Open letter to Deirdre Imus

Dear Deirdre,

Hi! How are you? I am sooo proud of you. I mean, when I have a serious personality flaw, I usually try to hide it, but you! You are willing to show the WHOLE WORLD how intellectually challenged you are (that means “stupid” LOL).

Your recent article in the Huffington Post was so brave. Seriously, it’s pretty clear to insiders that there are problems at the CDC. But to get it so wrong took real guts.

For example:

These criticisms have been voiced for several decades. An example of how the agency can design a study so that it fails to link disease and pollution can be found in the way the CDC investigated the cancer clusters in Fallon, Nevada and Sierra Vista, Arizona…

The CDC itself admits the agency repeatedly fails to identify, or connect, environmental chemicals to these clusters. Quoting from the CDC website, “From 1961 to 1982, CDC investigated 108 reported cancer clusters in 29 states and 5 foreign countries…The studies were begun in hopes of identifying a viral cause of cancer clusters. During these investigations, however no clear cause was determined for any of the reported clusters.”

I love it! A failure to find the result Deirdre wants equals failure! The grandiosity—it’s so…Paris Hilton!

But you saved your real courage for influenza. You showed the whole world that it doesn’t take brains or research to have an opinion. I mean, a conspiracy to inflate flu death statistics to raise money! Brilliant! OK, maybe it’s not original, but at least it’s, um…well, let’s see.

I’ll quote you so I get it right:

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Criminal Profilers and Cold Readers

Malcolm Gladwell has an interesting piece in this week’s New Yorker concerning criminal profilers, individuals who try to determine who a criminal is based on characteristics of the crime. The idea of criminal profiling has become very popular, with many television shows and movies based on the idea that a psychologist could divine the identity and motives of a killer. Gladwell explores whether these profilers really predict anything well, and in the process, compares the basic tricks used by psychics to criminal profilers:

A few years ago, Alison [author of “The Forensic Psychologist’s Casebook”] went back to the case of the teacher who was murdered on the roof of her building in the Bronx. He wanted to know why, if the F.B.I.’s approach to criminal profiling was based on such simplistic psychology, it continues to have such a sterling reputation. The answer, he suspected, lay in the way the profiles were written, and, sure enough, when he broke down the rooftop-killer analysis, sentence by sentence, he found that it was so full of unverifiable and contradictory and ambiguous language that it could support virtually any interpretation.

Astrologers and psychics have known these tricks for years. The magician Ian Rowland, in his classic “The Full Facts Book of Cold Reading,” itemizes them one by one, in what could easily serve as a manual for the beginner profiler. First is the Rainbow Ruse–the “statement which credits the client with both a personality trait and its opposite.” (“I would say that on the whole you can be rather a quiet, self effacing type, but when the circumstances are right, you can be quite the life and soul of the party if the mood strikes you.”) The Jacques Statement, named for the character in “As You Like It” who gives the Seven Ages of Man speech, tailors the prediction to the age of the subject. To someone in his late thirties or early forties, for example, the psychic says, “If you are honest about it, you often get to wondering what happened to all those dreams you had when you were younger.” There is the Barnum Statement, the assertion so general that anyone would agree, and the Fuzzy Fact, the seemingly factual statement couched in a way that “leaves plenty of scope to be developed into something more specific.” (“I can see a connection with Europe, possibly Britain, or it could be the warmer, Mediterranean part?”) And that’s only the start: there is the Greener Grass technique, the Diverted Question, the Russian Doll, Sugar Lumps, not to mention Forking and the Good Chance Guess–all of which, when put together in skillful combination, can convince even the most skeptical observer that he or she is in the presence of real insight.

He then goes on to describe the results of a brainstorming session from three FBI criminal profilers in 1984 who were trying to solve the BTK murders. Their recommendations sound a lot like a cold read and were far off from the mark:

They had been at it for almost six hours. The best minds in the F.B.I. had given the Wichita detectives a blueprint for their investigation. Look for an American male with a possible connection to the military. His I.Q. will be above 105. He will like to masturbate, and will be aloof and selfish in bed. He will drive a decent car. He will be a “now” person. He won’t be comfortable with women. But he may have women friends. He will be a lone wolf. But he will be able to function in social settings. He won’t be unmemorable. But he will be unknowable. He will be either never married, divorced, or married, and if he was or is married his wife will be younger or older. He may or may not live in a rental, and might be lower class, upper lower class, lower middle class or middle class. And he will be crazy like a fox, as opposed to being mental. If you’re keeping score, that’s a Jacques Statement, two Barnum Statements, four Rainbow Ruses, a Good Chance Guess, two predictions that aren’t really predictions because they could never be verified–and nothing even close to the salient fact that BTK was a pillar of his community, the president of his church and the married father of two.

Doctors are conspiring to convince you you’re sick!

How do doctors decide what is healthy and unhealthy? Do they arbitrarily decide on risk factors to line their pockets – creating false epidemics as Sandy Szwarc at Junkfood Science suggests? Or, is there actually a science, called epidemiology, that is the basis for health recommendations?

As I’ve said repeatedly, one of the sure signs you’re about to hear total BS is if someone suggests there is some conspiracy by scientists or doctors to hide the truth. In an article challenging the use of serum troponin levels to determine whether myocardial infarction (MI) has occurred (a more sensitive method) Sandy suggests this is yet another example of doctors lowering metrics of illness and risk to generate the impression of false epidemics.

There must be a health crisis to bring the greatest funding for research, treatments and education… even if an epidemic has to be created. One of the most common tactics is to change the definition. When diagnostic criteria is broadened, suddenly, with the stroke of a pen, new cases can appear to explode in number.

With heart disease deaths dropping dramatically for the past half century, the world’s top four organizations representing heart disease interests have all gotten together to change the definition … of a heart attack.

The World Heart Federation, American College of Cardiology, American Heart Association and the European Society of Cardiology have been championing the new criteria over recent years, and will officially release it next month in the Journal of the American College of Cardiology and in the AHA journal, Circulation. The new definition will use elevations of troponin levels, rather than the traditional cardiac biomarkers, such as the MB-CK enzyme.

This is a truly bizarre argument. Because measuring troponin will allow us to detect more MIs that have occurred, it must of course be part of a plot to make Americans think they’re less healthy. Never mind that more sensitive tests for MI are what is known as a good thing, and that current tests clearly are missing minor heart damage thus underestimating the number of true MIs. Any revision of current standards must be part of a plot! The fact that those scientists got together is a sure sign. We should never let them do that.

While troponins may go up for other reasons, the idea that the test will misdiagnose as heart attacks other disorders is pretty silly. This isn’t a test that is going to be used to diagnose MI in the absence of chest pain or abnormal ECG findings – which enhances the specificity of the test – and doctors are aware of confounding diagnoses – it’s their job to find them. Further, the idea that the new criteria were designed to somehow justify funding for heart disease (an area of medicine that will never lack for funding) is downright hilarious.

But this isn’t the only example of “false epidemics” being created by those greedy doctors trying to convince people that they’re ill. Sandy mentions other excellent examples.

First, because this is Sandy, is of course obesity:

“Overweight:”Definition changed from BMI ≥ 27 to BMI ≥ 25 by the U.S. National Heart Lung and Blood Institute in 1998, instantly increasing by 43% the numbers of Americans, an additional 30.5 million, deemed ‘overweight.’

So, did doctors just pull that figure out of nowhere to line their pockets? Or does data exist that justify the decision? This study in NEJM(1) is a prospective study of over a million people evaluating all-cause mortality (as well as a number of independent risk factors) showing the relationship between BMI and mortality. Here is the relevant figure – the dark line is most relevant – showing the relative risk of death versus BMI.

Continued below the fold:
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WSJ: Oppose CAFE! Ignore Reality! Why, Because I Know Econ 101!

In today’s Journal, Robert Crandall and Hal Singer argue that America shouldn’t drink the corporate average fuel economy standard (CAFE) Kool-Aid. Why? Well why do you think? Because the market is perfect and thus there is no problem! Bring on the Econ 101!

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…if there was [sic] fuel-saving technology out there that cost $1,000 but generated $2,500 in the discounted present value of fuel savings over the life of the vehicle, carmakers would surely voluntarily embrace that technology…

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No need for regulation there. With large numbers of vehicle producers and well-informed consumers, the market is so efficient, in fact, that it ensures that all such transactions will occur, generating the socially optimal level of fuel economy…

i-9d936ebcbb671ac98c18d0fb1b4e58c6-4s.jpeg Are these guys parodying economists? I wonder, because this is so ill informed, and so unsophisticated that it is difficult to take them seriously. Our “socially optimal” level of fuel economy is so poor because many carmakers have used technology to increase power and performance instead of efficiency. We have hybrid cars that use the electric engine to provide more horsepower rather than save gas!

But it gets worse, ladies and gentlemen, because they feel compelled to explain what they learned in class today–the idea of “market failure:”

Any call for regulation must be based on a market “failure” — that is, failure of private markets to provide the proper incentives for contributing to social value. In the case of the current call for increases in CAFE, the market failure is generally identified as global warming or national security. But CAFE is a horribly inefficient mechanism for reducing carbon emissions because it does nothing to reduce emissions from power plants, older vehicles, home furnaces or industrial facilities. Nor would it apply to any emissions outside the U.S. Even if one accepts the debatable proposition that less reliance on oil would improve our national security, we should focus our attention on all oil consumption, not just that used in new vehicles. The cost of trying to reduce the harmful external effects of any form of consumption by arbitrarily taxing just 5% of it is extremely costly. A smaller tax on a much wider tax base always reduces the distortions caused by the tax.

Where to start with this? Because CAFE doesn’t address old home furnaces, it isn’t worth pursing?

My favorite part about this absurd oped is how often they bemoan the benighted state of politics, because the public ignores economists:

Aside from economists, whose voices often carry little weight in Washington, there is virtually no opposition to this form of regulation. Not even from a Republican president.

[…]

When exposed to the piercing light of economic analysis, the alleged benefits of more stringent CAFE standards burn away. Too bad these proposals will not be subjected to economic scrutiny before they become law.

[…]

Ask any economist and he’ll tell you that estimating the private costs and private benefits of increasing fuel economy is a fool’s errand.

Maybe we should have an “ask any economist” contest. What, exactly, should be the response to someone who asserts, “any economist would say X.” Should “so what?” be the response? My favorite response comes from one of my brainy students here at Berkeley: “being an economist means never having to say you’re wrong!”

I could go on forever, but will leave it with this:

Mr. Crandall is senior fellow in economic studies at the Brookings Institution. Mr. Singer is the president of Criterion Economics. They have advised General Motors on CAFE issues.

Oh, maybe this explains why no one wants a GM car! Instead of leading like Toyota and Honda on fuel efficiency, they think the market has solved the problem. GM should fire these guys.

WSJ and anti-government conspiracies

Leave it to AEI writing for the WSJ editorial page to allege a grand conspiracy of the government against pharmaceutical companies. Their proof? The government wants to compare the efficacy of new drugs to older ones to make sure they’re actually better.

The reauthorization of the State Children’s Health Insurance Program (Schip), created in 1997 to cover children from lower-income families who make too much to qualify for Medicaid, is up for renewal this fall. Tucked into page 414, section 904 of the House bill is a provision to spend more than $300 million to establish a new federal “Center for Comparative Effectiveness” to conduct government-run studies of the economic considerations that go into drug choices.

The center will initially be funded through Medicare but will soon get its own “trust fund.” The aim is to arm government actuaries with data that proponents hope will provide “scientific” proof that expensive new drugs are no better than their older alternatives. The trick is to maintain just enough credibility around the conduct of these trials to justify unpopular decisions not to pay for newer medicines.

While there’s nothing inherently wrong with this sort of fiscally minded clinical research, Medicare is no ordinary payer: It dictates decisions made in the private market. So as the government begins tying its own payment decisions to the results of its own studies, there’s a great temptation to selectively interpret data and arbitrarily release results. Clearly, this obvious conflict of interest demands even more outside scrutiny and transparency than has been the usual fare when it comes to government research.

Yes, because private research is so much more transparent than studies performed by the government. Gottlieb’s example of a government hit on expensive drugs, was of all things, the Women’s Health Initiative.

More insane conspiratorial nonsense from AEI and the WSJ below the fold.
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Denialist Deck Applied: PRISM

It’s that time again. Bora’s got the scoop on this new organization PRISM (Partnership for Research Integrity in Science & Medicine). They purport to be the saviors of scientific publishing, protecting us from the evil of open access. But how much do you want to bet they’re the same old industry lobbying group, disguising themselves as actors in the public interest? Well, there’s an easy way to tell. Let’s apply the deck of cards!

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Please KQED, Stop it with the Bogusity

Where does one start with this?

bogusitySome bald dude who lives in Maui and talks about ancient Chinese texts and gives advice on “The Power of Intention” belongs in a strip mall, not on PBS.

Looks like the PBS Ombudsman has commented on objections to Dr. Wayne Dyer (PBS can’t say his name, not once, without prefacing it with Dr.) in the past, in the way that ineffectual ones always do–by simply restating individuals’ objections. Yes, I heard you. You said X. Congratulations. Sincerely, the Ombudsman.

What’s most annoying about this is that it must work. Loopy Californians must watch this guy, like him, and donate. All one needs to say is “Eastern Wisdom” here and brains stop working and pocketbooks open!

What’s next for PBS? Are they going to sell crystals?

Profile of a Crank – Julia Stephenson

Ben Goldacre at Bad Science is leading the way on opposing this new absurdity of “electric smog”, and one of it’s leading proponents in Britain, Julia Stephenson.

It’s really too easy. Remember the crank HOWTO? Well, she’s just about a perfect example.

It all started when she got wifi in her apartment…
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Beware the bashers of peer review

I’d like to hear from some other sciencebloggers and science readers what they think reform of peer-review should look like. I’m not of the opinion that it has any critical flaws, but most people would like to see more accountability for sand-bagging and other bad reviewer habits. Something like a grading system that allows submitters to rate the performance of their reviewers, then editors of magazines would tend to only consult with reviewers that authors felt were doing a fair job of evaluating their paper.

The drawback of course would be that reviewers might start going easier on papers just because they don’t want bad grades.

One thing I do know for sure though, we shouldn’t take advice about peer review from HIV/AIDS denialists…
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Fake Experts

You know who they are – those organizations that have words like “freedom” and “rights” “choice” and “consumer” in their names but always shill for corporate interests…those occasional MDs or engineers creationists find that will say evolution has nothing to do with science. They are the fake experts.

But how do we tell which experts are fake and which are real?
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