Chance News 85

Quotations

“Journalists could help people grasp uncertainty and help them apply critical thinking to health care decision-making issues…rather than promote false certainty, shibboleths and non-evidence-based, cheerleading advocacy.”

-- Gary Schwitzer, at HealthNewsReview.org

"To treat your facts with imagination is one thing; to imagine your facts is another."

-- John Burroughs (1837-1921), quoted in Gary's talk at the conference
Science Writing in the Age of Denial, University of Wisconsin, Madison

Submitted by Paul Alper

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"A big computer, a complex algorithm and a long time does not equal science."

-- Robert Gentleman, quoted at One R Tip A Day

Submitted by Bill Peterson

Fish oil

Weighing the evidence on fish oils for heart health
by Anahad O’Connor, Well blog, New York Times, 11 April 2012

According to O'Connor,

Fish oil supplements have become some of the most popular dietary pills on the market, largely on the strength of medical research linking diets high in baked and broiled fish to lower rates of heart disease. Across the United States, annual sales of purified fish oil, commonly sold as omega-3 fatty acids, are in the neighborhood of a billion dollars. And in some parts of Europe, doctors routinely prescribe fish oils to patients with heart disease.

People who put their faith in fish oil supplements may want to reconsider. A new analysis of the evidence casts doubt on the widely touted notion that the pills can prevent heart attacks in people at risk for cardiovascular disease.

And well the people might. O’Connor is referring to “Efficacy of Omega-3 Fatty Acid Supplements (Eicosapentaenoic Acid and Docosahexaenoic Acid) in the Secondary Prevention of Cardiovascular Disease; A Meta-analysis of Randomized, Double-blind, Placebo-Controlled Trials” by S.M. Kwak, et al., to appear in the Archives of Internal Medicine. Not only did:

Our meta-analysis showed insufficient evidence of a secondary preventive effect of omega-3 fatty acid supplements against overall cardiovascular events among patients with a history of cardiovascular disease,

But also:

Furthermore, no significant preventive effect was observed in subgroup analyses by the following: country location, inland or coastal geographic area, history of CVD, concomitant medication use, type of placebo material in the trial, methodological quality of the trial, duration of treatment, dosage of eicosapentaenoic acid [EPA] or docosahexaenoic acid [DHA], or use of fish oil supplementation only as treatment.

Discussion

1. The authors started their meta-analysis with 1007 articles; eventually, after 181 studies were excluded as duplicates and others were dropped out for various other reasons, they were left with “14 randomized, double blind, placebo-controlled trials.” The total number of subjects in the 14 trials was 20, 485. As stated above, statistical significance was not to be seen. Two large studies of 11,234 and 18, 645 subjects, respectively which did show beneficial effects from fish oil were not included in the 14; they were rejected because they were “open-label” studies. Why are open-label studies suspect?

2. Why did the subjects in the placebo arm of the 14 studies receive various vegetable oils? Some of those subjects in the placebo arm received olive oil. Why might this “have disguised the ‘true’ benefit of omega-3 fatty acid supplementation?”

3. If not fish oil, O’Connor says the authors conclude that

it may make the most sense to spend your money on actual fish, rather than fish oil supplements.

They argue that by eating fish, you end up replacing other less healthy protein sources, like processed foods and red meat. For that reason, a diet high in fatty fish — one that includes at least two servings a week — may make a difference over the long term, they say.

If the above is correct, why are so many people eschewing fish for fish oil?

Submitted by Paul Alper

How to choose a spouse?

The purpose of spectacular wealth, according to a spectacularly wealthy guy
by Adam Davidson, New York Times Magazine, 1 May 2012

Davidson describes an interview with Edward Conard, one of Mitt Romney's former associates from Bain Capital, who has written a book entitled Unintended Consequences: Why Everything You’ve Been Told About the Economy Is Wrong which is described here as a defense of big rewards for risk-taking investors. About halfway through this long article, we read:

There’s also the fact that Conard applies a relentless, mathematical logic to nearly everything, even finding a good spouse. He advocates, in utter seriousness, using demographic data to calculate the number of potential mates in your geographic area. Then, he says, you should set aside a bit of time for “calibration” — dating as many people as you can so that you have a sense of what the marriage marketplace is like. Then you enter the selection phase, this time with the goal of picking a permanent mate. The first woman you date who is a better match than the best woman you met during the calibration phase is, therefore, the person you should marry. By statistical probability, she is as good a match as you’re going to get. (Conard used this system himself.)

Discussion

1. They almost got the description of the optimal algorithm for the famous Secretary Problem correct. What is missing here?

2. Do you believe that Conard actually used this system himself?

Submitted by Charles Grinstead