nos-trum. pronunciation: \nos'-trum\. noun. Etymology: Latin, neuter of noster our, ours.
1. a medicine of secret composition recommended by its preparer but usually without scientific proof of its effectiveness.
2. a usually questionable remedy or scheme.
See here for more discussion.

Wednesday, January 12, 2011

New Book On How Fear Undermines Sensible Medical Decision-Making

Journalists manage to distort so many things.  It's a pleasure to see one that investigated his subject in depth, and can tell the difference between evidence and testimonials.

I've just begun The Panic Virus, by Seth Mnookin, an exploration of the impact of fear, distrust, and the media on how parents and others make decisions about life-threatening risks; fear that is motivated by the sense of loss and disorientation we experience in a culture that calmly announces we each create our own reality.  We accept without question that there is no reality other than that we intuit, and it is different for each of us.

The springboard for the book is the anti-vaccine nonsense, and how it came to exert influence over parents, the media, and public policy.  I've written about this multiple times (see category "vaccine" for a list)

You may have recently seen the news regarding the discredited British physician Andrew Wakefield, how he manipulated and distorted the clinical data from his 12 autistic subjects to publish a study that claimed to show a link to the MMR vaccine.  Investigation showed that he fraudulently changed dates and clinical histories, in some cases changing the date of diagnosis to after vaccination, when the records show onset prior

The second part of the story appeared yesterday (Science Daily, Jan 11), revealing that even as Wakefield was caring for the first of those 12 children, he was making business deals secretly to cash in on his own alternative vaccines and diagnostic kits, which would only be financially rewarding if he could discredit the current vaccine.

Mnookin's book came from his puzzlement over why people made decisions to not vaccinate when the evidence is clear and unambiguous.  If you've never heard of "cognitive dissonance," and the role it plays in sustaining belief in the face of contradiction, this is a good place to learn.

Outstanding book.  Entertaining while instructive.  A perfect compromise between rigorous analysis and the technical jargon of original research, along with vignettes from the history of contagion and vaccination (like George Washington's personal experience of smallpox, and subsequent dilemma as a general leading an army undergoing an outbreak he knew could be prevented by vaccination, but would be politically dangerous to do).

I subsequently read an interview with the author (Wall Street Journal Health blog, Jan 11).  I was struck by the quotation below.   The interviewer asked Mnookin how the media had contributed to the Wakefield-induced fear that led to declining vaccination in Britain and subsequent outbreaks (and child deaths).  His answer indicts his own profession for being uncritical of unsubstantiated claims.
"We would never have the type of reporting about business that we do about science. You wouldn’t see a story on the front page that Apple was going to declare bankruptcy based on the opinion of one person — even if he had a business degree. We have to take a greater responsibility to train reporters and editors in the topics they cover."
This reminds me of the "cold fusion" debacle some years back.  A pair of scientists claimed to have developed a method of nuclear power generation that was safe.  Unfortunately, no one could duplicate their results, and the underlying premise was implausible to begin with.  In a wave of uncritical journalism, the media hailed the potential breakthrough.  The whole thing unraveled fairly quickly, but not before comical news interviews appeared that provided "balance" by pairing the chairman of the Dept of Physics at the Univ of Md against a man who was trying to market a perpetual motion machine.

Doc D

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