Junk science a la mode

Andrew Gelman makes an important general observation in the context of the (essentially non-existent, which is the point) controversy over the Q-Collar. What is the Q-Collar?

Is the Q-Collar effective at concussion prevention, and is it safe? Matthew Futterman wrote a well-rounded critique of the device for The New York Times. Concussion Alliance wrote about the Q-Collar when the FDA first cleared it. Futterman directs the reader to the FDA summary, which states that the Q-Collar was not approved to prevent concussions and there are some risks to the device. 

The Q-Collar was inspired by the observation that woodpeckers don’t get brain injuries from repetitive hits (in fact, woodpecker brains do show damage). Researchers developed a collar that “restricts the flow of blood from the head” on the theory that slightly more blood in the head would give the brain “an extra layer of cushioning,” protecting it “from effects associated with repetitive sub-concussive head impacts.” This last statement is from the October FDA summary of its decision, which Futterman points out is “far more measured than the February 2021 approval announcement.” This summary lists the limitations of the Q-Collar, which include the following:

• “The Q-Collar has not been demonstrated to prevent long-term cognitive function deficits and the ultimate impact on clinical outcomes has not been evaluated.”
• “Data do not demonstrate that the device can prevent concussion or serious brain injury.”

In the FDA summary, the Q-Collar’s “probable benefits” outweigh the “probable risks.” The risks include a risk of syncope (passing out) and giving the user a “false sense of protection,” which Futterman also discusses. “The danger with a device like this is that people will feel more protected and play differently and behave differently,” according to physiology professor James Smoliga, “who has led a crusade in academic journals against the device.”

That’s a reference to a four-year-old NYT piece on this thing, which I had never heard of not surprisingly. Gelman delves into the published academic work which provided the FDA with its justification for approving the Q-Collar, and it isn’t pretty. Mix very sloppy statistical reasoning with a discreet dollop of p-hacking with venal motives with the sociology of (non)retraction of bad trending to fraudulent scholarly publications and you get something like this. And what “this” is goes to Gelman’s general point:

You can think of Q collar as a baby version of health scams promoted by wealthy and powerful medical-adjacent celebrities such as Dr. Oz, Andrew Huberman, and RFK Jr. It’s junk science, but junk science with a purpose, in this case not so much to promote an ambitious social climber (as with Agus and Arday), it seems to be more about the money. And in that way it could be seen as a more typical (if less dramatic) example of a science scam. It doesn’t involve any plagiarized giraffes or implausible claims of ultra-marathoning, just the exploitation of people’s legitimate health concerns and the lure of the filthy lucre.  It could even be that the scammers believe their own claims (remember, the first step is to fool yourself; the rest then comes easy) and believe they’re doing well be doing good.

We should probably be doing more coverage of science-adjacent medical scams like the “Q collar” and less on the repulsively self-promoting but ultimately less harmful Aguses, Ardays, Wansinks, Hausers, and Arielys of the world who each in his way degrades the reputation of science but isn’t so closely locked in to a moneymaking scheme.

This reminded me of something Krugman wrote a few days ago, about the fundamental economic motivation behind what Rick Perlstein called “the long con” in his classic 2012 treatment of the topic (and things have gotten way worse since then obviously).

At first sight, the monetary interests behind anti-vax politics are less obvious than the fossil-fuel interests backing climate denial. After all, nobody benefits directly when children get measles.

Peddling quack medicine is, however, a highly profitable business. And it’s a business deeply enmeshed with the right-wing media ecosystem: Ads for dietary supplements with no proven medical benefits and other forms of snake oil have for decades been a key revenue source for right-wing talk radio, conspiracy-theory websites, and more. So there is a longstanding connection between hucksters touting fake cures and hard-right politics. Some observers were startled to see Dr. Mehmet Oz — who has touted, among other things, the health wonders of bovine colostrum — named by Trump as administrator for Medicare and Medicaid, a job for which he has no relevant qualifications. But given the underlying monetary and political incentives, Oz’s appointment is no surprise.

Why are right-wing audiences receptive to the lies of the snake oil industry along with agitprop against vaccines? To understand such gullibility, we have to address the culture war part of this debacle.

The modern right is a deeply anti-intellectual, anti-science, anti-expertise movement that is highly receptive to conspiracy theories. And like RFK Jr during his recent interview with CNN’s Dana Bash, when confronted with scientific facts it flies into a sputtering rage. So the snake oil industry targets its marketing to the kind of person who listens to the rants of right-wing influencers, gets their news from Newsmax, and finds common cause with the neo-Nazi posters on X. By framing their false claims as “The Medical Miracles that the Elites Don’t Want You to Know About”, the snake oil hucksters create a receptive audience for conspiracy theories that malign actual medical miracles like vaccines.

As is always the case here in the Gilded Palace of Sin, there’s money to be made. Gelman is one of a handful of academics who are struggling to get anyone in the media to pay attention to this story, but as he notes it’s complicated and not very sexy, plus nobody wants trouble around here mister, this was a quiet town where people minded their own business until you showed up:

Without any additional knowledge of this particular case, just based on my general understanding of such things, my guess is that the journals’ decision to do nothing here is motivated less by corruption and more by simple laziness. If you retract an article, the authors can scream at you. If you do nothing, people like Tutwiler and me will scream at you . . . but people like us are much less dangerous than authors who refuse to let go of bad research: Those people have money and reputations on the line and can lash out or even sue! So safer to just do nothing and pretend that all is well. 

All this naturally reminds me of what happened after I with a big assist from Steve Lubet exposed Alice Goffman’s fraudulent academic career, which was nothing. Yeah she didn’t get tenure but she wouldn’t have gotten tenure at Wisconsin anyway if we never written a word about her, as she published almost nothing during her time in Madison, and that won’t cut it at a top department. Here’s a funny little coda that ties in well with what Gelman is writing about: A few years after I made a big deal in a 10,000-word piece in what was by academic standards anyway a vety prominent venue about how the University of Chicago Press (along with FSG, Princeton, the New York Times, the American Sociology Review etc.) had enabled Goffman’s many frauds via failure to catch them I was trying to publish a book, and my agent decided to send it to Chicago. After I found out she had done this I laughed and said well that’s a waste of time, I excoriated them quite publicly and had an extensive back and forth with the EIC there about the whole business, so good luck with that. You can guess the punch line.

On a much more serious note, although everyone should do everything they can to fight against that outcome, the odds are high that after “this” is all over basically nothing is going to happen to Trump and his top henchmen and women are quite high. The motives — fear, laziness, venality, and most of all the social consensus that it’s better to let bygones be bygones, to look forward not back, to let sleeping dogs lie — that create enormous inertial forces against accountability for anybody important, powerful, and in particular in the Gilded Palace of Sin, rich, are immense.

As one gets older it gets harder and harder to fight the cynicism that comes with age, as this little story from one of Orwell’s newspaper columns reminds me:

It was at a village cricket match. The captain of one side was the local squire who, besides being exceedingly rich, was a vain, childish man to whom the winning of this match seemed extremely important. Those playing on his side were all or nearly all his own tenants.

The squire’s side were batting, and he himself was out and was sitting in the pavilion. One of the batsmen accidentally hit his own wicket at about the same moment as the ball entered the wicketkeeper’s hands. ‘That’s not out,’ said the squire promptly, and went on talking to the person beside him. The umpire, however, gave a verdict of ‘out’, and the batsman was half-way back to the pavilion before the squire realized what was happening. Suddenly he caught sight of the returning batsman, and his face turned several shades redder.

‘What!’ he cried, ‘he’s given him out? Nonsense! Of course he’s not out!’ And then, standing up, he cupped his hands and shouted to the umpire: ‘Hi, what did you give that man out for? He wasn’t out at all!’

The batsman had halted. The umpire hesitated, then recalled the batsman to the wicket and the game went on.

I was only a boy at the time, and this incident seemed to me about the most shocking thing I had ever seen. Now, so much do we coarsen with the passage of time, my reaction would merely be to inquire whether the umpire was the squire’s tenant as well.