It seems impossible to keep politics out of science. It’s a pity because politics can end up forcing science to produce the results desired by politicians. When this happens the ideal aim of science – the pursuit of objective knowledge – can get lost.
We rightly disapprove of external political and commercial influences on science. But there is another insidious form of politics derived from ego, personal ambition and the promotion of research by institutes and individual researchers. This is very often driven by the competition for research funding – the loudest researcher gets the grant. These days this is a real problem – the classical introverted scientist, no matter how bright, is often at a complete disadvantage when it comes to the fight over research funding.
In my own career, I have seen excellent researchers driven to redundancy simply because they did not have the political skills to fight for research funds. And at the same time, I have seen mediocre scientists, often producing poor quality or even misleading science, get those funds – simply because of their ambition and political skills.
These thoughts came flooding back to me as I read the new opinion piece by Christine Till, the leader of the research group that published several of the recent fluoride-IQ/ADHD and similar papers that I have critiqued here. Papers that have been heavily promoted by the authors and Till’s institute as well as the anti-fluoride/anti-vaccination crowd and, at the same time, extensively critiqued by the scientific community.
The citation for her article is:
Till, C., & Green, R. (2020). Controversy: The evolving science of fluoride: when new evidence doesn’t conform with existing beliefs. Pediatric Research.
Unfortunately, the article is not a reply to critics or a good faith scientific engagement with the scientific issues. It is simply an attack on those who have made honest and respectful critiques. An attack which attributes unjust motives to her critics and comes close to personal.
Attempt to close down science by personal attacks
I discussed some of these issues before in my articles Scientific integrity requires critical investigation – not blind acceptance and Fluoridation science and political advocacy – who is fooling who?
In this case, I was concerned about the way Dr William Ghali, one of the promoters of Christine Till’s work, attacked and attempted to belittle scientific colleagues who were indulging in the normal peer-review process of critiquing published papers which they considered had faults. Nothing new about that scientific critique – it goes on all the time. It is expected by authors and, in the end, it helps to improve the science. I Personally think such critique should be welcomed by researchers.
If the opponents of scientific exchange like Dr Ghali are successful in their attempt to prevent such scientific debate then we are all losers. How can we trust scientific findings that are protected from scrutiny?
This is what is wrong with the opinion piece by Till and Green cited above. Instead of entering into a good-faith scientific exchange with their critics they attribute motives and biases to them. Even accusing them of attempting to prevent the progress of science. They accuse critics of a “tendency to ignore new evidence,” of “overt cognitive bias” and of promoting a “polarized fluoride debate.”
But, in fact, these critiques have come because the “new evidence” is not being ignored but is being evaluated. It is being critically considered. The article more or less admits this when it says “critics attacked the methodology of the study [Green et al (2019] and discounted the significance of the results.”
True, the so-called “fluoride debate” is polarised. After all, it is being promoted by anti-fluoride/anti-vaccination activists who are attempting to prevent or remove, a health policy known to benefit children. Till & Green may be unhappy that they have not been able to win over the scientific community with their paper but it is hardly honest to reject the critiques of the paper by calling them “attacks” or by claiming they “ignore” the evidence.
An admission the paper had difficulties
The article admits the Green et al (2019) paper had difficulties right from the beginning. It took three attempts before a journal would accept it for consideration. Even then it ended up having “several additional rounds of review by the JAMA editors until we eventually reached a compromise.” This gives some substance to my speculation of problems in the review process which lead to the unprecedented publication of an editor’s note – a political action I have never seen before (see If at first you don’t succeed . . . statistical manipulation might help).
They acknowledge that even their colleagues in environmental epidemiology “were initially sceptical.” And so they should have been – all new research should be reviewed sceptically and critically.
Refusing to engage scientifically
But the annoying thing is that these authors attempt to write off the scepticism and critical review of the wider scientific community as being due to “experts” (yes in quotes), “who held strong beliefs . .” This despite the fact that in the published critiques it is not “strong beliefs” which were presented, but detailed consideration of the methodology and statistical analyses used in the original paper.
All these critiques were made respectfully – and often with thanks to the Green et al (2019) for their new work. Yet Till and Green accuse these reviewers of making “vitriolic comments and claims with little scientific basis” – a comment which is, in itself, disrespectful to those who took time to make their critiques. They resort to smearing two of the reviews (by the UK-based Science Media Centre and Dr Berezow, a specialist from the American Council on Science and Health) by accusations these bodies are “both heavily funded by the pharmaceutical and food and beverage industries.” This funding smear is commonly used by anti-science activists who attempt to discredit scientific findings or analysis but refuse to consider the science itself.
They say of these two reviews that they claim “the results are driven by outliers” – yet a simple search shows that this comment simply does not appear in the cited reviews. The critique of Dr Berezow from the American Council on Science and Health does not include either of the words “outlier” or “driven.”
The only reference to “outliers” in the Science Media Centre review was by Dr Oliver Jones, Associate Professor of Analytical Chemistry, RMIT University who wrote:
“The authors state that an increase of 1 milligram per liter (1 mg/L) increase in fluoride was associated with a 4.49 point lower IQ score but fluoride intake appears to have been below 1 mg/L for most people in the study, even for those with fluoridated water, and nearly everyone (bar a few outliers) had a fluoride intake of less than 2 mg/L (which multiple previous studies have shown is safe) . There is also a Lot of variation in the data – which makes drawing firm conclusions/ predictions from it difficult.”
A valid criticism which needed a response – not a smear.
My search for the word “driven” produced these two comments:
Dr Joy Leahy, Statistical Ambassador, Royal Statistical Society, wrote:
“if a woman is living in an area with fluoridated water during pregnancy, then her child is likely to grow up drinking this same fluoridated water. Therefore, it is difficult to say whether any association found is driven by the fluoride consumption in pregnancy, or an assumed fluoride consumption in the infant after birth.”
Prof Rick Cooper, Professor of Cognitive Science, Birkbeck, University of London, said:
“a significant decrease in IQ was found only in boys – girls showed a non-significant increase in IQ. The negative effect was driven by a small number of boys whose mothers had extreme levels of fluoride exposure, but even these children had IQ in the normal range.”
These are valid points that again deserve a scientific response yet Till & Green describe them as “vacuous claims exemplify attempts to manipulate the scientific evidence and manufacture doubt.”
We all support using new knowledge to adjust policies
Till & Green attempt to claim the high moral ground by asserting:
“Science advances by continuously challenging old ideas and adjusting our beliefs as new knowledge emerges, even if this new evidence conflicts with conventional wisdom or is inconvenient.”
Of course, this is true and I think it is dishonest of them to pretend this is not also the position of those who critiqued their paper. These reviewers were interested in looking at the new results, evaluating them and seeing how relevant they are. Seeing if they do indeed require us to adopt new thinking.
After all, look at what Dr Berozow, one of the critics they smeared by implying he was influenced by industry funding and was falling back on “vitriolic comments” and “vacuous claim”, says in introducing his critique:
“The investigation by Green et al into the effect of maternal consumption of fluoride on the IQ of children is important. It is always wise to constantly evaluate and reevaluate long-standing public health practices in the light of new evidence.”
Till & Green are simply resorting to attributing motive and asserting their critics are not open to new knowledge as a way of avoiding facing up to the valid criticisms made by experts who reviewed and critiqued their work.
Confirmation bias – the pot calls the kettle black
We all suffer from confirmation bias and scientists (including Till & Green) are not immune. It is well understood that scientists are the last people to recognise problems in their own work. That is why peer review and open critique of scientific reports is so essential. But, in line with the whole approach of this opinion piece, Till & Green attempt to present a picture that only their critics suffer from this problem. They say:
“We typically fret about subtle biases, like recall bias and unmeasured confounding, but confirmation bias, the tendency to ignore or debunk data that does not conform to what we believe, is arguably a much larger problem.”
I find their attempt to belittle concerns about “unmeasured confounding” rather ironic. After all, this was the problem with Till’s original fluoride-ADHD work (which she used to win research grants for her later fluoride research) that I highlighted in Perrott (2018) Fluoridation and attention deficit hyperactivity disorder – a critique of Malin and Till (2015).
I am aware that Till has read my paper in its pre-publication and published forms but studiously ignores it. For example, the ADHD paper of Riddell et al (2109), which she co-authored, simply does not include Perrott (2018) in its discussion and continues to present Malin & Till (2105) as authoritative despite the obvious flaw that it ignored important confounders, and when these are considered their claim of a relationship between fluoridation and ADHD prevalence proved to be false.
So much for her attribution of confirmation bias to others – when she is obviously guilty of it in this case by ignoring “data that does not conform, to what [she] believes.”
The Till & Green opinion piece is unwise
Till & Green seem to have simply reacted emotionally to the reviews and critiques the Green et al (2019) paper received. They, of course, had the right – even the obligation – to respond scientifically to the reviews. But I believe their response in this article is unwise, maybe even professionally damaging, and they should not have committed these emotional outbursts to print. After a cooling down period, it is possible they will withdraw the article – and that would be best for them in the end.