a public statement about his HIV status. With the stigma associated with AIDS in that part of the world, this was a tremendously courageous thing to do. The Treatment Action Campaign have some very thoughtful words about him

He started taking anti-retro-viral medication in 1996 but unfortunately, he stopped them in 2000 after encountering quack AIDS-denialist views that ‘HIV did not cause AIDS’. When confronted with the evidence and his error in judgement, he changed his mind and became one the most vociferous supporters of Aids Medication in Africa. He was also forthcoming in his repudiation of AIDs related quackery in Africa which was on the rise, not least because of the disastrous policies of South African President Thabo Mbeki.

Winstone Zulu , a man who fought a personal battle with AIDs and TB with great courage; a man who (when confronted with the error of his ways) had the integrity to own up to them and to back it up with tireless campaigning on behalf of the millions afflicted with AIDS and TB, died on October 12th, 2011.
RIP

Here is an old clip of him speaking on the Global Situation and Strategies for addressing HIV/TB at the HIV/TB Global Leaders’ Forum

Posted in Africa, AIDS, Politics | Tagged , , | 1 Comment

Ashton Hayes: England’s first Carbon Neutral Village

Ashton Hayes leading the way

Ashton Hayes is a small village/parish in NorthWest England. A seemingly typical English countryside habitation, it gained notoriety in 2006 for aiming to become the first truly Carbon Neutral village in the country. A concerted effort was made to take measurements of the annual output of CO2 from that village and a community-wide campaign was launched to reduce the emission levels. It included a thorough examination of how houses were being insulated; how much electricity could be saved; and how people – in general – could reduce their carbon footprint whilst being able to conduct their day to day activities. Of course one can definitely pick holes in this, pointing out that if people are traveling out of the village and they are taking long flights for holidays etc, then there is still a huge chunk of CO2 emissions they are still responsible for.

However, that would be harsh, as part of the spirit of what they are attempting to do is to kick off a trend which hopefully sees other villages/parishes follow in their footsteps and reduce their Carbon emissions as well. It seems counter-intuitive but living in urban city centers is the greener thing to do (CO2 emissions-wise) compared to villages and rural areas because less energy/per head is used. Apartment buildings are always going to be more Carbon efficient residential assets than houses. In non-urban areas, people tend to have bigger houses; they require more energy for electricity and heating purposes and they have to drive more (on average) for simple day-to-day tasks. I guess the worst of both worlds (from Carbon emissions point of view) are suburbs, because they not only mean more CO2 emissions from Cars, but also people living in bigger houses (therefore higher heating and electricity requirements). And what do authorities/local governments – especially here in North America – do about it ? Well, they promote and subsidize the suburbs over the City apartments – another little reminder how hopelessly off the ball they are, when it comes to tackling Climate Change.  So, it is even more laudable that a rural community like Aston Hayes is taking up this challenge.

Anyway, that’s the boring (ranty) bit out of the way. Here is what I really wanted to share.  A short film on the town of Ashton Hayes and how the entire community is coming together to help out with the CO2 reduction. (And yes, when primary school kids are carrolling about ‘Carbon neutrality goals’, you know, you’r onto a winner)

Posted in Carbon Emissions, Climate Change, Economics, Uncategorized | Tagged , , | 1 Comment

Adam Smith’s Ideas on Labour and Value (Part II)

Adam Smith (via Financial Times)

[Disclaimer: This is the second of a 2-part post of the same essay. The first part of the essay can be read  here. Perhaps it would be useful for you to  read the first part to get some context for the is post. Also DoL refers to “Division of Labour”]

While Smith did not explicitly forecast the advent of the ‘Industrial Revolution, he did lay the conceptual ground work for that to flourish. The key to that were once again, his ideas of DoL. He compared the agricultural process to the manufacturing process and came to the conclusion; that for the latter, labour capital stock is of much higher significance. Complementing this, he provided a sound rationale (as discussed earlier) as to how this ‘DoL’ leads to improvements in the production process as a result of vigour and focus. Underpinning that idea – according to Smith – is the desire to reduce ones labour as much as possible. For Smith, Labour can also be seen as a quantity with negative utility. Putting aside the psychological assumptions implicit in that statement, it is worth examining what it means in an economic sense. The desire to ‘reduce one’s labour’ is not a comment (at least in Smith’s mind) of the degenerative state of society. It is in fact the driving force which leads to innovation and technological improvements which assist and enhance the production process. An example of this was be the invention of the piston (a seminal innovation in the technology of that time) in a trains which essentially came about from a desire for a young boy who effectively wanted to save his labour and decided to think of solution which was not only sufficient in completing his designated task but also allowed him to save time to devote to activities from which he drew pleasure – in his case meant spending more time with his friends. The important conclusion to draw from this is that whenever DoL is allowed to flourish and take a central role in the production process, technological improvements are a very probable and predictable consequence. We have been able to establish the virtues of DoL and how magnificently catalytic its impact can be on an economic system. But we haven’t yet looked at what it is that causes this human affinity towards DoL. Smith believed that this is due to the innate nature of human beings to trade and to barter. One can look at a specific task as a type of good. For instance in a butcher shop, two people can divide the task of removing fat from the meat to cutting it in different pieces. Implicit in that arrangement is the sense of barter; i.e. the fat-remover is solely doing that because he trusts that the cutter will duly oblige with his task. This trust Smith would probably assert is that inherent human quality. The resultant increase in efficiency is the payoff for both people as they realise that their potential is best optimised by DoL.

However it has to be pointed that this assertion of innateness of humans in their ability to trade may not be entirely accurate. Smith surmised that this was ability only specific to human beings and no other animal has been able to replicate that prowess. This is indeed concurred by Thomas Lewis (“Political Consequences of Markets”) who also viewed the capacity to barter as innately human. Michael Shermer, a prominent academic and a prolific author on evolution and adaptive systems wrote in his book The Mind of the Market (which devotes a significant to discussing Adam Smith) that there are numerous studies in Chimpanzees which show an appreciation of the process of barter and trade. Since our lineage (in evolutionary terms) is very close to that of Chimpanzees as we share a common ancestor, one can deduce that the sense to barter does not necessarily entail innateness to human beings. However it is slightly inaccurate to state – as Smith did – that no other animal shows this inclination. There are many examples in the natural world that speak to the contrary. Still, nonetheless, it is self-evident that no other species has been able to incorporate so extensively the idea of barter, trade and eventually DoL in their day to day living as human beings

One of the fallacies of economic thinking (still exists today among many circles) is that it is competition which drives people in search of better and improved ways of producing their output – hence the advance in technology. Smith showed that this may in fact be an illusion. Technological advances are very similar scientific advances. Both require critical and rigorous evaluations of the status-quo mechanisms and addressing the existing flaws in order to imporve (often incrementally) on the previous theory, paradigm or technology. Smith shows quite succinctly and successfully that the optimum condition for that is not necessarily competition but DoL. Many economic systems have (to varied degrees) had success in initiating technological advances. The Soviet Union saw the emergence of many new technologies in many different types of production processes which assisted in their growth for a time. This  was not a competition-based economic system. So how was it able to be so successful in being toe-toe with the US (if not better at one time) in technology race? One need not look further than read the first few chapters of The Wealth of Nations to answer this quandary. Smith would argue that the Soviet Union – despite being a command economy – had sufficient DoL and it is this division of labour which was responsible for their surge in technological advancement in 50s and 60s. An open competitive marketplace may be where this DoL is optimised but it certainly is not the ‘necessary’ condition for these advances to occur.

Adam Smith however was keen to point out that “the division of labour is limited by the extent of the market”. In other words, Smith was of the view that the greater the extent of the market, the greater the prospect of DoL. This would in turn lead to increased productivity. He stressed on the markets because there is a feedback quality to them which by definition point to (through demand) gaps or openings which can be filled. The invisible hand – a term he coined to describe the corrective behaviour of the markets – is key in his advocacy of markets being that optimum place for DoL to flourish. Indeed he quite elegantly points to the urban-rural divide and how, one can spend an entire life in urban areas and not know how to do basic DIY activities. In cities or urban areas, one can always hire an expert at a cost to do this task ably and effectively. This is not the case in rural areas where survival requires – often intimate – knowledge of various aspects of sustenance. That is why there is a vast wealth-gap between rural and urban areas.

A closer examination of this profound idea tells that this is – rather like Darwin’s natural selection – an extremely simple explanation of why and how we are settled the way we are. It explains why most urban areas throughout the world are more likely to be ports – thereby facilitating trade. It explains why historically civilisations were able to enrich themselves beyond the crude militaristic explanations. It explains why some countries are richer (not withstanding colonialism) and some poorer. It is even relevant to the example of the Soviet Union. The reason why the Soviet Union – despite its massive boom at one point – was unable to sustain itself was because of its failure to appreciate the role of markets in DoL. It failed to take advantage of the natural feedback mechanism which a bottom up market-based economy can employ to create more DoL and thereby more wealth. It also allows us to put into proper perspectives the decadence of ‘western aristocrats’ matched by the decadence of ‘African aristocrats’ and how the latter is a far more significant burden on their society as opposed to the former. E.G West, the author of the paper “Adam Smith’s two views on the Division of Labour” contends that if one is to follow through on Smith’s thinking, a contradiction emerges namely; as wealth increases via DoL, the needs and wants of the population are redefined and as such from a sociological point of view begin to diminish as more prosperity begins to take hold of the work force. While it is an apt summary of the Wealth of Nation, West’s extrapolation towards sociological consequences is both exaggerated and unsubstantiated. It is true that, more wealth does indeed create a situation where the needs and wants of society change to a point- where the old satisfactions may not not be enough. However, it is a mistake in that view is to assume that all economic states are fixed and not dynamic. And that is the key mistake in this analysis; because often it is the aversion to negative utility is what drives prosperity and this is what makes Smith’s approach to this question very robust.  In short while lassez faire economics is a concept central to Adam Smith’s thinking; one cannot truly appreciate his final analysis without his discussion on Labour and how that labour is divided in an economy.

Division of Labour (DoL) was central in the origin and use of money. As systems become more complex and difficult to arbitrate, the need for a uniform notational placeholder for value is ever more important. This is where the introduction of money was key, in facilitating more DoL. Many commodities have served as the ‘medium of exchange’ but most nations and societies settled on metals such as gold, silver and bronze as the ideal commodities for this purpose. The reason for that is twofold; firstly because they were durable and portable meaning that they did not depreciate in their own value and were relatively easier to carry around. Secondly they were divisible which meant that even more complex trades of goods and services would be easier to undertake to everyone satisfaction. The ‘divisive’ nature of the metals eventually leads to coinage and currency. To digress briefly, this introduction of coinage meant that the value of metals went down and this ended up benefiting borrowers at the time who were now able to pay back their creditors with lesser valued ‘money’. There are quite solid foundations in the book and elsewhere that suggest that this was a way for the aristocracies to alleviate their own financial burden

Smith saw the advent of money as an important thing, not because it was a more comprehensive store of value but because it facilitated more DoL. It would be easier for people to return the favour in monetary terms as opposed to entering into negotiations over how much different types of labour was worth. This is a counterintuitive development in Smith’s thinking because throughout he has maintained and championed the free bottom up flourishing of trade and markets without influence from above. However, this has led him – with consistency it has to be pointed out – endorsing what is effectively top-down arbitration in terms of money. Perhaps this is an inkling towards the fact that his ideas maybe somewhat different today had he been alive to witness the exponentially more complex economic systems of today. He might have even favoured Keynesian top-down thinking if they facilitated more DoL. In fact he might have been pro-immigration not because it may the means of alleviating some the populations of failing states – compelling though this argument is  – but primarily because that would be good for DoL.

Adam Smith’s discussion of value is also dominated by the concept of labour. He defines the value of commodities by the labour embedded and the labour commanded by those commodities. A paper called ‘Command over Labour – a study in Misinterpretation’ by V.W Bladen contends that many of his ideas were misappropriated in aid of concepts which Adam Smith himself would not be comfortable with. The important thing to remember in these situation is to consult the primary text and Adam Smith’s concept of Value is dominated by Labour. The following extract more than makes this clear;

“What every thing really costs to the man who wants to acquire it, is the toil and trouble of acquiring it. What every thing is really worth to the man who has acquired it, and who wants to dispose of it, or exchange it for something else, is the toil and trouble which it can save to himself, and which it can impose upon other people. That this is really the foundation of the exchangeable value of all things, excepting those which cannot be increased by human industry, is a doctrine of the utmost importance in political economy” (Smith, Wealth of Nations 1776)

Moreover he puts the emphasis of that in ‘primitive societies’ the amount of labour used in producing a good is what determined its value (in exchange). But he did not extrapolate this concept into more advanced economies; he stated that the market price is not representative of the labour cost. He explained this by pointing to the fact that the entire produce of labour ‘does not always belong to the labourer’. He was intimating to the myriad forms of favours other people have to do for him to produce the output (most case being the land owners of course) According to Smith, the value of the good or commodity would reflect that layer of complexity

The emphasis of value is firmly put on to labor in no uncertain terms. This is also evident in his subsequent criticisms of groups of ‘politically aligned’ individuals who use their influence (also known as special interest lobbying in modern parlance) to manipulate the governing bodies to cater for their interests which may not necessarily linked to the interests of the collective economy. In fact this is the key point where his criticism of government involvement begins to take shape. He felt that governments or states  are entities subject to easy manipulations from the interest groups and thus are able to secure unfair subsidies which give them an unfair advantage into proceedings. State-subsidies drew people to the trades that would otherwise be normal, and as a result it would collectively lower their wages. As mentioned before, Smith views labour as the opposite of utility (e.g pain, toil and effort) and value can be seen as a minimization of labor. As a result activities from which one draws pleasure are not quite labour in Smithian terms. They can be partially labour, but not quite in the same sense as he would understand it. And he saw value first and foremost as the amount of labour it can command and embody. The following passage makes this abundantly clear

“People of the same trade seldom meet together, even for merriment and diversion, but the conversation ends in a conspiracy against the public, or in some contrivance to raise prices. It is impossible indeed to prevent such meetings, by any law which either could be executed, or would be consistent with liberty and justice. But though the law cannot hinder people of the same trade from sometimes assembling together, it ought to do nothing to facilitate such assemblies; much less to render them necessary” (Smith, Wealth of Nations 1776)

However his discussion on value does not end at as a mere function of labour (though it is highly significant). He points to the usefulness and utility of a commodity as a chief identifier of value in a commodity. This however proves no more than a good rule of thumb as the diamond-water paradox exemplifies. He articulates this with characteristic eloquence that is very evident in the entire book

“The word VALUE, it is to be observed, has two different meanings, and sometimes expresses the utility of some particular object, and sometimes the power of purchasing other goods which the possession of that object conveys. The one may be called ‘value in use ;’ the other, ‘value in exchange.’ The things which have the greatest value in use have frequently little or no value in exchange; and on the contrary, those which have the greatest value in exchange have frequently little or no value in use. Nothing is more useful than water: but it will purchase scarce any thing; scarce any thing can be had in exchange for it. A diamond, on the contrary, has scarce any value in use; but a very great quantity of other goods may frequently be had in exchange for it.” (Wealth of Nations)

Once again it is his ability to spot the paradoxes in his own ideas which make him a formidable theoretician. A paper entitled “Adam Smith’s approach to the Theory of Value” by H.M.Robertson and W.L Taylore discusses the genesis of Smith’s thinking into this. While there is speculation around the various concepts that existed prior to Smith, the comprehensive nature of Smith analysis is seldom rivalled. Indeed this model of Value as a function of use or utility fails to account for the Water-diamond paradox, however his work in identifying this was key in the development of theory of Marginal Utility Theory by his successors such as Jevons, Menger and Walras. His ideas about Value do not begin and end with a discussion on Use alone. He also defined Value ‘in exchange’ i.e the relative proportion with which a good exchanges for another good. This could also be a discussion of relative prices of goods if money is injected into the analysis. S Kaushil, the author of ‘The Case for Adam Smith’s Value Analysis’ delves deeper into this point. He points that the differences in his definition of values is not of a conceptual nature but rather as a consequence of his cause versus measure analysis. What causes this value and how to measure are two different things; and this is something Smith was mindful and was thoroughly consistent in articulating.

Posted in Economics, History | Tagged , , | 2 Comments

Fishing for “Interesting-ness”: The trouble with Malcolm Gladwell

Malcolm Gladwell (via http://screenplayhowto.com)

If you frequent libraries and bookstores here in Canada, you’ll find that Malcolm Gladwell is almost a ubiquitous presence. You cant miss a copy of ‘Blink’, ‘Outliers’, ‘The Tipping Point’ or ‘What the Dog Saw’. Full disclosure though; I’m not his biggest fan. I think he is guilty of accentuating things beyond what they are, and celebrating patterns and statistics which aren’t necessarily as compelling as he makes them out to be. Outliers is a classic example of this kind of thing (maybe his other books aren’t but I don’t know). So recently a very nerdy friend of mine directed my attention to an article he wrote for the New Yorker (last year) about the Pharmaceutical Industry and the process of developing drugs for Cancer Treatment. It is entitled “The Treatment: Why is it so difficult to develop drugs for cancer”. You can find it here. It was definitely a compelling read.

However, if I’m being honest, it only served to reinforce my opinion of him. I hope I’m not coming across as someone who criticises just for the sake of it, I really do have problems with how he lays out his thinking (and of course I’m happy to be convinced otherwise) For what it’s worth, he does do a good job of describing the accounts of people involved in the Pharmaceutical Process. But that is slightly soured by the fact that in doing so, he does caricature and butcher the process of Science and evidence based medicine. Accurate appraisal of the process gives way to ‘interesting-ness’ (and that too of very cliché kind) which I’m not naturally inclined towards.

So here are some of the things I’m not a fan of;

Single study fishing
Just like you can’t extrapolate lab-data to make grand conclusions, the same thing is true of one single study. That’s what he does when he talks about the ‘discoveries’ of treatments. It is implicit in his description of the process that these treatments were grounded out and shown to work from 1 breakthrough study. Which is not at all how it works. Before drugs get approval they get tested and re- tested, and all studies and their methods (and methodological flaws) are reviewed and controlled for – often when regulatory bodies get a hold of this. This is a key – and I would say driving – part of the process. This is what a systematic meta-analysis is, you look at wide variety of studies and trials and you evaluate them and review them as a composite. And if the results are significantly positive after all of that, then we’re talking.

 “Positivity”

Again the narrative he uses as this ‘mental struggle’ from a group of earnest people (which of course it is and they are) to fight the elements and produce a positive result for their drug, is slightly problematic. Firstly the purpose of evidence-based medicine is to iron out what doesn’t work as much as what does. So negative results  are valuable because they can allow us to eliminate what isn’t effective or perhaps indicate problems with the current thinking. The article seems to dismiss those as a complete waste. (Which they probably are from a commercial point of view) They certainly aren’t from a scientific point of view. And Pharmaceutical companies are keen to push this kind of narrative and Malcolm Gladwell – I’m afraid – has done the standard thing here. It certaily brings a fascinating insight into the finding that Industry Sponsored Drug Trials are more likely to report positive results.

Science Innovation vs Business Innovation:
I think a lot of people conflate innovation of business with innovation of science which are two different things. Science moves incrementally with new themes emerging from a framework of older ones and the key thing is the critical evaluation of the evidence behind the claims and ideas expressed. The ‘disproving of hypothesis’ is a central pillar of it all. And in the article he says that the dream of a scientist is to present a paper and then receive a standing ovation from other academics for discovering breakthrough cures. I think it is really lazy to think that science academia works this way. In reality, academics are really ready to tear strips of the papers that are present and they’ll find flaws. Business world works differently. You won’t get someone like (the late) Steve Jobs prancing about on a stage in an academic conference without people scrutinising every single thing he has to say. I’m not making a value judgment as a less moral modus operandi. I’m merely saying that critical thinking and evaluation is much more important in a science-academic setting than it is in a business setting. And at times, I do feel that innovators in business want the glory of science without necessarily subjecting themselves to the same nitty gritty. If they did It would require them to offer caveats and hedges to every claim they make- something which the business world (Of which pharmaceuticals are a subset of) aren’t prepared to do

 Compelling human interest angle
Often when you are dealing with Cancer or other debilitating diseases, it is very easy to be sidetracked by people’s stories. It is heart-breaking and you feel helpless, you want to do everything you can to defeat this thing which is causing so much pain and suffering to you’re friends and loved ones. I can certainly relate e.g. personally, I’v had relatives battle and eventually lose to it). Sometimes biases creep in if people bring in sentimentality into the science. Of course support-mechanisms for people are vital when they are battling these diseases. But ultimately, while evaluating the science of cancer treatment, you need more than just good intentions – you need solid, replicated, peer reviewed, statistically significant data sets.

Posted in Evidence-Based Medicine, Medicine, Pharmacuetical, Science | Tagged , , | 3 Comments

Embattled Seismologists: Italy’s Trial and Error

Italian Scientists on trial (via cnn.com)

[Disclaimer: Since this article was written, it has come to my attention (from Guardian’s Lay Scientist[1] )that some of the information may have been misrepresented vis a vis the actual charges of the L’Aquila Earthquake trial. Which seemed to be that the Scientists predicted that it definitely won’t happen. This clearly has an implication on how you should read the article. However I still maintain that the main theme of the article which is the claim by Giampaolo Guiliani about being able to predict earthquake is a dodgy basis for judging the merits and demerits of this story. Maybe that the matter is not as black and white as my conclusion will have lead you to believe. Still it is a fascinating topic and some of the information below might be useful – flawed though it may be]

Despite what the headline says, this is NOT an ‘Amanda Knox’ article. However it  is- equally if not more – damaging for the Italian Justice system, as it emerged a few weeks ago that Scientists, some of them members of the “Commissione Grandi Rischi” (Commission for High Risks), and civil protection officials, in Italy are being put on trial [2]for manslaughter. The basis for the indictment is that these people did not provide a short-term alarm to the population after a meeting of the Commission held in L’Aquila six days before the Mw 6.3 earthquake that struck that city killing more than 300 people in April of 2009. This is indeed a bizarre and chilling development in the aftermath of a tragedy. Now, obviously, the spirit of this blog is to try to think through these things as opposed to forming a knee-jerk opinion at the outset. Although at the same time, I have to be honest and say, that it does reek of ‘Scape-goatism’.

So why do these Scientists find themselves with the threat of being in the dock? Well, a Mr Gioacchino Giuliani (who is one of the guests on that AJE program I have linked to above)  has had quite an impact on this story. There was an article [3] on Bad Science last year which dealt with his role in all of this.

Gioacchino Giuliani is a laboratory technician who became convinced that he was able to predict earthquakes by measuring the emission of radon from the ground. He ignored the doubts of seismologists – he has never published his theories or evidence in an academic journal – and invested in several measuring devices to let him make his predictions.

Shortly before the earthquake struck, Giuliani became convinced something serious was coming. He began desperately trying to warn the public, even posting a video on YouTube explaining his theory, and warning people to evacuate their houses urgently. Vans loaded with loudspeakers were driven around the town to spread the warning. Giuliani tried in vain to persuade the mayor that he was right.

But they did not heed this warning: instead, the local government reported him to the police for spreading unnecessary panic and alarm, forced him to remove his warnings from the internet, and forbade him from telling anyone anything about the coming earthquake.

In reality, of course, Giuliani made a lucky guess (and he was out by 55km). Nothing has changed, and there is still no reliable or validated way to predict an earthquake. Because of this, seismologists around the world are united in explaining that the best way to protect your population is not through an impossible early warning system, but rather by investing in preparedness, to mitigate against the damage done by one rare,unpredictable, horrific outcome.

The most important thing to remember is that this guy didn’t go to any scientific journals etc to get his methods peer reviewed. He basically didn’t subject his ideas to the Scientific test. He circumvented that scientific infrastructure and went straight to the press. His initial arrest for doing so was indeed unfortunate. But it shouldn’t detract from the fact that what he essentially did is the standard quack thing. Going to the press and whipping up hysteria about how there is a ‘conspiracy’ by the scientists to keep the genuine earthquake detecting mechanism secret (presumably because they have secretly bought stalks in tents and amenities and they will have an absolute boon after the earthquake or something equally ludicrous) This is a tell-tail sign of bullshittery and is the preserve of AIDs denial-ists, Anti Vaxers, Climate-Denialists and others (As hopefully you will no doubt come across in the future). The key thing in all of this is whether his methods on predicting earthquake were accurate or not? And of course – due to his own actions – we are none the wiser.

Giampaolo Guiliani: Earthquake Predictor

Following that, the narrative of the story now became ‘Scientist withhold/or are negligent about information in L’Aquila earthquake’. And so  they must now face the music. They must bare the responsibility for essentially not being able to predict exactly where the earthquake struck. (Never mind the radon-guy who was also off by 50 km) It is absolutely absurd especially in an age where Science in the public domain is often viewed with suspicion and cynicism. Yet at the same time, the margin of error they have to abide by is almost minuscule. Does this rule apply to journalists when they get things wrong? Or Politicians and government officials? There are plenty of holes in this narrative but in post-tragedy hysteria filled environment, critical thinking tends to be  in short supply

One cant help but be frightened by the air of cynicism involved in all of this. It is actually a Planning and Regulations failure on the part of the authorities. How can you prosecute Seismologists when there is no reliable way of predicting earthquakes anywhere in the world. There is however risk-evaluations that can be done and after that its the authorities that have the final responsibility. Besides if you want your scientists to submit over-precautionary findings than you’ve contaminated the process anyways. It is prejudiced and the results of findings will likely be skewed by that prejudice rendering it scientifically unreliable – and that rather defeats the entire purpose

People will say this is  Italy and therefore one must take everything that comes out of that country with a pinch of salt. But actually this a very widespread problem. It will create a chilling effect for not only Italian Scientists (who make great contributions lets not forget) but also scientists elsewhere, who will now think twice about publishing findings pertaining to the public domain/interest because it is too risky for them personally. And that will be to the detriment of everyone as they are the most reliable source of establishing ‘facts’ about that public interest. Big companies are already in the process of contaminating and prejudicing the peer-review system all around the word (Yes the British Libel laws will come in for a kicking on this blog, you can be sure of that). The press – for their part – try to sensationalize stories which – on closer examination – are no more than irresponsible conjecture. The end result of it all, is messy hodge-podge situation where the only casualty (apart from the victims of course) is the Science and our ability to truly tell the hows and the wheres of the forces of nature.

You can join the protest against this case by clicking on this link [4].

References

Posted in Law, Media & Journalism, Science & Law, Science and Politics, Uncategorized | Tagged , , , | 1 Comment

Eugenie Scott : The Lady who fights Creationism in the US

Eugene Scott at TAM9 (via skepticmoney)

The teaching of Evolution in US High Schools is in many ways a microcosm of the ‘war’ between Science and Religion. And as the work of Eugenie Scott suggests – it is one fraught with legal and political maneuverings.  Science ‘denialism’ will be one of the main themes for many posts on this blog. The intricacies that are involved  and many of the arguments that are put forth by the ‘Intelligent Design’ Crowd (a reincarnation of Creation Science  [1] people) are quite similar to other areas where such type of denialism exists. Be it HIV ‘doesnt cause AIDS’ to Climate Change ‘isnt linked’ to Human activities; the same diversionary tricks, and pseudo-scientific manipulation of data seems to occur. One of the most prominent defenders of the scientific consensus around this issue of Evolution, is Dr Eugenie Scott, who has set up National Center of Science Education NCSE  [2],  specifically to combat political (and religious) forces that undermine this, by pressurizing local school boards and various PR offensives.

This is a classic case of Science finding itself in the thick of a political storm. Here is a branch of science which is perhaps at odds with the cultural and social ‘values’ of people and hence, many are trying to have it discredited. This has its roots in the days of the Scopes trial [3]where a biology teacher in Tennessee decided to brave the institutions, and began to teach the theory of evolution the classroom. The fuss it generated – and owing to America’s secularly-inclined constitution – resulted in the theory becoming part of the high school curriculum.

Opponents of Evolution, campaigned to have it banned from schools but could not find the requisite legal proficiency to challenge it in the courts. So they devised a new strategy, namely presenting themselves as a branch of Science (known as Creation Science [4]). But as their ideas began to be scrutinized, they were being exposed as outright psuedo-science. Here is footage of a TV debate [5] regarding the teaching of Creationism in the Science class called ‘Headlines on Trial’ moderated by Arthur Miller who was a prominent legal figure at the time.

This is Dr. Scott’s first appearance on National TV, and one of the gentlemen sitting on the opposing side is Mr Duane Gish (of the Gish Gallop [6] fame). It also demonstrates how difficult it is to communicate Science in the media (especially when it becomes a ‘news item’)

The Creationists (who later branded themselves as Intelligent Design Proponents) use a whole host of strategies to advertise their agenda. It begins by simply ignoring the evidence suggesting that ‘no transitional fossils have been found‘ [7] when – not withstanding the obvious problems with the term ‘transitional fossils’ (We are all in some sort of transition to something else arent we?)  there is a mountain of such fossils [8] in existence. (I only added the wikipedia article because it is simple demonstration of this evidence. For those skeptical, they can look up the references at the bottom or even search in journals to find the overwhelming fossil-evidence that has been unearthed). Morever, the ‘fossil record’ is a mere luxury, much more precise evidence is secured from DNA comparisons which overwhelmingly come out in support of the theory of evolution.

Another argument is to claim that there are problems with the theory of Evolution. The Discovery Institute  [9](the most prominent Intelligent Design people in America) tell us that there are disagreements on evolution among Scientists. This is a fairly common claim by creationists and demonstrates quite vividly the deep misunderstandings, they have, of the scientific method.  It reeks of people thinking that Science is a about authority figures in lab coats giving us arbitrary truth statements about nature. They are very keen to wheel out people with degrees etc, as if an argument from authority is evidence for a scientific claim – or in their case, a refutation of one.

In reality, Science is a much more fluid and cooperative process. It is about critically evaluating the evidence behind descriptions of natural phenomenon. There are bound to be limits to our understanding, but just because we don’t have infinite knowledge about something DOESNT mean that we have NO knowledge. And if we want to progress scientifically, we need to rid our self from is this fallacy.

The theory of Intelligent Falling?

Without wanting to belabor the point too much, but there is a mountain of evidence from various different fields ranging from Genetics to Geology and even Cosmology that corresponds to the theory of Evolution. It is the basis of Biology and we cant seriously be expected to make advances in Medicine without an understanding of Evolution. Moreover, its implications on other fields such economics, psychology etc are quite significant as it is beautiful manifestation of how Adaptive Systems work and how complexity occurs from simple beginnings. To my mind withholding this, from students constitutes a grave injustice.

This is where Eugenie Scott’s campaign is vitally important. It is not about bashing or pushing back religion but actually standing up for Civil Rights. Kids essentially will have to unlearn things in College that they learnt in High School, all so that politicial or religious interests can be appeased. This is fundamentally immoral and Dr Scott’s work in helping secure victories against ID (famously in Dover Pensylvania[10]) and others needs to be recognized. This article is not about laying the case for Evolution. There is a 150 year Science that has done a rather good job of it already. But it is about what Science means in our society and especially when it comes into conflict with other interest groups.  I’ll finish with a (paraphrased) quote from Eugenie Scott herself (durring an interview she gave to ‘Point of Inquiry‘[11]) which quite succinctly provides the main reason why she is opposed to the study of Creationism in the Science Classroom;

If Intelligent Design was a genuine science, its proponents would present papers to academic journals, be keen to publish their ideas and have them challenged. But no! They do none of that. They just want to jump the queue and have their ideas presented to high school kids without going through the rigourous process that others have to follow.

And if none of this persuades you that Evolution is the most compelling scientific explanation of how we came to be how we are and who we are, then I’m left with no alternative but to deffer to ‘Da Ali G Show’ [12]

References

Posted in Creationsim, Education, Evolution, Intelligent Design, Science, Science and Politics, Science and Religion, Secularrism | Tagged , , , , | Leave a comment