Tony Hatfield's Retired Ramblings

Another example of HMG refusing to follow the evidence

Prof David Colquhoun's written memo to  the Science and Technology committee. HMG ignored evidence & let the NHS go for the snake oil.

Thought for the Day- 15th November 2009

"For decades, pharmaceutical heroine was prescribed by doctors to patients who had become addicted after operations, particularly soldiers who had undergone battlefield surgery.They spent years on a legal supply: it did them no damage, and they led healthy, fruitful lives. Enid Bagnold, for example,who wrote National Velvet, was prescribed it after a hip operation and spent twelve years injecting up to 350 mg a day. Enid- as far as history records-never mugged a single person or sold her body on the streets, but died quietly in bed at the age of ninety-one. Until the American prohibitionists closed him down in the 1920s, Dr Willis Butler, ran a famous clinic in Shreveport, Louisiana, for some of these 'therapeutic addicts'. Amongst his patients, he included four doctors, two church ministers, two retired judges, an attorney, an architect, a newspaper editor, a musician from a symphony orchestra, a printer, two glass blowers and the mother of the commissioner of police. None of them showed any ill effect from the years they spent on Dr Butler's prescriptions. And, as Dr Butler later  recalled, ' I never found one which we could give an overdose to, even if we had  wanted to. I saw a man take twelve grains intravenously at one time. He stood up and said, " There, that's just fine", and went on about his business.' "

Nick Davies-Flat Earth News 2008   

Bacon and Sausages off the Today Menu?

This morning, Today Programme allowed the World Cancer Research Fund (WCRF) to peddle the link between processed meat, sausages, bacon, salami and ham, and colorectal cancer. You can listen to the interview here.

The link was made in the 2007 report of the World Cancer Research Fund and American Institute for Cancer Research, with the title ‘Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective‘. It is a 537 page report with over 4,400 references. Its panel was chaired by Professor Sir Michael Marmot, UCL’s professor of Epidemiology and Public Health.

Over a year ago, the Daily Telegraph reported   it with this  a scary headline " sausage a day can increase bowel cancer risk"

This morning, Lisa Cooney, the head of education at the WCRF, asserted " there is convincing  scientific evidence linking the consumption of processed meat with an increased risk of bowel cancer". The hapless Evan Davis accepted this assertion and moved on.

There is a brilliant piece on precisely this topic on  Professor David Colquhoun's blog, DC's Improbable Science

Ok, there's a lot of statistics in there, but my O level maths didn't let me down.

Colquhoun's piece starts with this challenge to the WCRF report.

..... there has never been a randomised trial to test the carcinogenicity of bacon, so it seems reasonable to ask how strong is the evidence that you shouldn’t eat it?  It turns out to be surprisingly flimsy.

He then asks the relevant question. Is there a causal link between the consumption of processed meat and colorectal cancer? If there is no such link, then why are the WCRF telling us not to eat bacon and sausages? 

In the case of sausages and bacon, suppose that there is a correlation between eating them and developing colorectal cancer. How do we know that it was eating the bacon that caused the cancer – that the relationship is causal?  The answer is that there is no way to be sure if we have simply observed the association.  It could always be that the sort of people who eat bacon are also the sort of people who get colorectal cancer.  But the question of causality is absolutely crucial, because if it is not causal, then stopping eating bacon won’t reduce your risk of cancer.  The recommendation to avoid all processed meat in the WCRF report (2007) is sensible only if the relationship is causal. Barker Bausell said

[Page39] “But why should non scientists care one iota about something as esoteric as causal inference? I believe that the answer to this question is because the making of causal inferences is part of our job description as Homo Sapiens.”

That should be the mantra of every health journalist, and every newspaper reader.

Colquhoun then goes on to examine in detail the studies relied on by the WCRF paper and concludes.

After all this, we can return to the original question. Do sausages or bacon give you colorectal cancer? The answer, sadly, is that nobody really knows. I do know that, on the basis of the evidence, it seems to me to be an exaggeration to assert that “The evidence is convincing that processed meat is a cause of bowel cancer”.

and finally

Sometimes I think we should say “I don’t know” rather more often.

Hear, hear to that.

Universal healthcare is terrorist recruitment tool

hat tip Bad Science

Ben Goldacre,Jeni Barnett, MMR and LBC's Heavy Legal Hand..!

Today, the Health Protection Agency  announced a staggering 36% annual increase in the confirmed cases of measles.  Since 1998, when the original, and now entirely discredited, work by Andrew Wakefield and his colleagues linked the triple MMR jab with autism and bowel disease, parents have failed to immunise their kids against these terrible diseases. 

However, in reporting the "scare", the media deserves  more,  even more, odure chucked on them than Wakefield. 

Clowns like "Mad" Melanie Phillips wrote drivel in the Daily Mail- I'm surprised that the article is still on her blog. Its nonsense clearly appeals to a Mr Rob Stavely of Essex who, on the Today Programme, (Ron's remarks can be heard in the first couple of minutes) trotted out all the rubbish from "Mad" Mel and some of his own for good measure. 

I'd thought the media's appetite for MMR nonsense had evaporated. Naaaa. Ben Goldacre's Bad Science blog posted an MP3 version of Jeni Barnett's recent rant on her LBC programme. He posted a link to an edited version, where it could be heard in all it's dangerous nonsense.

As Ben comments 

It is my view that in this extended broadcast Jeni exemplifies every single canard ever uttered by the antivaccination movement. “It’s a conspiracy by the pharmaceutical industry.” “Science always changes so you can believe what you like.” “It’s a debate and a controversy.” “Measles was never that bad anyway.” “Immune systems are damaged by being understimulated.” “Immune systems are damaged by being overstimulated.” And so on.

But worse was to come. 

Within hours, LBC's lawyers had written to Ben, inviting him to take down the excerpt from Barnett's programme as "a clear infringement of their copyright. 

I wonder when these lawyers will eventually realise that this kind of threat is completely counterproductive. The audio has now appeared on Wikileaks.  And I've no doubt links will appear elsewhere.

Of course, I'm not responsible for the content of any external websites! 

The power of prayer...let the children die.

Madeline Kara Neumann

Hundreds of thousands of Christian worshippers will be trooping into their churches this Sunday. Without exception they will acknowledge the  existence of an invisible deity. A deity with absolute power over the world as we know it. A network of priests, bishops, archbishops, deacons, will be on hand to help the believers. No doubt they will emphasise the power of prayer to heal the sick, and that  the "desire of the righteous to will be granted".

As this claptrap pours forth  from thousands of pulpits, the worshippers  should think of the an 11 year old girl, Madeline Kara Neumann. Madeline died an horrific death....not much less painful that Christians used to inflict on non believers centuries ago. She was suffering from Diabetic ketoacidosis.   The terminal symptoms include vomiting, severe abdominal pain, extreme weakness and air hunger. It is a condition that is relatively easy to treat.  Madeline's parents, Dale and Leilani, held a blind belief that prayer would cure their child.
"We stayed fast in prayer.... We believed that she would recover. We saw signs that to us, it looked like she was recovering"...and of course she died.
Four cheers for James Randi here

We can easily say that Dale and Leilani Neumann were simply stupid. Perhaps so, but more importantly, they – and we – have been swindled by the priests, and society continues not only to tolerate them, but to support them by granting them exemptions from the regulations and ignoring their folly and arrogance.

An astonishingly, Madeline was not the only child to be allowed to die by god fearin' folk in the US.

A few days earlier 15 month old Ava Worthington died after her parents, with the same  nonsensical belief in the power of prayer as the  Neumanns,  refused to administer a simple regime of antibiotics to their child. Ava was suffering from bronchial pneumonia.
Her parents have now been charged with manslaughter.

But the Wisconsin statute applicable  to the Neumanns is interesting.

Wisconsin state statute 948.03(6),  provides against failing to act to protect children from bodily harm. It contains an exemption for what it refers to as " Treatment through prayer." To wit: "A person is not guilty of an offense under this section solely because he or she provides a child with treatment by spiritual means through prayer alone for healing in accordance with the religious method of healing … in lieu of medical or surgical treatment."

It's difficult to see  either a moral or ethical argument to support this  parental behaviour.  But surely the Wisconsin statute belongs to another age.......!

The Rambler and "Thought for the Day"

I normally grumble when the Today Programme interrupts its current affairs with "Thought for the Day". But I listened to  Rev. Dr. Allan Billings' contribution on 31st March with increasing interest.
He adopts the same position as I do. In a short paragraph below,  he demolished the idea that Cardinal O'Brien and  other members of the Catholic Church  were peddling over Easter . They   cannot discriminate between the few cells of an embryo and a mature human life.

"The objection to creating embryos is on the grounds that an embryo is a human life and should be accorded the same rights as mature human life. I find this unconvincing. To treat a microscopic bundle of cells as if it were a mature human being seems to me to be a failure in discrimination. An acorn may be a potential oak tree, but there is a difference between the two."

This is an important issue. But it seems that the debate is being conducted with little or no knowledge of what actually is being proposed- what those scientists at Newcastle University are up to.
The best starting point is the Human Fertilisation and Embryology Authority's (HFEA) booklet " Hybrids and Chimeras available from their website here (in pdf 880kb).

Whatever your view, the idea that human/animal embryos  will create  "Frankenstein"or some other kind  of   monster is just  plain nonsense. Within  eight pages  of the HFEA's booklet  the science is described in fairly straightforward language. As a non-scientist, I even ended up with a basic understanding of the difference between mitochondrial and nuclear DNA!

Cameron falls straight into the Mail's abortion trap!

Today I read in the Daily Mail...no folks I don't buy the rag....an interview with David Cameron.
The Mail's headline is " Cameron: Cut the abortion limit to 21 weeks" The reason he gives for supporting this is:

"I would like to see a reduction in the current limit, as it is clear that, due to medical advancement, many babies are surviving at 24 weeks."

And the Mail with it's usual selective use of statistics on the issue of abortion continues by asserting

"Research at one of Britain's top neonatal units revealed the survival rate of babies born very prematurely has doubled in the past 20 years."

I suspect the research, both Cameron and the Mail are quoting, is from  John Wyatt.  He is the  Professor of Neonatal Paediatrics at University College, London, and a member  of the Christian Medical Fellowship (CMF).
He gave evidence before the House of Commons Committee on Science and Technology last Autumn. Professor Wyatt failed to tell the Committee that he was a member of the CMF with an established position,  on abortion, similar to that of  the Daily Mail,.
Wyatt's research does  indeed show that  survival in births below the present limit if 24 weeks has doubled. But when you examine the data from the Epicure study, the picture is very different indeed. That study shows an increase in survival at 24 weeks but virtually none with births between 22 and 23 weeks. The idea punted by Cameron.
The next statistical analysis has been done brilliantly by Bad Science's Dr. Ben Goldacre. You can read his piece in full  here.  What Wyatt does is play around with figures.

Over to Dr. Ben.

For the next bit, you need to understand one simple piece of primary school maths, which is central to medical statistics. In the sum 3/20, 3 is the numerator and 20 is the denominator: 15% survive; 3 out of 20. For Epicure, the numerator is survival to discharge from hospital, and the denominator is all births where there is a sign of life, carefully defined: 3 out of 20.

I suspect you can see where this is going?

Back to Goldacre.

There are two ways you could get a higher survival percentage. One would be a genuine increase in the number of babies surviving, an increase in the numerator: 8 out of 20 live births survive, 40%. But you could also see an increase in the survival percentage by changing the denominator. Let's say, instead of counting as your denominator "all births where there is a sign of life in the delivery room" you counted "all babies admitted to neonatal intensive care". Now that's a different kettle of fish altogether. To be admitted to neonatal ICU, the doctors have to think you've got a chance. Often you have to be transferred from another hospital, in an ambulance, and for that you really do have to be more well. Therefore, if your denominator is "neonatal ICU admissions", your survival rates will be higher, but you are not comparing like with like. That may partly explain Prof Wyatt's figure for a very high survival rate in 23-week babies. But it's not clear.

He now examines the evidence Wyatt gave to the  House of Commons Committee.

First in his written evidence he said that the data was from a "prospectively defined" study (where they say in advance what they plan to collect). Then he was asked in the committee, when giving his oral evidence: "What was the denominator for that? Was that ... 42% survival at 23 weeks of all babies showing signs of life in the delivery room, or was it a proportion of those admitted to neonatal intensive care directly or by transfer?" Prof Wyatt replied: "The denominator was all babies born alive in the labour ward in the hospital at UCL [University College London]." This, as later became clear, turned out not to be true. Then he was asked to send the reference for the claim. He did so. It was merely an abstract for an academic conference presentation three years ago. It did not contain the figures he was quoting. He then says he has done the raw figures on a spreadsheet, especially for the committee, bespoke, if you will, and sent them in. They are entered into the record as a memo, on October 18. They show new, different, although broadly comparable figures: 50% survive at 22 weeks, then down to 46% at 23 weeks, then up to 82% at 24 weeks, then down again to 77% at 25 weeks. (That bouncing around is because the raw numbers are so small that there is a lot of random noise).

Are you still with this? When asked about the denominator

Prof Wyatt is clear: "I have provided the numbers and percentage of infants born alive at University College London Hospitals who survived to one year of age." The committee asked for clarification of this. Finally, October 23, another memo arrived, from Prof Wyatt, entered into the record, for all to see. For the widely quoted 42% survival rate at 23 weeks, Prof Wyatt admitted that the denominator was all babies admitted to the neonatal intensive care unit. But in his new special analysis, giving this new "46% survive at 23 weeks" figure, the figures in the previous paragraph, he claimed, the denominator was "all live births". Has he undone a prospectively designed study, and retrospectively re-designed it? Or is this now a completely different source of data to the original reference?

Like drawing teeth isn't it?

Goldacre's devastating conclusion follows

But science is about clarity and transparency, especially for public policy. You need to be very clear on things like: what do you define as a "live birth", how do you decide on what gestational age was, and so on. Even if this data stands up eventually, right now it is non-peer reviewed, non-published, utterly chaotic, personal communication of data, from 1996 to 2000, with no clear source, and with no information about how it was collected or analysed. That would be fine if it hadn't suddenly become central to the debate on abortion.

Cameron and his advisers have fallen headlong  into the Daily Mail's  statistical trap, Why on earth they didn't  listen to the  British Medical Association and the Royal College of Obstetricians and Gynaecologists who  have said they do not believe there is a case for changing the time limits for abortion.

Observer's MMR Piece vanishes from its Archive!!!!

The link to the Observer MMR piece will, I'm afraid, no longer take you to the Observer archive. Never fear folks, you can reach it on the Googlecache here

Dennis Campbell, The Observer and the Truth

Last week I blogged about the, now infamous, MMR  piece by Dennis Campbell in the Observer. Campbell's piece contained this.

"the MMR jab which babies receive at 12 to 15 months, might be partly to blame. Dr. Fiona Scott and Dr. Carol Stott both say it could be a factor in small numbers of children."

Dr Scott subsequently e-mailed Ben Goldacre. The e-mail contained the serious allegation that some of the stuff in the Observer piece had been "fabricated".
Sunday's Observer contained a pathetic/feeble  piece by Stephen Pritchard to justify the article. He mumbles on about anything, but fails to put to  Campbell-who's never mentioned by name-the serious allegation made in Scott's e-mail to Goldacre. Was the piece or any part of it fabricated?

An interesting comment appeared today on Prichard's defence. You can scroll down the list till you reach it at 11.31 a.m. today. But to save you from adding to your  RSI I've copied it below.

DrFJScott

July 16, 2007 11:31 AM

I feel, given that I was one of the two 'leaders in the field' (flattering, but rather an exaggeration) reported as linking MMR to the rise in autism, that I should quite clearly and firmly point out that I was never contacted by and had no communication whatsoever with the reporter who wrote the infamous Observer article. It is somewhat amazing that my 'private beliefs' can be presented without actually asking me what they are. What appeared in the article was a flagrant misrepresentation of my opinions - unsurprising given that they were published without my being spoken to.

It is outrageous that the article states that I link rising prevalence figures to use of the MMR. I have never held this opinion. I do not think the MMR jab 'might be partly to blame'. As for it being a factor in 'a small number of children', had the journalist checked with me it would have been clear that my view is in line with Vivienne Parry of the JCVI. The 'small number' was misrepresented by being linked inappropriately and inaccurately with 'rise in prevalence', leading readers to arguably infer that it is in fact NOT a small number!

I wholeheartedly agree with Prof Baron-Cohen, and many of the posts and responses received to date, that the article was irresponsible and misleading. Furthermore I reiterate that it was inappropriate in including views and comments attributed to me and presented as if I had input into the article when I had not (and still have not)ever been contacted by the journalist in question. I am taking the matter under advisement.

Assuming the Dr Fiona Scott is the Fiona Scott in question,  things can't be clearer. The Observer journalist failed to contact the person whose "private beliefs" he quoted. He has fabricated that part of the piece.

The Observer has now had seven days to correct this. Although I'm no conspiracy theorist I note with interest that Goldacre's "Bad Science" column is missing from its regular spot in Saturday's Guardian! I do hope he's spending time writing, what my old boss would describe as  "a blister", for his piece  next Saturday.