Merry Christmas to all who celebrate!

Some beautiful charts in this Pew Research overview of their 2022 findings. What they show is not as beautiful, but you can’t win them all.

For those of you completely off Twitter, it is now in the impossible-to-avoid-Elon-Musk phase, where even if you block his account there will be people re-tweeting, quote-tweeting, subtweeting… if for nothing else then to complain.

Sadly, it is still the go-to place for medical conference updates, and right now there is a big one.

…is $1.5 million.

A few days ago, The Washington Post wrote about two medical students who are also identical twins being accused of cheating. Their school, the Medical University of South Carolina, apparently doesn’t have anyone on staff who is both versed in statistics and willing to participate in an investigation. Enter paid consultants:

The university sent their test scores to a data forensics company, Caveon, which reported that the chances of two tests that similar being completed independently was “less than a person winning four consecutive Power Ball drawings.”

Invocation of forensics is the first red flag (see: Calculated Risks by Gerd Gigerenzer). Comparing any real-life probability ⊕ Rule of thumb: if what you are doing professionaly made it into xkcd you should stop doing it. to lottery is the second. The uncertanty of real-life probabilities has little to do with known odds of games of “chance”. Confusing the two leads to the ludic fallacy, or “misuse of games to model real-life situations”. Nassim Taleb, The Black Swan, 2007.

The twins, now lawyers, sued and won the said $1.5M. Good for them.

This is the perfect number of times a year to have cranberry sauce: one.

John Roderick (or was it Ken Jennings) on the Omnibus podcast.

Happy Thanksgiving to all who celebrate.

“…and Neymar will fall and cry like a baby”, predicts a boy in Belgrade about tomorrow’s match. Even if his 3–0 win for Serbia against Brazil doesn’t materalize, the fall almost certainly will. ⚽️

So, for people new to soccer watching the World Cup, just to clarify: that wasn’t an offside, that was highway robbery.

FIFA is second only to the International Olympics Committee in corruption. ⚽️

Today I found, via a (paywalled) Janan Ganesh article, an hour-long conversation between Cormac McCarthy and David Krakauer. Krakauer is an evolutionary biologist at the Santa Fe Institute, where McCarthy spent some time writing. I could watch ten hours of this.

Prof. Devi Sridhar in The Guardian about the epidemic of missed cancer cases:

Early [cancer] diagnosis is important because it improves survival outcomes. In England, more than 90% of people survive bowel, breast and ovarian cancer for at least five years if diagnosed at the earliest stage. This allows treatment to start earlier, before the cancer has spread through the body. Yet even with a cancer diagnosis, the NHS is struggling to provide treatment within the current 62-day target time: 36% of patients waited longer than 62 days in England, 21% in Scotland and 43% in Wales. The main bottleneck is staff shortages, which the Covid-19 pandemic has made more acute. Again, this points to the need for investment in the NHS – in not just infrastructure, but also the workforce.

Prof. Sridhar is chair of global public health at the University of Edinburgh so I was surprised to see her make a basic error in epidemiological reasoning. “Early cancer diagnosis is important because it improves survival outcomes”, the paragraph begins, citing not original research but a comment in The Lancet which, yes, is a prestigious journal, Impact factor 202.731, which is ridiculously high. but calling on comments to back your claims without primary literature are level 0 data.

The Lancet article ⊕ There is a story here about going down rabbit holes due to poor citation practices — I once spent two days hunting for the primary reference to a single sentence for a letter in a journal nobody reads — that deservs a post of its one. One day., “Earlier diagnosis: the importance of cancer symptoms” does refer to a 2015 systematic review of 209 studies in the British Journal of Cancer — not as prestigious, you’ll notice Impact factor 9. — whose main conclusion was that the studies were of such varying quality that “Heterogeneity precluded definitive findings”.

The authors did speculate in the conclusion that they “believe that it is reasonable to assume that efforts to expedite the diagnosis of symptomatic cancer are likely to have benefits for patients in terms of improved survival, earlier-stage diagnosis and improved quality of life, although these benefits vary between cancers”. Which, fair enough, but: number one, that’s just like, your opinion, man; and number two: there is already a plethora of data about lead time bias fooling you into thinking your early detection prolongs survival when in fact all it did was make the person aware they had cancer for longer without making an iota of difference on when and of what they would die. ⊕ I base this claim purely on personal anecdote, where people “cured” of their lymphoma were reluctant to get a mammogram — a possible side effect of chest radiation — so they wouldn’t have the aura of cancer hang above them once again. Since this is a situation for which we know that when the cancer does occur, a so-called “secondary malignancy”, it is more aggressive than usual, they ended up doing it, and good for the patient! Yes, there are people who would rather know, but a good proportion — as this is a blog post and not a commentary in The Lancet I am going to allow myself some speculation here — possible more than half would rather not!

So what is going on here? Surely the chair of global public health at a well-known university knows about the lead time bias? The last three years made me question jumping to that conclusion right away, but let’s give some benefit of doubt. The key word here, I’m worried, is public health, a blunt-force instrument which does away with nuance in favor of broad if not deep messages and interventions. Sometimes these are terrifyingly successful: witness the eradication or near-eradication of infectious diseases, or my favorite — plummeting smoking rates in the United States after a public campaign and a flurry of lawsuits that saved more lives than all statins and chemotherapeutics put together. But the dangers of oversimplification are real, like the crusade to ban saturated fats in favor of simple processed sugars backfiring spectacularly. Caveat audiens.

So anyway, that’s why I don’t read newspaper coverage of medical matters, opinion pieces, or The Guardian.

After a 10-month hiatus I am reactivating my linkblog account on Radio3, one of Dave Winers' many great projects. It has cross-posting to Micro.blog which Just Works™️. Happy days.