Neil DeGrasse Tyson with some Carl-Sagan-esque thoughts (h/t Ben Goldacre). The first half is good but if you’ve only got 5 minutes, start listening at 7:35:

I hate writing a post only to critique another post but sometimes you learn more from ideas that are wrong than from those that are right. My problems, however, start with the title: “Why medicine is not a science and health care is not health.” Definitely eye-catching but a title that doesn’t match the text very closely (particularly when the first two sub-headlines seem to confirm that medicine is, in fact, a science as does a portion of the text). A minor issue maybe, but the point of the article, as far as I can tell, is that medicine doesn’t focus enough on the difficult to measure aspects of health, which I agree is an important point, and that might be, in part, due to the fact that the powers that be have no motivation to dredge up these complex issues. Bringing the discussion of medicine as a science is neither informative or, I think, accurate.

Here’s an example of this confusion:

My real objection to medicine as a science is that by focusing on what can readily be quantified, it ignores what cannot, such as the social determinants of health and disease.

I can see that point here is that we don’t focus enough on the social determinants of health and being a social epidemiologist, I couldn’t agree more. But why confuse this important idea with the idea that medicine isn’t a science? Ignoring problems doesn’t make something not a science.

Further, is she talking about medical practice here or research? She can’t be talking about research because there is an entire field of research, social epidemiology, that addresses this. Is it difficult to study? Are social determinants of health difficult to quantify? Yes and yes. But what’s being done is still clearly science and, at least some of the time, of value.

If she’s talking about medical practice, are we now expecting our already overburdened front-line physicians to be addressing questions as complex as the social determinants of health? I very much wish we could do this. Actually, I’m told at least one physician has made a good start by inventing what is essentially social pediatrics (unfortunately the website is in French only). It would seem to me more effective to address the social determinants of health at the level of public health and policy, where science is both possible and being done, rather than at the point of care.

As a kind of technical aside, and as I’ve mentioned in a previous post, epidemiology in this case, will never be able to say why an individual gets a particular disease precisely because it is a science and inference on that level isn’t possible (without a time machine!). Epidemiology can answer the question, “why do people get sick?” but not, “why did this person get sick?”

Now into the health care is not health section:

Science prefers to isolate and understand one thing at a time, but the ideas I just mentioned are difficult to separate from their social context and cannot readily be studied in a controlled environment. The topics for medical research that seek and receive funding are those that investigate ‘reductionist’ theories of disease: things that fit neatly into categories sanctioned by the medical establishment and that can be readily measured, compared, and replicated. The cause and effect relationship between stressful living conditions and the health of individuals does not fit neatly into any simple mechanical model with the potential to make successful predictions.

First, science isn’t limited to ‘controlled environments.’ If that were true then, yes, clinical medicine or observational epidemiology wouldn’t be science but then neither would astronomy, climate science (which the writer admitted earlier was a science!) or a number of other alleged sciences. Science is more difficult without ‘controlled environments’ but not impossible.

Second, we can and do study all of the things mentioned. Is it difficult? Yes. Are we as confident in our results as we would be if they came from a trial? Not by a long shot. But these things are being studied to the best of our abilities (although at our social epidemiology journal club I’d probably be more likely to say ‘to the worst of our abilities’!).

I fully agree that the social determinants of health need higher priority in our health system both from the points of view of research and practice. I also agree that it’s disingenuous to say any kind of for-profit health system can have health as its true bottom line. But why drag whether or not medicine is a science into this discussion? Even if there were good arguments for this being true, which is not the case here, why distract from the main points of the post? Then again, if this article hadn’t had these particular quirks, I would have had nothing to write about! Actually, I have a couple partly finished posts that I should really get around to…

The “About us” section of the website only says: “We are three film students and we didn’t care about nature. This is our way to do something.”

As @bouchane said on twitter:

Along these lines, a couple days ago, the Ottawa Citizen published an article referencing a Science editorial about how terrible jargon is. The first line of the Citizen article–the lede in journalist jargon–says it all:

One of the world’s top academic journals is begging scientists to speak plain English — or German, or Chinese — instead of the “insane newspeak” of jargon that’s only used for showing off.

So, you’d think I’d be totally on board with this. Jargon is used for showing off but it’s far cry from being “only used for showing off”. Both the writer of the Citizen article and the Science editorial recognize the existence of an important problem but the wrong one.

Jargon, acronyms and abbreviations all have a very important role to play in science writing and communication. Used properly, they can relate a complicated idea to someone in one word rather than in two paragraphs. The problem isn’t the existence of jargon but that some scientists’–or any class of specialists really–inability to recognize when their audience can’t match the jargon with the definition.

In a scientific journal–especially one with an expensive paywall–the target audience is other people who are specialists in the field. I don’t see any problem using jargon people with a similar background will understand. The problem starts when these scientists talk to the press of give a presentation to a general audience and use the same jargon.

I still think scientific articles should be accessible to the general public but rather than making the article itself more accessible to the public, it should be accompanied by a lay-summary detailing how the study was done and its main results and implications. That way, a more detailed understanding of the research is still available in the scientific article to those who want to do a bit of background reading in order to understand it.

I’m sure everyone reading this either works or is interested in a field where they use jargon that other people might not understand. If you’re good at communicating you recognize what jargon people will understand and which they won’t.

Now I’m just have to go back and reread this post to make sure I didn’t use any jargon…

(Via: @dgardner)

To quell that storm, the following week another guest came in to talk more in depth about cancer screening but this guest then made the mistake of mentioning how many cancers can be attributed to behaviours such as obesity and smoking. In fact, the guest said, behaviours cause more cancers than environmental toxins despite host Michael Enright prodding her to say otherwise. Cue another deluge of angry letters saying that ‘isn’t it obvious that the toxins in our environment are causing pretty much all our cancer and shame on this researcher for blaming the victims of cancer instead of the big corporations spewing all these toxins!’ Whoa. That was intense.

When it comes to blaming the victim, these people have it entirely backward. Epidemiology cannot, ever, point to a person and say with certainty that their cancer was caused by x, y or z. Even if a three-pack-a-day smoker got lung cancer, there’s always the chance that something else caused the lung cancer.

What epidemiology can do is to look at two groups or people who are as similar as possible in every way except one being obese and the other not (which, especially in the case of obesity, is very difficult to do). If it turns out one group has more cancers than the other, epidemiologists can attribute it to obesity. Epidemiology can only ever tell what might affect your risk of cancer, it can never say why a particular person actually got cancer.

The only way we could ever blame a specific person for their cancer is if we went back in time, made them not obese in this case, and ran the clock forward again to see if they still got cancer. If they didn’t, then you could say their obesity, in some way, caused their cancer. We’re a long way from time travel so we’ll have to settle for the first approach I described.

What’s more is it’s clear that the public, and more than likely a good chunk of those angry listeners, do blame victims of cancers in some cases. I can’t find the data right now but which cancer charity do you hear the least about: breast, prostate or lung? Why do you think that is?

Jesse Galef of Measuring Doubt caught ESPN writer Pat Yasinkas making a classic mistake called outcome bias. Talking about the Atlanta Falcons who tried and failed on a fourth and inches attempts:

When Mike Smith first decided to go for it on fourth-and-inches in overtime, I liked the call. I thought it was gutsy and ambitious. After watching Michael Turner get stuffed, I changed my mind. Smith should have punted and taken his chances with his defense.

I hope it’s pretty obvious what’s wrong with . It’s easy to decide what the right call would have been after the fact. Next time Yasinkas wants to play the lottery, he should ask to see if he can see the numbers that will be drawn first. Read the rest of Galef’s post in which he demonstrates that the Falcon’s actually did make the right call.

I see sports fans making this mistake all the time and I’m sure I do it too. Why didn’t the Canadiens draft Jeff Carter, Ryan Kesler or Ryan Getzlaf with their first pick in 2003 instead of Andrei Kostitsyn (this might seem like an obscure complaint but Habs fans will never forget it)? There is definitely skill involved in assessing hockey talent in young players–some scouts are better than others–but there’s also a lot of unpredictable things that can happen to a young player that makes him a better or worse player than he was on draft day.

I also see people and journalists judging politicians in the same way. We expect our politicians to always make the right decisions and we judge them based on the outcomes of their decisions when we should really be judging them against what the opposition would have done in the same situation (ignoring the fact that the opposition will always say they would have done the right thing).

But there’s another more subtle way people make this mistake. When discussing Canadian healthcare with my more conservative friends I often hear, “why should I have to pay for someone else’s healthcare?” Oh, my dear conservative friend, you don’t get to see the outcome of the lottery before you decide whether you’re going to buy your ticket. In classic Rawlsian style, what if I asked you to choose before you were born, before you knew you were going to be born healthy or with a debilitating expensive-to-treat disease, whether you wanted single payer healthcare or not, would you choose to risk it? Maybe. You might decide you still want to roll the dice but the choice shouldn’t be as obvious anymore.

I would then go on to ask you if it’s fair that someone who has a genetic disease should pay for their disease given that are not to blame for their disease, but that’s for another post.

(via Open Culture)

The first is that a study aiming to measure the Earth’s temperature increase over the past 60 years, and funded in part by people who have been vehement climate change deniers, has shown that the Earth is indeed warming. Of course, this doesn’t placate a lot of the climate change deniers who find ways–although none that seem valid to me–to discredit the study. I mean, there are always tiny things to nitpick about in any study, but the bottom line is would the interpretation of the results change? I also wonder if climate change deniers require the level of evidence they demand on this topic, for other things they believe–the economic policies they believe in for instance.

The second is seven quick facts that demonstrate that people are responsible for altering the climate. Number two in this list was the one that put me over the top on believing that climate change is happening although I find numbers one and four also particularly convincing.

So…can we now put the questions of if climate change is happening and what is causing it behind us and decide what we’re going to do about it?

1. Hear a hot new track that I really like.
2. Play it 6 to 7 million times
3. Get the album the song is on
4. Categorically hate the album.

Now don’t get me wrong, I appreciate a great one hit wonder as much as the next guy. 80s night at La Tulipe would be pretty weak without a gem like “Take on Me” by Aha swaying the masses. But I also am a big believer of judging an artist by the body of his/her/its work. I would also feel differently if the albums of these artists were merely average. However, the truth is, in most cases these albums are as bad as a 15^th century Cave Troll.

I wonder if these artists are writing a great song and then feel as though they need to make a whole album of filler to satisfy the industry norms. Why not just release the single and call it a day? The reality is that in this hifi wifi world, the album does not have the impact it did when Exile On Main Street was released.  These artists should embrace that and live by the old adage, “if you have nothing nice to say, say nothing at all”.

I am getting a bit ornery, let’s focus on the good songs:

I first heard of Little Dragon as a cameo on the already reviewed Gorillaz track “Empire Ants”. I loved the sound of Yukimi Nagano’s voice and I thought the band name was badass mainly because dragons breathe fire and that is badass. Then I found out that Yukimi was half Swedish half Japanese and I think that combo is the only hope for the future of mankind. I heard the song Ritual Union from the new album and was pumped. It makes me feel like I am going to some dimly lit lounge in London to purchase 5 million dollars worth of African Blood diamonds.  I am obviously wearing a suit in this scenario. Wearing a suit is my new “thing”.

 
 
The second song is by a guy names Gotye and it features a girl named Kimbra. This sounds like a new Godzilla movie to me. Gotye and KImbra vs Godzilla!!! Anyway, I like how this song builds and breaks at the end like a sweet surfing roller at Puerto Escondido. The chorus of this song has the line, “Now you are just somebody that I used to know,” which is pertinent to anyone who has an ex they don’t talk to anymore.  I feel this song does straddle that grey line of cool/cheesy but manages to stay on the right side.

 
 
My song of this past summer is Novocaine by Frank Ocean.  I love the ridiculous lyrics. I love the cockiness. I love the beat. I love the R&B crooning. I love the video. I love how hot he is right now (sorry Hansel). To be fair, the rest of his album does have a few good songs but also has a weird Coldplay cover so that negates all the positives. I am not worried about Frank though. He has a friend named Earl Sweatshirt, he will be fine.