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

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

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.

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.

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!

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!

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.

I don't think the no dust cover aspect of this book was in the description. Not as pictured, not as described.The author was still Theodore Dalrymple, of which I have read many of his books, and have yet to read one I didn't care for. Sometimes his books become hard to get a hold of and go way up in price. It would have been nice to havehad the dust cover. I'm sure I would have given 5 stars. The only reason I didn't give it a one star was who wrote the book. I think very poorly of the one who sent out a book without its dust cover.

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,

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.