Pseudoscience: The Correlation = Causation Fallacy and Disease Mongering

On NPR this morning, I heard about how doctors are finding out that treating a certain number associated with your health, for example, cholesterol levels, may not reduce chance of the targeted outcome, for example, heart attacks. I think this is an example of the correlation = causation fallacy. High cholesterol may be associated with increased chances of heart attacks, but that doesn't mean high cholesterol causes heart attacks. In one study presented, the researchers found that decreasing cholesterol may not decrease arterial plaque, the leading cause of heart attacks. In this example, numerous third variables could exist, lifestyle choices being the most prominent, such as diet, exercise, and stress levels.

The correlation = causation fallacy is apparent in many aspects of our lives, and we need to be vigilant to such logical errors in order to avoid being duped by marketers trying to sell us anything from a "sexy" van admired by a sexy woman or a drug pushed for a "disease." (There’s a new TV advertisement with this woman in a bikini admiring a van, almost as if she wants the van sexually, which is reinforced by what she says: "Say it again." It’s a weird commercial, and it drives my fiancée crazy.)

In a similar vein, I recently read an article about "disease mongering"—basically, the selling of a medication by telling the public about the existence, prevalence, or severity of mild health or life problems as diseases treatable by the medication. I noticed this in the promotion of drugs for "restless leg syndrome." My fiancée, Kyra, has noted that my legs fidget in the middle of the night. I've noticed my legs fidget at night and other times, even now sitting at my desk at work, and I don't think it's a problem, as I am not kept awake by it as far as I can tell, and it doesn’t bother me during other times. (It could be one reason I like to dance!) However, according to new advertisements, restless leg syndrome may be keeping me awake at night, and what do you know!, the company has a pill I can take, although it may cause high blood pressure, headaches, nausea, and in rare cases, sudden death (just kidding, I don't really know the side-effects, although I might not be too far off). The sale of a drug for this rather mild problem is a good example of disease mongering. (There may be people out there who have this so bad that it does cause problems. However, I would think that some sort of lifestyle change—for example, more exercise—would alleviate the problem.)

Here's an excerpt and a link to the original article about disease mongering:
"Through the work of investigative journalists, we have learned how informal alliances of pharmaceutical corporations, public relations companies, doctors’ groups, and patient advocates promote these ideas to the public and policymakers—often using mass media to push a certain view of a particular health problem. While these different stakeholders may come to these alliances with different motives, there is often a confluence of interests—resulting in health problems routinely being framed as widespread, severe, and treatable with pills, as has happened recently with social anxiety disorder [5]. Currently, these alliances are working with the media to popularize little-known conditions, such as restless legs syndrome [6] and female sexual dysfunction [7], in each case lending credence to inflated prevalence estimates. In the case of female sexual dysfunction, there has been a serious, though heavily contested, attempt to convince the public in the United States that 43% of women live with this condition (see pp. 175–195 in [2]). This is happening at a time when pharmaceutical companies perceive a need to build and maintain markets for their big-selling products and when pipelines for new and genuinely innovative medicines are perceived as being weak." (Moynihan & Henry, online)
If you're interested in reading more about this type of "Bad Science," I recommend reading the website and online journal named after its topic by Ben Goldacre:


Moynihan, R, & Henry, D. (2006). The fight against disease mongering: Generating knowledge for action. PLoS Med, 3(4): e191. Retrieved March 20, 2008 from


Carla said...

I'm amused by you "possible restless legs syndrome." You don't have it. Trust me. I have it, and you would know. Mine started with feelings that my legs were filling with water and they would jerk uncontrollably as if I were being hit with a reflex hammer at the hip. The said medicine FOR rls, did NOTHING for me, it actually caused more problems and gave me restless ARMS syndrome too. Anyways - keep an eye on Kyra, though. RLS is common in pregnant women. :-)

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