Fake news, science, and pseudo journalism
To understand the motivations of Paul Thacker it may help to read a profile written of him by his former editor at Audubon Magazine, and an adjunct journalism professor at New York University: “The Once Promising Journalist Who Became a Sadistic Troll.” It describes a bizarre, unpleasant, unprofessional campaign of trolling science writers and scientists over alleged conflicts of interest with industry. These apparent conflicts, in Thacker’s view, turn these journalists and scientists into illegitimate and fake sources of scientific insight. The problem, as Kloor details, is that Thacker stops reporting at the point where he can assemble a narrative of malfeasance, and, as a consequence, he frequently misrepresents and mischaracterizes his targets. Having taken on the pharma industry as an investigator for Sen. Chuck Grassley (R-IA) a decade ago, Thacker sees the influence of industries everywhere: any piece of information that might frame a science journalist as linked to an industry becomes prima facie evidence of industry influence, and, therefore, something to be prosecuted with the fury of a hanging judge.
The problems with such a heuristic is that it can turn one into a conspiracy theorist; moral righteousness blinds to awkward facts; cherry picking creates a spurious logic, and attempts by targets to correct what often are egregious misunderstandings simply force the theorist to plunge ever deeper down the rabbit hole. None of this may be apparent to the ordinary reader, because the topics require wading into the weeds to understand why you’ve being suckered into a swamp.
Unfortunately, too, the challenge of correcting a conspiracy theory is that one expends a vastly greater sum of words explaining why and how the theorist is incorrect than the theorist did in being incorrect. This leads us to the twin ironies of Thacker writing an opinion piece on the problem of “Fake News” in journalism—The pharmaceutical industry is no stranger to fake news—and his promotion of a webinar on fake news which he conducted with Carey Gilliam, a former reporter for Reuters, now employed by USRTK, a group that is funded by the organic industry and, it seems, a foundation promoting anti-vaccination.
Normally, we try to ignore such fringe-y nonsense. But as we—Trevor Butterworth, Maia Szalavitz, and Rebecca Goldin—have either starring or supporting roles in Thacker’s story of fake news, we feel the need to point out how his approach to holding science advocates and writers accountable is a case of pseudo journalism.
Here’s what we suggest everyone do: Just follow the links. They almost never say what Thacker says they say. They are false citations, to the point where you wonder, “did he actually read what he is linking to?” In theory, that kind of disconnect should be the end of his credibility; but as most people don’t follow every link in a news story or opinion piece, any attempt to explain this requires revisiting the original articles in some detail to describe how their content doesn’t match his characterization of the content—or manages to leave out a critical detail that shifts the entire meaning.
Let’s dive into the piece and the first claim:
“My [Thacker’s] reporting led me to a fleet of industry-friendly scientists and writers who had the habit of pooh-poohing the potential dangers of products, dismissing studies finding possible harm, and attacking the FDA. Several websites that trafficked in this messaging caught my eye, especially the now-defunct Statistical Assessment Service (STATS). In several instances, STATS staffers had disparaged journalists at the Orlando Sentinel and the New York Times who reported on the potential dangers of opioids. Trevor Butterworth, a STATS editor, later wrote a report that attempted to downplay the bias of industry-funded studies that experts cite as one cause of the Vioxx scandal.”
During the time period discussed by Thacker, we were relentless in defending the integrity of the FDA’s regulatory process: this was the motivation for our extensive writing about how the FDA regulated bisphenol a (BPA). We gave voice to scientists doing laborious, important work at the FDA’s National Center for Toxicological Research, because no-one else did, and (in the case of Butterworth) accepted invitations to speak on FDA panels at PittCon, JIFSAN, and on a joint EPA-FDA-EFSA panel at the Society for Risk Analysis.
Now onto opioids. First, it is important to note that the Orlando Sentinel investigation was about careless prescribing and accidental addiction to OxyContin and not about opioids in general; and readers of the Thacker op-ed might be surprised to note that the journalist who wrote the investigation resigned after an internal investigation by the paper uncovered serious errors in her reporting; two editors were reassigned; and, the Sentinel investigation was retracted. In short, Maia Szalavitz’s expose of the Orlando Sentinel’s work on OxyContin held up (Szalavitz was a STATS fellow at the time), although some small errors were promptly corrected. This does not deserve the frame of “fake news.”
Our criticism of the New York Times investigation was extremely detailed—and included testimony from one expert source who said the paper “misportrayed” his position on accidental addiction. There were other troubling problems, most notably the failure to address the data on polypharmacy that existed at the time.
In all this, we were not defending the pharma industry or responding to the pharma industry or taking money from the pharma industry; our key concerns were the following: If you looked at emergency room data then available, people were not overdosing on OxyContin alone—they were abusing other drugs too, and the rate of accidental addiction to OxyContin from prescribing for chronic pain was low. Back then, as now, research conducted for the Substance Abuse and Mental Health Services Administration shows the most prescription opioid misuse starts as recreational use of someone else’s prescription— not during chronic pain care.
Secondly, and following from the failure to grasp this, the Drug Enforcement Agency’s expansion into the surveillance of doctors prescribing pain medication—at the behest of the Department of Justice under then Attorney General John Ashcroft—threatened to prevent genuine patients in need of pain relief from getting treatment. While there have been, and will always be, unscrupulous or negligent doctors when it comes to writing scripts, the DEA crackdown risked turning doctors who practiced legitimate medicine into drug pushers—and people in chronic pain into criminals.
Which is what happened.
As Maia Szalavitz, noted in a story for Reason, Dr Feelscared, Assistant U.S. Attorney Gene Rossi “declared that the feds would ‘root out’ such doctors ‘like the Taliban.’ There was nothing subtle in the DEA/DOJ’s approach: armed agents stormed pain clinics; doctors were threatened with hundreds of years in prison; one, Benjamin Moore, hung himself.
And what of the one-fifth of Americans who experience chronic pain at some point in their lives? What of the patient in need of regular or increasing doses of opiates to simply live? As CBS’s Morley Safer reported for 60 Minutes, in the case of Richard Paey, law enforcement simply hadn’t a clue about the reality of pain treatment. An even deeper dive into the calamity facing doctors and patients was brilliantly reported by Tina Rosenberg for the New York Times Magazine in 2007 with all the nuance missing from the original NYT investigation into the drug.
These were the angles we covered 14 years ago—with a twist. Szalavitz, herself, once was addicted to heroin; and one of her key interests as a journalist has been uncovering the science and neuroscience behind addiction, and what this should mean for treatment and drug policy. Her most recent book, “Unbroken Brain,” is a New York Times bestseller; David Sheff describes her as “one of our most incisive thinkers about neuroscience in general and addiction in particular.” We (Butterworth and Goldin) agree. More to the point, her concern for people with addiction—one of the most punched-down groups in society—has been without peer in the news media. And nearly alone among people who write about addiction, she has also spotlighted the plight of chronic pain patients who are caught up in the current opioid crackdown. It should go without saying, but, just to emphasize: she has never taken industry funding.
It should be clear, at this point, that Thacker does not read carefully, or care to. Anything that can be shoehorned into his narrative of industry malfeasance is shoehorned regardless of context or accuracy.
The practice of disingenuous framing used by Thacker extends to the next point:
This—if you follow the link to the original—is a 27,000-word piece on the chemical Bisphenol A (BPA) which, as previously noted, is largely about the work of the EPA, FDA, and EFSA scientists who conducted risk assessments, and who failed to replicate the small scale, low powered studies claiming harm from the chemical. The piece is exhaustively sourced to these scientists, and the government-funded and conducted research they did. It draws on the recommendations of the NTP subpanel of statisticians who established how BPA experiments should be designed to produce valid results. Mention of industry-funded research in the piece is largely as part of the historical narrative; but industry funded studies disappear because the key replication studies were conducted by government entities. This is something environmental activists have a hard time accepting.
We avoided talking to the chemical industry at all in this piece. One key source, who had worked for the Center for the Evaluation of Risks to Human Reproduction for years had moved to a pharma company, which was noted. As of writing, the EPA, FDA, and EFSA have still failed to replicate the original or subsequent claims of harm. Atul Gawande waded into the controversy at a recent National Academies of Science meeting, and took a position that we took almost a decade ago: if you keep refusing to address the widely-noted limitations and criticisms of your research as noted by leading scientists in the field, there’s something wrong with the way you’re doing science.
Our piece was particularly critical of the Milwaukee Sentinel Journal’s investigation into BPA, which catapulted the issue into public consciousness like no other media coverage, and which reported the issue almost entirely from the perspective of the small group of scientists who did the basic research claiming a risk from BPA. We defy anyone to wade through our criticism and say it is an act of downplaying or dissembling. We covered the regulatory position because no-one else in the media, at that time was. We let regulators explain why the Journal Sentinel’s coverage was misleading.
Finally, Goldin wrote critically about Vioxx and statistical manipulation. Either Thacker doesn’t know or doesn’t care.
Next point, Avandia.
“I took a job with the U.S. Senate, running investigations of corruption in medicine. I learned that the players and tactics there were quite similar to those in the tobacco industry. One of my first jobs was leading the Finance Committee’s investigation of Avandia, a diabetes drug sold by GlaxoSmithKline that a study in the New England Journal of Medicine found to be associated with cardiac events.
In Zelig-like fashion, both Milloy and Butterworth magically appeared, with Milloy dismissing the NEJM study as a “statistical fantasy” and Butterworth writing a muddled column that sought to characterize the congressional investigations as a “partisan slugfest.”
A study commissioned by the FDA later found that Avandia likely led to more than 50,000 Americans dying or having strokes or other cardiac events. After the committee released the report I wrote on Avandia, which found that the company likely knew the drug was dangerous and had spent years attacking independent researchers who questioned Avandia’s safety, UBS analysts wrote that GSK likely faced up to $6 billion in legal liability.”
But wait, what was the eventual decision on Avandia? Not the 2010 developments cited by Thacker, but the conclusion to the saga in 2013? That would be the FDA affirming the safety of the drug (at least to the point of it being no more dangerous than any other diabetes medication) and lifting all restrictions on its use.
Butterworth wrote three pieces on the original Avandia scare in 2007 for the Huffington Post, and several for STATS. Thacker links to the one that does his narrative the least amount of damage. Overall, our focus was on the original study, a meta analysis by the Cleveland Clinic’s Steve Nissen and Kathy Wolski and why it was flawed—according to the biostatisticians who looked at it. This was a huge issue, spawning several highly critical academic responses and studies on Nissen and Wolski’s work. To give a flavor of the problem, here’s an extract from Medscape:
“Diamond et al take issue with how Nissen and Wolski selected the 42 trials for inclusion in their study, despite having first identified 48 by their predefined inclusion criteria (having a randomized comparator group, plus at least 24 weeks of drug exposure). Six trials, however, were excluded from the start because they did not report any CV events.
“Right off the bat, that is not appropriate,” Kaul told heartwire . “When you define a selection strategy, you don’t take a peek at the data and then make up your mind whether or not you’re going to include that trial. It’s an axiom in science that the hypothesis should drive the data; the data should never drive the hypotheses.”
For us, the central aspect of the story was this—a meta analysis that, critically, left out relevant studies that found the null effect (which is to say no relationship between the drug and an adverse effect). Again, we were, in fact, defending the FDA regulatory process against safety trial by media and congressional spectacle.
Next point. Thacker writes in his op-ed:
“Months later, the paper [the Milwaukee Journal Sentinel] rolled out an investigation of STATS, noting that the Center for Media and Public Affairs had provided media monitoring for tobacco companies and that STATS acted as a stealth public relations defender of the plastics industry.”
The Center for Media and Public Affairs president Robert S. Lichter did indeed conduct two studies for Philip Morris on the media’s coverage of tobacco, one of which found that experts thought the media underplayed the risks of tobacco. We believe Dr. Lichter gave congressional testimony on this, but we can’t say for sure as his work was conducted in 1994, almost a decade before any of us were hired to run STATS. You can read Lichter’s response to the Journal Sentinel accusations here.
The “proof” of Butterworth being a stealth public relations defender of the plastics industry, however, is farcical—and quite literally so, as it largely involves a letter written to the then popular media watercooler site Romenesko about a charm offensive by the New York Times on media critic Michael Wolff. As the Journal Sentinal put it (with a large side of hyperbole):
“Trevor Butterworth, editor of STATS, has become BPA’s fiercest advocate. He combs the Internet for stories that raise concern about the chemical, even on the most obscure blogs, and he chastises those who claim BPA can be harmful.
Butterworth offers this advice on a journalism Web site:
“Forget conventional PR! If some bratty journalist gives you a whack, whack back with obscene, jaw dropping disproportion: knee him in the groin, pull what’s left of his hair out, tell him he writes in clichés, and misuses the semicolon, and stomp on his iPhone! A hack is like a bully, and charming a bully is a bit like reasoning with a psychopath or writing a novel on Twitter. For the tough cases, go Dada. … Defending the brand means exacting respect and that will come from fear not charm.”
Now read the full letter with the Journal Sentinel’s extracts highlighted in red:
Title: Conventional PR won’t work for the Times
Posted By: Jim Romenesko
From TREVOR BUTTERWORTH: Hell’s bells, Catherine Mathis, a “charm offensive” is not going to work on hacks. Nor, for that matter, will a posse of cutesy labrador puppies, all running from ye olde corner store with a copies of the Times in their teensy, tiny mouths to an array of happy, diverse, breakfasting families, do the trick.
Forget conventional PR! If some bratty journalist gives you a whack, whack back with obscene, jaw dropping disproportion: knee him in the groin, pull what’s left of his hair out, tell him he writes in cliches, and misuses the semicolon, and stomp on his iPhone! A hack is like a bully, and charming a bully is a bit like reasoning with a psychopath or writing a novel on twitter. For the tough cases, go Dada. Hire a team of actors, in full costume, to follow Michael Wolff as if he’s Robin Hood and they’re his merry men. Have them camp outside his house. For a week. The less sense it makes, the more unnerving and annoying it will be. Promise Wolff that every time he says something unfair about the Times, you’ll dream up some fiendishly absurd way to punish him. He’ll get the message *eventually* (and you might get a movie deal).
My point is defending the brand means exacting respect, and that will come from fear not charm. Reporters should hear the dread words “Catherine Mathis on the phone for you” and quiver, much in the same way as Bertie Wooster did on hearing the name of Aunt Agatha, “the one who chews broken bottles and kills rats with her teeth.”
Perhaps the over-the-top comic intent–Bertie Wooster is the protagonist in PG Wodehouse’s Jeeves books,–was lost on the Journal Sentinel reporters; but this is clearly a comic letter about the New York Times finances. It is not about chemicals or the chemical industry; and it certainly isn’t professional advice from a PR expert. But that’s how the Journal Sentinel reported it. At the same time, the paper refused to respond to any of the substantive criticism by the scientists in our BPA piece of the paper’s coverage, which is the far bigger problem.
Plus, Michael Wolff is everywhere.
“STATS eventually gave birth to a new “sound science” organization called The Genetic Literacy Project. Its executive director has called the FDA the “government’s most dysfunctional agency.” The Genetic Literacy Project, which court filings reveal receives funding from Monsanto, provides industry-friendly messaging on genetically modified organisms, a key part of Monsanto’s business. The URL for the STATS website now takes you to Sense About Science USA, which is headed up by Butterworth. Started some years ago in London, this organization now lobbies on EU policy in Brussels and seeks to train medical journalists on the proper use of statistics.”
The Genetic Literacy Project joined the Statistical Assessment Service in 2011 under the same 501c3, although its operation did not overlap with STATS. Internal disagreements about purpose soon led to the dissolution of the Statistical Assessment Service. Those of us most excited about the mission to work with journalists on quantitative and statistical literacy, formed STATS, the project, and joined the newly established Sense About Science USA. The Statistical Assessment Service’s nonprofit status 501c3—was given to the Genetic Literacy Project allowing it to go its own way. STATS became a project of Sense About Science USA in association with the American Statistical Association. Goldin became the Director of the STATS project and Butterworth Executive Director of Sense About Science USA. SAS USA has its own 501c3 and does not accept industry funding.
Under SAS USA, STATS’s efforts shifted to focus more exclusively on educational projects. Hundreds of journalists have taken our workshops in partnerships with the Shorenstein Center at Harvard, the Grady College of Journalism, the Knight Science Journalism Fellowship Program at MIT, and even one in the STAT newsroom that was, according to the testimony of STAT reporters, very well received. Our STATScheck service enables journalists to connect with a volunteer board of academic statisticians to help them understand statistical data. We have helped journalists hundreds of times in the past couple of years. The questions they have represent a new engagement with scientific data, and reflect a sophistication that didn’t exist in the media even five years ago. They want to understand what the data really says. This is fantastic. We are also developing statistical educational tools for clinical trial researchers with the Annals of Internal Medicine, given that there are many statistical problems bedeviling biomedical and social science research—as everyone from the National Institutes of Health to Stanford’s Metrics Research Center has pointed out in the past several years.
Sense About Science USA—and its sister organization in the UK—also run, as noted, the AllTrials Campaign for Clinical Trial Transparency, which has, in fact, changed EU legislation to insist on clinical trial transparency, by uniting hundreds of patient groups and professional organizations to push for clinical trial transparency. That major fact, of course, doesn’t comport with Thacker’s obsession with a pharma industry conspiracy, so it is ignored. The hundreds of other stories that have been pursued over almost two decades and which draw attention to the misuse of data, the misunderstanding of methodology and statistics in the fabric of daily life are ignored too.
We note that Thacker’s track record of untrustworthy narration has led to the retraction of a piece he co-authored for PLoS after complaints of inaccuracies by the Union of Concerned Scientists (see also here and here). We can only conclude that the attack on our work in his STAT op-ed is an attempt to delegitimize what we do. But while he attacks our work for what he perceives as industry sympathy, he hurts the efforts for transparency in scientific research and for journalistic investigations using quantitative methods. It is worth remembering what the Washington Post’s Victor Cohn wrote in the classic, News and Numbers, about conflict of interest arguments: “The peddler of a biased point of view is as likely to be an antiestablishment crusader—or an academic ladder climber—as a corporate darling.” Our way to figure that out, literally, is through statistics.
The bottom line is that the piece he wrote if submitted as a news story would not pass rudimentary fact checking by STAT’s own estimable news editors; and as facts are for news, so should they be for opinion.
Executive Director, Sense About Science USA
Professor of Mathematical Sciences, George Mason University, Director STATS
Author, Unbroken Brain: A Revolutionary New Way of Understanding Addiction.
Image adapted from iStock.com