Why does anyone believe this works? The dangers of cupping.

Cupping therapy. If this looks painful and possibly damaging

to the skin, that's because it is.

People are easily fooled. Even smart people.

I'm not talking about voters in the U.S. and the UK, although both groups have recently demonstrated how easily they can be conned into voting against their own interests. You can read plenty of articles about that elsewhere.

No, I'm talking about the wide variety of health treatments that call themselves alternative medicine, integrative medicine, traditional Chinese medicine, energy medicine, and other names. These are all just marketing terms, but many people, including some physicians and scientists, seem captivated by them.

This week I'm going to look at "cupping," a rather bizarre treatment that, for reasons that escape me, seems to be growing in popularity.

I just returned from a scientific conference, where I happened to speak with an editor for a major scientific journal who also follows this blog. She remarked that she liked some of my articles, but she disagreed with me about cupping, which I wrote about during the 2016 Olympics, where swimmer Michael Phelps was observed to have the circular welts that are after-effects of cupping. This editor's argument boiled down to "it works for me," which left me somewhat flabbergasted.

And just two weeks ago, when I was at my physical therapist's office getting treatment for a shoulder injury, I heard her discussing cupping with another therapist. I then noticed a large box containing cupping equipment on one of the counters. Thankfully, my therapist didn't suggest cupping for me; I'm not sure how I would have replied.

What is cupping? It's a technique where you take glass cups, heat the air inside them, and then place them on the skin. Because hot air is less dense, it creates suction as it cools, which sucks your skin up into the glass. (Some cupping sets use pumps rather than heat to create this effect.) Imagine someone giving you a massive hickey, and then doing another dozen or so all over your back, or legs, or wherever the cupping therapist thinks you need it. If that sounds kind of gross, it is.

Quacktitioners Practitioners of cupping think that it somehow corrects your "qi," a mysterious life force that simply doesn't exist. When pressed, they often remark that it "improves blood flow," a catch-all explanation that has no scientific basis and that is more or less meaningless. What really happens, as the physician and blogger Orac noted, is this:

"The suction from cupping breaks capillaries, which is why not infrequently there are bruises left in the shape of the cups afterward.... If you repeatedly injure the same area of skin over time ... by placing the cups in exactly the same place over and over again, the skin there can actually die."

So maybe cupping isn't so good for you.

Cupping is ridiculous. There's no scientific or medical evidence that it provides any benefit, and it clearly carries some risk of harm. A recent review in a journal dedicated to alternative medicine–one of the friendliest possible venues for this kind of pseudoscience–concluded that

"No explicit recommendation for or against the use of cupping for athletes can be made. More studies are necessary."

Right. That's what proponents of pseudoscience always say when the evidence fails to support their bogus claims. Let us do more studies, they argue, and eventually we'll prove what we already believe. That's a recipe for bad science.

Even NCCIH, the arm of NIH dedicated to studying complementary and integrative nonsense medicine, can't bring itself to endorse cupping. Their summary states:

• There’s been some research on cupping, but most of it is of low quality.
• Cupping may help reduce pain, but the evidence for this isn’t very strong.
• There’s not enough high-quality research to allow conclusions to be reached about whether cupping is helpful for other conditions.

In other words, some bad scientists have conducted a few studies but haven't proven anything. But wait, it gets worse. NCCIH goes on to warn that:

• Cupping can cause side effects such as persistent skin discoloration, scars, burns, and infections, and may worsen eczema or psoriasis. 
• Rare cases of severe side effects have been reported, such as bleeding inside the skull (after cupping on the scalp) and anemia from blood loss (after repeated wet cupping). 

And still, otherwise intelligent people say "it works for me." I'm left speechless.

The bottom line: save your money and your skin. Don't let anyone suck it into those cups.

The #1 bogus argument that quacks and the government use to promote pseudoscience

This does not reduce pain.

Chairman Mao would be delighted, if he were alive to see it. He now has the U.S. government buying into arguments that he used to hoodwink his own people, decades ago. Never mind that the arguments are all bogus.

This morning, the front page of The Baltimore Sun describes how the U.S. Veterans Administration is using acupuncture to treat chronic pain in veterans. The VA especially likes something called "ear acupuncture," the creation (out of thin air) of a VA doctor who claims that a few needles inserted in your ear will cure pain anywhere in your body. The VA also calls this "battlefield acupuncture," and it is not only fake but also dangerous, so much so that in 2011 I labelled it the worst quackery of the year.

And yet it hasn't gone away, as the Baltimore Sun reports. The VA uses acupuncture "across the country," offering it to veterans who have little choice about their health care provider. A few years ago, the VA argued this could help veterans manage chronic pain from war injuries. Now they're claiming that acupuncture will help solve the opioid epidemic. Whether it works or not seems beside the point: a VA doctor quoted in the story argues that "if patients believe that it’s helping their pain, then it is." Unfortunately for her patients, she seems unaware that science has shown that acupuncture does not work–for anything (as Yale neurologist Steven Novella succinctly put it).

Why is the VA offering quack treatments to veterans? One reason is that these treatments are popular. The same argument appears in countless forms, but it boils down to: "the people want this, so we should give it to them."

I get it: popularity is good news if you're an actor, or a writer, or a singer, or an athlete, or especially a politician. But it means nothing when we're trying to decide if a medical practice is effective. Doctors in medieval Europe used to bleed their patients, often killing them, in the belief that sickness was caused by "ill humors" in the blood. Bleeding was popular, but it was a very bad idea.

It's not just the VA. This past fall, two Colorado Congressmen, Jared Polis (D) and Mike Coffman, (R) announced the creation of a bipartisan Integrative Health and Wellness Caucus, explaining that:

"While at least a third of Americans use complementary or alternative medicines, access is often inconsistent."

It's not surprising that Polis and Coffman believe that we should give people whatever treatments they ask for. Neither of them is a scientist, so they live in a world (politics) where popularity counts for a lot. How ironic that, in the hyper-partisan U.S. political scene today, the parties have come together to support something that is flat-out wrong.

Just stop it already. Stop arguing that just because something is popular, it must be true, or at least worth investigating (at taxpayer expense). For centuries, most humans believed the Earth was flat, but that didn't turn out to be true, though it was popular. We figured it out and moved on.

Today's versions of medieval bleeding include acupuncture, homeopathy, naturopathy, chiropractic, reiki, Ayurveda, healing touch, various "detox" treatments, and more. Science has figured out that all of these are nonsense, and moved on. (And by calling them "nonsense," I am being generous. Some of them are dangerous.) But people who make money off these practices have been waging a decades-long campaign to keep them going.

Acupuncture is a scam foisted on the Chinese people by Mao Tse-Tung, whose country was too poor to provide real medicine to its population. Instead, Chairman Mao launched a marketing campaign to convince them that the old, traditional medicine was just as good. Kimball Atwood wrote a 4-part history of these events; in part 3 he reveals this gem, from Mao's personal physician:

"Publicly, the Chairman was the leading advocate of traditional medicine, but he refused to use it himself."

And now the U.S. government has fallen for the same scam.

Universities are prey to this as well. This fall, we saw the University of California at Irvine announce a $200 million gift to create a new medical center dedicated to integrative medicine, a disturbing intrusion of junk science into the academic mission of the university. One of the donors, Susan Samueli, argued that "The public is not only interested [in integrative medicine], but they are clamoring for it.”

There it is again–the argument from popularity. And even though this might be privately funded, it is based at a public, state-funded university.

One might hope that the NIH would help set things straight. Think again. Here's an example from NIH's National Center for Complementary and Integrative Health (NCCIH:

"Many Americans—more than 30 percent of adults and about 12 percent of children—use health care approaches developed outside of mainstream Western, or conventional, medicine."

NCCIH's website is careful not to state explicitly that popularity is equivalent to evidence. But then what are they saying? That NIH thinks that 30% of Americans are wrong? (By the way, that 30% number is highly dubious. It includes a wide array of practices, some reasonable and others wacky.)

Why do we even have an NIH center devoted to integrative medicine? It's not because there's any science behind it. On the contrary, NCCIH is a monument to a deep misunderstanding on the part of former Senator Tom Harkin, who created it back in 1991. For an excellent summary of NCCIH's history, see this short video from Reason TV:

or my own talk from a 2015 conference, here. Harkin earmarked a few million dollars to create a small Office of Alternative Medicine in 1991, and with his help it grew over the years into a large, money-wasting administrative behemoth.

NCCIH's website is replete with misleading statements. After pointing out that "millions of Americans use complementary health approaches" (there's that popularity argument again), they offer this sage advice:

"Choose a complementary health practitioner, such as an acupuncturist, as carefully as you would choose a conventional health care provider."

Face, meet palm. No one shouldn't be choosing a "complementary" health provider in the first place, and NIH shouldn't be telling people to do it carefully, whatever the heck that means.

Yes, this stuff is popular. And its popularity has enriched the numerous practitioners of bad medicine, many (most?) of whom may genuinely believe that their snake oil works. But popularity doesn't make something true. Or maybe it does–I hear that the tooth fairy is very popular.

Washington Post's Science section descends into pseudoscience

The Washington Post has some bad news about migraines.

Every Tuesday, the Washington Post has a special section devoted to Health and Science. It’s usually my favorite section, with features such as “medical mysteries” and highlights of the latest news from the world of science.

Not this week. Instead, the front page of the section featured a lengthy article that was a long anecdote by a woman who firmly believes that acupuncture cured her migraines. The title gave me a feeling of dread: “Acupuncture needles stung, but they cured my migraines” (the online version linked here has a different title). As I feared, there wasn't a whit of science in it.

Let’s get one thing out of the way first: acupuncture is rank pseudoscience. It’s based on a primitive, pre-scientific notion of a “vital force” (for which no evidence exists), usually called qi, that runs through the body along meridians (no evidence for these either). Plunging needles into the meridians is supposed to manipulate this vital force and cure all sorts of things, ranging from pain to infections to cancer. All of this is nonsense. If you want to know more, I recommend Acupuncture Watch; or see Ben Kavoussi’s article explaining how postmodernism, with its notion that all truth is relative, has allowed acupuncture and other mystical, archaic beliefs to gain traction in medical practice; or check out Jann Bellamy’s discussion of acupuncture as “legalized quackery”.

I’ve written about the nonsense that is called acupuncture before (in 2013, and in 2012, and in 2010), so I won’t rehash that here. But it’s really disheartening to see a great (or once-great?) newspaper devote a large chunk of its weekly science section to pseudoscience.

Back to this week’s nonsense article. In this lengthy piece, author Margarita Gokun Silver describes how she began to experience debilitating migraines after the age of 40, which grew worse over time. She tried pain relievers, which worked at first but then stopped working. One expensive pill worked for the migrations but gave her severe nausea. Eventually, she writes, “exhausted by these side effects, I turned again to the Internet.”

Great. Now, there’s nothing wrong with looking for solutions in the Internet–we all do it. But this is an article in the Washington Post Science section! Nowhere does the author describe anything resembling actual science. Instead, she describes how she discovered a “breakthrough” in her yoga class, when another yoga student suggested acupuncture. She decided to give it a try.

(You might be wondering, who is Margarita Gokun Silver? She describes herself as a writer, novelist, and painter–not a scientist or a doctor.)

After several acupuncture sessions, the author tells us, her migraines seemed less frequent, and eventually she decided she was cured. She still gets migraines, but when they get bad she uses acupuncture again. This, she tells us, is her cure.

The entire story is a classic example of how we can fool ourselves into thinking that whatever we tried last is what worked. Migraines come and go, and this woman’s story is not unusual. She had a long series of bad migraines that eventually subsided, and she still gets them. When they were at their worst, she tried everything she could find, and when the episodes became less frequent, she gave full credit to acupuncture. She might just as well have tried chocolate milk, and then written an article claiming “chocolate milk cured my migraines!”

I don’t blame the author (well, not much) for wrongly believing that correlation equals causation. But we have scientific methods that are really, really good at figuring out if a treatment works. Scientists have already looked at this particularly claim, and the bottom line is that acupuncture doesn’t cure migraines. If you don’t believe me, then read the article about treating migraines by Dr. Steven Novella, a Yale neurologist who specializes in headaches, and look at his summary of how not to treat migraines, which points out that

“acupuncture proponents have been able to change the rules of clinical research so that essentially negative or worthless studies of acupuncture are presented as positive.”

Last week's Washington Post Science section was a major fail. I can't imagine why they gave a lengthy forum to a non-scientist to write about pseudoscience. If they wanted to feature a story about migraines, there's plenty of good science out there, even if there's no magical cure. What's next, Washington Post? Will you invite Jenny McCarthy to write about vaccines and autism, or Gwyneth Paltrow to discuss detox treatments? I sure hope not.

Bad news flash: scientists did not cure autism, cancer, or Alzheimer's

This week I'm calling out some recent headlines about medical "breakthroughs" that were wildly misleading. Even when the science itself is good, bad reporting raises false hopes and eventually undermines the public's confidence. At some point, people will just no longer believe the headlines claiming that someone has once again cured cancer.

My first example of bad news is from a couple of weeks ago. I was struck by a headline that showed up in one of my news feeds that read

"Neuroscientists reverse autism symptoms"

Wow, I thought. This would be a real breakthrough if it were true. I traced the headline back to the MIT press office, where I then saw the subheading: "turning on a gene later in life can restore typical behavior in mice." Uh oh: extrapolating any treatment from mice to humans is fraught with problems, and studying a complex behavioral disorder like autism is even more difficult.

The HuffPo fell for it, though. Their headline read "Some Autism Symptoms May Be Reversed By Gene Editing, Scientists Suggest". So did the Daily Mail, which went with this headline:

"Reversing autism 'at the flick of a switch': 'Turning on' a single gene in mice has been found to reduce autistic behaviours"

At least they mentioned mice in the headline. But then they wrote that “scientists have announced a major breakthrough in treating the genetic cause of the spectral condition." Sorry, but there's no new treatment available. (Never mind the poor writing that used "spectral condition" to describe autism spectrum disorder.)

What did the researchers actually do? They studied a gene (see the paper here) that is already known to be associated with autism in humans–though only about 1% of cases–and that has already been shown to affect the behavior of mice as well. They created a means of "fixing" this gene in mice, and showed that it can restore some of the mouse behaviors to normal. My assessment: this is nice incremental work on a gene that seems to affect behavior in both mice and humans. I don't see it leading to any advances in the treatment of human autism for at least a decade, if ever.

So where are we on reversing autism? Probably no closer than we were before this report appeared. I give the science a B, but the science news gets an F.

A second, more recent bit of "bad news" appeared just a few days ago, when CNN reported that

"Breakthrough in cancer research could spawn new treatments"

Sigh. I can't count the number of times I've read that cancer is about to be cured, only to learn that no new treatment exists, and nothing is even close. So what is this new breakthrough?

CNN reported that

"Researchers discovered that even though cancer cells mutate wildly within a person's body, the cancer cells within each patient also have common mutations–ones that could be isolated and fought off by certain immune cells."

This didn't sound like news to me. Genome scientists have sequenced the DNA of cancer cells in exquisite detail in recent years, and we already know that cancer cells share common mutations. The paper itself, which appeared in Science on March 3, revealed a far less dramatic story.

First of all, the new research applies only to lung cancer. It's a highly technical result that showed that certain immune cells in the body could–just maybe–fight off a particular type of lung cancer. There's no new treatment here, and there won't be for many years, if ever. The science here is pretty good, so I'm giving it an A-, but the reporting over-hyped its impact. Because they included the cautionary "could spawn new treatments", I'll give CNN a C.

The third bit of news is older, but it's still making the rounds on social media. The headline is a real attention grabber:

"New Alzheimer’s treatment fully restores memory function"

If this is true, we're talking Nobel Prize material. Alzheimer's is a devastating condition that affects a large percentage of elderly people, and there's no known treatment. But when I looked up the paper itself, from March 2015, I discovered that it's a study in mice, not humans. The scientists here used a mouse that's been genetically modified to have brain defects that resemble some signs of Alzheimer's. They showed that they could use ultrasound–actually this part is pretty cool and quite exciting–to reduce some of the brain defects in the mice.

Will this lead to any human treatments? Maybe, but there are numerous problems and caveats, as neuroscientist Matthew Zabel pointed out soon after the study appeared. And the effect, even in mice, was rather small: it's wildly inaccurate to claim that it "fully restores memory function." I give the science an A, but sciencealert.com gets an F for that headline.

In all of these cases, the scientists involved are at least a little bit (if not a lot) complicit in the over-exuberant headlines. I understand their eagerness to call attention to their work, but by promising too much, they risk disappointing the public when no cures emerge one, two, five, or even ten years later. Journalists and scientists need to work harder to come up with headlines that excite people about the potential of science without making it seem that we've already cured humankind's most devastating diseases.

Controversial GMO corn study being retracted over the authors' objections

Retractions are always interesting. When a scientific paper is retracted, it usually means the authors have found a serious error, and that the major conclusions are no longer valid. The error can be unintentional, but in some high-profile cases, the story is far more interesting.

Reading about a retraction is, for a scientist, kind of like reading about a celebrity divorce. You know something went wrong, and it just might be a bit scandalous.

Last year, I wrote a detailed takedown ("Does genetically modified corn cause cancer?") of a very poorly done scientific study by Gilles-Eric Seralini and colleagues, in which they claimed that genetically modified corn, Roundup Ready® corn, caused cancer in rats.  The study had many egregious flaws, and I explained a few of them after reading the paper.  Hundreds of other scientists criticized the study at the time, and six French science academies took the unusual step of issuing a joint statement that rejected the study's conclusions.

Among the many flaws, the study used far too few rats to make statistically valid conclusions, and it contained self-contradictory results, such as data showing that rats fed the highest amount of GMO corn lived longer than rats fed the lowest amounts.  They also used a strain of rats that is highly prone to cancer.  Basically, it was unconvincing junk science.

Last week, Retraction Watch reported that this paper is being retracted. Particularly interesting was the news that the retraction is being made by the editors of the journal, not by Seralini and his co-authors, who are pretty darned upset about it. The journal conducted a lengthy investigation (much too lengthy, I might add - they should have been able to act more quickly) and decided that the many flaws in the paper mean that its major findings are not valid.  It is very unusual for editors to force a retraction like this, especially when fraud is not involved. The journal, Food and Chemical Toxicology, issued a statement that said:

"A more in-depth look at the raw data revealed that no definitive conclusions can be reached with this small sample size regarding the role of either NK603 [RoundupReady corn] or glyphosate [Roundup] in regards to overall mortality or tumor incidence. Given the known high incidence of tumors in the Sprague-Dawley rat, normal variability cannot be excluded as the cause of the higher mortality and incidence observed in the treated groups."

In other words, the editors concluded that Seralini's results were not supported by the data. Together with the rest of their statement, it seems pretty clear the editors are admitting that they screwed up during the peer review process, and they never should have published the article.

Seralini is very unhappy.  So unhappy, in fact, that he's threatening a lawsuit, as Forbes contributor Jon Entine reported.

But is this grounds for retraction? Lots of bad science gets published, often due to sloppy peer review, and most of these papers aren't retracted. In this case, it's pretty clear that the high-profile nature of the paper played a role.  Seralini is part of an anti-GMO organization, CRIIGEN, which has used this paper as justification for an aggressive campaign to ban GMO crops in Europe and elsewhere.

As bad as this study is, and as much as I'd like to see it retracted, I'm not sure that the justification given by the editors of Food and Chemical Toxicology is sufficient for retraction. Maybe it's because their statement is too carefully worded - wimpy, in fact. If they just came out and stated clearly that the study's conclusions are erroneous, then they would have a much better case for forcing the retraction. But they don't quite say that.

Here's what they are trying to say: "we screwed up and did a shoddy job in the peer review process, and now we realize that we never should have published this piece of dreck. Now we want to retract it so that no one will associate our journal with this bad science."

I know some very good scientists who have retracted papers merely because they couldn't replicate the results, and they grew worried that something was wrong. That's how science should work: rather than publish something erroneous, most scientists will admit their errors and retract their findings, or at least issue a correction. Obviously, Seralini has no plans to do this. His intent on publishing this paper was to make a political point, not a scientific one, and he distorted his findings in the paper itself, overstating his results with insufficient statistical evidence, and more so in statements to the press.

Retractions are indeed interesting. I'm still not sure the journal did the right thing to retract this paper, but I know they never should have published it in the first place.

(And for those who don't have time to look at the controversy after the original study: no, genetically modified corn does not cause cancer. Not even a little bit.)

Dr. Oz tries to do science again, this time with green coffee bean extract

Dr. Mehmet Oz hosts a popular TV show in which he promotes all sorts of medical treatments, some good and some - well, not so good.  And once in a while, he tries to do a science experiment, as he did in 2011 with a badly flawed experiment on arsenic in apple juice.

Well, Dr. Oz has done it again.  This time he wanted to re-examine a claim that he himself had made on an earlier show about green coffee bean extract.

In April 2012, Oz aired a segment on his TV show called "Green Coffee Bean Extract: The Fat Burner That Works!"  On it he "this miracle pill can burn fat fast, for anyone who wants to lose weight." Not surprisingly, sales of green coffee bean extract skyrocketed in response.

"A marketing apocalypse was ignited!" Dr. Oz pointed out in his show in September of 2012.  "I was surprised by the firestorm," he said.

Dr. Oz loves this topic, by the way. He's run dozens of shows on weight-loss gimmicks, such as "The New Silver Bullet for Weight Loss" in which he promoted a new diet pill called Qnexa, and "Ancient Ayurvedic Secrets to Lose Weight".  But let's leave those for another day.

One problem with Oz's first green coffee bean show was that he based it on a study that has some serious problems.  That study claimed that a particular brand of green coffee bean extract called GCA led to significant weight loss.  Subjects lost a lot of weight, too: 8 kilograms (over 17 pounds) on average.    Dr. Oz called it "a staggering, newly released study."  Wow, must be good, right?

Let's look at that study, shall we?  First, it only involved 16 people, a tiny sample.  There were 3 treatments: high dose GCA, low dose GCA, and placebo.  The subjects were divided into 3 even smaller groups, but not by treatment: instead, each group took all 3 treatments, for 6 weeks at a time, with a 2-week rest period in between.  The only difference between groups was the order of the treatments (high-dose/low-dose/placebo).  Subjects in all 3 groups lost about the same amount of weight.  What was the difference?  Well, the authors claimed that the amount of weight loss during the periods when the subjects were taking GCA was greater than when they weren't, even though they lost weight even during placebo treatment.

One critique of the study is there was no proper placebo control.  Looking at the paper, it is impossible to tell how much weight loss is being attributed to the green coffee beans rather than the daily monitoring of diet, which is known to help with weight loss.  And it's a really, really small study.

Perhaps a larger problem is that the trial was carried out in India, and then written up by a U.S. researcher, Joe Vinson from the University of Scranton, as revealed by a story in The Globe and Mail (Canada) last December.  That's right: the subjects were recruited in India, all data was collected there, and the data was emailed to Vinson so he could write it up.

Even more troubling was that Vinson was paid by the makers of GCA to write the study.  Worse yet, the paper states that "The authors report no conflicts of interest in this work." When asked about this by The Globe and Mail:

"Vinson said that he doesn’t gain financially if the company sells a lot of product and that the journal didn’t require him to disclose the relationship."

This small, badly run study was anything but "staggering", as Dr. Oz called it.  I have little confidence that the data sent to Vinson from India was even correct.

Maybe Dr. Oz might was worried too, because a few months after his original show, he ran another show in which he looked at green coffee bean extract again.  He said he was responding to criticism of his earlier show, and he wanted to set the record straight.  For his second show, "Green Coffee Bean Extract: The Answer to Weight Loss?" he ran his own experiment:

"For the first time, we are doing an unprecedented experiment," he said. "We're doing our own study, right here on this show.... the first of its kind EVER on television!"  

Oz's experiment involved 100 women - all of them in the studio audience for his show - who took either green coffee bean extract or a placebo pill for two weeks.  And the result?  I won't make you watch the video; here is the entire statement of results, from Oz's website:

"In two weeks, the group of women who took the green coffee bean extract lost, on average, two pounds. However, the group of women who took the placebo lost an average of one pound – possibly because they were more aware of their diet for that two weeks because of the required food journal."

On the show, Oz stated proudly: "green coffee bean worked for us."

Maybe Dr. Oz's science experiment was better than the Vinson study.  But that doesn't mean it was any good.  First off, Oz seems to have ignored some critical rules on how to run a experiment involving humans.  As Scott Gavura pointed out at the Science-Based Medicine blog, Oz's study "makes a mockery of good research methodology."  Oz failed to explain how the women were recruited for the experiment, and Gavura points out that apparently did not obtain the ethics board approval that all experiments on human subjects require.

Oz also seems willfully ignorant of the notion that 2 weeks is far too short a time to assess the value of a weight-loss treatment.  Will he go back to those same women a few months later to see if the effect lasted? Somehow I doubt it.

But what about that result?  The women who took the coffee bean extract lost 2 pounds, versus just 1 pound for the other group.  (Actually, thanks to Scott Gavura, we know that the difference was even smaller, just 0.76 pounds.) Oz provides no statistical analysis to demonstrate that is even marginally significant. Nor does he provide the raw data that would allow others to replicate his analysis, as he might have to do if he were actually to try to publish his study. But for Oz, what he described on his show seems to be proof enough.  That's is a poor excuse for science.

Meanwhile, sales of green coffee bean extract continue to climb.  My advice: save your money.  And the next time Dr. Oz runs a science experiment, be skeptical.

PNAS and the eHarmony dating site: a perfect match

Well, here's a shocker.  eHarmony, the online dating service, commissioned a survey that found out that couples who get married after meeting online are more satisfied than other couples.

I'm sure there's no bias in that survey.

But here's another shocker: a leading scientific journal just published the eHarmony survey as a bona fide scientific study.  The lead author is a consultant to eHarmony (and a former advisory board member) and another author is eHarmony's former research director, Gian Gonzaga.  According to the published paper, Gonzaga designed the study.

The journal in question is the Proceedings of the National Academy of Sciences (PNAS), a high-profile journal that is published by the prestigious U.S. National Academies.

Why would PNAS publish an article that is basically an advertisement for eHarmony.com?  I'm sure the editors at PNAS would argue that it's a well-executed scientific study, but they sure got lots of publicity, with articles in the Los Angeles Times, USA Today, and Nature, not to mention a short piece in Forbes. (And yes, I'm doing it too.) A cynic might point out that both eHarmony and PNAS got what they wanted.

But what about the study itself?  Well, let's take a look.  The study, titled "Marital satisfaction and break-ups differ across on-line and off-line meeting venues," is based on a survey of 19,131 people who got married between 2005 and 2012.  6,654 of these people met online, 35% of the total, which is a surprisingly high percentage.

The headline result is the claim that couples who met online have "higher marital satisfaction." People who met this way reported a satisfaction of 5.64, on average, versus 5.48 for those who met offline.  That's a very small absolute difference, but with such large numbers in the survey, even this small difference is, in a narrow technical sense, statistically significant. The satisfaction scale ranged from 1 "Extremely Unhappy" to 7 "Perfect."  So all this fuss and publicity is over a difference between 5.5 and 5.6 in a survey.

But the higher average satisfaction might have nothing to do with how the couples met.  In my reading of the study, it seems much more likely that other factors explain the difference.

Several things are immediately obvious when one looks at the composition of the online versus offline couples.  The online couples are significantly older, wealthier, and more educated: for example, 40.5% of those who met their spouse online reported an income of $100,000 or more, compared to just 26.1% of the offline couples.  These factors alone could explain the difference in marital happiness.

The authors claim that they controlled for all of these confounding factors, and that the marital satisfication score was still significantly higher for online couples. Alas, they don't provide enough details, even in their supplementary data, to evaluate this claim. I guess we're just supposed to trust them. (Note: I believe them when they say they controlled for these variables.  I'm just not sure precisely how they did it, or if the control function really eliminated all bias.) They did recruit two independent statisticians as co-authors, which is supposed to assure us that they were unbiased. But these steps wouldn't eliminate bias that might have crept in earlier, when the eHarmony-sponsored survey was being conducted.

The article also reports the marital satisfication score of specific online dating sites. Guess which one scores the highest? That's right: eHarmony.  Why am I not surprised?

At the end of the article, the authors speculate about why couples who met online might have more satisfaction in their marriages.  (This assumes, of course, that the effect is real.)  They suggest that

"among on-line dating sites, it is also possible that the various matching algorithms may play a role in marital outcomes."  

There it is!  That's the conclusion that eHarmony wanted.  I think they got their money's worth.

In many ways, this study seems like the often-criticized studies funded by drug manufacturers that find small but significant benefit for the sponsors' drugs. Certainly there's a difference here, in that the only result is that someone might be convinced to try an on-line dating site, which might not be harmful at all.

It seems that eHarmony has found another perfect match: PNAS and eHarmony.com.

(Note: The authors did make all their raw data available, a feature that is still quite rare in scientific publishing.  They deserve kudos for doing so.  I've long advocated for more openness in data release and these authors have done the community a service by releasing theirs.)

Dr. Oz takes a big bite of bad science

Mehmet Oz hosts a popular TV show that reaches millions of people.  He offers a constant stream of medical advice, and he is popular because he makes his topics sound dramatic, or exciting, or surprising, or all three.

Unfortunately, Dr. Oz sometimes has a poor understanding of science.  At least I hope so, because he promotes so many outrageous treatments, with such enthusiasm, that the only other explanation I can think of is that he is simply a fraud. I don't think that's true, so let's give him the benefit of the doubt and assume that when he makes a mistake, he is simply ignorant of the truth.  His latest startling revelation is that the metal fillings in your teeth are very, very bad for you.  Or are they?

Last week, Dr. Oz hosted a show called "Toxic Teeth: Are Mercury Fillings Making you Sick?  The show looked at silver amalgam fillings, which contain a small amount of mercury chemically bound within them.  Mercury is indeed a toxin.  Should you worry?  

One problem with taking a skeptical look at a Dr. Oz show is that he packs each episode with scientific claims, coming at you thick and fast, and it would take hours to critique them all.  Instead, I'll just pick a few, which illustrate Oz's lack of concern for accuracy, and his apparent ignorance of the underlying science about dental fillings.

Dr. Oz opens his show with a dramatic claim about mercury: 

"This thermometer contains mercury," he says, holding up a very small thermometer. "If I were to drop it, we would have to evacuate this entire studio immediately!" 

Now, this is complete nonsense.  If you drop a mercury thermometer, you should carefully clean up the mercury, which beads up into nice little silver-colored balls.  No one in the room is in danger, unless perhaps they try to drink it.*

This opening salvo should set off anyone's skeptical alarm bells.  Here's a guy who doesn't seem to mind exaggerating to make a point.  Why trust anything he says in the rest of the show?  I suspect, though, that after watching this episode, thousands of Oz's loyal viewers raced to the phone and made appointments to have the silver fillings in their teeth removed.

Dr. Oz continues his introduction by explaining that mercury is contained in silver tooth fillings.  No one knew, he claims, that mercury vapor could be released from these fillings, but this news:

"sparked a firestorm 30 years ago [here the show cuts to a graphic of a fireball exploding] when major news reports brought to light the potential TOXICITY of mercury fillings.  ... Now there's mounting new evidence showing mercury is released when you eat, and even when you brush your teeth."

Quick, run to the dentist!  Get this toxic mess out of my mouth!  

But hang on a minute.  Why aren't people dropping like flies from the fillings in their teeth?  With little effort, I determined that, contrary to Dr. Oz's statements, nothing new has been discovered lately about silver tooth fillings.  I found studies going back to the 1970s that shown that we've long known for decades that mercury is released from these fillings. But Oz ignores all these.  He even announces, a few minutes into the show, that 

"for the first time ever, I'm going to show you what happens when you brush your teeth with mercury fillings."  

No, this is not the "first time ever."  As a scientist, I find it worrisome that Oz seems quite comfortable claiming, incorrectly, that he's the first person ever to tell the world about this.

Perhaps the most outrageous - and unintentionally funny - segment of the show is the "demonstration," where Oz introduces an Oz-certified expert on mercury vapor, David Wentz, who has a gizmo that looks like it was built by a sideshow huckster.  The device is a plexiglass box that looks like it was meant to handle biohazards, with black rubber gloves that let you manipulate its contents.  In the box: a set of fake teeth containing... silver fillings!  And a toothbrush!  

As he walks over to the device, Oz says "I work with Dave Wentz and his Ph.D. dad."  This goes by really fast, so you would be excused for not realizing that Dave Wentz himself doesn't have a Ph.D., and for not knowing whether he has any credentials at all.  Dr. Oz conveniently omits the fact that Wentz and his father run a highly profitable nutritional supplements company, USANA http://www.usana.com/dotCom/about/index, which happens also to donate money to Oz's nonprofit corporation, HealthCorps.  Hmm.

Dr. Oz then reaches into the box, and while the audience watches in hushed excitement, he brushes the teeth, right on top of those silver fillings!  Right on cue, Wentz proclaims that the mercury vapor reading hits 61 in just a few seconds. 

"Anything over zero is toxic," Wentz proclaims.  "And we're at 61."
"Oh my goodness, 61!" Dr. Oz exclaims.
"That mercury is coming off the fillings, into your mouth, going across the blood-brain barrier, into your brain," says Wentz dramatically.

Wow.  I've been brushing my teeth (which have several fillings) for years.  How can I not be dead?

As Dr. Oz should know, "the dose makes the poison."  Even water can kill you if you drink too much of it.   Wentz is clearly wrong to say that "anything over zero is toxic."  

How much mercury is safe, then?  

According to the EPA, 0.1 micrograms of mercury per kilogram of body weight per day is safe.  For an adult who weighs around 150 pounds, that's about 7 micrograms.  A 6-ounce can of tuna has about 20 micrograms of mercury, about 3 times the safe amount per day.  Scientists do have real concerns that mercury in tuna and other fatty fish might present a health hazard.   

Dr. Oz's device seemed to show that 61 micrograms of mercury were released from brushing teeth, which would be about 9 times the exposure that is considered safe.  Is there really a risk here?

Well, no.  The EPA has found that "nearly all methylmercury exposures in the U.S. occur through eating fish and shellfish."  (Admittedly, though, this is not mercury vapor.) The precise question that Oz claims to be explaining "for the first time" has been examined in multiple studies, and the evidence is that silver fillings are harmless.  (See the FDA summary here.)  

A thorough scientific review in 2004 concluded that:

"The current data are insufficient to support an association between mercury release from dental amalgam and the various complaints that have been attributed to this restoration material. ... Individuals with dental amalgam-attributed complaints had neither elevated HgU nor increased prevalence of hypersensitivity to dental amalgam or mercury when compared with controls. The findings of these studies suggested that individuals with complaints self-attributed to dental amalgam should be screened for underlying dental, physical, and psychiatric conditions."

So no, there's no evidence that mercury from silver fillings causes any health problems.  None.

But what about that device on Dr. Oz's show, which showed 61 micrograms being released in just a few seconds of brushing the teeth?  My conclusion is that the device in Dr. Oz's studio was either wildly inaccurate or simply fraudulent.  The setup was almost a parody of what real scientific instruments look like, and nothing about it gave me any confidence that it was reliable.  I would suggest to Oz that before making a claim like this, he should ask rigorously trained scientists to make the measurements using properly calibrated equipment.  A TV studio is no substitute for a real lab. 

But wait: Mehmet Oz is a Professor of Surgery at Columbia University - he must know his science!  Plus he has an M.D. from the University of Pennsylvania, and he did his undergrad studies at Harvard.  By all appearances, he is a very smart guy.  If his show were about heart surgery - his specialty - it would no doubt be professional, accurate, and probably far too technical to attract an audience.

Here's the rub: despite his credentials, Oz is not an expert on mercury amalgam fillings.  He probably could have read and understood the science, but he appears to be unaware, or too busy to  be bothered by, the many scientific studies on this subject. Had he done his homework, he might not have presented such a spectacularly overblown episode that seems intended to scare people into removing the silver fillings from their teeth.  

So there's no need to go out and get your silver fillings replaced.  It's too bad that a highly educated surgeon like Mehmet Oz, with such a big audience, prefers to present wild exaggerations rather than telling people the truth.  Perhaps, though, the truth just isn't that exciting.

*Note added on followup: Even swallowing is rarely harmful.  From J. Dodes: "Acute toxic exposures to  elemental mercury are rare but there have been cases of elemental mercury being accidentally released directly into the  bloodstream from broken rectal thermometers and when elemental mercury had been swallowed intentionally in an attempt at suicide.  In all these cases there was no long-term effects from the mercury."  Dodes, JE.  The Amalgam Controversy:an evidence-based analysis.  JADA, 132:348-56, 2001.

Everything in this journal is wrong

Moxibustion at work.

In real science, we agonize over every detail.  When we publish a paper, we strive to get everything just right.  We qualify our findings, always allowing for the possibility that we might have missed something.

Oh, to be freed of the constraints of reality.  But fiction, alas, doesn't work in the real world.  Fantasy medicine is, well, a fantasy.  Or is it?  Let's enter the world of Complementary and Alternative Medicine.

Imagine a scientific journal in which every single article was wrong.  Not just an occasional mistake, as happens with many journals.  No, I'm talking about a publication where every single article has at least one fundamental flaw.

No, it's a real journal, published by BMJ, the publishers of the well-known journal by the same name (the British Medical Journal).  "Helping doctors make better decisions since 1840", they proclaim.  Then why, among their 40+ journals, do they publish Acupuncture in Medicine?

It appears - I can't prove this, but it seems to be so - that every single article in this journal is wrong.  Not just a little bit wrong, either.  Let's look at the "Editor's choice" article from the latest issue, which must be one of their best.  It's called "Using moxibustion in primary healthcare to correct non-vertex presentation: a multicentre randomised controlled trial".

In this study, a group of Spanish doctors looked at the use of moxibustion to correct a common problem in pregnancy known as a breech position - that's a baby that is turned the wrong way round in the mother, head up instead of down.  What, you may ask, is moxibustion?  Well, let me use the authors' explanation:

"The application of heat from the combustion of Artemisia vulgaris (moxibustion) for therapeutic purposes has long been used in China. Among other effects, it is believed to contribute to correcting the non-vertex presentation of the fetus when applied at a specific acupuncture point (BL67 Zhiyin) located at the outer corner of the little toenail."

That's right: you burn an herb (Artemisia) next to the little toenail of the pregnant mother, right next to an acupuncture point, and that's supposed to make baby flip right around so its head comes out first.

You can't make this stuff up.

These guys are serious.  They ran a study where they divided pregnant women into 3 groups, with about 135 women in each.  One group got moxibustion, another got "fake" moxibustion, where they burned the herb next to a different toe (really!), and the last group got standard care.

Amazingly, the doctors found that it works!  More of the women with moxibustion had babies born the right way round, head down, than in either of the other two groups.  To be precise, 79 babies in the moxibustion group came out the right way, versus 60 and 59 in the other two.  By the authors' own analysis, this difference was statistically significant.

Wow.  Maybe this stuff really does work.  And moxibustion is cheap and easy to administer.  Maybe this is the solution to our rising health care costs.

How to explain this result?  I see several possibilities:

1. The small effect was just a random variation, not due to the treatment.  Previous studies of exactly the same treatment (such as this one) showed that moxibustion did not work.  So either those studies are wrong, or this one is.
2. There was bias in how the women were assigned to treatment, and the effect can be explained by that.
3. The authors manipulated the data to make the numbers come out better.  (Quelle surprise! Not in a BMJ journal!)  Of course we can't prove this without much more investigation.
4. Burning an herb next to the little toe at just the right place - and nowhere else - stimulates a mystical "qi" pathway, and zaps that little baby back around the way he's supposed to be.

Hmmm, which seems the most likely?

OK, I admit it: I haven't read every single article in BMJ's acupuncture journal.  So I don't really know that they are all wrong.  But who has time to read all this bad science?  The latest issue has a disturbing number of articles about acupuncture for cancer, which I find particularly upsetting because that practice takes advantage of highly vulnerable patients.  It also includes an article on ear acupuncture, a practice invented out of whole cloth by an Army doctor in the U.S., who has been inflicting it on injured service members, as I've written about before.

Actually there is one article that seems plausible.  It reports a case of arterial hemorrhage caused by an acupuncture needle.  But we don't need to dwell on that.

Acupuncture in Medicine has all the trappings of a real journal, including an editorial board whose members work at respectable medical schools.  I know that BMJ wants us to believe it; after all, they make money on this stuff.  As for the journal itself: I can't bear to read any more.  It is just too painful.  Perhaps acupuncture would help.

Naturopathic shenanigans in the Maryland state legislature

Quacks never give up.  In their never-ending quest to make money from bogus treatments, they try all kinds of strategies to convince people that what they're selling really, really works, despite the evidence to the contrary.

One strategy is creating a legal licensing system.  If the government licenses your profession, it must be legitimate, right?  Legislators wouldn't approve a licensing system for nonsense, would they?  Of course not!

So it's strange that the Maryland legislature is considering a bill in its upcoming session to allow naturopaths to practice medicine in the state of Maryland.  

Some of you might be wondering, what the heck is a naturopath?  As Peter Lipson explained recently in his Forbes column, naturopaths are little more than fake doctors, whose practices are a modern-day version of folk medicine.  When naturopaths got licensed in Minnesota, PZ Myers suggested they be called "witch doctors."  Too harsh?  Well, one thing is clear: naturopaths are trying to get licensed in multiple states (Lipson described their efforts in Michigan) as a route towards legitimacy.

There's an easy way to become legitimate: practice science-based medicine.  This would be awfully difficult for naturopaths, whose practices include homeopathy, colloidal silver treatments, and chelation therapy, to name but a few.

When the naturopaths tried this in Massachusetts 10 years ago, my colleague Kimball Atwood put together detailed testimony describing many of the unscientific and downright dangerous practices of naturopaths.  I encourage anyone to read his full testimony or his series of blog articles.  Here, though, is a brief sample of the erroneous claims made by naturopaths, courtesy of Dr. Atwood:

• "... that hydrogen peroxide dissolved in a bath can provide vital oxygen through the skin of a patient suffering from an acute asthma attack [5]; 
• that balloons inflated inside the nose can cure learning disorders [8];
• that strokes in progress can be reversed by cold compresses applied over the carotid arteries [9]; 
• that vitamin C is an effective treatment for approximately 100 conditions, including glaucoma, male infertility, and AIDS [12]; 
• that high blood pressure and coronary heart disease should be treated with unproven herbs and chelation therapy [17]."

The numbers refer to citations that Dr. Atwood provides for each of his points.

Among other things, the proposed new law (House bill 1029 and its companion Senate bill 783) specifically authorizes hydrotherapy, stating: 

"A license authorizes a licensee to ... administer or perform hot or cold hydrotherapy, naturopathic physical therapy, electromagnetic energy, colon hydrotherapy ... for the purpose of providing basic therapeutic care."

[Aside: I have no idea what it means to "administer electromagnetic energy"; perhaps you simply shine a light on the patient?  I suspect the legislators who are sponsoring this bill haven't a clue either.]

Hydrotherapy doesn't sound so bad until you learn what naturopaths do with it.  According to the naturopathic organization's own experts, 

"One technique is to lower your body temperature, with a cold bath for example, as much as possible without inducing shivering as soon as possible after a stroke has occurred, or is suspected to have occured.... Another hydrotherapy technique with a similar rationale is to soak the feet in a hot foot bath, as soon as possible after the stroke has occurred, while applying a cold compress to the neck, face and scalp. If this technique can be applied as a stroke is happening, it may even abort the stroke."

Again, quoting Dr. Atwood: "All strokes are potentially life-threatening, and are considered to be medical emergencies that require prompt and expert evaluation and supportive care. The treatments described above will do nothing to improve the outcomes of strokes, but are certain to delay competent diagnosis and treatment. 

Most disturbing, perhaps, is that the new Maryland bill would require physicians to violate medical ethics.  The AMA code of ethics states that

"It is unethical to engage in or to aid and abet in treatment which has no scientific basis and is dangerous, is calculated to deceive the patient by giving false hope, or which may cause the patient to delay in seeking proper care."

By adding a naturopath to the Maryland State Board of Physicians, and by requiring them to license naturopaths to practice medicine, the legislature is forcing physicians to act unethically.

So if you live in Maryland, take a few minutes and write to your state representative telling him or her not to support this quack bill.  Heck, contact them even if you don't live in Maryland, and tell them you were thinking of moving but now you want to move to Virginia instead. 

Bad medicine infiltrates M.D. Anderson Cancer Center

M.D. Anderson Cancer Center in Texas is usually considered one of the country's top cancer centers, but that hasn't stopped it from promoting bad science.   In Friday's Huffington Post, Dr. Lorenzo Cohen, Director of MD Anderson's Integrative Medicine program, writes that it is "time for acupuncture to become part of standard care" for cancer.  He claims that acupuncture is "an appropriate treatment alongside conventional care for chemotherapy-induced nausea/vomiting."

As evidence, Dr. Cohen cites a newly published review article.  There are many problems with Cohen's arguments. Let's start with what he fails to tell us.

First, he states that he is reporting on the results of "a recent systematic review conducted by researchers in the Integrative Medicine Program at the MD Anderson Cancer center."  He conveniently neglects to say that he is the senior author of that review!  He should have made it clear that he's writing about his own report.  Unless his readers look up the original article, they may not realize that he is is merely promoting his own work, in a highly biased way.  He also fails to point out that his article doesn't provide any new evidence itself; it only reviews other, earlier studies.

Second, Cohen tells us that his group found 41 studies evaluating the use of acupuncture for treating the symptoms of cancer therapy.  (To be precise, he writes that "41 studies were found," still disguising the fact that he's the one who found them.)  He neglects to mention that out of 41 studies, all but one were highly biased, by his own review's judgment (and therefore scientifically worthless).  Rather than concluding that "it's time for acupuncture to become part of standard care," Cohen should be lamenting the fact that nearly all studies of acupuncture are badly done.

Third, Cohen does mention that his review article considered 8 symptoms of cancer treatment: pain, nausea, hot flashes, fatigue, dry mouth, constipation, anxiety, and sleep disturbance, but he doesn't explain that the only study out of 41 that wasn't excessively biased (according to his own criteria) looked at nausea.  Thus Cohen should have told us that acupuncture is not effective for any of these other conditions.  At best, if he insists on putting a positive spin on it, he should have explained that the evidence is insufficient to recommend acupuncture for any of these symptoms.

Let's look at that one positive study, published in 2000 by Joannie Shen and colleagues.  It's a small study, with about 33 patients in each of 3 groups, where the treatment group got electroacupuncture, which means an electric current is run through the needles.  This isn't the same as traditional acupuncture, and the study didn't compare identical groups with and without the electrical stimulation.  So we can't know whether the electrical current was the real reason the treatment showed a benefit.  The study also failed (and this is a huge problem) to "blind" either the patients or those providing treatment: obviously the patients knew they were getting electroacupuncture.  Despite this, Cohen claimed in his review article that the 12-year-old study had a low risk of bias for blinding.

The patients that received electrical stimulation plus acupuncture had fewer episodes of vomiting.  This suggests that something in the treatment - maybe the acupuncture, maybe the electricity - somehow reduced this particular symptom.  Or maybe not: the study had a possibly serious flaw in the assignment of patients to groups: in the electroacupuncture group, only 51% had vomited during previous chemotherapy sessions, significantly fewer than in the other two groups.

Despite the methodological flaws, if acupuncture works, surely that 12-year-old study would be replicated by now, yes?  Well, no.  Cohen neglects to mention a much more recent study on acupuncture for nausea, published just last year, which his own reviewed graded as unbiased for 5 out of 6 criteria, including blinding.  That study was negative: acupuncture was no better than sham acupuncture.  When a small, problematic study fails to replicate, good scientists conclude that the treatment simply doesn't work.  Cohen, though, ignores this larger (twice as many patients), better-done study in his HuffPo piece.

So based on one mediocre study from 12 years ago, involving only a small number of patients, for only one condition, Cohen is calling for acupuncture to become standard treatment for all cancer patients.  Could this be because he is currently running his own clinical trial on acupuncture for the treatment of cancer patients?  Could he be biased by the $777,886 he is currently receiving from NIH to study acupuncture?

Given that Cohen is its Director of Integrative Medicine, it's not surprising that MD Anderson has been using acupuncture on its patients since 2003:  they even list a fee schedule, $80 on the first visit and $65 for each follow-up, and they recommend at least 8-10 treatments.  MD Anderson's website offers up this gem of an explanation:

"A block in the meridians can deny the muscles and surrounding tissues of Qi, creating an imbalance of health. However, the flow of Qi can be restored by inserting needles at specific acupuncture points."  

This pseudoscientific babble does not belong in one the nation's best cancer centers.  What's worse is that MD Anderson is offering ineffective treatments to cancer patients - a highly vulnerable population - accompanied by claims that they should know are false.  This is inexcusable.

MD Anderson's many outstanding scientists surely know that acupuncture is wildly implausible, and many of them (although not Dr. Cohen) must know that it has repeatedly failed to stand up to scientific scrutiny.  US News ranks MD Anderson as the country's top cancer hospital, followed by Memorial Sloan-Kettering and Johns Hopkins Hospital. After reading Dr. Cohen's article, and looking at MD Anderson's promotion of unproven pseudoscientific treatments, I would argue that MD Anderson should be dropped many, many notches down in those rankings.

How to predict an election? Ask the math geeks.

Mark Newman's rendering of the 2012 U.S. election,
 weighted by population

It's time for a bit of gloating.  No, not for Democrats over Republicans, though I'm sure that's going on.  It's time for the math geeks to throw a bit of scorn at those insufferable, over-confident frat boys who call themselves political prognosticators, and who spent most of the past two years telling us that they knew how the election would turn out.  They bloviated endlessly on talk shows, explaining why their favored candidate would win, and how he would do it.  

Politicos behave just like promoters of quack treatments when things go wrong: they always have a ready answer, and somehow their "theories" can never be proven wrong.  It seems that the only thing these guys are really expert at is getting themselves onto talk shows. Now that the election is over, let's hope that happens a bit less often.

Instead, pay attention to the math geeks.  The statisticians and analysts who build mathematical models based on multiple polls and other data absolutely nailed this election.  Nailed it!  Nate Silver at FiveThirtyEight blog predicted the winner of the presidential election in all 50 states.  So did Sam Wang , a biophysics professor at Princeton, over at the Princeton Election Consortium blog.  And so did Simon Jackman, a political science professor at Stanford who writes for HuffPo.  Nate Silver first drew everyone's attention in the 2008 election, when he correctly predicted 49 out of 50 states.  Last week's success shows that this is not an anomaly, although it has the mathematically challenged pundits in a tizzy.

Hopkins statistics professor Jeff Leek wrote a nice explanation of how these models work over at Simply Statistics, so I won't explain it here.  Suffice it to say that mathematical models don't work by chattering with their buddies at political rallies.

Mathematics delivered the goods.  And make no mistake, this is the way of the future.

That hasn't stopped the punditocracy yet.   On election night, Republican hatchet man Karl Rove was sputtering on Fox News that Romney could still win, after Fox News itself - which is little more than a media arm of the Republican party -called Ohio and the election for Obama.  Rove, who predicted that Romney would win with 285 electoral voites, also orchestrated the spending of over $127 million on Romney, not to mention his spending on 12 Senate candidates, 10 of whom lost.  Has he admitted he did anything wrong?  Nope.

Rove wasn't the only one wrong.  As Techcrunch pointed out, 

"every single major pundit was wrong - some comically wrong."  

The Atlantic created a detailed score sheet listing all the pundits and their predictions of the overall winner, the electoral college total, and the winner in all the swing states.  And indeed, even those who predicted correctly that Obama would win got most of the swing states wrong.

Here's what needs to happen.  The television networks need to realize that political expertise is meaningless when it comes to making statistical predictions.  Let's treat political forecasting just like weather forecasting, using models that are demonstrably accurate (such as Silver's).  Television stations can hire attractive political "forecasters" (because physical appearance matters on TV, like it or not) who will describe the latest forecasts just like today's weather forecasters do.  Now that I think of it, why not let the weather forecasters do both jobs?  We already have them in place at every local TV station in the country.  Think of all the money the networks will save.

But what about all that air time they need to fill with talking heads arguing about who will win elections?  Well, this makes about as much sense as having two self-proclaimed experts arguing about whether it's going to snow this weekend.  Maybe they can find real experts who will argue about issues rather than about who's ahead in the polls.

Ha ha, just kidding!  Who wants to hear about issues?  But if you must know how the race is going, ask the math geeks.

GM corn causes cancer in rats: a study in bad science

Last week a scientific paper appeared that reported that eating genetically modified (GM) corn causes cancer in rats.  Specifically, the scientists fed Roundup Ready® corn, or maize, to rats for two years, and reported that both females and males developed cancer and died at higher rates than controls.  

This is very surprising.  If GM corn causes cancer, why aren't Americans "dropping like flies," as one scientist asked?  We've been eating Monsanto's Roundup Ready® corn for over a decade, even if most of us aren't aware of it.  But our rates of cancer haven't increased more than Europeans, who eat far less GM corn.  Maybe the effect is limited to rats - in which case we should also have seen dramatic increases in cancer in lab rats.  But we haven't seen that either.

So what's wrong?  The best way to find out is to read the paper, which I did.  It turns out to be a very badly designed study, and the report itself omits many crucial details that may (and probably do) completely invalidate the findings.  The scientists leading the study have a strongly biases agenda and a conflict of interest, which they failed to reveal. I'll explain below, but meanwhile this study has already been taken up by politicians as proof (proof!) that GMO crops are harmful.  As Forbes blogger Tim Worstall explained, this paper is more politics than science.

Let's look at the study itself, which was led by Gilles-Eric Seralini (more on him below) and published last week in Food and Chemical Toxicology.  (A copy of the full paper is here.)

The authors studied 200 rats for 2 years, dividing them into 20 group of 10 rats each.  The test rats were fed a variety of diets:

1. Non-GM corn comprising 33% of the diet (this was the control group).
2. Roundup Ready corn comprising 11%, 22%, or 33% of the food.
3. Roundup Ready corn that had been treated with Roundup during cultivation.
4. Non-GM corn but with Roundup itself added to the rats' water.

So what happened?  Well, in some groups, the rats got more cancer than controls.  But not always.  In fact, the authors had to cherry-pick their own data to support their conclusions.

One major problem is that only 10% of the rats were controls - 10 male, 10 female. The study's main claim is that rates of cancer were significantly higher in the rats fed GM corn.  Martina Newell-McGloughlin from UC Davis, in an interview with Discovery News, said 

"The type of statistical analysis they used is really a type of fishing expedition.  One individual referred to it as 'fantasy statistics.' "

Another major problem is that there's no dosage effect.  In other words, if Seralini is right and GM food is bad for you, then more of it should be worse.  But the study's results actually contradict this hypothesis: rats fed the highest levels of GM corn lived longer than rats fed the lowest level.

A third problem, as Discovery News and other sources reported, is that the rats used in this study are a special laboratory strain that is highly prone to cancer.

Perhaps most damning, though, is the fact that rats fed Roundup directly had the longest survival times.  As Seralini's own Figure 1 shows, the longest-living rats in the entire study, out of all the conditions, where those that drank Roundup in their water.  These rats outlived the control rats.

Yum!  Maybe Perrier should start selling Roundup-enhanced spring water?

Seralini and colleagues struggle to explain the internal contradictions in their study.  They write, 

"Interestingly, in the groups of animals fed with the NK603 [Roundup Ready corn] without R[oundup] application, similar effects with respect to enhanced tumor incidence and mortality rates were observed."  

This tortured English is their way of admitting that rats did worse ("similar effects") when fed GM corn that was grown without Roundup.  They don't want to admit that this result contradicts their central hypothesis.

The study was designed to fail: the sample sizes (10 rats in each group) are so small that all the results are likely just due to chance, and none of the differences are meaningful.  It's exceedingly unlikely that the Roundup in the rats' water made them live longer, just as it's unlikely that Roundup Ready corn had any effect on the incidence of cancer.

I know that ad hominem attacks aren't valid, but I can't resist pointing out that Seralini's co-author, Joel de Vendomois, is a homeopath, with a "Homeopathy and Acupuncture Diploma", a double dose of quackery in a single degree.  Seralini has also published a book about the supposed dangers of GMOs, and he and de Vendomois are the lead scientists at CRIIGEN, an organization devoted to lobbying against GMOs. Of course, even if Seralini and de Vendomois are bad scientists, and even if they have a strong bias, their paper isn't necessarily wrong.  It's wrong simply because the science is wrong.

Not surprisingly, an anti-GMO group in California has gleefully embraced the claims of this dreadful paper to argue in favor of Proposition 37, a ballot initiative that will require labelling of genetically modified foods.  And Jose Bove of the European Parliament has used it to claim that all GM crops are harmful to human health.

Let's be clear about the science here.  Genetic modification of foods is a powerful technology that can be incredibly beneficial.  The recent development of salmon that can grow faster is an example: these salmon (developed by a company called AquaBounty) will make fish farming more efficient, and thereby help preserve the perilously endangered wild fish species in our oceans.  On the other hand, GM technology can be used, as Monsanto has done, simply to allow farmers to use more pesticides, which doesn't seem to benefit anyone other than the pesticide producers.  It's unfortunate that Monsanto's behavior has been used as an excuse to give all GMOs a bad name.

Now we have a bad study done by anti-GMO scientists who have allowed their political agenda to trump their scientific judgment.  What a mess.