European Health Systems and the Internal Market: Reshaping Ideology ?

1)
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Health Care Anal. 2010 Nov 17. [Epub ahead of print]

European Health Systems and the Internal Market: Reshaping Ideology?

da Costa Leite Borges D.

Source

European University Institute, Via Boccaccio 121, CAP: 50133, Florence, Italy, danielle.borges@eui.eu.

Abstract

Departing from theories of distributive justice and their relation with the distribution of health care within society, especially egalitarianism and libertarianism, this paper aims at demonstrating that the approach taken by the European Court of Justice regarding the application of the Internal Market principles (or the market freedoms) to the field of health care services has introduced new values which are more concerned with a libertarian view of health care. Moreover, the paper also addresses the question of how these new values introduced by the Court may affect common principles of European health systems, such as equity and accessibility.

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Link:
http://www.ncbi.nlm.nih.gov/pubmed/21082357

Recap:
I'm starting out with kind of a dud, here. What apparently happened in Europe is that a high court declared 'capitalism' to be the new law of the land when it comes to health care delivery. What makes the author seem relatively dumb is the stated aim: to demonstrate that court-ordered 'capitalism' introduces a new, libertarian view.

Somebody stop the presses, because this author is going to go ahead and boldly link "market freedoms" to a "libertarian view." Wow. What kind of intellectual juggernaut would try to take on that kind of seemingly-insurmountable task? Holy cow, has this author got some real cajones. I mean, I would have never thought that market freedoms would be associated with libertarian views! Would you?

:-)

Ed

(Edited by Ed Thompson on 8/14, 12:10pm)

Post 1

Sunday, August 14, 2011 - 12:22pm

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J Pers Soc Psychol. 2011 Aug;101(2):307-20.

In the worst rather than the best of times: Effects of salient intergroup ideology in threatening intergroup interactions.

Vorauer JD, Sasaki SJ.

Source

Department of Psychology.

Abstract

Three studies demonstrated that a salient multicultural ideology increases hostile treatment of threatening outgroup interaction partners. The effect of multiculturalism on hostile behavior was evident regardless of whether threat was operationalized in terms of disagreement with an outgroup partner on important social issues (Studies 1 and 3) or rejection by the partner (Study 2). Moreover, the results clearly point to the learning orientation fostered by multiculturalism-as opposed to other factors such as enhanced other-focus, group-level attributions, or focus on differences-as the critical mediator of its effect on hostile behavior under threat. Thus, it appears that multiculturalism enhances the expression of hostility because it prompts individuals to really engage with and attach meaning and importance to threatening behaviors exhibited by outgroup members. The effects of multiculturalism were distinct from those of anti-racism and color-blindness, which set in motion processes that in many respects are directly opposite to those instantiated by multiculturalism. The findings highlight that the behavioral implications of multiculturalism may be quite different in conflictual interactions than they have previously been demonstrated to be in less threatening exchanges.

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Link:
http://www.ncbi.nlm.nih.gov/pubmed/21381853

Recap:
Multiculturism (i.e., cultural collectivism) increases tribalistic ("them-us") hostility? Really? Well, I could have told you that without an expensive empirical study! The next thing you know they are going to be studying whether or not getting a job increases the chance of getting a paycheck, or whether being out in the sun a lot increases your exposure to UV radiation. Of course multiculturalism destroys the very fabric of society!

Geezus, researchers, get yourselves a good philosophy -- so that you don't have to waste more research money on an elaborate process of "discovering" things already knowable without further empirical investigations.

Ed

Post 2

Sunday, August 14, 2011 - 12:35pm

3)
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Public Underst Sci. 2010 Nov;19(6):743-61.

Evaluating the effects of ideology on public understanding of climate change science: how to improve communication across ideological divides?

Zia A, Todd AM.

Source

Department of Community Development and Applied Economics, University of Vermont, Burlington, VT 05405, USA. Asim.Zia@uvm.edu

Abstract

While ideology can have a strong effect on citizen understanding of science, it is unclear how ideology interacts with other complicating factors, such as college education, which influence citizens' comprehension of information. We focus on public understanding of climate change science and test the hypotheses: [H1] as citizens' ideology shifts from liberal to conservative, concern for global warming decreases; [H2] citizens with college education and higher general science literacy tend to have higher concern for global warming; and [H3] college education does not increase global warming concern for conservative ideologues. We implemented a survey instrument in California's San Francisco Bay Area, and employed regression models to test the effects of ideology and other socio-demographic variables on citizen concern about global warming, terrorism, the economy, health care and poverty. We are able to confirm H1 and H3, but reject H2. Various strategies are discussed to improve the communication of climate change science across ideological divides.

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Link:
http://www.ncbi.nlm.nih.gov/pubmed/21560547

Recap:
So, let me get this straight. You discovered that college education and higher general science literacy don't lead to higher concern for global warming (i.e., that getting smarter and more informed doesn't increase concern for global warming), but you are still trying to communicate concern for global warming to conservatives? Have you ever thought of questioning global warming science yourselves? I mean, if being smarter and more informed on the matter doesn't lead to increased concern, then don't you think it's possible that it's not a valid concern in the first place?

Are you so wedded to your preconceived notion about global warming alarmism that it goes right over your own heads that there's a disconnect between increased information and perspective and increased concern? I mean, this isn't just the blind leading the blind. This is the blind trying to figure out convoluted ways in which to lead the sighted! This is Ray Charles as a dance coach.

:-)

These friggin' experts!

Ed

Post 3

Sunday, August 14, 2011 - 1:17pm

Ed, what lessons do you want to share from polywater?

"Polywater was a hypothetical polymerized form of water that was the subject of much scientific controversy during the late 1960s. By 1969 the popular press had taken notice, and by 1970 doubts about its authenticity were being circulated.[1][2][3] By 1973 it was found to be illusory.[4] Today, it is used as an example of pathological science."

"It has been suggested that polywater should have been dismissed on theoretical grounds. The laws of thermodynamics predicted that, since polywater had a higher boiling point than ordinary water, it meant that it was more stable, and the whole column of ordinary water should have turned spontaneously into polywater, instead of just part of it.[10] Richard Feynman remarked that, if such a material existed, then there would exist an animal that would not need food. That animal would just ingest water and excrete polywater, using the energy released on the process to survive.[10]"

Post 4

Sunday, August 14, 2011 - 2:58pm

Ed,

I see lots of those studies that simply leave out a key fact about human nature that would have more effect on the studies outcome than the variables they examined.

Why don't they study the tolerance for cultural diversity between different cultures? For example, they could look at the toleration of different religious views here in the states versus in say, Mecca.... oh, that's right, individuals from other religions aren't allowed in that city - toleration = 0. Must be some kind philosophical difference, and that might correlate with a psychological trait, and that might turn on the exercise of volition... On what? Oh, that's right they don't accept that as a human trait since they've decided that either genes or environment are the only active causal agents at large when discussing human motivation.

"Ray Charles as a dance coach" - well, he would at least get the beat; these people can't even hear the tune.
(Edited by Steve Wolfer on 8/14, 3:00pm)

Post 5

Sunday, August 14, 2011 - 6:17pm

Luke,

I did a search for "polywater" in PubMed (largest medical database in the world) and nothing turned up. As far as I can tell, polywater was a deliberate or accidental invention of communist scientists in Soviet Russia with results published in communist science journals -- and should be afforded the same evaluation as the notorious 5-year economic plans from the same era (i.e., as unjustifiedly-authoritative communist propaganda). As an example, if you told me that NAZI scientists discovered a way to travel through solid objects, or to go back in time, then I would put that into the same broad evaluative category as the communist "invention" of polywater (just a bunch of collectivists spewing another round of nonsense and trying to make it legitimate by assigning lab values to it).

As an item of bad science, it does fit with my blog, but I have started with 3 examples from peer-reviewed scientific journals. In other words, conventional (professional, accredited) scientists are writing and publishing the nonsense that I posted above. I didn't grab the articles from fly-by-night magazines or spurious infomercials. Instead, these are the real deal -- a snapshot of the state of science in the world today (where even the experts are often relatively dumb).

Ed

(Edited by Ed Thompson on 8/14, 6:22pm)

Post 6

Monday, August 15, 2011 - 3:46am

Ed, thanks for sharing your work. They are all interesting. In particular, this is one I will pursue through my university library for the full test. "J Pers Soc Psychol. 2011 Aug;101(2):307-20.
In the worst rather than the best of times: Effects of salient intergroup ideology in threatening intergroup interactions.
Vorauer JD, Sasaki SJ. Three studies demonstrated that a salient multicultural ideology increases hostile treatment of threatening outgroup interaction partners. ..."

However, your comment raises a basic issue.
"Geezus, researchers, get yourselves a good philosophy -- so that you don't have to waste more research money on an elaborate process of "discovering" things already knowable without further empirical investigations."

Small-o objectivism is rational-empiricism and Capital-O Objectivism also warns against both philosophical rationalism (Descartes, Kant, von Mises) and formalized empiricism (Hobbes, Comte, Keynes). Theories must be more than "internally consistent" - a necessary but not sufficient test of truth. They must also explain and predict perceived experiences.

I found the abstract interesting enough to want to acquire the paper. I would like to see how they operationalized and tested their variables to validate their hypothesis. I also want to see what else they have done and how they are perceived within their own academic communities.

Post 7

Monday, August 15, 2011 - 8:17am

Mike,

Theories must be more than "internally consistent" - a necessary but not sufficient test of truth. They must also explain and predict perceived experiences.

I respect your view on the matter, but there are a lot of things in life that can be explained via reference to first principles. It's not 'discussionarily' gratuitous to hold out and say: "Well, you know Ed, things could have turned out differently." It is a general truth that if you divide folks into groups they will become antagonistic. There was once a study where half the students were told to wear red shirts and the other half wore yellow (or blue, or whatever).

They started to become hostile to the kids in other-colored shirts.

This is not a grand discovery. It is merely empirical verification of a general truth. When Ayn Rand wrote novels, she showed how collectivism leads humans to hate each other. Her novels resonate with folks, which hints that there is a deeper truth to the matter. In fact, all of history is already proof of that. You can even parse it down to first principles. You do not need to stay at the complex level where you like to stay, Mike (for whatever reason) -- always holding out and saying "Well, it could have turned out differently."

Identity exists and prevents some things from "turning out differently." I invite you to consider accepting that fact and integrating it into new experiences in your life journey.

:-)

Ed

(Edited by Ed Thompson on 8/15, 8:18am)

Post 8

Monday, August 15, 2011 - 1:15pm

There was once a study where half of a group of rats were made to wear red shirts and the other half wore yellow (or blue, or whatever). But nothing significant came of that study either.

Post 9

Tuesday, August 16, 2011 - 5:03pm

I found some bad science at the National Snow and Ice Data Center. In Figure 2 at http://www.nsidc.org/arcticseaicenews/ you can see monthly sea ice extent in the artic. The graph shows data for 2007, 2008, 2010, and 2011. Before reading on, do you see anything wrong with that?

Okay, I'll cut to the chase: the year 2009 is missing, and if you go to http://www.arctic.noaa.gov/reportcard/seaice.html, then you will see that 2009 was a year with tons of ice (a "refreeze" of the "melting" arctic). So, NSIDC produces a graph that selectively omits a year ... and we're not supposed to catch them in the act (of selective omission)??

Busted!

:-)

Ed

Post 10

Friday, August 19, 2011 - 3:44pm

I contacted the Ice People and pointed them to this entry of your blog.

I reviewed some submissions to the Libertarian Papers and I asked a couple of my professors about the process. One of them said - and I did not need to be told - that you cannot ignore a problem so that you can reply or publish later: you cannot blindside or sandbag the author.

You assume that they were being dishonest; and you cited a reason why this omission was unlikely to have been accidental. But you don't know until you ask. They might fix the chart and thank you.

Post 11

Friday, August 19, 2011 - 4:13pm

Thanks, Mike.

You are right that I went straight to an assumption, instead of contacting the source directly. You are really just stating the obvious. I look forward to learning more about this (from NSIDC). Maybe there is some overt (rather than covert) reason for them to have excluded the year: 2009. It sure looked like a 'smoking gun' to me, though.

Ed

Post 12

Friday, August 19, 2011 - 5:44pm

I found some bad science by the FDA:

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Nutr Rev. 2006 Aug;64(8):357-63.

Chromium picolinate intake and risk of type 2 diabetes: an evidence-based review by the United States Food and Drug Administration.

Trumbo PR, Ellwood KC.

Source

Division of Nutrition Programs and Labeling, US Food and Drug Administration, College Park, Maryland, USA. Paula.Trumbo@FDA.gov

Abstract

The labeling of both health claims that meet significant scientific agreement (SSA) and qualified health claims on conventional foods and dietary supplements requires pre-market approval by the US Food and Drug Administration (FDA). Approval by the FDA involves, in part, a thorough review of the scientific evidence to support an SSA or a qualified health claim. This article discusses FDA's evidence-based review of the scientific evidence on the role of chromium picolinate supplements in reducing the risk of type 2 diabetes. Based on this evidence-based review, FDA issued a letter of enforcement discretion for one qualified health claim on chromium picolinate and risk of insulin resistance, a surrogate endpoint for type 2 diabetes. The agency concluded that the relationship between chromium picolinate intake and insulin resistance is highly uncertain.

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Link:
http://www.ncbi.nlm.nih.gov/pubmed/16958312

Recap:
According to the FDA, there is (or was, in 2006) a ton of uncertainty with regard to the relationship between chromium picolinate and insulin resistance. But is that really the state-of-the-science in 2006? Evidence suggests not. Check out this quote from a 2002 review of the matter:

The beneficial effects of chromium on serum glucose and lipids and insulin resistance occur even in the healthy. Serum glucose can be improved by chromium supplementation in both types 1 and 2 diabetes, and the effect appears dose dependent. Relative absorption of various chromium compounds is summarized and the mechanism of low molecular weight chromium binding substance (LMWCr) in up-regulating the insulin effect eight-fold is discussed.

Link:

The safety and efficacy of high-dose chromium.

Or check out this quote from a 2003 review of the matter:

Insulin initiates chromium transport into the cells where it is bound to the oligopeptide apochromodulin. This oligopeptide combined with four chromium(III) atoms forms chromodulin, which is important for amplifying the insulin signalling effect. After binding to insulin-activated receptor, chromodulin increases tyrosine kinase activity by one order. This enzyme forms a part of intracellular portion of insulin receptor.

Link:
[Chromium as an essential element].

Or check out this quote from a 2004 review of the matter:

Several studies have now demonstrated that chromium supplements enhance the metabolic action of insulin and lower some of the risk factors for cardiovascular disease, particularly in overweight individuals. Chromium picolinate, specifically, has been shown to reduce insulin resistance and to help reduce the risk of cardiovascular disease and type 2 diabetes. Dietary chromium is poorly absorbed. Chromium levels decrease with age. Supplements containing 200-1,000 mcg chromium as chromium picolinate a day have been found to improve blood glucose control. Chromium picolinate is the most efficacious form of chromium supplementation. Numerous animal studies and human clinical trials have demonstrated that chromium picolinate supplements are safe.

Link:

A scientific review: the role of chromium in insulin resistance.

And, finally, check out this long quote [full abstract] from a 2006 review of the matter:

Chromium (Cr) picolinate (CrPic) is a widely used nutritional supplement for optimal insulin function. A relationship among Cr status, diabetes, and associated pathologies has been established. Virtually all trials using CrPic supplementation for subjects with diabetes have demonstrated beneficial effects. Thirteen of 15 clinical studies (including 11 randomized, controlled studies) involving a total of 1,690 subjects (1,505 in CrPic group) reported significant improvement in at least one outcome of glycemic control. All 15 studies showed salutary effects in at least one parameter of diabetes management, including dyslipidemia. Positive outcomes from CrPic supplementation included reduced blood glucose, insulin, cholesterol, and triglyceride levels and reduced requirements for hypoglycemic medication. The greater bioavailability of CrPic compared with other forms of Cr (e.g., niacin-bound Cr or CrCl(3)) may explain its comparatively superior efficacy in glycemic and lipidemic control. The pooled data from studies using CrPic supplementation for type 2 diabetes mellitus subjects show substantial reductions in hyperglycemia and hyperinsulinemia, which equate to a reduced risk for disease complications. Collectively, the data support the safety and therapeutic value of CrPic for the management of cholesterolemia and hyperglycemia in subjects with diabetes.

Link:
Clinical studies on chromium picolinate supplementation in diabetes mellitus--a review.

Now, when you read that last quote, do you get a sense that the relationship between chromium picolinate and insulin resistance is "highly uncertain?" It'd be great to be able to pin-down those FDA researchers and ask them directly: "Exactly what is it about the relationship between chromium picolinate and insulin resistance that you take to be highly uncertain?" Is it the safety? Is it the mechanism? What is it? Until the FDA can come forward and provide a good reason why they, alone, have come out with a review of chromium with a peculiar and isolated "highly uncertain" conclusion -- their study has to be added to my metaphorical dust-bin of b-a-d s-c-i-e-n-c-e.

:-)

Ed

(Edited by Ed Thompson on 8/19, 5:48pm)

Post 13

Saturday, August 20, 2011 - 5:10am

It sure looked like a 'smoking gun' to me, though.

I don't doubt it. I just put the ball in their court... We will see if we get a reply...

Post 14

Saturday, August 20, 2011 - 9:54am

I found some bad science funded by the National Institutes of Health.

Earlier, I wrote an article for RoR on the philosophy of science. In that article, I caught some researchers engaging in research that was "designed to fail." The researchers were studying herbs in relation to immunity, and they chose a poor species of an herb to study (E. angustifolia) rather than the conventional species (E. purpurea). They also used an uncommonly-low dose, but that is tangential to the point at hand. What they did was kind of like a "strawman argument" (an example, which is purposefully set up to fail). Another analogy would be the "bait-and-switch" technique used by salesmen and women of questionable-to-low character.

What they did was: they studied a type of echinacea that was less likely to work, and then concluded that all types of echinacea are not likely work. Anyway, I caught NIH "doing" (actually, funding, and therefore approving of) the same thing in a 2006 study -- this time with glucosamine supplements used for osteoarthritis. Here is the full study, entitled the Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT):

http://www.nejm.org/doi/full/10.1056/NEJMoa052771

In it, you will discover that they used a specific form of glucosamine -- glucosamine hydrochloride -- in order to ascertain a measure of the general benefit of all glucosamine supplements. What is wrong with this is that it is not glucosamine hydrochloride that has been used successfully by many researchers -- but glucosamine sulfate. Here is the evidence of that:

2002
Glucosamine sulfate use and delay of progression of knee osteoarthritis: a 3-year, randomized, placebo-controlled, double-blind study. [good evidence that glucosamine sulfate can actually reverse osteoarthritis]

2003
Structural and symptomatic efficacy of glucosamine and chondroitin in knee osteoarthritis: a comprehensive meta-analysis.

Relief in mild-to-moderate pain is not a confounder in joint space narrowing assessment of full extension knee radiographs in recent osteoarthritis structure-modifying drug trials.

2004
Can we reduce disease burden from osteoarthritis? [provides cost-benefit analysis of glucosamine sulfate use in osteoarthritis]

Glucosamine sulfate reduces osteoarthritis progression in postmenopausal women with knee osteoarthritis: evidence from two 3-year studies.

Glucosamine for osteoarthritis: part I, review of the clinical evidence. [refers to the NIH study but, most curiously, mentions "glucosamine sulfate"]

2005
Glucosamine long-term treatment and the progression of knee osteoarthritis: systematic review of randomized controlled trials.

Glucosamine oral bioavailability and plasma pharmacokinetics after increasing doses of crystalline glucosamine sulfate in man.

The efficacy of glucosamine and chondroitin sulfate in the treatment of osteoarthritis: are these saccharides drugs or nutraceuticals?

Current concepts in the therapeutic management of osteoarthritis with glucosamine.

2006
Assessment of joint space narrowing with conventional standing antero-posterior radiographs: relief in mild-to-moderate pain is not a confounder in recent osteoarthritis structure-modifying drug trials. [related to 2nd study in 2003 above]

To put the nail-in-the-coffin, another "bad science" review was published just after the results of the NIH-funded trial. Perhaps this study is the real study that can be categorized as really, really bad science. Here is the full abstract, so that nothing is left out:

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J Am Acad Nurse Pract. 2006 Oct;18(10):487-93.

Evidence-based practice: review of clinical evidence on the efficacy of glucosamine and chondroitin in the treatment of osteoarthritis.

Distler J, Anguelouch A.

Source

Department of Family and Community Health, University of Maryland School of Nursing, Baltimore, Maryland, USA. distler@son.umaryland.edu

Abstract

PURPOSE:

To evaluate past and current evidence from randomized controlled trials on the efficacy of glucosamine sulfate (GS), glucosamine hydrochloride (GH), and chondroitin sulfate (CS) for the treatment of osteoarthritis (OA).

DATA SOURCES:

An extensive review of four meta-analyses and a review of the findings of the recently published Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT) funded by the National Institutes of Health.

FINDINGS:

Review of previous studies on the efficacy of GS, GH, and CS in the treatment of OA showed inconclusive results because of weak research design. The GAIT attempted to provide clarity on the use of GH and CS in treating knee pain from OA by using a rigorous research design to elicit cause and effect. The GAIT results showed that GH and CS were not effective in reducing knee pain in the study group overall; however, these may be effective in combination for patients with moderate-to-severe knee pain.

IMPLICATIONS FOR PRACTICE:

There is now clinical evidence indicating that recommending GS, GH, and CS for the treatment of mild knee pain from OA is ineffective. Further research needs to be done to identify specific characteristics in patients that results in a positive response. Until the findings of the GAIT undergo further peer review, the results of the research needs to be interpreted with caution.

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Recap:
Did you notice the "bait-n-switch" there? They start off with the honest recognition of different kinds of glucosamine -- glucosamine sulfate (GS) and glucosamine hydrochloride (GH) -- they then transition into talking about evidence for one of the two kinds of glucosamine ... and then they somehow miraculously arrive at the enlightened conclusion that the evidence of one kind of glucosamine indicates that both kinds of glucosamine are ineffective (for mild knee pain)! This is exactly the same technique used by the researchers in my original RoR article -- and it's bad science.

Caught in the act!

Ed

(Edited by Ed Thompson on 8/20, 11:26am)

Post 15

Saturday, August 20, 2011 - 11:16am

And another thing wrong with the NIH-funded GAIT study:

The researchers got together and decided, before the study, what kind of a response would be characterized as a positive response to treatment. This is, so far, good science. It is always good to state, beforehand, what kind or level of results would justify accepting or rejecting hypotheses. But here is the rub: they chose a decrease in a pain-score (WOMAC pain score) of 20%, but included many study participants who had a really low pain-score in the first place.

Here's an analogy. Let's say that you want to see if negative advertisement reduces your sales volume -- sales volume is your dependent variable or primary outcome.

Let's say you start your study by saying that you will accept the hypothesis that negative advertisement reduces sales if-and-only-if sales decrease by 20% after the negative advertising campaign. Let's say you include some Fortune 500 companies, but that you also include some Mom-and-Pop shops that had really low sales to begin with. What you will likely find is that there is a decrease of 20% or more in the high-sales-volume Fortune 500 companies, but you don't get the same proportional decrease in sales from the Mom-and-Pop shops. This is the effect of scaling, or a scaling effect. It would be bad science for you to include the Mom-and-Pop shops in your analysis of the primary outcome.

The reality is that negative advertisement reduces sales, but that that effect gets really, really hard to measure when sales start out really low (as it does in Mom-and-Pop shops). It would be ignorant, or worse, for you to conclude that negative advertisement doesn't reduce sales (i.e., to reject your hypothesis) -- simply because you included the low-sales companies in the analysis, and that inclusion brought down the overall statistical significance of the findings. This is exactly what the GAIT study did.

What you get is a factor that really does matter with regard to outcomes in real life, but an opposite "scientific" conclusion based on statistical signficance (due to the confounding effects of scaling). You get a "scientific" study that -- due to methodological limitations -- a "scientific" study that does not correspond to reality. It's bad science.

Ed

p.s. To the study authors' credit, they did state that a limitation of their study was that folks didn't start out in a lot of pain. It is still misleading, however, to reject the hypothesis (because it doesn't correspond to reality).

(Edited by Ed Thompson on 8/20, 11:34am)

Post 16

Saturday, August 20, 2011 - 4:45pm

I think there's a better analogy. Let me try another one. Let's say you wanted to study whether hydrochlorothiazide is diuretic.

You predetermine that you will accept the hypothesis that "hydrochlorothiazide is diuretic" if you find that it reduces whole-body water by 20% or more. You test folks for whole-body water both before and after administration of hydrochlorothiazide. If you include a lot of folks who had normal or high amounts of body water to begin with, then you will discover that hydrochlorothiazide is diuretic. You will accept your hypothesis.

However, if you start out with a bunch of folks who come into the study already dehydrated, then you will not discover that hydrochlorothiazide is diuretic. You will reject your hypothesis. This is a scaling effect. In the case of hydration, the body will not allow for extremes if they are life-threatening. If someone is already dehydrated, then you are probably not going to be able to give them a pill and watch their hydration status fall by another 20% (which may be close to being deadly for them). Redundant hydration mechanisms of the body kick-in when you get to extremes in hydration status, confounding the expected diuretic effects of taking a pill.

In any case, the diuretic effect will be smaller if your hydration status is lower to begin with. In osteoarthritis, the analgesic effect of glucosamine will be smaller if your pain is low to begin with. An important point is that this lower effect may not even be proportional (lower, but proportionally so). This is not surprising and can be understood by reference to first principles. In order for you to get the exact same percentage reduction in osteoarthritic pain from taking glucosamine at different levels of osteoarthritic disease, you would have to assume a linear, one-to-one relation of the level of glucosamine and the level of pain.

In other words, you would have to make the absurd assumption that osteoarthritis is nothing more than a simple, nutritional deficiency of glucosamine. When these researchers rejected their hypothesis that glucosamine lowers WOMAC-scored pain by 20% -- because it didn't do that for a large minority of folks who started out with very little pain (even though it totally worked wonders for folks in lots of pain and who really needed it!), then that is exactly the kind of absurd mental justification required.

You end up with this thing that works really, really well for osteoarthritis (perhaps better than any conventional therapy known to man) -- and you end up publishing a negative (failed) study about it.

Go figure.

Ed

Post 17

Saturday, August 20, 2011 - 6:56pm

August 2006
Associations between intermediate age-related macular degeneration and lutein and zeaxanthin in the Carotenoids in Age-related Eye Disease Study (CAREDS): ancillary study of the Women's Health Initiative.

More bad science from our dear ole' FDA:

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Am J Clin Nutr. 2006 Nov;84(5):971-4.

Lutein and zeaxanthin intakes and risk of age-related macular degeneration and cataracts: an evaluation using the Food and Drug Administration's evidence-based review system for health claims.

Trumbo PR, Ellwood KC.

Source

Division of Nutrition Programs and Labeling, Food and Drug Administration, College Park, MD, USA. paula.trumbo@fda.gov

Abstract

The labeling of health claims that meet the significant scientific agreement standard and of qualified health claims on conventional foods and dietary supplements requires premarket approval by the Food and Drug Administration (FDA). The FDA conducts an evidence-based review to ascertain whether sufficient evidence exists to support a significant scientific agreement standard or a qualified health claim. The FDA recently reviewed intervention and observational studies that evaluated the role of lutein and zeaxanthin in reducing the risk of age-related macular degeneration and cataracts. On the basis of this evidence-based review, the FDA concluded that no credible evidence exists for a health claim about the intake of lutein or zeaxanthin (or both) and the risk of age-related macular degeneration or cataracts.

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Link:
http://www.ajcn.org/content/84/5/971.long

Recap:
By November of 2006, there was supposedly no credible evidence for a health claim about intakes of lutein and/or zeaxanthin and risk of age-related macular degeneration, or "AMD" (an example of an age-related maculopathy, or an "ARM") or cataracts. But is that true? Was there really no credible evidence? Evidence from earlier that year suggests otherwise:

June 2006
Plasma lutein and zeaxanthin and other carotenoids as modifiable risk factors for age-related maculopathy and cataract: the POLA Study.:

After multivariate adjustment, the highest quintile of plasma zeaxanthin was significantly associated with reduced risk of ARM (OR=0.07; 95% CI: 0.01-0.58; P for trend=0.005), nuclear cataract (OR=0.23; 95% CI: 0.08-0.68; P for trend=0.003) and any cataract (OR=0.53; 95% CI: 0.31-0.89; P for trend=0.01). ARM was significantly associated with combined plasma lutein and zeaxanthin (OR=0.21; 95% CI: 0.05-0.79; P for trend=0.01), and tended to be associated with plasma lutein (OR=0.31; 95% CI: 0.09-1.07; P for trend=0.04), whereas cataract showed no such associations.

We observed direct associations between serum lutein level and advanced AMD, with statistically significant trends, although the CIs around the
estimates were considerably wide (data not shown).

We did not observe the hypothesized association between dietary lutein and zeaxanthin intake and prevalence of intermediate AMD in the full study sample of women aged 50 to 79 years. However, secondary analyses disclosed a statistically significant, protective association in women younger than 75 years with stable intake of lutein plus zeaxanthin, without a history of cardiovascular disease, diabetes, hypertension, and/or previously diagnosed AMD.

September 2006
Lutein and zeaxanthin and the risk of cataract: the Melbourne visual impairment project.

To evaluate the association of cortical, nuclear, or posterior subcapsular (PSC) cataract with dietary intake of lutein-zeaxanthin (LZ) in a population-based sample.

For nuclear cataract the odds ratios were 0.67 (0.46-0.96) and 0.60 (0.40-0.90) for every 1-mg increase in crude and energy-adjusted daily LZ intake, respectively. The odds ratios (95% CI) for those in the top quintile of crude LZ intake was 0.58 (0.37-0.92; P = 0.023 for trend), and it was 0.64 (0.40-1.03) for energy adjusted LZ intake (P = 0.018 for trend).

Do the 3 studies directly above look like "credible evidence" to you? They do to me. Be wary, those guys over at the FDA are busy pumping out bad science.

Ed

(Edited by Ed Thompson on 8/20, 7:32pm)

Post 18

Thursday, August 25, 2011 - 5:22pm

{nsidc-233808} Re: Arctic Sea Ice News and Analysis August 22, 2011 5:17 PM
From: nsidc@nsidc.org
To: mmarotta
Dear Mr. Marotta,

The text below the graph details that it is showing previous low-ice extent years, with 2007 being the year of the record low in September. There is year to year variation in ice extent and the number of recent low years is scientifically significant. In years such as 2009 the minimum extent was higher than 2007 and 2008 but the ice was young and thin and melted away in 2010 (the year of the third lowest minimum). The monthly analysis always shows a trend graph for the month which plots all years as seen in Figure 3 of the August 3rd posting for July:
http://nsidc.org/arcticseaicenews/2011/080311.html

Regards,
Kara
NSIDC User Services

mmarotta@emich.edu wrote:

> referring_page: http://www.nsidc.org/arcticseaicenews/
> filled_form: asna.html
> file_returned: thanks.html
>
> first_name: Michael
> last_name: Marotta
> organization: Institute for the Study of Consequences
> address_1: 3588 Plymouth Road #113
> city: Ann Arbor
> state_province: MI
> postal_code: 48105
> country: USA
> email: mmarotta@emich.edu
> phone: 734-223-9054
> category: usa
> type: university
> message_question_comment: BAD SCIENCE BLOG
> http://rebirthofreason.com/Spirit/Blogs/137.shtml
> Post 9 Tuesday, August 16 - 5:03pm
>
> I found some bad science at the National Snow and Ice Data
> Center. In Figure 2 at http://www.nsidc.org/arcticseaicenews/
> you can see monthly sea ice extent in the artic. The graph shows
> data for 2007, 2008, 2010, and 2011. Before reading on, do you
> see anything wrong with that?
>
> Okay, I'll cut to the chase: the year 2009 is missing, and if
> you go to http://www.arctic.noaa.gov/reportcard/seaice.html,
> then you will see that 2009 was a year with tons of ice
> (a "refreeze" of the "melting" arctic). So, NSIDC produces a
> graph that selectively omits a year ... and we're not supposed
> to catch them in the act (of selective omission)??
>
> Busted!
> :-)
> Ed
>
>
>
> recaptcha_challenge_field: 03AHJ_VutqvK3skux1BVVIzFy-D5gM663iIBfxtJEpcZiZHcY8Mq1or6C9Vb8MydN4F5JDySNFySz0B35LnDeH0653kJxqt1YFx975ZF2SLKVZQj-DK9JfWUXz60uvC2_USnYdN-ib7H9qO-YA8r0mxhdPz1wk8MsYKQ
> recaptcha_response_field: real xtengti
> address_3:
> address_2:
> fax:
> type_other_name:
> title:
> ip:68.40.193.59
>

________________________________________________________________________

NSIDC User Services Phone: +1 303-492-6199
CIRES, 449 UCB Fax: +1 303-492-2468
University of Colorado Email: nsidc@nsidc.org
Boulder, CO 80309-0449, USA WWW URL: http://nsidc.org

National Snow and Ice Data Center * Distributed Active Archive Center
* World Data Center for Glaciology, Boulder *
________________________________________________________________________

Post 19

Thursday, August 25, 2011 - 7:33pm