Alison Oliver
Alison Oliver
Editor,  Statistics Views, Wiley

Ben Goldacre is a best-selling author, broadcaster, campaigner, medical doctor and academic who specializes in unpacking the misuse of science and statistics by journalists, politicians, drug companies, etc. His first book Bad Science has sold over half a million copies to date and reached number one in the UK non-fiction bestseller charts.

He is also working on the AllTrials campaign which aims to aggregate information from a variety of sources to build up and provide a comprehensive, global picture of the data on all trials conducted on medical treatments. This month sees the release of their Trials Transparency Index, an audit of the 50 largest global drug companies.

Below is an excerpted interview with Dr. Goldacre recently published in Statistics Views.

 

Source: Dr. Ben Goldacre
Source: Dr. Ben Goldacre

Q. You have a very active Twitter feed. What do you like about Twitter and how important has social media been in giving Bad Science a voice to raise awareness of issues? Are there any key successes you can highlight?

A. What I love about Twitter is that you can follow a thousand people who are all working in different and interesting fields and just every now and then, trail your fingers into this river of information as it passes by. Also, as it is so low threshold, you gain access to the passing thoughts of very clever people which you never previously would have had. In the past, if Richard Horton, Editor of The Lancet, was waiting in the check-in queue at Heathrow and was reading a global health story in a newspaper which he thinks is wrong, that thought would have eventually disappeared. But now, he can pull out his phone and tweet that the news story is incorrect as the The Lancet published an article on that subject some months back.

So being able to sift through those tailored feeds of serendipity is absolutely amazing and I think it is also really interesting for showing you who is truly clued up on their subject matter. I have a deep-rooted prejudice which is that if people can talk fluently in everyday language about their job, it strongly suggests that they have fully incorporated their work into their character.

Q. AllTrials is a campaign which calls all past and present clinical trials to be registered and their full methods and summary results reported. How did this project come about? Are you able to measure its progress so far?

A. AllTrials is not really about open research in the sense of open lab books or anything technical. Its message is this - if you have completed a clinical trial, you have to share the full methods and summary of results with doctors, researchers and patients because that is the only way we can make truly informed decisions about which treatment works best.

It was precipitated by claims from people in the industry around 2012 that the problem of trials going missing in action no longer existed and that it had been fixed. This was in response to my book Bad Pharma. I was kicking around on my own trying to get people working in government to take it more seriously and simultaneously, many leading names in academia had been trying to raise these issues for some time, such as Iain Chalmers and various people at the BMJ. It seemed to me that we needed to work in a constructive and collective way in order to fix this problem.

So we hooked up with Sense About Science, a professional lobbying organization and a really great, interesting charity who previously mocked quacks in science but also worked with others in helping to take the public engagement with science more seriously. They also worked on the libel reform campaign which came about after my friend, Simon Singh got sued for libel over some unkind things he said about chiropractors and that was a couple of years after I got sued by a vitamin pills salesman called Matthias Rath in a case which was unsuccessful but it cost the Guardian  500,000 to defend. We got a change in the law and it was clear to me that Sense About Science was strategic and cut straight to the heart of the matter and that’s what we needed with clinical trials.

In terms of our impact, one can quickly measure process outcomes e.g. we can count the number of meetings we have had with MEPS, journalists, etc.; we can say for definite that we have triggered various stories; we have seen our policy analysis being picked up and used by others. We are just about to launch our trials transparency index which is an audit of the 50 largest global drug companies. To be clear, drug companies are not the only bad people here because non-industry sponsored trials are often appalling at sharing their results too but what is interesting about drug companies is that they are the only people who actively campaign against transparency. This makes them out as the enemy which I don’t think they are – there is a range of views, policies and activities within the industry and what we have done with the trials transparency index is set about trying to map that.

Q. What kind of feedback do you receive from your audience? In terms of positive feedback, do they include statisticians or members of the public who applaud you for spotting these inconsistencies? How about the negative?

A. Yes, people like what I do and there are also people who despise me! You have to be really careful if you have any kind of public profile because you need to keep listening to feedback and yet ensure that the positive and negative stuff doesn’t really hit you. I think that is one nice thing about being a doctor and working in difficult areas for a long time, in that you develop a degree of equanimity. The approval of strangers is clearly intoxicating and you see people being taken in by it. You have to try not to get caught up in it and when people say horrible things, it is pretty easy to ignore. If someone is cross with me on Twitter, I sometimes check their profile and it turns out that that person is cross with everyone. You also have to read and make sure that someone has not identified something where you have been either flat wrong or more commonly, that there may have been nuances or other more interesting contextual issues that you had missed.

Q. What do you see as the greatest challenges facing the professions of medicine and statistics in the coming years?

A. I think in medicine and statistics it is really obvious. We need to up our game and obtain structured, shared, interlinked data on everything that we do. You can see that people are making baby steps towards that e.g. ORCID IDs for authors so that you can match up papers and the standard results from clinical trials. You can imagine a vast interlocking network of data from evidence-based medicine that would support shared decision-making in a clinical setting. This would then free up doctors to do what only people can do with patient interaction – to talk about priorities and benefits vs side effects, etc. I think the real challenge for doctors and statisticians now is how we can create an information architecture of the process of gathering and disseminating knowledge to doctors and patients, so that they can then have a chat on the best techniques. That is something that we are insufficiently ambitious about in medicine and that is partly what I am doing here at Oxford. There are hundreds of people around the world working on these issues but they don’t get the same amount of money as one individual clinical trial and that is very peculiar. That is probably our fault, because we don’t have a better catchphrase than the information architecture of evidence-based medicine.

To watch a video interview with Dr. Goldacre and to read the complete interview online, visit: Statistics Views.