Denialism Blog

Author: denialism_bv2x6a

  • Back into the storm—the pseudonymity lab

    When we get to ScienceOnline09 in January, Abel and I will be leading a session on blogging and anonymity. I agreed to get involved because it sounded interesting, but I had no idea it would become such a big deal. There have been active discussions at many of the Sb blogs on this issue, particularly here, at Abel’s TerraSig, and at DrugMonkey. As part of the discussion, I put out a piece on the ethics of blog anonymity. Now here’s a related question (which I would prefer to treat in a general sense, without referring to any ongoing RL disputes).

    Let’s take a quote from an anonymous writer:

    We shouldn’t have anonymity or pseudonyms in place to protect people from the consequences of expressing bigotry, we have it so they can tell the truth.

    It is true that we can always be held responsible for what we write, and anonymity is not guaranteed. I’ve written earlier that I don’t think anonymity is a right, as such, but more of a clause in a contract. If I, as the writer, break the contract by launching nasty attacks on others, does that abrogate the responsibility of my readers to guard my identity?

    Another anonymous writer brings up a glitch here:

    What you are saying here is that if you, personally, think someone should be outed for whatever arbitrary personal reasons you would do so.

    Since there is no agreed-upon set of rules in the blogosphere (remember, it’s dangerous—bring a helmet), there can be no single answer here.

    If a blogger is spewing hate-filled white-supremecist rhetoric, I won’t feel so bad about outing him. But that’s just my (ultimately) arbitrary judgment. Is there a decision-making tool in our ethics kit that measures when an outing or threatened outing is fair? Part of the decision-making process has to involve the good or bad that accrues with either outing or not outing someone.

    I’d like to see a real discussion of this, without over the top hostility, and without reference to any ongoing disputes. Thanks.

  • Migraines prevent breast cancer!!!!!!!

    ResearchBlogging.orgWhen reporting on science, reporters and editors like sexy stories. Since most science isn’t particularly sexy, there’s usually a hook. If you can squeeze “risk” and “cancer” into a headline, an editor sees good headline. What I usually see is a sensationalist article that is going to get it very wrong.

    One of the questions most often asked in the medical literature is “what is the risk of x?” It’s a pretty important question. I’d like to be able to tell my patient with high blood pressure what their risk of heart attack is, both with and without treatment. And risk is a sexy topic—the press loves it. Whether it’s cell phones and the “risk” of brain cancer, or vaccines and the “risk” of autism, risk makes for cool headlines. Take this one for example:

    Migraines cut breast cancer risk 30 percent: study

    What does this mean? Should I tell my wife to go out and find some migraines? What the hell is risk, anyway?

    Risk, in the most basic sense, is a causal association. If, for example, I find that members of the “Thunderstorm-lovers Golf Association” have a higher incidence of being struck by lightning than golfers who don’t belong to this odd club, I may have stumbled upon a measurable risk. There is both a measurable association, and a plausible reason to causally link the associated variables. If I find that members of the National Association of Philatelists have a higher incidence of heart disease than other folks, I may or may not have stumbled on a risk. Is there a reason that philatelists should have more heart disease? Is it a coincidence? Is it worth investigating further? Is there a confounding variable, e.g. are philatelists in general older, and did I fail to control for this?

    Then there is the question of the degree of risk. How strong is the risk observed?

    Statisticians have ways of measuring risk, but many of these terms—such as relative risk, absolute risk reduction, odds ratio—are not intuitive concepts.

    Let’s take the study in question. The premise is interesting. Migraines and breast cancer are both associated with estrogen. Many breast cancers are estrogen-dependent, and the risk of developing breast cancer correlates with exposure to estrogen.

    Migraines appear to be associated with estrogen as well, but negatively. This is a much more tenuous connection. It has been observed that migraines tend to wax during estrogen-poor times, and wane during estrogen-rich times—high estrogen, fewer migraines; low estrogen, more migraines. Or so it’s been observed.

    The authors of this study invoked migraine as a negative risk factor for breast cancer. The English meaning of “risk” is a bit lost here—what they are saying is that women who have migraines are less likely to develop breast cancer than women who don’t have migraines. This shouldn’t be all that surprising, as migraines and breast cancer are both associated with, well, womanhood.

    But all this aside, it’s the “30%” headline annoys me. That a big number! Get me a migraine, stat! But thirty percent is an “odds ratio“, which is a mathematical way of describing an association in a case-control study such as this one. Odds ratios are not intuitive, and as a measure of risk, they tend to break down when looking at common occurrences, such as migraines.

    If we look directly at the data from the study, the data used to calculate the odds ratio, we see something else. In this study, the control group was post-menopausal women without breast cancer. The case group was women with breast cancer. Among women without breast cancer, 19% had ever had a migraine. Among women with breast cancers, 14-15% had ever had a migraine. So, there was about a 4-5% difference in migraine rates between women with and without breast cancer. Does that still sound like a big number?

    Statistics are non-intuitive. I have to work pretty hard to try to dig out the clinical meaning from stats, and I still get it wrong sometimes. The press gets it wrong much more often. Be very wary of banner headlines about risk. Besides the difficulty of understanding the difference between risk reduction and odds ratios, what does it mean in the real world?

    To be perfectly frank, I think the authors have studied a question that no one is asking. We already know that estrogen is positively associated with breast cancer, and we suspect that estrogen reduces migraine frequency (maybe). What is the point of looking at the relationship between two secondary outcomes? In other words, if a and b are both dependent on c, does it even mean anything to say that a and b vary inversely? I don’t think so. Do you?

    References

    R. W. Mathes, K. E. Malone, J. R. Daling, S. Davis, S. M. Lucas, P. L. Porter, C. I. Li (2008). Migraine in Postmenopausal Women and the Risk of Invasive Breast Cancer Cancer Epidemiology Biomarkers & Prevention, 17 (11), 3116-3122 DOI: 10.1158/1055-9965.EPI-08-0527

  • "Kennedy" is a name, not a qualification

    I can’t cover this topic better than Orac; he’s the expert. I would like to suggest that you go read his post.

    This is important. I voted for Obama. I believe that he is one of the brightest people we’ve every had the chance to vote for, and I think that after 8 years of open hostility to science, we have a chance to remove some of the politics from the issues that affect all of us.

    But Obama has floated a lead balloon for the head of EPA. Robert Kennedy, Jr. is an anti-science wacko. He has drunk the Kool Aid (I know, Flav-R-Ade, stop correcting me!) of the anti-vaccine movement, and crankery is never isolated—it always carries over from one area to the next, as it indicates a flawed way of thinking. Read Orac’s post for specifics.

    Building an administration is probably hard. Please, Mr. Obama, don’t get off on the wrong foot with science. Please?

  • Double Plus Good: No George Bush Waste Station in SF

    A group in San Francisco managed to get a measure on the city ballot that would rename our Oceanside Water Pollution Control Plant to the “George W. Bush Sewage Plant.”

    I thought this a supremely bad idea. Such a move (like protesting the Marine Core in Berkeley) would invite a conservative reaction, possibly stripping the city of federal funds.

    And as a local public utilities supervisor pointed out, our waste station is progressive, like much of the city: “The potential irony here is that this is a modern facility that protects the ocean and the environment every day,” [Tony] Winnicker said, “and I’m not sure that’s the right legacy for President Bush.”

    Well, Measure R failed by 69-30 percent! There is some good sense in San Francisco, sometimes. We also rejected a measure that would have legalized prostitution. More on that later.

  • How drunk is too drunk—another foray into medical ethics

    The best ethical questions are real ones. Sure, it’s fun to play the lifeboat game, but when you’re dealing with flesh and blood human beings on a daily basis, games aren’t all that helpful. So here’s a non-life-and-death question: if a patient comes to see you and smells of alcohol, can you add an alcohol level to their blood work without specifically informing them?

    Ethical discussions are best held as, well, discussions, so I’ll lay out some ethical principles and let you discuss before I weigh in further.

    First, any patient who comes to see a doctor signs a “general consent for treatment” which usually contains a phrase such as:

    I request and authorize Health Care Services by my physician, and his/her designees as may deem advisable. This may include routine diagnostic, radiology and laboratory procedures and medication administration.

    Second, for your reference, here is the summary of the AMA’s code of medical ethics.

    And finally, a brief list of the most agreed-upon basic principles of medical ethics:

      Beneficence – acting in the best interest of the patient.
      Non-maleficence – avoid harm to the patient
      Autonomy – the patient has the right to refuse or choose their treatment
      Justice—fair distribution or resources
      Dignity
      Truthfulness/informed consent

    Remember that ethics aren’t a checklist. Real life situations are just that—real, with real people.

    OK, the thread is now open.

  • Looks Like the Same-Sex Marriage Amendment Passed

    Here in California, the Mormons poured millions into an initiative constitutional amendment to ban same-sex marriage, after the California Supreme Court found a right to marry in the State’s Constitution.

    Proposition 8 looks like it has passed. Currently, it’s 52-48 in favor, with 95% of the vote counted.

    I’m really just posting this in order to share this anti-Proposition 8 commercial that was running in California. It might be the most offensive political ad ever. Check it out:

  • Watch the returns here!

    Watch it happen live! And if I can, I’ll though in some useless editorializing.

    Now fivethirtyeight and CNN have excellent widgets to watch as well. Fivethirtyeight.com is especially cool, as it has developed a nice reputation for actually being right. Currently, they are projecting a rather wide victory for Obama.

    Ohio an Penn!!!!!

  • The Adman Can Attack Afflictions!

    The Times’ Amanda Schaffer covers a retrospective of public health posters on display at the National Academies until December 19th, 2008. The catalog (pdf) is online.

    My favorite:

    It reads:

    “No home remedy or quack doctor ever cured syphilis or gonorrhea. See your doctor or local health officer.”

    You could replace “syphilis or gonorrhea” with just about anything! Perhaps we should reissue this poster to deal with the modern quacks!

  • Discourse give me hives

    But a fascinating lesson in scientific discourse is currently underway in the blogosphere. It all started with a harmless little analysis of a letter published in NEJM. The strange part (to those of us who live here) was that the authors responded. On the blog. For real. And they were kinda pissed (in the American sense of the word; I have no idea if they’d been drinking, but probably not. After all, they’re not bloggers).

    Communication in medical research is slow. In general, this can be a good thing. Before research is published in a respected journal, it should be thoroughly reviewed. Follow up letters to the editor are necessarily few and delayed, given the nature of the medium.

    Blogs are changing this. More and more scientists and physicians are blogging about peer-reviewed research, and how this will affect scientific discourse is anyone’s guess.

    (more…)

  • If You're Surpsied, You're Not Paying Attention

    The Journal reports the obvious under the headlines “Tainting of Milk Is Open Secret in China” and “Milk Routinely Spiked in China:”

    Before melamine-laced milk killed and sickened Chinese babies and led to recalls around the world, the routine spiking of milk with illicit substances was an open secret in China’s dairy regions, according to the accounts of farmers and others with knowledge of the industry.

    Farmers here in Hebei province say in interviews that “protein powder” of often-uncertain origin has been employed for years as a cheap way to help the milk of undernourished cows fool dairy companies’ quality checks. When the big companies caught on, some additive makers switched to toxic melamine — which mimics protein in lab tests and can cause severe kidney damage — to evade detection.

    […]

    China’s biggest local seller of liquid milk, Mengniu Dairy Co., and multinational food company Nestlé SA both say they were aware that Chinese farmers and traders added unauthorized substances to raw milk, but that they didn’t know melamine was among them. “We knew there was adulteration” going on for many years, says Zhao Yuanhua, Mengniu’s spokeswoman. Among other common milk additives: a viscous yellow liquid containing fat and a combination of preservatives and antibiotics, known as “fresh-keeping liquid.”

    If you’re buying pet food made in China or anything else for that matter, it’s time to pay more for a product manufactured in a country like America, where we have had oversight and controls on food production for over a century.