Cancer Medicine Politics Pseudoscience Skepticism/critical thinking

It’s nice when your efforts are appreciated by those who need them the most…

…at least, that was my first reaction when I first read this reaction by the Karen Malec of the Coalition on Abortion/Breast Cancer to posts by Mark Chu-Carroll and myself pointing out the numerous flaws in the latest “study” being circulated to “support” a link between abortion and breast cancer.

Then I thought about it. That post was one of my more ambitious posts, and it reached a length even greater than the usual Orac-ian standard of logorrhea to match its ambition. Indeed, the post took me two or three times longer to put together than the typical heapin’ helpin’ of Respectful Insolence™ usually does. (In comparison, both posts for today were written in their entirety, other than adding hyperlinks, during a two and a half hour train ride home last night–with time left over for a cat nap.) This amount of time was due to the loving attention I took to actually reading and analyzing the “study” by Patrick S. Carroll in the Journal of American Physicians of Surgeons (JPANDS) to which Chicago Tribune columnist Dennis Byrne referred so glowingly in his embarrassingly credulous editorial, coupled with the time I took to look up a bunch of articles and re-review the peer-reviewed scientific literature on the topic of whether there is a link between abortion and breast cancer. Mark, I’m sure, took a lot of time as well to deconstruct the statistical sins committed by Carroll in such overwhelming abundance. Add to that all the work that both Kathleen Seidel and I earlier put into posts that I linked to demonstrating, with copious examples and equally lengthy discussion, that JPANDS is nothing more than a pseudo-Libertarian propaganda sheet masquerading (poorly) as a “peer-reviewed” journal, and I don’t think it’s unreasonable of me to expect an enumeration of exactly what, if anything, was in error in my deconstruction of the Carroll article in JPANDS.

Do you?

What I got instead was whining about how Mark and I are supposedly not behaving like “experts,” because (1) we blogged about the Carroll study rather than writing a letter to the editor of JPANDS and (2) I use a pseudonym. This latter complaint is no doubt a mark of ABC’s frustration at not easily being able to dig into every bit of my background and use it to launch ad hominem attacks. Once again, as I have pointed out before, cranks tend to be obsessed with the identities and credentials of their critics When they become aware of someone criticizing their poor science on Usenet, discussion boards, or a blog under a pseudonym, their first reaction is often to try to unmask that person, not to refute their criticism. Failing that or instead of that, their other reaction tends to be to whine about the anonymity of their critics rather than addressing the meat of the criticism.

I also got a plaintive complaint about how I supposedly “prejudged” the article because it was in JPANDS and how I was so horribly, horribly unfair in characterizing JPANDS so harshly. Again, ABC obviously didn’t bother to read the links to my and Kathleen‘s posts that described in incredible detail exactly why we both dismiss JPANDS as being a truly crappy and biased journal. (Hint: It has published a lot of antivaccination nonsense, including articles by Geier père et fils, but in particular some utterly despicable articles trying to blame shaken baby syndrome on vaccine reactions. And that’s just the beginning; the American Association of Physicians and Surgeons, the organization responsible for JPANDS, even publishes dubious articles “doubting” the science behind anthropogenic global warning, along with anti-immigration screeds, homophobic articles, and articles supporting creationism and denouncing evidence-based medicine.) Suffice it to say that for nearly two years I have observed AAPS and JPANDS and the sorts of articles they publish, and the pattern is quite clear: JPANDS routinely publishes some of the absolute worst medical science I have ever seen in my entire career, and I’m not even its harshest critic.

Nor did ABC seem to notice that my complaints against the methodology in the Carroll article were described in almost nauseating detail. It’s all there for them to refute, if they can, with reasoned defense of Carroll’s methodology against my evidence- and statistics-based criticism, rather than through little more than lame appeals to “biological plausibility” of an abortion-breast cancer link. Biological plausibility is all well and good to speculate about, but mere plausibility just doesn’t matter much if the clinical data directly looking at the question do not support the process for which biological plausibility is argued. Indeed, my entire point was that, if there is indeed a link between abortion and a woman’s subsequent risk of breast cancer, the Carroll study sure wasn’t convincing evidence of it, particularly given the number of large, well-designed studies that have failed to find such a link. If my (and Mark’s) criticism were so off-base and hopelessly biased, it should have been child’s play to craft a devastating rebuttal to Mark, me, and, while she’s at it, to the Arch Pundit.

Finally, I can’t speak for Mark, but my answer to Karen Malec’s challenge to write a letter to the editor of JPANDS enumerating what’s wrong with the Carroll article is this: It’s been tried before without good results, leading me to conclude that it would be a waste of my time. Besides, the purpose of the Carroll article strikes me as being more to provoke credulous commentators and journalists (like Dennis Byrne) to trumpet the news that there is a study “confirming” a link between abortion and breast cancer, rather than to convince researchers and doctors interested in breast cancer (the vast majority of whom can easily see through the sloppy statistical model used by Carroll) that there is indeed good evidence for such a link. Given that, it seemed better to me to produce an article aimed at both a general audience and my fellow physicians and researchers that, if linked to widely enough, could serve as at least one lone voice questioning the breathless propagandistic cheering of the Carroll study by groups such as ABC showing up on Google searches.

Once again, whatever you think of abortion, whether to you it’s inherently murder, a necessary evil short of murder, a morally neutral act, or a moral good (the last of which is a view over which I took some flak for disagreeing with), I hope that we can all agree that attributing risks to the procedure of abortion that are not supported by science contributes nothing to the debate. Those who think abortion is morally abhorrent do their cause no favors by misrepresenting the scientifically validated risks of the procedure. In any case, it’s depressing to think that all that work only warranted such a slipshod reply.

ADDENDUM: Oh, look: Malec’s press release has made it to ChristianNewsWire.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

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