How do you analyze evidence? - Page 4

[Jen123]

:

[Deborah]

A bit more on the library school lessons on evaluating source material.

Anything that purports to be scientific research should come with certain trappings. Foot or endnotes. A bibliography. Unless there is a really good excuse, it should be published in a peer-reviewed journal, appropriate to the subject matter.

Scientific articles published on a web-site should still have the footnotes, etc., plus information about the journal wherein it originally appeared. Work in progress should have the usual trappings, plus explanations of what has been done to date and what is planned for the future.

All of the above can be misused or faked, alas, but it still sets some sort of standard for the proper, consistent presentation of certain types of information.

It should be possible to evaluate the qualifications of the authors. Do they actually have expertise in the area they are investigating? An example is the infamous study by Pichichero of mercury excretion after vaccines. Although he does have considerable experience in vaccine research, he has almost no expertise in heavy metals and how they behave in the human body.

An article about medieval Florence by an expert on 18th century Scotland will not be taken seriously by historians or librarians.

Web-site evaluation is another big area for librarians. Besides looking to see who finances the site and looking for ads, it is important to see if the site is selling something, perhaps covertly. A natural health site may be pushing a particular brand of vitamins. Research may reveal that the site is actually owned by the vitamin company. This sort of link is unfortunately common in medicine. Doctors may own the lab that does a lot of their testing: giving them a hidden motive to recommend additional tests.

A few more obvious bits:

How often is the site updated? A well-managed site will have this information in an easy to find location. Individual articles should have posting dates, and edited dates.

Links should be checked regularly. Any site that has a lot of "rotten" links has probably been abandoned by its owner, or is at least seriously neglected.

Is there a clear "about" statement in a prominent place? How about contact information?

Most of this applies to magazines and books, too. All except the "link rot."

Nana

[amnesiac]

Nana- do you happen to have any specific tips on evaluating books since those are recommended constantly on this forum?

[Deborah]

Books are tricky. For example, I've heard librarians say "Is it from a respected publisher?" But I've seen really great books come from small, fringe presses.

The pieces I go with when trying to decide if I should buy a book for my public library:

1)reviews-I read library journal and booklist and the NYT book review and I look on Amazon (your typical book buying librarian can spend 20 hours a week reading book reviews and making notes on possible purchases).

2)background and experience of the author

3)if I can actually look at the book before buying, I would check out the footnotes, index, bibliography, table of contents and read a few excerpts. If there is a topic I know well, I'll look it up in the index and check to see if it is covered/included and if the author does a good job with it.

4)I'll ask other librarians if they have it yet, and if it looks good

5)I ask library patrons for recommendations, especially in their areas of expertise-for example, I ask members of our local garden club to look at book reviews of garden books. Even though I am a total flop as a gardener (I hate it) my latest two gardening book purchases have gotten rave reviews (pause while I pat myself on the back).

6)I also look for gaps in the library collection, or for outdated books on a particular topic and then go hunting for recent books that will fit into that "space." Amazon is very useful for finding books that fit neatly into a narrow category. For example, I recently found a book on backcountry ski trails in NY and VT. Our previous book on this subject was 20 years old. How does this apply to finding books on medical topics? Look at your collection. How old are the books? Perhaps something is outdated? Do you need a book on treating children with homeopathic remedies or one on wound care? And so on.

This is probably a bit too broad, sorry. I should go to bed!

Nana

[applejuice]

I agree Deborah.

I worked in a public library, and I can recall the reference librarian telling everyone that Prevention was a fringe magazine ... as well as Organic Gardening, published by the same people.

[xerxes]

Thanks, D. There's a lot of good advice there. I especially like the idea of picking out a topic that you know well and looking it up in the book to see how the author has treated that subject. In addition to picking a topic that's familiar (meaning the author has definitely talked about it so you can review it), I also like to pick out a fringe topic (i.e. aluminum's effect on antigen presenting cells which so far is the single biggest factor linking aluminum exposure to autoimmunity) and check whether or not the topic is even mentioned. In addition to being a very important piece of information it is also research that has been published in the last few years so it will tell you not only the author's level of comprehension but also the author's ability to include recent data. Unfortunately books often serve as cursory reviews for older data so there never seems to be any satisfaction in this regard.

D, thanks so much for all the great info.

Also, MK, I think it helps to discuss specific examples such as the link to autism (for instance that we were discussing). For the life of me I couldn't understand where the discussion was going before that point. IMO, concrete examples really help to illuminate the points being talked about. It'd be cool to see D's methodology applied to a specific example (perhaps the next time a book or piece of research is being touted).

[amnesiac]

It'd be cool to see D's methodology applied to a specific example (perhaps the next time a book or piece of research is being touted).

That would be super, I'd love to see that.

[amnesiac]

Bumped to go with Deborah's new thread.

[Momtezuma Tuatara]

Originally Posted by ERSsmom

A book I read recently kept claiming that if you get Whooping Cough once you will have life-long immunity. I thought this was wrong so I googled it. I found several state health dept sites that stated that getting WC does not give you life-long immunity, although it may give you immunity for a few years. Because of this discrepancy, I was skeptical of everything else in the book. The author should research everything she includes in her book.

I'm interested in how you decide what a reliable source is.

The medical profession used to say that one clinical bout of whooping cough gave life-long immunity. And actually, it did... to clinical disease, with a proviso about which they had no understanding.

That proviso was that every time there was a four yearly outbreak of pertussis your body would "finger" the bacteria again, and the internal immunological hard-drive would say "Ah yes, I remember that", and do a little bolsterring from inside. Becausse there were no symptoms it was presumed that "nothing" was happening, when something was.

The problem is that the extensive use of the pertussis vaccine means that the bacteria no longer flows around quite so fluidly. It's still out there, witness the outbreaks we see. But its sort of "jerky" and like kangaroo petrol.

What they have discovered recently, is that it seems the time needed for the immune system to do a reboot is about 12 years. After that if you get a good dose of pertussis, the immune system has slept for a bit too long, and you will get repeat clinical symptoms for two reasons. Firstly, the sleeping immune system.

Secondly, the pertussis bacteria does "shift" antigenically, slightly, over time.

That's no problem if every four, or eight years, it becomes a commensal bacteria in your nasopharynx, because the body registers the slight "shift" or "drift" whichever way you want to catagorise it.

The point of the above dribble is that the author of that book, rather than being wrong, was outdated.

The medical profession should have figured out, by now, as Amnesiac has pointed out, that vaccine which interfere with the community circulation of bacteria can actually do more harm than good.

The same applies, but in a different way, to other vaccines as well.

Take the meningitis issue. Neisseria meningitidis is a normal commensal throat bacteria that we all carry AT LEAST three times a year. The body registers that, ticks it off the list, and most of us simply get immunity.

But if they introduce a vaccine which wipes out that bacteria from circulating in the community, you do two things. You create a hole or vacuum, into which can step another variety that NO-ONE has had any prior experience with. The second thing you do, is that you put everyone MORE at risk as a result. Not just the vaccinated but also the unvaccinated.

In a sense that is what is happening with the pertussis vaccine. They have changed the normal times in which people are getting an immune alert, and if the gap is wide enough, and there is enough genetic drift, then that is enough to allow the bacteria to evade what priming existed in the first place.

[Momtezuma Tuatara]

Quoted by Amnesiac

I'm a snob about healthcare authors. I don't particularly like it when practitioners write about things that are beyond their scope of practice - like say a chiropractor that writes about baby food or medication.

Well, bang goes my credibility then. Since I write about everything I've never had any "practice" in, in the first place.

[amnesiac]

No, what I mean is that I dislike it when people use their professional titles as a position of authority but write about something beyond their scope of practice. Example: An article called "Formula is Unhealthy for Babies" by Dr. Bigshot Lady. Sort of gives the impression Bigshot Lady is speaking from a position of authority as some sort of medical doctor. Then when you read the byline at the end you find it's a chiro. That's what I dislike.

[mamakay]

But if you introduce a vaccine which wipes out that bacteria from circulating in the community, you do two things. You create a hole or vacuum, into which can step another variety that NO-ONE has had any prior experience with. The second thing you do, is that you put everyone MORE at risk as a result. Not just the vaccinated but also the unvaccinated.

How, exactly, does that work? I know there is an internal balance between bacteria and fungi, but how do different types of bacteria keep each other in check?

[Momtezuma Tuatara]

Benji's mom... even a sample size could be irrelevant.

for example.

This country is severely deficient in Selenium, and most people in this country don't know that. We KNOW that selenium is crucial for a well-functioning immune system, and that a deficiency of selenium can increase the virulence of the influenza virus for instance. That's the only one they've studied so far, so it could influence the "virulence" of a whole lot of other pathogens as well. We know that a selenium deficiency results in a greater strike rate for cancer.

So, if you were evaluating a large study on something from this country, and DIDN'T know that this country is selenium deficient across the board, and if THAT wasn't reflected in the study itself, you could make an assumption that that study applied to you personally when in fact it may not.

And these are some of the hidden confounders. Because you could read a study that looks just great on the surface, yet when you do some basic basic research, you could find many biological, social or economic confounders that actually destroy the conclusion of the study itself.

[Momtezuma Tuatara]

Deborah, my book was recently rejected by a mainstream publisher. The commissioning editor loved the book, BUT the decision to publish was based on whether or not it "fitted" into the way they analyse risk taking. The "risk" of publishing a book wasn't worth the effort to do so.

So anything that is controversial is less likely to be touched by "reputable" publishers, who get most of their business from the mainstream train of thought. To publish something that questions a paradigm risks losing work from mainstream, worth many more millions of dollars than that garnerred from the heretic.

Even if the "heretic" might, in X decades, become the mainstream.

So you'd like to think that anyone with brains can see that the real "truth" if controversial, is unlikely to be garnered through "reputable" publishers, any more than the "real" truth is likely to be got from "reputable" peer review medical journals.

[Momtezuma Tuatara]

Originally Posted by mamakay

How, exactly, does that work? I know there is an internal balance between bacteria and fungi, but how do different types of bacteria keep each other in check?

I'm not quite sure what it is you don't understand mamakay. I can see it in my head, and part of the explanation is above in the post about pertussis. It could be that I don't understand your question, because I can "see" what you are "thinking" in your head.

But I'l have a go. If its not what you want to know, then ask again.

When the primary circulating bacteria in any community was Hib, then the bacteria was primarily commensal, meaning we all carried it, and most of us simply got immunity to it.

A few, with lifestyle factors, immunodeficiencies, or nutritional deficiencies, would have enough "breaches" in the normal defences to move from having commensal bacteria to colonisation, to infection, and land up with one of the many varieties of "infection" that Hib can cause.

The mass use of the vaccine stopped the Hib bacteria from spreading in its tracks.

Which essentially left a "hole" in the circulating bacteria. The bacteria that stepped in to fill the breach (as in the saying that Nature abhors a vacuum) was the bacteria for which there is now the Prevnar vaccine.

Now, in the communities where the Prevnar vaccine is used, other bacteria have stepped in to fill the "hole" that the vaccine has caused. And the real problems start there, because many of the new bacteria are a lot less "treatable" than the old ones were.

Am is the expert on this one, and I don't want to go much further, because this thread isn't really about that. But she's the thread queen, so if she choses to go further with that, that's her call.

[ERSsmom]

Originally Posted by Momtezuma Tuatara

In a sense that is what is happening with the pertussis vaccine. They have changed the normal times in which people are getting an immune alert, and if the gap is wide enough, and there is enough genetic drift, then that is enough to allow the bacteria to evade what priming existed in the first place.

That makes perfect sense to me. It is similar to what I hear about chicken pox. Perhaps the author was referring to this phenomenon and I misunderstood. I will reread that particular part again. Thanks.

[Momtezuma Tuatara]

Okay, now add this into your analysis.

You KNOW that the early information on Pertussis was faulty, because they didn't understand what they were seeing, so the whole of the vaccination programme was based on flawed assumptions.

Since this thread is about analysing information, analyse this for me, and tell me what it says to you;

http://www.medscape.com/viewarticle/506457

US Clears Sanofi-Aventis Whooping Cough Vaccine




WASHINGTON (Reuters) Jun 10 - Sanofi-Aventis won U.S. approval on Friday to sell Adacel, a vaccine against pertussis for people ages 11 to 64, the Food and Drug Administration said.

Adacel is the first shot approved to boost immunity against whooping cough in adults, the FDA said. Adacel combines a whooping cough vaccine with routine tetanus and diphtheria booster shots.

Whooping cough vaccines are routine for U.S. children, but experts believe immunity to the disease wanes by adolescence. They hope booster shots for teenagers and adults will reduce infections in those age groups and keep the disease from spreading to infants, who can die from whooping cough.

The FDA approved GlaxoSmithKline Plc's whooping cough booster shot, Boostrix, in May for people ages 10 to 19.

[mamakay]

The mass use of the vaccine stopped the Hib bacteria from spreading in its tracks.

Which essentially left a "hole" in the circulating bacteria. The bacteria that stepped in to fill the breach (as in the saying that Nature abhors a vacuum) was the bacteria for which there is now the Prevnar vaccine.

That's what I was asking about.
I guess to be more specific, I'm wondering how and why that is. How does it work?
(Sorry for taking the thread off track...I'm just facinated by this phenomenon...)

[Momtezuma Tuatara]

Health ministry says polio vaccine doesn't cause fatalities

Since we are analysing information analyse this article and tell me what the assumptions are behind the statements of the health authorities are... based on what you KNOW of the history of this vaccine.

http://www.thejakartapost.com/yester...d=20050613.A03

The recent deaths of at least four children has raised concerns over the safety of the polio vaccine administered under the government's nationwide program.

.....

a preliminary report made by an independent team investigating the cause of the children's deaths had made it clear there was nothing wrong with the vaccine.

The team told us that the children's deaths had nothing to do with the vaccine dispensed during the May 31 mass vaccination. The children may have suffered other diseases they contracted before their vaccination," the physician told The Jakarta Post.


LBH Kesehatan claimed that a total of 61 babies, including six in Jakarta, one in Depok, and one in Bandung, had become victims of the substandard vaccine.

"As far as I know, the vaccine has no side effects at all. It is definitely safe. That's why the World Health Organization has allowed non-medical assistants to give it to babies," Jane said.

"We are afraid that after hearing the vaccine can cause fatalities, parents will be reluctant to vaccinate their children. Just one dose is not enough to make babies immune from polio. They have to be given at least three doses," she added.

[mamakay]

Originally Posted by Momtezuma Tuatara

Okay, now add this into your analysis.

You KNOW that the early information on Pertussis was faulty, because they didn't understand what they were seeing, so the whole of the vaccination programme was based on flawed assumptions.

Since this thread is about analysing information, analyse this for me, and tell me what it says to you;

http://www.medscape.com/viewarticle/506457

That would be called immunodependence upon a product in my weird world.