Tag Archive | research

The BMA’s Attack on Smokers with Made-Up ‘Evidence’

The British Medical Association, the Physicians’ trade union, has called for a ban on smoking in private cars, to add to the 2007 restriction on smoking in enclosed ‘public’ places. Their reason is that such a ban is a small price to pay to reduce the exposure of minors carried as passengers. Apparently, the level of toxins detectable in a smoker’s car is 23 times that found in pre-2007 smoky pubs. The Evening Standard published a piece supporting the proposed ban, deciding that “Demanding that people stop driving in a self-generated cloud of poisonous gas doesn’t seem a big ask.”

But it does seem a ‘big ask’.

For objections to this illiberal proposal, the first has to be the good word of the BMA itself, which campaigned heavily before the 2007 ban. It’s representatives sent out to TV and radio stations laughed pompously at the objectors warnings of the slippery slope such a ban would put the UK on: it was only to protect innocent pub-goers, they said, who had no choice in what they breathed in when exerxising their alcohol imbibing rights. Don’t they deserve to be protected?

That alcohol was by far the most hazardous part of a Friday night seemed to have been considered unimportant when smoking was coming to be seen as antisocial and presented an easy target of opportunity.

 The law banning smoking in public places also overlooked that most of the affected locations were, in fact, privately owned, and no person was obliged to visit a smoking pub or restaurant.

For the Children

It turns out that the ridiculed ‘slippery slope’ argiment was spot on, and campaigners are now openly pushing towards an outdoor ban and wispering about the move into homes. Of course, it will be phrased as if a ban was ‘for the children’, but you can be sure it will be a blanket ban that is demanded, as is the case for the current BMA proposal, for ease of enforcement.

Or just because smoker-persocutors are the new witch-finders and are bolstered by the political momentum to go for the criminalisation of tobacco, openly and without embarrassment.

Although I am, a lifelong non-smoker who has benefitted from smoke-free pubs and offices, I have fundamental objections to the BMA’s demand:

First is the liberty one. It is no business of doctors, in my mind, to stop me doing risky things if the risk to others is small. I am not prevented from climbing mountains, paragliding, skating on icy lakes, driving a car at high speeds (with passengers), and drinking alcohol. The BMA has not yet suggested banning these activities, but since they have a habit of sliding down the slippery slope, I am willing to draw the line at banning smoking.

Fake Figures

The second objection is the ’23 times more toxic than the smoky pub’ figure that is being quoted withoud attribution. The Today program speaker explained that this was the case even when no smoking was actually happening since the ‘toxins’ soaked the inside of the car. Is this serious? Just what was measured? And did it really equate to 23 times more hazardous than a pub atmosphere? It seems remarkably suspicious, and the BMA today withdrew its claim (See the Factcheck site for a debunking of this media myth, with sources.)

The argument for a wholesale ban on in-car smoking is a practical one: that it will be easier to enforce ‘for the children’ if everyone was banned.  This will include people without children, and people who will never carry children in their cars. In a spirit of tolerance, only dangerous activities should be prohibited – anything else is just illiberal. Why ban people from smoking in their own car just to make enforcement easier? (Foreign laws against smoking in cars only forbid smoking with a child in the car.) It will clearly result in the bulk of prosecutions being of drivers of cars with no children, since they are the ones who will most disagree with such a law.

Slippery Slope

The final criticism is made with the slippery-slope argument. Usually a poor excuse for logic, the current debate has used the existing ban on smoking in work vehicles and public spaces as justification. One can easily imagine a future when the argument move on to be that the only place a child can breathe smoke is in the home, so that it is a dangerous loophole that should be closed.

Intolerance breeds intolerance by emboldening the nannys that build on victory after victory, incrementally moving us from the traditional character of the country, where a free person can partake of anything not specifically banned, to the continental tradition where you can only do what is specifically prescribed, with everything else forbidden. 

The BMA took a fake fact about smoking with children in the car and made it into an attack on all smokers. Anyone who values the freedom to choose what risks to take for themselves will be wise to protest this move – if this moves onto the statute book, the nanny campaigners will not stop there in their programme to save us from ourselves.
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Passive Smoking, Active Disinformation

Much as I enjoy smoke free pubs and restaurants, I always took the view that I had a free choice of where to go of an evening if I wanted to avoid cigarette smoke. Admittedly, there were few locations that banned smoking, but that was a commercial decision of the proprietors.

Key for those who see the ban on smoking in enclosed public spaces as a small start towards banning smoking anywhere is any evidence that smoking in private homes and cars impinges on the rights of powerless third parties. So the news that passive smoking increases the risk of still-births by a whopping 13% and that of birth malformations by 23% was reported widely.

The BBC news site quoted the press release freely:

“Fathers-to-be should stop smoking to protect their unborn child from the risk of stillbirth or birth defects, scientists say. They looked at 19 previous studies from around the world.
A UK expert said it was ‘vital’ women knew the risks of second-hand smoke.”

Vital that women knew the risks? So what are the risks? The paper (abstract) was not primary research, but combined data from multiple studies, which sounds good. But most of the studies were either of poor quality or did not address the desired health outcomes. In the end, it came down to 19 studies with four separate outcome measures. Two of them, the risk of miscarriage and the risk of perinatal or neonatal death, came out negative: no increased risk. The other two came out with the 13% (4 studies) and 23% (7 studies) increased risk.

So, the news reports could have started with headlines of “Passive Smoking Does Not Cause Miscarriage” or “New Study Produces Contradictory Results”, or even “We’re Trying Really Hard But We Still Can’t Prove Passive Smoking is Particularly Dangerous”. Although I can’t imagine researchers from the UK Tobacco Control research Network policy advocacy group pushing that last one!

Statistical Significance

When researchers attribute risks to particular behaviours, they calculate not only the best estimate of the increased risk (eg an odds ratio of 1.13, or an increase of 13%), but also the high and low limits within which they are confident that the ‘true’ risk lies. Any measurement will have uncertainties, and to be confident that a risk is real it must be repeatable: that is, doing the whole study again will produce the same result.

Obviously, you can’t wait until the next study before you publish, so you use the mathematics of chance to see the results might have been if thing had gone slightly differently during the study. The outcome, then, is not a ‘best’ figure, but a ‘confidence interval’ which the ‘true’ result would be within 95% of the time. (or outside the range 5% of the time).

Confidence Tricks

The study found that two of the outcomes had confidence intervals that started below an odds ratio of 1. That is, there is a real chance that there was no risk at all, even though the ‘best’ figure was higher. So the results are dismissed as not significant.

What of the other two? Stillbirth came out as 1.01 – 1.26 (middle value 1.13), with malformations as 1.09 – 1.38 (middle value 1.23). So, even without a further look, stillbirths could be increased by perhaps 1%, or as much as 26%. We can’t tell which, but we can tell that presenting 13% as the figure is misleading.

But it is worse that that. The researchers looked at many outcomes and picked out to publicise the ones which had the wanted results, which makes it far more likely that you will find significance in your results. As an example, let’s say that you roll four dice. The chance that any one of them will come up a six is 1/6 (or 17%), but the chance that at least one of the four will come up a six much greater at 48%.

For the researchers to be confident that their overall result of, say, ‘passive smoking causes harm to unborm babies’, an allowance must be made (eg the Bonferroni correction) for each of these multiple comparisons to get the overall confidence back up to 95%. For four tests as here, the intervals should be increased by the factor of around 1.27, so they become:

Still birth relative risk: 0.98 – 1.30
Congnital malformation relative risk: 0.91 – 1.40

Note that both now include the relative risk (ie no risk) in the range. On this test, none of the outcomes is significant.

Two Bites at the Cherry

The upshot is this. If you use statistical arguments to judge outcomes, you should know that the more measurements you make the more likely you are to come up with spurious results, so you should make allowances for it.

The headline should have been, at best, “Our Research Was Too Underpowered to be Sure of Anything, but it is Worth Asking for More Funding“.

Unlikely to be reported in the papers, but honest.

The Double Standards of Professional Contrarians

I normally avoid leaving comments on online newspaper articles as I don’t enjoy the anonymous behaviour of participants: rudeness, ignorance and unwillingness to engage in proper debate. But I did get stuck in to one of James Delingpole’s Telegraph Blog entries. (My spell-checker wants to replace ‘Delingpole‘ with ‘Delinquent‘. I’m tempted.)

Delingpole seriously embarrassed himself in the BBC’s Horizon programme Science Under Attack when he debated climate change with Nurse, a Nobel Prize winning scientist. Specifically, Delingpole described his climate change ‘journalism’ as interpreting interpretation: he didn’t read scientific papers, not even the abstracts.

More specifically, he has found a few people who share his biases and then uses their writings as evidence for his own opinions, as they use his to buttress theirs. ‘Science’ is a word used often, but the scientific method seems to be unknown to them as they resort to rhetoric instead. It seems that winning an ill-natured argument is far more important to them than actually being right. (They fervently believe they are right, of course, though they make no effort to develop secure lines of reasoning, relying on the whole list of pseudo-science techniques described here.)

The comments on the blog entries are even less nuanced, as they don’t even try to use rhetorical tricks and deceptions. If you have ever had so little going on in your life that you feel able to interact with the low-lifes that inhabit these sites, then you may skip to the end.

But this is the nature of argument from those that worship the self-important journalists such as Delingpole. Insults are the order of the day: anonymous posters are just rude. If you come up with a good argument, data that disproves a statement or even just try to act as a moderating influence, then expect to get flamed.

Ignore reasoned arguments

Tell the poster that their sort of person makes you sick and you can’t believe how much they wriggle and squirm in a proper debate. Tell them how thin skinned they are. If you are lucky, they will be distracted by your bilge and not notice that you had no answer to their line of argument.

Consensus Plays No Part in Science

If anyone has the front to point out that the specialists in the field are virtually unanimous in their judgements, so you are likely to be mistaken, bang on about the ‘fact’ that consensus plays no part in science. This is a great move, since you can act as an expert in your own right at the same time as denying real experts know anything about the reality of the science. It is, of course, nonsense. Science does not have authorities that pass judgement on theories when there is disagreement. The only way for tentative theories to enter the canon of accepted principles is for them to be debated back and forth along with the data in journals and at conferences, until everyone has had their objections answered and consensus is reached. Far from ‘consensus plays no part in science’, a lack of consensus is fatal to the progression of a scientific theory. Consensus is the only way in science.

Apply Different Standards of Evidence to Opponents

Appear to carefully pick apart statistical inferences with which you disagree, then slip in a non-sequitur based on an absence of evidence. For instance, challenge the last fifty years of warming by selecting your data from one of the regularly occurring decades where the warming slows or stops for a few years, say that there is no statistically significant warming. If there is warming, pick a new start year that is especially warm and try again to fit a negative gradient. Ignore the fact that the correlation is very weak (r=0.1) and insignificant. Try the line that since warming is not proven, so cooling must be happening. And add an insult as a diversion so no-one notices the sleight of hand.

Libel the Experts

Repeatedly point out that some of the experts are actually computer modellers, chemists or physicists, not ‘climate experts’, and make claims that they are in the pay of large governmental and NGO conspiracies. Refer to your own sources as ‘renowned climate experts’, even if they are retired engineers or computer modellers. (‘Renowned’ is the give-away term, as no reputable scientists refer to anyone as renowned.)

Quote Your Own Consensus

Quote a big, long list of scientists who signed up to an online statement supporting your view, but don’t worry if none of them are actually working in a related field of study. As long as they give academic titles and put PhD after their name, they are scientists, right? And don’t call it a consensus, as you have already claimed that consensus is not part of science.

Hide Contrary Views

To force recent posts that challenged your statements off the bottom of the first page, find a contrarian web site and cut and paste large chunks of it into your posts. This has the bonus of not requiring any thought whatsoever on your part. When the offending posts have disappeared, you can repeat what you wrote before, secure in the knowledge that new readers will not see that there are good reasons not to trust what you say.

The Lesson

This was the first time I tried to sustain interest in a blog comments section for a couple of days, and there were over a thousand posts in that time (some commenters seemed to post continually day and night – didn’t their mothers tell them to come up out of the basement and go to bed?)

I tried to direct arguments towards a discussion of evidence, towards an understanding of the statistical limits of certainty, towards the problematical bias of picking an opinion and searching out individuals who support that idea instead of dispassionately assessing opinions and evidence in the round. But it was for naught.

Delingpole told Paul Nurse in the Horizon programme that he didn’t read proper research papers, because peer-to-peer review (clever, huh!) was an improvement on peer-review because it allowed journalists and anyone with an interest to get stuck in.

And he said it with a straight face!

Cable’s Barmy Plan

Much of the current focus in the education press is on the threat to funding for Universities, with the Telegraph reporting a plan to allow badly run universities to go bust and close, and the LibDem Minister Vince Cable announcing that his department will in the future only fund the highest quality university research.

Cable’s plan is especially barmy, even if he does have a crystal ball to sort the research wheat from the chaff (who saw the value of lasers, developed solely to test a subtle prediction of Einstein’s, or knew that the quantum physics of the 1920s would lead to the digital revolution?)

If only the top research centres survive, where will the career progression for freshly qualified post-docs be? Where will Ph.D. students find posts to cut their teeth on and develop their skills? Why would the most talented students in schools be attracted to research instead of banking?

Britain’s research base is still world class, which is a near miracle given how much is done with so few resources. But the structure of our research base is lean already. If Vince Cable seems intent on reducing it back further, he will find that it is not the fat he is cutting away. Real and irreversible damage to the country will be done. It will not be easily reversed by cash injections in a few years time when the damage becomes apparent.

A Law Professor, Research and Feminist Rhetoric

I have spent some years arguing from a position of ignorance and opinion that feminism is founded less on a desire for equal opportunities than it is on seeking extra rights for women over men, whom they despise. Having just sat through an inaugural professorial lecture by an academic lawyer, who specialises in European law with a focus on feminism and the Strasbourg European Court of Human Rights, I am more convinced that is true.

I attended with an expectation that a legal academic with a taste for evidence and rational, unbiased judgement would present a much more attractive face of feminism than I see in the papers, with images in my head of CND campaigners and Harriet Harman foaming at the mouth at the unfairness of it all. But I was wrong.

The professor did not, to her credit, talk at all like Harriet Harman, nor look like a shapeless ‘Nukes Out’ Greenham Common camper. She was well spoken and lucid as she presented her research, but the research was not what I expected from academics at a good university. I had, in my naïveté, assumed that most research was similar to the physics papers I read, suffused as they are with original data, error margins, logical deductions, principles and proposals for falsification.

Research?

The reality was that the research was a survey and tabulation of just over a hundred cases heard by the European Court. Not the sample size of a thousand favoured by pollsters, despite figures reported to a tenth of a percent. There was no study of failed cases. No statistical analysis of the data to find significant differences. Just cases divided up into groups based on the sexual identity of the claimants and the type of right allegedly infringed.

Everything is a Feminist Issue

The main approach taken was to recast every rights claim as a sex discrimination case if a woman was involved. So, a woman as a single parent traveller, fighting a planning decision preventing her from setting up home in a green belt, should has claimed sex discrimination. (Why? Would a man have been treated differently?) A student at a Turkish university wanted to be able to express her religious identity by wearing an Islamic headscarf should have framed the claim ‘as a female autonomy case’ instead of a religious freedom one. Domestic and sexual violence, since they were ‘female-specific harms’, should require the state to intervene pro-actively to prevent breaches of the Act. This last point prompted a (male) member of the audience to query whether these were really female specific harms (and, by implication, whether framing all infringements affecting women should be twisted into gender issues). This drew sneering, eye-rolling and “for goodness sake” responses from others – how dare a MAN critique a feminist argument!

But the point was a good one. Equality for women under the law is a good thing, and pretty much achieved already. But to grant half the population additional rights, simply on the basis of their gender, is not equality. It is a single issue group advancing the political cause of those under the feminist umbrella at the expense of those outside. And that is not good.

Trying to be Right

Is this a case of lawyers trying to win an argument instead of trying to be right? The professorial lecture the following week was by a female science education researcher, who spent her time showing evidence (real research!) that girls’ and boys’ brains (minds?) are objectively different, and it is possible to teach them in such a way that far fewer girls will be put off studying physics and maths. No sneers here, just questions about the implications of the data. The lady was a self identified feminist, but instead of trying to bias the legal system, she had set to to find the causes of and solutions to the problems she has identified.

OK, so the social sciences have an unhealthy regard for weak correlations and use limited experimental procedures, but they seem to stand head and shoulders over the legal-eagles.

At Least I’m Not Bored!

I am up to my neck in coursework, annual appraisals, parents’ evenings and open days, in one of those months that make up for the long lazy holidays. So it is nice to know that teachers are the least bored workers in the country, according to a three year old survey I just found (note to the TDA – your press releases are not getting much attention!).

While researchers are in sixth place in the boredom stakes and engineers only marginally better in eighth, teachers report the lowest amounts of boredom of all graduate professions.

The full list from the Training & Development Agency for Schools’ Boredom Index:

  1. Administrative/secretarial (10 out of 10)
  2. Manufacturing
  3. Sales
  4. Marketing/advertising
  5. IT/telecommunications
  6. Science research/development
  7. Media
  8. Law
  9. Engineering
  10. Banking/finance
  11. Human resources
  12. Accountancy
  13. Hospitality/travel
  14. Healthcare
  15. Teaching (4 out of 10)

The press release adds:

When asked why they find their job interesting, 81 per cent of teachers questioned said it is the challenge of the role, 81 per cent because no two days are the same, and 86 per cent said they enjoy the interaction with people. Sixty-four per cent also rate the opportunity to use their creativity.

Employees surveyed say they are mainly bored because of the lack of challenge in their jobs (61 per cent), whilst not using their skills or their knowledge makes life tedious for 60 per cent. And boredom through doing the same things every day (50 per cent) is also to blame.

You might ask yourself how I found myself browsing through three year old press releases when I’m so busy …

Claims of HIV Vaccine Success are Premature

HIV vaccine
The excitement is palpable — the vaccine that nobody thought would work “appeared to lower the rate of HIV infection by 31.2 percent compared to placebo ”, according to the press release, although printing all three significant figures sets my inner sceptic on edge.

The BBC story improved things marginally, reporting a rounded percentage:

“Scientists announced last month that a combination of vaccines gave a 31% level of protection in trials among 16,000 heterosexuals aged 18-30.
Doubts had been raised about whether the finding was significant.
But new data published at a conference in Paris indicates that, while small scale, the findings are robust and statistically significant.”

Exciting, but while statistically significant sounds very scientific and reliable (the results were published in the New England Journal of Medicine (NEJM) no less), the journalists should have read the report itself. The figures reveal a little sleight of hand.

The study randomised over 16 000 people to either the vaccine program or a placebo, with none of the participants knowing what they had (a double blind trial — the best sort). The randomisation here is key, as the study was rather underpowered and was only likely to produce a marginal result at best, and any deviation from this randomisation may have introduced biases that were hard to spot.

The researchers actually carried out three statistical tests on the data from the trial: intention to treat (ITT), per-protocol and modified intention to treat (mITT) analyses. The first two look at those participants who were enrolled (ITT) or completed the treatments (per-protocol), and so preserve the randomisation of patients. These both failed to show a statistically significant benefit from the vaccine.

The mITT process removed several people from the analysis, both breaking the randomisation and producing a statistically significant result. This might have been useful if the vaccine had a clear benefit, but the published benefit was not 31.2% exactly. Rather the confidence interval for the benefit (the range in which the researchers were confident that the true benefit figure lay) was 1%-52%, with the lower bound only staying positive because of the arbitrary choice of 95% confidence intervals chosen by statisticians over the years.

With the two tests that avoided the possibility of bias getting ignored by the press (since they didn’t make the press release), and the remaining result showing that the vaccine could have had no actual benefit, the publicity seems a little unjustified.