Weekend Reading

The weekend is nearly upon us. Here’s some recommended reading.

With Vaccines, Bill Gates Changes The World Again – Matthew Herper of Forbes magazine crafts an insightful profile of Bill Gates and his new work, using vaccines to improve the lives of millions:

To deliver pneumococcal and rotavirus vaccines to 250 million children, GAVI raised more than $3 billion from various governments, including the U.K., Norway and the U.S., and Gates kicked in the final $1 billion to make it all work. The results have been equally massive: 3.4 million lives saved from hepatitis B, which causes liver cancer, 1.2 million lives from measles, 560,000 from the Hib bacteria, 474,000 from whooping cough, 140,000 from yellow fever and 30,000 from polio. In the past year the new initiatives have prevented another 8,000 deaths from pneumonia and 1,000 from diarrhea.

I Flu Delta -The National Vaccine Information Center, an antivaccine organization, is running antivaccine advertisements, inflight, on Delta Airlines. The advertisement (viewable online) downplays the seriousness of influenza and encourages visits to the NVIC website, which is rife with demonstrably false statements about vaccine safety and efficacy. More at Respectful Insolence. Take a few minutes to send a message to Delta about the veracity of NVIC’s claims.

Q&A: Edzard Ernst on alternative medicine - A great interview with physican Edzard Ernst, coauthor of a book I highly recommend, Trick or Treatment. There are two exchanges here that resonated with me:

Q: A lot of people use acupuncture, yet high-level studies show that sham acupuncture is just as good as ‘real’ acupuncture. What does this tell us?

A: It shows how important the placebo effect can be, particularly if expectations are high. But we do not need bogus treatments to benefit from a placebo response. Any effective therapy also comes with a free placebo effect in addition to its specific therapeutic effects, as long as it is administered with compassion and empathy.

Q: What do you say to people who argue that conventional medicine kills more people than alternative medicine and that the latter is even more dangerous, so we should focus on this threat to public health?

A: I say it’s true but misses the point. Treatments must be judged by their risk-benefit balance. If a therapy causes some harm but, at the same time, saves thousands of lives, it still might be worth considering. Very few alternative medicines generate a lot of benefit. This means even small risks can affect the risk-benefit balance significantly.

The interview is conducted by Julia Belluz, author of the science-advocacy blog Science-ish.

DIY statistical analysis: experience the thrill of touching real data - Ben Goldacre’s weekly column in The Guardian is a must-read for me, and last week’s column, on cancer rates, funnel plots, and and the Poisson distribution was excellent. Highly recommended.

New edition of “Testing Treatments”, best pop science book on Evidence Based Medicine ever – Also from Ben Goldacre, a link to a free download of a book he describes as follows:

There are many reasons to read this book. At the simplest level, it will help you make your own decisions about your own health in a much more informed way. If you work in medicine, the chapters that follow will probably stand head and shoulders above any teaching you had in evidence-based medicine. At the population level, if more people understand how to make fair comparisons, and see whether one intervention is better than another, then as the authors argue, instead of sometimes fearing research, the public might actively campaign to be more involved in reducing uncertainties about the treatments that matter to them.
But there is one final reason to read this book, to learn the tricks of our trade, and that reason has nothing to do with practicality: the plain fact is, this stuff is interesting, and beautiful, and clever. And in this book it’s explained better than anywhere else I’ve ever seen, because of the experience, knowledge, and empathy of the people who wrote it.
Testing Treatments brings a human focus to real world questions. Medicine is about human suffering, and death, but also human frailty in decision makers and researchers: and this is captured here, in the personal stories and doubts of researchers, their motivations, concerns, and their shifts of opinion. It’s rare for this side of science to be made accessible to the public, and the authors move freely, from serious academic papers to the more ephemeral corners of medical literature, finding unguarded pearls from the discussion threads beneath academic papers, commentaries, autobiographies, and casual asides.

Huffington Post: Irresponsible mouthpiece for the World of Woo – If you’re looking for science misinformation, look no further than the Huffington Post. After a simply atrocious piece appeared in the HuffPo (“6 Medical Myths Even Your Doctor May Still Believe”) I was thrilled when Emily Willingham took it on and eviscerated it. An excerpt:

Huffington Post is notorious for publishing anti-science garbage. But I don’t think anything they’ve vomited into the Webosphere is as egregiously misleading and anti-scientific as this piece by one Robert A. Kornfeld in which he purports to let us all know exactly why your physician’s belief in the efficacy of modern medicine is a myth and in which he exposes an ignorance about genetics so profound that I may lose hope in humanity.

Science, Before Your Very Eyes! – Not a reading activity, but an event: Next week, the Lorne Trottier Public Science Symposium Series takes place in Montreal. A free event, this year’s theme is “Alternative Medicine Under the Microscope” and features Science-Based Medicine’s Harriet Hall, physician and author Paul Offit, author of the recommended book Autism’s False Prophets, as well as Edzard Ernst, profile above. If you can get to McGill University on November 7/8, it looks like a fantastic event.

Photo from flickr user Kevin McShane used under a CC licence.

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