The unbearable uncertainties

Conflict of interest is a real problem in the scientific community.  It looms the largest over medical research, where published studies slide straight from the journal into your doctor’s office.

We hope that science progresses like this:

  1. Someone does a study and proposes a theory
  2. Other scientists read the study and think about it
  3. Other labs try to repeat the experiment and get the same results
  4. Other researchers come up with alternative theories and test those
  5. A consensus in the community is reached
  6. The theory becomes practice

For many reasons, though, medical research often skips steps 2-5.  When you’re looking for a cure, when your patient is asking questions, yesterday is not soon enough for an answer.  As soon as a promising study suggests a treatment, doctors and their patients want to try it.

And when science is silent, patients and parents take matters into their own hands.  The October issue of Scientific American ran a fascinating and sad article Desperate for an Autism Cure about parents of autistic children experimenting with their own therapies.

But there’s no need to turn to unsubstantiated claims for bad advice.  Medical journals publish studies every day suggesting treatments, cures, therapies, and drugs that may or may not be effective.  The short loop of study leading directly to treatment, or at least to medical advice, makes the problem of bad science much worse in medical research.

Suppose that the study is wrong?  Suppose the researchers were biased by the drug company that funds their work?  Suppose their findings were published because the journal wanted something interesting, something new, something heretical on their front page?

Dr. John Ioannidis does suppose these things, and he proves them, too.  There’s a great article about him and his team in the November 2010 Atlantic.  Consider the excerpt below:

He and his team have shown, again and again, and in many different ways, that much of what biomedical researchers conclude in published studies—conclusions that doctors keep in mind when they prescribe antibiotics or blood-pressure medication, or when they advise us to consume more fiber or less meat, or when they recommend surgery for heart disease or back pain—is misleading, exaggerated, and often flat-out wrong. He charges that as much as 90 percent of the published medical information that doctors rely on is flawed.

Despite the depressing topic, this article is well-written, engaging, and definitely worth your while.  It examines the different ways that bias can enter medical research and explains why the so-called safety nets designed to catch errors, such as peer-review, scientific honesty, and researcher integrity, are failing.

While reading this article I was struck in particular by one quote from Athina Tatsioni, one member of Ioannidis’ team:

“Usually what happens is that the doctor will ask for a suite of biochemical tests—liver fat, pancreas function, and so on,” she tells me. “The tests could turn up something, but they’re probably irrelevant. Just having a good talk with the patient and getting a close history is much more likely to tell me what’s wrong.”

This put me in mind of another article I’d recently read about a Stanford physician seeking to re-energize the practice of giving a physical exam.  The New York Times Health section profiled Dr. Abraham Verghese, his philosophy, and his teaching methods.

Apparently, “he likes to joke that a person could show up at the hospital with a finger missing, and doctors would insist on an M.R.I., a CT scan and an orthopedic consult to confirm it.”  Ha ha, quite clever!

Something tells me that Ioannidis and Verghese would get along.  It seems as though Verghese’s approach is a good way to mitigate some of the problems that Ioannidis’ work has uncovered.  Good bedside manner, however, can only be helped by some good science, which it seems is in short supply.

Ioannidis reminds us that science is supposed to be filled with errors and spurious theories and confusing results.  That’s the way it works.  Truth is a messy undertaking.  Both doctors and patients need to be cautious and allow the machinery of science time to work.  And recognize that sometimes, we just don’t know the answer yet.

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No need for helplessness in the face of an invasion


Tree of heaven, Ailanthus altissima (courtesy Plant Conservation Alliance)


Tree of heaven. In China, the mature tree is a metaphor for the father. On the east coast of the United States, ecologists curse its name. Landscapers planted it in urban environments because it’s tough enough to survive there, but it soon spread across the country.

It thrives in disturbed areas, along roadsides, at construction sites, on the edges of plowed fields, anywhere it can get a bit of sun. It produces a chemical that inhibits the growth of other plants around it and exploits habitats that native plants avoid, tolerating even the most acidic soils and overwhelming its habitat with thousands of seeds. If you cut it down, it sprouts again and again from the old stump, producing new, healthy trees to succeed it.

The tree of heaven pushes aside our native plants that provide food and cover for native species. It reduces biodiversity. It has no natural predators.

Invasive plants like tree of heaven, mimosa, and Japanese stilt grass threaten to turn our environment into something entirely different, with new and exotic species at every level, from plants to birds to mammals. Happily there are local organizations aimed at addressing this problem which anyone can join.


Japanese stilt grass, Microstigeum viminium


Dr. Julie Reynolds, a researcher at Duke University, mobilized her students and conceived the citizen science project Plant Stalkers. The program trains members of the public to identify invasive plant species and then deploys them onto trails in the Eno River State Park. Volunteers use a GPS device to mark the location of the plants they find and then upload the data to Google Earth.

Master’s student Leslie Stark, for instance, used data collected by Plant Stalkers to model the extent of invasive plant coverage in the park. Her models predict where invaders are most likely to colonize based on soil type, nearness to water, and other factors for three key species: tree of heaven, Chinese privet, and multiflora rose.

Data collected by Plant Stalkers are primarily used to “help rangers be more systematic in their eradication efforts,” says Reynolds. State agencies have limited resources to devote to this goal, so maps and models made by students and volunteers can help them focus their destructive efforts to have the greatest effect.

The North Carolina Native Plant Society also offers members of the public the opportunity to enlist in the struggle against invasive plants. With eight chapters across North Carolina, the society promotes saving native species and certifying healthy habitats. They sponsor talks and offer grants.

For citizen scientists they provide a valuable resource: a prioritized list of those plants that are most dangerously invasive in our region. Twenty-seven plants make their “severe threat” list, including tree of heaven, kudzu, and the others mentioned in this article. More than a hundred other species are divided into categories based on their ability to invade. The NCNPS site is a great place to become familiar with the enemy and prepare for battle.

Invasive plants are a serious problem that ordinary people can help address locally. NCNPS suggests planting native species and avoiding invasives, and provides invasive plant guides that can help concerned citizens locate invaders in their own yards. Volunteers with programs like Plant Stalkers and the NCNPS can provide the surveillance that agencies need to monitor the lands under their protection and be the first soldiers on the ground in the effort to save our native species.

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Funny article, sad picture

Does science reporting sometimes seem terribly formulaic?  Check out Martin Robins’ brilliant blog entry and cutting parody.  Science writers will get a chuckle out of this.  Be sure to read all the way to the end and see the “links” section.  Also that figure is…just awesome.  Dinosaurs!!!!!  In space!!!!!

Complete change of pace:

In other news, this picture really paints a thousand words.  Sea birds swallow plastic, fill their stomachs, and then starve.  Not a cheery article, but the photograph is so perfect.  It really writes the story all by itself.

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Confirmation bias confirmed

We hear what we want to hear.  I suppose that’s not really news, but the application of this old adage to new fields seems to be yielding some great data in the realm of cognitive psychology.  Check out this great discussion on Ars Technica.

Why are there so many climate-change-deniers in the general public?  Why is evolution still treated so skeptically?  The answer really has little to do with the science itself and everything to do with human nature.

The suggestions made by the authors for overcoming this sort of bias seem pretty weak to me.  I wish I could offer a better suggestion, but honestly it really looks hopeless.  I’ll leave the synthesis of human thought processes up to the experts.

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The pursuit of truth

Some researchers want you to forget what you know about good study habits. But probably you won’t.

“Instead, we walk around with all sorts of unexamined beliefs about what works that are mistaken,” Dr. Robert A. Bjork says in an article by New York Times writer Benedict Cary.

Staunchly held misconceptions seem to be a hallmark of the human condition.

Winston Churchill is quoted as saying, “we occasionally stumble over the truth, but most of us pick ourselves up and hurry off as if nothing had happened.”

Science doesn’t have to be something weird that professors do with test tubes and bunsen burners. It can be a way of looking at the world. It can mean requiring proof before believing something. It can mean asking “why should I do it like this?” or “why do I think this?”

You don’t need an expensive education to ask these questions (though it might help you to answer them).  You don’t need to work in a lab or have any publications to your credit.  You don’t need to be rich or have too much time on your hands.  Anyone can do it!

Come on, let’s all be scientists! It’ll be great.

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Patience and Perserverance

In 1933 Erwin Schrodinger won the Nobel Prize in Physics for his equation describing the changes over time in the quantum state of a physical system. A series of four famous papers he published in his 30’s were integral to the early formulations of quantum physics. He interacted with people like Einstein, Max Plank, Pauli, Bohr, Heisenberg, James Watson and Francis Crick, Paul Dirac, and Richard Feynman.

Of quantum physics he once said: “I do not like it, and I am sorry I ever had anything to do with it.”

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