How much do you know about science?

These science fair researchers applied the scientific method to study glowsticks. How about you?  Do you know what science actually is? Test your knowledge! Photo from Ref. 1.
These science fair researchers applied the scientific method to study glowsticks. How about you? Do you know what science actually is? Test your knowledge! Photo from Ref. 1.

I saw an article from National Geographic entitled “How much do you really know about science?” The article contains a quiz to test your science knowledge. However, the author of this article makes a typically fatal mistake: mistaking facts about the natural world obtained through the scientific process with the process of science itself. Science is a process that leads to a collection of facts, but it is not the facts themselves.  You can read the article and take the quiz yourself here: http://newswatch.nationalgeographic.com/2013/06/20/how-much-do-you-really-know-about-science/. The author of this article is mistaking rote memorization for science.

I thought it would be much more interesting to, instead, offer up a quiz on actual science and see how people fared. Post your responses in the comments section. I’ll post the answers later.

Test your knowledge of science!

  1. What is a “theory”?
    1. Any opinion about the cause of a phenomenon, which may or may not be testable, and whose reliability is not required.
    2. An explanation about the cause of a phenomenon that has been tested and whose reliability has been assessed using a single test.
    3. An explanation about the cause of a phenomenon that may or may not have yet been tested, and whose reliability is not required.
    4. An explanation about the cause of a phenomenon that has been tested and whose reliability has been assessed using multiple tests.
  2. Which of these is a scientific explanation of the diversity of biological systems?
    1. Natural Selection, which holds that life on earth developed to its present state over a long period of time thanks to pressure from the surrounding environment.
    2. Abrahamic Creationism, which holds that life on earth was created in its present form over just a few days by an omnipotent and universal god.
    3. Intelligent Design, which holds that life on earth may have largely developed slowly over a long period of time, but certain organisms are too complex and only explainable by intervention of an intelligent agent.
    4. All of the above
  3. A lightbulb is attached to a circuit, containing a battery (source of power) and a switch( which can interrupt the circuit and cause the light to go off). The switch is flipped to connect it to the battery, and the lightbulb does not light. Which of these is a “construct”?
    1. There is a problem with the battery (it might not be charged)
    2. There is a problem with the switch (it might be broken and never close the circuit)
    3. There is a problem with the lightbulb (it might be burned out or damaged in some other way)
    4. Invisible fairies who are shy and undetectable are eating the light from the lightbulb before it can reach my eyes.
  4. Which of these is not a stage in the scientific method?
    1. Observation of a phenomenon
    2. Formulation of an hypothesis to explain a phenomenon
    3. Asking your supervisor if the idea is good or bad
    4. Proposition of an experiment to test an hypothesis
  5. Your friend claims that he has built a device that can detect platinum at a depth of up to 50 feet. Which of these is a reasonable experiment to test the claim?
    1. Dig ten 50-foot holes, place a platinum ring in one of them, and cover all the holes with buckets so that your friend cannot see the platinum. Ask him to detect which hole the platinum is in. Repeat this at least a few times. Make sure the person recording the tests is not the person who placed the platinum.
    2. Get 10 buckets and arrange them uniformly. Place a platinum ring under one of them so that your friend cannot see the platinum. Ask him to detect which bucket the platinum is under. Repeat this at least a few times. Make sure the person recording the tests is not the person who placed the platinum.
    3. Get 10 buckets and  arrange them uniformly. Place a pound of platinum under one of them so that your friend cannot see the platinum. Ask him to detect which bucket the platinum is under. Repeat this at least a few times. Make sure the person recording the tests is not the person who placed the platinum.
    4. Get 10 buckets and arrange them uniformly. Place a platinum ring under one of them so that your friend cannot see the platinum. Ask him to detect which bucket the platinum is under. Repeat this at least a few times. Make sure the you are with him the whole time when he conducts his search.

[1] Photo from: http://www.flickr.com/photos/73645804@N00/5615589933/in/photolist-9yenf6-7LMxoQ-c6XXR5-aPLgBz-dpFi9y-dpF8KK-dpF8Hi-dpFir7-dpFiBo-dpFiou-dpFifm-dpF8uR-dpF8qe-dpF8x6-dpF8ik-boTkRD-9GVYs3-9GT6Bv-9GVYfE-9GT6CK-9GT6Rx-9GT6R2-9GVYpf-9GVYmd-9GT6M4-9GT6F2-9GT6Mr-9GVYoQ-9GT6N4-9GT6KV-9GVYgs-9GVYq5-ei1Weu-aq1tuV-7MHw2c-7TmK8y-7TmMFL-7NRfyZ-9LJyJ5-7NVd6E-aqizFs-crCwxE-evQFUi-7Bmmt6-8ZievD-8CDE5a-aqeDKk-aqeAR2-aqhhWJ-aqeD34-aqeA8i

Bad science reporting on Mayo Clinic Proceedings “Prescription Drug Use” paper

CBS demonstrates the inability to even read the abstract of a scientific paper when reporting on prescription drug use.
CBS demonstrates the inability to even read the abstract of a scientific paper when reporting on prescription drug use.

I saw on Facebook today some repeats of a CBS article from Atlanta entitled “Study: 70 Percent Of Americans On Prescription Drugs” [1]. The news article cites this actual scientific article from the Mayo Clinic’s “Mayo Clinic Proceedings,” entitled “Age and Sex Patterns of Drug Prescribing in a Defined American Population” [2].

The CBS article claims right in the first paragraph of their story that

“Researchers find that nearly 70 percent of Americans are on at least one prescription drug, and more than half receive at least two prescriptions.” [1]

This is demonstrably a false statement, as reading the abstract of the paper will tell you:

“Objective: To describe the age and sex patterns of drug prescribing in Olmsted County, Minnesota.” [2]

So, the authors say NOTHING of how many generic Americans are taking at least 1 prescription drug. Later on, at the very end of the paper they note that

“In general, drug-prescribing patterns in this population are consistent with those in previous population-based studies in the United States . . . Our findings cannot be compared directly with findings from these previous studies because of differences in methods (weekly or monthly use vs annual use and data derived from drug prescriptions vs self-reports, pharmacy records, or insurance claims).” [2]

but that is about the grandest statement they make. They don’t note that the data is anomalous with expectations based on drugs prescribed to certain age classes, etc. They report this as data-gathering to help inform healthcare system studies, but they don’t consider these numbers representative of “abuse.”

The CBS article also makes the outcomes of the study sound horrible by using the weasel word, “prescription drug,” but when you read the data breakdown in the paper the numbers actually make a lot of sense and, if anything, reflect the current trend toward obesity in the United States (in other words, then negative connotations of the paper are more aligned with a known underlying health problem in the U.S. whose symptoms can be treated with a range of prescription drugs).

Taking all age groups together:

  • 26% are taking an antibiotic or erythromycin of some kind – not a surprise, since bacterial infections are common and this is how they are treated.
  • 11% are taking vaccines of some kind. That’s great news!
  • 10% are taking anti-asthmatics – again, not a surprise, since asthma affects an estimated 7% of the U.S. population and anti-asthmatics can be used to treat other related diseases [3]. So these numbers are in-line with the affected population.
  • 9% are taking anti-infective/anti-inflammatory drugs – that’s good. Preventing inflammation and infection are not bad things, and thank goodness we have drugs to help control these issues.
  • 6% are taking drugs (throat and nasal agents) that would be used to treat symptoms or complications associated with nose, chest, or throat infections (e.g. flu, severe cold, etc.). No surprise there. For instance, the percentage of people that get the flu each year varies between 6-20% [4].
  • 14% are taking drugs for digestive reasons (laxative, etc.).
  • 7% are taking diuretics, which are used in the treatment of heart, kidney, and other problems – the most heavily using sub-population of these was people over 50 . . . so not a surprise, because that’s when heart, liver, and kidney problems begin to crop up.

A few other categories had 5% or fewer usage, but they are all explainable for a variety of diseases that are common in sub-populations.

The ones to watch out for are the fraction on medications intended to treat blood pressure or heart issues, or depression:

  • 11% take anti-lipemic agents, chemicals designed to lower cholesterol
  • 7% take beta-blockers and 7% take ACE inhibitors, which help treat heart and blood pressure issues
  • 13% take anti-depressents
  • 12% take opioid analgesics, which can be habit-forming (which is why they are given on prescription, of course)

Let’s consider the 11% who take anti-cholesterol drugs and the 14% that take a drug intended to treat the heart in some way. About 1/3 of the U.S. adult population is obese [5], and obesity raises your risk factors for heart and cholesterol-related problems (I myself have struggled with high blood pressure, which is very well-controlled by keeping my BMI below 30 . . . but that is just me, and should not be mistaken for the actual copious medical evidence that obesity increases significantly all the risks to your heart and lungs). So it’s not a huge surprise that a non-trivial fraction of the population takes drugs to control problems associated with one of the largest health issues facing our nation. If anything, it’s worth focusing on the obesity issue and less on the drugs issue, which is more a symptom than a cause.

The other concerning issue is the number of people taking anti-depressents, but . . . again . . . taking anti-depressants is a response to the underlying cause:

An estimated 26.2 percent of Americans ages 18 and older — about one in four adults — suffer from a diagnosable mental disorder in a given year. [6]

We’ve gotten better at identifying how behaviors are related to the chemistry of the mind, and especially to depression and related classes of mental state. Right now, effective treatments for many people involve drugs. Perhaps, in the future, we’ll find other ways to control depression, but the reality is that now we have classes of drugs that can have positive effects on people fighting with depression.

All of the numbers simply reflect the fact that we know how to treat a lot of disease classes using drugs, and so drugs get prescribed. Keep in mind, again, that CBS blew their reporting on this article in the first line of their story, when they said it applied to all Americans. Wrong. Just wrong.

[1] http://atlanta.cbslocal.com/2013/06/19/study-70-percent-of-americans-on-prescription-drugs-one-fifth-take-5-or-more/

[2] http://www.mayoclinicproceedings.org/webfiles/images/journals/jmcp/jmcp_ft88_7_2.pdf

[3] Fanta CH (March 2009). “Asthma”. New England Journal of Medicine 360 (10): 1002–14. doi:10.1056/NEJMra0804579PMID 19264689

[4] http://www.webmd.com/cold-and-flu/flu-statistics

[5] http://www.cdc.gov/obesity/data/adult.html

[6] http://www.nimh.nih.gov/health/publications/the-numbers-count-mental-disorders-in-america/index.shtml#Intro

Weasel Words

A mountain weasel. Weasel words are how people try to trick you into accepting a position without thinking. Learn how to protect yourself. Photo from Ref. 1.
A mountain weasel. Weasel words are how people try to trick you into accepting a position without thinking. Learn how to protect yourself. Photo from Ref. 2.

In our class on the Scientific Method, Profs. Cotton, Scalise, and I talk about “Weasel Words.” [1] These are a form of logical fallacy – specifically, of “equivocation,” wherein a word is used with vague and various definitions, leaving it to the listener to choose the definition that best suits their biases or world view. Weasel words are everywhere, and their use is an indicator of propaganda (e.g. advertising is a form of propaganda aimed at getting you to buy something; politicians use weasel words all the time to get you to agree with them). Weasel words are meant to take advantage of your biases, your ignorance, or your pre-conceptions, and trick you into siding with something that you actually might not agree with, if you thought carefully about this issue. If someone is using weasel words, and you know how to spot them, you immediately learn two things about that person:

  1. They think you are an idiot who can be duped to their cause; they are using weasel words to take advantage of what they perceive of as your stupidity. You already know what they think of you – they think you are a stooge.
  2. They are using pseudoscience or weak-sense critical thinking to argue for a claim, and this should set off alarm bells that what they are peddling may be utter nonsense. You know that they are in a weak position with little or no evidence to argue their cause; otherwise, they would use the evidence.

Since the tricks and lies of the “alternative medicine” industry are in the spotlight, I thought it might be useful to show you some of the weasel words used by people who (a) advocate for the causes of this industry or (b) have been tricked by the industry and inadvertently have become their mouthpieces. Once you add these weasel words to your B.S.-detector toolkit, you will be in a better position to resist being fooled, and more apt to think critically about the claims of alternative medicine peddlers.

  • “Natural” or “All Natural” or “Naturopathic” (in reference to a product)
    • If you think about the universe critically for a moment, you realize that there is nothing outside of nature. All things that are in the universe are natural. So, already, you can see the “weasel word” aspect of this – they are trying to appeal to a sense that what people make is “unnatural,” even though people are also part of nature.Even if you accept the claim that things people make are “unnatural,” and everything that people don’t make is “natural,” there are reasons to be skeptical. The use of the word “natural” or “all natural” in reference to a product is meant to be equivocated with the words “safe” or “harmless.”
    • However, don’t be fooled. There are plenty of natural things that will kill you: hemlock, for instance, is a natural toxin to human beings (and is famous for how Socrates killed himself); you can find an extensive list of poisonous plants here:  http://en.wikipedia.org/wiki/List_of_poisonous_plants.
    • The use of these weasel words is intended for one purpose: to make you pay money for something that you are tricked into believing is safer and as/more effective than a science-based product, such as a medicine. You have to be very careful about this; you may be buying something that hasn’t been tested at all, either for harm or good. If the product is so effective, demand the multiple, independent, peer-reviewed studies of drug trials against the leading drug on the market and against placebo. If none exist, WALK AWAY.
  • “Alternative Medicine” or “Non-Western Medicine” or “Traditional Medicine” or “non-allopathic medicine”
    • There is only one kind of medicine: evidence-based medicine. Anything else is a fairy tale. Either a product delivers what it promises under controlled conditions, and does so better than placebo, or it doesn’t do anything at all. These weasel words are meant to imply that the product or procedure is somehow a secret passed down through the ages that works better than the best evidence-based method.
    • As comedian Dara O’Briain says, (and I paraphrase a bit here), “I’m sorry. ‘Herbal Medicine.’ ‘Oh, Herbal medicine has been around for thousands of years.’ Indeed it has. And then we tested it all, and the stuff that worked became ‘medicine,’ and the rest of it is just a bowl of soup and some nice potpourri.’ Either it works, better than placebo (e.g. taking a non-medical intervention that fools the patient into thinking an actual medical intervention is occurring) or it doesn’t work at all and should be discounted or discarded.
    • Anyone who uses these weasel words and cannot show you actual evidence for the efficacy of the procedure is trying to steal your money.
  • “Chemical free”
    • All atoms and molecules are chemicals. The only thing that distinguishes them is their reactivity, which is determined by the number of free electrons (or number of absent electrons) in the atom or molecule. Everything is chemicals. Water is a chemical. Vinegar is a chemical. There is no such thing as “chemical free.”
    • When someone uses this, they fundamentally misunderstand the universe. Walk away.
    • This is also used when somebody wants to distinguish their product or procedure from one that involves a laboratory-tested chemical. The reality is that laboratory-tested chemicals have effects on the human body (or, at least, on animal bodies) that are documented. You can complain all you want about whether or not all chemical or drug trials are released by manufacturers, but that is a separate issue; if somebody has a chemical-free process to sell you, not only are they lying, they probably have not tested the effects of their process on humans (unless it’s something like “rinsing with water,” whose relative safety has been long established by trivial observation).
    • Bottom line: there is no such thing  as “chemical-free” – there are only chemicals whose effects on the body are documented well, or less well-documented. Demand chemicals whose effects are well-documented, but don’t buy because of this weasel word.

[1] I find the etymology of this phrase fascinating, as I do with most language. The Wikipedia article on “Weasel Words” (http://en.wikipedia.org/wiki/Weasel_word) cites a magazine article (recorded in The Macmillan Dictionary of Contemporary Phrase and Fable) that explains the meaning of the phrase, “weasel word”: “words that suck the life out of the words next to them, just as a weasel sucks the egg and leaves the shell.” Weasels cannot actually suck eggs empty, but you get the idea.

[2] http://commons.wikimedia.org/wiki/File:Mountain_Weasel_(Mustela_altaica).jpg

Big AltPharma

Many people think that alternative medicine – what I call “sham medicine”  – is the positive opposite of science-based medicine. Peddlers of sham medicine make all kinds of opposition claims. Claim: Science-based medicine has negative side-effects, whereas sham medicine only cures and never hurts. Claim: Science-based medicine is the domain of “Big Pharma,” a shady cabal of large pharmaceutical companies who withhold cures for cancer to make big money [1] and lobby the Federal government to get their way.

These beliefs have been propagated, in part, by the sham medicine industry. That’s right – pushers of sham medicine are a multi-tens of billions of dollar industry, with everything to  lose if they are forced to demonstrate efficacy of their claims. They have lobbyists to get laws passed that treat them differently; they organize propaganda campaigns;. They do all the stuff that “Big Pharma” is routinely accused of (often by these sham peddlers).

The difference? None of what the sham medicine industry peddles is actually medicine. None of what the sham medicine industry sells is held to the same scientific standards as the science-based medicine industry. There are no serious controls on manufacturing (c.f. homeopathic dilutions), no requirements for rigorous independent reviews or studies of their medicinal claims (e.g. against placebo). They can sell without prescription, direct to consumer – unlike most of science-based medicine. “Doctors” who peddle this dangerous medicine are not required to be actual Medical Doctors (M.D.s).

There is a very good story on all of this in today’s USA Today, and an upcoming book from Paul Offit documenting the abuses of the sham medicine industry. I hope that exposés like this will lead to regulation and oversight of this industry, holding it to the same standards of harm prevention and effectiveness assessment as actual science-based medicine. We need a “The Jungle” moment for the sham medicine industry.

[1] Fun fact: an economic estimate of the value of the cure for cancer suggests that it is worth trillions of dollars, while withholding such a cure and maintaining the status quo is worth orders of magnitude less money than that. c.f. http://www.nber.org/papers/w11405

[2] http://www.usatoday.com/story/news/nation/2013/06/18/book-raises-alarms-about-alternative-medicine/2429385/