Tag Archives: NHS

Lots of sexual partners is apparently good for you !

5 Nov

Even by the standards of the British media this is a very strange bit of reporting. Last week a number of usually fairly conservative parts of the British press reported on a study suggesting that having more that twenty sexual partners could reduce a males chances of developing prostate cancer !

telegraphmirrormailindy

Each of these newspaper stories is reporting a paper by Spence, Rousseau and Parent called ‘Sexual partners, sexually transmitted infections, and prostate cancer risk’ published in the journal  Cancer Epidemiology.

As a teaching example, this story has two great things going for it. First, as I’ve previously written about, ‘sex’ stories are a great way of engaging undergraduate students, and second you don’t have to be a urology expert to start demolishing this story. A moments thought about what hypothesis might be being tested here is worthwhile. Initially you might imaging some sort of ‘exercise’ theory, but of course we’re not talking here about frequency of sexual intercourse, but number of sexual partners (one could have had 21 sexual partners and only had sex 21 times, or one sexual partner and sex many hundreds of times !), which leaves me to think that we might be talking about a ‘promiscuous personality’ in some way inoculates against prostate cancer. As you might imagine, what you actually find is only post-hoc theorising about causality !

When you actually delve into the paper itself two things emerge, firstly that the 19% reduction in cancer risk reported in the newspaper stories wasn’t statistically significant, and secondly that the effect reported only appeared with 20+ sexual partners, 19 partners made no difference at all.

As the wonderful NHS Choices websites speculates, you do wonder if this isn’t an example of just recycling the press release, rather than actually reading the original paper, and whether those writing these stories have and ‘science’ knowledge to back up their work. I shall try this out with my students next week, and report back on the impact !

 

Flu jab cuts heart attack deaths ??

3 Sep

Screen Shot 2013-09-03 at 12.48.53Last week the Daily Express reported a study from Australia suggesting that the winter flu vaccine had a positive effect on heart attack deaths amongst middle aged people, and thus was a very cheap way for the NHS to cut spending on heart related treatment. This story offers a couple of really good opportunities to get students to think rationally.

Just by getting students to read the whole of the Express’s story it becomes rapidly clear that whilst the headline refers to heart attack deaths, the study didn’t actually ever look at people who had died from heart attacks. This sort of exercise seems like a very simple way of getting students to delve a little further into stories, and not to take them at face value.

This story becomes a good deal more interesting if one delves even deeper into the original research (Full details can be found on the excellent NHS Choices site). The point that appealed to me, and seems like it would grab the attention of students is that the original study was financed by GlaxoSmithKline that produces a flu vaccine. Or course, this doesn’t necessarily suggest any impropriety on the part of the paper’s authors but it does impact on how a reader interprets the study.

As currently in the process of writing a new lecture on the UK’s MMR vaccine fiasco, and thus anything that gets students to focus on all the details of a study (including where the funding came from) seems really useful.

 

 

 

 

NHS seems to think homeopathy isn’t too bad !

21 Feb

Homeopathic_medicine

This is a really disappointing story that I came across via the excellent blog of David Colquhoun, Professor of Pharmacology at UCL.

For a number of years I’ve been encouraging my students to the National Health Service’s web site NHS Choices as a reliable source of about the range of health-related news stories that populate the British press on a daily basis. Sadly, if you look at the NHS Choices page on Homeopathy something very odd appears. Unlike the equivalent American website, NHS Choices fails to point out the there is no scientific evidence supporting homeopathy and it would be perfectly possible to read the page as an endorsement of homeopathy as a treatment for a range of ailments.

All of this is depressing enough, but it becomes worse when you look at what Professor David Colquhoun discovered, that the changes to the NHS Choices page seem to have been driven by an organisation supported by Prince Charles !! ~It seems like the NHS may have fallen pray to a rather odd combination of political correctness and the desire for ‘balance’ that undermines a lot of TV news science coverage.

What I find really intriguing is that what seems like a serious backward step in getting rationality to a wider audience might actual benefit my teaching. When I get around to teaching about homeopathy in the autumn it will be interesting to see the impact on the students when they realise that they understand something that the NHS appears not too. I suspect that this might actually reinforce the value of learning to think rationally. So every cloud may well have a silver lining.

UPDATE 22nd FEB 2013

In an even more bizarre turn of events I’ve just read a Daily Mail article that very nicely summarises what David Colquhoun has uncovered. We now seem to be in the very odd situation of the Daily Mail being a more reliable source of information than the National Health Service !

The Irrationalists have landed. Another Americanism crosses the Atlantic !

19 Sep

A few week’s ago I wrote about cultural differences between the US and the UK, and talked about the Texas Republican Party’s decision to try to outlaw critical thinking. The subtext of much of the writing about this bizarre position (including my own writing !) was ‘we Europeans are much saner than those odd Americans’, but a couple of things that I’ve read over the last week make me think that the irrationalists may well have crossed the Atlantic and established a bridgehead in the UK Government.

Last week’s Government reshuffle in the UK led to the appointment of Jeremy Hunt as Secretary of State for Health, running one of the worlds largest employers with a multi-billion pound budget. Things become interesting if you delve a few years to an Early Day Motion put before the House of COmmons in 2007. EDM 1240 stated :

‘That this House welcomes the positive contribution made to the health of the nation by the NHS homeopathic hospitals; notes that some six million people use complementary treatments each year; believes that complementary medicine has the potential to offer clinically-effective and cost-effective solutions to common health problems faced by NHS patients, including chronic difficult to treat conditions such as musculoskeletal and other chronic pain, eczema, depression, anxiety and insomnia, allergy, chronic fatigue and irritable bowel syndrome; expresses concern that NHS cuts are threatening the future of these hospitals; and calls on the Government actively to support these valuable national assets’

It is worrying enough that 206 MPs supported this motion, but amongst those MPs was Jeremy Hunt. We thus now have the slightly odd position of the British National Health Service being run by someone who doesn’t think ‘Science’ is the best approach to medicine. There is an interesting postscript to this, in that one of Hunt’s constituents wrote to him to question his support for EDM 1240, and received the following response :

Dear Mr Ellis,

Thank you very much for your letter regarding EDM 1240 in support of Homeopathic Hospitals. I appreciate that you are disappointed that I added my name to this motion, and read your comments on this issue with interest.

I understand that it is your view that homeopathy is not effective, and therefore that people should not be encouraged to use it as a treatment. However I am afraid that I have to disagree with you on this issue. Homeopathic care is enormously valued by thousands of people and in an NHS that the Government repeatedly tells us is “patient-led” it ought to be available where a doctor and patient believe that a homeopathic treatment may be of benefit to the patient.

I am grateful to you for taking the time to write with your concerns. I realise that my answer will be a disappointing one for you, but I hope that the letter helps to clarify my view.

Yours sincerely,

(Signed)

Jeremy Hunt Member of Parliament South West Surrey

You’ll notice here that Hunt’s has moved slightly from suggesting there is evidence supporting homeopathy to suggesting that ‘because people want it the NHS should pay for it’. You can find more of this story in an excellent summary written by Tom Whipple

The man charged with running the NHS being an advocate of homeopathy is worrying enough, but a second recent story suggests that ‘irrational’ thinking may well be spreading across the UK.

As part of the UK’s move towards state-funded schools being run by private organisation a number of new ‘Free’ school are due to open shortly. Amongst these are schools run by the Steiner Waldorf Schools Fellowship. Steiner already run an academy in Hereford where some disturbing evidence has appeared. The Hereford Academy has written to parents seeking permission to treat students using homeopathic medicines (including for burns !!!) and uses a Science textbook that questions the Darwinian explanation of evolution.

For anyone who might be imagining that this is a party-political point, it’s worth noting that the 206 MPs who signed EDM 12040 came from all three major political parties including some who really should know better (Vince Cable). ‘Irrationalism’ doesn’t seem to be associated with a particular political view.

(Just as I was about to post this piece live seen Mitt Romney’s ‘47%’ speech. Maybe the UK still has a way to go to reach the USA level of ‘Irrationalism’ !!!)

All of this seems to me to suggest that the ‘irrationalism’ that looks rampant in the USA is spreading to this country. It makes me even more convinced that universities need to be producing a generation of graduates who are equipped with the rational cognitive skills to fight back !

Homeopathy as a teaching example

3 May

I talk about homeopathy with my students, as an example of applying their rational thinking skills. I’ll write more extensively about how I integrate it into teaching over the summer (when marking has finished), but in the meantime a couple of things that have caught my eye.

FIrst, Ben Goldacre has just posted on his blog about UCH promoting a homeopathy course to their doctors.  I usually ask students if they think the NHS should pay for homeopathy, but asking if they should teach about it takes things to a whole new level.

Second, for the most part I shy away from using comedy in lectures, as I’ve suffered a few ‘tumbleweed’ moments during the past, but this example is too good to miss and after my lecture on homeopathy students seem to find it funny.

Ben Goldacre’s work

24 Apr

Doctor/Journalist Ben Goldacre has done a great job in the UK of promoting rational thinking, through his Guardian Column, web site and book he has written accessibly about ‘dodgy’ science and ‘dodgy’ science reporting.

FRom the point of view of teaching it’s particularly useful that many video recordings of Ben are available around the web. Students seem to find videos a very attractive medium, and hopefully by watching they they are attracted to reading Ben Goldacre’s written work.

I’ve included links below to some of my favourite Ben Goldacre videos

A talk from TED on his attempts to combat Bad Science

NHS video on the Placebo Effect

Newspaper headlines as an introduction

18 Apr

Getting students to realise that they can think rationally about material that is presented to them can be difficult when the material is from the discipline they are studying. Level 1 students seem to arrive at university pre-programmed to ‘record’ subject-specific information rather than ever ‘question’ it.

I have taken to using newspaper stories as a means of getting students to realise that they are able to question the material that is presented to them. During my first Level 1 lecture of the year I show students a range of newpaper stories and ask them to tell me what might be wrong with them. WIth very little prompting from me students are able to identify problems, even though they might not be able to attach an appropriate ‘label’ to the issue. I’ve set out a few of the examples I use below, but I always encourage students to email me new examples they come across.

I usually start with an obviously daft example to get them in the mood, i.e. this great story from the Daily Mail suggeasting that wine can turn you into a werewolf ! I don’t (usually) have to tell students that werewolves don’t exist, and with little prompting they come up with the idea of single-case studies themselves.

In the summer of 2009 the Daily Express produced a run of stories that provided good material. The front page story on the 5th July was Coffee cures Alzheimers’, and three days later on 8th July the front page story was about a pill that could add 20 years your life-span. A month later, on the 10th August the front page reported eye-drops that will cure blindness

These three stories allow me to start to introduce students to a range of ideas. The first story about coffee and alzheimers is solely work conducted on mice, the second story is frankly just a little odd. It usually provkes a discussion about ‘wouldn’t we have heard about this somewhere else’ and ‘wouldn’t the big cosmetics companies be involved in this’. The final story moves on from just mice as ‘participants’ to rats and then three human participants. The students can usually derive for themselves that the jump from three human participants to ‘WILL cure blindness’ is rather a large one.

At this point at least one student will usually suggest that these stories all seem a bit trivial and not much to do with psychology. However if you ask them to put themselves in the shoes of someone who’s partner is blind, or who’s parents (maybe grandparents) have Alzheimer’s and think about what their reaction would be, they rapidly see the point. This can also lead to a discussion of how enquires about such unproven treatments can tie up NHS GPs time, and allows me to introduce the students to the NHS’s web site addressing such stories.

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