Misleading arguments

"...we must, before all else, possess trustworthy principles and methods for the discernment of truth.
[Logic] includes the thoery of criteria and of proofs; so it is with this that we ought to make our beginings."

- Sextus Empiricus

Logic is the study of the methods and principles used to distinguish correct from incorrect reasoning.

Logicians define an argument as any group of propositions of which one, (the conclusion) is claimed to follow from the others, (the premisses) which are regarded as providing support or grounds for the truth of the conclusion.

This section of the How promotion influences health care site aims to list and explain misleading arguements that are used in promotion.

Misleading arguments are a subset of persuasive arguments.

The US FDA’s "working definition" of misleading drug advertising is: "A misleading prescription drug advertisement is one which causes - either through (1) its verbal content, (2) its design, structure and/or visual artwork or (3) the context in which it appears - at least n% if a representative group of practicing physicians to have a common impression or belief regarding the advertised drug which is incorrect or not justified".
-quoted in Goldman and Montagne (1986)

"Arguments, or appeals, must have three components to be true. First, all relevant information must be considered: that is, nothing should be left out. Second, the facts not only must be true but also must be applicable. Last, a sound reasoning process should connect these true and applicable facts to the conclusion. If any of the conditions is not met, a non-rational appeal, or "fallacy of logic" has been presented and the conclusion (i.e., "this is the best treatment for my patients") may be invalid.

If we are to take a critical attitude toward information presented to us, we must also understand the difference between evidence and other devices that are sometimes used to make us believe the things people want us to believe.

Experts in critical thinking currently list about 130 fallacies. Fallacies have catchy descriptive names, often expressed in Latin. The names are not important; the importance is in recognizing the conscious or unconscious use of these fallacies in drug promotion efforts."
- Shaughnessy et al (1994)

Methods for misleading arguements include:

• False statements
• Opinions from one end of the spectrum
• Omission
  • Disclosing minor adverse effect but not major ones
• Fine print
• Ambiguity
• Suggesting, but not stating, a false conclusion
• Evidence of poor quality
• Exaggeration of benefit
• Minimisation of risks
• "Red herring" surrogate endpoints
• Science babble
• Using lack of evidence as evidence for the opposite
• Statements of relative risk
• Widening the indications
• Wrong comparator
• Statistically significant vs Clinically important
• Selective quotation
• Longstanding use
• Wrong comparator
• Oversimplification
• Use of publication bias
• Use of funding bias
• Exaggeration of the disease
• More is better
• Newer is better
• More expensive is better

Goldman R, Montagne M. Marketing "Mind mechanics": Decoding antidepressant drug advertisements. Soc Sci Med 1986;22(10):1047-58
Shaughnessy AF, Slawson DC, Bennett JH. Separating the wheat from the chaff: identifying fallacies in pharmaceutical promotion. J Gen Intern Med 1994;9:563-8.

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