Dowsing for IEDs

So unbelievably fucking disgusting it makes my skin crawl. The Halliburton of woo. Not entirely unlike the use of pointless lie detectors by the British government only this time it leads to lots of people dying - arrogant and ignorant morons in power will never cease to piss away millions of pounds on magic beans because they sound cool.

Tedious psychological turf wars

Richard Bentall has a new book out so it was only a matter of time before he made his way into the British press. I don't have time for an indepth critique but here's a few selected highlights:

"Many studies have also reported an association between trauma in early life and psychosis. These effects are large: one recent study estimated that individuals who had been sexually abused in childhood were 12 times more likely than others to suffer from serious mental illness, and another calculated that the population-attributable risk of a diagnosis of schizophrenia associated with an inner-city childhood was 15% (that is, there would be 15% fewer cases if we all grew up in the countryside). The risk associated with having a parent with the diagnosis is 7% (ie, there would be 7% fewer cases if patients stopped having children)."(my emphasis)

Note that what this segment subtly doesn't point out is that the evidence suggests that schizophrenia in particular isn't actually associated with childhood abuse (unlike, say, depression).

The whole piece is a depressing blow in a pointless academic turf war where psychologists seek to undermine 'biological' psychiatric research (which, is to some extent justified) only to posit even weaker little barely-theories to replace it:

These effects are understandable in the light of psychological research. For example, early trauma seems to disrupt the process by which we distinguish between our own thoughts and our perceptions, leading to a specific risk of hallucinations. Disruption of early relationships with caregivers, coupled with victimisation, create a tendency to mistrust others and to anticipate threats, leading to paranoid delusions.(my emphasis)

I mean, seriously, what is the highlighted sentence even supposed to be telling us? That there is an association between trauma and hallucination? But he's just told us that, what does 'psychological research' tell us on top of that? What are the useful therapeutic insights that this research igives us?

To date, about 30 trials of cognitive therapy for psychosis have been completed; by comparison, in the period 2001-3, nearly 400 drug trials were published in the five leading American psychiatric journals. There is therefore an urgent need to develop a less drug-based, more person-centred approach to understanding and treating mental illness, which builds on the recent scientific findings and which takes the experiences of patients seriously.

CBT is similarly effective to antidepressants (but of little use in psychosis compared to anti-psychotics) but if psychologists think the recent success of psychological therapies supports their approach then they are going to have to look very hard at why their therapies are little better (and often worse) than the 'biological' therapies they seek to undermine.

The problem wth Bentall (and I've read Madness Explained) is that he makes valid but somewhat overstated arguments against things like psychiatric labels or the efficacy of psychoactive drugs but then thinks that he has somehow completely demolished existing medical understanding of mental illness and its treatment (rather than having slightly deflated its claims) and then goes on to make 'psychological' theories that are often much worse supported that the 'biological' theories he has just tried to undermine and also to present them as radically opposed to existing understanding rather than being complementary (which is what they are).

This is really just a slightly more sophisticated vesion of Oliver James - if mental illness doesn't have a genetic component then drugs don't work, if mental illness is associated with childhood abuse then we need psychological therapies. That mental illness is probably both partly genetic and partly associated with envronmental factors including childhood abuse (a) tells us nothing about whether drugs or therapy work, and (b) that the evidence tells us that both drugs and therapy work (depending on the diagnosis) is just too complex and nuanced for this pathetic dick-swinging Sunday supplement debate.

Dr Simon Jenkins

Dr Jenkins shares his well informed views of how trivial swine 'flu is:

...a condition correctly diagnosed by a Dulwich 12-year-old during the initial outburst of hysteria in May as "like a cold"

...the one thing not to take is Tamiflu...People should take an aspirin.

After all, who are you going to trust, doctors and scientists who have dedicated their lives to studying and treating disease, trying their best to plan and advise based on incomplete information, or some bloke in the pub?

If swine 'flu turns out to kill a lot of people this Autumn* then Jenkins should really be forced to confront his words***. Of course, it probably won't, further inflating his dick swinging braggadocio, until we finally do get a pandemic viral illness (which we will eventually) - when he'll be clamouring to know why more wasn't done**. Ah, the privilege of consequence free comment pieces, the life of a journalist is so easy - you get to feel so important while doing fuck all. Reminds me a little of the greatest intellectual struggle of our time.

EDIT: Heh, Gimpy got there first, pointing out that aspirin shouldn't be used in children, although there are plenty of other errors tackled in the comments to Jenkins's article. Also jonnyhead covers it and the Times's Mark Henderson.


* I really hope it doesn't, not least because it'll mean I have to deal with the consequences at work as everyone in the NHS goes off sick or to look after their children, leaving me with a massive workload and lots of really sick patients trying their hardest to infect me.

** And, I'd be willing to bet, making demands that health workers and/or other people (e.g. patients or healthy people depending on whether he's caught it) risk their own health to preserve his.

*** According to Gimpy, it would appear he's already been wrong about another viral epidemic - so it looks like it probably wouldn't bother him. Here's Jenkins on AIDS/HIV:

"Aids has been confined largely to homosexuals and drug abusers, whose activities put them at risk of blood contamination and leave them vulnerable to lethal disease. There are some Aids cases outside the “high-risk” groups, but numbers are tiny: 60 at most in Britain. As far as Britain is concerned, the plague appears to be passing."

'New Vegetarianism'

I was all ready to make the above joke after reading this article:

The worst thing about not eating meat isn't the limp salads - it's the other vegetarians

But I was beaten to it by the second comment:

"New Vegetarianists" are so shrill.

NICE infiltrated by Berties

As they say on teh interwebs, quoted for truth:

First the MHRA lets down the public by allowing deceptive labelling of sugar pills (see here, and this this blog). Now it is the turn of NICE to betray its own principles.
...
If NICE does not reconsider this guidance, it is hard to see how it can be taken seriously in the future...

David Colquhoun on NICE, low back pain, and the Woo-sters here, here, and here.

I think D^2 has an interesting, but ultimately flawed take on it:

Similarly, in the early days of the evidence-based medicine movement, when they were the Young Turks or punk rockers, shaking up a complacent medical establishment that had got out of touch with the cutting edge of medical research, they had the potential to do a lot of good. But now they are the establishment, and as a result of that, the very evidence that they rely on, is shaped by the fact that it needs to appeal to them. The fact that a movement which begun by trying to bring science back into medicine, has now ended up putting its imprimateur on some obvious pseudoscience, ought to worry us more than it does, because this is only the most obvious manifestation of the general problem.

I think he is wrong here, in fact I'm not even sure exactly what he's trying to say is the institutional weakness of Evidence Based Medicine - the strength of EBM is that it has relatively objective and impartial methods to decide questions like this - which is why this failure to adhere to those standards has caused such outrage.

Also, see the guy in the comments lamenting that these EBM enthusiasts have no way to combine data from multiple trials and other misapprehensions.

Simon Singh

Simon Singh is to appeal and fight on against the ridiculous libel action brought by the British Chiropractic Association for his article accusing them of promoting 'bogus' treatments. I urge you to sign the petition about this abuse of the overly harsh libel laws of England & Wales:

We the undersigned believe that it is inappropriate to use the English libel laws to silence critical discussion of medical practice and scientific evidence.

The British Chiropractic Association has sued Simon Singh for libel. The scientific community would have preferred that it had defended its position about chiropractic for various children's ailments through an open discussion of the peer reviewed medical literature or through debate in the mainstream media.

Singh holds that chiropractic treatments for asthma, ear infections and other infant conditions are not evidence-based. Where medical claims to cure or treat do not appear to be supported by evidence, we should be able to criticise assertions robustly and the public should have access to these views.

English libel law, though, can serve to punish this kind of scrutiny and can severely curtail the right to free speech on a matter of public interest. It is already widely recognised that the law is weighted heavily against writers: among other things, the costs are so high that few defendants can afford to make their case. The ease and success of bringing cases under the English law, including against overseas writers, has led to London being viewed as the "libel capital" of the world.

Freedom to criticise and question in strong terms and without malice is the cornerstone of scientific argument and debate, whether in peer-reviewed journals, on websites or in newspapers, which have a right of reply for complainants. However, the libel laws and cases such as BCA v Singh have a chilling effect, which deters scientists, journalists and science writers from engaging in important disputes about the evidential base supporting products and practices. The libel laws discourage argument and debate and merely encourage the use of the courts to silence critics.

The English law of libel has no place in scientific disputes about evidence; the BCA should discuss the evidence outside of a courtroom. Moreover, the BCA v Singh case shows a wider problem: we urgently need a full review of the way that English libel law affects discussions about scientific and medical evidence.

Putting any reservations I might have about SaS to one side, this is an important fight - libel law should not be used to shut down scientific disagreements.

Atheists: No God, just whining

This is amusing reading:

"I can't stand atheists – but it's not because they don't believe in God. It's because they're crashing bores...and their fixation with the fine points of Christianity.

The problem with atheists – and what makes them such excruciating snoozes – is that few of them are interested in making serious metaphysical or epistemological arguments...

What primarily seems to motivate atheists isn't rationalism but anger – anger...So, atheists, how about losing the tired sarcasm and boring self-pity and engaging believers seriously?"