Maybe I should cut Boston Globe some slack on this, since their entire science and medicine department got sacked due to budget cuts… except that every single newspaper makes exactly this mistake, including the Boston Globe when it still had a fully-staffed science department. Wait, shit, I’m burying the lede, aren’t I? Damn, maybe those journalists are good for something after all.
You may have noticed that whenever you read a science article in a newspaper, even when they’re just quoting from a press release, journalists will almost never give the title of the study they’re talking about. If you’re lucky, they’ll give the lead author’s name or the name of the journal in which the study was published.
I can kind of see how they might justify this. After all, most academic journals are subscription-only, so most newspaper readers wouldn’t be able to look up the article if they wanted to. But, even for the pay journals, usually an abstract is available online, as it is in the case of the New England Journal of Medicine article that the linked Boston Globe story references. However, failure to give citations is less about whether Joe Average has a subscription to NEJM and more about respecting the process of science. As Ben Goldacre writes here about the media’s propensity to treat science as “absolute truth statements from arbitrary authority figures in white coats, rather than clear descriptions of studies, and the reasons why people draw conclusions from them”.
You can certainly see that at work in the Boston Globe article on vetebroplasty. The writer sets up a tired old “he said, she said” frame, pitting the arbitrary authority of “two recent studies” against the anecdotal wisdom of “many patients – and their doctors”. It’s as if the study authors just randomly decided (is that what they mean by a “randomised trial”?) one day that vertebroplasty is crap, the experience (read: anecdotes) of real-world doctors and patients be damned! Ivory tower! Arrogance!
Of course, that’s not how it works. In reality, the authors of the vertebroplasty studies wanted to figure out whether this popular procedure has any effect, so they designed an experiment to figure it out. (I just picked one study I found in NEJM that was published this month. I have no idea whether it’s either of the studies Boston Globe is talking about, since they didn’t give the article titles, so I just have to assume it is. This is why the titles are fucking important to know.) As per the academic gold standard of the Randomised Controlled Trial, they collected volunteers to undergo either a sham surgery (the controlled part) or the real deal, selected at random (the random part). It’s unclear whether the surgeons were blinded, but that’s usually difficult to do with surgery.
The results? “Improvements in pain and pain-related disability associated with osteoporotic compression fractures in patients treated with vertebroplasty were similar to the improvements in a control group.” This is something we typically see, a non-significant difference between the treatment and the placebo drug or sham procedure. The abstract even includes exact numbers, for those with the statistical knowledge to interpret them.
An obvious criticism leaps out at me: the study has a sample size of 131, which is too small to be really conclusive. But note that this isn’t a criticism anybody makes in the Globe article. The Globe’s not interested in what the study actually says or what its actual flaws might be. It’s only interested in pitting authority versus authority, because that’s easy and doesn’t require any knowledge of the subject area or tedious investigation.
But, hey, it’s not for us plebes to go questioning authorities like academic medical researchers or some doctors or newspaper writers. Just sit back, relax, and take their word for it.
Our next book is The Immortal Life of Henrietta Lacks by Rebecca Skloot. It is the story of HeLa cells, the first immortal cell line which has been and continues to be used extensively in many fields, including cancer research, vaccine development and testing, AIDS, aging, genetics, and the effects of radiation on living cells. It is also the story of Henrietta Lacks, a poor African American woman raised as a share-cropper on a Virginia tobacco farm who died a horrible death from cancer at age 30 in 1951. It is also the story of her family who only found out about the source of the HeLa cell line many years later. (Informed consent was apparently never sought or obtained.)
