From Bad Science comes news that bloggers are eviscerated in a post-modern way by Professor Alan Pearson. Remember the paper Deconstructing the evidence-based discourse in health sciences: truth, power and fascism? Prof Pearson takes to task commenters on one specific blog who denigrated this paper in a non-scholarly way in his paper Scientists, postmodernists or fascists?, behind subscripition barrier. The abstract is fascinating:
The somewhat frenzied reaction to publication of a provocative, discursive paper titled ‘Deconstructing the evidence-based discourse in health sciences: truth, power and fascism’ by Holmes et al. in the International Journal of Evidence-Based Healthcare is both surprising and worrying.
Worrying perhaps, but surprising? Someone says that scientists are a bunch of microfascists in a provocative manner, and you’re not expecting a reaction? What kind of reaction should someone expect from a provocative paper? It is possible that Pearson is expressing surprise that anyone could be bothered to read it.
The paper is essentially a postmodernist critique of evidence-based healthcare. In the same issue of the journal in which the paper was published both the guest editorial and a response to the paper refute its claims.
This I will admit confuses me slightly. The paper was about Evidence-Based Medicine, which I took to be a specific system which had taken the name and not necessarily about all medical research that was evidence-based. This would be interesting because then by taking that name you’re implying that research which doesn’t work to those criteria isn’t evidence-based. Which is why I didn’t feel the urge to take it apart, because not all of the paper was evidently rubbish to me as a non-specialist, merely substantial portions. Nor was I aware of the response or editorial and I’ll come back to that.
However, media coverage on the paper gave rise to numerous defensive responses that attacked the paper through claiming it represents ‘bad science’ or by disparaging the International Journal of Evidence-Based Healthcare, its Editor, its peer review processes or the organisation linked to the journal, the Joanna Briggs Institute. It is clear that those who mounted these attacks had no knowledge of the journal (or of the editorial and response refuting the claims made in the paper, published in the same issue) or its parent organisation; and none of them attempted to critique the paper in a scholarly fashion.
So, if I understand the argument correctly, Pearson’s arguments are:
- The attacks aren’t evidence-based
That might be amusing, but for reasons above I’m not convinced evidence-based means the same as Evidence-Based. There is an obvious reason for why the criticisms are not fully evidence-based. This is tackled below if you can’t work out why.
- The responses did not cohere to the form of the scholarly journal in which they were published.
Now this is interesting. The major point of the paper is that the respondents on the web didn’t respond in the established way. Fair play to the Professor, he does point out below in his abstract that this too could be construed as microfascist — however acknowledging the point doesn’t refute it.
- The sum total of responses to the paper are represented by the comments on the Bad Science blog.
This is indefensible.
For a start, there is no substantial response in the full paper to the commentary by Ben Goldacre, the chap that wrote the article that the commenter are responding to. Further there is more than one website available on the internet. There are other comments. Here’s an entry on Pharyngula, which isn’t a blanket condemnation. Here’s another entry at Respectful Insolence. Orac puts together a long article discussing the paper and bringing evidence from other sources. This isn’t ill-informed rambling, it is a serious critique, even if it isn’t in a traditional format. It’s also skewered briefly by Ophelia Benson at Butterflies and Wheels. While the entry is brief, there is extensive discussion in the comments which, ironically, question the rigour of the original paper. That’s quite a collective critique. How do you respond to that?
This paper sets out to construct a scholarly argument to refute these claims and to consider why it is that those who support evidence-based healthcare and/or science chose to disparage a journal and an organisation that promotes and facilitates evidence-based approaches to healthcare – and the value of the Cochrane Collaboration – rather than developing a rigorous critique of the argument developed in the Holmes et al. paper.
Interesting use of the word rigorous, which is a value-laden term. It implies that rigour is mono-dimensional, that there is one uncontested scale of rigour and that the Professor is in a position in which he can judge this. As for scholarly, I suppose this depends on what Pearson’s target is. If it’s blog-centred critique of the Holmes paper, then it’s poor.
Although this response appears to be an attempt to silence dissenting views (and may, to some, suggest that the reference to microfascism in the paper in question may, indeed, have some validity) we conclude that the postmodernist critique of evidence-based healthcare embodied in the paper sets out criticisms that, though widespread in healthcare, can be challenged in a considered, scholarly way. The ill-informed, reactionary responses to it by the defenders of science make little contribution to the ongoing development of evidence to improve global health.
So here the ends, post-modern emancipatory liberation, justify the means, which appears to be a titled authority selecting a weak target for criticism. Here ends the abstract.
Now if I left the end there, then this would be a largely mis-representative critique of Pearson’s article. Continue reading