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"People tend to conform their factual beliefs to ones that are consistent with their cultural outlook, their world view," Braman says. The Cultural Cognition Project has conducted several experiments to back that up. Participants in these experiments are asked to describe their cultural beliefs. Some embrace new technology, authority and free enterprise. They are labeled the "individualistic" group. Others are suspicious of authority or of commerce and industry. Braman calls them "communitarians." In one experiment, Braman queried these subjects about something unfamiliar to them: nanotechnology — new research into tiny, molecule-sized objects that could lead to novel products. "These two groups start to polarize as soon as you start to describe some of the potential benefits and harms," Braman says. The individualists tended to like nanotechnology. The communitarians generally viewed it as dangerous. Both groups made their decisions based on the same information. "It doesn't matter whether you show them negative or positive information, they reject the information that is contrary to what they would like to believe, and they glom onto the positive information," Braman says.

"Basically the reason that people react in a close-minded way to information is that the implications of it threaten their values," says Dan Kahan, a law professor at Yale University and a member of The Cultural Cognition Project. Kahan says people test new information against their preexisting view of how the world should work. "If the implication, the outcome, can affirm your values, you think about it in a much more open-minded way," he says. And if the information doesn't, you tend to reject it. In another experiment, people read a United Nations study about the dangers of global warming. Then the researchers told the participants that the solution to global warming is to regulate industrial pollution. Many in the individualistic group then rejected the climate science. But when more nuclear power was offered as the solution, says Braman, "they said, you know, it turns out global warming is a serious problem."And for the communitarians, climate danger seemed less serious if the only solution was more nuclear power.

The North American Spine Society and the Society of Interventional Radiology have pointed to flaws in both studies. And earlier studies, published over 15 years, found major benefits to kyphoplasty and a related procedure called vertebroplasty. "We're missing opportunities for patients to receive a safe and effective treatment that can significantly reduce their pain and disability," said Malamis, an interventional radiologist. The procedures are used to treat vertebral compression fractures in patients with osteoporosis and other conditions that result in brittle bones. In a vertebroplasty, an acrylic cement is injected into a fractured vertebra. In a kyphoplasty, a balloon-tipped catheter first is inserted into the fracture. The balloon is inflated to restore the height and shape of the vertebra before the cement is injected. Neva Nelson, 74, of Naperville, Ill., said a kyphoplasty that Malamis performed in October, 2009, has greatly reduced her pain in a vertebra in her lower back that she fractured after falling on ice. Before her kyphoplasty, Nelson had to sit on cushions. Walking, and especially standing, were painful. "I had to do something," she said. "I could not go on like that." Nelson said that since undergoing her kyphoplasty, "I don't have to worry about my back any more." In the controversial studies, patients were randomly assigned to receive a vertebroplasty or a placebo-like "sham" procedure. In the sham procedure, patients received an injection of anesthetic, but no cement. However, patients in severe pain are reluctant to enroll in a trial where there's a 50 percent chance of receiving a sham treatment. In one of the studies, researchers had to screen 1,813 patients to enroll just 131 subjects. In the other study, only 78 of 219 eligible patients were enrolled. This low enrollment rate raises the possibility that the patients who did enroll were not representative. Patients experience the greatest pain during the first three months after a compression fracture. Thereafter, pain gradually subsides. Thus, a vertebroplasty or kyphoplasty provides the greatest benefit when performed within a week or two of the fracture. But the studies enrolled patients up to 12 months after fractures. In addition to reducing pain and disability, a kyphoplasty can reduce the risk of subsequent fractures by improving the angle and height of the spine. The studies evaluated vertebroplasty alone, and did not include the more innovative and very different kyphoplasty procedure. Malamis suggests the medical community wait for the results of additional studies now underway before passing final judgment on vertebroplasty or kyphoplasty. In the mean time, he notes that Medicare still covers the procedures.