Autism & Internet Memes

I ran across this meme on my FB feed today:

What strikes me as fascinating is not that Mr. Wakefield said these things, if indeed he did. One might be surprised that he is continuing to push this particular line after being so thoroughly discredited from his profession for doing so. But that's his affair, and in a way ego defense isn't very surprising.

I'm also not surprised that he has attached his cause to the US presidential campaign. That tends to happen with all sorts of issues - people who feel strongly about something try to tie themselves to one camp or the other in the hopes of elevating the status of their issue by attaching it to something more visible than themselves. So this is par for the course.

What I do find striking is that he apparently still has a following. Despite being thoroughly discredited, denounced, and stripped of his license to practice medicine in his own country (the UK), folks still believe in his message.

These same folks frequently talk about the need to "do your own research", and are often quite adept at using the internet and research databases to find scientific or pseudo-scientific works that support their point. Yet they do not read, cite, or credit the large meta-analysis studies that have examined (and discredited) vaccine-autism correlation, nor do they seem to pay any attention to half the feed that appears if you google "Andrew Wakefield" or if you read the man's Wikipedia entry.

Leaving aside the scientific questions here for a moment, the social science here is fascinating. Followers of Mr. Wakefield have constructed an entire alternative reality, complete with its own websites, its own documentary, and its own "research" and articles. The audacity of this alternate universe is far greater than that employed by those interested in what used to be known as "creation science". In that case, young-earth creationists were content to simply call for "teaching the controversy", standing their material up against the opposite view. Here, Mr. Wakefield's followers deny the legitimacy, or even the existence, of everything that doesn't support his views. All of it is held to be a vast conspiracy promulgated by multinational drug companies to profit from harming infants - a claim as breathtaking in its scope as it is unbelievable.

The level of cognitive defense required to maintain this view is really quite remarkable. It's one thing to say, hey, I think there's something to this, let's look into this further. It's another to wish away every last bit of evidence published over nearly 20 years in most of the major relevant scientific journals around the world. To continue to defend this position over time means not only violating the very "do your own research!" cry that Mr. Wakefield's followers are so fond of; it means sealing yourself off from most of the rest of the world on the one issue that you claim matters to you most.

I doubt that Mr. Wakefield's argument above is going to have any significant impact on the US presidential election, because I don't know that there are enough people in the US passionate enough about this issue to matter electorally. But the social behavior itself really is fascinating.

Expertise Matters

Like most of us, I get a fair bit of nonsense that floats by my feed on Facebook. This is actually the byproduct of a deliberate strategy of keeping a diverse group of FB friends and connections. I don't want to fall into the "echo chamber" trap, and I find it interesting to see what people who think very differently from me are thinking and sharing among each other.

Sometimes, though, I run across something so ridiculously silly I just can't ignore it. Today is one of those days:

Now, I get that there are people out there convinced that everything that pharmaceutical companies do is evil. Pharmas like Eli Lilly and Pfizer have unfortunately done enough bad things that, if you cherry-pick your evidence, it's not hard to justify this viewpoint (I don't say it's right, but I can see where you could get the evidence for it).

But the response to this belief is for folks to go out and "do their own research". Do they first bother to go out and obtain degrees in biomedical sciences so they can do that research? Of course not! Because anybody can read peer-reviewed scientific research in obscure journals and understand it, right?

I'm not surprised, but it does still amaze me that people can manage to tie their minds up into this particular pretzel. Even allowing for the different meanings of the term "research", this is an absurd proposition. If by "research" we mean here going directly "to the source" and reading the results that non-biased, non-industry scientists produce in their labs, the notion that anybody with less than a graduate education in the relevant field can do this is laughable. I have as much chance of getting into this summer's olympics as the average suburbanite with a college degree in communications has of understanding the real meaning of an article published in the International Journal of Toxicology, much less in understanding the broader scope of literature in which that article is situated.

This, of course, is one of the factors that allows for communities of people to band together and believe absurd things. The echo chamber that is Facebook facilitates this, but long before Mark Zuckerberg some folks figured out that you can ignore the rest of the world and believe whatever you want about it, so long as you discard the idea of expertise. In order to uphold this notion, you have to believe - even if you don't articulate - that education, practice, and experience don't really matter, and that anybody can master anything with just a little bit of effort. I mean, how hard can biochemistry be really?

The problem, of course, is that the world doesn't care what we think. As Richard Feynman famously wrote in the last sentence of his report on the Challenger disaster, "For a successful technology, reality must take precedence over public relations, for nature cannot be fooled."

So folks are welcome to think that drug companies are evil (and somehow, amazingly disciplined - you'd think that more of the thousands of employees would leak the plans of their evil mastermind overlords). They're welcome to think that research that reaches conclusions they don't like isn't true, and that junk science and psychobabble that confirms their beliefs is real. What none of this will change is the reality underlying the science. Bacteria, genetic mutation, climate change - all of these things will happen whether we understand them or not, and whether we like them or not.

So if you find yourself patting your friends on the back for doing their "own research" that fits some broader conspiracy theory about science, take a step back. Adopt a little humility. Imagine for a moment that the thousands of people who have collectively spent millions of hours in labs struggling to master complex subjects might actually know something that you don't. Then imagine a world in which we struggle to find the truth together through dialogue and real research rather than snarky, self-congratulatory memes.

How to Mislead with Spiffy-Looking Graphs, or The Importance of Good Education

I ran across this graph today on my FB feed:

Now, I cannot easily or quickly verify the source of this data or figure out who the "Andrew Barr" named here is. But let me take these numbers at face value for the purposes of argument.

The data appears to make a remarkable comparison. At first glance, it appears to show that measles as a public health problem had largely died out long before the vaccine was introduced in the United States. This observation, if true, would call into question the relationship between vaccination and the suppression of the measles disease - precisely what the poster of this graph wanted to do.

But notice what is actually being compared here. This is not a graph of measles cases. It's a graph of mortality, normed per 100,000 population. It's not a graph of how much measles there is in the US population, but rather a graph of how deadly the disease is in a proportional sense over time.

In that light, it's not at all surprising to see the decline. Advances in modern medicine have permitted us to render many things which used to be fatal now much less so. Today, people who contract measles are much less likely to die than in those who caught the disease 100 years ago. That's a great thing, and the decline in mortality does in fact have little to do with vaccination.

The rate of measles, on the other hand, is another story entirely. Here's a graph of the actual number of measles cases in the US, in thousands, from 1954 to 2008:

This graph is based on CDC data; I retrieved it here. If you want to argue that CDC data are falsified by some devious government conspiracy, then the conversation is over and you might as well go elsewhere. Otherwise, we can continue.

Note what this graph shows. In the latter half of the 1950's and the early 1960s, the number of measles cases did decline, but was still up over 400,000 cases per year. From 1964 to 1968, the years following the introduction of the vaccine, that number collapses, and with two brief blips over 50,000 in the 1970s never recovers again. Today the number of cases is negligible, essentially reduced to a statistical zero.

The argument that "the measles vaccine didn't do anything" falls apart the moment you show the second graph. Of course, folks who want desperately to believe that vaccination is bad won't show you this graph - they won't even find it themselves.

This is why education is so important. We need to teach our children how to read graphs, how to understand the difference between a graph of total numbers and one normed per 100,000 population, and how to question the data presented to them and the conclusions drawn therefrom. There are lots of charlatans and snake-oil salesmen out there with pretty graphs and thundering voices trying to get us to buy their wares. The defense against this is strong education, from elementary school all the way up to college. We don't have to fall for this kind nonsense, however pretty it is.

Vaccines, Climate Change, and the Misuse of "Research"

Because of the increase in measles cases across the United States, a lot has been written recently about vaccines and the anti-vaccine movement. I've avoided blogging on the subject, partly because the discussion has been a lot of heat and not very much light and partly because it's not so much a debate or a conversation as a minority of folks screaming at the top of their lungs while holding fingers in their ears lest they listen to anyone else. Frankly a lot of it is pretty ugly, so while I have taken some pains to make sure I read some "authentic" voices on the anti-vaccine side, on the whole it all just makes me sad.

I do think that the continual parade of claims and counter-claims, of facts and factoids and made-up nonsense, is counterproductive because it isn't an argument about science or what's true. The primary drivers, as they so often are, amount to tribalism - people protecting their self-identities. I read this piece the other day and was glad to find a medical professional who gets this. Click the link - it's well worth a read.

So what do I have to add to this conversation? I want to focus on the use - and more particularly the misuse - of one word, "research". I have seen this word misused in recent weeks by anti-vaccine parents, I have seen it misused in exactly the same way by climate change "skeptics" in recent years, and in similar fashion by partisans on any number of issues over time.

As an illustration, let me borrow words from an anti-vaccine parent posted to the internet (underlining added):

You want to vaccinate? Go for it. I choose not to. But shouldnt we all have the freedom to choose what's right for our family? My unvaccinated child is not putting your vaccinated (and therefore protected-right?) child at risk. In fact it's the opposite. Your vaccinated child sheds his/her vaccine for days putting my child, and others who cannot vaccinate due to medical reasons, at risk. But I'll assume that risk and hope his immune system is strong enough to protect him. You do your thing. I'll do mine. Just stop assuming I don't care about others, because I do. I care enough to watch Vaccine Nation to understand herd immunity and research vaccines for myself. I've read the package inserts from the manufacturer websites. Have you?

Now, to be clear - I do not doubt this person's sincerity or motives. I believe this author genuinely believe these words. The problem here is a fundamental misunderstanding of the term "research".

I see this claim a lot, not just from anti-vaccine folks but from climate change skeptics, gun-rights advocates, and many other partisans for various issues. They will claim to have "researched" something to come to their own conclusions - a subtle cultural argument that appeals to Americans' individualism. After all, who wouldn't want to come to their own conclusions instead of being one of the "sheeple" who follow the herd, right?

The problem is that what these people call "research" consists only of reading stuff that other people have written. The most generous thing that could be said is that they are engaged in literature review - reading the research of others in order to get a sense of what's already out there in the field. Lit reviews, as anybody trained in any academic or scientific field knows, are a necessary precursor to doing research. But they are not research itself.

Actual research involves:

• Formulating a falsifiable hypothesis
• Designing a legitimate and non-biased test for that hypothesis including valid and reliable operational measures for the key concepts
• Gathering original data to perform that test
• Analyzing the results
• Carefully drawing conclusions by comparing the data with the hypothesis
and then (the gold standard)
• Allowing the entire process to be author-blind reviewed by other established experts in the field who are qualified to judge the work.

The parent cited above, and all of this ilk, haven't done any of this. All they have done is read some other stuff that other people did, usually based on non-falsifiable hypotheses to begin with (for example, "the CDC is the center of a global conspiracy to cover up the truth.")

Moreover partisans on a given issue don't even do lit review right, because they only read or watch the stuff that already agrees with their point of view. They will occasionally cite a peer-reviewed article, often misreading its conclusions in the process (since they are rarely, themselves, actual experts in the field). They dismiss studies that draw different conclusions and evaluate studies with the grossest and most obvious of double standards. Watching a documentary film made by this man hardly qualifies as a thorough review of the relevant literature on any subject.

This, of course, is why actual expertise is worth something. People who are qualified to conduct actual research in a given field have to spend years learning how to do it right. Because of my education, I am qualified to do research on political phenomena. I am not qualified to do research on vaccines. And neither are nearly all of the anti-vaccine voices out there.

So the next time you run into someone spouting what appears to be a questionable point of view on a given subject and claiming to have "done their own research", call them on it. Ask what that "research" consists of. Ask what data they have collected, what testing and analysis methods they used, and what hypothesis they were testing. I expect the answers you get will be much more heat than light, because this isn't really about science. But at least people should admit that.