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Posts Tagged ‘Pseudoscience’

AirborneMuch to the dismay of the millions of faithful Airborne users, and to the absolute glee of those of us who think critically, Airborne Health has agreed to settle a class action lawsuit against the company’s false claims about it’s products. The plaintiffs successfully sued the company on behalf of those who fell for the cutesy marketing and bought the product with the belief that, as the company falsely claims, it can prevent and cure colds. The settlement amounts to $23.3 million to be paid to those who purchased the product in the prior 6 years. A large sum of money, until you realize that the company sells (unbelievably) some $300 million worth of it’s product each year. And insult upon injury, the legal fees incurred are to be taken out of the settlement, bringing the amount actually awarded to consumers to just a tiny fraction of their purchase price.The real story here, however, is not that the company lost this law suit. That was a given. The real shocker should be just how popular this product is. I say should be, because of course it sadly comes as no surprise that this many people could be so credulous as to believe in another cure for the common cold. One created, no less by a school teacher. That’s right. Airborne Health’s proud statement, right on the front of the colorful, cartoony box, that the product was “Created by a school teacher” is actually one of it’s big selling points. This truly does come as no surprise to me. I am amazed, but never surprised, how parents will fight me tooth and nail over vaccinating their children (an intervention with more science supporting it’s effectiveness at preventing severe disease and even death than medical science has ever devised) while at the same time uncritically buying into the “immune boosting” properties of wheat grass juice, just because some guy behind the counter at their health food store recommends it. That a school teacher might have the knowledge, untapped by anyone else in the history of science, to create a vitamin and herb potion that can prevent and even cure the common cold somehow doesn’t seem implausible to most people. The company claimed (and still does – the settlement incredibly does not require them to stop making the claims they were found to be guilty of falsifying) that their product can prevent and cure a cold by “boosting the immune system”. Their Airborne Seasonal product (presumably an allergy medicine), which they claim uses a “non-drowsy formula” (not surprising since it doesn’t actually contain an antihistamine!) works by “promoting normal histamine levels”. Of course, nothing in these products does any of the things they are claimed to do. Hence the lawsuit. But again, why do people believe these preposterous claims in the first place? Like the saying goes, there’s one born every minute.

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ABC Drama Takes on Science and Parents

 

Richard Cartwright/ABC

Jonny Lee Miller, left, as Eli Stone, with Laura Benanti as the mother of an autistic child, and William Topputo in “Eli Stone.”

 

Eli Stone, the evil corporate lawyer turned superhero defender of the downtrodden, recently made his debut performance on ABC by battling the dark vaccine menace. With this program, the public is once again bombarded by the sensational but utterly false premise that vaccines are a cause of autism. Here he helps defend a mother and her little boy, hapless victim of the pharmaceutical companies and their vaccine preservative, mercuritol (in real life, thimerosal), which has rendered him autistic. Those of us on the side of science and reason just can’t get a break. As a pediatrician, I struggle daily to reassure, explain, and convince parents that there is no rational basis for believing that vaccines are a cause of autism. That there is, in fact, just as much evidence that your astrological star chart can predict your future. Or that homeopathy is more than an expensive placebo. Reams of data from a very large number of well conducted studies have clearly and overwhelmingly (at least in the halls of science which, after all, are the only halls we should be traversing here, right?) refuted any notion of a purported link . There is not enough room to discuss the origins of that myth here (stay tuned for a future entry on that voluminous subject), but suffice it to say that there really is no controversy among respected scientists and physicians. If you follow an evidence-based approach to medical decision making, there is no conclusion to draw other than that absolutely no such link exists. As for the issue of the vaccine preservative thimerosal being a cause of autism, again the data do not demonstrate any evidence of a link. On a multitude of levels there is ample reason to reject any link between thimerosal and autism:

 

  1. All of the legitimate studies to date have failed to demonstrate any link. That’s a pretty good reason right there:
  2. The apparent increase in autism cases has continued even after the removal of thimerosal from vaccines.
  3. Finally, and a usually neglected part of the story, the kind of mercury contained in thimerosal (ethylmercury) is very different from the kind produced by industrial pollution, and that ends up in the fish you eat (methylmercury). While methylmercury becomes concentrated in the body’s tissues (most importantly the brain) and thus remains for prolonged periods, ethylmercury is much more rapidly eliminated, and is therefore much less readily stored by the body. Recent studies have demonstrated just how different the pharmacokinetic properties of these two types of mercury are in the bodies of infants. This is important when we consider the US EPA “reference dose” (RfD) for mercury. This is the upper level daily amount, over a lifetime, of a substance that is considered safe to the most sensitive individuals in a population. The RfD for mercury set by the EPA is 0.1 micrograms per kilogram of body weight per day. Many people who believe the thimerosal-autism link point to the fact that, before thimerosal was removed from vaccines, some infants received a total daily dose of mercury from vaccines that came close to or exceeded the EPA’s RfD for mercury. Keep in mind, however, that the RfD was based on long-term, life-time daily exposures, not one time or even multiple time exposures. Also, as a safety factor the RfD was set 10 times higher than the actual estimated safe level. But most importantly, the RfD for mercury is based on data for methylmercury, not ethylmercury. That is, all the assumptions about the hypothetical dangers of exceeding the RfD for mercury, on potentially a few occasions, are based on an RfD for the wrong kind of mercury. As discussed above, the data on the pharmacokinetics of ethylmercury suggests a very different, and far less concerning picture for thimerosal in vaccines.

Which brings us back to Eli Stone and his heroic quest to slay the evil, two-headed, medical-pharma beast. It’s nothing new to see television making mince meat of science. It is fiction after all. In fact, after the American Academy of Pediatrics wrote ABC to protest the airing of the show, the producers placed a disclaimer of sorts at the end of the show (while people were channel surfing or getting another beer from the fridge), stating that vaccines are important, and directing viewers to the CDC’s website. Needless to say, the damage was done. The danger of this kind of TV is that people actually do often believe what they see and hear on the boob tube. Even if they know that what they’re watching is fictional, the messages absolutely effect behaviors. Particularly when they are so often bombarded by misleading and factually incorrect information. In this case, those behaviors involve potentially very dangerous errors in judgement regarding an extremely important medical decision about childrens’ health. Of course, the real-life court room drama that unfolded last month, involving the Federal Vaccine Court, will do even more damage. While the court’s ruling in favor of the family of an autistic child said nothing about vaccines causing autism, the perception many have come away with is just that – that the government has conceeded that vaccines are a cause of autism. I will discuss this case in more detail in an upcoming post. But the two courtroom dramas, one fictionalized, the other frightfully real, will both serve to further tarnish the image of the greatest advance medical science has ever seen, and take us another step backward toward the prevaccine era, and the re-emergence of more childhood death and disease.

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McCain

John McCain is the most recent vector of a raging new epidemic. The disease spread by this epidemic moves quickly, attacks mostly the educated and media savvy in our midst, and is potentially devastating in its consequences. I am referring to the dangerous and fast-moving epidemic of medical and science misinformation that is sweeping the land, pushed along by the strong winds of the media. John McCain, in response to a question posed to him at a recent town hall meeting, stated that

 

It’s indisputable that (autism) is on the rise amongst children, the question is what’s causing it. And we go back and forth and there’s strong evidence that indicates that it’s got to do with a preservative in vaccines.

He went on to say there’s “divided scientific opinion” on the topic of whether vaccines can cause autism. The media is also a major force in the spread of medical and science misinformation. It is often quick to point out that there is a scientific debate on an issue, and to present the topic with the balance so sought after in responsible journalism. The problem with the issue of vaccines and autism is that there is no scientific debate on this issue. There is no balance to the scientific data. The scales are tipped so far to one side (that there is no science linking vaccines to autism) that any reasonable interpreter of the data would conclude it’s time we give up on this particular witch hunt.

The notion of an autism “epidemic” alluded to by Senator McCain, and so often highlighted on the news, is also predominantly a media creation. In fact, the best epidemiology indicates that there is likely no true change in the prevalence of autism, just in the way we define the cases and count the numbers. Incredibly, I have yet to see a single media story that has attempted to intelligently cover this less shocking, but fact-supported, angle.

But the main problem with John McCain’s statement is that he fails to understand what “strong evidence” means in the context of science. Strong evidence is evidence that is presented for peer review, poured over for sound reasoning, scrupulous and meticulous methodology, and accurate statistical analysis. Good scientific papers will also point out their own limitations and flaws, and make suggestions on how to improve on the science. To be declared truly “strong” however, the data must also be replicated and validated by multiple independent investigators. When the evidence is assessed by this standard (the standard by which all science must be judged), John McCain’s statement is seen as entirely erroneous.

The reason Senator McCain was so quick to jump on the vaccines-are-evil bandwagon, and the reasons for this epidemic of medical and science misinformation, are complex. They involve mistrust in the medical establishment, in the Federal government and its oversight, and in the pharmaceutical industry. They also involve the frustrations inherent in the loss of autonomy over one’s own health, an age old problem made more extreme by the ever-evolving complexity of scientific insights into health and disease. At the heart of Senator McCain’s erroneous statement, however, lies an even more ominous sign that indicates this epidemic has no end in sight. A major factor allowing this type of misinformation to take root so easily is the public’s relative ignorance about the general workings of science. If our educational system did a better job teaching science and explaining it’s centrality to so much of what we take for granted in our lives, these types of misstatements would be far less likely to occur and the misunderstandings about so many scientific issues, from believing vaccines cause autism to believing in the efficacy of homeopathy, would fail to become so widespread.
It is ironic that in this election year a major presidential candidate, with both advancing science and improving our educational system as major underpinnings of his platform, would fall victim to an epidemic at least partly preventable by both.

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