Confounding Variables

Over at Psychology in Action there’s a decent post on confounding variables.

The focus is on conducting and reading research and determining good research study practice but I think there is value in everyone knowing what confounding variables are.  So what are they?

Well, read that post……

Ok, good.

Another example that I got in my stats class (many moons ago) was the correlation of matches with cancer. Those people who tend to carry boxes of matches in their pockets also have a higher risk of cancer.

As in the Murder vs Ice-cream example given at the link above, there is no direct link between matches and cancer (though it’s obviously related), the most probable explanation is that those who carry matches are more likely to be those who smoke and it is the smoking that relates to cancer.

Smoking can then be said to be the confounding variable – the variable that explains both of the explicitly stated variables and either ties them together with a causal mechanism (Matches -> Cancer) or shows that there is no direct relation (Ice-cream -/-> Murder).

A similar effect may be seen with something like surveys, the manner in which a survey is carried out may introduce confounding variables (say a phone or internet survey which pre-selects participants by their access to said communication methods) or the questions asked may smuggle in assumptions that do not separate out confounding variables.

For example a survey may ask “Are you Religious” and “Are you Happy” (as many have). The Religious question smuggles in a number of extra factors that may contribute to a person’s level of happiness eg religions usually come with a feeling of belonging to a community, social interaction, social support networks or guilt over actions and feelings. Each of which may more directly impact happiness that religion per se.

Other areas may also suffer from the confounding variable problem, alternative medicine springs to mind. Say you suffer from a cold, you soldier through it until you can’t take it any more and start downing some homeopathic remedy. In a day or two your symptoms resolve and you feel better. Did the remedy work?

In this case the confounding variable could be the natural history of the disease. Colds don’t last for ever (it is “self limiting”), it could be that you took the remedy right before the cold would have resolved itself anyhow. If this is so the conclusion that the remedy “cured” your cold would be invalid, there would not be a causal connection between the remedy and the cold symptoms going away.

The natural history of the disease would explain the reason you took the remedy when you did (symptoms had reached a climax) and why the remedy appeared to work (the cold would have resolved anyway).

When we examine issues closely we can see that confounding variables crop up, and should be carefully considered, every time we try to determine a causal connection between two events or phenomena. This is the reason that skeptics chant “Correlation does not equal causation” like a mantra.

Just for fun, suggest some instances of confounding variables in the comments. The more obscure the better.

Related articles

• I Was A Skeptic, but… (sciblogs.co.nz)
• Five Signs You Might Be Wrong (sciblogs.co.nz)
• Amber Teething Beads a Few Points to Consider (sciblogs.co.nz)

Get Your Up-To-Date Vaccine News

Thanks to my recent single-minded posting I’ve stumbled across this resource that pulls together news and blog posts on vaccines and anti-vaccine topics.

It uses a cool functionality of Scoop.it to collect posts which are then “curated” by a real person (hate those obviously fully automated ones that often ping my posts).

Vaxfax monitor is a Scoop.it site, which means the curator specifies keywords and the software trawls Twitter, Google, Digg and Youtube to generate content that matches the keywords. Once this is done the output is offered to the curator to vet. The posts that are retained through this process are published to the main site while those that don’t make the cut are discarded.

The curator of this feed is a poster who goes by the handle anarchic_teapot. Regarding anarchic’s chosen Nym I took this from the about page:

“My handle was chosen entirely at random, so don’t read anything political, social or ironic into it. I have no connection with the Anarchist Teapot Collective, or the coder using the handle anarchic.teapot (with a period, not a hyphen). I’m pretty certain I used the name first, though.”

I contacted anarchic_teapot to get a bit more information about the process involved in putting this feed together and to get a feel about the person behind the page and for why this resource is important.

[Scepticon] Where abouts in the world are you based?

[anarchic_teapot] I live in France, surrounded by sunshine, wine and cheese. And lots of other stuff that’s bad for my diet.

[Scepticon] The agregator uses keywords to collect content, is there any way to get random stuff you’ve noticed into it?

[anarchic_teapot] It’s also possible to scoop stories directly off the Internet, using a browser widget. In fact, the 3 main aggregators I use: paper.li, scoop.it and newsvine now all offer this service.

[Scepticon] What’s the difference between those services?

[anarchic_teapot] Scoop.it will publish each article immediately it’s validated. You choose any tags and which sites you’re going to publish to. It’s useful for getting breaking news out the door, but does require a lot of time curating. Another drawback is that it can mean a lot of tweets going out, and I don’t like flooding the intertubes, out of respect for my long-suffering readers. I want to keep them!

Paper.li does quite a good job of finding keywords, and you can pick the regularity at which it’s updated. At most, you’ll have two tweets a day.
The (big) disadvantage is that you can’t remove unwanted content until after an update.

Newsvine doesn’t send out tweets, although I suppose it would be easy to send your personal RSS feed through a service like Twitterfeed for that. On the other hand, it does allow comments, so you can get a discussion going. You can also write quite a lengthy post about the article you’ve seeded, as they call it. However, you have to go find your content for yourself; it won’t go looking for you. Although you *will* be warned if Newsvine thinks someone has already seeded the same story.

[Scepticon] Once the stories are gathered what happens?

[anarchic_teapot] Every time I check the feed, I have up to 100 stories that I can either discard, block the source (porn sites, bots, or other minor noise) or decide to publish. I try to keep Scoops recent (past 2-3 days) and from reliable sources. I also try to keep repetition down.

[Scepticon] Why did you feel the need to create such a resource, what do you see as the goal of aggregating all this stuff in one place?

[anarchic_teapot] I suppose the need comes from not having enough time to check major news sources regularly, and nobody to do it for me. I’ve always been one to let the computers do the spadework. Putting it all in one place gives me the chance to spend more time sifting through the dross. There is a lot of dross. I have some absolute doozies lined up for future blogging.

At the same time, to see so much quackery being sold so hard scares me.
It keeps me motivated, and I understand why others are so implicated in the struggle for science too.

[Scepticon] What is the criteria for inclusion, do you simply include those things you already agree with?

[anarchic_teapot] Well, it’s all a bit subjective, as things have to be when you’re playing editor (I hate the word curator, that’s for museums) to any sort of publication. As a rule of thumb, I try to keep to stuff that’s informative, not too technical – I’m not the health professional in the family – and of immediate use. I had to think about announcements of potential breakthroughs (HIV and malaria are currently doing the rounds) but decided it would be quite enough to deal with currently available vaccines.

[Scepticon] What is the main focus, news stories that demonstrate harm of anti-vaccine views or information about vaccines themselves?

[anarchic_teapot] Both, really. For reasons of space, I try to avoid localised reports, unless the story is of wider relevance (e.g. a clinic offering free shots probably won’t make it, but an outbreak of mumps may). I occasionally throw in some of the nastier antivax stuff, well flagged as such, in the hope that someone better qualified than me will pick it up and pillory them.

The teapot also admitted to using the generated content prior to publishing as a means of keeping an eye on the shall-we-say “less reasoned” content out there. I believe the term used was “Stupidity detector”, turning these gems into the bases of blog posts.

One of the things that I am grateful the anarchic for is the attempt to keep the feed from turning into an agglomeration of random crap.As noted earlier, I often get pingbacks from sites that have linked to my posts (and sometimes published portions of them) that when I check are simply grabbing everything with a keyword with in filtering, even to the point that the main purpose of a page is 180^o opposed to what I’ve written but presents my content as if it’s in line with the site’s philosophies.

According to the teapot:

“The nice thing about Scoop.it is that you don’t *have* to publish anything.”

Ah, how refreshing.

Related articles

• Vaccines and Autism – Media Report Card Expanded (sciblogs.co.nz)
• Anti-Vaccine Charities – Is there any Quality control on Charities? (sciblogs.co.nz)
• IAS Complaint Part 1: Thimerosal in Your Vaccine? No. (sciblogs.co.nz)
• IAS Complaint Part 2: Gardasil Horrors – Horrific Reasoning (sciblogs.co.nz)
• IAS Complaint Part 3: Vaccine Ingredients: Not So Bad Really (sciblogs.co.nz)
• IAS Complaint Part 4: Anti-Vaccine Impact in New zealand (sciblogs.co.nz)
• Defending The Term “Anti-Vaccine” (sciblogs.co.nz)
• The Legitimate Risks of Vaccines (sciblogs.co.nz)

Defending The Term “Anti-Vaccine”

I have spent some time recently labelling the IAS as anti-vaccine. They themselves categorically state that they are not anti-vaccine. Who am I to say that I’m right and they are wrong?

Well, nobody really. I can’t read their minds, although if I could would that change anything? All anyone can do is examine their output, and that of others, and try to make a determination as to whether it is more consistent with an impartial, or simply safety concious, approach to vaccines and vaccination or an anti-vaccine stance.

I hope that my previous posts have demonstrated that the IAS in particular produces anti-vaccine rather than balanced vaccine safety material.  The mission of the IAS is to cast doubt on the safety and efficacy of vaccines not to educate responsibly about the real concerns and limitations of vaccine use. If this was their aim they could do a much better job. Look at the articles produced on their website and you will see many that promote the “dangers” of vaccinations, try to discredit health campaigns and generally aim to undermine public confidence in vaccines.

An organisation concerned about vaccine safety and promoting responsible use of vaccines might write about reducing wide-scale vaccination in favour of targeted vaccination of at risk populations. Perhaps They would also try to work with health authorities to examine ways in which vaccine production can be improved (better production techniques might avoid allergy issues mentioned below), or ways in which the distribution of vaccines can be made more effective and thereby reducing the need to preservatives that are thought by them to be harmful.

It is important to note that someone can be concerned about the safety of vaccines while not being anti-vaccine at the same time. I alluded to this above, but there are legitimate safety issues surrounding vaccine use and vaccines should indeed be closely scrutinised prior to mass roll-out via safety and efficacy trials and post roll-out via surveillance systems and doctors reports. It is a valid complaint that procedures are not always carried out effectively.

Sometimes though they are carried out quite effectively and in a follow-up post I will look at a couple of examples of this. The trouble is that often when a “danger” of vaccines is reported more coverage is given to the sensationalistic claims than the eventual explanation. Also (perhaps because of this) these claims have a tendency to hang around and affect public sentiment long after the coast is clear from a safety standpoint.

As I mentioned there are real risks associated with vaccine use, there are known side effects that can have implications for the health of a small number of vaccine recipients. One of the more obvious being allergic reactions to the vaccine ingredients. Those with egg allergies are urged to use vaccines cultured via chicken embryos with caution and may be unable to receive the vaccine at all. There can be other serious and not so serious or transitory side effects for specific vaccines and effects that are general to vaccines (such as redness, soreness, syncope etc).

As such there are a variety of non-histrionic ways that vaccine safety can be discussed, without impugning the general safety of vaccines. Likewise reasonable conversations may be had regarding relative efficacy of vaccine preparations against the myriad of infectious agents that we are exposed to as well as discussions about cost effectiveness of mass vaccination for low incidence infections.

Serotype replacement (or replacement disease) is another issue that can be raised. As infectious strains are targeted by vaccines there is the possibility that other strains that were less important in the pathology of disease become more prominent once the “Top Dog” has been removed.

Encouraging the production and research into more effective vaccines that give better or more long lasting protection could also be a fruitful line of approach. Perhaps we could focus on immunogenicity, better adjuvants would give a vaccine the ability to provoke a stronger immune response, possibly with fewer antigens – as has already been achieved with modern vaccines. If vaccines are improved in this way then there will likely be more local reactions with the inclusion better adjuvants. This again is a reasonable discussion to have.

The lack of large RCTs on all vaccines and the challenges of working around this (for example ethics prohibit withdrawing a measles vaccines then trying a new one against a placebo). The types of studies required or currently used to give us the appropriate information to act upon is something that we can all try to resolve together.

All these things are such that reasonable people may disagree and we should be able to marshal evidence based (rather than emotive) arguments to discover the optimal us of vaccines in society. To my reading of the IAS, their output appears limited to vitriolic and divisive attacks on health authorities and other informational agencies, vilification of pharmaceutical companies, fearmongering over the alleged dangers of vaccination and downplaying the risks of infectious diseases.

Where we start treading into anti-vaccination territory is when we start to become entrenched in a view that sees vaccination as an evil unto itself, perpetrated in the name of profits by immoral pharmaceutical companies and carried out by unethical doctors who are either ignorant dups or willing accomplices. Those who take this stance may make all of the reasonable arguments that I outline above but also be resistant to evidence that contradicts their views and committed to a general non-vaccine outlook.

In discussing this it is very difficult to convey the range of views that may be represented. Obviously we all exist on a spectrum – from fully pro-vaccine to recalcitrant anti-vaccine. It can also be very difficult to determine the views of people in conversation. I prefer to err on the side of caution and assume people are generally well intentioned and open to evidence until proven otherwise.

One of the defining characteristics of the anti-vaccination crowd, it seems to me, is the hyping of dangers far beyond what the evidence supports. As can be seen in some of the attacks on vaccine ingredients, lists of ingredients are given and scary information accompanies them with the toxicological effects of these compounds on living organisms. In these cases  though the dose is often ignored. Dose response is one of the corner stones of medicine and the dose makes the poison. Drink large quantities of formaldehyde and you’re in trouble, but in the tiny doses found in vaccines your body can easily handle it. as noted in a previous post our bodies actually make formaldehyde as part of normal metabolism and the amount found in vaccines is far smaller than that made by the normal process of living.

When it comes down to the bottom line – Vaccines work, and they actually perform that holy grail of CAM, “boosting” the immune system and allowing the body to heal itself. Not in some vague, feel good alternative medicine way but in real objectively measurable and observable ways. Your immune system is primed to react to infectious agents in such a way as to reduce the amount of time that it takes for an effective immune response to be mounted against the pathogen.

With this priming your body can fight off infections much more efficiently and this translates into keeping us healthy, or reducing the severity of diseases. While we can debate the finer points of vaccine safety and efficacy in the end we have a system that works and has saved many lives. I see that as a win.

[for more on this topic see this post from David Gorski of Science-Based Medicine published last year]

Related articles

• Vaccines and Autism – Media Report Card (sciblogs.co.nz/skepticon)

IAS Complaint Part 4: Anti-Vaccine Impact in New zealand

Finally in the series of extracts from my IAS Charity complaint, I give a brief look at the impact of anti-vaccine information in New Zealand. I also bring together information from other parts of the complaint that have not been covered in the extracts so far.

Impact of Anti-Vaccinationist Misinformation in New Zealand

Maintaining a high level of vaccine coverage is important for reducing the probability of disease outbreaks and to limit the spread of disease in the community. Diseases (often) spread due to contact between infected and uninfected individuals. If the uninfected individual has partial protection from the disease due to immunisation then the disease will spread with more difficulty. This is often referred to as “Herd Immunity”.

Herd immunity does rest on several assumptions, one of which is that immunised individuals are spread evenly throughout the population. If pockets of unvaccinated individuals develop then diseases can gain a foothold in that part of the population and spread outward – even to vaccinated individuals. If parents in a community are convinced by the IAS information not to vaccinate their children then an in-road for disease is created and outbreaks can occur. As such this would constitute a detriment to both children and the wider community – in direct contradiction to the IAS stated charitable aims.

New Zealand has struggled to reach recommended vaccination levels in the past with the coverage rate in 2005 being only 77% at two years of age¹. With such low rates of vaccine uptake in the population there is a risk of vaccine preventable disease outbreaks occurring in the population and putting children’s lives at risk. In fact this is happening now with the measles outbreak in Auckland. Health officials have linked this outbreak to lowered vaccine uptake attributable to anti-vaccine misinformation².

Vaccine coverage for a disease such as measles needs to be at approximately 90% or greater in infant populations to prevent epidemics³. Despite a focus on increasing coverage since earlier this century and improving coverage since the 2005 survey New Zealand still only sees an average of 85% vaccination coverage in this age group, with some areas dropping as low as 75%⁴.

In 2004, just prior to the Vaccine Coverage survey, a study was performed to see what reasons parents gave for not vaccinating their children⁵. The results of the study found that many of the parents interviewed made a decision not to vaccinate based on perceived risk of the vaccines. The risks cited were common anti-vaccinationist misunderstandings, including linking vaccines to autism and the belief that children’s immune systems are weakened by immunisations.

While almost all of the study participants consulted their GP for vaccination information, this source was seen as biased. In fact many of the “Pro-vaccine” sources were considered biased and parents expressed interest in information provided by groups outside the “medical establishment” indicating distrust of medical advice on this topic in general. The Immunisation Awareness Society was explicitly listed as a source of information by 76% of survey respondents, along with Naturopaths and Homeopaths (43% and 48% of respondents respectively).

The Immunisation Advisory Centre is sufficiently concerned about misleading anti-vaccination claims that they have included a page dedicated to rebutting this information on their website⁶.

Conclusion

The IAS dispute that they are “anti-vaccine” both in their Charity “Rules” (3. Beliefs, subsection C⁷ and through comments on their website. This claim rings hollow though when the actual content of their writings is examined. Therefore it is important to look at the effective output of the ideologies, philosophies and stance of the charity rather than their explicit statements.

In regard to IAS staff and members, belief that they are acting in the public interest, belief that their materials constitute an educational resource and belief that they are in fact doing the right thing are not enough. I have no doubt that the founding members, the officers and members of IAS sincerely think that they are provide a public service and that their interpretation of the scientific facts is the correct one. This however only affords them the right to be respected as individuals and for their views to be given fair hearing, it does not constitute a right to charitable status and does not exempt their views from criticism.

The IAS has shown through their materials that, despite protestations to the contrary, their views are anti-vaccine. This entails that their views are factually and scientifically incorrect, that they have an agenda to reduce or stop vaccinations being performed and that through this their actions may translate into serious harm for individuals, the community and the public at large. The IAS currently enjoys charitable status, as such they are exempt from taxation on their income. This amounts to a government subsidy of anti-scientific and potentially harmful views.

————————————————————————————————-

One last point, I am pretty clear to paint the IAS as anti-vaccine. They themselves deny this label, as mentioned above. But then I have a bias don’t I? Well, heres a link to a website that has the opposite bias, they list the IAS as on of their “100+ Great Anti-Vaccination Information Links“, I’d say that;s telling.

Footnotes:
1. NZ Vaccine coverage survey 2005
http://www.moh.govt.nz/moh.nsf/pagesmh/6028/$File/national-childhood-immunisation-coverage-survey2005.pdf
found on:
http://www.moh.govt.nz/moh.nsf/indexmh/national-childhood-immunisation-survey-2005

2. Stories covering the Aucland Measles outbreak:
http://www.stuff.co.nz/marlborough-express/news/5220199/Immunisation-rate-of-refusal-growing
http://www.nzherald.co.nz/immunisations/news/article.cfm?c_id=461&objectid=10553617
http://www.stuff.co.nz/national/health/5222511/Measles-outbreak-likely-to-spread

3. Predictive model for Measles Outbreaks. Coverage at 15months should be >90%
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2810912/pdf/10813154.pdf

4. Immunisation Coverage report 2010:
http://www.immune.org.nz/site_resources/Professionals/Research/2010_Immunisation_coverage_report.pdf
Found Here:
http://www.immune.org.nz/?t=603

5. Study looking at reasons NZ parents give for not vaccinating:
http://www.nzma.org.nz/journal/117-1189/768/

6. IMAC website with anti-vaccination rebuttals:
http://www.immune.org.nz/?T=938

7. Charities Register page for IAS:
http://www.register.charities.govt.nz/CharitiesRegister/CharitySummary.aspx?id=17c102eb-e79c-de11-9604-0015c5f3da29

IAS Complaint Part 3: Vaccine ingredients – Not so bad really

Next up in our voyage of crank discovery, via extracts from my IAS charity complaint, is a breakdown of simplistic reasoning around vaccine ingredients. Again, I have reproduced elements of the original article here for your convenience.

The following example was posted as a look at vaccine ingredients in two parts. I will not be so lenient – Both in one for you.

Vaccine Ingredients – Part 1
posted May 6, 2011

This post contains a number of misunderstandings and falsehoods both explicitly stated and implied. The post lists the type of cell culture lines that viruses are cultivated in in order to create vaccines and then implies that the cells from these cultures are still found in the final vaccine product that is injected, including the emotive claim that we are injecting aborted foetal tissue into our children with the vaccine.

[Quote]
“I bought Sue Claridge’s fantastic book “Investigate Before You Vaccinate,” and turned to page 44 which states: “The cell cultures used to grow the viruses and bacteria include monkey kidney (vero cells), foetal calf serum, chick embryo fluid, yeast and human diploid cells (cells from aborted human foetuses). WHAT?! You mean to tell me that we are injecting aborted human fetal cells into our babies?!”

This is incorrect.

While it is true that there are some cell lines used to culture viruses used in vaccines, it is inaccurate to say that we are injecting these cells into children. Once again precision in language is important, there are currently existing cell lines that were originally cultured using aborted foetal tissue. These cell lines used originated in the 1960s¹, meaning that the cultures used now many cell replication generations removed from the original tissue and are now are simply cells grown for medical use – not foetuses.

The only vaccine in the New Zealand schedule to be developed using cell lines derived in this fashion is the MMR vaccine, due to the inability to grow Rubella virus in any other type of cell line². Vaccines must also be purified before use in order to remove these cells prior to injection^3,4. Following purification the cells of the original culture are no longer present.

The article then proceeds to give a laundry list of possible vaccine ingredients, with the implication that the levels of these compounds are harmful at the doses provided in the vaccine.

[Quote]
“…formaldehyde (an embalming fluid). SERIOUSLY?! Oh, it gets better!!! Some vaccines also contain mercury, aluminium, preservatives, stabilisers, lactose, sorbitol, sodium chloride, sucrose, sodium borate, magnesium chloride, sodium phosphate, hydrolised gelatine, neomycin, gentimicin, streptomycin and human albumin…”

This dose insensitivity of the anti-vaccine rhetoric is recurrent and important. All chemicals have a threshold above which they can have detrimental effects on human physiology, the question is whether this threshold is exceeded by vaccine ingredients. The medical community is in agreement that the answer to this question is “no”. At this point the anti-vaccine community does not need to provide proof that the levels of compounds found in vaccines are harmful, the only goal is to raise questions about safety.

The United States CDC website has a page dedicated to vaccine ingredients and countering anti-vaccine questions about them⁵. The IAS article highlights that formaldehyde is used in vaccines and points out that this is used as an embalming fluid. The CDC website answers this question and it is telling that the IAS article does not mention that formaldehyde is also made in the body during normal metabolism. In fact it is calculated that a baby (depending on size) would have more than 50 times the amount of formaldehyde in its body naturally than it would get from a vaccine dose.

Most of the rest of the ingredients listed are stabilisers and preservatives of the vaccine components. Several such as sodium chloride (table salt) and sucrose (sugar) would not be considered harmful by most reasonable people. As such I will point out a small selection that would seem to be concerning and give the actual facts behind their use.

The first that would seem worrying is amorphous aluminum hydroxyphosphate sulfate. The approximate amount of this compound used in vaccines is 225 μg. Used as an adjuvant (a vaccine additive that modifies its effects) this ingredient actually makes the vaccine more potent by enhancing the body’s immune response to the vaccine. As such it has an 80 year track record of safety in vaccines⁶. Also, dietary sources of aluminium are not insignificant, estimated at 1.6-13 mg per day⁷ or 7-60 times that in the vaccine, even though bioavailability of chemicals is affected by the method of introduction to the body (oral vs injection) it’s hard to see how this minuscule amount would make any difference.

Another potentially scary sounding chemical in vaccines is sodium borate, the approximate dose per injection of vaccine is 35 μg. This is used to balance the pH. The LD50 (a measure of toxicity) for this compound is 2-3 g/kg in mammals⁸ and as such is actually slightly less toxic than table salt (~3 g/kg⁹), the 35 μg in the vaccine if given to a 50kg individual equals a 0.7 μg/kg dose, this isn’t even close to a dose high enough to cause even a minor problem.

The article goes on to make a specious assertion that we were “created perfect as we are” and that we shouldn’t need to inject “formaldehyde and monkey cells” into our bodies to make our immune systems work, if we did we would be “born with it”.

[Quote]
“Weren’t we created perfect as we are? Do we really need to be “fixed” or “made better” by injecting these substances into our bodies? If we were meant to have formaldehyde and monkey cells in our bodies in order for our immune systems to work, wouldn’t we have been born with it?”

Aside from the unintended irony that we actually were born with formaldehyde in our bodies this claim is poor reasoning. By this criteria some of us would have also been “born with” glasses or contact lenses or hearing aids. This article also would appear to refute the utility of acquired immunity – if we needed foreign bodies in our system to make our immune systems work then we would have been born with them.

Finally the question is asked “If we’re all suddenly going to get sick or die if we don’t get these vaccines, then how did we survive for tens of thousands of years without these ingredients inside us?” ignoring for the moment that it is not the vaccine ingredients themselves that we need but rather the antigens in the vaccine that the rest of the ingredients stabilise and preserve, the simple answer to this question is “millions of us didn’t survive”.

Vaccine Ingredients – Part 2
Posted May 9 2011

This post appears to be one long argument attempting to cast doubt on the level of knowledge we have regarding the operation of our immune system. By quoting from an anatomy and physiology text book¹⁰ and emphasising tentative sounding words such as “appears”, “may” and “apparently” the author is attempting to show that the entire field on immunology is in doubt.

[Quote]
“On page 778, after talking about T cell maturation, it mentions that “less is known about the factors that control B cell maturation in humans” i.e. they haven’t quite figured out how B cells mature in our bodies yet. Another classic is on page 792, when they try to explain why the immune cells sometimes attack foreign human cells when a patient has received a graft. Their explanation is that “apparently, [emphasis mine] the cytotoxic T cells sometimes ‘see’ the foreign class I MHC antigens as a combination of self class I MHC protein bound to foreign antigen” i.e. they don’t actually [emphasis mine] know how it works, but this is their best guess.”

The fact that the text is dealing with minutia of the immune system down to the level of cell generation and activity seems to not persuade the author that in fact there is a great deal currently known about immunity and how our immune system works. To the point that it is considered feasible (by the author) that future text books will recall the use of vaccines and their “toxic ingredients” as complete folly.

The level of argument here is such that similar reasoning could be used to show that since the fluid dynamics at the edges of aircraft wing tips is not completely worked out, in the future we may discover that airplanes cannot fly after all. The point of this parody is to show that the author is confusing knowledge of mechanism with knowledge of efficacy. We know vaccines work, study upon study of new and old vaccines verify this fact every day. The inability of science to answer every minute facet of why they work does not invalidate this data. Once again the only goal here is to plant a seed of doubt about the safety and effectiveness of vaccine in the minds of the public. As such the IAS once again demonstrates the education is not the desired outcome of their operation.

—————————————————————————————

Footnotes:
1. Cell lines

http://www.viromed.com/services/product/wi38.htmhttp://www.viromed.com/services/product/mrc5.htm

2. Vaccine Manufacture

http://www.immunizationinfo.org/issues/vaccine-components/human-fetal-links-some-vaccines

3. Vaccine Purification:

http://www.cuno.com/healthcare/pdfs/application_briefs/vaccine_production.pdf

4. Vaccine requirements(Section III, sub section B.5. paragraph 2):

http://www.fda.gov/BiologicsBloodVaccines/GuidanceComplianceRegulatoryInformation/Guidances/Vaccines/ucm074801.htm

5. CDC Vaccine ingredients page:

http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/VaccineSafety/ucm187810.htm

6. Aluminium track record:

http://www.webmd.com/parenting/news/20040129/aluminum-in-vaccines-poses-no-harm

&

http://www.chop.edu/service/vaccine-education-center/hot-topics/aluminum.html

7. Dietary aluminium:

http://www.efsa.europa.eu/en/efsajournal/pub/754.htm

8. Sodium Borate MSDS:

http://www.anachemia.com/msds/english/f880%28vcr%29.pdf

9. Safety sheet for NaCl

http://msds.chem.ox.ac.uk/SO/sodium_chloride.html

10. The Text book that appears to be written about:

http://www.campusbooks.ac.nz/product/21980-HumanAnatomyandPhysiology-9780321584199

IAS Complaint Part 1: Thimerosal in Your Vaccine? No.

As promised here is the first of the articles that I deal with in the formal complaint I made to the Charities Commission regarding the misinformation spread by the anti-vaccine charity IAS.  So, with out further ado (what is ado anyway?) here is the link to the offending piece and my rebuttal:

Thimerosal in your Vaccine?
Posted September 13, 2010

This post on the IAS website (made up of basically an uninformed question about the harmfulness of ethyl mercury and a video) insinuates that Ethyl Mercury (also known under the trade name Thimerosal)¹ is both harmful in the amount contained in vaccines and, by extension, that New Zealand vaccines contain this substance and should therefore be viewed with suspicion.

The first thing to note is that the Thimerosal post is irrelevant to New Zealand populations as Thimerosal is not present in any of the vaccines used in New Zealand². Bringing up this issue in the context of New Zealand vaccines (implied as this is a New Zealand organisation geared towards New Zealand residents) is at best ignorant and at worse disingenuous scaremongering. Even so it is useful to deconstruct the post anyway as it is indicative of the faulty reasoning and scientifically inaccurate content of the IAS website.

The post includes a link to the Material Safety Data Sheet (MSDS) for Ethyl Mercury as support for this claim³. The relevant part of the MSDS has been reproduced below to give an indication of what the post considers concerning about the use of Thimerosal in vaccines.

Quoting from the MSDS:

“Effects of Overexposure: Topical allergic dermatitis has been reported. Thimerosal contains mercury. Mercury poisoning may occur and topical hypersensitivity reactions may be seen. Early signs of mercury poisoning in adults are nervous system effects, including narrowing of the visual field and numbness in the extremities. Exposure to mercury in utero and in children may cause mild to severe mental retardation and mild to severe motor coordination impairment.”

This is used in conjunction with a video link on the page⁴ to advance the hypothesis that Thimerosal in vaccines causes  autism, despite the fact that the symptoms listed are explicitly due to overexposure, not the trace exposure that  constitutes the vaccine dose. This type of “any level is harmful” approach to medicine neglects the dose response  relationship of drugs and other chemicals in the body. This hypothesis also ignores scientific research into
mechanisms of autism, the epidemiology of the increase in autism reports and the failure of the hypothesis to account for the continued rise of autism cases after Thimerosal was removed from the majority of vaccines.

The web-based resource Science Based Medicine has a reference page containing summaries of and links to the various studies showing no link between Thimerosal in vaccines and development of autism or autism spectrum disorder (ASD)⁵. The studies in aggregate looked at the claim of a link between Thimerosal and autism in a number of ways. Several looked at large groups of individuals and attempted to find any sort of correlation between childhood exposure to Thimerosal and development of autism symptoms. All together these studies combed through the data of over 750,000 individuals in several different countries and found no evidence to support a link.

Continuing to disseminate information that implies a link between Thimerosal and autism is to be either wilfully ignorant of the current state of research, in which case claims to educational content are not accurate, or to be dismissive of the current research as being an inaccurate reflection of the facts. This second option depends on there being some sort of conspiracy within the scientific/medical community to hide the truth. No such conspiracy can be substantiated.
As an side, the MMR vaccine has also been linked to development of autism in the minds of anti-vaccine campaigners since Andrew Wakefield’s now discredited and retracted paper in the Lancet⁶. A Cochrane review of the evidence shows

“No credible evidence of an involvement of MMR with either autism or Crohn’s disease was found.”

and

“Exposure to MMR was unlikely to be associated with Crohn’s disease, ulcerative colitis, autism or aseptic meningitis…”⁷

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Footnotes:
1. Thimerosal clarification of chemistry:
The chemical IUPAC name of Thimerosal is actually
Ethyl(2-mercaptobenzoato-(2-)-O,S)mercurate(1-) sodium.
This breaks down to Ethyl Mercury in the body.
http://en.wikipedia.org/wiki/Thiomersal

2. Vaccine ingredients:
a. Childhood vaccine Schedule:
http://www.moh.govt.nz/moh.nsf/indexmh/immunisation-schedule-html
http://www.betterhealth.vic.gov.au/bhcv2/bhcmed.nsf/pages/wycpreve/$File/wycpreve.pdf
http://www.betterhealth.vic.gov.au/bhcv2/bhcmed.nsf/pages/gwcinfih/$File/gwcinfih.pdf
http://www.betterhealth.vic.gov.au/bhcv2/bhcmed.nsf/pages/gwcinfiv/$File/gwcinfiv.pdf
http://www.betterhealth.vic.gov.au/bhcv2/bhcmed.nsf/pages/gwchibrx/File/gwchibrx.pdf
http://www.betterhealth.vic.gov.au/bhcv2/bhcmed.nsf/pages/gwcbostv/$File/gwcbostv.pdf
http://www.betterhealth.vic.gov.au/bhcv2/bhcmed.nsf/pages/cscgarda/$File/cscgarda.pdf

b. Influenza Vaccines:
http://www.moh.govt.nz/moh.nsf/indexmh/influenza-a-h1n1-2010-faqsseasonal#safety
http://www.moh.govt.nz/moh.nsf/Files/swineflu/$file/vaxigrip.pdf
http://www.moh.govt.nz/moh.nsf/Files/swineflu/$file/Fluvax.pdf
http://www.moh.govt.nz/moh.nsf/Files/swineflu/$file/Influvac.pdf

3. MSDS cited on the IAS website:
http://www.vaccine-tlc.org/docs/Thimerosal%20Material%20Safety%20Data%20Sheet.pdf

4. Misleading video posted under the heading “Thimerosal in your Vaccine?”:

5. The Science-Based Medicine resource page on Vaccines and Autism:
http://www.sciencebasedmedicine.org/reference/?p=1

6. Andrew Wakefield:
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2810%2960175-4/fulltext
http://www.bmj.com/content/342/bmj.c7452.fullhttp://www.nature.com/ajg/journal/v105/n5/full/ajg2010149a.html

7. Cochrane review:
http://www2.cochrane.org/reviews/en/ab004407.html

Anti-Vaccine Charities – Is there any Quality control on Charities?

I haven’t really been writing much lately, for this blog at least. Much that is due to simple procrastination but earlier this year my free time was spent doing something equally stimulating.

Back in July I submitted a complaint to the New Zealand Charities Commission, which they (allegedly) are currently investigating, about the Immunisation Awareness Society (IAS). This is a charitable organisation that disseminates anti-vaccine information, while at the same time denying that they are anti-vaccine.

Grant has recently done an excellent post on some of the nonsense put out by IAS representatives, go have a read if you’ve not seen it yet.

My complaint focuses on the fact that to be a registered charity an organisation must fulfil a charitable purpose (makes sense). The particular legislation outlines these purposes as:

“the relief of poverty, the advancement of education or religion, or any other matter beneficial to the community.”

In my complaint I detail how the advancement of education is not met by the IAS, that they are anti-vaccine and that they therefore do not constitute a benefit to the public. As they do not relieve poverty nor advance religion this effectively should remove them from the arena of “Charity”.

To answer the question posed in the title, theoretically – yes there is quality control over charities. Part of the mandate of the Charities Commission is to:

“promote public trust and confidence in the charitable sector”,

“monitor charitable entities and their activities to ensure that entities that are registered as charitable entities continue to be qualified for registration as charitable entities”

and

“inquire into charitable entities and into persons who have engaged in, or are engaging in, conduct that constitutes, or may constitute, a breach of this Act or serious  wrongdoing in connection with a charitable entity”

In large part my compliant is based on this previous post about the IAS, cleaned of snark and updated with a few references. In addition I dismantle a few of the “Educational” posts on their website to show how the information they promote is factually incorrect and geared towards convincing parents not to vaccinate their children.

In particular I look at This post that attempts to link NZ vaccines with Thimerosal and thereby to Autism even though both links in this chain are fictitious. Next I go over This post which is a copy of a submission to an FDA committee by Roberta Boyce founder of the anti-Gardasil website truthaboutgardasil.org, predicably criticising the Gardasil vaccine for being some sort of secret plot to make people sick and sterile. Okay maybe you couldn’t have predicted that. Finally I take apart yet more claims about the “Toxic” ingredients of vaccines, similar to another of my previous posts. Then I cover potential and actual damage caused by anti-vaccine sentiment (like the Auckland Measles outbreak).

I have no doubt that the IAS will rail against this complaint claiming that I’m trying to suppress free speech (nothing of the kind, they can continue their activities without being a charity) or that I’m attempting to smear them (no need, their output speaks for itself) or that I’m a henchman for the Immunisation Advisory Centre (no affiliation, but if they want to throw some money my way…;-)).

I’m hopeful that this complaint will at least get the Charities Commission to pay attention to the IAS and it’s output. Like I said I’m not interested in shutting them down, upholding free speech means defending those you don’t agree with (or something, I’m hazy on the details. People tell me it’s good). The issue I have is that these guys are essentially receiving a government subsidy (in the form of tax exemptions) for spouting inaccuracies.

Finally I have to give enormous thanks to Simon Clendon who kicked me into action after my post on the IAS philosophies and took on the task of editing the brain dump that resulted. He also made a bridge to the nice people at the IMAC who provided some extra info (still no affiliation just a few emails).

For those who want more on how I deal with the IAS misinformation I will repackage the various sections of the complaint as follow-up posts (tagged “IAS complaint”). Plus, I went to all that work, might as well eh?

If you want to read the full complaint in all it’s damning detail and mind numbing depth you can find it in PDF form Here, I’ve also got a snappy snip url: http://snipurl.com/iascomplaint. Go on, you know you want to. Tell your friends.

There are also a few supporting documents at that address as well, just to make finding them easier. If this inspires you to make your own complaints then go for it, the more the merrier, probably. I’m sure you needn’t go to as much trouble as I did (though if you want to, it’s fun. Plus by now the IAS has continued to march ahead with new misinformation).

Related articles

• Why are Internet anti-vaccine messages dangerous (medicalxpress.com)
• Vaccines and Autism – Media Report Card (scepticon.wordpress.com)

A Better World Through Video Games

Over the last few years evidence has been mounting that violence in the media and especially interactive media such as video games contributes to aggression displayed by individuals.[1] This ability to influence our behaviour in such a way is concerning and may undermine attempts to build a peaceful society that nevertheless respects a person’s right of autonomy and the ability to choose the entertainment in which we wish to partake[2].

If we accept that the entertainment we consume may have negative effects on our behaviour, (and much as I hate to admit it the evidence is pretty convincing) at what point do we decide that it is our responsibility to curtail these forms of entertainment for the greater good?[3] I’ll leave you with that to ponder ‘cos that’s not actually what I’d like to address, this is just the lead-in.

The research suggests that, like yawns, aggression is contagious. Bad stuff. But, what about positive feelings and outcomes? Can we propagate happiness and kindness in the same way? A recent paper suggests: yes.

‘“Remain Calm. Be Kind.” Effects of Relaxing Video Games on Aggressive and Prosocial Behavior‘ is the title of a paper recently published in the journal Social Psychological and Personality Science. In it authors  Jodi Whitaker and Brad Bushman look at the effects playing different sorts of video games has on post game behaviour. The full paper remains locked behind a pay-wall but a decent overview is provided here. Essentially the researchers randomly assigned participants to either relaxing, neutral or violent games. The participants then had their levels of aggression or prosocial tendencies measured in one of two ways.

In the first experiment the subjects participated in a mock competition (not mock to them, they thought it was real) in which they had to push a button faster than their “competitor” If the competitor won the study participant chose an amount of money to give them. If the competitor lost then the subjects got to blast them with noise, and could choose how loud and long the blast was.

Predictably, those who had played the violent games hit their opponents with longer and louder sound blasts than those who played the neutral games, who in turn were more aggressive than the relaxed gamers. Conversely the most money was given to winners by the participants who played relaxing games.

The second experiment was a little more subtle. Post gaming the participants were given a questionnaire measuring their mood, once this was completed the participants were told the experiment was over. The researcher then asked for help sharpening pencils for another study, how many pencils the participants choose to sharpen was used as a measure of prosocial behaviour.

As you will have inferred, the (now) hippy-dippy gamers opted to spend more of their time sharpening pencils than their amped-up counterparts. Thus the world is made just a little bit better through the use of video games. Or at least there are slightly more sharp pencils than there would otherwise have been, that’s progress, right?

I’d like to know the full suite of games that were used in the studies but we do have one example from each category: “Endless Ocean” is one of the relaxing games, “Super Mario galaxy” is a neutral game and “Resident Evil 4” is, of course, the violent game. Now I know what you’re thinking, “that stupid scuba game couldn’t possibly be as much fun as blasting zombies!” well, apparently, it is. An independent group of students rated the entertainment and enjoyment value of each of the games and the researchers were careful to match the game ratings.

I doubt that relaxing and calming games are likely to supplant the violent kind in the gaming ecosystem any time soon but it is nice to see that people can be influenced in good ways as well as bad by media.

To plagiarise and butcher a quote from Homer Simpson:

“To video games! The cause of, and solution to, all of life’s problems.”

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Whitaker, J., & Bushman, B. (2011). “Remain Calm. Be Kind.” Effects of Relaxing Video Games on Aggressive and Prosocial Behavior Social Psychological and Personality Science DOI: 10.1177/1948550611409760

Footnotes:

1.Here’s a list of publications supporting a link between games and aggressive behaviour spanning couple of decades. Obviously more of a taster than a full list:

Bushman, B., & Gibson, B. (2010). Violent Video Games Cause an Increase in Aggression Long After the Game Has Been Turned Off Social Psychological and Personality Science, 2 (1), 29-32 DOI: 10.1177/1948550610379506
http://spp.sagepub.com/content/2/1/29.full.pdf+html

Gentile, D., Lynch, P., Linder, J., & Walsh, D. (2004). The effects of violent video game habits on adolescent hostility, aggressive behaviors, and school performance Journal of Adolescence, 27 (1), 5-22 DOI: 10.1016/j.adolescence.2003.10.002
http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.120.746&rep=rep1&type=pdf

Silvern, S. (1987). The effects of video game play on young children’s aggression, fantasy, and prosocial behavior Journal of Applied Developmental Psychology, 8 (4), 453-462 DOI: 10.1016/0193-3973(87)90033-5
http://www.sciencedirect.com/science/article/pii/0193397387900335

Anderson, C., Shibuya, A., Ihori, N., Swing, E., Bushman, B., Sakamoto, A., Rothstein, H., & Saleem, M. (2010). Violent video game effects on aggression, empathy, and prosocial behavior in Eastern and Western countries: A meta-analytic review. Psychological Bulletin, 136 (2), 151-173 DOI: 10.1037/a0018251
http://psycnet.apa.org/psycinfo/2010-03383-001

2. With the normal caveats of not harming anyone else or restricting their freedoms, yada yada. My point is how far up the chain do we determine that an action harms another?

3. As we do with other forms of potentially harmful behaviour eg speeding limits, driving blood alcohol limits etc.

Holy Hyperbole Batman!!

Apparently the Armageddon predicted by Harold Camping is not the only one we have to contend with. Watch out, it’s The Next Armageddon!

Did you know that the WHO is not the health promoting organization we think it is but really the most nefarious institution in human history?[1]

According to one conspiracy nut[2] the WHO has put into action a plan to kill over 3 billion[3] people. Huh, WHO’da thunk it?

WHO is really going to take this seriously?[4]

The target of this hysteria is the Codex Alimentarius, a set of regulatory guidelines put out by the WHO to:

“..develop food standards, guidelines and related texts such as codes of practice under the Joint FAO/WHO Food Standards Programme. The main purposes of this Programme are protecting health of the consumers and ensuring fair trade practices in the food trade, and promoting coordination of all food standards work undertaken by international governmental and non-governmental organizations.”

At least, that’s what “They” want you to think. Mwahahaha!

Russians and Nazis and conspiracies, Oh My!

The first thing you’ll notice about this brightly coloured screed[5] is the complete absence of references. A large number of extremely serious allegations are made and not a single effort has been made to allow you to verify these for yourself.

The first real claim made (apart from the whole killing three billion people thing) is that a Nazi war criminal teamed up with the United Nations to control the population of the world through the food supply. Not a sniff of backing for this is included in the text. Searching on the name of the Nazi[6] and United Nations turns up only other conspiracy sites using virtually identical text. I’m convinced.

This page also taps into the paranoia around water fluoridation by asserting that fluoride is both a poison and has the effect of eliminating aggression and ambition. the proof?

“…. and the fact that it is used in many drugs prescription[sic] shows that it eliminates aggression and ambition in people.”

What more do you need sheeple??? Obviously it must be true, its all in black and white (except the bits in red). Plus, you know, the Russians used it in experiments and got the same results. Uh, where did you get that tidbit? Show me that paper, and the others where it was replicated. Oh, it’s part of the conspiracy you say. How convenient.

Regarding poisons, I’ve said it before: Dose Matters. Things that in high doses would kill us are routinely used in medicine. There is a range where the benefit’s of a substance outweigh the risks. To deny this is to fundamentally misunderstand medicinal and toxicological science.

Of course, this is all the work of evil entities that have been planing population control since the early 1960′s. I have to say that this is some impressively long term planning. I’m surprised there’s no mention of the “Illuminati” if anyone is good at long term, surely it’s them.

Conspiracies, conspiracies everywhere….

“Why Are You Not Aware Of This?

Because the strategy was so thought-out that it’s almost impossible to realise our food is being used against us.  But when you dig deeper you will see that everything is set up to kill us slowly over time… without one factor being the main cause, because there are many. Basically, for those who die… it will be made out as their own fault…”

Yep, almost impossible. Almost. Only those who have the ability to scratch the surface, pull back the curtain and pierce the fog can work it out. Gosh they must have keen insight. Or perhaps they are engaging in overactive pattern recognition and faulty reasoning, not to mention MSU[7] syndrome. It could go either way.

But wait, there’s more. Not only is this guy warning us out of the goodness of his heart, he’s also willing to sell us a book that tells you how not to be killed by the evil powers that be. How nice.

The price of USD$37 is just symbolic, you know nominal, don’t worry about it at all.

My favourite of the benefits touted as to why you should buy the book is:

“The naked truth behind UMAMI (the taste scam behind 90% of the foods today…which is so toxic and makes the foods taste so good and irresistible). What you don’t know is that UMAMI has a terrible effect over your health. Here’s how to avoid it… “

I’ll give him the benefit of the doubt and presume that this is an example of poor editing. Umami isn’t a chemical, it’s the subjective experience of taste that we interpret as savoury/meaty taste. Perhaps what is being referred to here is glutamate or MSG, which for a short time was considered to have negative health effects.[8] Subsequent study has failed to bear this out. So even that generous reading of this point is, well, wrong. Sorry.

If it seems like I haven’t really taken any of this seriously, it’s because I don’t. There are some claims where the only reasonable response is ridicule. There are dozens of assertions put forward on the web page in question. Many of which don’t even give enough information to know exactly what is being claimed[9], let alone providing any basis for refutation or confirmation.

Without providing any details the page is “not even wrong” it’s incomprehensible. The only value it has is to whip up unfounded fear and paranoia, all to pave the way towards buying the book that will save you. From another perspective it has one other value, entertainment.

HT to Alison for bringing this to my attention. Thanks for the hilarity.

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Footnotes:

1. If you’re an anti-vaxxer, don’t answer that. Also, don’t quote-mine me. Satire has it’s weaknesses.

2. He says he’s not but methinks he doth protest too much.

3. For maximum effect try to read this in the tone of Dr. Evil.

4. Last one, honest.

5. Though not nearly as bad as most conspiracy sites, so there’s that.

6. Hermann Schmitz, president of I.G. Farben the major producer of poison gas for the Germans. http://www.ess.uwe.ac.uk/genocide/cntrl10_trials.htm#Farben

7. Making Shit Up.

8. Ooooh, the dreaded Wikipedia. Inside joke, don’t worry about it.

9. “All nutrients (vitamins and minerals) that have any positive health impact on the body are to be considered toxins/poisons and are to be removed from all food because Codex prohibits the use of nutrients to “prevent, treat or cure any condition or disease”. “   -What does that even mean? Are they going to suck all of the beta-carotene out of carrots? How would you even go about implementing such a retarded scheme?

“I was a Skeptic, but…”

I wish people wouldn’t say this, it’s usually followed by some lame reason why we should trust their anecdotal experience over empirical data. Sure the word skeptic (or sceptic if you prefer) has a certain colloquial definition and to a large extent words are defined by the way they are used, I mean no-one uses the word “gay” to refer to being happy anymore.

Even so this usage is getting on my nerves. When I use the word “skeptic” to refer to myself I mean someone who evaluates the available evidence and comes to a reasonable conclusion. Implicit in my definition is also  an understanding of human foibles with regard to cognitive biases and a deep seated inability to view our own experiences impartially. Refer to my previous post for more in this vein.

On a whim I thought I’d look up what on-line dictionaries had to say about the word, I found some variation of the following to be popular:

“1. One who instinctively or habitually doubts, questions, or disagrees with assertions or generally accepted conclusions.”

That doesn’t seem any better to me. So, what’s my problem?

Well for a start those alluded to in the title of this post are not applying skepticism they are merely doubtful. And when evaluating claims they are not using the methods of science they are using the unreliable guide that is personal experience. Thus, while their protestations of skepticism and subsequent conversion sound impressive, they are (to my ears) merely the hollow echo of true inquiry.

Harsh enough for you? well perhaps. I don’t expect all who use the word skeptic to apply to it the same definition that I do, but it still chafes.

The dictionary definition given above is also lacking in nuance, it appears more suited to define a contrarian than skeptic. What my favourite skeptical interviewer DJ Grothe refers to as “knee-jerk skepticism”. A skeptic isn’t someone who just says “no”, a skeptic is someone who asks “how do we know?”.

The reason my hypothetical skeptical convert gets on my wick so much is when answering the “how do we know?” question they assume that they can draw general conclusions from their informal experiment where n=1. This ties into the “don’t knock it ’til you’ve tried it” line of argument. NO. Trying it myself is not the way to determine the validity of a claim. This falls under the category of anecdote, and anecdotes are not good quality evidence. At best they should be the start of investigation – not the end.

When evaluating a claim we should look at two things in particular, yes we should determine the direct evidence for the claim i.e. is there evidence to show that it acts as claimed? but we should also attempt to see how the specific claim fits into the wider scientific ecosystem – the prior probability if you will.

Often in day to day claims this is of little practical importance and so it becomes overlooked when it is relevant. A new gadget or medication is often based on previous iterations of the same technology or medical practice and represents an incremental improvement or merely an additional option in the sphere or possibilities. However some claims are sufficiently far from mainstream understanding that we should take a step back and consider the likelihood that the claim is possible, irrespective of the evidence presented for the claim itself.

In the case of say, homeopathy or power balance bands our current understanding of the science should make us extremely wary of efficacy even before the specific claims are considered. To be clear here though, plausibility should be used as only part of the process, there are many things that work without us knowing how they work but the further outside of current knowledge something is the stronger the evidence we should require before we accept it. Certainly for many “alternative” therapies that strong evidence simply does not exist, as I presented for Amber teething beads there is no reason to think they should work from a physical or medical point of view so our standard of evidence should be higher than the earnest assurances of people in mothering forums, or even our own experience – as noted above.

But this is exactly the sort of pseudo-evidence that we are wired to find most convincing. Throughout most of our history the ability to evaluate randomised trials, statistics and p-values would not have aided our survival one whit. Therefore it’s not surprising that most of us are bad at it.*

Yes, it’s hard. Yes, it requires work, and yes you will probably get it wrong most of the time.** But it’s worth it. So give it a try – be skeptical, like you mean it.

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* Arguably all of us, it requires practice and even the “experts” can get it wrong.

* I certainly do.

Related articles

• I Can Fly (theness.com)
• Think Like a Skeptic (psychcentral.com)
• Five Signs You Might Be Wrong (scepticon.wordpress.com)

fMRI Foundations Get a Little More Secure

“it’s all about getting to the truth” – Karl Deisseroth. May 20th Nature Podcast

fMRI, it’s everywhere. From studies looking at how we separate fantasy from reality to identifying psychopaths. The technique offers a very powerful way analyse that most elusive of domains, the contents of another person’s brain. Even so the technology is not without it’s flaws, one flaw is the method of determining relevant data from noise. Another is that the most common signal studied with fMRI, blood oxygenation level-dependent (BOLD) signals, are only an indirect measure of neural activity. Further, it has been until now* an assumption with little empirical support.

To put this in proper perspective it is necessary to explain a little more fully what a BOLD signal is. Essentially the oxygenation level of the blood can be determined via the fMRI by discerning the difference in magnetic properties of oxygenated versus deoxygenated haemoglobin (the protein responsible for shuttling oxygen around our body and keeping us alive). Now, the link between blood oxygenation levels and brain activity is made like this: active neurons are performing cellular functions, cellular functions require energy, energy requires metabolism, metabolism requires oxygen, higher metabolism requires higher oxygen levels. Thus you can make a logical connection from an increase in neuron activity (representing brain activity) and an increase in oxygenated blood flow to an area of the brain.

Because neurons do not have an internal supply of either glucose or oxygen the chain of reasoning above is valid but not having direct empirical support is a potential weakness. To the rescue comes Optogenetics, this relatively new field concerns itself with engineering neurons in such a way as to allow them to be activated by pulses of light. I think you can see where this is going.

The paper “Global and local fMRI signals driven by neurons defined optogenetically by type and wiring” published in Nature details how this technique can help in fMRI work.  In this case rats were used as a model animal instead of humans. The procedure consisted of injecting the brains of the rats with a viral vector that was targeted to particular cell types in the brain, cortical neurons to be specific. This caused these cells to express a light sensitive protein that would in essence cause the cell to be activated**.

By specifically targeting the cell types of most interest this technique has shown that the BOLD signal detailed above really is correlated with neuronal activity. In reality, while this is an important result of the early implementation of this approach and provides a firmer foundation for the theoretical underpinnings of fMRI work it’s true power lies elsewhere.

In addition to activating the cells of a specific region of the brain this technique can also highlight larger networks that operate within the brain. Neurons do not fire in a vacuum, often one will trigger another which set off a third and so on in a cascading chain which results in thoughts or actions. By selectively activating areas of the brain researchers can then watch the downstream effects of those activations in other parts of the brain that were not directly stimulated. In this way we can effectively build a map of neuronal networks.

This approach will both stimulate new research and perhaps provide a method of validating conclusions drawn from previous work. This looks to be an important new tool for brain research, the full power of which we may not yet realise.

Now that’s exciting.

Footnotes:

* For a given definition of “now”, which corresponds to earlier this year when the paper was published. I really need to get to this stuff faster.

** An ion channel protein, stimulation of which causes ions to flow through the cell membrane. Just like the process that occurs when a neuronal signal is initiated.

Submit To Open Laboratory 2010(What’s This?)

–
Lee, J., Durand, R., Gradinaru, V., Zhang, F., Goshen, I., Kim, D., Fenno, L., Ramakrishnan, C., & Deisseroth, K. (2010). Global and local fMRI signals driven by neurons defined optogenetically by type and wiring Nature, 465 (7299), 788-792 DOI: 10.1038/nature09108

Related articles

• Gamblers Rewarded by Near Misses (scepticon.wordpress.com)
• Mind-reading, lie-detection and telekinesis with fMRI and EEG – Science fact and fiction (psychologyinaction.org)
• Functional MRI at the crossroads. (citeulike.org)

Vaccination Awareness Week Round-Up

There’s still officially one more day of Anti-Vaccine Awareness Week (two really, as it’s an American idea) but here’s a round up of the posts anyway. While I know there are lots of great in-depth posts around the blogosphere on this the following list has been restricted to NZ posts to keep the local flavour. The posts are in roughly chronological order.

The University of Auckland Library at Tamaki Library blog Misinformation spread about HPV vaccine

Me Anti-Vaccination in NZ

Scott at Imperatorfish They Can’t Vaccinate Against Tin-Foil Hat Syndrome

Michelle at Skeptics In The Pub Vaccines: The actual facts (well, the links to some anyway…)

Alison Campbell at Bioblog on polio

Michelle at Skeptics In The Pub More facts about vaccines….

Me A Side Benefit of the ‘Flu Vaccine – Reduction in Heart Attacks

Michael Edmondsat Sciblogs Guest Work “I’m not a Scientist but …”; Dissection of an antivaxxer’s argument

Alison Campbell at Bioblog chelation quackery around vaccination

Grant Jacobs at Code for Life Immunisation, then and now

Alison Campbell at Bioblog homeopathic vaccinations – fail

The next couple are not specifically about vaccination but I think are worth a mention:

Grant Jacobs at Code for Life If presenting a claim on a popular issue

Megan Leask at Southern Genes This Week in Science History: 1-11-10

If anyone knows of a post I’ve missed then please feel free to add it in the comments.

[Edit] One more – Alison @ Bioblog vaccination & smallpox

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For those of you interested in the international posts, blogger Liz Ditz has done an awesome job collating all of the posts here:

The Big List of Reality-Based Vaccine & Infectious Disease Blogging

Is Acupuncture Worth a Punctured Lung? or Does the Risk Out Weigh the Benefit?

Friday’s issue of The New Zealand Medical Journal includes a case report of pneumothrorax in a recipient of acupuncture. For the interested layperson out there a pneumothorax in the collection of air in the space between the lung and chest wall leading in extreme cases to cardiac arrest. Acupuncture can result in pneumothorax when the needle is inserted into the lung tissue while the patient is breathing leading to the laceration of the lung and air being forced out of the lung and into the pleural cavity¹. Mmm-mmm, gimmie some of that lung collapsing goodness.

Now lest I give the impression that complications from acupuncture use are common I will hasten to add that they are not. One paper estimates the rate of serious adverse events at approximately 1 per 20,ooo patients². Though if we look at the rates of acupuncture use in the United States as an example, as of about 2007 approximately 1% of the population reported using acupuncture in the previous 12 months³. This translates to about 155 serious adverse effects per year. Another study found over 2% of patients reported adverse reactions that required treatment⁴, commonly for bleeding or pain. Multiply these figures by the likely worldwide numbers of people receiving acupuncture.

Lets compare this with the conventional medical field, the drug Terfenadine marketed under the trade name Seldane (Teldane here in NZ) was removed from the market in the US due to increased risk of cardiac arrhythmia when used in conjunction with certain other drugs. This expressed itself as a risk of 0.04 – 0.08 per million “defined daily doses”⁵. Once a replacement drug came on the market Terfenadine was taken off.

Pneumothorax as a complication from acupuncture is  rare even in this subgroup. More common is infection. As I’ve noted before⁶, the underlying theory of acupuncture is the manipulation of life energies (Qi or Chi), blockages or imbalances in which are the cause of disease. If such is the case then why should the treating physician⁷ bother with proper antiseptic technique? I suspect that most modern practitioners are however not so far down the rabbit-hole that they have thrown away germ theory completely, at least the outward practical side involved in cleaning and sterilising implements. Which is why even infections are still relatively infrequent.

I would like to point out however that given the implausibility of the treatment basis, coupled with the fact that most large well designed studies find no benefit beyond placebo does make the existence of any complications ethically troubling. If your treament is no more than an elaborate placebo, are you willing to suffer adverse effects because of it? As reported by Dr Novella of Science Based Medicine⁸, a recent review of acupuncture admitted that sham (placebo) acupuncture was as good a “real” acupuncture.

Lets delve into the definition of “sham” acupuncture a little more to give the proper context to this revelation. Whereas “real” acupuncture depends on the proper insertion of the needles in specific meridian points on the body sham acupuncture can be considered to be either the placement of needles into non-meridian points, or the use of implements that feel like needles to the patients but do not pierce the skin like toothpicks⁹. This indicates that it doesn’t matter where you stick the needles and it doesn’t even matter if you stick the needles. How then can we conclude that acupuncture works if you don’t need to perform the two defining characteristics of acupuncture?

Given this background I find it difficult to imagine why acupuncture continues to be recommended despite convincing evidence of efficacy and indisputable evidence of harm. All medical interventions carry some element of risk, this is then weighed against the potential for benefit. However when there is no benefit any amount of risk must make that equation lopsided with regard to harm. With that in mind, if you are attracted to acupuncture as a therapy let me recommend sham acupuncture as the way to go. All the placebo-y goodness of real acupuncture without the potential for the nasty drawbacks of infection, bleeding, pain or even pneumothorax.

Further reading:

Type “Acupuncture” and “Infection” or “Pneumothorax” into Pubmed as key words and you will find a variety of papers, a selection of which are below:

Acupuncture induced pneumothorax:a case report (not the report mentioned in the post)

Editorial:Acupuncture transmitted infections

Cutaneous Mycobacterium haemophilum infection in a kidney transplant recipient after acupuncture treatment.

Acupuncture needle-associated prosthetic knee infection after total knee arthroplasty

Footnotes:

1. Clinical analysis on 38 cases of pneumothorax induced by acupuncture or acupoint injection

2. A cumulative review of the range and incidence of significant adverse events associated with acupuncture

3. http://nccam.nih.gov/health/acupuncture/introduction.htm

4. Safety of acupuncture: results of a prospective observational study with 229,230 patients and introduction of a medical information and consent form.

5. Detection and reporting of drug-induced proarrhythmias: room for improvement

6. Scepticon: Acupuncture

7. And here I use the term loosely.

8.Acupuncture Pseudoscience in the New England Journal of Medicine

9. I kid you not, here are a couple of the studies:
Description and Validation of a Noninvasive Placebo Acupuncture Procedure
A randomized trial comparing acupuncture, simulated acupuncture, and usual care for chronic low back pain

Submit To Open Laboratory 2010(What’s This?)

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Round Numbers are Over Rated: Celebrating 191 Posts

I’ve long found the fascination with celebrating milestones that have no intrinsic worth to be somewhat puzzling, why should we make more effort for birthdays falling on a multiple of ten than those that come just before or after? There is nothing about the number itself that makes such a milestone special.

In this vein I decided that rather than trumpet my 200th post I would pick a number that is more interesting (and closer). So, welcome to my 191st blog entry. Compared to some of my more prolific colleagues on Sciblogs and in the blogosphere 191 posts over a period of almost 3yrs is practically laughable but you work with what you’ve got.

So, why 191? Well according to the Oracle of Wikipedia this number has many special features.

191 is an odious number, apparently numbers can be categorised as either odious or evil. This is a reference to it’s properties when converted into binary. As you are likely aware the binary system represents numbers as strings of zeroes and ones. For example the number six can be represented as 110, the number 191 is represented by the string 10111111. A number is evil if there are an even number of 1s in the string (like number 6) and odious if the number of 1s is odd. Those mathematicians are a funny bunch. (play with binary here)

The number is a prime, and apparently there are a large number of prime flavours and this one has quite a few. It is a palindromic prime number, and not only that it is the smallest such prime that you also get a palindromic prime number when you sum the individual numbers.

191 is a Chen prime, which mean if you add 2 to it you also get a prime (or the product of two primes, but in this case a prime).

It is also the first number of a prime quadruplet, so that in addition to adding 2 and getting a prime as above you can also add 6 and 8 and still get primes as well.

Sophie Germain prime numbers occur when you can multiply a prime number by 2, add 1 and get another prime. Guess what, 191 is one of these too.

Those were the less esoteric prime properties that 191 displays. Aren’t you glad I didn’t keep going?

191 is also a Thabit number, or a number that can be arrived at using the formula 3 x 2ⁿ – 1.  ie run this formula and plug values into the exponent position n and you will get a series of numbers of which 191 is one (n=6 BTW). This formula can be used to generate a sort of number called Amicable numbers, but beyond that I have no idea why this would matter.

Finally 191 is the atomic number of a theoretical element called Unununium, sounds like the start of a sneeze.

There you go, 191 is way more interesting than a boring number like 200. A far better choice for celebration.

Still on the topic of numbers here’s a visually stunning video looking at numbers in nature, specifically the Fibonacci sequence.

Youtube Direct

Delayed Gratification = Success?

Today we are going to step into the time machine and go back 21 years to 1989. It was in this year that the study to become known as the “Marshmallow experiment” was published. Performed by Walter Mischel at Stanford University this experiment showed an amazing thing, that testing a child’s self-control at 4yrs could predict academic success later in life.

The numerous experiments actually entailed in this study started with the same basic premise. Children were told that they could obtain a small reward immediately or could hold out for a more valuable reward later. The rewards were carefully calibrated to produce conflict in the child over whether to go for the immediate reward or wait for the larger reward (eg one marshmallow vs two, hence the name of the experiment). The experimenter would then leave the child alone and return a short (although not for the child) time later, typically about 15 minutes. The child could ring a bell at any time to recall the experimenter and receive their lesser reward.

Over a series of experiments the researchers examined what strategies were most effective at helping the child to delay their own gratification the longest. In some situations the rewards were fully visible, allowing the children to see only the immediate reward, only the delayed reward or both. In others the rewards were present in the room but hidden. We might find it obvious but those children who could see the rewards could not wait as long as those that had the rewards hidden.

It’s important to remember here that while some of the conclusions of the study seem obvious in hindsight (and possibly to anyone with young children) previous theories of the ability to delay gratification have considered the ability to conceptualise rewards instrumental to being able to to inhibit impulsivity. To explore this hypothesis then the researchers primed the children with various thoughts prior to the experiments, either by encouraging the children to think about the rewards or by giving them other fun things to think about.

The findings showed that how the child thought about the rewards significantly impacted how long they waited, whether or not the rewards was sitting in full display in front of them. Those children that were distracted by the fun thoughts could hold out longer than those who ere primed to think about the rewards.

To examine this further children where then primed to think about the rewards in different ways. Those who were told to think about what were termed “arousing” properties of the rewards, for example the texture and taste of a food reward, had much more difficulty delaying than those who were directed to think about the abstract qualities of the reward. Indeed, those children who were told to imagine real rewards were only pictures of the objects did much better than children who were told to imagine that pictures of the rewards were real.

One of the best strategies found by the study was for the child to imagine the arousing properties of a different food to the one they would get as a reward, eg thinking about the taste of pretzels while waiting for marshmallows.

So far so good, here’s where the real surprising aspect comes, in a follow-up to these experiments children from the original studies were then looked at more than ten years later to see if the ability to delay self gratification had effects later in life. They authors predicted that differences in the ability of children to delay when they had been given no strategies to help them (eg hiding the rewards) would perform better later in life than those who had the rewards removed from sight. This prediction turned out to be upheld, those students who could had been able to delay their own satisfaction without external help had higher test scores and were described by their parents as, to quote the study:

“more verbally fluent and able to express ideas; they used and responded to reason, were attentive and able to concentrate, to plan, and to think ahead, and were competent and skillful. Likewise they were perceived as able to cope and deal with stress more maturely and seemed more self assured.”

The results of this study seem to imply that those individuals who are able to spontaneously generate strategies to aid them in planing for and achieving future rewards are better equipped to deal with life. Hhmm, when I put it that way it seems obvious, I have to point out though that it is only through experiments and observations such as this that these conclusions become obvious. Without the ability to identify the ability of children to employ coping strategies themselves there would have been no basis upon which to predict this outcome.

Congratulations, you’ve made it to the end of this post, here’s a reward. An amusing video featuring a re-creation of the original experiment showing children in the sweet agony of indecision.

Youtube – Marshmallow Experiment

Submit To Open Laboratory 2010(What’s This?)

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Mischel, W., Shoda, Y., & Rodriguez, M. (1989). Delay of gratification in children Science, 244 (4907), 933-938 DOI: 10.1126/science.2658056