Field of Science

Robert Kennedy's Anti-Vaccine Craziness

Robert Kennedy is obsessed with the notion that vaccines cause autism. He’s particularly obsessed with the discredited idea that thimerosal, a preservative used in some vaccines, causes autism. Now Kennedy is about to publish a new book on this topic, and he’s promoting it both in the press and, as described in today’s Washington Post, in the halls of Congress. He’s recently had personal meetings with U.S. Senators Barbara Mikulski and Bernie Sanders to try to convince them to take action based on his claims. Why is it that a scientifically unqualified anti-vaccine advocate can get a private audience with a U.S. Senator? Because he’s famous, that’s why.

Robert F. Kennedy Jr. is part of the most famous family in America. He’s the nephew of a former president and the son of a former senator and Attorney General, both tragically assassinated in the 1960s. Another uncle, Edward Kennedy, was a U.S. Senator for Massachusetts for decades. He gives hundreds of speeches a year, mostly on environmental issues, and he’s been an influential figure in the environmental movement.

But on the thimerosal issue, Kennedy has gone completely off the rails. He authored a Salon.com and Rolling Stone article (jointly published) nearly ten years ago that claimed not only that thimerosal-containing vaccines cause autism, but that “the government” knew about it and had been covering it up. Kennedy wrote then that
The story of how government health agencies colluded with Big Pharma to hide the risks of thimerosal from the public is a chilling case study of institutional arrogance, power and greed.”
Alarming-sounding stuff. The article is full of dramatic claims like this one. The only problem is, it’s all false.

I’ve been writing and speaking about the anti-vaccine movement for years, including articles in 2009 and 2010 on three landmark vaccine court rulings. As I explained back then:
Why was thimerosal introduced into vaccines? Well, early vaccines were administered from multi-dose bottles, in which bacteria could grow. In one particularly disastrous incident in 1928, 12 children in Australia died from staph infections after getting the diptheria vaccine from the same multi-dose bottle. After the introduction of thimerosal, bacterial infections caused by vaccination virtually disappeared.”
In the late 2000's, a special vaccine court conducted three lengthy hearings in which the anti-vax advocates were asked to present their best cases. One of the cases focused specifically on the question of whether thimerosal in vaccines cause autism. In that case, the judge concluded:
“The numerous medical studies concerning the issue of whether thimerosal causes autism, performed by medical scientists worldwide, have come down strongly against the petitioners’ contentions. Considering all of the evidence, I find that the petitioners have failed to demonstrate that thimerosal-containing vaccines can contribute to the causation of autism.”
As a lawyer, Kennedy should be able to understand this. The science, which Kennedy apparently does not understand, leads to the same conclusion: in study after study, scientists have found no link between thimerosal and autism, or any other kind of neurological disorder. And as RFK Jr knows, thimerosal was removed from childhood vaccines in the U.S. over a decade ago, and the rate of autism diagnosis continued to rise. This fact alone contradicts his major claim. 

What was shocking to me, the first time I heard Kennedy talk about thimerosal in vaccines, was how absolutely certain he is that he is right. Today's Washington Post article describes a man who remains utterly convinced, despite the mountain of evidence against him.

After Kennedy's Salon.com article appeared, scientists responded quickly and convincingly, pointing out its numerous flaws and distortions. Salon.com tried to fix the problem, issuing five corrections before throwing up their hands and removing the article entirely from their website. Rolling Stone also took down the article. Salon’s editor-in-chief wrote an apology, saying 
I regret we didn’t move on this more quickly, as evidence continued to emerge debunking the vaccines and autism link. But continued revelations of the flaws and even fraud tainting the science behind the connection make taking down the story the right thing to do .”
Kennedy has steadfastly refused to admit any errors, ever. As of today, his own website still displays the original article, without even the small corrections that Salon.com had made. He’s been embraced by the anti-vaccine movement: he gave a keynote talk at their annual conference, Autism One (prompting this response from one well-known science blogger), and he even spoke at one of Jenny McCarthy’s “Green Our Vaccines” demonstrations.

As Keith Kloor wrote today in his online column at Discover, Kennedy has not only failed to convince the world that he’s right (and the entire scientific community is wrong), but he doesn’t really care. He told Kloor that “if I die poor, then I go down fighting for what’s right.” (This despite the ridiculousness of the notion that the wealthy Kennedy family will ever be poor.)

By ignoring the scientific evidence that shows that thimerosal and vaccines have no link to autism, Robert Kennedy has placed himself firmly in the camp of conspiracy theorists and cranks. He’s also demonstrated breathtaking arrogance. He believes that despite his lack of scientific training, he knows the truth that every scientist who’s studied this issue has missed. 

Even worse, Kennedy is using his fame to spread anti-vaccine misinformation, which has contributed to an alarming rise in the number of infectious disease outbreaks here in the U.S., including major outbreaks of measles and whooping cough. Though I doubt he will listen to me (he’s ignored everyone else), Kennedy needs to take a hard look at the harm he’s causing to defenseless children, the elderly, and cancer patients, and anyone else with a weak or compromised immune system. His advocacy of bad science will cost lives, if it hasn’t already.

When I've heard Kennedy talk about environmental topics, where I agree with him almost completely, I’ve been impressed by his passion and his seeming command of the issues. But having heard him speak about thimerosal and vaccines, I now realize that he’s a dangerous idealogue, willing to distort the truth so thoroughly I can’t believe a word he says. The only solace I can take from today’s Washington Post article is that Senators Mikulski and Sanders don’t believe him either. Both of them brushed him off. Next time, they shouldn’t bother giving him an audience.

Stop teaching calculus in high school

Math education needs a reboot. Kids today are growing up into a world awash in data, and they need new skills to make sense of it all. 

The list of high school math courses in the U.S. hasn’t changed for decades. My daughters are taking the same courses I took long ago: algebra, geometry, trigonometry, and calculus. These are all fine subjects, but they don’t serve the needs of the 21st century. 

What math courses do young people really need? Two subjects are head-smackingly obvious: computer science and statistics. Most high schools don’t offer either one. In the few schools that do, they are usually electives that only a few students take. And besides, the math curriculum is already so full that some educators have argued for scaling back. Some have even argued for getting rid of algebra, as Andrew Hacker argued in the NY Times not long ago.

So here's a simple fix: get rid of high school calculus to make way for computer programming and statistics.

Computers are an absolute mystery to most non-geeks, but it doesn’t have to be that way. A basic computer programming class requires little more than a familiarity with algebra. With computers controlling so much of their lives, from their phones to their cars to the online existence, we ought to teach our kids what’s going on under the hood. And programming will teach them a form of logical reasoning that is missing from the standard math curriculum.

With data science emerging as one of the hottest new scientific areas, a basic understanding of statistics will provide the foundation for a wide range of 21st century career paths. Not to mention that a grasp of statistics is essential for navigating the often-dubious claims of health benefits offered by various "alternative" medicine providers. 

(While we're at it, we should require more statistics in the pre-med curriculum. Doctors are faced with new medical science every day, and statistical evidence is the most common form of proof that a new treatment is effective. With so much bad science out there (just browse through my archive for many examples), doctors need better statistical knowledge to separate the wheat from the chaff.) 

Convincing schools to give up calculus won’t be easy. I imagine that most math educators will scream in protest at the mere suggestion, in fact. In their never-ending competition to look good on a blizzard of standardized tests, schools push students to accelerate in math starting in elementary school, and they offer calculus as early as the tenth grade. This doesn’t serve students well: the vast majority will never use calculus again. And those who do need it - future engineers, physicists, and the like - can take it in college. 

Colleges need to adjust their standards too. They can start by announcing that high school programming and statistics courses will be just as important as calculus in admissions decisions. If just a few top universities would take the lead, our high schools would sit up and take notice.

We can leave calculus for college. Colleges teach calculus well, and 18-year-old freshmen are ready for it. Every major university in the country has multiple freshman calculus courses, and they usually have separate courses designed for science-bound and humanities students. Many students who take high school calculus have to re-take it in college anyway, because the high school courses don’t cover quite the same material. 


Let’s get rid of high school calculus and start teaching young students the math skills they really need.

Can a cosmetic lotion turn back time? Not yet.

A few years ago, L’Oréal introduced two new product lines that used “gene science” to "crack the code" and make your skin young again. The new products were supposed to boost the production of “youth proteins” in your skin, making it look years younger. According to L’Oreal’s ad campaign, the benefits were clinically proven.

Except they weren’t. Last week, the FTC announced that L’Oréal had settled charges that the advertising for these products, Youth Code™ and Lancôme Génifique, was deceptive and misleading.

In a statement, L’Oréal responded that these claims "have not been used for some time now" and "the safety, quality, and effectiveness of the company's products were never in question."

What did L’Oréal claim? Here are some quotes from an ad for Lancôme Génifique:
"At the very origin of your skin's youth: your genes. Genes produce specific proteins. With age, their presence diminishes. Now, boost genes' activity and stimulate the production of youth proteins."
This sounds pretty amazing - and expensive, as much as $132 per bottle for Lancôme Génifique. L’Oréal Youth Code™ makes similar claims: on of its ads asks "Imagine: what if you could grow young?" and then goes on to promise "Even though you can't grow young, we now have the knowledge to help you begin cracking the code to younger acting skin."

The FTC apparently disagrees with L’Oréal's statement that the effectiveness of these cosmetics was not in question. Here is just one claim from a L’Oréal's ad that was highlighted by the FTC:
Génifique Youth Activating Concentrate is clinically proven to produce perfectly luminous skin in 85% of women, astonishingly even skin in 82% of women, and cushiony soft skin in 91% of women, in seven days.
This claim appears in a very scientific-looking bar graph in ad for Lancôme Génifique. It must be science - it's a graph! Alas for L’Oréal, the FTC states that science doesn't support this claims and that it is "false and misleading."

When I asked what studies supported the claim that these products could activate genes, a L’Oréal spokesman pointed me to two published studies, here and here. These are indeed peer-reviewed studies in high-quality journals. However, they don't support the claims made for these skincare products. Instead, they examine which genes are activated when the outer layer of skin is stressed by tape stripping, UV radiation, and washing with detergent. Neither study provides any evidence for a lotion that could activate the same genes, nor do they show that activating those genes could restore skin to its youthful state.

Can skin cream possibly make your skin young again? Well, it's plausible. A baby's skin does behave differently from an adult's skin, and much of that difference may be due to genes being turned on or off. But today, even if we knew the identity of these "youth proteins", we don't have the technology to turn them on.

To their credit, L’Oréal does invest significantly in research, so maybe they will find a youth-restoring cream one day. But not yet.

It's easy to find dramatic claims for products that restore youthful skin. Procter and Gamble's Olay® has many webpages devoted to anti-aging products, and you can be pretty certain that none of them will make you young again either. Like L’Oréal, P&G makes claims about genes:
"That discovery [the human genome] led P&G Beauty Scientists to explore how skin-related genes respond to aging and environmental stress at the molecular level."
As a geneticist myself, I can't help liking the idea that we might somehow convince skin cells to turn on a set of genes to restore their youthful state. Perhaps one of these companies will someday develop a lotion to do this - I hope they will. But they haven't done it yet. So for now, save your money: expensive skin creams are no better than inexpensive ones.

The Cable Companies Want to Control our Internet Access. We are so hosed.

If you’re reading this, you care deeply about net neutrality - even if you don’t know what it means. How would you like to pay 2, 3, or maybe 10 times as much to access all the websites you frequent? Think it can’t happen? Well, think again.

The cable TV companies that control most of America’s access to the Internet want to change your online experience - for the worse. If we allow them to destroy net neutrality, here’s how your Internet service might look very soon:
Try out “Basic Internet” package! For only $49.99/month, we’ll set you up for super-fast Internet, with 100’s of websites available - but wait, there's more!

Do you like Gmail? Get Gmail service for just $8.99 per month extra! Want to watch Netflix movies? Just $29.99/month for speeds almost as fast as you enjoy now! And try our “News Xtra” package featuring CNN for another $29.99! Sports? Of course! Our Active package, including ESPN, is just $49.99!

But wait! Our special SuperNet package gives you all these websites and more for just $129.99/month!*
*Don't expect us to really explain what the * means.

This is no joke: the cable companies already deliver television this way, despite years of complaints from consumers about high costs and bundles with hundreds of useless channels. When you have a monopoly, you don’t have to listen to customers.

As bad as it might be for Google and Netflix, the end of net neutrality will be far worse for the countless small entrepreneurs and innovators who can’t afford to pay fees to the ISPs. The Los Angeles Times reported this week that YouTube video stars fear that “the end of the world is near.” These are independent video artists who make a modest living from the small amount of ad revenues they earn from their content. If net neutrality goes away, they’re toast.

Net neutrality is very simple - it’s how the Internet works now. Basically, all traffic is treated the same, just bits and bytes zipping around on the network. Net neutrality says that Internet service providers (ISPs) should treat all data equally, just as they do now. The ISP just provides the pipes.

One of the best explanations of net neutrality that I've found is here. Check it out.

The FCC can safeguard net neutrality by simply declaring that Internet service should be regulated as a utility, like electricity or gas. But FCC Chairman Tom Wheeler has other plans; he wants to try self-regulation first. 

Let’s see how that works out. 

The issue goes beyond simply the cost of net access. Free speech is under threat too. Suppose Comcast, Time Warner, AT&T, or Verizon decides it doesn’t like the content of, say, Fox News. Or The Huffington Post (this cuts both ways). They can just increase the costs to access those sites, and viewership will crumble. 

The possibilities for limiting or even censoring content providers are endless.

FCC Chairman Wheeler is a former lobbyist for the cable industry; thus it’s no surprise that he is sympathetic to the cable companies. His latest proposal would allow ISPs to charge us more for Netflix (say) as long as it’s “commercially reasonable”. This could be the beginning of the end of the Internet as we know it.

The ISPs must be salivating over the prospect of how much more they're going to charge us. This will be almost pure profit: they'll just monitor our web traffic and send us the bill.

All is not yet lost. The FCC had a policy in place to guarantee net neutrality until January of this year, when a federal court ruled it had exceeded its authority. The court made it clear, though, that the FCC could simply re-classify broadband Internet service as a “telecommunications service” (which is precisely what it is) and it could then re-impose the previous rules. But the cable companies have jumped into high gear and are lobbying furiously for Wheeler - who used to lobby for them, remember - to proceed with his “commercially reasonable” discrimination policy.

Wheeler’s proposed policy will be a disaster. The FCC needs to take action before irreparable damage is done. If you want to express your opinion, FreePress.net has an easy way to do so.

The cable industry is famous - almost laughably so - for bad customer service. Indeed, Comcast won the “Worst Company in America” competition this year, followed closely by Time Warner, Verizon, and Monsanto. I can’t think of a worse collection of companies to control our Internet access.


Let's speak up for research that saves lives

In this week’s Science magazine, former Republican Congressman John Porter calls on scientists to “speak up for research.” Well, I’m all in.

We’re in the midst of a remarkable stream of scientific and medical advances, spurred by dramatic advances in biotechnology, computing, and miniaturization. Our knowledge of biology has led to amazing leaps in our understanding of aging, immune responses, inherited diseases,  and brain function, to name but a few. And yet we're cutting science funding, year after year. As Porter writes,
“the general public, and in particular elected officials, have failed to embrace the promise of cutting-edge science as a means to improve health and the economy.” 
Somehow we found (or borrowed) $2 trillion dollars to spend on wars in far-off countries whose citizens don’t like us - a cost that will at least double before we’re done paying the bills. And some politicians this past week were demanding that we invest billions more in Iraq, money that we don’t have. It's touching how concerned they are for the citizens of Iraq.

Meanwhile, eight of the top 10 causes of death in the U.S. are diseases that we might cure through better research, including heart disease (#1), cancer (#2), Alzheimer’s, diabetes, and kidney disease. We already have far better treatments for these diseases than we had a few decades ago, thanks to our past investments in biomedical research.

In this column over the past few years, I’ve highlighted just a tiny sample of the remarkable advances coming out of the scientific world, such as


Curing these diseases will not only save lives - it will also save money. A nonpartisan study revealed that publicly-funded research generates returns of 25 to 40 percent a year. And former Congressman Porter explains,
“If a treatment became available in 2015 that delayed the onset of Alzheimer's disease by 5 years annual Medicare and Medicaid spending would be $42 billion less by 2020.”
Without investment in research, though, these treatments will never arrive. Meanwhile, we’re spending $400 billion (13 times the entire annual NIH budget) on a new fighter plane that won’t even be ready to fly for another 5 years, after which the Pentagon says it will cost $850 billion to keep it going. We’re spending billions more on military equipment that even the Pentagon doesn’t want, such as the Global Hawk drone program, which Congress is forcing the Air Force to keep.

Obviously, the military-industrial complex has better lobbyists than we in the biomedical research world have.

We don’t invest in research just to make money, though. Make no mistake: biomedical research saves lives. We’ve effectively cured many types of childhood cancer such as retinoblastoma and Hodgkins lymphoma, but there are over 200 types of cancer, most of them still needing far more research.

We need elected leaders with the vision to re-examine our priorities and invest in the future. The U.S. scientific research enterprise remains the envy of the world, but it won’t stay that way long if we keep cutting it as we have been.

How much should we invest in biomedical research? Let me put some numbers on the table - not that we can get there overnight, but we could set these as goals and and then figure out how to get there.  How about allocating 2% of our total budget - $75 billion - for all of our biomedical (NIH) and basic science (NSF) research?  NIH’s budget is currently about 4 times the size of NSF; if we keep that ratio then NSF would get $15B and NIH $60B. That’s about twice what we spend now. We've done this before: Congressman Porter and his colleagues advocated a doubling of the NIH budget between 1998 and 2003, and we could do it again.

Congressman Porter wants us to speak up for research. Let’s start now.

Fox News expert with mail-order degree blames “homosexual impulses” for Santa Barbara mass shooting

Robi Ludwig, media commentator
In the wake of the mass shootings by a disturbed man in Santa Barbara, California last week, Fox News featured comments from Robi Ludwig, a self-described psychotherapist, who blamed the shooting on the “homosexual impulses” of the shooter. Her comments caused an immediate firestorm, and a few days later, real estate company Coldwell Banker, for whom she consulted, announced “we feel it best to part ways with her as our lifestyle real estate correspondent.”

As Salon.com’s Sarah Gray pointed out, it is unethical to diagnose a patient whom you’ve never met. This didn’t seem to stop Ludwig, who also claimed that the shooter might have been in the early stages of schizophrenia. Ludwig later attempted to take back her comments on her Facebook page, claiming she was misunderstood.

Does it matter if Ludwig, who uses the title “Doctor” in all her media appearances, is a real doctor? It's presumably why we are supposed to take her seriously when she diagnoses a mass murderer on television.

The title of doctor also matters to the thousands of people who have spent years of study and research to earn a Ph.D. or an M.D. Robi Ludwig, it turns out, has neither. 

Ludwig previously hosted a reality TV show on TLC where she offered marriage advice. Her listing at Psychology Today shows “School: University of Pennsylvania” and lists her graduation year as 1990. Sounds legitimate, right? U. Penn is an Ivy League school; a doctorate from there is certainly impressive.

Her website reveals a different story.  Her “doctor” title, which she uses in every mention of herself and the name of the website itself (drrobiludwig.com), is based on a Psy. D. degree from Southern California University for Professional Studies, an online-only, for-profit correspondence school,  which changed its name in 2007 to California Southern University. 

Note to readers: an online degree is not a doctorate. Any online, for-profit college that claims otherwise, and this obviously includes Cal Southern, is just trying to fool people.

I’ve known hundreds of scientists and scholars who’ve put in the sweat equity required for a Ph.D.: years of course work, mastery of a specialized area of study, and additional years doing original research and writing a Ph.D. dissertation. The Cal Southern Psy.D. requires nothing more than course work - no dissertation required - and the courses are all online. This falls grievously short of a real doctorate. Taking a bunch of online courses at a third-rate online school does not earn one the right to be called “doctor.”

I checked the American Psychological Association’s site to see if the Psy.D. program at California Southern is accredited. It is not. (Very few Psy.D. programs, which are much less rigorous than Ph.D. programs, are accredited. Most clinical psychologists have Ph.D.s.)

In other words, “Dr.” Ludwig has a mail-order degree from an unaccredited program. Her undergraduate degree is from Cedar Crest College, a small women’s college in Pennsylvania. So how can her Psychology Today profile list the University of Pennsylvania as her only school? Apparently she does have a master’s in social work from U. Penn, but her undergrad and Psy.D. degrees are from far less prestigious institutions. Her Psychology Today profile also lists a license number, without saying what the license is for. Apparently it’s her license as a social worker, not as a clinical psychologist. 

Being called a doctor is obviously important to Ludwig. But it wasn’t important enough for her to spend the years of study required to get a Ph.D.

Let’s return to Ludwig’s Psychology Today profile. Does she claim to be a psychologist there? No: although she uses the title “Dr.”, she is listed as “Clinical Social Work/Therapist.” Psychology Today explains that 
Clinical social workers commonly hold a master's degree in social work (or the equivalent) and have completed two years of supervised practice to obtain a clinical license. They may use a variety of therapeutic techniques, including psychodynamic therapy or cognitive-behavioral therapy.” 
So Ludwig is a licensed social worker who has an unaccredited Psy.D. from an online university. Not to criticize social workers, who provide valuable services to society, but they are not doctors.

Fox News probably doesn’t care that Ludwig isn’t a real doctor or a licensed psychologist, or what the “Dr.” in her title means. But that’s just a guess.

Having a Ph.D. is no guarantee of competence. Plenty of people with Ph.D.s make stupid comments on television, especially when they are spouting off about subjects outside their expertise. But the Ph.D. degree does mean something, which is why so many people work so hard to earn them. But an online Psy.D. degree from California Southern University isn’t even remotely comparable to a Ph.D. If Ludwig wants to earn the title Doctor, she has a long way to go.

Dr. House Was Right

I’m a big fan of the show House, which ran on the Fox TV network for 8 years and is now on Netflix. Gregory House, masterfully played by actor Hugh Laurie, is an brilliant doctor who diagnoses patients whose bewildering symptoms have stymied other doctors. He’s also unbelievably rude: he insults and harrasses his patients and his fellow doctors alike, but they tolerate him - usually - because he’s almost always right.

I doubt that any real doctor is as rude as House. But like any group of professionals, doctors vary widely in their people skills. Recently, though, Medicare has started using patient satisfaction as a component of how it pays hospitals. In response, some doctors now try harder to give patients what they want, rather than what they need, as described last year by Kai Falkenberg at Forbes.  On Medscape recently, William Sonnenberg wrote that “patient satisfaction is overrated” and said of Press Ganey, a company that runs patient satisfaction surveys:
Press Ganey has become a bigger threat to the practice of good medicine than trial lawyers.”
You can find Medicare's hospital survey online. Dr. House would fail, big time.

What’s wrong with giving patients what they want? It turns out that patient satisfaction is tied to higher costs and, even worse, a higher death rate. A large survey covering 52,000 patients, published by a team led by Joshua Fenton at the University of California-Davis  found that the most satisfied patients not only spent about 9% more than average, but had a 26% higher death rate. From the study: “The most satisfied patients had statistically significantly greater mortality risk compared with the least satisfied patients.”

For patients who think a nice doctor is a good doctor, this might come as very disappointing news. Was the effect due to patients already in poor health, who might be more inclined to like their doctors? No: when the researchers excluded the sickest patients and looked only at the healthier ones, the risk of dying was even higher. (It’s important to note here that this is relative risk; only 3.8% of patients died during the six-year followup to the study.)

Over at The Daily Beast last week, Daniela Drake summarized this trend as “You can’t Yelp your doctor.” (Not that Yelp isn’t useful for finding a good pizza place.) And yet, as Scott Hensley reported on the NPR blog Shots, online ratings of doctors are becoming very popular, even though they don’t measure how good a doctor is at diagnosing and treating illness.

This study has implications for so-called “alternative medicine” as well. Patients who frequent alternative providers such as acupuncturists, homeopaths, and naturopaths often report high levels of satisfaction, as if satisfaction correlated with better care. Now we have a large study showing that this is simply not the case.

It makes sense that patient satisfaction is related to cost: patients often demand treatments that they don’t need, and “Patient requests have also been shown to have a powerful influence on physician prescribing behavior”, as Fenton and colleagues reported. It is less clear why the most satisfied patients died at higher rates.

Obviously, doctors don’t need to act like Dr. House to be effective. But doctors need to be able to tell patients things they don’t want to hear. Just because you want an antibiotic for your sore throat or your child’s ear ache doesn’t mean you should get one.  The UC Davis study demonstrates that using patient satisfaction surveys to adjust reimbursement rates, as Medicare is currently doing, is a recipe for higher costs and lower quality of care.

Given a choice between a friendly doctor who gives me what I want and a brilliant doctor who gives me what I need, I’ll take Dr. House.