It's only fair to share…

Earlier this year a group calling themselves the “Friends of Science” sent a letter to a variety of Universities calling for the scrapping of courses, which they regarded as “unscientific”. These included courses on chiropractic and others on various natural health topics.

These courses were seen as standing in contrast to the sound scientific courses such as medicine and the “Friends” were of the view that universities were lending credibility to “non-scientific “ pursuits by offering the courses.

Quite apart from the fact that it is still a free country and institutions are able to offer courses to students who in turn can select or reject them, there are three other really important issues in this.

Firstly nothing is “scientific” or not “scientific”. Some things have been demonstrated scientifically and others have not. Today we know that every human cell has at its core genetic material called DNA and that this is our genetic blueprint. One hundred years ago if someone had made the claim that each cell had DNA they would have been described as “unscientific”. The DNA has always been there. It is just that now we can demonstrate it to the satisfaction of our five senses.

To use a perhaps ridiculous example there may or may not be life on other planets. Whether we can demonstrate it or not does not change whether the life is there or not. Scientific observation is extremely important and helpful. However it ultimately is limited by what our five senses can detect (even enhanced by magnification) and our ability to understand what we can detect.

Hence the fact that something cannot be proved scientifically may not mean that it is not there or does not work. It may mean we do not have the capability to detect or explain it.

There is a bigger problem. Most of the professors and doctors who rave on about science have a blind spot when it comes to the other side of the coin. Medicine is supposedly a science. In reality the practice of medicine is an art based on science.

Yet that science is very imprecise because people are not machines. We are all similar but not identical. A spare part for a particular car will fit any car of that make and model. The same does not apply to humans.

Much is made of the evidence base of Western Medicine as against “natural health”. Some of this reflects that the studies have been done on pharmaceuticals but not on naturally found substances because there are no patents and hence no money.

But the biggest problem and this is the one that really grinds my gears is with what actually constitutes scientific evidence and how credible is it? There has been a growing concern over what is called publication bias. In simplest terms studies showing a positive result (usually for a drug) are far more likely to be published than those, which don’t.

About seven years ago in response to concerns about suppression of negative results many medical journals required that any paper, which was to be considered for publication, had to “register” before it commenced. However registration does still not mean the paper had to be published.

A recent example of this was with the influenza drug Oselyamivir (Tamiflu) where an analysis showed that much of the data supporting use of the drug had never been published. Requests by reviewers to the company for primary data were refused.

When unpublished data on the effectiveness of antidepressants are combined with published data the positive effect of the drugs halves. A recent look at second-generation antipsychotics showed four trials, which showed no benefit from the drugs, were not published but those, which did show a benefit, were all published.

The Friends of Science were fairly quiet on this one.  Someone who had an opinion on this, was Professor Chris Del Mar, professor of public health at Queensland’s Bond University. He told MJA Insight “… if doctors only read published research, they would get a biased view of these medications.”

But it gets even worse. Professor Gordon Parker, professor of psychiatry at University of NSW told MJA Insight that “ pharma-sponsored trials give little useful information because trial patients and real-world clinical patients contrast like apples and oranges, so that the real-world effectiveness and true side-effect profile often took years of naturalistic observation by clinicians to identify.”

Chris Del Mar went on to opine”… at the moment, our system for providing information to clinicians about the efficacy of commercially sensitive products is broken.”

All pretty damning stuff! And I haven’t even touched on from ghost-writing and straight out scientific fraud which is a growing problem(or maybe we just hear more about it these days).

Does this mean we should go back to the days of witch doctors and Sharman’s? No it does not. It does mean that there is no clear delineation between so called scientific medicine and so called “alternative medicine”. Some treatments work whether we can explain then or not. Some treatments do not work despite the publication of scientific trials.

Science is extremely useful to us and the “bastardization” of the process is tragic. There is light though as at least the problem is being recognized.

For the individual it is vital to keep an open mind and not slavishly adhere to one “system”.   Seek out what works best for you.

Above all else be wary of pious people claiming to be scientific and therefore somehow better than everyone else.