Science Myths

Thanks to Julie and co, it is now more widely known than it once was that the belief that relaxation is an effective form of fertility treatment (as in: "Oh, just relax and it'll happen!") is both inaccurate and exceedingly frustrating for infertile people.  For anyone who doesn't read the Barren Bitches' Brigade regularly, then a) you should, and b) here is a quick summary of precisely why "Oh, just relax and it'll happen!" is one of the many things you should never, ever say to someone struggling with infertility:

1. Since it is in fact one of the many Infertility Myths out there, you will look like a gigantic idiot for believing it.  It really doesn't take too much thought to realise that if a woman happens to be both infertile and tense, it's highly likely to be the former causing the latter rather than the other way around.

2. The word 'just' in that statement implies that a) relaxation under such circumstances is easy, b) it's therefore clearly all the infertile person's fault that she's going through the agony of infertility, and c) even though she wasn't smart enough to work this out for herself, she can at least count herself lucky that she has you as a friend/relative/next-door-neighbour/random stranger she met on the train, since you can now solve all her problems by explaining to her that all she needs to do is Just Relax.  All of which is more patronising than anyone should be allowed to be without being beaten about the head and neck with a yoga manual.

Infertile people apparently have to deal with this inanity rather a lot of the time.  So it's not at all surprising that when some research was recently published that actually appeared to back up the idea of a possible link between tension and infertility, the infertiles of the Internet collectively blew a gasket.  Unfortunately, in the process, the majority of them managed to fall for the classic Science Myths. 

Oh, there were some excellent comments on there as well - from people who'd actually read the study and made informed, intelligent critiques of it; from people who hadn't read the study but raised sensible queries about possible design flaws; from people who were able to differentiate between the study findings and their interpretation in the popular press.  But the comments were absolutely rife with Science Myths.  And since those are just as widespread, inaccurate and potentially harmful as Infertility Myths, I thought it might be worth discussing some of them.

1. The 'My Anecdote Trumps Your Data' myth.  This is also known as the '100% myth', since it appears to be based on the belief that 'greater probability' equals '100% probability'.  Hence, if a study shows that Group X have a greater probability of Outcome Y, then this is interpreted as a declaration that 100% of Group X will have Outcome Y.  (Any actual percentages mentioned in the study report will be ignored completely, in order to maintain this particular Science Myth.) 

Accordingly, any personal anecdote of things going differently from the outcomes found to be more probable in the study group is considered as proof that the study findings are wrong.  Thus, if a study shows that in a particular group of women monitored for the first couple of weeks after conception, 90% of the ones with high cortisol (a marker of stress) miscarried at that initial am-I-even-pregnant-or-aren't-I stage, whereas you yourself conceived at a time of high stress and nine months later had a healthy baby, this is interpreted as meaning not that you were one of the lucky 10%, but as meaning that the study was wrong.  Oh, yes, and that the researchers are stupid for having reported facts that differed from the way things happened to go in your personal sliver of the universe. 

Sorry, guys - but that's just another version of "My aunt's postman's dog's vet's cousin adopted a baby and then got pregnant, so, you see, adopting obviously makes you get pregnant!"

2. The 'Research As Malice' myth.  If researchers come up with a finding that happens to be annoying or upsetting to you, then this obviously can't have anything to do with them having, say, found out some actual facts that they then reported.  It must be their deliberate attempt to get at you.  Any researchers who dare to do this are mean heartless people who have clearly never been in your position, or they would have known better.  Why, if any of the researchers in this study had ever miscarried and knew just how painful it was, obviously their research subjects would have had cortisol levels much more obligingly in line with a 'stress has nothing to do with it' theory!

3. The 'Causes vs. Cures' myth.  This is the idea that research should be directed at the latter rather than the former - that, instead of looking at 'this sort of thing' (factors possibly linked to infertility and/or miscarriage), researchers should be concentrating on doing something about the problems.  This sounds sensible and practical, but the fallacy here is the idea that the two can be separated out clearly into an either-or.  In fact, they're inextricably linked.  Finding out the pathophysiology behind disease processes is a crucial part of finding out how best to treat them. 

When looking at a study that gives us only the tiniest fragment of knowledge about a topic as vast as fertility and its problems, the obvious response is to wonder what good that was, and why the researchers were wasting time on this instead of all the much more important issues out there.  It's only in retrospect that it's possible to see that sometimes the most apparently abstruse of studies actually give us vital information about the way the human body works, and that gathering as much information as possible and gaining as wide an understanding as possible of problems is ultimately going to help us to manage them better than we would if we just stumbled around taking blind guesses as to what to try.

4.  The most common myth, and the biggest one, which is why I saved it for last - the 'But Reality Wouldn't Dare Differ From My Opinion!' myth.  This is the belief that the accuracy of a piece of research is best judged according to the attractiveness of the result obtained.

We all fall for this one, myself included.  There is no such thing as a truly impartial mind.  Show me a person who believes that their own personal opinions have no bearing at all on their interpretation of the available data, and I will show you someone who is existing in a pleasant haze of self-delusion.  And if any of us wants to see that person, a good place to start is with the nearest mirror.

But some examples of this way of thinking are more blatant than others.  In fact, the sad thing is that most examples of this way of thinking are more blatant than others.  And the debate on Julie's blog was no exception.  Most of the commenters - and, for that matter, Julie herself - were talking as though the mere fact that this study infuriated them meant that it couldn't possibly be true.  And the researchers were Really Stupid for having got these results.  Plus, they were ugly and their mothers dressed them funny.

Of course, this is not to say that there may not be perfectly valid reasons for doubting the results of this study, or at least for doubting their applicability to women going through infertility treatment.  As I said, a few commenters suggested several possible such reasons.  The point is not that those reasons don't exist, but that "I don't like this result!" doesn't count among them.  However little a particular research result may suit you, you still need to come up with some actual flaws in the research or its applicability in order to discount it.

While we're on the subject, I'd like to point out that the reverse is also true.  I've spent a fair bit of time learning how to analyse studies, so if I see one I don't like then I can give you a more informed opinion than the average person as to why it's a load of rubbish.  If you want a really scientific discussion of why it's obvious that the researchers are ugly and their mothers dress them funny, then, hey, I'm your woman.  What I have to keep reminding myself of is that this doesn't just apply to studies whose results I don't like. 

Due to some crucial differences between human beings and, say, chemicals, it is simply impossible to do a study in a medical or psychological field that doesn't contain at least some potential flaws to be picked at, exposed, and held up for all to see as glaring examples of why the study shouldn't be trusted as far as you can throw it, if such is your wont.  But the temptation is to do this only for the studies that give us results we dislike. And part of being fair-minded is applying the same strict standards to a study that tells us something we want to hear as we do to a study that tells us something we'd rather not hear.  How many of us can do that?  Maybe the myth that's really the biggest is the one that we all secretly believe - that it's only our opponents who are closed-minded.

Comments

[Alex]

This is beautiful. Can I kiss you?

[Melissa]

Very, very well written. The scientist in me goes a little bonkers every time this type of dicussion takes place, but I don't have a blog in which I can address the points you just made quite effectively. Don't get me wrong. I love Julie's blog. It's just...science, ya know? I'd not discovered your blog before today (here via the trackback to Julie's entry), but now I'm interested in seeing what else you have to say. Thanks for sharing your thoughts on this...

[potentilla]

Oh yes, I like this. I will be back. I just found you via the comments on Dr Crippen's blog, partly because I was enchanted that someone else had taken him to task for ranting and taking the piss - but watch out, I have been flamed a couple of times for doing the same. But you're probably safe as you're a doctor!