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Theodore Dalrymple

False Positive: A Year of Error, Omission, and Political Correctness in the New England Journal of Medicine Hardcover – June 25, 2019

by Theodore Dalrymple (Author)

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The New England Journal of Medicine is one of the most important general medical journals in the world. Doctors rely on the conclusions it publishes, and most do not have the time to look beyond abstracts to examine methodology or question assumptions. Many of its pronouncements are conveyed by the media to a mass audience, which is likely to take them as authoritative. But is this trust entirely warranted?

Theodore Dalrymple, a doctor retired from practice, turned a critical eye upon a full year of the Journal, alert to dubious premises and to what is left unsaid. In False Positive, he demonstrates that many of the papers it publishes reach conclusions that are not only flawed, but obviously flawed. He exposes errors of reasoning and conspicuous omissions apparently undetected by the editors. In some cases, there is reason to suspect actual corruption.

When the Journal takes on social questions, its perspective is solidly politically correct. Practically no debate on social issues appears in the printed version, and highly debatable points of view go unchallenged. The Journal reads as if there were only one possible point of view, though the American medical profession (to say nothing of the extensive foreign readership) cannot possibly be in total agreement with the stances taken in its pages. It is thus more megaphone than sounding board.

There is indeed much in the New England Journal of Medicine that deserves praise and admiration. But this book should encourage the general reader to take a constructively critical view of medical news and to be wary of the latest medical doctrines.

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Editorial Reviews

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“False Positive examines the central paradox of modern medicine that while it must, by necessity, deal in reliable knowledge, it is nonetheless permeated by error generating numerous contradictory claims about the ubiquitous threats to health in our everyday lives and the value, or otherwise of the latest medical advances. Theodore Dalrymple's investigation of a year's worth of the most authoritative and influential of all medical journals may not seem the most beguiling of subjects but allows him to illuminate with great clarity and much wit how wishful thinking, the selective presentation of data, unacknowledged personal bias and the dead hand of political correctness can obscure and distort the truth. Forthright, thought provoking, and profound, this is the most revealing book on the current intellectual state of medicine one could hope for.”
―James Le Fanu, author of The Rise and Fall of Modern Medicine

About the Author

Theodore Dalrymple was born in London in 1949. He retired as a full-time doctor in 2005. He is the author of many books, notably Life at the Bottom (Ivan Dee) and Romancing Opiates (Encounter), which challenges the notion that heroin addiction is a bona fide disease.

Product details

Publisher : Encounter Books; 1st edition (June 25, 2019)
Language : English
Hardcover : 272 pages
ISBN-10 : 1641770465
ISBN-13 : 978-1641770460
Reading age : 18 years and up
Item Weight : 1.2 pounds
Dimensions : 6 x 0.75 x 9 inches

Best Sellers Rank: #523,307 in Books (See Top 100 in Books)
- #340 in Medical Research (Books)
- #433 in Pathology Clinical Chemistry (Books)
- #462 in Medical Diagnosis (Books)

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55 ratings

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Paul V. KATCHALOV

All Medical Doctors and Scientists Must Read.

Reviewed in the United States on September 3, 2019

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I feel very ashamed for my years-long proud reading of the NEJM, that I believed as one of few sources of reliable medical enlightenment. Alas. Now I would try to do my best to read medical “scientific” journals with Dr Dalrymple’s eyes, though this will make the reading much slower. What the medical scientific community have to do after such an incisive critique — I don’t know. But it’s evident that actual publishing procedures failed, and need some cardinal revision throughout. It would be better for all to have two or three times less paper sold to the libraries, than continuing such an abomination.

9 people found this helpful

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R. Kelsey

Principles are important, and finding a good teacher is unusual.

Reviewed in the United States on August 29, 2019

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This book is well worth reading, and maybe two or three times. The author makes points that go way beyond medicine and into dealing with a lot of things in our world today. It is written very subtly, with an approach that is at one time easy to read and extremely perceptive. I found myself rereading passages because I could not believe the depth of the writing at first reading. That went on through the entire book.

8 people found this helpful

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velodog revolver

Another wonderful read

Reviewed in the United States on March 19, 2020

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Disclaimer: I am a dyed in the wool Theodore Dalrymple fan...As a young physician I revered every copy of the NEJM and had plans to "bind" them for my library. As time passed and the culture morphed I began to see "smudges" of faulty logic and political correctness which had nothing to do with scientific "truth". Wonderful to read a years worth of critical analysis of this Magna Carta of Medicine. We are ALL too human. The sins of hubris extend to the hallowed halls of the NEJM. Thank you Dr D! Reader beware!

5 people found this helpful

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bpb1800

Important perspective for all physicians and scientists

Reviewed in the United States on July 2, 2019

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The author views with fresh eyes The New England Journal of Medicine's exalted reputation among all medical journals, and sees many faults overlooked by most elite physicians and scientists. Although this is not Dr. Dalrymple's best writing (thus earning my 4 stars instead of 5) in criticizing the current reigning medical/industrial/academic hierarchy it may be his most courageous work.

6 people found this helpful

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Joseph Kessler, Jr.

A Look Outside the Medical Groupthink

Reviewed in the United States on September 5, 2019

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This is really a nice little book. He moves through the year in the Journal choosing a few studies or articles for each date. His insight is so refreshing as he questions some of the things we've been taught in medical school and gives a fresh way to look at what's being written as medical science. It's time to look critically again at what is being presented and this book starts to teach us how to examine the literature again. Each chapter is a few pages long so you can read at any pace. I looked forward each night to sitting down with the book for a few chapters. I highly recommend the book!

5 people found this helpful

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David L. Pogge, Ph.D.

Once again, an insightful examination of our knowledge and culture

Reviewed in the United States on July 15, 2020

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In his year-long examination of the NEJM Dr. Dalrymple turns his eye on the things that are said and unsaid in contemporary medical research. By pointing out hidden biases, implicit agendas, methodological flaws, exaggerated claims, and tendentious interpretations of data he helps us to understand the crucial limitations in modern medical research and heightens our awareness of its often woeful lack of objectivity. That, in itself, would be a valuable contribution. But, as always, he offers his observations in the uniquely articulate, literary, and humanistic fashion that marks all of his writing, and makes it a delight to read his work. This should be required reading for all of those in the medical and health services professions, for journalists who report on medicine and science, and for all of us who are so frequently struggling to deal with the latest - and often contradictory or nonsensical - pronouncements of medical researchers. Since they have become the secular clerics of Western civilization, understanding their limitations and agendas is essential for the critical thinker or the person who wants to take some responsibility for their own life.

One person found this helpful

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jbdmd

IMPORTANT, TIMELY, ACCESSABLE TO THE NON-MEDICAL READER

Reviewed in the United States on November 8, 2020

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Thank you Theodore Dalrymple (aka Dr. Anthony Daniels) for encapsulating for the general audience the problems that have been both historically present (data integrity and study reproducibility issues and drawing conclusions beyond the study data), and also newly suffused into the field of medicine (toxic political correctness via the "Perspective" and editorial sections in which spewed shibboleths are fired out as if as axiomatic as "The Sun Rises In The East".

Having practiced newborn intensive care and general pediatrics for 39 years I have watched with deep concern as the NEJM (New England Journal Of Medicine) has in the approximately past 10 years mutated into the NEJWM (The New England Journal Of Woke Medicine[and political phrenology]). Unfortunately this is not a benign mutation and metastasizes into the general culture (even if benign, given the influence of the NEJM is in a malignant location in terms of causing damage to the culture). On a personal professional level caring for children I found this most disturbing in their Clinical Practice guidelines "Care of Transgender Persons" N Engl J Med 2019; 381:2451-2460 DOI: 10.1056/NEJMcp1903650 in which they quote the American Academy Of Pediatrics (AAP) Guidelines on the same topic. In both of these papers "watchful waiting" and caution in patient selection is summarily declared "obsolete" and "harmful". Just one problem. The references given in support of this statement (#45 in particular in the AAP guidelines) are not new longitudinal follow-up data but rather further policy/opinion/consensus statements. By putting out such a practice guideline. NEJM has created a form of feedback loop in which it seems that "everyone" agrees. Dalrymple notes many such examples (usually buried quietly within articles or reviews) in which the tone and statement create a political undertow intended to drag the reader to the only correct position (the "woke" one) on the issue.

Dalrymple notes a constant flow of statements within "scientific" articles as well as opinion pieces that all lean in the direction of removing agency from any and all sufferers of conditions in which their own behavior would be understood by most non-medical people to have contributed to their condition (obesity, alcohol abuse and drug abuse in particular). He notes that "abuse" is never used to describe the behavior, there is only "use". One must never judge anyone the NEJM clearly communicates However, he quite appropriately attacks the physicians who wantonly prescribed opiates for all types of pain when such use was not indicated. To be fair to some of these physicians, at least in the United States, they were caught between a rock and a hard place which Dalrymple does not discuss. In my state we (physicians) were required to obtain 12 credit hours of training in pain control and end-of-life care and other such topics or risk losing our license to practice medicine and could be subject to medical board sanction and lawsuits for not adequately controlling pain. Similar laws and vulnerability to lawsuits were also created in many other states.

Complex inferential statistics come under scrutiny with the caveat (true) that most physicians will not be able to deeply understand these tools and must therefore rely on authors and journal editors to act in good faith in terms of verifying that the methods are valid and support the conclusions. Unfortunately, concludes Dalrymple, such quality control is often lacking and articles are therefore misleading on some level (usually by overestimating the benefit of a new drug or treatment). Often the abstracts of such articles focus on relative risks and ignore absolute risks when the subject is exposure to some agent, toxin, or dietary choice. If something doubles one's risk of a certain cancer (relative risk), yet the absolute risk is only one-in-a-million does it really matter from a practical standpoint if now the risk is two-in-a-million?

Some of the material covered in this book is also covered in other works by Dalrymple. In particular "Life At the Bottom" and "Our Culture, What's Left Of It" (particularly the movement away from personal agency and responsibility. An excellent and complementary book would be "The Parasitic Mind: How Infectious Ideas Are Killing Common Sense"
by Gad Saad

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Reader

Brilliant

Reviewed in the United States on July 6, 2019

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A must read for doctors, medical writers and others.

3 people found this helpful

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Alberto

Excelente!

Reviewed in Brazil on June 29, 2020

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Muito bom livro, com abordagens lógicas e coerentes de aspectos muito interessantes ocultos nos "artigos científicos". De fato, a deturpação dos dados e o torcer e retorcer da lógica levaram ao climax da "junk science", de maneira a que os ditames ideológicos passaram a nortear o que deveria ser orientação baseada em fatos e evidências em políticas de saúde. Justifica-se o que se quer, em nome do que se deseja, para que a realidade se torne o nosso sonho. Dalrymple disseca aspectos que nortearam a ocultação de fatos e seus responsáveis em nome do politicamente correto. Para todos que almejam integridade e correção em pesquisa clínica, é obra indispensável,

2 people found this helpful

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Thor

Interesting info but writing tone is a put-off

Reviewed in Canada on July 27, 2019

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The analysis of articles is interesting and makes one who lacks a medical or health professional background to question before simply accepting information in print - regardless of the allegedly respected source. As a publisher of health studies, one need be aware of who is on the review board before submitting manuscripts - some are stacked with people mainly from the same universities - same opinions and less inclined to see value beyond a traditional lens. I found reading this book a challenge not due to the content, but due to the tone of the writer. Some sections seem written with a tone of bitterness. I could be wrong, but it was distracting from the well-done analyses. It would not stop me from buying the book - just don't let it distract you from the content.

One person found this helpful

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