Does the New York Times Hate American Medicine?

While reading the New York Times’ massive investigation into whether CT Scanners are more medical scam than vital diagnostic tool, it was difficult not to give up after the following graph:

“Some medical experts say the American devotion to the newest, most expensive technology is an important reason that the United States spends much more on health care than other industrialized nations — more than $2.2 trillion in 2007, an estimated $7,500 a person, about twice the average in other countries — without providing better care.”

Who says this? More to the point, why is this comment even in the piece when it pushes a fact that is easily disproved?  Last year, the journal Lancet Oncology published a huge comparative study of cancer survival rates in European countries and contrasted them with United States. The results:

Colon and rectal cancer: 65.5 percent in the U.S. vs 56.2 percent in Europe.
Breast cancer: 90.1 percent in the U.S. vs 79 percent in Europe.
Prostate cancer: 99.3 percent in the U.S. vs 77.5 percent in Europe.

All cancers (age adjusted), Men: 66.3 percent in the U.S. vs 47.3 percent in Europe.
All cancers (age adjusted), women: 62.9 percent in the U.S. vs 55.8 percent for women.

No individual country surpassed the U.S. on any of these measures – and these percentage differences add up to lives saved. If that doesn’t amount to “better care,” what does?

The authors of the study say much of the difference reflects better “timeliness” of diagnosis in the U.S., particularly with regard to prostate cancer, resulting from more intensive screening. One of the authors, Professor Michel Coleman of the London School of Hygiene and Tropical Medicine, authors, also told the BBC that Britain’s poor showing was due to a lack of cancer specialists compared to other countries.

Another recent study from the Annals of Oncology shows a correlation between survival rates in the U.S. and access to newer (and more expensive) cancer drugs. Britain’s Telegraph cited one of the study’s authors, Dr. Nils Wilking, a clinical oncologist at the Karolinska Institute in Stockholm:

“Our report highlights that in many countries new drugs are not reaching patients quickly enough and that this is having an adverse impact on patient survival. Where you live can determine whether you receive the best available treatment or not.

To some extent this is determined by economic factors, but much of the variation between countries remains unexplained. In the US we have found that the survival of cancer patients is significantly related to the introduction of new oncology drugs.”

Now perhaps CT scanning is mostly a waste of time, with a high price tag to consumers and high dosage of radiation to boot; but it’s also the fact that a snapshot of medical technology does not reflect that major developments in health care are often evolutionary. Small benefits in technology and drugs pave the way for further small developments, and eventually, these all add up to significant changes in treatment. Initial risks can also be reduced along the way (think early x-rays), while new uses and applications can arrive through a pure inspiration.

But the case against CT scanners shouldn’t involve deploying false claims that they are part of a massive fraud being perpetrated on the public by American medicine.

Congress Gets Tough on Tough Love Industry

On Huffington Post, STATS Fellow Maia Szalavitz, author of the first book-lenght expose of the “tough love” industry, reports victory:

The House Wednesday overwhelming passed HR 6358 (formerly HR 5876) by a vote of 318-103, with provisions to ban degrading and humiliating treatment, set national standards, create a national hotline that must be accessible to teens in program to report maltreatment and $15 million in funding for enforcement and regulation.

Teen “boot camp” “tough love” “wilderness” and “emotional growth” boarding schools and programs currently hold some 20,000-100,000 teens. There have been hundreds of corroborated reports of emotional, physical or sexual abuse and dozens of deaths in the programs, which are currently under no federal regulation, despite being the equivalent of private jails for children.

Still, 103 voted against even as the Government Accounting Office detailed deaths and mistreatment far worse than Abu Ghraib. Onwards and upwards to the Senate.

The Carbon Cost of Bathing

Want to reduce your carbon footprint? Forget about switching off electrical appliances and try showering less and wearing more clothes around the house at the expense of cranking up the heat. These are among some of the obvious conclusions drawn by physicists, such as Professor David J C MacKay of Cambridge University in the U.K. For instance, forgoing one bath will save the same amount of energy as leaving your TV off standby for over six months.

Of course, the rejoinder is that every little bit adds up, but the question is just what needs to be added to what in order to kick the carbon addiction? This is where Professor MacKay’s Ph.D in computational physics comes in handy. Take the United Kingdom, which Greenpeace believes could meet its energy needs without resorting to nuclear or coal-driven power stations. But work the math and the country, as Lewis Page puts it,

would be literally covered with — and girdled by — massive wind farms, tidal barriers and wave barrages, and every sizeable body of water in the land would rise and fall to the strange new tides of the national grid. We would have literally rebuilt the British Isles as a single mighty renewable generator, pouring concrete and erecting steel on a scale so far matched only by human habitation — industrialising the land and sea in a way that would make intensive agribusiness look like a wildlife refuge. And still we’d be importing power.

Biofuel is not much of a solution either. As MacKay notes, to provide one-quarter of Britain’s current energy consumption, 75 percent of the nation’s land mass would need to be planted with biomass crops.

And in case you’re wondering, Professor MacKay is not a paid up member of the fossil-fuel industry, he’s just your average liberal academic who’s worried about global warming, believes we should reduce our reliance on fossil fuels and our overall energy consumption but – thanks to a Ph.D in computational physics from Cal Tech – also believes that to deal with these problems, “we need numbers not adjectives.”

To read more numbers, check out the online version of Professor MacKay’s book, Sustainable Energy – Without the Hot Air. (Hat tip to The Register, via Arts and Letters Daily.)

Greenpeace Urges Americans to Lie to Congress

Greenpeace’s “Action Center” provides concerned citizens with an opportunity to lobby congress to ban phthalates in children’s toys.  The reason is that the environmental advocacy organization wants “to make sure children grow up in a safe environment and one of the easiest (and most obvious) places to start is with safe toys.”

Of course, one of the things most normal parents tell their kids to do is not to tell lies, because not telling the truth is generally considered to be wrong. Greenpeace, on the other hand, has no problems telling people to sign on to a form letter that includes the following text and then mail it to their congressional representative:

“Unfortunately phthalates have been linked to a number of serious health problems including birth defects, early puberty and testicular cancer. They have no place in our children’s toys, especially since safe alternatives exist.”

The reality, as STATS has been pointing out for the past three years, is that no study has shown that phthalates in toys have been linked to birth defects, early puberty or testicular cancer in  children or humans. This is a wild distortion of the scientific research, and this is one of the reasons William Knowles, a recipient of the 2001 Nobel Prize in Chemistry recently declared that environmental groups were misleading the public on the risk. Moreover, even if phthalates proved to be as dangerous as Greenpeace claim, children are not exposed to phthalates in toys in any meaningful way. Rather, as the National Institutes of Health has pointed out, children’s exposure to phthalates is overwhelmingly from food and dust. Banning the chemical from toys will not alter this exposure.

When Scientists Corrupt Science

According to a survey conducted by the Gallup Organization, a substantial amount of misconduct in government-funded scientific research is going unreported. The survey has been submitted for journal publication, and is not yet available online, but Bloomberg reports:

The data was based on surveys of 2,212 scientists holding research funding from the National Institutes of Health, asking if they believed they had observed fraud in 2002-2005. The scientists surveyed in the report said they observed 201 instances of “likely misconduct” over a three-year period, or about three cases per 100 people per year.

Again, this behooves reporters to respect the weight of evidence when it comes to reporting new research claims which appear novel or shocking.

Washington Post Consumer Blog Covers Great Shower Curtain Scare of 2008

In an unusual inversion of the conventional wisdom that newspaper reports are supposedly more accurate or comprehensive or researched than blogs, The Checkout – the Washington Post’s consumer affairs blog – manages to do what news reports couldn’t do  in the great shower curtain scare of 2008: read the study.

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ABC News reports on the “chilling” future awaiting a world where nothing is done to combat global warming.

The Los Angeles Times, Perez Hilton, Fishing Monkeys, Toxic Shower Curtains, and the Future of Journalism

At the risk of lèse-majesté, I would like to offer a couple of suggestions to Sam Zell and other Tribune executives to ponder as they struggle to measure the productivity of their reporters and streamline their newspaper empire: first, forget about the recent news that monkeys can fish. I know, it’s a tempting solution to the bloated newsroom – and it would end that old saw about typewriters and the complete works of Shakespeare – but even as our common ancestry reveals all manner of new intelligences, it is highly unlikely that researchers are on the cusp of discovering that macaques, baboons, chimpanzees or even orangutans can either type or copyedit, or write headlines and lay out pages.

And though the average monkey could probably do a reasonable impression of talking on the phone, copying isn’t always the same as doing. One doubts the average monkey’s ability to interrogate the average bureaucrat, politician or, indeed, executive – although all evince the capacity to babble in a manner which could, uncharitably, be described as simian.

From this follows the equally dispiriting news that “copying press releases” isn’t “journalism.” Think about it this way: if you see a dog chasing a ball, it would be a mistake to describe the dog as “playing soccer,” and then hire it to play alongside David Beckham. A dog, no matter how clever, is just not going to grasp the offside trap. Or even the concept of passing the ball. And it’s the same with writing up press releases: it may look like journalism, but it’s not. (A shame, as copying press releases would be an easy way for reporters to hit that 300 – 3000? – page copy productivity mark).

The thing about press releases is that they are not always accurate. Take, as a convenient case in point, today’s LA Times story warning people about the toxic fumes given off by shower curtains. Scary, huh? But it’s based on a study by an activist group, and if you *read the study,* you’ll find, albeit towards the end of the 44-page document, that the group admits its emission tests couldn’t find the chemicals (phthalates), which are touted by the LAT as especially risky, migrating from the curtains. And if they don’t come out, how can they be a risk? It’s a bit like saying “if you drink gasoline, you’ll get sick; therefore (read all about it!) cars are toxic.”

Given that William Knowles, who received the Nobel Prize in 2001 for work crucial to developing green chemistry, recently denounced this kind of activist science on phthalatees, don’t you think you should reward journalists for doing more than transcription? I mean, if that’s all you want journalism to be, write a program to trawl Ascribe or the PR news wires, and hire a few reporters from Britain’s tabloid press to come up with catchy, provocative headlines and scandalous spin. Alternatively, think about the value of journalists *not* writing inaccurate stories by doing background research, otherwise known as “reading,” and leaving the cubicle to go out and “talk” to people.

Finally, you may or may not remember the late LAT journalist David Shaw. He won the Pulitzer Prize for criticism in 1991 – an honor that barely describes his service to the public and his standing in the journalism profession. Shaw spent months researching important stories – often to show how his own colleagues got it wrong (the McMartin Preschool child molestation case, for example) – and, memo to the LAT Health desk, how activist groups routinely spun journalists with badly-done studies.

I clicked on Shaw’s LAT obituary today, and in one of those painful ironies, there was an ad (and there may still be) for an LAT story about how celebrity blogger Perez Hilton “made it.” The teaser uses Hilton’s own words:

“I think what I do is noble. I think my job title is entertainer. I shine the light on celebrities behaving badly, and I also shine the light on those that get it right.”

The juxtaposition of Perez Hilton’s sense of nobility on holding truth to celebrity next to the life of Shaw, who not only deprecated this kind of blogging, but worried that newsroom cutbacks would doom papers to such sensationalism, really sums up what’s at stake for the LAT and the Chicago Tribune, and for Tribune execs: In life we can aspire to the sublime or wallow in the ridiculous; the trick to nobility is not to confuse the two.

Congress Doesn’t Know Much About Science, Says Democrat Physicist

In an entertaining and yet unnerving article in the New York Times, Rep Rush Holt (D-New Jersey), formerly assistant director of the Princeton Plasma Physics laboratory laments the state of scientific literacy in the House of Representatives:

There are 435 people in the House, Mr. Holt said, and “420 don’t know much about science and choose not to.” He recalled his exasperation when anthrax spores were discovered in the Capitol in 2001 and colleagues came to him and said, “You are a scientist, you must know about anthrax,” a subject ordinarily missing from the physics curriculum.

“The difference,” he said, “is we would be perfectly happy to pick up a copy of The New England Journal of Medicine and read about the etiology of anthrax… “We know more than our colleagues,” Mr. Holt said, “but not more than they could know.”

Enviro Psycho! Embarrassing Disclosure in Poisonous Shower Curtain Scare

Some chemicals just keep on giving and giving to the poisoned well of urban nightmares. The latest attempt to wring a health scare out of phthalates (indicted by environmental activists as presenting a threat to health in everything from iPhones to dildos) is that they’re in your shower curtains.

Despite recent statements by William S. Knowles, one of the 2001 Nobel prize winners for chemistry, that phthalates pose no threat to health and that the environmental activists jihad is the real toxic problem, and statements to congress by Dr. Earl Gray of the EPA that the real area of concern is the effects of exposure to IV tubing in infants, a new self-published (i.e., non-peer reviewed) “scientific” study by The Center for Health, Environment and Justice (CHEJ) claims the smell you get when you open up a new shower curtain is toxic.

And this is enough to get reporters and the public all worried about dying from cancer or becoming infertile. As Kate Merrril for WBZ Boston reported:

The group tested several shower curtains and found lead, mercury and high levels of phthalates.
“They affect particularly the developing reproductive system,” said Ruthann Rudel, a scientist with the Silent Spring Institute, a research group dedicated to tracking environmental causes of cancer.

She says children and pregnant women are particularly vulnerable to these chemicals, and that worries Brookline mother of two, Judy Robinson. “It’s a little overwhelming to feel like you have to be a scientist to go to the store to buy things for your family.”

But there is no actual evidence in the report, or any actual scientific study to suggest that there is a risk from a shower curtain being used as a shower curtain. What the CHEJ measured was the off-gassing of certain chemicals; it didn’t account for likely routes of exposure in humans and infants and whether there was evidence that these exposures showed a risk. Nor did it suggest a way that traces of mercury or lead could be ingested through showering.

And this leads to the real absurdity of the report, which should have been obvious to any reporter who read it: even though the CHEJ warned about all the ways in which phthalates could be dangerous to health (in the process mischaracterizing research by Shanna Swan on reproductive health in baby boys to claim harm where none occurred), the Center was forced to concede that:

The lab was not able to achieve the lower detection limits necessary to identify phthalates off-gassing to the air of the small chamber for this study. CHEJ is considering an additional investigation with a laboratory that could achieve the lower detection limits needed, since initial results indicated the presence of phthalates in shower curtains.

In other words, the study found phthalates in the shower curtains but couldn’t find phthalates coming off the shower curtains. And if you can’t measure migration, how can you claim there’s an exposure risk? It’s a bit like saying, “there’s vinyl covering the wires inside a TV set; vinyl contains phthalates; phthalates are dangerous; we couldn’t really measure any phthalates coming out of the TV, but there must be (wait for another study), and meanwhile, watch out, TV exposes you to toxic chemicals.

Equally sly is the CHEJ’s conclusion that the chemicals released by shower curtains are a major source of indoor air pollution, and that the American Lung Association (ALA) considers indoor air pollution a major health problem; it does, but there’s nothing in its fact sheet to indict shower curtains or vinyl. Instead, the ALA warns about “biological pollutants, including molds, bacteria, viruses, pollen, dust mites, and animal dander,” radon, tobacco smoke, formaldehyde, asbestos, carbon monoxide, nitrogen dioxide, and potential exposures to chemicals in household cleaning agents, personal care products, pesticides, paints, hobby products, and solvents.

The determination of the CHEJ to find a risk from phthalates at any level – let’s keep lowering the detection limits! – is why activist science demands skepticism: instead of trying to determine if there is a risk, the CHEJ is determined to prove that there is a risk, even if the evidence – at least for phthalates – doesn’t quite get there.

But in a spirit of scientific collaboration, and seeing that the CHEJ is going to follow up with more research, STATS has a suggestion: why don’t the members of the CHEJ eat a variety of shower curtain samples? That’s the surest way of seeing if those nasty phthalates are really toxic.