I’d like to thank revere right now publicly. He’s taught me a new word:

Methodolatry: The profane worship of the randomized clinical trial as the only valid method of investigation.

Many of you have e-mailed me and other SBM bloggers about a recent article in The Atlantic by Shannon Brownlee and Jeanne Lenzer, two reporters whose particular bias is that we as a nation are “over treated.” That may be true, although not to the extent that Brownlee, at least, seems to think, and her article on swine flu was truly biased and painful to read. Moreover, “methodalatry” perfectly describes one of the complaints we at SBM have about the “evidence-based medicine” paradigm. So I’m really glad that revere took it on and demolished it.

The hero of The Atlantic article, Tom Jefferson clearly has an agenda about flu vaccines. Indeed, he has such an agenda that he was invited to the National Vaccine Information Center’s vaccine conference in early October. The NVIC is the oldest and biggest antivaccine organization there is. Either he didn’t know that, in which case he’s clueless, or he didn’t care. In any case, it was clear that he was invited there because of his stance on flu vaccination, and he was even going to be awarded the NVIC “Courage in Science” Award. To his credit, Jefferson backed out when he found out that he would be sharing the stage with Andrew Wakefield, who was to be given the NVIC “Humanitarian Award.” He was appropriately horrified. Still, he should never have accepted in the first place, given that the NVIC clearly wanted to coopt him and use his gadfly status to make its anti-vaccine stance seem reasonable and science-based.

That’s just one reason why I don’t take Tom Jefferson particularly seriously anymore. I tend to agree with revere that Jefferson is drifting perilously close to crank territory with respect to flu vaccines. Indeed, “methodolatry” is an awesome term to describe his approach. Actually, it’s a great term to describe some of the Cochrane scientists responsible for analyzing the efficacy of mammography screening, as well; their conclusions and methods rather remind me of Jefferson’s.

Finally, you might also want to reread (or read for the first time if you haven’t read it already) Mark Crislip’s article on flu vaccine efficacy, which, although not directly written in response to Brownlee’s article, does address many of the shortcomings in its analysis of H1N1 vaccine efficacy.