'More Complicated Than That'

British libel law is so stringent and unforgiving -- so notorious for its tendency to find in favor of the aggrieved party -- that I am reluctant to say much more about it than that. Come to think of it, “stringent and unforgiving” seems a bit harsh. As does “notorious.” No aspersions on the British judicial system are intended; please don’t sue.

Between 2003 and 2011, the epidemiologist Ben Goldacre -- currently a research fellow at the London School of Hygiene and Tropical Medicine -- wrote a column called “Bad Science” for The Guardian as well as a book about shady practices in the reporting of clinical-trial results called Bad Pharma (2012). “Writing about other people’s misdeeds,” he says in the introduction to his new book, I Think You’ll Find It’s a Bit More Complicated Than That, “collecting ever greater numbers of increasingly powerful enemies – and all under British libel law – is like doing pop science with a gun to your head.”

Actually, reporting honest research can have the same menacing consequences. A few of the items in More Complicated Than That – a 400-page collection of Goldacre’s smart and mordant investigative reporting and commentary over the past dozen years – discuss cases of scientists and doctors sued just for going public with an informed opinion, or even lab results. Goldacre’s default mode is a lot more aggressive than that. Examining news and debates in both professional journals and the mass media, he’s constantly exposing unsupported claims, analyzing doctored statistics, and explaining the limitations, as well as the necessity, of the peer-review system. And with a suitably scathing tone, much of the time. No doubt Goldacre’s solicitor keeps very busy

Well before this point in a column, I would normally have provided a link to the press that brought out I Think You’ll Find It’s a Bit More Complicated Than That (here it is) but it may be a while yet the book reaches stores in the United States, where the large majority of Inside Higher Ed readers live. It hit the shelves in England only a few weeks ago. Consider the lag time of Big Pharma: Faber & Faber published the U.S. edition in April, a good two years after it drove the Association of the British Pharmaceutical Industry into damage-control mode. (In early January, the House of Commons Public Accounts Committee issued a report echoing Goldacre’s call for drug companies to increase disclosure in reporting of clinical-trial methods and findings.)

For now, American reader can order the print edition of More Complicated Than That from online bookstores. The ebook is available in England and with some pressure could probably be made available here sooner rather than later.  Frankly, Goldacre deserves a much bigger following than he has in the States, where the need for continuous, accessible public tutoring in statistical literacy and logical thinking (and in how they can be suborned by the unscrupulous) remains every bit keen as in the UK, to put it mildly.

One of Goldacre’s specialties is challenging “science by press release” – cases of the media “cover[ing] a story even though the scientific paper doesn’t exist, assuming it’s around the corner” or rewriting statements “from dodgy organizations as if they were health news.” The blame can hardly be borne by “quacks and hacks” alone, since the “dodgy organizations” sometimes include academic institutions. In 2004, one British university issued a press release on a study showing the wonderful health benefits of “nature’s superdrug,” cod liver oil. It did something or other to cartilage (the details went unelaborated) by means of an enzyme, presumably to be named later.

When more than a year went by without a report to the scientific community, Goldacre contacted the university asking what happened to the paper. He got an evasive though patronizing response (“Mr. Goldacre is quite right in asserting that scientists have to be very certain of their facts before making public statements or publishing data”) from the researchers involved, but no offprint. He would have to be patient, they said.

“In 2014, after being patient for a decade as requested,” he writes in an afternote, Goldacre tried again but received only “a skeletal description [of] a brief conference presentation,” running to four paragraphs. The original press release (which cannot have been written without the cooperation of the scientists, of course) had been 17 paragraphs long. “I’ll try them again in a decade,” Goldacre concludes.

It would be more amusing if not for another essay in which he explains the significance of a study (published in Annals of Internal Medicine in 2009) of 200 press releases selected at random from a pool of “one year’s worth of press releases from twenty medical research centers” at “a mixture of the most eminent universities and the most humble, as measured by their U.S. News & World Report ranking.”

Goldacre notes that half the studies were done on human subjects. But 23 percent of the press releases in that category “didn’t bother to mention the number of participants – it’s hard to imagine anything more basic – and 34 percent failed to quantify their results.”

Forty percent of the press releases on research involving human beings concerned studies “without a control group, small samples of fewer than thirty participants, studies looking at ‘surrogate primary outcomes’ (which might measure a blood-cholesterol level, for example, rather than something concrete like a heart attack) and so on.” While the results would not be as reliable as those of a study with a stronger design – involving randomization, control groups, and more subjects – Goldacre acknowledges that they might nonetheless be of value. But an astonishing 58 percent of the press releases analyzed “lacked the relevant cautions and caveats about the methods used and the results reported.”

O.K., that was quite a lot of numbers just now, and not nearly as entertaining as the pieces in which Goldacre scrutinizes claims about caffeine intake and hallucination (“Drink Coffee, See Dead People”) or explains how make-believe expertise informs public debate (“Politicians Can Define Which Policy Works Best By Using Their Special Magic Politician Beam”) or characterizes a paper in the non-peer-reviewed Elsevier journal Medical Hypotheses (“with a respectable ‘impact factor’… of 1.299”) as “almost surreally crass.”

At his best, Goldacre writes with a combination of Martin Gardner’s knack for science exposition (and pseudoscience demolition) with Christopher Hitchens’s dedication to eviscerating fools gladly (a reliable source of schadenfreude, at least if you agreed with him on who counted as a fool). As the holiday season approaches, anyone with a bright young relative showing an interest in science or medicine – or a leaning toward serious journalism – should consider I Think You’ll Find It’s a Bit More Complicated Than That as a possible gift. Consider it an investment in public intelligence.