Tuesday 23 June 2015

The difference between science and 'public health' - a visual illustration

A recent article in the Journal of the American Medical Association discusses the decline in hospitalisations for children with gastroenteritis after the rotovirus vaccine was introduced in 2006. It is a good news story but I can find no record of it being reported anywhere outside the specialist medical press. It comes with a graph which tells the story very clearly...

Note the straightforward presentation of the data, with the decline in admissions being immediately visible after 2006. There is no modelling, remodelling, trickery, counterfactuals or any kind of flim flam.

Contrast this with the widely reported study which claimed that there was a large reduction in hospitalisations for children with respiratory disease after the smoking ban was introduced in England. That study also came with a graph, but it clearly showed a rise in admissions. The rest of the story came from the wishful thinking of activist-researchers and an indefensible methodology. Pitifully, the media lapped this up as proof that "11,000 fewer children have been admitted to hospital with lung infections since the ban was enforced".

Or contrast it with the study (involving the same author, Christopher Millett, plus Stanton Glantz) which claimed that there was a dramatic decline in childhood admissions for asthma after the same smoking ban. This time, the rate was roughly the same before and after ban, but once again the activist-researchers retrospectively painted a slightly higher line above the post-ban series in a (successful) attempt to fool the media into believing there had been a "sharp fall" (as the BBC put it).

What these graphs really show is the difference between science and 'public health'. It is the difference between medicine and political activism. It's a big difference, as big as the difference between hospital admissions falling and hospital admissions rising.

The first graph shows a major decline in hospital admissions as the result of effective, evidence-based medicine. The results speak for themselves. They require no salesmanship, no spin and no statistical tricks.

The other two graphs show no decline in admissions. That is hardly surprising since the intervention was an evidence-free political act drawn up by single-issue pressure groups who have little, if anything, to do with health and nothing at all to do with medicine.

The first study is a serious piece of research which received no media attention. The other two studies are policy-driven quackery of the worst kind which received global media attention.

That, in a nutshell, is what defenders of reason are up against.

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