Wednesday, August 23, 2006

More NYT Nonsense

The New York Times health section is making it too easy today. Let's start with the final paragraph of this article to lay out the conclusion:

“They show quite convincingly, yet again, that overweight and, in particular, obesity, raise the risk of mortality,’’ Dr. Stampfer said. “It really should be the final word on this issue that’s arisen as to whether overweight is actually bad for you or not.”

Strong words, eh? Too bad he can't back them up. Here's the main claim being made regarding the modestly overweight:

The researchers said the more telling analysis arose when they focused on 186,000 healthy men and women who had never smoked. Among men and women, being overweight raised the risk of death 20 percent to 40 percent compared with normal-weight people, the researchers said.

Sounds scary. Let's examine some of the methodological issues so that we can aspire to the correct level of scared-ness. First, the population is drawn from those in the AARP. As the article acknowledges:

Because all the participants were recruited from AARP, they are not exactly representative of the population as a whole, and the participants reported their weight themselves, which contributes to some uncertainty in the results.

Kudos for the honesty.

Dr. Leitzmann said neither factor would probably skew the results considerably because “it’s a very large sample of people.”

Statistically the word skew has a specific meaning and the more correct term would be bias. Also, the good doctor is full of it. A large, non-representative sample is still non-representative. One possible advantage is that with a large enough sample you could select a random subsample that is representative of whatever population you're trying to capture (in this case the whole US). The article does not say whether they did this or not.

Secondly, the size of the sample reduces uncertainty but it does not reduce bias. In this case it means that peoples self-reported weight has been measured very accurately. It does not mean that their actual weight has been measured accurately at all.

Errors in reporting weights — people sometimes say they weigh less than they actually do — would also not produce a large effect, he added.

At least he acknowledges the potential bias, but, as I said above, it is not possible to know if the results are truely accurate or not.

Additionally, the mechanism for categorizing people as overweight is the body-mass index (BMI). The BMI was invented over 150 years ago. Its purpose is to categorize those with average body composition. Anyone with abnormal body composition, will not be categorized correctly. As an example, I am just below the overweight cut-off with my BMI, even though I am in excellent health. The disparity is due to my lifting weights and the subsequently higher muscular composition of my body.

“No single study is able to solve a controversy of this magnitude,” Dr. Leitzmann said, but he recommended that anyone overweight “should be looking to lose weight.”

I have to respect his honesty in his conclusion here. He may be reaching a bit, but he at least acknowledges that his study is not the end-all be-all of all research. Unlike Dr. Stampfer, who was not involved in the study, but throws out the concluding quote found above. This study suggests the possibility that being slighly overweight increases mortality, but it does not even come close to being the "final word" on the subject.

The study is an example of an observational study, in which a sample of existing data is analyzed for correlations. These types of studies are far inferior to randomly selecting the sample and assigning people to one category or the other. Obviously this is not possible to examine this problem; it is not realistic to randomly assign certain people to be overweight or normal weight. That means that there will be no single study, no matter how large, that will definitively answer the question.

Somatization Some of THIS

I found this New York Times article deeply offensive. Here's the lede:

People with a long history of medically unexplained symptoms — aches, pains, fatigue, dizziness and other complaints for which doctors can find no physical cause — might finally find relief.

Literal meaning: Hey, all you who people who modern medicine can't help, we might be able to help you.

Sounds pretty promising, right? Unfortunately the next paragraph blows that out of the water:

Two new studies by researchers who specialize in the baffling condition called somatization syndrome, estimated to affect up to 3 percent of adults, suggest that the quest for a physical explanation may take on a destructive life of its own. Instead, those with the syndrome should focus on practical strategies to regain normal function and relieve symptoms, the researchers say.

Wow. That is poorly written. Let's dissect that nonsense. First, they make up a name, somatization syndrome, as a catch-all for everything that doctor's can't seem to diagnose. That's unhelpful.

Then the article obliquely says that nothing is wrong with these people; it's all in their head. Well, golly-gee, if doctor's can't figure out what's wrong with you what does that leave? Nothing. You must be fine; you're just crazy. It can't possibly be the doctor or modern medicine that's at fault. No sir-ee, if doctor's can't diagnose it that means it doesn't exist.

Of course, they can't be honest and just tell you that they think you're crazy right to your face. That wouldn't be very effective. So instead, later in the article, they introduce "cognitive behavioral therapy" to, as the second paragraph says, "focus on practical strategies to regain normal function and relieve symptoms". RIIIIIIIIIGHT. They couldn't send people to psychologists because that would imply they were crazy, so let's make up a pseudoscientific therapy to go along with our pseudoscientific syndrome. Yeah, that's the ticket.

I'm sure that there are some subset of people with unexplained symptoms that are mildly hypochondriatic, but piling everyone with vague symptoms but no diagnosis in the same category is absolutely ridiculous. The arrogance is astonishing. To think that EVERYONE that doctor's can't diagnose is a whack-job is breathtakingly vile and condescending.

I've been looking for the following headline: "God Dead: Doctors/Lawyers Take Over", but I have to say I haven't seen it quite yet. Why don't they just admit that doctors are people too, and maybe, just maybe, they don't know everything.

Full disclosure: I have twice had many months-long illnesses that doctors could not diagnose. Both times I had to self-diagnose and treat. I now have a healthy skepticism about modern medicines' ability to do anything beyond antibiotics and trauma.

Tuesday, August 01, 2006


Just want to point out two articles claiming to explain women. They seem remarkably similar. I'm not going to make any pronouncement as to how accurate the picture they portray is, except to say that I sincerely hope they are far from universal.

The first, from Michael Williams, points to a translated article about how women (allegedly) view the world.

The second, is an old article by Spengler at the Asia Times, that is referring to the possibility of women priests. He uses that as a launching point to discuss the general psychology of women.

Read at your own risk.

The Tower of Babel and Jargon

In Genesis, there is a story in which man tries to build a tower high enough to reach God. In punishment for such hubris, the Lord creates a proliferation of language among the peoples of Earth, such that they are divided and unable to muster such organizational capacity again (see wikipedia entry). I don't know if the story is literally true or intended allegorically, but it doesn't affect what I have to say.

Every professional field has their own language, consisting of various acronyms and words used with sometimes vastly different meanings than the norm. Economists talk of "declining marginal utility", the military has FUBAR and "five-by-five", businessman have "core competencies" and "shareholder value", engineering has "system-of-systems" and "modeling and simulation environment". Take each individual word from these terms, find its meaning, and you will find that it is at best tangentially related to the underlying meaning of the relevant term. Why is this? Why do these obscure terms exist? What drives the need to create technical jargon that often obfuscates as much as it elucidates? Why did I just use such big words?

I submit that it all goes back, conceptually, to the Tower of Babel. Apocryphal or not, it cannot be denied that there exists an enormous number of languages. Communication, and therefore cooperation, would be much easier for disparate peoples if all spoke a single language. With such manifest advantages, there must be a good reason why different tongues exist, beyond mere accident.

Language serves two purposes beyond its primary one of communication. The first is as a means of inclusion. Language is an identifier of what group an individual is a member. The second is the converse, as a means of exclusion. To define a group, there must be both members and outsiders, or else the distinction is meaningless. This directly relates to the biblical story, in that the abundance of languages is presented as a means of division and disorganization.

In every field, the use of jargon has two purposes. The first of these is communication. The use of specialized language allows often complicated ideas to be more efficiently presented than if each nuance was perfectly explained. This is the ostensible reason for jargon usage; because it facilitates communication among those who understand the terms. The problem with this is that often the meaning of technical jargon is at best imperfectly understood. There often don't exist clear, well-established meanings for technical terms. This can cause often painful miscommunication when two parties disagree on a terms meaning, especially when the difference is not explicitly addressed.

The second purpose, which I've been alluding to since the introduction, is to define membership in some group. Membership in some group helps to establish credibility to reinforce the trust of the hearer in the speaker's argument (see this column by Arnold Kling on trust cues). So while technical jargon can often seem to be irritating and unnecessary, it actually has an important role to play in both stating a position and in getting another person to believe in that position.