The true cost of the anti-vaccination lies

I have been watching the reported cases of whooping cough, pertussis, grow almost daily for the last month. The state of Washington is being particularly hard hit (so far). They are spending over $200,000 to try and "catch-up" on vaccinations.

I saw a reported fatality this morning which will probably be the first of many. This is the real cost of the anti-vaccination lies of Randall Hoven, and his right-wing pals at American Thinker. Now they truly are Baby Killers.

Randall Hoven IS either stupid, or a liar.

Randall Hoven is either stupid, or lying, Part II

Right-Wingnut Randall Hoven: Stupid, Liar, or Lazy? Part III

As I said at the time,

So, Mr. Hoven concludes that he and his should skip vaccinations, and leave all the associated costs and risks to others because, “We should not be treated like benighted troglodytes for being skeptical of medical "science.”

No, not troglodytes, Mr. Hoven- you should be treated like lazy, stupid, selfish, dishonest parasites.

Right-Wingnut Randall Hoven: Stupid, Liar, or Lazy? Part III

I dealt with two of the gross lies about vaccination, and medical research being spread by Randall Hoven, writing for the ironically named right-wing rag, “American Thinker.” Right-Wingnut Randall Hoven next makes the asinine assertion that,

“Do you know how many medical research papers were withdrawn from publication due to major errors or outright fraud in the last decade? The answer is 788.

That is, hundreds of medical research papers have errors so egregious that the papers had to be withdrawn completely. And half or more of the rest might have serious errors.

This pushed several of my out-rage buttons. First, the medical literature is very different from the normal science literature. In a scientific publication the originality and novelty of the research is hugely important. It is considered entirely unprofessional, and unethical to repeat a publication, or “self-plagiarize.” So, a research project will have the following minimal sets of publications, 1) a technical, or progress report to the funding source, 2) one or more conference Abstracts, 3) a journal publication, 4) a book chapter. Until you get to step 3) a journal, all the others are considered “prepublication,” and are not given much academic or scientific credit. Anyone publishing the same data, with the same analysis more than once will either be rejected from publication, or at least privately disparaged as a “publication whore.” Most large journals have specific instructions on prepublication. Since the number of publications a young professor has weighs so heavily toward their retention, or promotion, we used to joke (darkly) about the academic SPDS, or Smallest Publishable Data Set.

The medical literature is very different. This has two reasons. The first is that there are many more medical publications than for the sciences. This is because medical device manufacturers, and pharmaceutical companies spend many millions of dollars each year on advertisements. These millions of dollars underwrite many hundreds of magazines, and thousands of editors. Something has to fill in the pages between the ads, and that something is medical research. The second difference is that the medical literature serves as the post graduation source for clinical education. These magazines, visits from drug vendors, and “continuing medical education” requirements are how daily practice physicians, nurses, and all other adjunct clinicians learn what current practices are. This creates a tremendous market for medical research articles. This also means that for many medical magazines, the readers are not trained as scientists and are far more trusting of a table of statistics than are general scientists. So, if there is a paper circulated in the medical literature with multiple authors to multiple journals, and at least part of the data is bad, then there could be five or six papers that become “contaminated.”

The link Hoven gave is to another “PhysOrg” news item, “US scientists significantly more likely to publish fake research” November 16, 2010;

“The study author searched the PubMed database for every scientific research paper that had been withdrawn—and therefore officially expunged from the public record—between 2000 and 2010.

A total of 788 papers had been retracted during this period. Around three quarters of these papers had been withdrawn because of a serious error (545); the rest of the retractions were attributed to fraud (data fabrication or falsification).

There are a few problems here. First, we are given no idea of how important these 788 withdrawn papers are in the grand scheme. Second, there are many reasons a paper might be retracted. Not infrequently, a journal will retract an article because it was plagiarized, and the real authors have complained. The results could be totally acceptable- they probably are- but they were stolen. Then, authors might find that they cannot repeat their own earlier result. This can happen totally innocently. I knew one fellow graduate student who brewed up a potential cancer cure- a real one shot “magic bullet.” Worked great, except the second batch did nothing, and the third batch did nothing. Nothing he tried for the next 2 years worked at all, and then he dropped out of school and was drafted.

And what are these numbers? Consider that in 2010 alone nearly 38,000 papers were published on medical/clinical topics as indexed by PubMed. This turns out to be not too far from an average annual rate. Even for all retracted papers as in the number quoted above, this is barely 20 per 10,000 papers withdrawn for any reason between 2000 and 2010. As we will see below, this is about the same global result found from several independent studies. Mr. Hoven is blowing his mind over a 20/10,000 “crisis.” It turns out to be even smaller, as the rate for deliberate fraud falls to under 2 in ten thousand.

Another problem is that the PhysOrg news item never gave a valid citation. Where did these numbers come from? This is a common problem with this source, and a competent ‘reporter,’ which Mr. Hoven is clearly not, would refuse to use unattributed assertions. A database search of all articles published in the Journal of Medical Ethics revealed only one potential study with the same combination of numbers, “Retractions in the scientific literature: do authors deliberately commit research fraud?” J Med Ethics 2011;37:113-117 doi:10.1136/jme.2010.038125

There are, ironically, methodological issues that I would have as a reviewer of Dr. Steen's articles. For example, the author R. Grant Steen was the only person (apparently) to have read the articles and retraction notices. It is only his opinion as to the validity of the retraction. Plus, of all the reasons a paper might be retracted, he split the entire list in either “fraud,” or “other error.” And in a re-analysis of his own data, Steen discovered that just “… two repeat offender authors were responsible for 14% of all articles retracted for fraud over the last decade.” (“Retractions in the scientific literature: is the incidence of research fraud increasing?” J Med Ethics 2011;37:249-253 Published Online First: 24 December 2010 doi:10.1136/jme.2010.040923). I think it is worth pointing out that in this reanalysis, the number of retracted papers had also dropped to 742.

And, the author of this study, R. Grant Steen, has published five articles from the same data in the last year; four of them in the same magazine; the Journal of Medical Ethics. This is a perfect example of how multiple papers are published in the medical literature from a single piece of research. Dr. Steen is also the President of a private company “Medical Communication Consultants (MCC)” that is “… a full-service, medical writing firm designed to meet the needs of pharmaceutical and biotechnology companies.” (From their corporate website: http://medicomconsultants.com/ ). So, in addition to a noble desire to advance knowledge, Dr. Steen has a very legitimate goal of furthering the interests of his company.

Motivated by the reports of medical literature fraud published by Dr. Steen, Prof. T. A. Abinandanan conducted a study of retracted papers from the PubMed index for the same years. Abinandanan found the misconduct rate from India, his homeland to be 44 per one hundred thousand papers, as opposed to a global average of 17/100,000. (“Publish and perish” VT Yadugiri, CURRENT SCIENCE, VOL. 101, NO. 4, 25 AUGUST 2011 477). That’s correct, 1.7 frauds per ten thousand publications. And now recall that Dr. Steen found that “… two repeat offender authors were responsible for 14% of all articles retracted for fraud over the last decade.”

There was a considerably stronger paper on medical literature article retractions that was also recently published by the Journal of Medical Ethics; “Why and how do journals retract articles? An analysis of Medline retractions 1988–2008.” The authors, Elizabeth Wager, Peter Williams use a better data sample from Medline, used a more sensitive evaluation criteria, and were able check each other for rating bias. (J Med Ethics 2011;37:567-570 doi:10.1136/jme.2010.040964). In all, the rated 312 examples of retracted papers out of a total of 870. I’ll quote their Methods, Results and Conclusion directly from the Journal;

Methods: We retrieved all available Medline retractions from 2005 to 2008 and a one-in-three random selection of those from 1988 to 2004. This yielded 312 retractions (from a total of 870). Details of the retraction including the reason for retraction were recorded by two investigators.

Results: Medline retractions have increased sharply since 1980 and currently represent 0.02% of included articles. Retractions were issued by authors (63%), editors (21%), journals (6%), publishers (2%) and institutions (1%). Reasons for retraction included honest error or non-replicable findings (40%), research misconduct (28%), redundant publication (17%) and unstated/unclear (5%). Some of the stated reasons might have been addressed by corrections.

Conclusions: Journals' retraction practices are not uniform. Some retractions fail to state the reason, and therefore fail to distinguish error from misconduct.”

So, to review for Mr. Hoven, the "Crisis" is fewer than 2 fraudulent papers per one hundred thousand. But, you idiot, YOU wrote,

That is, hundreds of medical research papers have errors so egregious that the papers had to be withdrawn completely. And half or more of the rest might have serious errors.

Where did "half or more of the rest might have serious errors," come from? RIGHT! That came from the other stupid errors you have made.

So, Mr. Hoven concludes that he and his should skip vaccinations, and leave all the associated costs and risks to others because, “We should not be treated like benighted troglodytes for being skeptical of medical "science.”

No, not troglodytes, Mr. Hoven- you should be treated like lazy, stupid, selfish, dishonest parasites.


What a dumb ass!

Randall Hoven is either stupid, or lying, Part II

I dealt with the gross lies by Hoven regarding vaccinations earlier, but he doubled down with some bullshit about statistics in the medical literature. I have to admit this is a particularly sore issue with me. I tried for years to teach statistics to medical residents when I was a professor of medicine, and soon had more faculty attending my seminar than students. The trouble was that none of them would do their homework I assigned. They always used “my patient was dying!” excuse. I preferred the more credible third grader's “The dog ate it” excuse.

Randall Hoven grossly misrepresented a recent article in the scientific literature, “Erroneous analyses of interactions in neuroscience: a problem of significance” Sander Nieuwenhuis, Birte U Forstmann & Eric-Jan Wagenmakers, (Nature Neuroscience, Vol. 14, 1105–1107 (2011) doi:10.1038/nn.2886 ).

Here is what Randall Hoven had to say;

Do you know how many doctors, some literally brain surgeons, made an important statistical mistake in their studies? Half of them. These were studies trying to prove that some medical treatment was actually effective.

Yes, half the studies showing that some medical treatment is effective are in error. We just found that out this week (at least for neuroscience journals).

This is either stupid, or dishonest. I cannot tell anymore. Really; Stupid? Dishonest? Dishonest? Stupid? It is so hard.

Randall quoted a secondary news article, “Study finds statistical error in large numbers of neuroscience papers” by Bob Yirka (PhysOrg, September 13, 2011). The quote is,

Sander Nieuwenhuis and his associates from the Netherlands have done a study on one particular type of statistical error that apparently crops up in an inordinately large number of papers published in neuroscience journals. In their paper, published in Nature Neuroscience, they claim that up to half of all papers published in such journals contain the error.

Well, Bob is a jerk (see below). So, does that let Randall of the hook? Only if he is too lazy to read the original article, and he expects his readers to accept his grossly incompetent ability to read. Probably this is a safe assumption, since none of these Bozos seem able to read a scientific paper.

The authors of the Nature Neuroscience article actually had a fairly modest goal to teach that, “when making a comparison between two effects, researchers should report the statistical significance of their difference rather than the difference between their significance levels.”

So, there is some event, E, and it is the possible result of variables A, and B. You need to look at the independent causes A, and B, but also the interaction AB on E. (I offer the crude example of “attractiveness of date” = Horniness + Beer + (Horniness X Beer).” Each of the three have a statitistial probability, p, and by conventional practice, only variables with a probability less than five persent, p<0.05, are called "significant." The paper’s authors correctly place greater emphasis on the interaction effect, (Horniness X Beer). So, any paper they reviewed that didn’t make enough effort to examine the interactive effects was rated as “ERROR, Will Robinson, ERROR!” (Actually, I fully agree). But, here is the short form conclusion from the original article, “Are all these articles wrong about their main conclusions? We do not think so.”

” Are all these articles wrong about their main conclusions? We do not think so."

Before I continue with the stupid, dishonest, or lazy Mr. Hoven, I want to just spend a few electrons on what the real scientific paper had to say. It is interesting. Most researchers in medicine like to keep things very simple. I was a professor of medicine, but not a clinician- I am a scientist. The sort of people who make good clinical workers (or at least good medical students) mostly don’t like things that are abstract. So, I found that presenting research results as a series of “if … then …, if not … then …” decisions was very successful.

The “keep it simple” extends into the presentation of research statistics, to the overall detriment of the research. From the actual, original research this right-wing, fundamentalist jerkwad has mangled, out of thousands of published articles from five major journals, only 513 even fit the selection statistics criteria. Of these, in only

… 157 of these 513 articles (31%), the authors describe at least one situation in which they might be tempted to make the error. In 50% of these cases (78 articles), the authors used the correct approach: they reported a significant interaction. This may be followed by the report of the simple main effects (that is, separate analyses for the main effect of training in the mutant mice and control mice). In the other 50% of the cases (79 articles), the authors made at least one error of the type discussed here: they reported no interaction effect, but only the simple main effects, pointing out the qualitative difference between their significance values (for example, vehicle infusions were associated with a statistically significant increase in freezing behavior; muscimol infusions were not associated with a reliable increase in freezing behavior).”

Lets review those numbers, thousands of papers published, only 513 even had data that fit the topic. Of that fraction, only 157 had data that might be analyzed with an AB interactive effect, and of those, the “correct” analysis was used half the time. So at MOST, there were 15% of studies in a very narrow subdiscipline of neurology that used statistical methods that were weaker than recommended by the study authors.

That is way fucking better than I would have expected.

What Randall Hoven stupidly wonders is,

“So how much can we trust an NAS study that is a study of studies, when half of those underlying studies contain a major error? “

So, OK. Hoven fails to do even a minimal check on sources. Even an dumb undergraduate should know that you do not cite papers you have never even read. The article’s real position that I quoted above was on the first page of the Nature Neuroscience article, and it did not require any statistical, or scientific background to understand. Basic reading comprehension would have been adequate to grasp,

”Are all these articles wrong about their main conclusions? We do not think so.”

But, he expects us to apply his ignorant version of the Nature article to the NAS Institute of Medicine study on vaccination. And, he concludes that his kids (and his reader's kids) shouldn't be vaccinated.

What a dumb ass.

Randall Hoven IS either stupid, or a liar.

Hoven writes for the rightwing rag “American Thinker.” A superb example of how this creature from the far-right ga-loon is not in any way a “Thinker” is his September 22, 2011, article called “Science for Stupid Idiots.”

I think he might have got that one part correct- he might have been referring to his rightwing pals as “stupid idiots,” in which case he was admirably direct and perspicacious. On the other hand, it could be titled “Stupid Idiot Mangled Sciences,” depending on your assessment of Mr. Hoven’s intellect and honesty. I put it low.

He makes a general attack on science, but takes particular aim at medical literature on vaccinations, dietary salt, physics/cosmology (dark matter, Big Bang), global warming, brontosaurus, museum aircraft displays, evolution, Steve Gould’s “Mismeasure of Man,” and the CERN search for the Higgs particle.

He might have had some valid points on museum airfoil displays, and Steve Gould. I don’t care. I’ll take on the rest of his bullshit in the order that he dropped it.

Starting with his anti-vaccination screed,

“Here's my thinking on a vaccine, before injecting one of my kids with one: what are the chances of harmful effects without the vaccine, and with the vaccine? I want two numbers. My nutty logic is that I want to minimize the chances of harmful effects on my child. To calculate that for a particular vaccine, I need those two numbers. An emotionless robot or computer would need those two numbers. Yet we are rarely given even one of those numbers, much less both. Not from my doctor. Not from the CDC. Not from geniuses who write articles about how dumb I am for not simply believing their repeated assurances. They tell me it's all about informed consent, but they don't inform me (with the two numbers I need), and they don't ask for my consent. (Sometimes you can opt out, but try that with Hep B shots for your kid.)”

The reason why this is apparently reasonable, but is really stupid will follow.

Case in point: a recent press release from the National Academy of Sciences. The NAS told us that "few health problems are caused by vaccines." That report was then used to tell idiots like me, "For Pete's Sake, Go Get Your Kids Vaccinated Already!"

The NAS did not put a number on "few." Even if it did, that would be only one of the two numbers needed. In fact, the NAS explicitly said it doesn't have those two numbers. It said this about its study committee. “It did not examine information that would have allowed it to draw conclusions about the ratio of benefits to risks.”

So the NAS cannot draw conclusions about the single thing of importance to a parent. But somehow everyone else can. You see, "fact-based" people can draw conclusions even where the NAS can't. And therefore, you are an idiot to not vaccinate your kid.

If you want us to be fact-based, you ought to provide us some facts.”

So, let us be so bold as to give Mr. Hoven some facts. In fact, we will give him facts from the very reports he either never bothered to read, or was too stupid to understand. (Alternately, Mr. Hoven is relying on the stupidity of his readers to cover for his, or he is lying). The first fact is that the 800 page full report is freely available on-line, and if Mr. Hoven has problems with the press release, he should read the full report. But, even the six page short form “Brief Report” is enough to show Mr. Hoven, and us why he is either stupid, or dishonest (Is morbidly lazy an option? Maybe).

I wouldn’t want Mr. Hoven to suffer from eye strain, so not only will I limit my comments to the Brief Report, I’ll only need Mr. Hoven to look at a single page of the six, the one with Table 1.

Can Mr. Hoven see why he is either dishonest, stupid, or morbidly lazy?

I’ll point it out.

The worst that can happen to a child, or adult receiving one of the vaccinations studied, is no greater than the risk of having the disease! I’ll rephrase, there is not any additional risk to receiving a vaccination compared to having the disease, and vaccinations will protect millions and millions of people without any adverse effect at all. The key provision is that nearly a majority of people will need to be vaccinated. And this is where Mr. Hoven stands out. People can freeload on vaccinations. Granted that vaccinations have less average risk than the pre-vaccination disease rate over a population of people, they cannot be made entirely risk free. If nearly everyone is vaccinated against a disease, then the disease cannot reproduce itself with enough social density to be a general danger. A freeloader like Mr. Hoven lets everyone else assume the risk and they count on taking all the advantage.

Right-wingers like Mr. Hoven want us to assume the risks for him, and absorb the costs for him, so he can get a free ride and then complain about how he is oppressed.

What a crooked dumb ass! And what a typical right-winger!

I continue my remarks regarding Mr. Hoven's lack of ability in Part II.