Trial and Error: How scientific-journal peer review allows fraud, error, and a bit of hubris

In New York Times Magazine, January 2006:

Many of us consider science the most reliable, accountable way of explaining how the world works. We trust it. Should we? John Ioannidis, an epidemiologist, recently concluded that most articles published by biomedical journals are flat-out wrong. The sources of error, he found, are numerous: the small size of many studies, for instance, often leads to mistakes, as does the fact that emerging disciplines, which lately abound, may employ standards and methods that are still evolving. Finally, there is bias, which Ioannidis says he believes to be ubiquitous. Bias can take the form of a broadly held but dubious assumption, a partisan position in a longstanding debate (e.g., whether depression is mostly biological or environmental) or (especially slippery) a belief in a hypothesis that can blind a scientist to evidence contradicting it. These factors, Ioannidis argues, weigh especially heavily these days and together make it less than likely that any given published finding is true.

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Run-AMC: Why Advanced Market Commitments for vaccines are being oversold

In Slate, December 2005:

The quest to save the world with vaccines has been faltering. After increasing during the 1970s and '80s, vaccination rates have fallen since about 1990 for basic diseases in developing countries. Development of vaccines for emerging and expanding diseases (like AIDS and malaria) has also moved haltingly. Only half the children in sub-Saharan Africa get basic vaccination for diphtheria, tetanus, pertussis, and measles; rates for those vaccines in some countries have dropped below 25 percent. Every year,  die from diseases for which vaccine development or delivery is lagging.

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Where's My Avian Flu Shot? The race to make a vaccine for bird flu

In Slate, October 2005:

If the bird flu that flew from Asia to Europe in mid-October mutates into a form that moves easily from human to human, historians will say of the 21^st century's first pandemic: They knew what was coming. Public-health officials have known for four years that the avian virus—H5N1—is a nasty one that might jump to human-to-human transmission. Alas, forewarned doesn't mean forearmed. Clinical testing under way suggests we'll soon have a viable vaccine. But neither governments nor private vaccine-makers have a way to produce vaccines fast enough to prevent or contain an outbreak.

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Kid Power: How vaccinating schoolchildren can save us all from the flu

In Slate, October 2005:

More than 10 million older Americans traveled last year, often in lousy weather, to stand in long lines and get poked in the arm with a flu shot. They made the trip in response to recommendations by the federal government that gave priority for flu vaccines to the elderly and the ailing. This, it turns out, is probably a bad idea. A Harvard study published last week adds to mounting evidence that the best way to ward off the flu's ravages is to target transmission (meaning a disease's main carriers, which in this case are kids) rather than risk (meaning the population at risk of death or serious illness, which with the flu is the old, the ailing, and infants). All signs are that giving children quick, painless nasal-spray vaccines while they're already gathered at school could spare the elderly from standing in long lines for flu shots—and better protect them and everyone else.

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Big Answers From Little People: Psychologist Liz Spelke plumbs the depths of infant cognition

In Scientific American Mind, October 2006:

If you’d been blind all your life and could suddenly see, could you distinguish by sight what you already knew by touch — say, a cube from a sphere? Would objects be objects and faces faces, or would they all be confusing patterns? How would you start to make sense of them? If we’re born knowing nothing, how do we come to know anything – for doesn’t every bit of knowledge follow from another? 

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Christof Koch's Quest: Chasing the neural correlates of consciousness

In Scientific American Mind, July 2005:

Consciousness, people in brain science will tell you, is the greatest problem facing human biology and perhaps all of science. It essentially means solving the long-intractable mind-brain conundrum: How do our material brains – the most complex physical systems known — produce our immaterial but  vital sense of awareness? Scientists and philosophers of mind argue fiercely about how to solve it and whether it’s even solvable. Some say consciousness is illusory. (Try to counter that one — a real headache.) Others say consciousness exists but at too complex a level for humans to fathom, like quantum mechanics to monkeys. Still others believe consciousness will yield only when we discover new physical laws underlying its creation.

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Buried Answers: How the autopsy's death harms medicine

In New York Times Magazine, April 2005:

When Dr. Alan Schiller's 87-year-old mother died in January, ''it took some convincing,'' Schiller says, to get his siblings to agree to an autopsy. ''They said: 'She had Alzheimer's. Let her rest.' But I told them: 'No, something seems funny to me. An autopsy is the only way to be sure.''' Schiller prevailed. A tanned, quick-minded, gregarious man in his 60's, he is naturally persuasive, and as chairman of pathology at Mount Sinai School of Medicine in New York, he carries a certain authority regarding autopsies. The word ''autopsy,'' he reminded his siblings, means to ''see for oneself,'' and they should see what happened to their mother. Schiller's mother died in Miami, so he called his friend Dr. Robert Poppiti Jr., chairman of pathology at Mount Sinai Medical Center in Miami Beach. She was on the table the next morning.

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Fact or Phrenology? Medical imaging forces the debate over whether brain equals mind

In Scientific American Mind, April 2005:

Functional magnetic resonance imaging — or fMRI— has made a bright splash since its development in the early 1990s. Operating at spatial and time scales far finer than previous scanning techniques, it has sparked great excitement for letting us finally “watch the brain at work.” Tens of thousands of fMRI studies have explored everything from the nature of Alzheimer’s to differences in brain activation between adolescents and adults, schizophrenic and normal minds, the impulsive and the methodical, the empathetic and the impassive. They have studied face, object, and word recognition, movements simple and complex, working memory and false memories; they have looked at people anticipating pain, mothers recognizing their children, people pondering ethical dilemmas, and people lying; they have even examined why many people buy Coke even though they really prefer the taste of Pepsi. Psychologists have welcomed fMRI for finally making their soft science hard. And cognitive neuroscientists have used it heavily in the recent explosion of understanding about the brain. 

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Malpractice Mess: Do the Swedes have a faultless fix?

In Slate, February 2005:

It's not a good sign that the current malpractice crisis—real, even if exaggerated by Mr. Bush—is America's third in as many decades. Even less promising are the solutions proposed (caps on awards, screening panels to filter out spurious claims, tougher standards of proof in court), which resemble prior fixes. Arguments over how to tweak our malpractice system—really a hodgepodge of state laws—amount to bickering about how to fix a machine of spectacularly bad design. Our current system purportedly seeks to a) compensate those injured by medical care, and b) improve health care by discouraging error.

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Brain Scans for Sale: As brain imaging spreads to nonmedical uses, will commerce trump ethics?

In Slate, January 2005:

The brain-imaging technology developed over the past three decades—first positron emission tomography, or PET, and more recently the faster, simpler functional magnetic resonance imaging known as fMRI—has given neuroscience a tool of unprecedented power. By tracing blood flow associated with neuronal activity, scanning methods enable researchers to see how different regions of the brain activate as a person thinks or acts. A subject, lying in a scanner, completes mental tasks or responds to various stimuli—solving a simple word puzzle, say, or a more complex task like characterizing facial expressions. As the subject works, the scanner tracks changes in blood flow to create images showing distinctive patterns of neuronal activation. The result is a visual representation of the "neural correlates" of various mental states.

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