Ben Goldacre: Battling Bad Science

譯者: Ou Chih-Hong 審譯者: Joan Liu

So I'm a doctor, but I kind of slipped sideways into research,

雖然我是醫生，但無心插柳做了點研究

and now I'm an epidemiologist.

所以現在我也是個流行病學家

And nobody really knows what epidemiology is.

沒有人真正知道流行病學是什麼

Epidemiology is the science of how we know in the real world

流行病學是一種科學，讓我們知道在生活中

if something is good for you or bad for you.

什麼東西對你好，或對你不好

And it's best understood through example

而有例可循最是簡單明瞭

as the science of those crazy, wacky newspaper headlines.

好比誇張、奇怪的新聞標題就是一例

And these are just some of the examples.

這裡有些例子

These are from the Daily Mail.

它們來自《每日郵報》，全世界各國都有類似的報紙

Every country in the world has a newspaper like this.

這類報紙一直都有個古怪、看似有理的企畫

It has this bizarre, ongoing philosophical project

就是將世界上所有不會動的物件

of dividing all the inanimate objects in the world

都分別歸類成致癌物或防癌物。

into the ones that either cause or prevent cancer.

Here are some of the things they said cause cancer:

這些是一部分最近據說會致癌的玩意兒

離婚、無線網路、衛生用品和咖啡

divorce, Wi-Fi, toiletries and coffee.

而這些則是據說能防癌的東西

Some things they say prevent cancer:

麵包皮、紅椒、甘草和咖啡

crusts, red pepper, licorice and coffee.

我想你看到了矛盾的地方

So you can see there are contradictions.

咖啡同時致癌也防癌

Coffee both causes and prevents cancer.

當你開始讀下去，你會發現

As you start to read on, you can see

that maybe there's some political valence behind some of this.

這些報導說不定別有用心。

For women, housework prevents breast cancer,

拿女性來說，做家事能預防乳癌

but for men, shopping could make you impotent.

但對男性而言，購物會使他們性無能

(Laughter)

所以，我們要開始

So we know that we need to start unpicking the science behind this.

揭露這一切背後的科學真相

And what I hope to show is that unpicking the evidence behind dodgy claims

我想要做的

是揭穿那些騙人的說法

以及那些假象背後的證據，

isn't a kind of nasty, carping activity;

這並非卑鄙、催毛求疵的事

it's socially useful.

這對社會有用，

But it's also an extremely valuable explanatory tool,

同時，也是個極具價值的

解說工具。

because real science is about critically appraising the evidence

因為真正的科學

是批判地評斷他人提出的證據

for somebody else's position.

這就是在學術期刊，

That's what happens in academic journals,

以及學術研討論上，上演的戲碼。

it's what happens at academic conferences --

有時在發言完後的問答時間

the Q&A session after a postdoc presents data is often a bloodbath.

就像場血戰。

And nobody minds that; we actively welcome it.

但沒人在乎，我們還熱烈歡迎。

It's like a consenting intellectual S&M activity.

就像是雙方同意，來場學術上的激烈性愛一樣。

(Laughter)

所以，接下來要讓各位看的

So what I'm going to show you is all of the main things,

是我的研究領域

也就是流行病學的主要特色－

all of the main features of my discipline, evidence-based medicine.

循證醫學。

And I will talk you through all of these and demonstrate how they work,

我會一步步的講解，

說明他們是如何運作的，

exclusively using examples of people getting stuff wrong.

但不會拿出錯的事情做為例子。

We'll start with the absolute weakest form of evidence known to man,

一開始，我們先談最不堪一擊的證據來源

就是權威。

and that is authority.

在科學界，我們不在乎你名字後面有多少頭銜，

In science, we don't care how many letters you have after your name --

我們想知道，你發表某樣事物的背後有什麼理由。

we want to know what your reasons are for believing something.

你怎麼知道那對我們是好，

How do you know that something is good for us or bad for us?

還是不好？

But we're also unimpressed by authority because it's so easy to contrive.

但，因為權威容易偽造，

所以我們對權威並不有什麼感覺。

This is somebody called Dr. Gillian McKeith, PhD,

這是麥基絲醫生博士

或者，給她一個完整的醫學頭銜，吉輪 ●麥基絲。

or, to give her full medical title, Gillian McKeith.

(笑聲)

(Laughter)

每個國家都有像這個的一個人。

Again, every country has somebody like this.

她是電視上的健康飲食大師，

She is our TV diet guru.

She has five series of prime-time television,

她有多達五個黃金時段的系列節目

giving out very lavish and exotic health advice.

分享又豐富，又充滿異國風情的保健建議

She, it turns out, has a non-accredited correspondence course PhD

結果，她的學歷只是在美國某一大學的

非公認的函授課程博士。

from somewhere in America.

She also boasts that she's a certified professional member

她也自豪地說她是美國營養顧問協會

的認證專業會員

of the American Association of Nutritional Consultants,

聽起來是多麼吸引人又讓人興奮

which sounds very glamorous; you get a certificate.

你有張結業證書，就什麼都有了

This one belongs to my dead cat, Hettie. She was a horrible cat.

這是我的貓，海地，她已經過世了，一隻很不乖的貓

你只要上網，填表格，

You go to the website, fill out the form,

交六十塊給他們，然後證書就郵寄給你

give them $60, it arrives in the post.

但，這不是我們覺得這傢伙是笨蛋的唯一理由

That's not the only reason we think this person is an idiot.

她也會說些話像是

She also says things like eat lots of dark green leaves,

你該吃很多的深綠色蔬菜，

they contain chlorophyll and really oxygenate your blood.

因為深綠色蔬菜有大量葉綠素，可讓血液充滿氧氣

但，任何在學校做過生物實驗的人都記得

And anybody who's done school biology remembers

葉綠素及葉綠粒

that chlorophyll and chloroplasts only make oxygen in sunlight,

只透過光合作用來製造氧氣

and it's quite dark in your bowels after you've eaten spinach.

而當你把菠菜吃掉時，身體裡其實是黑暗的

接著，我們需要正確的科學、有理的證據來證實

Next, we need proper science, proper evidence.

So: "Red wine can help prevent breast cancer."

「紅酒可預防乳癌。」

這是英國的《每日電訊》的頭條新聞

This is a headline from The Daily Telegraph in the UK.

「一天一杯紅酒能幫助預防乳癌。」

"A glass of red wine a day could help prevent breast cancer."

接著你去找這則新聞，你會發現

So you find this paper, and find that it is a real piece of science.

這確實有科學佐證

It's a description of the changes in the behavior of one enzyme

這是描述某實驗室的工作臺上的培養皿，

when you drip a chemical extracted from some red grape skin

把紅葡萄皮上所萃取的化學物質，

滴到一些癌細胞上，

onto some cancer cells

in a dish on a bench in a laboratory somewhere.

酵素會產生變化

And that's a really useful thing to describe in a scientific paper.

就科學報告而言，

這樣的實驗描述很有用，

But on the question of your own personal risk of getting breast cancer

但，一問到喝紅酒

和得到乳癌的風險為何，

if you drink red wine,

這樣的實驗描述什麼屁都沒告訴你。

it tells you absolutely bugger all.

事實上，你得到乳癌的風險

Actually, it turns out that your risk of breast cancer

會隨著你喝的含酒精飲料

increases slightly with every amount of alcohol you drink.

一點一點的增加

So what we want are studies in real human people.

因此，我們要看的，是拿真人做的研究

And here's another example.

這是另一個例子

This is from Britain's "leading" diet nutritionist in the Daily Mirror,

來自英國的《每日鏡報》，一位頗具影響力的飲食營養學家

《每日鏡報》是英國銷售量第二的報紙

our second-biggest selling newspaper.

「2001年，澳洲當地的實驗發現

"An Australian study in 2001 found that olive oil,

若把橄欖油與水果、蔬菜，或豆類植物搭配食用，

in combination with fruits, vegetables and pulses,

將對皮膚防皺有相當顯著效果。」

offers measurable protection against skin wrinklings,"

然後，他們就給妳這樣的建議：

and give the advice:

「如果把橄欖油及蔬菜搭配著吃，你的皺紋會比較少。」

"If you eat olive oil and vegetables, you'll have fewer wrinkles."

他們也很熱心地告訴你文獻出處

They helpfully tell you how to find the paper,

而在你看完報告後，你就會知道這是份觀測研究

and what you find is an observational study.

很顯然地，沒人有辦法

Obviously, nobody has been able to go back to 1930,

回到1930年

把同個產科所有出生的小孩找來

get all the people born in one maternity unit,

and half of them eat lots of fruit and veg and olive oil,

其中一半給他們吃水果、蔬菜和橄欖油

另一半給他們吃麥當勞

half of them eat McDonald's,

and then we see how many wrinkles you've got later.

之後，看他們的皺紋誰多誰少

你得拍照記錄人們的樣子

You have to take a snapshot of how people are now.

當然，你會發現到

And what you find is, of course:

吃蔬菜和橄欖油的人，確實皺紋較少

people who eat veg and olive oil have fewer wrinkles.

But that's because people who eat fruit and veg and olive oil are freaks --

但，這是因為那些吃水果、蔬菜，橄欖油的人是怪胎

他們不正常，就像你們一樣

they're not normal, they're like you; they come to events like this.

他們會出席TED這樣的活動

(Laughter)

他們受歡迎、有錢、也不太可能做室外工作

They're posh, they're wealthy, less likely to have outdoor jobs,

也不太從事勞力的工作

less likely to do manual labor,

they have better social support, are less likely to smoke;

他們在社會上獲得較多的支持，他們不太抽菸－

因此，這麼多關於社會、政治，文化等等原因，

for a host of fascinating, interlocking

這些原因這麼棒，又如此環環相扣

social, political and cultural reasons,

而這些人，也就不太可能有皺紋

they're less likely to have wrinkles.

這並不意味著蔬菜還是橄欖油的功勞

That doesn't mean it's the vegetables or olive oil.

(笑聲)

(Laughter)

所以，做實驗往往是最理想的選擇

So ideally, what you want to do is a trial.

People think they're familiar with the idea of a trial.

大家都認為，他們對於實驗都得很熟

實驗是個老話題。第一個是出現在聖經－但以理書，第一章十二節

Trials are old; the first one was in the Bible, Daniel 1:12.

這試驗很簡單，你找一群人，把他們分兩組

It's straightforward: take a bunch of people, split them in half,

這兩組人，你都用不同的方法去對待他們

treat one group one way, the other group, the other way.

過了一下子之後

A while later, you see what happened to each of them.

你就看會他們會發生什麼事

現在我要和你說的這個試驗

I'm going to tell you about one trial,

在過去十年的英國新聞媒體報導中

which is probably the most well-reported trial

可以算是名聲相當不錯的試驗

in the UK news media over the past decade.

這是個魚肝油的試驗

This is the trial of fish oil pills.

魚肝油宣稱，可以改善大部分小孩的學業表現

The claim: fish oil pills improve school performance and behavior

及學校行為

in mainstream children.

他們說：「我們做了個試驗

They said, "We did a trial.

All the previous ones were positive, this one will be too."

而之前的試驗結果都是好的，我想我們的也會是好的。」

會這樣說，就是個警訊

That should ring alarm bells:

當你已經知道實驗的結果，那還做它幹什麼

if you know the answer to your trial, you shouldn't be doing one.

無論這試驗只是隨意起草

Either you've rigged it by design,

or you've got enough data so there's no need to randomize people anymore.

或是你已有充分的數據，而你已不需要隨機挑選更多的試驗者

實驗就是這樣進行的

So this is what they were going to do in their trial:

They were taking 3,000 children,

他們找了三千位孩童

they were going to give them these huge fish oil pills, six of them a day,

並給孩童吃很多的魚肝油

一天吃六顆

and then, a year later, measure their school exam performance

一年後，他們來測量孩童的學業表現

and compare their performance

並把得來的結果和

against what they predicted their exam performance would have been

這些孩童沒有吃魚肝油的預期結果

來兩相比較

if they hadn't had the pills.

Now, can anybody spot a flaw in this design?

有人現在看出這實驗設計的缺失了嗎？

(Laughter)

所有臨床試驗方法的教授

And no professors of clinical trial methodology

are allowed to answer this question.

都不準回答這問題

So there's no control group.

這實驗沒有對照組

But that sounds really techie, right? That's a technical term.

聽起來像電子迷才會做的事

那是一個專業術語

The kids got the pills, and their performance improved.

孩童吃了魚肝油，他們的學業表現進步了

What else could it possibly be if it wasn't the pills?

除了魚肝油，還有什麼其它的原因嗎?

他們隨著時間長大了

They got older; we all develop over time.

And of course, there's the placebo effect,

當然，還有安慰劑的影響

one of the most fascinating things in the whole of medicine.

安慰劑的效果是所有藥品中，最令人神往的一個

不是吃藥而已，然後你的表現變好，疼痛舒緩如此而已

It's not just taking a pill and performance or pain improving;

是我們的信念，以及期望

it's about our beliefs and expectations, the cultural meaning of a treatment.

這就是治療的文化定譯

許多很好的研究也和安慰劑的效果

And this has been demonstrated in a whole raft of fascinating studies

做了對照實驗

comparing one kind of placebo against another.

So we know, for example,

舉例來說，一天吃兩顆糖的人

that two sugar pills a day are a more effective treatment

較不容易得到胃潰瘍

for gastric ulcers

和吃一顆糖的人相比

than one sugar pill.

一天吃兩顆糖比吃一顆糖更有用

Two sugar pills a day beats one a day.

儘管這個發現讓人覺得奇怪又好笑，但這是事實

That's an outrageous and ridiculous finding, but it's true.

We know from three different studies on three different types of pain

從三種不同疼痛的研究當中，我們瞭解

注射生理食鹽水來治療疼痛，是個較有效的方法，

that a saltwater injection is a more effective treatment

相較於吃糖果，安慰劑...等等沒有任何藥品成分的東西

than a sugar pill, a dummy pill with no medicine in it,

not because the injection or pills do anything physically to the body,

而這並非是注射或吃藥對生體產生了什麼影響

but because an injection feels like a much more dramatic intervention.

而是人們覺得注射是種更強力的手段

我們曉得自己的信念，期待

So we know that our beliefs and expectations can be manipulated,

是可被操控的

which is why we do trials where we control against a placebo,

這也為什麼我們做實驗時

需要拿安慰劑來對照

where one half of the people get the real treatment,

一半的人接受真正的治療

and the other half get placebo.

另一半的人則使用安慰劑

But that's not enough.

但，這樣是不夠的

What I've just shown you are examples

目前為止，我給你們看的實驗例子的方法，都很簡單易懂

of the very simple and straightforward ways

簡單到記者、食物供應商、糖果小販

that journalists and food supplement pill peddlers and naturopaths

以及自然療法醫生

can distort evidence for their own purposes.

都可以根據他們自己的目的，來曲解證據

What I find really fascinating

令我相當驚訝的

is that the pharmaceutical industry uses exactly the same kinds

是那些醫藥工業

他們使用相同的方法、設備

of tricks and devices,

只不過把證據扭曲成較複雜的版本

but slightly more sophisticated versions of them,

in order to distort the evidence they give to doctors and patients,

而醫生及病人，都根據那些扭曲的證據

做出攸關性命的重要決定

and which we use to make vitally important decisions.

So firstly, trials against placebo:

首先，大家都認為

一個和安慰劑對照的實驗，應該是

everybody thinks a trial should be a comparison

拿新藥品和安慰劑來相比較

of your new drug against placebo.

但，在很多情況下，這樣的方法是錯的

But in a lot of situations that's wrong;

因為，我們通常已經有了一個可行的良好療法

often, we already have a good treatment currently available.

我們就不需要知道那可有可無的

So we don't want to know that your alternative new treatment

替代療法

is better than nothing,

我們想知道的是，替代療法是否比現行的最佳療法更好

but that it's better than the best available treatment we have.

然而，你卻看到人們一再地

And yet, repeatedly, you consistently see people doing trials

拿安慰劑來對照做實驗

still against placebo.

And you can get licensed to bring your drug to market

只要你得到許可證，你的藥品就可以上市

with only data showing that it's better than nothing,

藥品背後的數據，證明這種藥物可有可無

對一個像我這樣需要做決定的醫生來說是沒有任何用處的

which is useless for a doctor like me trying to make a decision.

而這不是唯一可以扭曲數據的方法

But that's not the only way you can rig your data.

你還可以把和新藥品要比較的物品

You can also rig your data

弄得像垃圾一樣

by making the thing you compare your new drug against

毫無價值

really rubbish.

You can give the competing drug in too low a dose,

在使用競爭者的藥品時，你也可以只給予很少的劑量，

而人們自然沒有辦法治療好

so people aren't properly treated.

或是你把劑量提高

You can give the competing drug in too high a dose,

這樣就會產生副作用

so people get side effects.

And this is exactly what happened

而這正是發生在治療人格分裂症的

with antipsychotic medication for schizophrenia.

抗精神病療程的事情

Twenty years ago, a new generation of antipsychotic drugs were brought in;

二十年前，從國外引進了一批新的抗精神病藥物

這些藥物都保證副作用比現有的藥物還少

the promise was they would have fewer side effects.

所以人們就開始拿這些新的藥物和舊的藥物

So people set about doing trials of the new drugs against the old drugs.

做實驗比較

But they gave the old drugs in ridiculously high doses:

但，他們卻把舊的藥物劑量提高很多－

一天要吃20毫克的施寧錠(抗精神病藥物)

20 milligrams a day of haloperidol.

結論可想而知

And it's a foregone conclusion if you give a drug at that high a dose,

要是你把一種藥物的劑量開這麼高

it will have more side effects, and your new drug will look better.

它的副作用當然比新的藥物還要多

過去十年，歷史不斷重演。有趣的是

Ten years ago, history repeated itself,

當那一批抗精神病藥品，像是理思必妥

when risperidone, the first of the new-generation antipsychotic drugs,

產權到期時，人人都可以自己做這些藥物

came off copyright, so anybody could make copies.

Everybody wanted to show their drug was better than risperidone,

大家想證明，他們自己做的藥比理思必妥還好

所以你會看到，有一堆的抗精神病藥物

so you see trials comparing new antipsychotic drugs

拿來和一天八毫克的理思必妥做比較

against risperidone at eight milligrams a day.

八毫克不是多得很瘋狂，也沒有超出合法劑量

Again, not an insane dose, not an illegal dose,

但幾乎游走在法律邊緣了

but very much at the high end of normal.

所以，你自己做的藥物當然比那些藥來的好

So you're bound to make your new drug look better.

果不其然

And so it's no surprise that overall,

industry-funded trials are four times more likely

藥商贊助的實驗

比那些獨立出資的實驗，得到陽性結果

to give a positive result

than independently sponsored trials.

機率高出四倍

But -- and it's a big but --

但是，但但但但是

(Laughter)

(笑聲)

最後卻發現

it turns out,

when you look at the methods used by industry-funded trials,

那些藥商贊助實驗所使用的方法

確實是比獨立出資的實驗

that they're actually better than independently sponsored trials.

要來的好

And yet, they always manage to get the result that they want.

儘管如此，他們仍設法去得到他們想要的結果

So how does this work?

怎麼做？

(Laughter)

這樣如此奇怪的現象該如何解釋？

How can we explain this strange phenomenon?

Well, it turns out that what happens

原來，那些負面的數據

is the negative data goes missing in action;

在實驗進行中被隱匿起來。

it's withheld from doctors and patients.

醫生和病人都不知情

And this is the most important aspect of the whole story.

而這正是整件事情的重點所在

證據都在這裡

It's at the top of the pyramid of evidence.

任一特定的療法，我們需要所有的資訊

We need to have all of the data on a particular treatment

來知道該療法是否有效

to know whether or not it really is effective.

而有兩種不同的方法可以讓你知道

There are two different ways you can spot whether some data has gone missing.

是否有數據在實驗中不見了

妳可以用統計數字，或是實例

You can use statistics or you can use stories.

I prefer statistics, so that's what I'll do first.

我個人偏好統計數字，所以我先講這個

This is a funnel plot.

這個圖表叫做漏斗圖

A funnel plot is a very clever way of spotting

漏斗圖的設計非常聰明

if small negative trials have disappeared, have gone missing in action.

要是有少量的負面結果不見的話，你會看得出來

This is a graph of all of the trials done on a particular treatment.

這圖表上，就是針對某一種醫療法的

所有實驗

As you go up towards the top of the graph,

隨著你接近圖表的頂端

what you see is each dot is a trial.

你看到的每一個點，都是一個實驗

As you go up, those are bigger trials, so they've got less error;

越往上看，那些實驗規模越大，也就越少出錯

they're less likely to be randomly false positives or negatives.

也就是越少隨便的假陽性效果、假的陰性效果

So they all cluster together.

他們全聚在一塊

The big trials are closer to the true answer.

規模較大的實驗，都較接近事實

Then as you go further down at the bottom,

而你越往底部看

what you can see is, on this side, spurious false negatives,

你就會看到捏造的假陰性結果

and over on this side, spurious false positives.

而另一邊，你也是看到捏造的假陽性結果

要是有發表篇倚(有統計同的結果更容易被發表)

If there is publication bias,

或是少量的負面結果在過程中消失

if small negative trials have gone missing in action,

you can see it on one of these graphs.

你在這些圖表都會看到

So you see here that the small negative trials

所以，那些本該在左下角的負面結果

that should be on the bottom left have disappeared.

全都消失了

這圖表展示的，是關於發表篇倚的研究中

This is a graph demonstrating the presence of publication bias

所出現的發表篇倚

in studies of publication bias.

我認為那是個流行病學的笑話，而且，我想這是你聽過的笑話中

And I think that's the funniest epidemiology joke you will ever hear.

最好笑的一個

(Laughter)

剛剛說的，就是說明該如何透過統記證明

That's how you can prove it statistically.

那麼實例呢？

But what about stories?

Well, they're heinous, they really are.

實例就比較可惡了，真的很可惡。

This is a drug called reboxetine.

這藥叫做瑞波西汀（抗憂鬱劑）

This is a drug which I, myself, have prescribed to patients.

我過去曾開過這種藥給病人

而我是個蠻書呆子的醫生

And I'm a very nerdy doctor.

I hope I go out of my way

我盡力去嘗試閱讀，並瞭解所有的文獻

to try and read and understand all the literature.

我看了這些實驗，他們都是陽性的，也都進行得很好

I read the trials on this.

They were all positive, all well-conducted.

我沒發現什麼缺失

I found no flaw.

不幸地是

Unfortunately, it turned out, that many of these trials were withheld.

許多實驗並沒有公布出來

In fact, 76 percent of all of the trials that were done on this drug

事實上，有76%關於這項藥品的實驗

並沒有讓醫生

或是病人知道

were withheld from doctors and patients.

現在，請你想一想

Now if you think about it,

if I tossed a coin a hundred times,

要是我擲一枚銅板一百次

and I'm allowed to withhold from you the answers half the times,

而其中有一半的答案

我都不和你說

then I can convince you that I have a coin with two heads.

那麼，我就有辦法說服你

這枚銅板兩面都是人頭

If we remove half of the data,

若我們刪除一半的數據

we can never know what the true effect size of these medicines is.

那我們永遠都不曉得，這些藥品實際的效果為何

而這類的實例都是息息相關的

And this is not an isolated story.

大約有一半抗憂鬱藥物的實驗至今仍未公佈

Around half of all of the trial data on antidepressants has been withheld,

甚至還超出一半

but it goes way beyond that.

The Nordic Cochrane Group were trying to get ahold of the data on that

而科克倫小組，正致力於獲得那些數據

來整合所有的事情

to bring it all together.

科克倫小組是個國際性，非營利的合作機構

The Cochrane Groups are an international nonprofit collaboration

他們有系統地提供過去的數據回顧

that produce systematic reviews

of all of the data that has ever been shown.

而他們需要管道，來獲得所有的數據

And they need to have access to all of the trial data.

但這些公司不讓他們知道那些數據

But the companies withheld that data from them.

So did the European Medicines Agency --

歐洲藥物管理局也是如此

已經達三年了

for three years.

This is a problem that is currently lacking a solution.

這個問題現在仍少個解決方法

And to show how big it goes, this is a drug called Tamiflu,

要讓你們知道問題的嚴重性。來看看克流感

which governments around the world

世界上許多政府

have spent billions and billions of dollars on.

花了數十億的金錢在克流感上

這些政府都承諾

And they spend that money on the promise that this is a drug

克流感可以降低

which will reduce the rate of complications with flu.

流感併發症的比率

我們既有的數據顯示

We already have the data

showing it reduces the duration of your flu by a few hours.

克流感是降低流感的持續時間幾小時

但我不在乎這個，政府也不在乎

But I don't care about that, governments don't care.

如果你得到流感，我很抱歉，我知道那很難受

I'm sorry if you have the flu, I know it's horrible,

但，我們絕不會花了幾十億

but we're not going to spend billions of dollars

只是要去縮短流感症狀的持續時間而已

trying to reduce the duration of your flu symptoms by half a day.

還只減少個半天左右

We prescribe these drugs.

我們會開這些藥，也會貯存他們為了緊急狀況

We stockpile them for emergencies

因為我們瞭解，他們可以降低併發症可能性

on the understanding they'll reduce the number of complications,

併發症可能是肺炎，或是死亡

which means pneumonia and death.

以義大利為根基的科克倫小組，正努力從藥品公司

The infectious diseases Cochrane Group, which are based in Italy,

想辦法獲得感染疾病的完整數據

has been trying to get the full data in a usable form

而這些數據都是正確可用的

out of the drug companies,

如此一來，科克倫小組才能決定

so they can make a full decision

about whether this drug is effective or not,

一個藥品有效與否

and they've not been able to get that information.

然而，他們卻無法獲得那樣的資訊

This is undoubtedly the single biggest ethical problem

無庸置疑

照是現藥品面臨的

facing medicine today.

一個嚴重的道德問題

若沒有這些資訊

We cannot make decisions in the absence of all of the information.

我們便沒有辦法下決定

So it's a little bit difficult from there

儘管，現在要下個有希望的結論

to spin in some kind of positive conclusion.

是有些困難

但，我會說

But I would say this:

I think that sunlight

我認為，陽光

is the best disinfectant.

是最好的消毒劑

我們眼前看到所發生的事物

All of these things are happening in plain sight,

and they're all protected by a force field of tediousness.

他們都被我們習以為常的陽光

給保護著

And I think, with all of the problems in science,

儘管現今科學界存在著這些問題

我認為，我們最好能做的一件事

one of the best things that we can do

is to lift up the lid, finger around at the mechanics

就是掀開事物的表層

仔細探查，檢視一番

and peer in.

謝謝你們

Thank you very much.

(Applause)

(掌聲)