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122 of 135 people found the following review helpful:
4.0 out of 5 stars
Solid, succinct, a few flaws, June 8, 2002
BOOK REVIEWJunk Science Judo. Self-Defense Against Health Scares and Scams by Steven J. Milloy, Cato Institute, Washington, DC, USA, 2001, ix-xii + 218 pp. A superb manual for understanding health claims and detecting fraud, "Junk Science Judo" is written in a punchy, easy-to-read style that allows the mathematically challenged, like myself, to interpret the usual bell-curve statistics that are used for environmental health threats and diet threats. One may also use this approach to judge the benefits of prescription drugs or alternative treatments. He shows how to look for p values of 0.05 or less, and he shows how to use the 95% confidence intervals (CI) to see whether the low or high limit crosses the reference value of 1.00. If it does, Milloy suggests disregarding any result that is claimed. In epidemiological or ecologic studies, Milloy suggests discarding those results in which the relative risk (RR) is between 0.5 and 2.00, whichever applies. Milloy goes far beyond the usual cautions that an association is not necessarily a cause. He is contemptuous of, but not totally dismissive of epidemiology. For Milloy, the descending pecking order of research on health hazards is: clinical trials, cohort studies, case-control studies, and ecologic studies. He describes publication bias, confounding, and "tainted experts". He reminds us that mice are not little people, and that there is a safe dose of everything. Milloy encourages intelligent contact with the sources of health advice to support or refute the recommendations, and he recommends a number of sources of supposedly reliable health information. His criticism of medical journals, which includes the defects of peer-review, is the most detailed I have seen in print, and very well-taken, in my opinion. He skewers broadcast media on their emphasis on ratings rather than accuracy or balance. He deplores the motivation of many activists. Many specific examples are given, from Alar to radiation. This book is extremely valuable for helping anyone who is not a medical or epidemiological specialist to judge the value of health or health-threat claims. Now the bad news. Milloy does not question the use 1-tailed statistics, or the failure of many relationships to follow a bell-curve (Kauffman, 2001). Milloy failed to warn of the common deception of reporting an effect of something on a certain health condition without the inclusion of total death rates. Milloy's fine example of prostate cancer "non-prevention" by eating foods high in selenium (p164) may mislead people into ignoring the benefits of selenium supplementation, which has been shown in a clinical trial to lower the RR of all cancers to 0.83 (95% CI 0.47-0.85), and is most effective against lung, prostate, and colorectal cancers (Clark et al., 1996). Milloy downplays the dangers of trans fats (Oomen et al., 2001), but his own example shows that the highest two quintiles of consumption are not healthful (p165). Milloy made the mistake of writing that the absence of a biological explanation for the claimed effects of electric and magnetic fields means that they have no effects (p76); readers of JSE know that such judgments based on lack of knowledge are faulty. .... Joel M. Kauffman ... References Clark, L. C. et al. (17), (1996). Effects of Selenium Supplementation for Cancer Prevention in Patients with Carcinoma of the Skin. A Randomized Controlled Trial. Journal of the American Medical Society, 276, 1957-1963. Kauffman, J. M. (2001). Article of Interest. Journal of Scientific Exploration, 15(4), 575-576. Oomen, C. M., Ocké, M. C., Feskens, E. J. M., van Erp-Baart, M.-A. J., Kok, F. J., & Kromhout, D. (2001). Association between trans fatty acid intake and 10-year risk of coronary heart disease in the Zutphen Elderly Study: a prospective population-based study. The Lancet, 357, 746-751.
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