Friday 13 May 2016

Credulous kills people

Dau.II is a fan of John Oliver's satire-and-outrage news and politics programme Last Week Tonight. Here he is sending up the media's coverage of scientific studies. Which is too often simplistic, fatuous or just plain wrong.  It has a sound bite from Brian "Bloboprev"Nosek.  As the daughter ordered: hang on in to the end, it's funny and its less than 20 minutes of crap-detecting.

And now for something completely serious. Yesterday, I was having a rant about the dodgy ethics of a couple of Californian doctors applying a half-arsed idea to real and very sick people; failing to cure them and quite possibly hastening their end. As they were very sick, chances are they would be dead anyway, but nevertheless you don't want to add complications and suffering to put daft theories 'to the test'.  If you want to do that without moral hazard you could take a note out of the books of either JBS Haldane and his dad or Barry Marshall and do a bit of auto-experiment in the cause of science.

Paolo Macchiarini is a man convinced of his own certainty in matters that go way beyond the evidence.  He was a charismatic transplant surgeon who talked a line about new techniques in using stem cells.  He was hired in 2010 by the uber-prestigious Karolinska Institutet in Stockholm to work his wonders on sick Swedish people.  A lot of senior people rowed in behind this cunning plan to acquire a wunderkind to generate positive publicity for the KI. Lest we slag the Swedes as being naive news-hounds with wide-open ethical controls, I'll point out that Macchiarini also landed a position in a medical institute Кубанский государственный медицинский университет in Краснода́р in S Russia. He really needed guinea pigs to practice his dark arts upon but he by-passed that step and went straight to operating upon people. As I described this week, compassion use allows doctors to carry out looney experimental therapies if the patient is very sick. Finding insufficient very sick people to play with, Macchiarini and his team seem to have reclassified benign tumors as malignant in order to qualify for the death-hastening 'treatment'. So far so bad.  When junior colleagues alerted the Institute about their concerns about data manipulation and misclassification of patients, an external expert was appointed who found that the accusations were substantively true. Nevertheless, there was a high-level "nothing to see here" white-wash, the external report was shelved and the star was re-instated. It took a couple of investigative journalists to expose the KI's dirty laundry and hang it out to dry.  Part of the problem was that Macchiarini professed to be using stem cells to make artificial organs, For the last several years, stem cells have been the sexiest cure-all since penicillin. If every scientist who has written a recent grant application to use stem-cell therapy was laid end to end, the line would stretch from KI, Stockholm to Perdition, KS.  Dorothy Parker had a better quip: "If all the girls who attended the Yale prom were laid end to end, I wouldn't be a bit surprised". A number of senior people have fallen on their swords and others are likely to be pushed. Very nice piece in forbetterscience, you can google up other commentary: Grauniad - Vanity Fair - Nature.

Any profession can have a bad apple or two: some people are ambitious self-regarding shits and they can't all finish up as futures traders or drug-barons. You'd hope that scientists, who are trained to have better crap-detectors than milkmen or dairy-maids, would be less credulous in their assessments of people who are carrying out extra-ordinary science. But they are not.  Indeed "Science" can be worryingly complacent about its self-regulatory nature and about how fraudulent or just plain wrong findings fail in replication and are scrubbed from the scientific canon.  But, as John Oliver asserts, the kudos resides in doing the next new thing, not re-evaluating last week's findings by someone in a different institution.

I think there is also an element of self-selection that doesn't help. Suppose that you have two very good scientists, who have brilliant ideas, pull in the money and the graduate students, get results, get them into print.  It is the loudest of the two who gets invited to be Key Note Speaker at Gordon Conferences - he gives such entertaining talks. That might give him [so often a him] an edge when a Head of Department, or Dean of Research, or Registrar is required and he is persuaded to take on a wider leadership role. I've ranted about how such a person believed nonsense 'ranking' statistics because they puffed his own institution.  Having come to believe his own publicity, Professor Charisma starts to believe the bombast of similar people and suddenly a Macchiarini is appointed to the Faculty.  It's not always true: you could not wish for a quieter, more unassuming Head of Department, with a better crap-detector than my pal Tony.  Bring on the evidence!

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