Chance News (September-October 2005)
Do car seats really work?
Freakonomics: the seat-belt solution
New York Times, 10 July 2005,
Steven J. Dubner and Steven D. Levitt
Dubner and Levitt are the authors of Freakonomics: A Rogue Economist Explains the Hidden Side of Everything (HarperCollins, 2005), which raises a host of provocative questions, including "Why do drug dealers still live with their mothers?" and "What do schoolteachers and sumo wrestlers have in common?"
In the present article, Dubner and Levitt challenge the conventional wisdom on car seats. Their take-no-prisoners style is evident in the following quote: "They [car seats] certainly have the hallmarks of an effective piece of safety equipment: big and bulky, federally regulated, hard to install and expensive. (You can easily spend $200 on a car seat).” Indeed, regarding the third point, the National Highway Traffic Safety Administration (NHTSA) estimates that 80 percent of car seats are not installed correctly.
What then are the benefits? Here the authors cite another NHTSA statistic: “[Car seats] are 54 percent effective in reducing deaths for children ages 1 to 4 in passenger cars.” It turns out, however, that this compares riding in a car seat to riding with no restraint. Surely the relevant comparison, as suggested in the title of this article, is to riding with seat belts.
The authors concede that for children up to two years old, seat belts are not an option, so car seats logically offer some protection. But for children of ages 2 and older, federal Fatality Analysis Reporting System (FARS) data shows no decrease in overall death rate for children riding in cars seats compared with seat belts. Moreover, this conclusion does not change after controlling for obvious confounding variables such as vehicle size or number of vehicles involved in the accident.
But perhaps the potential benefit of car seats is being masked by the installation woes noted earlier. To check this, the article reports that Dubner and Levitt had an independent lab conduct crash tests, using both 3-year-old and 6-year-old dummies, to compare car seats to lap-and-shoulder seat belts. In 30 mile per hour crashes, the impact figures for 3-year-olds were “nominally higher” with seat belts; for 6-year-olds the figures were “virtually identical.” In addition, both restraint systems performed well enough against federal standards that no injuries would be expected.
Is there a housing bubble?
Be Warned: Mr. Bubble's Worried Again
The New York Times, August 21, 2005
Irrational exuberance-Second edition Princeton University Press, 2005 Robert Shiller
According to the Times article, in December 1996 Shliller, while having lunch with Federal Reserve Chairman Alan Greenspan, asked him when the last time was that somebody in his job had warned the public that the stock market had become a bubble.
The next day while driving his son to school, Shiller heard on the radio that stocks were plunging becuased Greenspan had asked in a speech whether "irrational exuberance" was infecting the markets. He told his wife "I may have just started a worldwide stock-market crash," She accused him of delusions of grandeur.
Well, it did not start immediately but Shiller's book came out in Aprill 2000 allowing the publisher t.o say that the market crash predicted in this book started one month after it was published. Needless to say Shiller's book became a best seller.
In first edition Shiller defined a "speculative bubble" as a situation in which temporarily high prices are sustained largely by investor's enthusiasm rather than by consistent estimation of real value. This certainly seems to fit the period of increasing values of internet stock illustrated by this steady increase of the NASDAQ from 1990 to 200 as illustrated by this graph
At this point we recommend that you read the Grinstead_Review of the first edition of this book that Charles wrote for Chance News. You will note that his discussion question was
<quote>?What do you think this reviewer did with his stocks after writing this review?</quote>
Just how reliable are scenitific papers?
John Ioannidis, an epidemiologist claims that 50% of scientific papers eventually turn out to be wrong.
While it is known that science is a Darwinian process, proceeding as much by refutation as by publication, noone has tried to quantify this issue until recently. The author sets out to understand how frequently highly cited studies are contradicted.
"There is increasing concern that, in modern research, false findings may be the majority or even the vast majority of published research claims," says researcher John Loannidis in a related analysis,Most published research findings may be false, which appears in PLoS Medicine an open access, freely available international medical journal. (The Public Library of Science (PLoS), which publishes The PLoS Medicine is a non-profit organization of scientists and physicians committed to making the world's scientific and medical literature a freely available public resource.)
Loannidis examined 49 articles which were cited at least 1,000 times in widely read medical journals between 1990 and 2003. But 14, about a third, were later refuted, such as hormone replacement therapy safety (it was, then it wasn't), vitamin E increasing coronary health (it did, then it didn't) and the effectiveness of stents in balloon angioplasty for coronary-artery disease (they are but not as much as first claimed).
One source of error is unsophisticated reliance on 'statistical signifigance', as twenty randomly chosen hypothesis are likely to result in one or more statistically signifigant results. In fields like genetics where thousands of possible hypothesis, genes that contribute to a particular disease, are examined, many (false) positive results will routinely occur purely by chance.
Other factors contribute to false results. One driving factor is sample size. "The smaller the studies conducted in a scientific field, the less likely the research findings are to be true," says Loannidis. And another factor is effect size, such as drugs that work only on a small number of patients. Research findings are more likely to be true in scientific fields with large effects, such as the impact of smoking on cancer, than in scientific fields where postulated effects are small, such as genetic risk factors for diseases where many different genes are involved in causation. If the effect sizes are very small in a particular field, says Loannidis, it is "likely to be plagued by almost ubiquitous false positive claims."
The author goes on to define a mathematical model to quantify sources of error. He concludes that a large, well-designed study with little researcher bias has only an 85% chance of being right. A small sample, poorly performing drug with researcher bias has only a 17% chance of reaching the right conclusions. And over half of all published research is probably wrong.
The author's overall conclusion is 'Contradiction and initially stronger effects are not unusual in highly cited research of clinical interventions and their outcomes. The extent to which high citations may provoke contradictions and vice versa needs more study. Controversies are most common with highly cited nonrandomized studies, but even the most highly cited randomized trials may be challenged and refuted over time, especially small ones.'
In their related editorial, the PLoS Medicine editors discuss the implications of Loannidis' analysis. They agree with him in some respects as "publication of preliminary findings, negative studies, confirmations, and refutations is an essential part of getting closer to the truth," they say. And the editors "encourage authors to discuss biases, study limitations, and potential confounding factors. We acknowledge that most studies published should be viewed as hypothesis-generating, rather than conclusive."
The original paper Contradicted and Initially Stronger Effects in Highly Cited Clinical Research, appeared in the Journal of the American Medical Association in July 2005. and is available on line for subscribers. The abstract is available on-line.
A related Guardian (September 8, 2005) article is Don't dumb me down. 'Statistics are what causes the most fear for reporters, and so they are usually just edited out, with interesting consequences. Because science isn't about something being true or not true: that's a humanities graduate parody. It's about the error bar, statistical significance, it's about how reliable and valid the experiment was, it's about coming to a verdict, about a hypothesis, on the back of lots of bits of evidence.'
In fact, the Guardian has a web page with weekly articles devoted to bad science. You are invited to make submissions 'if you are a purveyor of bad science, be afraid. If you are on the side, of light and good, be vigilant: and for the love of Karl Popper, email me every last instance you find of this evil. Only by working joyously together can we free this beautiful, complex world from such a vile scourge.'
Dr Ioannidis's study focuses on medical research only. Would the same conclusions be applicable to other sciences such as physics or is there an inherent bias in his research?
The Economist article finishes by asking 'Is there a less than even chance that Dr. Ioannidis's paper is itself wrong?'
Submitted by John Gavin.
Paulos on errors in medical studies
Why medical studies are often wrong; John Allen Paulos explains how bad math haunts heath research
Who's Counting, ABCNews.com, 7 August 2005
In this installment of his online column, Paulos considers the JAMA report about contradictions in health research (Ioannidis, J.P.A. Contradicted and initially stronger effects in highly cited clinical research. JAMA, July14, 2005; 294:218-228 ). This research is well described above.
In the present article, Paulos cites a number of reasons for the problems. A single study is rarely definitive, but headlines and soundbites usually don't wait for scientific consensus to develop. People fail to appreciate differences in quality of research. Experiments are stronger than observational studies; in particular, surveys that depend on patients' self-reporting of lifestyle habits can obviously be unreliable. These ideas echo points made by the medical journals themselves in response to news reports (see, for example, see this Associated Press report).
Paulos also describes some conflicting psychological responses to medical news. People can be overly eager to believe that a new treatment will work. On the other side of the coin, in what he calls the "tyranny of the anecdote," people also overreact to stories of negative side-effects, even though such incidents may be isolated.
On the last point, Paulos writes:
A distinction from statistics is marginally relevant. We're said to commit a Type I error when we reject a truth and a Type II error when we accept a falsehood. In listening to news reports people often have an inclination to suspend their initial disbelief in order to be cheered and thereby risk making a Type II error. In evaluating medical claims, however, researchers generally have an opposite inclination to suspend their initial belief in order not to be beguiled and thereby risk making a Type I error.
Do you understand the distinction being drawn? To what hypotheses does this discussion refer?
Poor people receive worst public services
Matt Weaver, September 1, 2005.
JRF report: poverty, affluence and area, Dr Ben Wheeler and Professor Danny Dorling from the University of Sheffield, Dr Mary Shaw from the University of Bristol and Dr Richard Mitchell from the University of Edinburgh.
In the UK, it seems that the poorer you are the less likely you are to have access to public services, such as health care. This counter intuitive result is known as the "inverse care law" - those in greatest need have the worst services. A new set of reports from the Joseph Rowntree Foundation (JRF) sets out to graphically illustrate the nature and extent of geographical and social inequality in the UK at the beginning of the twenty-first century.
This study addresses inequalities using data from the 2001 Census, such as the geographical relationship between poverty, affluence and area. Appropriate Census data were extracted from the Census database and their distribution explored using maps, graphs and charts.
For example, 4.5 million people in the UK reported that they had both poor health and a limiting long-term illness in 2001. 5.9 million people said they provide care to family and friends on an informal basis. The amount of this informal care is provided in direct proportion to the rate of poor health in areas across the UK. The authors use a carefully constructed graph, based on census data, to illustrate the strong relationship between the two social variables.
In another example of the ‘inverse care law’, the authors use geographic data to highlight that higher numbers of practising, qualified medical practitioners tend to live and work in areas where the rates of illness are lower.
The authors comment on the graph that "Perversely, people living in the poorest neighbourhoods with the greatest needs are often the least likely to have access to the services and support that would help them improve their lives." Given the results in the graphs, the authors are not surprisingly very negative on their views of social equality in the UK today. Prof. Dorling said "it is acutely disappointing to discover that so many opportunities and resources still depend on where people live." And Dr Ben Wheeler, also from the University of Sheffield, said that "the census data shows quite clearly that although living standards have increased in 60 years, the rich and poor in Britain continue to live in two different worlds."
These graphs demonstrates the power of the Census to provide easily interpreted data that consider the entire population and make obvious the continued unequal distribution of resources and prospects in the UK today.
The authors advocate the use of simple quantitative methods throughout their work, the most complex being correlation coefficients. Typically, they use pairs of variables, derived from the Census data, are compared across the geographical areas, with most pairs representing one measure of need and one measure of availability. The objective is demonstrates associations rather than proving causes.
A related ‘inverse education law’ also appears to exist in the case of education. Areas which have the highest proportions of young people with no qualifications tend to have the fewest teachers available.
Some parts of some Joseph Rowntree Foundation reports are available on-line and are well worth reading.
For example, Thomas Clarkson won a prize in 1785, while he was a student at Cambridge, for An essay on the impolicy of the African slave trade. His essay includes an analysis of the very high rates of mortality (20%) among seamen on board eighty-eight slave ships that returned to Liverpool from their respective voyages in September 1787. This analysis was intended to counter the then prevalent pro-slavery argument that slave trade provided a nusery for British seamen. He includes some chilling graphics on life for slaves on board as well. This essay provoked him to pursue the goal of the abolition of slavery. This link also provides an harrowing extract from his book, History of the abolition of the African slave trade, which was first published in 1817, in which he gives more details of conditions of the lives of slaves.
Do you think that a lack of doctors lead to areas with generally poor health, or are areas with generally poor health unattractive places for doctors for they live, causing them to relocate elsewhere?