Methodology – Page 10 – artdiamondblog.com

Data Set Too Small to Support Claim of 250,000 Annual ER Deaths Due to Misdiagnosis

(p. A17) A shocking headline recently claimed that every year 250,000 people in the U.S. die after misdiagnosis in the emergency room. Even more shocking, the statistic was extrapolated from the death of one man—in a Canadian emergency room more than a decade ago.

. . .

The statistical methods used to arrive at the report’s estimate of 250,000 deaths are very bad, resulting in inaccurate findings that exaggerate potential harm in ERs. The estimate was derived from a single study that included only 503 patients discharged from two Canadian emergency rooms from August to December 2004. Researchers found that among the 503 patients, one person unexpectedly died related to a delay in diagnosis by an ER physician. The patient had signs of an aortic dissection—a tear in the major vessel that carries blood from the heart. For reasons we don’t know, the diagnosis was delayed for seven hours.

The goal of the Canadian study was to measure all kinds of medical errors, not to estimate the death rate from erroneous or late diagnoses. The sample size wasn’t big enough for that. Had nobody in the study sample died, would that mean that ERs never make fatal errors? Obviously not.

The AHRQ report misused this single death to estimate a death rate across the entire U.S. Dividing one death by 503 patients, the researchers estimate a death rate of 0.2%. They then multiply 0.2% by total annual ER visits in the U.S.—130 million—and come up with 250,000 deaths.

For the full commentary, see:

Kristen Panthagani. “A Study Sounds a False Alarm About America’s Emergency Rooms.” The Wall Street Journal (Friday, Dec. 30, 2022): A17.

(Note: ellipsis added.)

(Note: the online version of the commentary has the date December 29, 2022, and has the same title as the print version.)

China Still Seeks to Censor International Journals and Databases on Covid

(p. A1) Early in 2020, on the same day that a frightening new illness officially got the name Covid-19, a team of scientists from the United States and China released critical data showing how quickly the virus was spreading, and who was dying.

The study was cited in health warnings around the world and appeared to be a model of international collaboration in a moment of crisis.

Within days, though, the researchers quietly withdrew the paper, which was replaced online by a message telling scientists not to cite it. A few observers took note of the peculiar move, but the whole episode quickly faded amid the frenzy of the coronavirus pandemic.

What is now clear is that the study was not removed because of faulty research. Instead, it was withdrawn at the direction of Chinese health officials amid a crackdown on science. That effort kicked up a cloud of dust around the dates of early Covid cases, like those reported in the study.

“It was so hard to get any information out of China,” said one of the authors, Ira Longini, of the University of Florida, who described the back story of the removal publicly for the first time in a recent interview. “There was so much covered up, and so much hidden.”

That the Chinese government muzzled scientists, hindered international investigations and censored online discussion of the pandemic is well documented. But Beijing’s stranglehold on information goes far deeper than even many pandemic researchers are aware of. Its censorship campaign has targeted international journals and scientific databases, shaking the foundations of shared scientific knowledge, a New York Times investigation found.

Under pressure from their government, Chinese scientists have withheld data, withdrawn genetic sequences from public databases and altered crucial details in journal submissions. Western journal editors enabled those efforts by agreeing to those edits or withdrawing papers for murky reasons, a review by The Times of over a dozen retracted papers found.

Groups including the World Health Organization have given credence to muddled data and inaccurate timelines.

For the full story, see:

Mara Hvistendahl and Benjamin Mueller. “China Censors Are Thwarting Covid Science.” The New York Times (Monday, April 24, 2023): A1 & A9.

(Note: the online version of the story has the date April 23, 2023, and has the title “Chinese Censorship Is Quietly Rewriting the Covid-19 Story.”)

Critique of Fed Claim That a Year of Above Average Temps Increases Odds of a Recession

(p. A17) . . . recently I published a critique of a study from the Federal Reserve Board claiming that a year of above-normal temperatures in countries around the world makes economic contraction more likely.

. . .

There are two main reasons why the Fed study appeared at first to show a statistically significant effect of temperatures on economic growth. First, each country in the sample had equal weight in the analysis. China had the same weight as St. Vincent though China’s population is 13,000 times as large. Equal weighting means that some small countries with unusual histories of economic growth greatly influenced the results.

The paper’s results disappeared when countries like Rwanda and Equatorial Guinea—which had economic catastrophes and bonanzas unrelated to climate change—were omitted. Omitting similar countries representing less than 1% of world gross domestic product was enough to eliminate the paper’s result. The complicated statistical techniques used in the Fed study magnified the influence of these unusual countries.

There’s a second reason why the Fed study appears to find that temperature affects growth: Many poor countries have warm climates. A warm climate doesn’t preclude economic growth, as is demonstrated by Florida, Arizona, Taiwan, Singapore and several Persian Gulf states. But the average poor country is warmer than the average rich country. Debate continues as to whether this correlation is random or causal, but the hypothesis of the Fed paper is that year-to-year increases in temperature reduce annual economic growth. The paper claims that its method controls for long-term differences in climate, but using simulated data I found that the Fed paper’s method can be fooled into finding an effect that doesn’t exist.

For the full commentary, see:

David Barker. “The Fed’s Climate Studies Are Full of Hot Air.” The Wall Street Journal (Monday, April 10, 2023): A17.

(Note: ellipses added.)

(Note: the online version of the commentary has the date April 9, 2023, and has the same title as the print version.)

Barker’s critique mentioned above is:

Barker, David. “Temperature and Economic Growth: Comment on Kiley.” Econ Journal Watch 20, no. 1 (March 2023): 69–84.

Mainstream Media Suppresses Scientific Debate on Cochrane Meta-Analysis of Mask Efficacy

(p. A11) On Jan. 30, [2023] the Cochrane Collaboration, highly regarded for its rigorous systematic reviews, published an update of its meta-analysis of masking and other physical methods to prevent respiratory illnesses. It found no strong evidence for masking, and the initial media response was silence. After conservative media covered the study, the mainstream press went on the attack. The Washington Post, the New York Times, the Atlantic and others piled on.

As an epidemiologist, I hoped the review might dent the politicized discourse surrounding masks and other prevention measures. I sent an article to Time magazine, which had recently published my work.

. . .

Eventually the editor . . . asked for some further changes, which I readily accepted. “I think we’re set,” he wrote. “My colleague will finalize and publish.” I heard nothing from him until two weeks later, when he finally confirmed Time had decided to kill the piece.

. . .

“Follow the science,” they said throughout the pandemic. You can’t do that if you suppress scientific debate.

For the full commentary, see:

Daniel Halperin. “Media Keep Stifling the Covid Debate.” The Wall Street Journal (Saturday, April 1, 2023): A11.

(Note: ellipses, and bracketed year, added.)

(Note: the online version of the commentary has the date March 31, 2023, and has the same title as the print version.)

The Cochrane meta-analysis mentioned above is:

Jefferson, T., L. Dooley, E. Ferroni, L. A. Al-Ansary, M. L. van Driel, G. A. Bawazeer, M. A. Jones, T. C. Hoffmann, J. Clark, E. M. Beller, and et al. “Physical Interventions to Interrupt or Reduce the Spread of Respiratory Viruses.” Cochrane Database of Systematic Reviews (Jan. 30 2023).

“The Reliability of Science Is Based” on Free Speech

Theoretical physicist Carlo Rovelli’s argument should be pondered by global warming and Covid scientists who want to censor and cancel those with whom they disagree. They should also read John Stuart Mill’s On Liberty.

(p. C5) Science is a process that builds upon existing theories and knowledge by continuously revising them. Every aspect of scientific knowledge can be questioned, including the general rules of thinking that appear to be most certain.

. . .

Consider a folk healer’s herbal medicine. Can we say this treatment is “scientific”? Yes, if it is proven to be effective, even if we have no idea why it works. In fact, several common medications used today have their origin in folk treatments, and we are still not sure how they work. This does not imply that folk treatments are generally effective. To the contrary, most of them are not. What distinguishes scientific medicine from nonscientific medicine is the readiness to seriously test a treatment and to be ready to change our minds if something is shown not to work.

Exaggerating a bit, one could say that the core of modern medicine is not much more than the accurate testing of treatments. A homeopathic doctor is not interested in rigorously testing his remedies: He continues to administer the same remedy even if a statistical analysis shows that the remedy is ineffective. He prefers to stick to his theory. A research doctor in a modern hospital, on the contrary, must be ready to change his theory if a more effective way of understanding illness, or treating it, becomes available.

. . .

What makes modern science uniquely powerful is its refusal to believe that it already possesses ultimate truth. The reliability of science is based not on certainty but on a radical lack of certainty. As John Stuart Mill wrote in “On Liberty” in 1859, “The beliefs which we have most warrant for, have no safeguard to rest on, but a standing invitation to the whole world to prove them unfounded.”

. . .

There is no secure method for avoiding error. Our point of departure is always just the ramshackle, error-filled totality of what we think we know. But uncertainty does not make knowledge worthless. If our theory is contradicted by experiment, this remains a real fact, solid as rock, even if we don’t yet know with clarity where our mistake lies. The fact that the assumptions in our reasoning can be mistaken doesn’t change the fact that scientific reasoning is our best cognitive tool.

For the full essay, see:

Carlo Rovelli. “The Best Reason to Trust Science.” The Wall Street Journal (Saturday, March 11, 2023): C5.

(Note: ellipses added.)

(Note: the online version of the essay has the date March 9, 2023, and has the same title as the print version.)

Rovelli’s essay quoted above is based on his book:

Rovelli, Carlo. Anaximander and the Birth of Science. New York: Riverhead Books, 2023 (2011).

Mill’s wonderful defense of freedom, mentioned above, is:

Mill, John Stuart. On Liberty and Other Essays, Oxford World’s Classics. New York: Oxford University Press, USA, 2008 (1859).

Cochrane Study Finds No Benefits of Mandatory Masking

During the pandemic, I wrote an op-ed piece advocating the voluntary (not mandatory) use of masks. I still believe that, based on the mechanics of disease spread, and the mechanics of physically blocking virus particles, that masks can have a modest effect in reducing the viral load we spread to others. I also still believe in free speech and believe that it was wrong to censor those who were skeptical of masks.

(p. A19) The most rigorous and comprehensive analysis of scientific studies conducted on the efficacy of masks for reducing the spread of respiratory illnesses — including Covid-19 — was published late last month. Its conclusions, said Tom Jefferson, the Oxford epidemiologist who is its lead author, were unambiguous.

“There is just no evidence that they” — masks — “make any difference,” he told the journalist Maryanne Demasi. “Full stop.”

But, wait, hold on. What about N-95 masks, as opposed to lower-quality surgical or cloth masks?

“Makes no difference — none of it,” said Jefferson.

What about the studies that initially persuaded policymakers to impose mask mandates?

“They were convinced by nonrandomized studies, flawed observational studies.”

. . .

These observations don’t come from just anywhere. Jefferson and 11 colleagues conducted the study for Cochrane, a British nonprofit that is widely considered the gold standard for its reviews of health care data. The conclusions were based on 78 randomized controlled trials, six of them during the Covid pandemic, with a total of 610,872 participants in multiple countries. And they track what has been widely observed in the United States: States with mask mandates fared no better against Covid than those without.

No study — or study of studies — is ever perfect. Science is never absolutely settled. What’s more, the analysis does not prove that proper masks, properly worn, had no benefit at an individual level. People may have good personal reasons to wear masks, and they may have the discipline to wear them consistently. Their choices are their own.

. . .

The C.D.C.’s increasingly mindless adherence to its masking guidance is none of those things. It isn’t merely undermining the trust it requires to operate as an effective public institution. It is turning itself into an unwitting accomplice to the genuine enemies of reason and science — conspiracy theorists and quack-cure peddlers — by so badly representing the values and practices that science is supposed to exemplify.

It also betrays the technocratic mind-set that has the unpleasant habit of assuming that nothing is ever wrong with the bureaucracy’s well-laid plans — provided nobody gets in its way, nobody has a dissenting point of view, everyone does exactly what it asks, and for as long as officialdom demands. This is the mentality that once believed that China provided a highly successful model for pandemic response.

For the full commentary, see:

Bret Stephens. “‘Do Something’ Is Not Science.” The New York Times (Wednesday, February 22, 2023): A19.

(Note: ellipses added.)

(Note: the online version of the commentary has the date Feb. 21, 2023, and has the title “The Mask Mandates Did Nothing. Will Any Lessons Be Learned?”)

Heat Deaths Rise Mostly Due to Rise in Fragile Aging Population

(p. A17) One recent and much-cited Lancet report appears deliberately deceptive.

The study offers a frightening statistic: Rapidly rising temperatures have increased annual global heat deaths among older people by 68% in less than two decades. That stark figure has been cited all over, from the BBC and Time to the Washington Post and the Times of India, the world’s largest-selling English-language daily.

. . .

Annual heat deaths have increased significantly among people 65 and older world-wide. The average deaths per year increased 68% from the early 2000s to the late 2010s. But that is almost entirely because there are so many more older people today than there were 20 years ago, in no small part thanks to medical innovations that keep us alive longer. Measured across the same time span the Lancet maps heat deaths, the number of people 65 and older has risen by 60%, or almost as much as heat deaths. When the increase in heat mortality is adjusted for this population growth, the actual rise that can be attributed to rising temperatures is only 5%.

It is hard not to see the Lancet study’s failure to adjust this figure as a deliberate act of deception.

For the full commentary, see:

Bjorn Lomborg. “The Lancet’s ‘Heat Death’ Deception.” The Wall Street Journal (Saturday, November 5, 2022): A17.

(Note: ellipsis added.)

(Note: the online version of the commentary has the date November 4, 2022, and has the title “Climate Change and the Lancet’s ‘Heat Death’ Deception.”)

Dogs Can Accurately Know by Smell When a Human Is Stressed

(p. C4) Dogs are champion sniffers, equipped with 100 to 300 million olfactory receptors in their noses—compared with a mere 6 million in our own—and an olfactory cortex 40 times as large as ours. They can be trained to detect disease in human beings, including cancer cells, a latent epileptic seizure, or a Covid infection, just by sniffing—no blood samples, biopsies, MRIs, antigen or PCR tests required.

. . .

In a study published in September in the journal PLoS One, Ms. Wilson and colleagues tested whether dogs can read and respond to our emotional states, without the benefit of facial expression, tone of voice, or social context. The researchers trained four dogs to detect and react to the smell of human stress, depending on their sense of smell alone to distinguish between a person’s baseline scent and the unique cocktail of volatile organic compounds (VOCs) in their sweat and breath when they’re feeling stressed out.

. . .

The results offered overwhelming confirmation that dogs can smell psychological states as well as physical ones. On average, the four dogs picked out the stress sample 94% of the time, with individual dogs ranging between 90% and 97% accuracy. “There’s a smell to stress,” Ms. Wilson concludes. “If we can add it to the dog’s repertoire, we can use it to identify anxiety and panic attacks before they occur.”

For the full commentary, see:

Susan Pinker. “MIND AND MATTER; Dogs Can Sniff Out When a Human Is Stressed.” The Wall Street Journal (Saturday, Oct. 22, 2022): C4.

(Note: ellipses added.)

(Note: the online version of the commentary has the date October 20, 2022, and has the title “MIND AND MATTER; Dogs Can Sniff Out Human Stress.”)

To End Inflation, Fed Should Commit “To Good Policy Rules,” and Not Stray to Increase Jobs

(p. A9) Growing up in Glens Falls, N.Y., Edward C. Prescott got an insider’s view of business from chats with his father, an engineer and later comptroller for a global supplier of pigments. Those insights made the economics courses he took in college seem less theoretical and more relevant than they might have seemed to other students.

. . .

With Dr. Kydland, he published an influential 1977 paper called “Rules Rather Than Discretion: The Inconsistency of Optimal Plans,” concluding that policy makers could err by straying from long-term goals to address short-run problems. For instance, central bankers might be tempted to ease up on their commitments to contain inflation in the short run as a way to boost employment. If so, the professors argued, people might start assuming that prices were out of control, creating a psychology that led to faster inflation for long periods.

Sticking to a sound policy was far more effective than jolting the economy with frequent adjustments, they argued. “You should not think in terms of controlling the economy,” Dr. Prescott said. “That leads to bad outcomes. You should think in terms of committing to good policy rules.”

. . .

Though revered by many of his students and colleagues, Dr. Prescott sometimes baffled them. The problem, he once explained, was that he thought much faster than he could talk. He sometimes jumped from one topic to another with no transition.

“His brain did not work like other people’s,” said Timothy Kehoe, an economics professor at the University of Minnesota who worked with Dr. Prescott for four decades, “and in some ways that was a tremendous advantage.”

For the full obituary, see:

James R. Hagerty. “Economist’s Policy Advice: Stick to Long-Term Plan.” The Wall Street Journal (Saturday, November 12, 2022): A9.

(Note: ellipses added.)

(Note: the online version of the obituary was updated Nov. 8, 2022, and has the title “Nobel-Winning Economist Edward C. Prescott Dies at 81.”)

Geophysical Science Is Not Settled

(p. D2) Last year, one of the most dangerous volcanoes in Africa erupted without warning.

. . .

Now, in a new study published this Wednesday [Aug. 31, 2022] in Nature, Delphine Smittarello, a geophysicist at the European Center for Geodynamics and Seismology in Walferdange, Luxembourg, and her colleagues articulated how the eruption managed to ambush everyone.

. . .

This sort of unannounced eruption offers scientists a harsh lesson: For every paradigm-shifting secret they extract from their mountainous subjects, “there are always things that we don’t understand,” said Emily Montgomery-Brown, a geophysicist at the U.S. Geological Survey’s Cascades Volcano Observatory who was not involved in the study. “It’s a good reminder not to get cocky.”

. . .

. . . it’s possible that we will never become perfect prophets of our volcanic futures. “There may be things we will never be able to forecast,” Dr. Montgomery-Brown said.

For the full story, see:

Robin George Andrews. “An Eruption That Forecasters Couldn’t Foresee.” The New York Times (Tuesday, September 6, 2022): D2.

(Note: ellipses, and bracketed date, added.)

(Note: the online version has the date Sept. 2, 2022, and has the title “A Volcano Erupted Without Warning. Now, Scientists Know Why.”)

The article in Nature mentioned above is:

Smittarello, D., B. Smets, J. Barrière, C. Michellier, A. Oth, T. Shreve, R. Grandin, N. Theys, H. Brenot, V. Cayol, P. Allard, C. Caudron, O. Chevrel, F. Darchambeau, P. de Buyl, L. Delhaye, D. Derauw, G. Ganci, H. Geirsson, E. Kamate Kaleghetso, J. Kambale Makundi, I. Kambale Nguomoja, C. Kasereka Mahinda, M. Kervyn, C. Kimanuka Ruriho, H. Le Mével, S. Molendijk, O. Namur, S. Poppe, M. Schmid, J. Subira, C. Wauthier, M. Yalire, N. d’Oreye, F. Kervyn, and A. Syavulisembo Muhindo. “Precursor-Free Eruption Triggered by Edifice Rupture at Nyiragongo Volcano.” Nature 609, no. 7925 (Sept. 1, 2022): 83-88.

(Note: the Sept. 1 issue of Nature was “published” on Aug. 31.)

Shy and “Docile” Raccoons May Be “More Likely to Learn”

(p. D3) Despite their reputation, little is known about why raccoons are so good at urban living.

Over the past few years, researchers have taken to the streets of Laramie, Wyo., to uncover the raccoons’ secrets, adapting a cognitive test designed for captive animals so that it can be deployed in the wild.

Preliminary findings suggest that the most docile animals learned to use the testing devices more easily than bolder, more aggressive ones did, a result that has implications for our relationship with urban wildlife. The study was published on Thursday [Sept. 22, 2022] in the Journal of Experimental Biology.

. . .

Dr. Stanton’s team . . . wanted to know if certain characteristics made a raccoon more likely to excel on the test. They noted each animal’s behavior throughout the trapping and tagging process and found that individual raccoons reacted differently to the stress of being captured: Some were aggressive, hissing at the researchers, whereas others were quiet in their traps.

The scientists had expected that bolder raccoons would be more likely to interact with the testing devices. “But this isn’t what we found,” Dr. Stanton said.

Instead, the docile raccoons were more likely to learn how the devices work. The surprising discovery has implications for how cities deal with raccoons.

Urban wildlife management tends to focus on aggressive animals that may be confronting people and their pets, noted Sarah Benson-Amram, a behavioral ecologist at the University of British Columbia and a co-author of the study. By neglecting the docile animals, we may be increasing the proportion of problem-solving raccoons living in cities.

“Maybe they’re the ones who are learning how to open up the chicken coops and steal your chickens or break into your attic,” Dr. Benson-Amram said.

The results of the study add to a growing body of research suggesting animals that aren’t as aggressive or stressed by the presence of people may also have cognitive skills that help them thrive in urban areas.

“This is perhaps the first step towards domestication,” said Benjamin Geffroy, a biologist at the University of Montpellier in France. “Now we need to know more about what comes first, docility or cognitive abilities.”

. . .

Working with captive raccoons has convinced Dr. Benson-Amram that they actually enjoy cognitive challenges. “We give them problems, and even when there’s no reward, they just keep going for it,” she said.

Raccoons in urban environments can also be remarkably persistent, said Suzanne MacDonald, an animal behavior scientist at York University in Toronto. For one study, she put an open can of cat food in a trash bin, secured the lid with a bungee cord and deployed it in backyards to see how raccoons would react.

“I had one female spend like eight hours trying to get in,” Dr. MacDonald said. “And she did.”