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Webwatch
October 2007
Science is widely misunderstood. I do not mean the nitty gritty details, the hard mathematics or challenging ideas in genetics, but the simple every day idea of what science is all about. In the case of ITP, this leads to all sorts of confusion, as can be seen on the internet.
On a website or even in a newspaper, you may see the headline "Scientists wrong about X". (In this case, whatever X is is not relevant.). The article is likely to continue about a widely held scientific belief that has been shown to be wrong. The trouble is more likely to be with the author of the article than the science. Usually, the writer has missed the point. Science describes the world based on the best model and evidence available. When new evidence comes along that shows an old model to be invalid, a new model or description is created. The old model is not "wrong" in the sense that 2+2 does not equal 5. If it was based on the best available evidence at the time, it was the best science, at that time. Good science does not state, as some will have us believe, that X is fact. It will state that X is the most likely explanation based on all available testable evidence.
A good example is still heard in modern language. You might hear a radio announcer speak of a programme going out "over the aether", i.e. being broadcast. In times past, scientists believed that to propagate light and radio, one must have a medium in which the light or radio signals must travel, i.e. travel "in" something. Later ideas have shown that an aether was not required, that light and radio could travel through a vacuum. Were the original scientists, one of whom was Issac Newton, actually "wrong"? Not in any valuable sense, they used the best evidence available at the time. It is interesting to read an explanation of the "Luminiferous aether" on en.wikipedia.org/wiki/Luminiferous_aether.
What has all this to do with ITP? Naturally, it has a great deal to do with ITP, if we are to "cure" those with ITP, we need the best possible evidence of what works, what does not work and what makes things worse.
Quite recently, a two part programme called "Enemies of Reason" was shown on Channel 4, presented by Richard Dawkins. The second part covered issues directly relevant to ITP, the whole issue of alternative medicine. Some video clips may still be available by the time you read this on www.channel4.com/culture/microsites/E/enemies_of_reason. The whole basis of the programme was that science has made great strides by using reason and that the current suspicion of science, GM crops, MMR etc. etc. will lead to very severe and regrettable consequences for us all.
A speaker in the second programme was Dr Mike Fitzpatrick, a GP in Hackney, London. He is a contributor to Sense About Science who have an excellent website at www.senseaboutscience.org.uk. and has worked hard to end the current MMR panic by providing the evidence of what parents should know. One of many websites on this can be found at www.spiked-online.com/Articles/0000000CA59F.htm.
The approach of Dawkins and Fitzpatrick is the same, the importance of evidence and distrust in blind belief.
Key points about science are the sharing of work, peer review and the acceptance of valid criticism. The alternative medicine world do not seem to require this rigour but science does and thrives on it. As an example, Shang et.al published a paper in The Lancet, 'Are the clinical effects of homeopathy placebo effects? Comparative study of placebo-controlled trials of homeopathy and allopathy' *. In this paper, the authors point to the end of homeopathy . The paper summarises their meta study, a study of studies, and they draw the conclusion that homeopathy is not effective. The rigour of science is demonstrated by the peer response which you can see on www.thelancet.com. You will need to register but that is free. Once you have registered, go to Article collections and put Shang is the search box, the direct web links are far too long and tortuous to print here. Not all articles are available free.
As a sample of the peer response, Klaus Linde and Wayne Jonas say "We agree that homeopathy is highly implausible and that the evidence from placebo-controlled trials is not robust. However, there are major problems with the way Shang and colleagues present and discuss their results, as well as how The Lancet reviewed and interpreted this study. We will point out two." They then criticise the science, the validity, testability and rigour of the paper. At the bottom, it says " We declare that we have no conflict of interest.". Even though they agree that homeopathy is very unlikely to work, they are concerned to get the science right. Believers would simply take the results and believe, no further work being required.
Other responses show the respondents to have links in the homeopathic industry. These criticise the Shang paper most severely. It is always of interest to see who writes a piece as well as what is in it.
There is an interesting article on homeopathy on the Sense About Science website at www.senseaboutscience.org.uk/pdf/SenseAboutHomeopathy.pdf.
* Shang, A. et al. 2005 'Are the clinical effects of homeopathy placebo effects? Comparative study of placebo-controlled trials of homeopathy and allopathy' Lancet, 366: 726-732.
If the march of unreason depresses you, there is hope. The UK Parliamentary Select Committee on Science and Technology issued a report about complementary and alternative medicine in 2000. It recommended "any therapy that makes specific claims for being able to treat specific conditions should have evidence of being able to do this above and beyond the placebo effect". The whole report is on the internet, a fact that itself reinforces the idea its authors are open to criticism in a similar manner to science. It is called "Science and Technology - Sixth Report" but the web link is too long to print, so if you visit www.parliament.uk/parliamentary_committees/science_and_technology_committee.cfm and click on "advanced search", put the words "Science and Technology - Sixth Report" (note the spaces) into the box next to "exact phrase", what you will find are several pages of links to this rather large work. (Link is now http://www.parliament.uk/parliamentary_committees/science_technology.cfm)
On the other hand, Parliament does not always take the advice of its Select Committees. As it says on www.senseaboutscience.org.uk/index.php/site/project/86, "On 1st September 2006, new regulations came into force that permit homeopathic products to make medical claims but exempt them from providing any scientific evidence that they are effective." On this webpage, you can sign a statement and send in your comments.
It seems to some that we are heading to a new dark age where science and reason take second place to blind belief and its resultant insanity. Surely we should seek to reverse what Dawkins has described as a Betrayal of the Enlightenment. See entertainment.timesonline.co.uk/tol/arts_and_entertainment/books/article2198063.ece.
Happy (reasoned) surfing.
Howard