Tuesday, December 20, 2005

Scientific fraud and public health lunacy

Two articles in recent days in New York City newspapers caught my eye. On Dec. 16, the New York Post ran an op ed by Dr. Elizabeth Whelan, president of the American Council on Science and Health entitled "A Year of Public Health Lunacy." She laments how public health advocates "seem to put politics before science," citing Iowa's ban on the preservative thimerosal in vaccines or banning soft drinks from schools to combat obesity (both regular and diet soft drinks). She notes the fall of the Harvard School of Public Health which has recently embraced junk science on at least a couple issues. Then, today's New York Times story "Global Trend: More Science, More Fraud" highlights research shennanigans in South Korea. The Times story cautions: "To be sure, most scientists resist pressures to cut corners and adhere to the canons of science, honoring the truth above all else. But surveys shuggest that there are powerful undercurrents of misbehavior and, in some cases, outright fakery. Just as we need strong and authoritative science so help us sort out issues like the healthfulness of dietary salt, science is under an attack that threatens its credibility. Preserving this credibility is of paramount importance, given the proclivity of both corporate marketers and "public interest" advocates, including those embedded in the federal bureaucracy, to cloak their policy preference in claims they are "evidence-based." It matters not whether the motivation is to increase market share for a product, raise funds by sounding a public alarm or protecting or advancing a professional reputation for advancing the frontiers of medical knowledge. Insidious "insider" manipulation of data and/or their interpretation risks depriving society of any authoritative source. As in other areas where sophistication outstrips morality, we must "go back to basics." In this case, that means to strip away the pretense of "science" and looking at the fundamentals such as study design and standards of interpretation. Everyone says theirs is "high quality" science, of course, even high schoolers' science projects. Fortunately, we can go back to basics by reviewing what it means to embrace "evidence-based" public health policy. Our Dietary Guidelines claimed to be evidence-based, but didn't hew to the definitive standard crafted by the Cochrane Collaboration. As governments slip into politicized health care policy, inviting scientists to explain their findings against the outcomes-based scientific method pioineered by the Cochrane Collaboration offers the most promising way to re-establish the credibility we need for science-based public health policy. Using its rigorous methods, the Cochrane Collaboration offers its views on "advice to reduce dietary salt for prevention of cardiovascular disease," specifically: "There was not enough information to assess the effect of these changes in salt intake (a reduction) on health or deaths." Let's move away from scientific fraud and the public health lunacy that follows in its wake and insist on true evidence-based public health policies.


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