A question of evidence

When we take a medication, we trust there is evidence that it will work. When we apply a cosmetic, we trust there is evidence that it is safe. When we put on a sunscreen, we trust there is evidence that it filters ultraviolet light. But evidence is not white or black; it runs the gamut from anecdotal to incontrovertible. Some people claim that placing a bar of soap under the sheet when they sleep solves the problem of restless leg syndrome. That’s what we call anecdotal evidence, and it remains so until it is confirmed or dismissed by proper randomized double-blind controlled trials. On the other hand, evidence that gold conducts electricity is ironclad. There are no ifs or buts about it. Often, though, the use of the term “evidence” is open to interpretation. An interesting example is a recent paper published in Nature, one of the world’s foremost scientific journals, intriguingly titled: “Evidence for human transmission of amyloid-beta pathology and cerebral amyloid angiopathy.”

Let’s dissect this title. Amyloid-beta proteins are one of the hallmarks of Alzheimer’s disease, so the title implies that evidence has been found that the disease can be transmitted from person to person. Little wonder that the paper generated headlines in the lay press ranging from “Alzheimer’s may be a transmissible infection” and “You can catch Alzheimer’s” to “Alzheimer’s bombshell.” All of these are highly misleading because the paper, in spite of its provocative title, does not provide evidence for the transmission of Alzheimer’s disease between humans.

So what did the researchers, led by Dr. John Collinge of University College London, actually find? They investigated the brains of eight people who had been injected with human growth hormone as children due to stunted growth back when this hormone was extracted from the pituitary glands of dead donors. Unfortunately, the donors from whom the hormone was extracted for these children had been harbouring proteins known as “prions” that cause Creutzfeldt-Jakob disease, a terminal neurological affliction. The recipients ended up dying from the disease they had contracted via the hormone.

Collinge found that six of the eight people also had amyloid plaques typical of Alzheimer’s disease. But none of 116 people who had died of Creutzfeldt-Jakob disease who had not received contaminated growth hormone showed any sign of amyloid protein deposits. Dr. Collinge therefore suggests that molecules that lead to amyloid plaque formation were passed to the recipients along with the growth hormone. A very interesting hypothesis to be sure. But the study did not show that the patients would actually have developed Alzheimer’s had they lived longer. A more appropriate title for the paper would have been “Possibility for human transmission of amyloid-beta pathology via contaminated growth hormone.” The word “evidence” should not have appeared in the title. The authors point out clearly that “there is no suggestion that Alzheimer’s disease is a contagious disease and no supportive evidence from epidemiological studies that Alzheimer’s disease is transmissible.” Nevertheless it was the term “evidence” that caught journalists’ eye and created undue public alarm with the suggestion that Alzheimer’s disease can be “caught.” Similar issues about “evidence” arise on many other fronts as well, which is the reason the theme of this year’s Lorne Trottier Public Science Symposium, organized by McGill University’s Office for Science and Society, of which I am director, is “A Question of Evidence.” We have invited four renowned speakers to address issues surrounding vaccination, genetic modification and cellphones, all current hot-button issues. The goal is to carry out a risk-benefit analysis by evaluating the strengths and weakness of the available evidence.

Physicians Paul Offit from the Children’s Hospital in Philadelphia and Brian Ward of McGill speak on vaccination on Monday, Sept. 28 at 5:30 p.m. At the same time Tuesday, Albert Einstein College of Medicine epidemiologist Geoffrey Kabat will examine controversies surrounding the use of cellphones and Wi-Fi, and Kevin Folta, professor of Horticulture at the University of Florida, will tackle the thorny subject of genetically modified food. The symposium takes place at the Centre Mont Royal, 1000 Sherbrooke St. West, corner Mansfield. It is free, no reservations required. There will also be a roundtable session with the speakers at 1:30 on Sept. 28 at the McGill Faculty Club, 3450 McTavish St., which will be open to the public. Come early as seating is limited. As philosopher David Hume opined, “a wise man proportions his belief to the evidence.”

We have invited four renowned speakers to address issues surrounding vaccination, genetic modification and cellphones, all current hot-button issues.