Sunday, November 22, 2009

Scientifically Illiterate

Dr. Nancy Snyderman just finished up a great appearance on Meet The Press. I've never seen her before but she should be doing more than hosting a show on MSNBC with her impressive grasp of science and health care policy. One thing she said really rang true - it went something like "We are in danger of becoming a scientifically illiterate country."

Nothing demonstrated that more aptly than the woman sitting next to her, another Nancy - Ambassador Nancy Brinker. Brinker admirably founded the breast cancer awareness/advocacy group Susan G. Komin for the Cure, but she is also a great example of how her advocacy and lobbying on behalf of increased breast cancer awareness has given her blinders when it comes to science and data.

Backing up, this is all about last week's minor uproar over the release of new federal guidelines for breast cancer and cervical cancer screening. Dr. Snyderman got right to the point by saying that these were scientifically arrived at guidelines and the negative reaction to them is a case of anecdote winning out over data.

Quick summary: The HHS Preventative Services Task Force found that the number of false positives in women in their 40's were large enough, and the number of real cancers caught early small enough, that mammograms for women in that age bracket did more harm than good overall (due to false positives resulting in stress, unnecessary biopsies, etc).

What an example of the battle between science and anecdote! Just like with the vaccine hubbub, in response to scientists saying "statistically early mammograms do more harm than good," anecdoters say "an early mammogram saved this person's life, therefore they must be good for everyone." (With vaccines it is the reverse - scientists say "statistically there is far far more risk in not getting vaccinated than in getting vaccinated," but anecdoters fixate on the one in a million chance that a vaccine might harm them.)

And then when you bring politics into it, it gets worse. Few politicians have the courage to lead and teach by correcting the public's preference for anecdote, instead choosing to back off the issue. This gives ground to those on the right who use public fear for their own political ends (I'm looking at you Rep. Marsha Blackburn - oh hi Dr. Nancy)

People like that really piss me off.

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