You may recall my examination earlier this month of a paper by Johnson and Stricker published in the Journal of Medical Ethics. In my view, it was not a terribly well-argued or coherent example of a paper on medical ethics. Now, judging from an eLetter to the journal from Anne Gershon, the president of the Infectious Diseases Society of America (IDSA), there is reason to question the factual accuracy of that paper, too. The Johnson and Stricker paper promised an exploration of ethical issues around an antitrust investigation launched by the Connecticut Attorney General examining the IDSA’s process for developing guidelines for Lyme disease. In particular, Johnson and Stricker suggested that conflicts of interest led the IDSA panel to improperly exclude “chronic” Lyme disease from their disease definition and treatment guidelines.
It’s true that IDSA has a horse in this race. However, as I noted in my earlier post, so do Johnson and Stricker. And unlike Johnson and Stricker, IDSA president Gershon seems to have a good handle on how to frame coherent and persuasive arguments.
From Gershon’s eLetter:
Category Archives: Methodology
The mechanics of getting fooled: the multiple failures in the fraud of Jan Hendrik Schön.
There’s an interesting article in the Telegraph by Eugenie Samuel Reich looking back at the curious case of Jan Hendrik Schön. In the late ’90s and early ’00s, the Bell Labs physicist was producing a string of impressive discoveries — most of which, it turns out, were fabrications. Reich (who has published a book about Schön, Plastic Fantastic: How the Biggest Fraud in Physics Shook the Scientific World) considers how Schön’s frauds fooled his fellow physicists. Her recounting of the Schön saga suggests clues that should have triggered more careful scrutiny, if not alarm bells.
Of Schön’s early work at Bell Labs, Reich writes:
Evaluating an article in the Journal of Medical Ethics.
At White Coat Underground, PalMD considers an article from the Journal of Medical Ethics. The article (L. Johnson, R. B. Stricker, “Attorney General forces Infectious Diseases Society of America to redo Lyme guidelines due to flawed development process,” Journal of Medical Ethics 2009; 35: 283-288. doi:10.1136/jme.2008.026526) is behind a paywall, but Pal was kind enough to send me a copy.
Pal writes:
I have a strong interest in medical ethics, although I’m not an ethicist myself. Still, I’m generally familiar with the jargon and the writing styles. This piece reads like no ethics article I’ve ever seen. It is basically an advocacy piece for the concept of chronic Lyme disease, and starts from an entire set of problematic assumptions.
I know very little about Lyme disease, and I have no horse in the race in the controversy about whether chronic Lyme disease exists, if so what it is, and how it might be treated.
I am, however, an ethicist with a strong interest in ethical issues connected to the building and use of scientific knowledge. So I told Pal I’d have a look at the article.
Here’s the abstract:
Researchers talking to journalists should assume the public might be listening.
In the wake of some recent deaths in Edmonton of teenagers who took Ecstasy, DrugMonkey gets irritated with a doctor who made some proclamation to the press:
Fake journals versus bad journals.
By email, following on the heels of my post about the Merck-commissioned, Elsevier-published fake journal Australasian Journal of Bone and Joint Medicine, a reader asked whether the Journal of American Physicians and Surgeons (JPandS) also counts as a fake journal.
I have the distinct impression that folks around these parts do not hold JPandS in high esteem. However, it seems like there’s an important distinction between a fake journal and a bad one.
Sniffing out bias in a sea of industry research funding.
One arena in which members of the public seem to understand their interest in good and unbiased scientific research is drug testing. Yet a significant portion of the research on new drugs and their use in treating patients is funded by drug manufacturers — parties that have an interest in more than just generating objective results to scientific questions. Given how much money goes to fund scientific research in which the public has a profound interest, how can we tell which reports of scientific research findings are biased?
This is the question taken up by Bruce M. Psaty in a Commentary in the Journal of the American Medical Association [1]. Our first inclination in distinguishing biased reports from unbiased ones might be to look at the magnitude of the goodies one is getting from one’s private funders. But Psaty draws on his own experience to suggest that bias is a more complicated phenomenon.
Circumstances under which it is OK for scientists to pull numbers out of thin air?
Some commenters on my last post seem to be of the view that it is perfectly fine for scientists to pull numbers out of thin air to bolster their claims, at least under some circumstances.
I think it’s a fair question to ask: In which circumstances are you comfortable giving scientists the go-ahead to make up their numbers?
A habit that never ceases to amaze me.
When scientists make claims with numbers they have clearly pulled out of thin air. For example:
Book review: Everyday Practice of Science.
Everyday Practice of Science: Where Intuition and Passion Meet Objectivity and Logic.
by Frederick Grinnell
Oxford University Press
2009
Scientists are not usually shy when it comes to voicing their frustration about the public’s understanding of how science works, or about the deficits in that understanding. Some lay this at the feet of an educational system that makes it too easy for students to opt out of science coursework, while others blame the dearth of science coverage in our mass media.
Rather than casting about for a villain, cell biologist Frederick Grinnell has written a book that aims to help the non-scientist understand what scientific practice looks — and feels — like to the scientists. This description of scientific activity connects the dry textbook accounts of scientific method to the vibrant, messy, frustrating yet invigorating terrain scientists inhabit as they try to build new knowledge. Grinnell’s book also connects the scientists’ world to the vibrant, messy, frustrating yet invigorating world they share with non-scientists as he considers ethical and societal dimensions of scientific practice.
Alternative medicine, scientific research, and a clash of world views.
Orac takes issue with a pair of posts I wrote yesterday about the National Center on Complementary and Alternative Medicine (NCCAM). I gather he thinks I’ve been far too trusting as far as the information provided on the NCCAM website, and that I’m misrepresenting the issues the critics of NCCAM have with the center. If my posts communicated that they were giving the straight dope on NCCAM and the objections to it, then I blew it; that wasn’t at all what was intended. Rather, I wanted to have a look at the ethical issues that arise from such an official effort to examine medical treatments that are not part of the mainstream, and to start to tease out how these might be connected to broader issues around the interactions between scientifically grounded health care providers and patients who are not adherents to scientific ways of thinking.
Here, let me reiterate that I am not an expert on NCCAM or the movement to get broad acceptance for alternative medical treatments. Rather, I’m trying to understand the political battles in terms of the divergent ways of understanding the world driving the participants in these battles.
With that in mind, some specific responses to Orac’s post: