Archive for the 'toxicology' Category

Will Like vs. Might Love vs. Might Hate

Saturday, February 28th, 2009

What to watch? Entertainment Weekly has a feature called Critical Mass: Ratings of 7 critics are averaged. Those averages are the critical response that most interests me. Rotten Tomatoes also computes averages over critics. It uses a 0-100 scale. In recent months, my favorite movie was Gran Torino, which rated 80 at Rotten Tomatoes (quite good). Slumdog Millionaire, which I also liked, got a 94 (very high).

Is an average the best way to summarize several reviews? People vary a lot in their likes and dislikes — what if I’m looking for a movie I might like a lot? Then the maximum (best) review might be a better summary measure; if the maximum is high, it means that someone liked the movie a lot. A score of 94 means that almost every critic liked Slumdog Millionaire, but the more common score of 80 is ambiguous: Were most critics a bit lukewarm or was wild enthusiasm mixed with dislike? Given that we have an enormous choice of movies — especially on Rotten Tomatoes – I might want to find five movies that someone was wildly enthusiastic about and read their reviews. Movies that everyone likes (e.g., 94 rating) are rare.

Another possibility is that I’m going to the movies with several friends and I just want to make sure no one is going to hate the chosen movie. Then I’d probably want to see the minimum ratings, not the average ratings.

So: different questions, wildly different “averages”. I have never heard a statistician or textbook make this point except trivially (if you want the “middle” number choose the median, a textbook might say).  The possibility of “averages” wildly different from the mean or median is important because averaging is at the heart of how medical and other health treatments are evaluated. The standard evaluation method in this domain is to compare the mean of two groups — one treated, one untreated (or perhaps the two groups get two different treatments).

If there is time to administer only one treatment, then we probably do want the treatment most likely to help. But if there are many treatments available and there is time to administer more than one treatment — if the first one fails, try another, and so on — then it is not nearly so obvious that we want the treatment with the best mean score. Given big differences from person to person, we might want to know what treatments worked really well with someone. Conversely, if we are studying side effects, we might want to know which of two treatments was more likely to have extremely bad outcomes. We would certainly prefer a summary like the minimum (worst) to a summary like the median or mean.

Outside of emergency rooms, there is usually both a wide range of treatment choice and plenty of time to try more than one. For example, you want to lower your blood pressure. This is why medical experts who deride “anecdotal evidence” are like people trying to speak a language they don’t know — and don’t realize they don’t know. (Their cluelessness is enshrined in a saying: the plural of anecdote is not data.) In such situations, extreme outcomes, even if rare, become far more important than averages. You want to avoid the extremely bad (even if rare) outcomes, such as antidepressants that cause suicide. And if a small fraction of people respond extremely well to a treatment that leaves most people unchanged, you want to know that, too. Non-experts grasp this, I think. This is why they are legitimately interested in anecdotal evidence, which does a better job than means or medians of highlighting extremes. It is the medical experts, who have read the textbooks but fail to understand their limitations, whose understanding has considerable room for improvement.

Flaxseed Oil Alert: Don’t Take When Pregnant

Monday, November 10th, 2008

From a press release:

A study has found that the risks of a premature birth quadruple if flaxseed oil is consumed in the last two trimesters of pregnancy. The research was conducted by Professor Anick Bérard of the Université de Montréal’s Faculty of Pharmacy and the Sainte-Justine Hospital Research Center and Master’s student Krystel Moussally.

In Canada, 50 percent of pregnant women take prescription medication. Yet many of them prefer to use natural health products during the pregnancy. “We believe these products to be safe because they are natural. But in reality, they are chemical products and we don’t know many of the risks and benefits of these products contrarily to medication,” says Bérard.

Bérard and Moussally set out to conduct one of the largest studies ever undertaken on by analyzing data from 3354 Quebec women. The first part of the research established that close to 10 percent of women between 1998 and 2003 used natural health products during their pregnancy. Before and after pregnancy they were respectively 15 and 14 percent to use these products. The increase means that about a third of women consuming natural health products stopped during the pregnancy.

The most consumed natural health products by pregnant women are chamomile (19 percent), green tea (17 percent), peppered mint (12 percent), and flaxseed oil (12 percent). Bérard and Moussally correlated these products to premature births and only one product had a very strong correlation: flaxseed oil.

“In the general population, the average rate of premature births is 2 to 3 percent. But for women consuming flaxseed oil in their last two trimesters that number jumps up to 12 percent,” says Bérard. “It’s an enormous risk.”

The correlation existed only with flaxseed oil, yet women consuming the actual seed were unaffected. Even if more studies must be undertaken to verify these results, Bérard recommends caution when it comes to consuming flaxseed oil.

Thanks to Joyce Cohen.

Ask Your Dentist Some Pointed Questions

Saturday, April 12th, 2008

This video, about mercury exposure from amalgam fillings, is all too convincing. Ugh.

Thanks to Dev Rana.

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