Computers and social media Medicine Politics Popular culture Science Skepticism/critical thinking

John Ioannidis and Vinay Prasad team up to lecture social media about “obsessive criticism”

Formerly respectable academics John Ioannidis and Vinay Prasad published a complaint about “obsessive criticism” on social media. Hilarity ensued, and many irony meters were reduced to sparking, smoking, sputtering ruin.

Those of us who have spent more than a few years dealing with medical misinformation, disinformation, malinformation, and conspiracy theories know one key thing about the brave maverick doctors who participate in spreading misinformation. It’s a characteristic shared by all of them. (At least, if there are exceptions, I have yet to find one, and, dear reader, you are free to provide examples of exceptions if you think I overreached by attributing this characteristic to all brave mavericks.) That characteristic is a persecution complex, in which “iconoclasts” of this sort come to view all criticism, legitimate or not, as “obsessive” (and often outright “persecution”), an attempt to “silence” them, or—these days—a manifestation of “cancel culture.” Remember the Galileo gambit? I first wrote about it 17 years ago, and it describes these “contrarians” perfectly; they view themselves as being unjustly “persecuted” by scientific authorities for the “heresy” of being too brilliant and ahead of their scientific colleagues.

There was a time when, if you told me that I’d be writing an introduction like this to a post about an opinion piece about “obsessive criticism” by John Ioannidis and Vinay Prasad published in a peer-reviewed journal like The European Journal of Clinical Investigation (EJCI), I’d have looked at you as though you had grown a third eye. Unfortunately, the COVID-19 pandemic has changed much in this world, and a depressing number of once-respected academics have joined the anti-public health disinformation machine—although I do note that in the case of Dr. Prasad the decline began at least a year or two before SARS-CoV-2 hit, when he started dismissing the efforts of skeptics to debunk alternative medicine and antivax quackery as “dunking on a 7′ hoop” and unworthy of his massive brainpower. Also, he suggested that we skeptics should join him criticizing big pharma clinical trials because, you know, it’s just too easy to combat medical misinformation and quackery like homeopathy and antivax pseudoscience and therefore not worth an academic physician wasting brainpower on.

I suppose that, in retrospect, it isn’t a surprise that Dr. Prasad has become a prominent “COVID contrarian” and opponent of masking and vaccines in children and has used the very same techniques that quacks and antivaxxers use to misrepresent scientific studies. He even compared public health interventions such as mask and vaccine mandates to incipient fascism. If you don’t think that understanding how misinformation and conspiracy theories can creep into even a brain as massive as that of Dr. Prasad, then you will be vulnerable to them.

In any event, let’s look at the abstract to the article, entitled Constructive and Obsessive Criticism in Science. It’s a doozy:

Social media and new tools for engagement offer democratic platforms for enhancing constructive scientific criticism which had previously been limited. Constructive criticism can now be massive, timely, and open. However, new options have also enhanced obsessive criticism. Obsessive criticism tends to focus on one or a handful of individuals and their work, often includes ad hominem aspects, and the critics often lack field-specific skills and technical expertise. Typical behaviors include: repetitive and persistent comments (including sealioning), lengthy commentaries/tweetorials/responses often longer than the original work, strong degree of moralizing, distortion of the underlying work, argumentum ad populum, calls to suspend/censor/retract the work or the author, guilt by association, reputational tarnishing, large gains in followers specifically through attacks, finding and positing sensitive personal information, anonymity or pseudonymity, social media campaigning, and unusual ratio of criticism to pursuit of one’s research agenda. These behaviors may last months or years. Prevention and treatment options may include awareness, identifying and working around aggravating factors, placing limits on the volume by editors, constructive pairing of commissioned editorials, incorporation of some hot debates from unregulated locations such as social media or PubPeer to the pages of scientific journals, preserving decency and focusing on evidence and arguments and avoiding personal statements, or (in some cases) ignoring. We need more research on the role of social media and obsessive criticism on an evolving cancel culture, the social media credibility, the use/misuse of anonymity and pseudonymity, and whether potential interventions from universities may improve or further weaponize scientific criticism.

I’m amazed that Dr. Prasad and Prof. Ioannidis know what “sealioning” is.

The first hit on my irony meter is observing that two tenured academics at very respected institutions are complaining about “obsessive criticism” on social media in a peer-reviewed journal for which one of them (Prof. Ioannidis) served until fairly recently as editor-in-chief. There is much other irony to mine here. For example, one author (Dr. Prasad) of this article lamenting a lack of civility on social media and complaining about “obsessive criticism” is no slouch at obsessive criticism on social media and some rather nasty attacks against his critics himself. The other author (Dr. Ioannidis) once used an article in the very same journal ostensibly answering criticism of some of his rather dubious studies and assertions about the COVID-19 pandemic to attack his critic for his appearance in his Twitter bio (including having a cat in his picture) and then later published a widely criticized article using the satirical Kardashian index to attack his critics as being all social media influence, no scientific influence. Of note (and unsurprisingly), he did not react well to the torrent of much-deserved criticism. This will figure in my discussion of the article, and the section with the ad hominem attack was ultimately removed from the paper:

As for Dr. Prasad…

Apparently, Prof. Ioannidis and Dr. Prasad think that we should all be as civil as Dr. Prasad.

Also, Dr. Prasad was known for his hot Twitter takes five years ago, in which he delighted in attacking big pharma and his own colleagues, but now that he’s on the receiving end of social media criticism that he can’t control he’s writing articles about “obsessive criticism.”

Basically, the whole EJCI article boils down to this:

Or maybe this:

In fairness, though, I do have to admit that there is a germ of a reasonable point in this article; it’s just that it’s impossible to separate the singer from the song, so to speak, and there’s a lot of nonsense and airing of personal grievances in the article as well. Let’s take a look.

On “obsessive criticism”

Early in the article, Prasad and Ioannidis complain about targeted harassment:

Social media in particular have unlocked new mechanisms of engagement. Many aspects of the new media are an improvement: platforms are democratic—anyone may engage—and the pace of response can occur in real time—shaping ongoing discussions. Concurrently, maladaptive processes may evolve: excessive focus on single individuals, ad-hominem comments, use of multiple, pseudonymous or anonymous accounts to create the impression of mass opposition, and the increasingly prevalent tactic of calling for scientists with whom one disagrees to be fired, banned or de-platformed.7 Criticism may become targeted harassment.

I, for one, welcome Prasad and Ioannidis to the club of the persecuted. Antivaxxers, cancer quacks, and their supporters have been periodically engaging in targeted harassment of yours truly going back to 2005, while even more prominent provaccine advocates like Dr. Paul Offit have endured death threats for years. Dr. Peter Hotez, another vaccine expert, has been regularly targeted by right wing social media (and sometimes by right wing old media like Tucker Carlson), resulting in tsunamis of harassment. As for me, even as a minor player in this space I’ve lost track of how many times cranks have harassed me at work by contacting my department chair, cancer center director, and/or medical school dean to complain about my social media and scientific activity, the intent being to get them either to shut me up or fire me. It’s good to know that Dr. Prasad and Prof. Ioannidis now have my back, and the backs of those of us who have been enduring this sort of thing periodically for years and years. May I conclude that they are talking about me (and Drs. Hotez and Offit and others of my fellow skeptics) in their article too?

I think you know the answer to that question.

Basically, Dr. Prasad and Professor Ioannidis have discovered that speaking up in public can have consequences, and they don’t like it. I’ve discussed some of them before in the context of my own history, such as when I was targeted with an abusive Michigan Freedom of Information Act request by Gary Null’s lawyer Neal Greenfield a few months ago. (I’ll update that story later in this post.) Before that, there was the time that a “Lyme-literate” doctor sued Jann Bellamy and most of the other editors of a blog for a post he didn’t like. Fortunately, it was dismissed, but not before causing considerable trouble. Then there was the time that Mike Adams published something like 40 libelous posts about me over the course of a few months and claimed to have submitted “complaints” about me to the local FBI office. Before that there was the time antivaxxers, led by a particularly nasty piece of work named Jake Crosby, flooded my university’s board of governors, my medical school dean, my department chair, and my cancer center director with complaints about a nonexistent “conflict of interest”. Those are just some “highlights”. There are many more examples.

I’m not defending any of these people. Rather, I am merely pointing out that someone like Prof. Ioannidis, as probably the most published currently living and active scientist, is far better equipped to weather this sort of criticism than even I, in my relatively privileged position, am. Also, Prof. Ioannidis famously likes to humble brag about how he “has no personal social media accounts,” the implication being that he is oblivious to social media, but for some reason he seems very aware of the criticisms being leveled on social media about his misleading statements and recent spate of bad science about COVID-19. (I now suspect that he lurks a lot.) As I began to read their article, I even hoped that they might surprise me and have useful suggestions for what to do about the problem. Unsurprisingly, I was disappointed.

Let’s look at how they define “obsessive criticism”:

Obsessive criticism may have several hallmarks (Table 2). Not all are necessary to make the diagnosis, but typically many are present. We divide this into issues of focus, behavior and duration.

Obsessive criticism focuses excessively on individual authors or specific teams on one side of the issue, ignoring complementary work. This may be coupled by lack of a track record of field-specific skills on the debated topic. Obsessive critics may ruminate on topics that require technical expertise they do not possess. The rumination may also acquire a strong personal focus.

Obsessive disputes often take on moral properties. Opponents are not merely incorrect or misguided, they are dishonest or malicious actors. An obsessive critic may view the ideas of the opponent as dangerous are harmful, and this view may be used to justify or vindicate their behavior. Repetitive, persistent, lengthy criticism is typical. It can take the form of typical sealioning, a technique of trolling or harassment where the critic claims to be sincere and civil but relentlessly and repeatedly asks for evidence and for answers to questions that have already been previously addressed. In addition, strawman arguments, argumentum ad populum, calls for cancellation, guilt-by-association, reputational tarnishing of individuals, posting sensitive personal information (like salary), anonymity, pseudonymity, and fake accounts may be deployed. In an era where social media follower counts, likes, favorites and retweets are widely visible, these metric may be seen as rewards. In some forms of social media, engagement carries financial benefits. E.g. Medium, a blogging platform, pays based on the number of “claps” an article receives.8 Diverse indirect financial gains (e.g. contracts, book sales, or advisory roles) may follow meteoric rise in public prominence. Obsessive critics often display a skewed ratio of criticism to pursuit of one’s research agenda. Another hallmark is distorting the target researcher’s message, and claiming, without evidence, that most other scientists disagree.

ZDoggMD and Vinay Prasad: Best buds forever versus obsessive criticism?
ZDoggMD and Vinay Prasad: Best buds forever?

That last paragraph is…something. So Dr. Prasad, an academic oncologist who has two Substacks (with “thousands” of paid subscribers for at least one of them, at a minimum of $5 a month), his own video podcast (again, complete with income), is a frequent guest on the podcast of ZDoggMD, Dr. Zubin Damania (and also does a group Substack with Dr. Prasad and two other doctors), who himself has evolved from a skeptic whose work I used to value into a COVID-19 contrarian and “alt-middle” purveyor of dubious pandemic takes, is insinuating—if not right stating—that “obsessive” critics have a financial conflicts of interest? It is projection at its finest, at least with respect to Dr. Prasad, to accuse critics of having a financial interest in generating outrage by attacking oh-so-reasonable scientists with “different” views, like Prof. Ioannidis and him! Basically, what the authors are doing is nothing more than a variation of the pharma shill gambit, specifically the more general shill gambit that is frequently used to argue that critics only express the views they do because they are either paid to express them or because having those views somehow generates more income for them. Of course, it’s hard not to observe here that the shill gambit cuts both ways.

In fairness, here I’ll express a little bit of admiration for Dr. Prasad, not just for his obviousness, but for somehow having build such a multimedia empire of pandemic “skepticism.” To be honest, these days I struggle to keep up at my day job and write my usual lengthy blog posts. (Indeed, longtime readers might have noticed that I am no longer nearly as prolific as I used to be back in the day.) So I do have to wonder how Dr. Prasad does it all. That’s not a dig. After all, Dr. Steve Novella is a multimedia god himself, but at least Steve serves the cause of science-based medicine and skepticism, not promoting misinformation for clicks, as I perceive Dr. Prasad to be doing. He just doesn’t like criticism that he perceives as too intense directed at him, although he certainly doesn’t mind ranting about physicians and scientists who advocate masking and vaccine mandates for COVID-19. Also, if his critics are “doing it for the clicks” (and therefore money), why is Dr. Prasad doing it, because he’s just so very dedicated to The Truth? I’ll let you judge.

In the meantime, let’s look at Table 2:

Ioannidis & Prasad Table 2: Obsessive criticism
The amusing thing here is that these are all techniques that COVID-19 pandemic disinformation generators use. Truly, Prasad and Ioannidis project a lot. I mean, what was the Great Barrington Declaration but one huge argument ad populum designed to give the false impression that a majority of scientists supported a “let ‘er rip” “natural herd immunity” approach to the pandemic, with ineffective “focused protection” of the elderly and vulnerable?

The above “defining characteristics” proposed for “obsessive criticism” are not entirely unreasonable; at least several of them are not. The problem is that this entire article is an exercise in guilt by association; Prasad and Ioannidis are trying to lump the many reasonable criticisms of their statements and bad science made on social media with the obsessives and trolls and thereby discredit the reasonable criticism along with the usual social media noise.

This brings me to another point.

Misuse of skepticism

At various points in the article, Prasad and Ioannidis try to invoke the language of skepticism that Prasad once so disparaged as being so beneath his Big Brain. Above, for instance, they tried to claim that their critics were using the logical fallacy of argumentum ad populum. I suspect they really meant is that their critics appealed to scientific consensus. That is not really an argumentum ad populum, which is an appeal to popular opinion, not to the opinion of experts. One can argue about what any given scientific consensus is at any given time, but scientific consensus is not the opinion of the general public, and I’ll refer Prasad and Ioannidis to the rational RationalWiki entry on argumentum ad populum for an explanation of the difference between an appeal to the scientific consensus and an argumentum ad populum.

Perhaps the most egregious passage in terms of misusing a concept in skepticism occurs when Prasad and Ioannidis misuse the term Gish gallop:

The length of rebuttal may be a crucial sign of obsessive criticism – cumulatively it may exceed the original work in volume many times over. Criticism may acquire the features of “Gish Gallop”: the critic hurls a huge amount of diverse material, including some reasonable statements, but also many half-truths and obviously wrong statements, in a way that the person criticized is given no chance to combat each point meaningfully, even less so during the timepressed environment where such criticism occurs. E.g., some journals employ rapid response sections, encouraging readers to comment in real time. This format offers advantages over the more formal letter writing, with strict word limits and limited response. However, back and forth dialog can quickly become repetitive and no longer constructive. The authors of a 3000 word research article may find themselves embroiled in 30,000 words of back and forth response with no end in sight and nothing new after the first few thousand words. Links to these responses may then be posted on social media to draw in new discussants.

Perhaps Prof. Ioannidis and Dr. Prasad would like to provide specific examples of their being subjected to a “Gish gallop,” because, having followed the criticism of their COVID-19 takes on social media and in rapid response sections, I am unaware of any. Let’s just say that it’s very easy to accuse long, detailed criticisms of being a Gish gallop in order to try to discredit them, but let’s consider what a Gish gallop really is.

Most skeptics are familiar with Duane Gish, after which the Gish gallop is named. Gish is a creationist whose technique of “debating” against the theory of evolution won it the eponym “Gish gallop.” These days, the technique is more formally known as firehosing and involves:

…drowning your opponent in a flood of individually-weak arguments in order to prevent rebuttal of the whole argument collection without great effort. It’s essentially a conveyor belt-fed version of the on the spot fallacy, as it’s unreasonable for anyone to have a well-composed answer immediately available to every argument present in the Gallop.


Gish Gallops are almost always performed with numerous other logical fallacies baked in. The myriad component arguments constituting the Gallop may typically intersperse a few perfectly uncontroversial claims — the basic validity of which are intended to lend undue credence to the Gallop at large — with a devious hodgepodge of half-truths, outright liesred herrings and straw men — which, if not rebutted as the fallacies they are, pile up into egregious problems for the refuter. There may also be escape hatches or “gotcha” arguments present in the Gallop, which are — like the Gish Gallop itself — specifically designed to be brief to pose, yet take a long time to unravel and refute.

Antivaxxers love the Gish gallop, too. They can often cite numerous dubious or bogus studies, observations, and factoids, each of which takes a lot of effort to refute; that is, if even a skeptic familiar with science denialist arguments can be familiar with every single citation used in a Gish gallop. Basically, the Gish gallop relies on Brandolini’s law, which states that the “amount of energy necessary to refute bullshit is an order of magnitude bigger than to produce it.” Personally, I think that Alberto Brandolini, the programmer who came up with this bon mot, was an optimist. In actuality, it takes more like two orders of magnitude—or greater!—more energy to refute bullshit than it does to produce it.

I happen to know what Prasad and Ioannidis are referring to. Remember the article I mentioned, in which Prof. Ioannidis used a scientific publication citation index intended as satire to portray critics of the Great Barrington Declaration (which he supports and whose concept of “focused protection” he arguably might have first popularized) to portray critics of the Great Barrington Declaration as “science Kardashians,” all social media influence but negligible scientific influence? As I noted before, he did not react well to the criticisms that flowed in the rapid response section after his article. Now look at his article and the rapid response section. I would argue that the criticisms were generally polite and civil but very much on point. I don’t see a single one that brought up irrelevant points, cited dubious studies, or looked anything like firehosing, even when taken in aggregate. There were common themes, such as how Ioannidis misused a satirical index, attacked critics by name, used no statistical analysis to speak of, misrepresented Twitter reach as representative of overall social media reach, and never got IRB approval for his study even though it is quite arguable that he should have. I would posit that it is no coincidence that, nearly five months after this kerfuffle, a paper is published in a journal for which Ioannidis was a longtime editor and that he misused to attack a critic. I’m only surprised that it took nearly five months.

As for the rest, such as accusations of straw manning, I note that Prasad and Ioannidis do not present a single example to demonstrate their point. You just have to take their word for it, I guess. Truly, I can’t help but agree with this sentiment regarding EJCI:
It’s true. Even if Prof. Ioannidis is no longer the editor of EJCI, it sure seems as though his successor will let him publish whatever nonsense he feels like writing.

Expertise and pseudonymity

The last really big grievance that Prasad and Ioannidis appear to have is that they perceive their “obsessive” critics not to be as awesomely expert in the relevant scientific disciplines as they are. It’s also rather difficult to think that they are not referring to a certain humble pseudonymous (here, at least) blogger when they rant:

Criticism should be encouraged regardless of credentials, stature, and academic rank . It is particularly important to empower young researchers to participate in scientific debate. However, meaningful scientific debate requires topic-specific and/or methodological expertise. While several skills can be acquired fast and can be even self-taught, for other scientific tools, mastering them can take years of committed engagement, hands-on experience and specialized training environments. For some technical topics, the population of scientists who can debate meaningfully is very limited. This is not an issue of elitism or of early career versus senior exclusivity. A Nobel laureate in physics would not be able to criticize meaningfully surgical technique; and a surgeon is unlikely to be able to comment on bosons in a way that will promote the field (unless also trained on particle physics).

I will note that I have never, at least as far as I can remember, expressed an opinion on bosons or particle physics. (As Dirty Harry once said in the 1970s police flick Magnum Force, “A man’s got to know his limitations.”) Still, it’s difficult to resist pointing out that a lack of relevant high level expertise in immunology, vaccines, pediatrics, virology, and other fields didn’t stop—or even slow in the least—Dr. Prasad from pontificating about COVID-19, masking, vaccination, SARS-CoV-2, or any number of topics outside his field of expertise. Remember, Dr. Prasad is an adult oncologist, not a pediatrician, nor is he an expert in child development, immunology, infectious diseases, vaccines, or arguably about anything other than cancer. He does have an MPH, but it’s hard to tell from the dubious criticisms he’s made about everything from masking to vaccines that he has public health training. I realize that he has published about problems in randomized clinical trials and fancies himself an expert in their design, but I can’t seem to find any that he’s actually designed and run himself. Let’s just say that I will compare without shame my contribution to the scientific discourse about COVID-19 to anything Dr. Prasad has written or blathered on his podcasts or videos.

Prof. Ioannidis is a more difficult case. While he lacks the high level expertise in immunology and public health that he attributes to his critics in this editorial, in fairness I need to point out that he did do an infectious disease fellowship decades ago at Tufts University and does know epidemiology and clinical trial design. On the other hand, what he shares with Dr. Prasad is a career built not so much on doing original research but on a “meta” sort of take on science, in which he studies existing research and find flaws in science that he critiques. (That’s not to say that such studies aren’t valuable—they most certainly can be and often are—but it is interesting to me how two physician-scientists who built their careers on critiques of how clinical science is carried out and published seem to have fallen prey to exactly the very same sorts of pitfalls that they attribute to their colleagues.) Prof. Ioannidis has built quite the career on this sort of critique as well. (As I noted before, he’s the most widely published living—and still active—scientist, although how he amassed 1,200+ papers indexed in PubMed over a career spanning thus far less than 30 years does raise the question of how much he’s actually involved in any individual paper.) It’s hard not to see massive arrogance in how Prof. Ioannidis pivoted to making pronouncements about COVID-19 so quickly after SARS-CoV-2 started spreading outside of China in early 2020. Indeed, his reaction to reasonable and civil criticism of his “science Kardashian” article suggests a large and easily bruised ego.

Also, to turn back the example of the surgeon discussing particle physics on the authors, I note that Prof. Ioannidis once appeared on Dr. Prasad’s Plenary Session Podcast, where he claimed (at 1:37:25) that “a lot of lives” were lost early in the pandemic in part because of doctors “not knowing how to use mechanical ventilation, just going crazy, and intubating people who did not have to be intubated.” Dr. Ioannidis did not provide any evidence for this claim, and Dr. Prasad did not push back. Let me quote Dr. Jonathan Howard on this incident:

Perhaps because it was said as an aside during a podcast, I don’t think this false claim got the scrutiny it deserved. But let’s be clear: a paragon of evidence-based medicine publicly accused frontline doctors of killing a large number of their patients. He not only did so without any evidence, but in direct contradiction to the evidence available at the time.

I’ll just add that board-certified critical care physicians likely know more about mechanical ventilation and when to begin it than a physician who hasn’t practiced medicine in decades and an oncologist who, as far as I can tell, barely sees patients any more. I’ll also reiterate that the idea that doctors were intubating patients willy-nilly who didn’t need to be intubated and thereby contributing to their unnecessary demise rapidly turned into a conspiracy theory that led many patients with COVID-19 symptoms to fear going to the hospital, lest they be placed on a ventilator and die.

Prasad and Ioannidis aren’t wrong to suggest that expertise is very important, but if they were really serious they would both admit their egregious mistakes and shut up about any scientific topic for which they lack high level expertise. That would include, in their case, most topics related to COVID-19.

Identify yourselves, you anonymous Twitterers and your obsessive criticism!

Another thing that Prasad and Ioannidis don’t like is pseudonymous social media influencers. They really, really, really don’t like them at all:

Anonymity and pseudonymity require special mention. They may be occasionally justified, e.g. if a whistleblower might be threatened, were his/her identity revealed. However, in some cases, the ethical concerns may be inverse. When anonymous and/or pseudonymous accounts acquire powerful influencer status, the justification for concealing identities becomes dubious. When influencer obsessive critics exert major influence on decisions and policies that affect many lives, the society, or economy at large, it is essential to know the technical expertise of the influencer, the nature of the connections with other influencers, and the potential conflicts of interest. At a minimum, one would wish to know if several accounts are actually run by a single person or somehow synchronized – and why. While junior people naturally worry about retribution; this must be balanced against the potential for a distorted or fake consensus to be created.

May I assume that Dr. Prasad and Prof. Ioannidis are concerned about the many pseudonymous accounts out there spreading pandemic misinformation and attacking science communicators like me? Some are quite influential and have large followings. Many clearly coordinate and synchronize their output, the better to amplify their message. Somehow, I suspect, that’s not what they’re talking about here. Rather, I suspect they don’t like accounts like that of Atomsk’s Sanakan, one of whose Tweets I cited above that was very critical of this very paper! But why don’t they like them? Would it be too…cynical…of me to speculate that maybe they don’t like pseudonymous accounts because they can’t figure out whom to attack or whose boss to complain to? Let me just also mention who else really hates pseudonymous accounts: Antivaxxers. (I know this from personal experience.) They hate pseudonymous accounts for the same reasons. They can’t easily attack pseudonymous social media denizens by name, nor can they harass them at their jobs, as they have done to me.

Don’t get me wrong. I know that pseudonymity can be abused. I also applaud our aggrieved authors for recognizing that there are legitimate reasons to use a pseudonym. (I myself still use one even after I was long ago “outed” because I like using it more as a pen name and alter ego than with any expectation that it protects me from any blowback over what I write.) However, it’s hard not to do a major facepalm at the most published living professor in biomedical science fearing such harm from junior faculty members criticizing him on Twitter when he used the journal for which he was longtime editor as an instrument to “punch down” at a much more junior scientist who had criticized him, even going so far as to mention his large glasses and cat featured in his Twitter bio and is now using the same journal again as his personal blog to attack his critics for incivility and “obsessive” criticism.

As Ed Nirenberg noted:

Meanwhile, Dr. Prasad’s social media presence between his Twitter account, Substacks, and podcast dwarfs all but the most influential of his critics in medicine and science. (A quick comparison, he has nearly three times the number of Twitter followers that I do.)

But what are the solutions?

I’ll start my conclusion by pointing out that in no way am I claiming that there is no problem here. That’s part of why I find Prasad and Ioannidis’ article simultaneously so hilarious and infuriating. If you don’t know the history of the authors, you might find a fair amount of what they’re saying to be reasonable. If you are familiar with their history, though, it becomes very obvious that they have an axe to grind, their sops to junior faculty, women, persons of color, and other groups most subjected to online harassment and retribution notwithstanding.

Harassment on social media is an issue. The spread of misinformation, disinformation, and malinformation on social media is a huge problem. The use of anonymous troll and bot farms to spread such disinformation is a huge problem. What Prasad and Ioannidis seem to be oblivious to, though, is that it is not “obsessive criticism,” to try to refute that misinformation and that it is not appropriate to ignore the distinction between attacks on scientists over legitimate takes and skeptics trying to refute misinformation. Worse, they can’t seem to see that they’ve allied themselves with the problem. My last irony meter also blew up when Prasad and Ioannidis cited a recent Nature survey showing how two-thirds of scientists doing media during the pandemic had faced negative consequences in terms of harassment or calls to be fired as a prelude to this:

One can perhaps learn from previous attacks on science under authoritarian regimes or from sensitive issues such as climate change,30 where scientists have been repeatedly targeted with obsessive attacks. Social sciences have studied some of these phenomena in the past and offer taxonomies and insights on how these types of “warfare” operate.31-33 Barnes et al. have found in experimental studies that ad hominem attacks may have the same degree of impact as attacks on the empirical basis of the science claims, and that allegations of conflict of interest may be just as influential as allegations of outright fraud,34 thus obsessive critics do have the power to cause major damage. While some of these problems have precedents, social media has created novel methods for dispute, which remain largely unmonitored and unchecked. At its best, social media is democratizing, capable of profound and biting criticism, disseminated in innovated and bold ways. At its worst, social media resembles a schoolyard, with bullying and harassment of individuals. We encourage others to study and contemplate this emerging problem. We suggest greater consideration into policies to help strengthen social media into a vibrant forum for discussion, and not merely an arena for gladiator matches. Institutions and journals can play an important role in reclaiming some portion of the dialog to prevent excesses.

At this point, I can’t resist combining a criticism of the two biggest bits of hypocrisy in this article by citing—you guessed it!—a pseudonymous Twitter account:

Well played, pseudonymous Twitter denizen. Well played indeed.

So what we have here are two investigators with huge axes to grind. One of them has a history of delighting in attacking pharma, colleagues, and others on social media but doesn’t like it when he becomes the target. The other—or so I suspect—has never faced significant criticism that he couldn’t answer or control and hence labels it “obsessive criticism.” Both are calling for more investigation into a problem in which neither of them have any relevant high-level topic-specific methodological expertise. They also do so while simultaneously comparing what is going on to authoritarian attacks on science and “cancel culture” to denigrate real concerns. Basically, they don’t like being on the receiving end of criticism and are gaslighting their history:

I’ll finish by making a prediction. Now that Dr. Prasad and Prof. Ioannidis have published this paper lamenting “cancel culture” over COVID-19 public health science, look for the usual suspects to amplify its message, proclaiming it a “peer-reviewed study” that conclusively demonstrates the toxic effect of social media “obsessive criticism” on those speaking “heresy” about COVID-19. (It was probably peer-reviewed—sort of, given the journal and Prof. Ioannidis’ history with it, but it’s not a study. It’s a glorified science op-ed.) I’m only surprised that Dr. Prasad hasn’t promoted it yet on one of his Substacks or published an article on the Brownstone Institute website yet.

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]

43 replies on “John Ioannidis and Vinay Prasad team up to lecture social media about “obsessive criticism””

Many aspects of the new media are an improvement: platforms are democratic—anyone may engage

Tangential I know, and so remove this if you deem it to be too far afield, but: that portion I emphasized is, IMO, the best thing about the many types of these social platforms: they allow people who historically were not able to have their voices heard in traditional venues the ability to speak out. I suspect that fact is one of the reasons there are so many attacks from the right (usually, although some are from the left) on the platforms.

This should have been just “they allow people to speak out”. And it is not “the best thing” because any crank can speak out and spread their ideas over the entire world.

And it is not “the best thing” …

Obviously I disagree: the fact that it gives cranks the ability to spread their crap is obvious, but IMO weeding through that is a small price to pay for the fact that for so long voices from groups unable to gain access to traditional media now have the ability to be heard on their own. I’m not going to blame the tools for how a certain subset use them.

I’m also not going to add any more to this discussion since it is so clearly off the primary point of Orac’s original post.

If you’re more visible, it’s kind of expected that critics will give you more attention than people less visible. Calling that “obsessive” is a bit weird.

Isn’t the goal of building an attention-seeking platform to be the focus of attention? If the argument is “yes, but not this kind of attention,” well, that’s a bit of an issue.

Targeted harassment can be horrible. But many people criticizing a very visible, well known academic writing a piece is not, by itself, targeted harassment, and that is true even when the piece deserves less criticism than these doctors’ work. I’m sure both people also got targeted harassment, but what they’re describing does not sound like it.

Trying to diagnose the reaction as “obsessive” is not only, as you point out, whiny, but it seems to be a special kind of ugly. It tries to use the stigma against mental health issue to tar their critics. It’s wrong both ways: by contributing to and feeding the stigma against mental health issues, and by painting critics as such.

That seems a lot closer to targeted harassment than what they’re complaining about, to be honest.

Great comment!

What struck me, and adds to the ugly, is the arrogance displayed by framing whiny grievance at being critiqued in the vocabulary and prose style of ‘objective science’ befitting a scholarly journal in medicine or psychology. Thus, Johnny and Vinnie cast themselves as disinterested parties above the fray. At least, Orac’s Twitter clips show plenty of people aren’t buying it,

That’s the deception. If you aren’t familiar with Prasad’s and Ioannidis’ history you might find the arguments in this paper reasonable, or at least not unreasonable. If you know the history of the authors, it’s impossible not to read it through that lens and realize that this is like the Festivus of scientific op-eds. It’s an airing of grievances, nothing more.

I have not read every comment published by Ioannidis and/or Prassad, but are there any public health recommendation that they have supported? Have they recommended to their many (older?) followers that they get vaccinated? Prassad posted a list of ‘foolish’ public health recommendations, without stating what should be done (if anything).

These are big names (Ioannidis was awarded the Albert Stuyvenberg Medal by the European Society for Clinical Investigation for 2021-22), and their recommendation might hold weight with some.

All the alties/ woo-meisters I’m aware of since 2000 ( plus New Agey natural health purveyors in the 90’s) fit Orac’s description. They are persecuted because they are truthful and ahead of their time and thus, dangerous to the status quo. In addition, they are humanitarians not despicable, money grubbing monsters. They predict future vindication and will ride the tsunami of paradigm shift. Very soon.

Indeed. I was especially taken by the irony of a guy with a Substack with thousands of paid subscribers—I don’t know how much he’s charging, but most Substack subscriptions are at least $5-6 or more a month—complaining about social media influencers generating outrage and clicks it for the money.

I’ll finish by making a prediction. Now that Dr. Prasad and Prof. Ioannidis have published this paper lamenting “cancel culture” over COVID-19 public health science, look for the usual suspects to amplify its message, proclaiming it a “peer-reviewed study” that conclusively demonstrates the toxic effect of social media “obsessive criticism” on those speaking “heresy” about COVID-19.

Once they look up the meanings of all the big bloviated words, I’m sure JLW and Bigtree will be all over this.

It seems to me that Substack is just indiscriminate. That there are any number of fine authors on the platform — just as there are many worthy groups on Facebook — along with a dollop of cranks and scammers. Bad apples bunches something something babies bathwater yadda yadda…

True, but cranks and scammers seem to gravitate towards Substack because of its proclaimed “free speech” stance and TOS that basically says that if it’s legal it’s fine. Also, monetization is easy.

As an example, Dr. Prasad’s Substack brags about “thousands” of paid subscribers. The minimum subscription fee is $5.00 a month; so let’s use that and guess that he has, say, the low end of “thousands” of subscribers. For example, 2,000 subscribers would generate $10,000 a month in gross income. Substack’s cut is 10% plus credit card processing (~3%), so let’s say 13% goes to Substack and its credit card processing service. That’d leave $8,700/month net income, or $104,400 a year, and it could be a lot more than that. For instance, if he had 9,999 subscribers (the maximum before it turns into “tens of thousands” of subscribers), would translate to nearly $522K/year net income.

I might add:
when Facebook, Twitter, YouTube etc were cutting alties/ woo-meisters for posting misinformation, ones I survey were bitching about free speech and simultaneously scrambling to find other outlets to widen their reach.
Usually, they lauded places that were less discriminating like Telegram, Parler, Gab etc and even set up their own alternatives, most famously, Mike Adams’ Brighteon and Null’s expanded PRN. Mercola lists several places’ icons on this site.
Substack would seem tp be ideal for them: less “censorship” and possible monetisation. Null as a Substack that includes a newletter and recipes.

Unctuous Doctor Prasad,
Sorely lacking a gonad,
..Wounded by critique,
..Stripped of his mystique,
Leaving him, oh, so sad.

“Social media is great when it uncritically amplifies my work but anyone using it to challenge my assumptions is demonstrating aberrant psychological behavior”


As to anonymous/pseudonymous critics, are Ioannidis and Prasad in an equal lather about participants at PubPeer? The most prolific and useful posters there (exposing image fabrication and other research hanky-panky) seem to be the pseudonymous ones. Shouldn’t we be primarily concerned about the accuracy of their findings, rather than hinting at conflicts of interest and other secrets they supposedly hide behind a lack of specific IDs? Note that the best-known research sleuth, Dr. Elizabeth Bik has been attacked for her work, most prominently by HCQ proponent Didier Raoult. She’s been slimed on social media by Raoult as a “crazy woman” and “failed scientist”, and been the target of a Raoult criminal complaint posted on Twitter, revealing her home address. It’s hard to blame her fellow sleuths for being less willing to expose themselves to such harassment.

Prasad and Ioannidis did mention PubPeer in the paper: They actually proposed that editors seek to transfer particularly heated debates over to PubPeer, which tells me that they don’t understand social media.

Elsewhere I have commented that criticism of ideas is intense in science. If you publish an idea that is rank nonsense, you can expect people to criticise it.

If your response to that criticism is not “Yes that was wrong”, but instead “It is the bestest idea ever invented and if you don’t agree you are a lightweight” you can expect the criticism to grow and become criticism of your behaviour.

This is the hole that Prasad and Ioannidis have dug for themselves. Sadly their choice of tool at present is a spade.

Chris: I think you mistake their position here for something less venal than it is. I’d argue Ioannidis’ prior take was less ‘if you criticize my idea you’re a lightweight’ than ‘if you criticize me you’re a lightweight.’ But here it’s advanced, or should I say dug further into a hole, to ‘if you continue to criticize us, you are mentally Ill.’

Orac needs a psychologist less than anyone I know including my black cat.

Prasad has been featured multiple times on Natural News, including in this June 28th article:

(Natural News) “Dr. Vinay Prasad is demanding that President Joe Biden’s health officials and mainstream media outlets “just tell the truth” about the effects of the Wuhan coronavirus (COVID-19) vaccines on children.”…

“You’re not persuading anybody” to give the COVID-19 vaccines to children, said Prasad in his message to the so-called experts in the FDA and the CDC. “You’re laying it on a little thick and you’re not being honest about it, and in the process you’re discrediting yourself.”

“Prasad noted that many parents are not interested in getting their children vaccinated, especially since the data shows that as many as 75 percent of them have already been infected and therefore have a natural immunity to coronavirus.”…

“Just tell the truth,” said Prasad, instead of “exaggerating and lying and distorting the truth.”

Sorry for any shrapnel injuries caused by remaining irony meters exploding into minute fragments.

Prasad has also gotten praise from that Objective Scientist, James Lyons-Weiler. Further, Prasad has been a stout defender of Joe Rogan, who he calls “open-minded” and “sceptical”.

That’s only a partial roll call from the Crank Mutual Admiration Society. Prasad has not to my knowledge appeared on Alex Jones’ show, but give him time.

Whoa. How did I miss that?

I knew, of course, that Dr. Prasad has his Substack articles regularly republished on The Epoch Times and the Brownstone Institute website, but Natural News is about as low as you can go. This is the same guy who claims that people killed by COVID-19 vaccines are being turned into liquid and turned into biosludge to fertilize crops.

Prasad is an example of how you can say stupid things while sounding really really nice, jovial and entertaining. He’s formed his own little cult, a cult of personality. He’s very personable, he’s very likeable. He’s just not a skeptic, he’s a cynic.

One thing that I find very interesting about Prasad and Ioannidis is that they share a background. Both built their careers not so much on original research or on clinical trials that they designed and carried out but far more on analyzing and critiquing other scientists’ research and clinical trials to look for patterns and shortcomings. Ioannidis was spectacularly successful at it, garnering close to 1,200 papers in 30 years. Prasad has been quite successful as well, just not stratospherically successful like Ioannidis.

It makes me wonder if this has something to do with their both going contrarian. I also can’t help but note that when they do try to design their own research studies (e.g., the Santa Clara study early in the pandemic), they don’t do so well.

Prasad and Ioannidis publishing an immature and childlike whine demonstrating the concept of:

“It all depends on whose ox is being gored.”

In this case it is theirs… and they don’t like it one bit.

These schoolyard bullies get punched in the nose and I, for one, applaud.
They are the ones trying to implement “cancel culture” on those who attack and ridicule their idiotic ideas.

Many aspects of the new media are an improvement: platforms are democratic—anyone may engage—and the pace of response can occur in real time—shaping ongoing discussions.

It’s been quite some time since SnuffPo used Disqustink.

placing limits on the volume by editors, constructive pairing of commissioned editorials

On Tw*tter? Has somebody been getting rapid responses at the BMJ? I don’t know how to contextualize this otherwise.

I am merely pointing out that someone like Prof. Ioannidis, as probably the most published currently living and active scientist

That’s going to leave a mark.

I always love it when folk with no discernible background in mental health (which would include Prasad and Ioannidis) start bandying around MH-style terminology like they actually know what it means…And think that this is perfectly fine.

Does this mean I, using their behaviour as an example of what is acceptable, can wade in, with their full approval, on their writings and other witterings?

Shirley they’ll be happy with that?

Regarding relevant background – was there a specific ‘Nobel laureate in physics(al chemistry)’, that has made lots of interesting predictions, that they were referring to?

One of their descriptors of this ‘obsessive criticism’ that really stood out to me was this one: “unusual ratio of criticism to pursuit of one’s research agenda. ”

Like, how do they even know how much research someone is doing versus how much time they spend on Twitter?
In the time it takes me to run my samples through the flow cytometer (which is just sitting there making sure nothing breaks or runs out of fluid) I could write a dozen twitter threads. Or I could be tweeting while standing in line at the grocery store, or while waiting for my flight to board, or even, gasp shock, in my spare time. (What do you want to bet that the authors are also the kind of researchers who think that you’re a bad scientist for taking weekends off?)

It reminds me of when I posted some pictures from the January 2017 Women’s March: a conservative friend of a friend basically asked me where I could possibly find the time to do all my “regular work” and also go to a march. Like, dude, it was one weekend day plus a few evenings of knitting hats (which I would have been doing anyway). I was more than able to do my full time work, my volunteering gig, my knitting donations and all of the rest of my life, and still go to one march. I (and I think many people) are capable of holding more than one idea or goal in our heads at the same time.

It does make me wonder how much time the authors are devoting to all of this, if they think that no one else is getting any work done.

Comments are closed.


Subscribe now to keep reading and get access to the full archive.

Continue reading