I should probably kick off this blog with some general comments about its motivation and goals. I’ve spent the last three years working on a book about why experts usually end up misleading us. The book, called WRONG, is just coming out now. (You can learn more about it at www.freedman.com.) Although WRONG looks at all sorts of experts and their highly flawed advice, I think the problem that has the most impact on the most people is the way that published medical research runs off the rails. We’re fairly bombarded on a daily basis with the latest medical findings, typically ripped from the pages of prestigious medical journals, and echoed in our most respected mass media publications and shows, telling us which foods and habits will lower our disease risk, what new pills show promise, which genes predict our health fates, and so on. There’s just one little problem: According to scientists themselves, most of these published findings will turn out to be wrong or highly exaggerated. Eating those foods probably won’t help you much, the pills probably won’t work well, the genes probably won’t tell you much. And this turns out to be true not just of what you read in the newspapers or see on TV or on news websites, but also of the work published in our top medical journals. (Journalists tend to make things worse, but we don’t cause the basic problem.) There are many reasons why most published findings turn out to be flawed, which I explore in detail in WRONG, and will be touching on as the need arises in this blog. But for now, let me just state that there is a wealth of consistent and mostly uncontested evidence from highly respected scientists that the published medical research you hear about is on average not trustworthy. (And if like many people you’ve been led to believe that large, randomized controlled trials can generally be trusted, you’ve been misled.)
You generally won’t hear about problems with the credibility of medical research when you’re alerted to new findings in the mass media, because almost no one has an incentive to focus on the problems or tell you about them. Why would most researchers take the trouble in their papers or in their interviews to highlight why their work is probably wrong? Why would most journalists take up space in their articles and time in their on-air reports to discuss why you probably shouldn’t take the reports very seriously? You might think you could count on your doctor to figure out which published findings really ought to be put into practice, but you probably can’t–most doctors don’t have the training, time or inclination to deconstruct the studies they read about in journals in order to spot the potential problems with them.
I’m not a doctor, I’m not a scientist, I’m not an academic researcher. I’m a journalist. I’ve spent a lot of time speaking to, and reading the work of, a lot of highly regarded scientists who study the problems with medical research, and I think I now know a thing or two about these issues. I’d like to share the insights I’ve gained (and the insights of the many scientists I’ll be interviewing for this blog), and help people apply them to the current news about medical findings, so that we can all make better guesses about which of these findings are really likely to improve our health and possibly save our lives, and which of them ought best be regarded with great skepticism. (Sadly, most of them will fall into the latter category.) You, of course, will use your judgment to decide how much you should trust me and this blog and the people I quote in it, as we all should with all the findings and advice and pronouncements that stream at us from so many sources.
I want to make it very clear that I’m not interested in turning anyone away from science and mainstream medicine–far from it. I’m as appalled as anyone by junk science, and I’m not an advocate of alternative medicine (though I respect its placebo effect, as do many mainstream clinicians). I trust my doctor, and believe many if not most scientists to be among society’s heroes, if highly imperfect ones. I believe that science is exactly the right way to get at truth. But we all need to understand just how messy and biased and flawed a process science is, how slowly and rarely it actually manages to close in on the truth, and how it becomes even further distorted when it’s communicated to us through journals and the media.