Junk science, junk journalism

[Guest guest]

By RegushABCNEWS.comJunk science, junk journalism, junk opinion, junk thinking. Quite a week for garbage pickup. And therefore yet another occasion to demand a high-profile public debate, but more on that later. The junk science I’m referring to is displayed well in the new Institute of Medicine report on breast implants. The media zoo that followed represents the worst in medical reporting I’ve seen in years. And the so-called experts who stood up for the report should be the envy of junkyard dealers everywhere. All in all, it was a rough day for the many women who have attributed their illnesses to breast implants. They were trashed by junk thinking. Which, of course, immediately transports me to the front page of The New York Times, where, on Monday, reporter Kolata scooped the world with her rendition of the institute panel’s report on breast implants. Junior ReporterWe learned at the top of her story that an independent panel of scientists had concluded that silicone breast implants do not cause serious illness. The panel, however, did point to the tendency of the implants to rupture or deflate, and to lead to infection, hardening and scarring of breast tissue. Well, hurrah for Kolata. She got right what the panel concluded. But as any junior reporter should know, and a so-called “newspaper of record” should expect from its reporters, a few probing questions about the nature of the science underlying the panel’s report might be appropriate. In fact, an editorial in the Times the next day at least suggests that the conclusions reached by the panel represented the available science and that new studies might put a different face on implant problems. And it mentions that a long-term National Cancer Institute study under way might be important in resolving the controversy. Where’s the Harm?One mistake in Kolata’s report is that she doesn’t make a distinction between proof of harm and proof of safety. Just because the available studies suggest there’s a lack of evidence of serious illness linked to the implants doesn’t mean the implants are safe. Kolata should know by now (after many years of science reporting) that in this country the onus is on the manufacturers to prove safety. And this usually means quality, long-term studies with large populations. Kolata should have informed her readers that the overall science surrounding breast implants has been inadequate and highly contentious. But maybe she just doesn’t get it. The sad fact is that the type of available science to date on breast implants wouldn’t qualify as strong evidence for the safety of any prescription drug or medical device on the market today. Because implant manufacturers didn’t bother to do appropriate research before doctors started performing breast-enhancement or reconstructive surgery, science has been playing catch-up. Usually when this happens, the data are controversial because the companies fund the studies, and they’re done quickly and often with small numbers of subjects. Junkyard DoggingThis is what I term “junk science.” It is science that is geared to support points of view. It is highly politicized science. And because junk science doesn’t prove safety, then so what? The IOM panel should have adopted this “so what?” attitude. Instead, it reviewed the available science as though it truly meant a lot. It doesn’t. The panel should have concluded that women with breast implants got a raw deal from the start and are still getting a raw deal because the required standards for evidence of safety haven’t been adequately fulfilled. And that until that evidence is in, we should adopt the cautionary principle and continue to view the relationship between serious illness and implants as a plausible hypothesis. This also means that any science showing a link between implants and serious disease has to be taken, at the very least, as hypothesis-generating. The truth won’t be known until good and verifiable evidence becomes available. Angell EyesNaturally, this complex kind of issue gets muddied by junk media. I have the impression that Kolata’s dismally incomplete article served as a staging site for much of the reporting that has gone on this week. Junk in, junk out. And then the so-called experts come on board, including The New England Journal of Medicine’s Dr. Marcia Angell. This is someone who makes a very big deal of the studies that have been done, including several published in her own journal. Angell is convinced that the available science showing there is no link between serious disease and implants is A-OK. Well, Doc, let’s do this: let’s you and I debate this issue publicly. The two of us. Face to face. Let’s examine the science and the concepts of harm and safety. You put your medical reputation on the line and I’ll put my reporting reputation on the line. Let’s find the proper venue and ABCNEWS.com will videocast the debate live for the world to see and hear. Do you have what it takes to fence with a science writer who has covered the breast implant story all the way back to the early 1980s? I think not. Dr. Munoz Rises to the ChallengeIn this vein, I’m extremely pleased to announce that Dr. Rodrigo Munoz of the American Psychiatric Association has agreed to debate me on the issue of antidepressant drugs and children. This debate will likely take place at APA meetings in New Orleans in October and will be videocast by ABCNEWS.com. If the APA takes me seriously enough to agree to a debate, then there shouldn’t be any reason for Angell to ignore my challenge. But if Angell should feel a tad inadequate to the task, then I’ll even encourage her to tag team with Kolata of The New York Times. I’m still waiting to hear from the discoverers of the hepatitis C virus about my challenge to debate them on their so-called virus, which they have not come close to proving actually exists. I’m beginning to wonder if they too have deep-rooted doubts about their “discovery.”