A recent study, presented as a poster at the American Stroke Association International Stroke Conference, found a 61% increase in risk of stroke and cardiovascular disease among survey respondents who reported drinking diet soda compared to those who drank no soda.  The study has resulted in a round of reporting from the media, and in turn I have received many questions about the study.

Frequent readers of this blog should have no problem seeing the potential flaws in such a study. First – it is an observational study based upon self-reporting. At best such a study could show correlation, but by itself cannot build a convincing case for causation. Perhaps people who are at higher risk of cardiovascular disease and stroke, for whatever reason, are more likely to choose diet sodas because they are trying to avoid unnecessary calories. Questions that should immediately come to mind – what factors were controlled for and how was the information gathered? According to an ABC report:

The researchers used data obtained though the multi-ethnic, population-based Northern Manhattan Study to examine risk factors for stroke, heart attack and other vascular events such as blood clots in the limbs. While 901 participants reported drinking no soda at the start of the study, 163 said they drank one or more diet sodas per day.

The study also controlled for “smoking, physical activity, alcohol consumption and calories consumed per day.”

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Brian Deer is the investigative journalist who has spent years building a case that Andrew Wakefield’s original Lancet paper alleging a connection between the MMR vaccine and an autism-GI disorder syndrome was not only bad science, it was fraud motivated by greed. In part two of his BMJ series detailing the results of his investigation, Deer follows the money, showing that Wakefield stood to make millions from a monovalent replacement vaccine as well as testing for his proposed new GI disorder. For those interested in the details – read the BMJ article. In short Deer builds a convincing case that Wakefield created a fraudulent study designed to generate fear regarding the MMR vaccine that he would then exploit to make millions. Meanwhile he was also paid over a million dollars by trial lawyers to build a case against the MMR vaccine.

What I want to write about today is a recent blog post by Brian Deer in which he accuses the medical establishment of circling the wagons (at least initially) around Wakefield. Deer specifically cites Ben Goldacre and Paul Offit as examples of physicians who were unwilling to accuse Wakefield of fraud. Deer writes:

But a Philadelphia-based commentator was not impressed by the BMJ’s intervention. “It doesn’t matter that [Wakefield] was fraudulent,” Dr Paul Offit, a vaccine inventor and author in Pennsylvania, was quoted in the Philadelphia Inquirer the next day as saying. “It only matters that he was wrong.”

I wasn’t surprised. From his establishment vantage-point, this was the third time Dr Offit had popped up to opine on the issue. Twice previously he’d been quoted as saying that my findings were “irrelevant” (although he’d been happy enough to use them in his books). Science had spoken, his argument went. There was no link between the vaccine and autism. It was experts like him who should rule on this matter, he seemed to imply, not some oik reporter nailing the guilty men.

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You may remember The Skeptologists – a TV pilot featuring a group of skeptical investigators taking on a range of pseudoscientific claims. Well – that project is not over, although it has morphed a bit. The working title of the show is now The Edge. And, rather than try to get a commercial TV executive to bite on the idea, the producers (Brian Dunning and Ryan Johnson) are trying to get a grant to produce a season for public television. It’s still an uphill battle, but they are making progress. Phil Plait has moved on with his Discovery Channel contract, including Phil Plait’s Bad Universe. So, Pamela Gay has stepped in to fill his role on the show.

Pamela is also helping with the grant – and she has asked for help. She needs to show that there is demand for the kind of content we aim to produce, and this is where you (potentially) come in.

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File this one under – massive and unjustified speculation based upon limited data.

There are multiple news reports of a recent study looking at mummies to see if there is any evidence of cancer. The results:

Professor Rosalie David, a biomedical Egyptologist at the University of Manchester, and a colleague, Professor Michael Zimmerman, searched for evidence of cancer in hundreds of mummies, fossils, and ancient medical texts. One might say that the silence was deafening.

This was an interesting study in medical forensics, but I do not think it is so obvious how to interpret it. The spin in the media is this:

The mummies don’t lie. David concluded that their findings, “along with other data from across the millennia, has given modern society a clear message—cancer is man made and something that we can and should address.”

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In an SGU interview with Christopher Hitchens he commented that journalists tend to have a limited pallet of story themes from which they choose, and then they conform the story to the chosen theme. Stories always need to be about something, such as corporate greed or government malfeasance, so that is the story that is told – regardless of the pesky facts.

Bad science journalism works that way also. That is why we can joke about common cliches, such as “Missing Link Discovered,” “Scientists Baffled,” and “It turns out everything we thought we knew was wrong.”

One such science journalism meme is the “Elixir of Life” – a scientific “breakthrough” (there are no advances, only breakthroughs) that offers the hope of extended life or a panacea of sorts. These stories often follow another theme – taking an esoteric bit of research that is very preliminary and/or has very narrow implications, and then pulling from that research the most extreme speculative future application. That is why every basic life-science “breakthrough” could “potentially lead to a cure.”

To make matters worse, science press releases are increasingly engaging in this kind of rhetoric, and there seems to be a proliferation of lazy science journalists who are happy to pass along these press releases without further investigation.

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Several months ago I was interviewed by 20/20 for a follow up news report on Desiree Jennings – the cheerleader who claims to have acquired severe dystonia from a flu shot – and that show just aired on Friday. I have been following this case as the core claim is neurological and has been grossly misrepresented in the media.

20/20 did a fair job, but it’s hard for me to tell what impression the average viewer will come away with. The first 2/3 of the story was presented from a credulous point of view – essentially just telling Jennings’ story without any hint of skepticism. But then the editorial tone flips, and they give the “other side.” They did a fair job in this section of the segment, and my point of view was reasonably represented. And then at the end they leave the audience with the question – real or fake? Not the best format from a scientific point of view, but it could have been worse.

To summarize the story, Jennings, who was 28 at the time, received a flu shot in August of 2009, after which she started to develop dramatic neurological symptoms including shaking and difficulty speaking. Her story was picked up by a local news station, and from their it was picked up by Inside Edition and became a national story. Jennings spread a considerable amount of unwarranted fear about the flu vaccine, aided by a credulous media who failed to do even basic vetting of her story. In an ideal world, the original reporters would have showed their video to an actual neurologist and the story would have been nipped in the bud right there. But that’s not he world we live in.

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Last night Frontline aired a show called The Vaccine Wars. You can watch the full episode online here. Overall, they did a good job of representing the current state of the science, and the anti-scientific nature of the anti-vaccine movement.

The overall theme of the piece was that anti-vaccine parents are irresponsible and go against the science. In fact, their view are immune to science, as they dismiss the evidence which contradicts their position, and constantly shift the goalposts when evidence goes against a link between vaccines and autism.

The piece did cut some corners on details, but probably will only be noticed by someone steeped in the anti-vaccine movement.

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Dr. Larry Dossey, author of The Power of Premonitions, has the audacity to educate us about the scientific method, appropriately enough in perhaps the most prominent anti-scientific venue on the web, the Huffington Post. He starts off with a horrid straw man quoted from Jeremy Rifkin:

The scientific observer is never a participant in the reality he or she observes, but only a voyeur. As for the world he or she observes, it is a cold, uncaring place, devoid of awe, compassion or sense of purpose. Even life itself is made lifeless to better dissect its component parts. We are left with a purely material world, which is quantifiable but without quality … The scientific method is at odds with virtually everything we know about our own nature and the nature of the world. It denies the relational aspect of reality, prohibits participation and makes no room for empathic imagination. Students in effect are asked to become aliens in the world.

This is a Hollywood level cardboard stereotype. It certainly does not resemble what I have experienced as science or scientists. Without getting too much into this side point, Rifkin himself is a controversial figure in the scientific world. He is an economist, not a scientist, and just to give you a flavor of his reputation, Stephen J. Gould once wrote about his work that it was, “a cleverly constructed tract of anti-intellectual propaganda masquerading as scholarship.”

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I have been following the libel case by the British Chiropractic Association against Simon Singh on this blog, so it is a pleasure to report that the BCA has dropped their case – Simon Singh has won. The Guardian reports that the BCA filed a discontinuation with the court yesterday.

Congratulations to Simon – this is a huge victory. It comes on the heals of him winning his appeal regarding the defintion of “bogus” and whether or not his statements were commentary or fact. Simon won the ability to defend his statements as opinion, which doomed BCAs case, so it is no surprise they are now dropping the case.

What remains to be seen is how much money Simon can recoup from the BCA for legal costs. Even in a best case scenario, he stands to lose a lot of money and two years of his life fighting this case.

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The anti-vaccine movement, as is probably typical for ideological movements, has natural enemies and allies. Once the notion that mercury in the form of thimerosal in vaccines might be responsible for neurodevelopmental disorders (it’s not) became popular in the anti-vaccine crowd, this made them natural allies with the “mercury-militia” – those who blame environmental mercury for a host of ills. The fact that some anti-vaccinationists seek to provide their children on the autism spectrum with unconventional biological treatments, based on their disproved “toxin” hypothesis, made them natural allies with the alternative medicine community. Both seek freedom from pesky regulation, and rail against the perceived deficiencies of science-based medicine.

Another ideological alliance is brewing – that between the anti-vaccine movement and extreme environmentalists. This post is not a commentary on environmentalism, and please do not take it as such – the purposes and claims of the two movements are quite distinct. But they share a common thread: distrust of scientific experts and government regulators who reassure the public that environmental exposures are safe.

Robert F. Kennedy Jr. has been the most prominent environmentalist to take up the anti-vaccine cause, in several articles and speeches. While he appears to be only a part-time anti-vaccinationist, his celebrity and street cred among environmentalists lend a great deal of weight to his paranoid musings about scientific fraud and government cover ups. It seems he wants to recapitulate the moral clarity that his uncles displayed in the 1960s, defending the little guy against abuses by the powerful and privileged. He is ready to see a conspiracy, and he wants to be the crusader for environmental justice – and if kids are the alleged victims, all the better. His article in the Huffington Post – “Attack on Mothers,” says it all.

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