According to Ben Goldacre, the author of Bad Science: "The Telegraph reported that red wine prevents breast cancer - with the flimsiest of nutritionist-style evidence - just two months after writing that alcohol causes breast cancer (the latter is more correct)."
http://www.guardian.co.uk/commentisfree/2008/dec/27/bad-science-2008-media-roundup Thus we come full-circle back to the discussion of alcohol and cancer. Rick Dr. Rick Froman, Chair Division of Humanities and Social Sciences Box 3055 x7295 [email protected] http://tinyurl.com/DrFroman Proverbs 14:15 "A simple man believes anything, but a prudent man gives thought to his steps." -----Original Message----- From: Paul Brandon [mailto:[email protected]] Sent: Thursday, February 26, 2009 9:42 AM To: Teaching in the Psychological Sciences (TIPS) Subject: Re: [tips] BBC NEWS | Antidote Fortunately, the BBC has an antidote: see http://www.guardian.co.uk/science/series/badscience On Feb 26, 2009, at 7:53 AM, Gerald Peterson wrote: > I agree with Chris about the value of the Gigerenzer article. It > also inspired me to think of how we might help our graduating > students teach health professionals about assessing medical > research and communicating risk assessments more clearly to their > patients. I think psych students--even undergrads, often have a > good research and stats background that might be of use in the > areas of consulting and training of health professionals. I wonder > if others have students trying to establish such a career track? > Gary > > >>>> "Christopher D. Green" <[email protected]> 2/26/2009 8:41 am >>> > Yesterday in my "rant" about the BBC (and other media) coverage of the > recent correlational alcohol-cancer study (below), I mentioned Gerd > Gigerenzer's work on how commonly-used conventions about the reporting > of medical statistics misleads many people (including doctors) > about the > real risks involved. (Indeed, there is evidence that some > pharmaceutical > companies intentionally manipulate the format of statistics to > maximize > the appearance of benefit and minimize the appearance of risk.) > > For anyone interested, I have a pdf of Gigerenzer's latest and most > detailed publication in this vein: > "Helping Doctors and Patients Make Sense of Health Statistics" > (/Psychological Science in the Public Interest/, 2008). I've attached > the abstract of the article below. It is longish (44 pp.) but it is so > good that I have been thinking about basing an entire course around > it. > The widespread misunderstanding of cancer and AIDS rates (and the > tests > that are supposed to detect them) are used as examples throughout. > Although I normally teach the standard statistics course in my > department (t, r, F, etc.), a course based on this information > would be > of much greater benefit to much wider range of students. > > Because the file is 1.8Mb, I don't want to clog up the entire list > with > it, but I would be happy to forward a copy to anyone who asks me (off > list, please). > > Regards, > Chris > -- > > Christopher D. Green > Department of Psychology > York University > Toronto, ON M3J 1P3 > Canada > > > > 416-736-2100 ex. 66164 > [email protected] > http://www.yorku.ca/christo/ > > ========================== > > SUMMARY Many doctors, patients, journalists, and politicians alike do > not understand what health statistics mean or draw wrong conclusions > without noticing. Collective statistical illiteracy refers to the > widespread inability to understand the meaning of numbers. For > instance, > many citizens are unaware that higher survival rates with cancer > screening do not imply longer life, or that the statement that > mammography screening reduces the risk of dying from breast cancer by > 25% in fact means that 1 less woman out of 1,000 will die of the > disease. We provide evidence that statistical illiteracy (a) is common > to patients, journalists, and physicians; (b) is created by > nontransparent framing of information that is sometimes an > unintentional > result of lack of understanding but can also be a result of > intentional > efforts to manipulate or persuade people; and (c) can have serious > consequences for health. > > > The causes of statistical illiteracy should not be attributed to > cognitive biases alone, but to the emotional nature of the > doctor--patient relationship and conflicts of interest in the > healthcare > system. The classic doctor--patient relation is based on (the > physician's) paternalism and (the patient's) trust in authority, which > make statistical literacy seem unnecessary; so does the traditional > combination of determinism (physicians who seek causes, not > chances) and > the illusion of certainty (patients who seek certainty when there is > none). We show that information pamphlets, Web sites, leaflets > distributed to doctors by the pharmaceutical industry, and even > medical > journals often report evidence in nontransparent forms that suggest > big > benefits of featured interventions and small harms. Without > understanding the numbers involved, the public is susceptible to > political and commercial manipulation of their anxieties and hopes, > which undermines the goals of informed consent and shared decision > making. What can be done? We discuss the importance of teaching > statistical thinking and transparent representations in primary and > secondary education as well as in medical school. Yet this requires > familiarizing children early on with the concept of probability and > teaching statistical literacy as the art of solving real-world > problems > rather than applying formulas to toy problems about coins and dice. A > major precondition for statistical literacy is transparent risk > communication. We recommend using frequency statements instead of > single-event probabilities, absolute risks instead of relative risks, > mortality rates instead of survival rates, and natural frequencies > instead of conditional probabilities. Psychological research on > transparent visual and numerical forms of risk communication, as > well as > training of physicians in their use, is called for. > > > Statistical literacy is a necessary precondition for an educated > citizenship in a technological democracy. Understanding risks and > asking > critical questions can also shape the emotional climate in a > society so > that hopes and anxieties are no longer as easily manipulated from > outside and citizens can develop a better-informed and more relaxed > attitude toward their health. > > > -------- Original Message -------- > >>>> On 2/25/2009 at 11:57 AM, Christopher Green <[email protected]> >>>> wrote: > >> Amadio, Dean wrote: >>> How else is one to study this issue? Much of health research is >>> precisely >> the same, due to obvious ethical concerns, including the research >> on alcohol >> and heart disease. > >> Which is precisely why medical research is, in general, so lousy >> and its >> (often overheated) conclusions keep changing from study to study, >> resulting ultimately in lowered public respect for science at large. >> >> What one should do is draw conclusions that are appropriate to the >> evidence they are drawn from. If those conclusions are too bland >> to be >> interesting, that doesn't justify falsely strengthening them to make >> them more interesting. And that seems to be what has happened here. >> (Note that "causes" is feature[d] in the very first sentence of >> the article.) > >>> This is also old news (there are previous studies which find the >>> same >> relationship among women). I've been advising my students for >> several years, >> especially females, to consider the cancer studies whenever they >> hear the >> research that alcohol is heart healthy. > >> If those cancer studies are like this one, then I would recommend >> that >> they ignore them, for they can tell [the students] nothing about >> the effect on >> their health of drinking moderate amounts of alcohol. They only >> tell us >> that the global genetics and lifestyles of people who choose to >> abstain >> from alcohol altogether do not result in cancer quite as much as >> those >> of people who do not adhere to such a prohibition. >> >> Also, they use global percentages in their presentation of risk, >> which >> almost inevitably misleads people about the actual increase in >> risk of >> low base-rate conditions like cancer. (See, e.g., the recent >> writings of >> Gerd Gigerenzer). For instance, the article says that 5,000 of the >> 45,000 annual cases of breast cancer are due to alcohol -- an >> increase >> of 11% they say. The population of the UK is about 60 million. >> Half of >> the those are female -- 30 million. About 20% of those are >> children -- >> leaving 24 million. (see >> http://www.statistics.gov.uk/cci/nugget.asp?ID=6). 45,000 out of 24 >> million = .0019: 19 in ten thousand women are diagnosed with breast >> cancer in any given year. Even if the alcohol-cancer causal link >> were, >> in fact true, the number of cancer cases would drop to 40,000 which, >> against a vulnerable population of 24 million is .0017: 17 in ten >> thousand. Now ask yourself the question: Would you change you >> lifestyle >> dramatically to reduce a risk by 2 in 10,000? And that's if the >> causal >> link had been established, which it hasn't been. Paul Brandon Emeritus Professor of Psychology Minnesota State University, Mankato [email protected] --- To make changes to your subscription contact: Bill Southerly ([email protected]) --- To make changes to your subscription contact: Bill Southerly ([email protected])
