Posts by James Green
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Oh. One more great thing... I think there is increasingly a trend for some of the top journals to publish more controversial, provocative, salacious and/or quirky papers than some of the lower ranked journals. That's not to say that they're bad science per se, but that it's important to be a little cautious, even if something is published in Nature or the Lancet or BMJ or whatever. Sometimes (and I stress only sometimes) the editorial will highlight this (and potentially provide a good critique), but again, not always.
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Another pitfall with science articles is the extent to which the data supports the discussion&conclusion. It's not uncommon for papers to gently overstep the strength of their findings. Like where a survey is used to measure behaviour, and then you end up with the survey data being used like it actually measures behaviour. Somewhat inevitably as it distils down, it gets a little more black and white. The results section is often a touch grey, the discussion a little less so, the conclusions a little less so, and what makes it into the abstract. That said, more power to people reading science.
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The source Steve forgot to cite:
http://www.theonion.com/content/node/56631 -
I've been rather underwelmed by Lillian Ng's reporting as well. I think much as medical schools are attempting to educate their students to be able to think more critically about research, a good honours student in a science discipline would probably whomp them hands down. The reality is that teaching in medical schools is primarily clinical, and it revolves around simply memorising lots of stuff. It's really easy to talk about teaching critical evaluation and the ability to integrate multiple sources to come to a reasoned conclusion, but it's still bloody hard work. (I guess I don't mean any disrespect, it's just not what the course is about)
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The fact remains that the epidemic strain of the disease was waning naturally before rollout.
That would be a pretty good argument. Except that the epidemic strain also naturally waned to a similar level in 1998. But then it waxed again (see graph). So what great exists to differentiate that waning from this waning, Wayne?
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Ron,
You're so obsessed with this that you're not even reading/thinking straight. If the vaccine works (and that is obviously open to debate), and it saves a life, that is presumably because there are fewer cases (The vaccine is supposed to prevent cases, not deaths). So if it does work, and there are fewer cases, then there are fewer hospitalisations, and thereby fewer deaths. Thus, if you're looking at cost savings, then there is saved cost not only from prevented deaths, but prevented hospitalisations. This has nothing to do with hospitalisation rates between vaxed and non-vaxed kids, which you'd expect to be the same anyway. After all, the vaccine (if it works) prevents infections. Once infected, the chance of being hospitalised should be the same. -
Ron, your answer speaks volumes.
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Ron,
Your failure to grasp the rather obvious difference between the cost calculation of MeNZB and Herceptin makes me wonder about the logic (or intellectual honesty) or your other arguments.
I calculated the cost per life saved for Herceptin because it would only be given to women who already have breast cancer. Thus, in terms of other costs, they're already in and out of hospitals, their families, lives etc. are already battered. Thus, dividing the cost by 19 is actually reasonably accurate.
In contrast, the fatality rate for MengeB is 4-6%. Because almost everybody that gets it is hospitalised, that means for every death there are at least 15 hospitalisations. Herceptin does not have such associated hospitalisations. It either prevents remissions (life saved), or it doesn't :(
Unlike the families of Her2+ breast cancer patients, the families of people that contract MengeB are not already in shock etc. etc. Therefore, dividing the number of MengeB deaths by the cost does not produce an accurate cost/benefit ratio. That's the reason I use different methodologies for each instance. It's because they're different(!)I think the real problem here is that you care a little too much about your point of view, and it's blinding you to gaping holes in your logic. I don't particularly give a toss about either of these cases, I just get annoyed by the misuse of statistics. Thus, I think I'll respectfully pull out of this debate, because I don't ever think you'll see the elephant in your living room.
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The first episode of Rude Awakenings was pretty bad. I think just awkward character introductions, but it's warmed up. I haven't seen a full episode of The Hothouse yet, but so far I don't think it's up to Insiders
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Dear Ron,
Thanks for your charming and patronising reply.I'm not sure what figures he's referring to but there were only 161 cases of meningococcal disease last year.
There were 113 strain cases in 2005, and 259 in 2003, so it's not a great stretch to see how over several years there could be a savings of hundreds. If there were indeed fewer than 100 strain cases last year, then there will indeed have been a savings of hundreds.
there is evidence that the rate of hospitalisation among vaxed kids is about the same as that among non-vaxed kids.
That's an entirely useless, pointless, and misleading statistic. The vaccine doesn't aim to prevent hospitalisation, but aims to prevent infection.
And as for your cost calculation. A few points.
1. While the vaccine is only given to under 20s (most of the cases), the older people (most of the deaths) have to catch it off someone. So if you reduce the number of cases, then the chances of the old people catching it and dying are lower. So using only lives under 20 saved is misleading.
2. You calculate only a cost per life saved (and then only young lives). However, there are other savings relating to non-hospitalisations and all sorts of other things. That's the bit that's hard to calculate.Actually, I think we do know. But some people prefer to ignore the evidence. It's called intellectual dishonesty.
Talking about yourself in the third person. Nice.