Thu Aug 20 21:50:34 EDT 2015

Problems with Medicine

  • Acupuncture and Quack Medicine at Georgetown University

    I was surprised when I saw this news item from Georgetown,

    Acupuncture Impacts Same Biologic Pathways in Rats that Pain Drugs Target

    and the coverage of it at The Guardian,

    Rats help scientists closer to solving the mystery of acupuncture.

    But thanks to Science Based Medicine it became clear:

    Basically, quackademic medicine is a phenomenon that has taken hold over the last two decades in medical academia in which once ostensibly science-based medical schools and academic medical centers embrace quackery. This embrace was once called "complementary and alternative medicine" (CAM) but among quackademics the preferred term is now "integrative medicine." Of course, when looked at objectively, integrative medicine is far more a brand than a specialty. Specifically, it's a combination of rebranding some science-based modalities, such as nutrition and exercise, as somehow being "alternative" or "integrative" with the integration of outright quackery, such as reiki and "energy healing," acupuncture, and naturopathy, into conventional medicine.
    ...
    Having received a ($1.7 million) grant from the then-National Center for Complementary and Alternative Medicine (NCCAM), renamed in December the National Center for Complementary and Integrative Health (NCCIH), to integrate CAM into its core curriculum, Georgetown proceeded to do just that.

    And as for the study in question:

    The kindest description of the conclusions of this study is that it shows that running electrical current through the leg, as opposed to running current through the skin of the back, might decrease stress by decreasing the effect of stress hormones. It does not show that acupuncture works. A more realistic description of these results is that they don't show much of anything that is scientifically interesting. One even wonders if, for instance, there is a simpler explanation, namely that having a needle stuck in the leg and having current run through it hurts less than having a needle stuck in the back and having current run through it. There's no way of knowing because we can't ask the rat. Alternatively, I also note that St36 is rather close to the sciatic nerve, whereas the acupuncture point on the flank used for the sham-EA control is nowhere near a major nerve.

    Basically, this is a poorly done study with small numbers that doesn't even test acupuncture but electricity. If this is the "evidence" for acupuncture that Georgetown touts, it's thin gruel indeed. Yet it was published in a respectable journal, Endocrinology. Clearly, Endocrinology needs a better class of peer reviewers, as peer review utterly failed in this case.

    Do read the entire SMB post Bastions of quackademic medicine: Georgetown University as it contains many more details and is entertainingly written.

  • The Cure Culture

    There is no cure for cystic fibrosis. There is no cure for cancer. There is no cure for diabetes. There is no cure for HIV. There is no cure for Tay-sachs or Huntington's disease or ALS.

    And yet, scientists, the media, and the foundations that fund research consistently promise patients and their families that cures for very serious, lifelong diseases are imminent, or at least "around the corner." For cystic fibrosis, that cure has been pitched as being gene therapy, in which a faulty gene is replaced with a functioning one.

  • An Epidemic of False Claims

    Competition and conflicts of interest distort too many medical findings -- John P. A. Ioannidis | May 17, 2011

    False positives and exaggerated results in peer-reviewed scientific studies have reached epidemic proportions in recent years. The problem is rampant in economics, the social sciences and even the natural sciences, but it is particularly egregious in biomedicine.

  • What is medicine's 5 sigma?

    "A lot of what is published is incorrect."

    The case against science is straightforward: much of the scientific literature, perhaps half, may simply be untrue. Afflicted by studies with small sample sizes, tiny effects, invalid exploratory analyses, and flagrant conflicts of interest, together with an obsession for pursuing fashionable trends of dubious importance, science has taken a turn towards darkness.

    Can bad scientific practices be fixed? Part of the problem is that no-one is incentivised to be right. Instead, scientists are incentivised to be productive and innovative.

  • Atul Gawande: Overkill

    An avalanche of unnecessary medical care is harming patients physically and financially. What can we do about it?

    The researchers called it "low-value care." But, really, it was no-value care. They studied how often people received one of twenty-six tests or treatments that scientific and professional organizations have consistently determined to have no benefit or to be outright harmful. Their list included doing an EEG for an uncomplicated headache (EEGs are for diagnosing seizure disorders, not headaches), or doing a CT or MRI scan for low-back pain in patients without any signs of a neurological problem (studies consistently show that scanning such patients adds nothing except cost), or putting a coronary-artery stent in patients with stable cardiac disease (the likelihood of a heart attack or death after five years is unaffected by the stent). In just a single year, the researchers reported, twenty-five to forty-two per cent of Medicare patients received at least one of the twenty-six useless tests and treatments.

    Doctors generally know more about the value of a given medical treatment than patients, who have little ability to determine the quality of the advice they are getting. Doctors, therefore, are in a powerful position. We can recommend care of little or no value because it enhances our incomes, because it's our habit, or because we genuinely but incorrectly believe in it, and patients will tend to follow our recommendations.

    The United States is a country of three hundred million people who annually undergo around fifteen million nuclear medicine scans, a hundred million CT and MRI scans, and almost ten billion laboratory tests. Often, these are fishing expeditions, and since no one is perfectly normal you tend to find a lot of fish. If you look closely and often enough, almost everyone will have a little nodule that can't be completely explained, a lab result that is a bit off, a heart tracing that doesn't look quite right.

    Excessive testing is a problem for a number of reasons. For one thing, some diagnostic studies are harmful in themselves--we're doing so many CT scans and other forms of imaging that rely on radiation that they are believed to be increasing the population's cancer rates. These direct risks are often greater than we account for.

    Overtesting has also created a new, unanticipated problem: overdiagnosis. ...
    For instance, cancer screening with mammography, ultrasound, and blood testing has dramatically increased the detection of breast, thyroid, and prostate cancer during the past quarter century. We're treating hundreds of thousands more people each year for these diseases than we ever have. Yet only a tiny reduction in death, if any, has resulted.

  • Doctor group seeks to clear confusion in cancer screening

    Cancer screening is a balance to ensure the people who will benefit most get checked while not over-testing. After all, there are potential harms including false alarms that spark unneeded extra testing, and sometimes detection of tumors too small and slow-growing to be life-threatening.

    Colonoscopies, which allow doctors to see precancerous growths in the colon, get the most attention. But the ACP advised people ages 50 to 74 to choose from equally good screening choices: a stool test every year; a colonoscopy every 10 years; a sigmoidoscopy, which views the lower colon, every five years; or a combination of a stool test every three years and a sigmoidoscopy every five years.


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Thu Jul 30 13:05:29 EDT 2015

Items of Interest

Various web links I found to be of interest recently:

  • Is There a Viable Alternative to the Iran Deal?

    Three Atlantic writers debate the merits of the Iran nuclear agreement.
    Peter Beinart, David Frum, and Jeffrey Goldberg -- July 17, 2015

    A reasonable and sensible discussion of pros and cons of the Iran deal. But still they only talk about problems trusting Iran and forget about problems trusting the United States as I have pointed out.

  • Paul Krugman vs Steve Moore 720

    Video of a debate between Paul Krugman (New York Times) and Steve Moore (Heritage Foundation) at FreedomFest 2015.

    Some commentary about it:
  • Here's what your stolen identity goes for on the internet's black market

    The going rate for a stolen identity is about twenty bucks.

    Though the transactions are usually illegal, marketplaces on the dark web function much like those on the popular internet. Prices for stolen identities vary based on factors like quality, reliability, robustness, and the seller's reputation.

  • The (Dis)Honesty Project

    (Dis)Honesty -- The Truth About Lies is a documentary feature film that explores the human tendency to be dishonest. Inspired by the work of behavioral economist, Dan Ariely, the film interweaves personal stories, expert opinions, behavioral experiments, and archival footage to reveal how and why people lie.

  • Harbingers Of Failure

    If You Buy The Stuff No One Else Likes, You Just May Be A "Harbinger Of Failure". In a study published in the Journal of Marketing Research, researchers identified particular kinds of consumers whose preferences can predict products that will flop, calling those folks "harbingers of failure," reports the Chicago Tribune.

    "Certain customers systematically purchase new products that prove unsuccessful," wrote the study authors. "Their early adoption of a new product is a strong signal that a product will fail."

  • Predicting things is hard, but we keep doing it. Why?

    This Commerce Department report from 1948 shows how disastrously, off-the-charts wrong forecasters can be.

    If you had to make a list of America's most important developments during the 20th century, the baby boom would be in the top 10. And it was totally unpredictable.
    ...
    What's more, the report's projection of total U.S. population wasn't just a little off; it was disastrously, off-the-charts wrong. The baseline 1948 forecast predicted 163 million people would live in America by the year 2000. In reality, it was 282 million. That difference -- 119 million people -- is the equivalent of missing three Californias, or 14 New York Cities.

  • Another 'Too Big to Fail' System in G.M.O.s

    By Mark Spitznagel and Nassim Nicholas Taleb

    The G.M.O. experiment, carried out in real time and with our entire food and ecological system as its laboratory, is perhaps the greatest case of human hubris ever. It creates yet another systemic, "too big too fail" enterprise -- but one for which no bailouts will be possible when it fails.

    I am not convinced by their argument. Scientists are not economists and they do not function in the same manner.

  • Jon Stewart skewers Scalia after justice's string of Supreme Court outbursts

    Supreme Court Justice Antonin Scalia shown to be the hypocrite he is.

    For more evidence see The Incoherence of Antonin Scalia by Richard A. Posner.

  • Judge Alex Kozinski identifies 12 huge lies about justice in America:
    1. Eyewitnesses are highly reliable
    2. Fingerprint evidence is foolproof
    3. Other types of forensic evidence are scientifically proven and therefore infallible
    4. DNA evidence is infallible
    5. Human memories are reliable
    6. Confessions are infallible because innocent people never confess
    7. Juries follow instructions
    8. Prosecutors play fair
    9. The prosecution is at a substantial disadvantage because it must prove its case beyond a reasonable doubt
    10. Police are objective in their investigations
    11. Guilty pleas are conclusive proof of guilt
    12. Long sentences deter crime
  • A non-French speaker just won the French Scrabble championship

    On Monday, July 20, Richards-- a native of New Zealand--won the French-language world Scrabble championship.
    He does not speak a word of French.
    ...
    Richards reportedly memorized an entire French dictionary in the two months leading up to the competition.

  • Give Well

    In-depth charity research.

    Thousands of hours have gone into finding our top-rated charities. They're evidence-backed, thoroughly vetted, and underfunded.


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Tue Jul 21 22:31:31 EDT 2015

Iran vs United States

With the signing of a nuclear agreement between Iran and the five permanent members of the United Nations Security Council plus Germany (P5+1), there is talk of Iran's support for people and groups the United States does not like, for example Bashar al-Assad in Syria and Hezbollah in Lebanon.

How do Iran's actions compare with those of the United States:

  • overthrow of the democratically elected Prime Minister of Iran in 1953 and support for the Shah
  • support for Iraq and its use of chemical weapons in war against Iran in the 1980's
  • support for terrorist groups inside Iran to kill their nuclear scientists
  • infecting with destructive software Iran's computers that were being used in their nuclear efforts (in support of or with Israel)
  • flying drones over Iran (they shot one down)

Which country has more reasons to distrust the other?

And why is Saudi Arabia considered a better ally than Iran?

  • Saudi Arabia is a monarchy and Iran is a democracy (albeit one we may not like)
  • Saudi Arabia has had 85 beheadings so far this year. All I can find for Iran is one beheading in 2003.
  • Saudi Arabia has given free reign to the conservative Islam movement Wahhabism and this has led to ISIL. Now they may be having second thoughts about it's alliance with conservative clerics, but it may be too late.
  • Fifteen of the nineteen 9/11 hijackers were citizens of Saudi Arabia. Can you imagine what people would be saying if they were from Iran?

Why during the endless interviews with those discussing the pros and cons of the Iranian nuclear deal are these issues not mentioned every time? I would like the opportunity to do so.

And finally this odd fact from The Economist:

Iran is not as unfamiliar with the West as it may seem. Mr Rouhani's cabinet boasts more American doctorates than Mr Obama's.


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Wed Jul 15 11:43:38 EDT 2015

R. Roberts vs P. Krugman

I've been listening to Russ Roberts' podcasts EconTalk for many years and it is one of my favorites, even though I often disagree. In Krugman is human, just like me he writes:

Krugman has responded to my claims about empirical evidence, confirmation bias, and the lack of science in macro policy discussions. Here's the argument so far.

I suggested on Twitter that economists see what they want to see. We tend to latch on to evidence that supports our worldview and ideology and ignore evidence to the contrary.

Krugman responded by saying that might be true of me, but not him. He is a Keynesian because of the evidence. He is mainly unbiased. Nor does his desire for a larger government role in the economy pre-dispose him to interpret the effects of fiscal policy in a particular way.

I responded that the evidence in support of Keynesian fiscal policy is very mixed. There is too much evidence. People on each side of this debate can easily find lots of evidence--some historical, some econometric to support there view. As an example of the challenge of using evidence vs. bias to reach a policy conclusion, I pointed out that in 2013, Krugman predicted that the fiscal contraction from increased taxes and reduced spending would hurt the economy. When economic growth turned out to be healthy in 2013 and greater than in 2012, Krugman responded by arguing that "other stuff" explained the failure of his prediction. This is a common response by people on both side of these kinds of debates. Very rarely does one side concede that their worldview may need revision. There is always "other stuff."

What and why people believe fascinates me and I've blogged about it and the associated confirmation bias a fair amount. It's been interesting for me to see how Roberts has, over the years I've been listening to him, come to realize that everyone, including himself, is susceptible to easily accepting evidence that supports their view while ignoring evidence that doesn't. However knowing this doesn't stop him from taking sides as witnessed that he blogs at Cafe Hayek.

But still that is better than claiming to be (mostly) bias free. Saying your predictions failed because "other stuff" happened is similar to some religious cult leader predicting the end of the universe and then when it doesn't occur saying it was because people didn't pray enough. Why when a prediction does come true, do you never hear anyone say it's because ""other stuff" happened?

For more discussion on the topic see Noah Smith's blog Economic arguments as stalking horses.

Following in the footsteps of the Open Science Framework, when economists make predictions they need to write down in advance what they think will happen and when and under what conditions, and what outcome would prove them wrong.


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Tue Jun 30 18:24:37 EDT 2015

Items of Interest

Various web links I found to be of interest recently:

  • Scientific method: Defend the integrity of physics

    Attempts to exempt speculative theories of the Universe from experimental verification undermine science, argue George Ellis and Joe Silk.

    This year, debates in physics circles took a worrying turn. Faced with difficulties in applying fundamental theories to the observed Universe, some researchers called for a change in how theoretical physics is done. They began to argue -- explicitly -- that if a theory is sufficiently elegant and explanatory, it need not be tested experimentally, breaking with centuries of philosophical tradition of defining scientific knowledge as empirical. We disagree. As the philosopher of science Karl Popper argued: a theory must be falsifiable to be scientific.
    ... This battle for the heart and soul of physics is opening up at a time when scientific results -- in topics from climate change to the theory of evolution -- are being questioned by some politicians and religious fundamentalists. Potential damage to public confidence in science and to the nature of fundamental physics needs to be contained by deeper dialogue between scientists and philosophers.

    There is also a related New York Times opinion piece A Crisis at the Edge of Physics
  • Are We Seeing the End of Homeopathy?

    Several years ago, during a lecture on Science-Based Medicine, I noted that if there were one medical pseudoscience that was vulnerable to extinction it was homeopathy. Homeopathy is perhaps the most obviously absurd medical pseudoscience. It is also widely studied, and has been clearly shown to not work. Further, there is a huge gap in the public understanding of what homeopathy is; it therefore seems plausible that the popularity of homeopathy can take a huge hit just by telling the public what it actually is.

  • Glen Greenwald: Don't Trust Anonymous Anti-Snowden Claims

    Western journalists claim that the big lesson they learned from their key role in selling the Iraq War to the public is that it's hideous, corrupt and often dangerous journalism to give anonymity to government officials to let them propagandize the public, then uncritically accept those anonymously voiced claims as Truth. But they've learned no such lesson. That tactic continues to be the staple of how major U.S. and British media outlets "report," especially in the national security area. And journalists who read such reports continue to treat self-serving decrees by unnamed, unseen officials -- laundered through their media -- as gospel, no matter how dubious are the claims or factually false is the reporting.

    And according to security expert Bruce Schneier

    Do countries like China and Russia have copies of the Snowden documents?
    I believe the answer is certainly yes, but that it's almost certainly not Snowden's fault.
    ...
    I believe that both China and Russia had access to all the files that Snowden took well before Snowden took them because they've penetrated the NSA networks where those files reside.

  • Here's the CIA's Just-Released Top Secret File on Saudi Ties to 9/11

    Why in the documents related to the September 11 attacks are 29 out of 30 pages about Issues Relating to Saudi Arabia redacted?

  • The Education Myth

    A country's income is the sum of the output produced by each worker. To increase income, we need to increase worker productivity. Evidently, "something in the water," other than education, makes people much more productive in some places than in others. A successful growth strategy needs to figure out what this is.

  • Doing good isn't being good

    Most of us like to be associated with "idealistic" groups that claim that they are doing good, i.e., making the world better. However, this is usually not our strongest motive in choosing to associate with such groups. Instead, we more strongly want to make ourselves look good, and gain good-looking associations. Most idealistic groups quickly learn to cater to this demand

    There is a related Julia Galef Rationally Speaking podcast with Robin Hanson discussing his signaling theory.

  • Mental Illness and Creativity: Two New Swedish Studies

    Psychotherapists, in an understandable desire to help their suffering patients, could quite naturally be led to over-interpret what is rather weak evidence.

    I empathize with these patients, and with their therapists, but I feel obliged to report the consensus that has emerged from decades of scientific studies: There is no link between creativity and mental illness. There may be a link between an undiagnosed tendency toward mental illness and elevated creativity; but we don't really know, because that's almost impossible to study (how do you study an undiagnosed tendency?). The jury is still out on that issue, and the Kyaga studies represent a contribution to that continuing debate. I'm impressed by the massive volume of data used in the Kyaga studies, and the patterns revealed are interesting, and worthy of further exploration. -- Keith Sawyer

  • Is Creativity Research Elitist?
    • Stage actors: compared with children's party clowns
    • Musicians: compared to vintage motorcycle mechanics.
    • Writers of novels and short stories: Compared to ministers who write Sunday sermons.

  • The Real Lesson of the Stanford Prison Experiment

    While it's true that some guards and prisoners behaved in alarming ways, it's also the case that their environment was designed to encourage--and, in some cases, to require--those behaviors.
    ...
    The lesson of Stanford isn't that any random human being is capable of descending into sadism and tyranny. It's that certain institutions and environments demand those behaviors--and, perhaps, can change them.

  • Fat, sugar cause bacterial changes that may relate to loss of cognitive function

    Notice the may.

    A study at Oregon State University indicates that both a high-fat and a high-sugar diet, compared to a normal diet, cause changes in gut bacteria that appear related to a significant loss of "cognitive flexibility," or the power to adapt and adjust to changing situations.
    This effect was most serious on the high-sugar diet, which also showed an impairment of early learning for both long-term and short-term memory.

    I'd bet this is a publicity seeking news release and the results will not hold up (even though I do think gut bacteria are important).

  • Real New Yorkers Can Say Goodbye to All That

    We did leave our hometown because of all these aspirational New Yorkers. But we didn't leave to get away from these people, exactly. We left because those of us who grew up there were less willing to bear any burden, pay any price, to stay. The dreamers simply outbid us for our New York, and in the process, they created a city we no longer loved quite so much. This is apt to make such musings hard reading for us.


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Thu Jun 18 23:16:20 EDT 2015

Diet, vitamins, health

  • I Fooled Millions Into Thinking Chocolate Helps Weight Loss. Here's How.

    We ran an actual clinical trial, with subjects randomly assigned to different diet regimes. And the statistically significant benefits of chocolate that we reported are based on the actual data. It was, in fact, a fairly typical study for the field of diet research. Which is to say: It was terrible science. The results are meaningless, and the health claims that the media blasted out to millions of people around the world are utterly unfounded.
    ... Here’s a dirty little science secret: If you measure a large number of things about a small number of people, you are almost guaranteed to get a “statistically significant” result. Our study included 18 different measurements—weight, cholesterol, sodium, blood protein levels, sleep quality, well-being, etc.—from 15 people. (One subject was dropped.) That study design is a recipe for false positives.
    Think of the measurements as lottery tickets. Each one has a small chance of paying off in the form of a “significant” result that we can spin a story around and sell to the media. The more tickets you buy, the more likely you are to win. We didn’t know exactly what would pan out—the headline could have been that chocolate improves sleep or lowers blood pressure—but we knew our chances of getting at least one “statistically significant” result were pretty good.

  • Being overweight 'reduces dementia risk'

    Being overweight cuts the risk of dementia, according to the largest and most precise investigation into the relationship.

    Their most conservative analysis showed underweight people had a 39% greater risk of dementia compared with being a healthy weight.
    ... Any explanation for the protective effect is distinctly lacking. There are some ideas that vitamin D and E deficiencies contribute to dementia and they may be less common in those eating more.
    ...
    But the research leaves many questions unanswered. Is fat actually protective or is something else going on that could be harnessed as a treatment? Can other research groups produce the same findings?
    ... "The report by Qizilbash and colleagues is not the final word on this controversial topic." Dr Qizilbash said: "We would agree with that entirely."

  • The Big Fat Surprise

    Why Butter, Meat & Cheese Belong in a Healthy Diet. A Conversation with Nina Teicholz

    Nina: I was a faithful follower of the low-fat, near-vegetarian diet, but when I started writing a restaurant review column, I found myself eating things that had hardly ever before passed my lips: rich meals of pâté, beef, cream sauces and foie gras. To my surprise, I lost the 10 pounds that I hadn't been able to shake for years, and to boot, my cholesterol levels improved. To understand how this could be possible, I embarked upon what became a decade of research, reexamining nearly every single nutrition study and interviewing most of our top nutrition experts. What I was shocked to find were egregious flaws in the science that has served as the foundation of our national nutrition policy, which for more than 50 years has all but forbidden these delicious and healthy foods.

    Also see, NYC Junto Podcast -- Debate: Nina Teicholz & John Mackey 2015

    "An animal foods/low-carb centered diet is unhealthy compared with a 90+% plant-based diet that excludes sugar and refined grain products."

    Teicholz takes the negative and Mackey (founder and CEO of Whole Foods) takes the affirmative.

    And Cholesterol & heart disease -- there is a relationship, but it's not what you think.

  • Nutrition: Vitamins on trial

    After decades of study, researchers still can't agree on whether nutritional supplements actually improve health.

    An editorial published in the Annals of Internal Medicine last year offers a striking case in point. In it, researchers at Johns Hopkins University in Baltimore, Maryland, and other institutions proclaimed with certainty that the US public should "stop wasting money" on vitamin supplements.
    ... Another important factor is genetic variability. "Every person has about 50,000 variations in their genes," says Steven Zeisel, director of the University of North Carolina Nutrition Research Institute in Chapel Hill. Any number of them could be important in metabolism. Yet "very few geneticists are collecting diet information, and very few diet people collect genetic information". Zeisel's work has uncovered, for example, that 44% of women have gene variants that significantly increase their dietary requirements for the nutrient choline. It is perhaps no wonder that trial results have been inconsistent - and that reviews often report null findings (see `Data deficiencies'). Plus, the effects of nutrition interventions are probably subtle: whereas drug trials compare exposure with no exposure, nutrition trials compare higher and lower exposures, because everyone eats and consumes some nutrients. Subtle differences may be hard to detect and have long latency periods. These limitations and considerations add up "in a way that causes trials to be heavily stacked against showing any benefit", says biochemist Balz Frei, director of the Linus Pauling Institute at Oregon State University in Corvallis.

    Also see, Rebuttal to Vitamins Are Bad Editorial by Rhonda Patrick, Ph.D.

  • Brittle Bones and Broken Hips: Drugs Aren't the Answer, Study Finds

    Osteoporosis drug sales have reaped billions. Is it a classic case of disease-mongering?

    Medications for osteoporosis, which makes bones more fragile and susceptible to breaking, do little to prevent hip fractures, the most devastating consequence of the disease, the authors conclude. And they can sidetrack patients who should instead be exercising, eating right, and quitting smoking.
    ... To prevent a single hip fracture, 175 women need to be treated with medication for three years, the paper says. In other words, a woman with osteoporosis would need to take medicine for three years to have a 1-in-175 chance that it would help them avoid a broken hip.

  • U.S. government poised to withdraw longstanding warnings about cholesterol

    The nation's top nutrition advisory panel has decided to drop its caution about eating cholesterol-laden food, a move that could undo almost 40 years of government warnings about its consumption.
    The group's finding that cholesterol in the diet need no longer be considered a "nutrient of concern" stands in contrast to the committee's findings five years ago, the last time it convened. During those proceedings, as in previous years, the panel deemed the issue of excess cholesterol in the American diet a public health concern.

  • Alcohol's evaporating health benefits

    Industry lobbying and promotion are rife and unchecked by governments

    Given the harms attributed to alcohol use, it is not surprising that reports1 2 showing possible mortality benefits for low level users attracted enthusiasm among consumers, the media, and the alcohol industry, along with those who welcomed this as a positive response to accusations that calls for action were based on moral fervour. These apparent benefits are now evaporating, helped along by an important contribution in this week's issue (doi:10.1136/bmj.h384).3 Through analyses based on the Health Survey for England, particularly designed to identify whether any reductions in mortality risk were greatest in older populations, Knott and colleagues show that if there is any beneficial dose-response relation, it is limited to women aged 65 or more--and even that association is at best modest and likely to be explained by selection bias.

  • Redefining chronic fatigue with better diagnosis, new name

    ... And the IOM's choice of a new name -- Systemic Exertion Intolerance Disease, or SEID -- reflects a core symptom, that exertion can wipe patients out.
    "This is not a figment of their imagination," said Dr. Ellen Wright Clayton of Vanderbilt University's Center for Biomedical Ethics and Society, who chaired the IOM panel. "These patients have real symptoms. They deserve real care."


Posted by mjm | Permanent link | Comments

Fri May 29 15:08:37 EDT 2015

Items of Interest

Various web links I found to be of interest recently:

  • Can States Boost Growth By Cutting Top Individual Tax Rates?

    Howard Gleckman

    A new paper by my Tax Policy Center colleagues Bill Gale, Aaron Krupkin, and Kim Rueben concludes the answer is "no" to both questions. In the cautious language of academic research: "Our results are inconsistent with the view that cuts in top state income tax rates will automatically or necessarily generate growth."
    But Bill, Aaron, and Kim also have a warning for those who assert that cutting state taxes is good for growth or raising them is bad: All taxes are not alike. It turns out that while individual income taxes don't matter much at all, and corporate taxes may actually boost growth a bit, higher property taxes do seem linked to slower growth though even that relationship seems to change over time.

  • How 'Mathiness' Made Me Jaded About Economics

    Noah Smith

    But the way math is used in macroeconomics isn't the same as in the hard sciences. This isn't something that most non-economists realize, so I think I had better explain.
    In physics, if you write down an equation, you expect the variables to correspond to real things that you can measure and predict. For example, if you write down an equation for the path of a cannonball, you would expect that equation to let you know how to aim your cannon in order to actually hit something. This close correspondence between math and reality is what allowed us to land spacecraft on the moon. It also allowed engineers to build your computer, your car and most of the things you use.
    ... But macroeconomics, which looks at the broad economy, is different. Most of the equations in the models aren't supported by evidence.

  • The Vindication of Edward Snowden

    A federal appeals court has ruled that one of the NSA programs he exposed was illegal.

    Telling the public about the phone dragnet didn't expose a legitimate state secret. It exposed a violation of the constitutional order. For many years, the executive branch carried out a hugely consequential policy change that the legislature never approved. Tens of millions of innocent U.S. citizens were thus subject to invasions of privacy that no law authorized. And the NSA's unlawful behavior would've continued, unknown to the public and unreviewed by Article III courts, but for Snowden's leak, which caused the ACLU to challenge the illegal NSA program.

  • Japanese hotel launches 'crying rooms'

    A hotel in Tokyo is offering rooms designed to allow female guests to "cry heartily" in private

    The crying rooms are the latest in a series of unusual hotels and cafes available in Japan.

  • Vin Scelsa Leaves the Airwaves May 2, 2015

    Vin Scelsa concluded nearly fifty years on New York's airwaves

    "Idiot's Delight" was a wonderful anachronism: unscripted, idiosyncratic, and unashamedly out of step with contemporary listening habits.

  • Why you should really start doing more things alone

    "The reason is we think we won't have fun because we're worried about what other people will think," said Ratner. "We end up staying at home instead of going out to do stuff because we're afraid others will think they're a loser."
    But other people, as it turns out, actually aren't thinking about us quite as judgmentally or intensely as we tend to anticipate. Not nearly, in fact. There's a long line of research that shows how consistently and regularly we overestimate others' interest in our affairs. The phenomenon is so well known that there is even a name for it in psychology: the spotlight effect. A 2000 study conducted by Thomas Gilovich found that people regularly adjust their actions to account for the perspective of others, even though their actions effectively go unnoticed. Many other researchers have since confirmed the pattern of egocentric thinking that skews how we act.

  • GMO Quarterly Letter 1Q 2015

    U.S. Secular Growth: Donkey or Racehorse? -- Jeremy Grantham

    Mainstream economics continues to represent our economic system as made up of capital, labor, and a perpetual motion machine. It apparently does not need resources, finite or otherwise. Mainstream economics is generous in its assumptions. Just as it assumes market efficiency and perpetually rational economic players, feeling no compulsion to reconcile the data of an inconvenient real world, so it also assumes away any long-term resource problems. "It's just a question of price." Yes, but one day just a price that a workable economy simply can't afford!


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Tue May 19 14:06:13 EDT 2015

Problems with Science

I am a big fan of science and so am happy to see that current problems with scientific research are being tackled.

  • The Trouble With Scientists

    How one psychologist is tackling human biases in science.

    Given that science has uncovered a dizzying variety of cognitive biases, the relative neglect of their consequences within science itself is peculiar. "I was aware of biases in humans at large," says Hartgerink, "but when I first 'learned' that they also apply to scientists, I was somewhat amazed, even though it is so obvious."
    One of the reasons the science literature gets skewed is that journals are much more likely to publish positive than negative results: It's easier to say something is true than to say it's wrong. Journal referees might be inclined to reject negative results as too boring, and researchers currently get little credit or status, from funders or departments, from such findings. "If you do 20 experiments, one of them is likely to have a publishable result," Oransky and Marcus write. "But only publishing that result doesn't make your findings valid. In fact it's quite the opposite."
    ... Surprisingly, Nosek thinks that one of the most effective solutions to cognitive bias in science could come from the discipline that has weathered some of the heaviest criticism recently for its error-prone and self-deluding ways: pharmacology. It is precisely because these problems are so manifest in the pharmaceutical industry that this community is, in Nosek's view, way ahead of the rest of science in dealing with them. For example, because of the known tendency of drug companies and their collaborators to report positive results of trials and to soft-pedal negative ones, it is now a legal requirement in the Unites States for all clinical trials to be entered in a registry before they begin. This obliges the researchers to report the results whatever they say.
    ... The idea, says Nosek, is that researchers "write down in advance what their study is for and what they think will happen." Then when they do their experiments, they agree to be bound to analyzing the results strictly within the confines of that original plan. It sounds utterly elementary, like the kind of thing we teach children about how to do science. And indeed it is--but it is rarely what happens. Instead, as Fiedler testifies, the analysis gets made on the basis of all kinds of unstated and usually unconscious assumptions about what would or wouldn't be seen. Nosek says that researchers who have used the OSF* have often been amazed at how, by the time they come to look at their results, the project has diverged from the original aims they'd stated.

    * See How the Open Science Framework works

  • Retraction Watch

    Tracking retractions as a window into the scientific process.

    So why write a blog on retractions?
    First, science takes justifiable pride in the fact that it is self-correcting -- most of the time. Usually, that just means more or better data, not fraud or mistakes that would require a retraction. But when a retraction is necessary, how long does that self-correction take? The Wakefield retraction, for example, was issued 12 years after the original study, and six years after serious questions had been raised publicly by journalist Brian Deer. Retractions are therefore a window into the scientific process.
    Second, retractions are not often well-publicized. Sure, there are the high-profile cases such as Reuben's and Wakefield's. But most retractions live in obscurity in Medline and other databases. That means those who funded the retracted research -- often taxpayers -- aren't particularly likely to find out about them. Nor are investors always likely to hear about retractions on basic science papers whose findings may have formed the basis for companies into which they pour dollars. So we hope this blog will form an informal repository for the retractions we find, and might even spur the creation of a retraction database such as the one called for here by K.M Korpela.
    Third, they're often the clues to great stories about fraud or other malfeasance, as Adam learned when he chased down the Reuben story. The reverse can also be true. The Cancer Letter's expose of Potti and his fake Rhodes Scholarship is what led his co-authors to remind The Lancet Oncology of their concerns, and then the editors to issue their expression of concern. And they can even lead to lawsuits for damaged reputations. If highlighting retractions will give journalists more tools to uncover fraud and misuse of funds, we're happy to help. And if those stories are appropriate for our respective news outlets, you'll only read about them on Retraction Watch once we've covered them there.
    Finally, we're interested in whether journals are consistent. How long do they wait before printing a retraction? What requires one? How much of a public announcement, if any, do they make? Does a journal with a low rate of retractions have a better peer review and editing process, or is it just sweeping more mistakes under the rug?

  • First results from psychology's largest reproducibility test

    Crowd-sourced effort raises nuanced questions about what counts as replication.

    An ambitious effort to replicate 100 research findings in psychology ended last week -- and the data look worrying. Results posted online on 24 April, which have not yet been peer-reviewed, suggest that key findings from only 39 of the published studies could be reproduced.
    But the situation is more nuanced than the top-line numbers suggest (See graphic, 'Reliability test'). Of the 61 non-replicated studies, scientists classed 24 as producing findings at least "moderately similar" to those of the original experiments, even though they did not meet pre-established criteria, such as statistical significance, that would count as a successful replication.

  • When All Models Are Wrong

    More stringent quality criteria are needed for models used at the science/policy interface, and here is a checklist to aid in the responsible development and use of models.

    Against this background of declining trust and increasing problems with the reliability of scientific knowledge in the public sphere, the dangers for science become most evident when models-abstracts of more complex real-world problems, generally rendered in mathematical terms-are used as policy tools. Evidence of poor modeling practice and of negative consequences for society abounds.
    ... The situation is equally serious in the field of environmental regulatory science. Orrin Pilkey and Linda Pilkey-Jarvis, in a stimulating small volume titled Useless Arithmetic: Why Environmental Scientists Can't Predict the Future, offer a particularly accessible series of horror stories about model misuse and consequent policy failure. They suggest, for example, that the global change modeling community should publicly recognize that the effort to quantify the future at a scale that would be useful for policy is an academic exercise. They call modeling counterproductive in that it offers the illusion of accurate predictions about climate and sea level decades and even centuries in the future. Pilkey and Pilkey-Jarvis argue that given the huge time scales, decisionmakers (and society) would be much better off without such predictions, because the accuracy and value of the predictions themselves end up being at the center of policy debates, and distract from the need and capacity to deal with the problem despite ongoing uncertainties.
    ... In this light, we wish to revisit statistician George E. P. Box's 1987 observation that "all models are wrong but some are useful." We want to propose a key implication of Box's aphorism for science policy: that stringent criteria of transparency must be adopted when models are used as a basis for policy assessments. Failure to open up the black box of modeling is likely to lead only to greater erosion of the credibility and legitimacy of science as a tool for improved policymaking. In this effort, we will follow The Economist's recommendations and provide a checklist, in the form of specific rules for achieving this transparency.

  • Science's Biggest Fail

    Scott Adams

    What's is science's biggest fail of all time?
    I nominate everything about diet and fitness.
    ... Science is an amazing thing. But it has a credibility issue that it earned. Should we fix the credibility situation by brainwashing skeptical citizens to believe in science despite its spotty track record, or is society's current level of skepticism healthier than it looks? Maybe science is what needs to improve, not the citizens.

  • Unreliable research: Trouble at the lab

    Scientists like to think of science as self-correcting. To an alarming degree, it is not.
    The Economist, Oct 19th 2013

    Dr Kahneman and a growing number of his colleagues fear that a lot of this priming research is poorly founded. Over the past few years various researchers have made systematic attempts to replicate some of the more widely cited priming experiments. Many of these replications have failed.
    In 2005 John Ioannidis, an epidemiologist from Stanford University, caused a stir with a paper showing why, as a matter of statistical logic, the idea that only one such paper in 20 gives a false-positive result was hugely optimistic. Instead, he argued, "most published research findings are probably false."

  • Defending Science

    The Project on Scientific Knowledge and Public Policy

    The Project on Scientific Knowledge and Public Policy (2002-2008) examined the nature of science and how it is used and misused in government decision-making and legal proceedings. Through empirical research, conversations among scholars, and publications, SKAPP aimed to enhance understanding of how knowledge is generated and interpreted. SKAPP promoted transparent decision-making, based on the best available science, to protect public health.
    How and why science works may be difficult for non-scientists to understand. The aura around science and scientists - reflecting the power of scientific understanding and its complexity - creates opportunities for misunderstanding and misuse of scientific evidence. Indeed, failure on the part of decision-makers to understand the norms of science may lead to inaccurate conclusions and inappropriate applications of scientific results.


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Thu Apr 30 14:58:31 EDT 2015

Items of Interest

Various web links I found to be of interest recently:

  • Randomness, Skill, and Investment Strategies

    Campbell Harvey of Duke University talks with EconTalk podcast host Russ Roberts about his research evaluating various investment and trading strategies and the challenge of measuring their effectiveness.

    Among topics discussed, two examples of (mis)understanding randomness given:

    • Significant: Jelly Beans Cause Acne
    • So let me set up what actually happens. So, let's say after those 10 weeks in a row you actually subscribe to this person's predictions. And then they don't do so well, after the 10 weeks. And the reason is that the original strategy was basically: Send an email to 100,000 people, and in 50,000 of those emails you say that Team A is going to win on Monday. And in 50,000 you say Team B is going to win on Monday. And then, if Team A wins, the next week you only send to the people that got the correct prediction. So, the next week you do the same thing. 25,000 for Team A, 25,000 for Team B. And you continue doing this. And the size of the number of emails decreases every single week, until after that 10th week, there are 97 people that got 10 picks in a row correct. So you harvest 97 suckers out of this.

  • No autism-vaccine link, study finds

    Research should focus on prenatal causes of the disorder, scientists say

    No association was found between autism and getting the MMR vaccine, according to a study published Tuesday in JAMA.
    The study of 95,000 children with older siblings also examined those at high risk for autism spectrum disorder (ASD), namely those who have an older autistic sibling. No link between the measles, mumps and rubella vaccine and autism was found in these high-risk children, researchers said in the study.

  • Declining Desire to Work and Downward Trends in Unemployment and Participation

    The US labor market has witnessed two apparently unrelated trends in the last 30 years: a decline in unemployment between the early 1980s and the early 2000s, and a decline in labor force participation since the early 2000s. We show that a substantial factor behind both trends is a decline in desire to work among individuals outside the labor force, with a particularly strong decline during the second half of the 90s. A decline in desire to work lowers both the unemployment rate and the participation rate, because a nonparticipant who wants to work has a high probability to join the unemployment pool in the future, while a nonparticipant who does not want to work has a low probability to ever enter the labor force. We use cross-sectional variation to estimate a model of nonparticipants' propensity to want a job, and we find that changes in the provision of welfare and social insurance, possibly linked to the mid-90s welfare reforms, explain about 50 percent of the decline in desire to work.

  • The Placebo Gene?

    In the current study researchers performed a retrospective analysis of an existing study population in which there was a no-treatment arm (waitlist control), placebo acupuncture with minimal practitioner interaction, and placebo acupuncture with enhanced emotional support (the "warm and fuzzy" arm). The study population are those with IBS, a syndrome known to have a substantial emotional component. Further, the outcome was the subjective report of symptoms from the subjects. In other words - the syndrome and outcomes were amenable to maximal placebo responses. Prior studies have consistently shown that for subjective symptoms such as this the interaction with the practitioner is the single most important factor in reporting a subjective improvement in symptoms from a placebo intervention.
    ... Patients with the gene variant associated with increased dopamine activity in both alleles (copies of the gene) showed more of a placebo response, especially to the warm and fuzzy intervention. While again I have to emphasize the preliminary nature of this research, the results are plausible and do make sense. IBS is particularly susceptible to suggestion and a warm interaction with a practitioner, interventions that reduce anxiety and improve mood. Anxiety, mood, and the emotional response to pain and discomfort are all brain phenomena, and dopamine is an important brain neurotransmitter involved with emotion and reward, so it's not surprising.

  • FT Masterclass: Pickpocketing and how to avoid it with James Freedman

    I ask if there are certain hotspots where pickpockets strike. Tourist spots, Freedman tells me, especially places such as Big Ben and the Eiffel Tower, where people's attention is directed upwards and away from their belongings. He says that many pickpockets also operate near signs warning us to beware of pickpockets. The irony is that when people read the signs, they check their pockets or bag, thus alerting the lurking pickpocket to where their valuables are.

  • Study: Believing You've Slept Well, Even If You Haven't, Improves Performance

    Results: Participants who were told they had above-average REM sleep performed better on the test, and those who were told their REM sleep was below average performed worse, even when researchers controlled for the subjects' self-reported sleep quality.
    Implications: A great victory was won here for lies, over truth. This study shows that if you're in the mindset that you're well-rested, your brain will perform better, regardless of the actual quality of your sleep. Conversely, constantly talking about how tired you are, as so often happens in our culture, might be detrimental to your performance.

  • Can you succeed at anything with enough practice?

    How much is achievement based on natural ability and how much hard work?

    In an international experiment, a table-tennis coach gave an "unsporty" adult an hour's coaching every day for a year in a bid to make him one of the top table tennis players in Britain.
    Why did the project fail?
    Table tennis has the smallest court, the smallest ball, the smallest bat, the quickest reaction times, the most spin, and it's the only sport where you play on one surface but stand on another.


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Thu Apr 9 14:48:02 EDT 2015

climate skepticism

  • Why I am a Climate Change Skeptic

    Dr. Patrick Moore, Greenpeace co-founder and former director Greenpeace International.

    My skepticism begins with the believers' certainty they can predict the global climate with a computer model. The entire basis for the doomsday climate change scenario is the hypothesis increased atmospheric carbon dioxide due to fossil fuel emissions will heat the Earth to unlivable temperatures.
    ... In fact, the Earth has been warming very gradually for 300 years, since the Little Ice Age ended, long before heavy use of fossil fuels. Prior to the Little Ice Age, during the Medieval Warm Period, Vikings colonized Greenland and Newfoundland, when it was warmer there than today. And during Roman times, it was warmer, long before fossil fuels revolutionized civilization.
    The idea it would be catastrophic if carbon dioxide were to increase and average global temperature were to rise a few degrees is preposterous.

  • It's Not The Heat, It's the Tepidity

    Clifford Asness and Aaron Brown

    Of course the real but rather small trend doesn't prove that global warming is a minor issue, far from it. We're just saying the graph taken on its own is actually pretty reassuring, at least compared to predictions, and declared danger points, of the IPCC and similar groups. If things continue along the way they have for the last 135 years, the point at which we reach dangerous temperatures is a very very long time from now. Those predicting that we face a big problem much sooner aren't arguing this from these data, instead they have to be arguing that historical warming trends will change drastically in the near future; that they will not continue at the trend of the past hundred years or so. The historical record to date, and in particular this ubiquitous graph, can't be the basis of an argument that we will hit dangerous levels soon . To argue that we will hit them in this, or even next century requires us to explain away this graph, to explain why the rate of warming will increase.
    ... Of course, this raises the very important issue of whether or not 4°C is the right danger line. No one knows the answer to this question, but 4°C seems the most common figure used by the experts. It’s what the IPCC uses in its most recent report. No one denies that there are some risks and costs to any amount of warming, and on the other hand, almost no one is predicting that warming at or slightly beyond 4°C will cause extinction of the human race either. Risks go up with the amount of warming. We just don't know how fast. Despite the uncertainties, there seems to e a scientific consensus that less than 1°C or 2°C of warming would make global warming no more serious than several other environmental issues, but warming above 4°C would likely make global warming a unique danger. Even if the danger point is 2°C this trend doesn't reach it until over 130 years from now.

    For reactions and rebuttals see Imagine if They Disagreed With Us!

    What we did not expect was the immediate and strong chorus of agreement, yes agreement, from climate scientists. Equally unexpected was that their agreement would be couched in unfriendly terms!


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