Reporting Risk

October 27, 2015
Posted by Jay Livingston

Thoughts of Mrs. S, my sister-in-law’s mother, rarely cross my mind. My brother’s wedding was the only time I ever met her. But as I read yesterday’s headlines about bacon, sausage, hot dogs, etc.  – “Processed Meat Causes Cancer” – I recalled the one salient fact about her that I knew: For lunch every day of her adult life, Mrs. S ate a hot dog. She died at age 86, having outlived most women in her cohort.

I’m using anecdotal evidence here not to refute the scientific reporting from the International Agency for Cancer Research and W.H.O. I’m not James Inhofe using a snowball in late February to demonstrate that global warming is a hoax. But those headlines do raise the problem of how to report scientific findings.

To many people, the word “cause” implies a nearly certain relationship. Gravity causes the apple to fall. Every time. The stronger the gravitational force, the harder they fall. So “Hot dogs cause cancer” means that if you eat hot dogs, you’ll get cancer. The more hot dogs you eat, the sooner and more severe the cancer.

Some headlines used the more cautious “linked to” instead of “cause.” But that too gets it wrong. It suggests that we have mere correlation with no sure cause.

The accurate headlines talked about risk. Or as the New York Times cautiously put it, “Meat Is Linked to Higher Cancer Risk.”

(Click on the image for a larger and perhaps crisper view of the bacon.)

But what is risk?  The way I explain it to intro students early in the semester is this: Risk is a way of talking about the individual as though she were a lot of people. The research shows that eating a lot of processed food increases the risk of cancer by about 18%. The overall risk of colorectal cancer in the US is about 50 per 1000. That is, if there were 1000 of you, 50 of would get cancer. Now if those thousand yous scarfed down the bacon and hot dogs, 59 yous out of the 1000 would get cancer. Your raised your risk 5rom 50 to 59 per 1000, or from 5.0% to 5.1%

Of course there’s only one of you. Either you get cancer or you don’t. You don’t get fifty one-thousandths of cancer or fifty-nine one-thousandths of cancer.

The headlines were also misleading in another way. The IARC report was not about a newly discovered increase in risk. It was about certainty. Their review of the existing research led them to put processed meats in their highest category of certainty: “causes cancer.” Non-processed red meat was in the next category: “probably causes cancer.” That increased risk for processed meats – from 5.0% to 5.1% – may have been small relative to other things you might do, like smoking cigarettes or working with asbestos, but the IARC was now sure that sausage and bacon caused that risk to increase.    

Maybe the headline should have been:      

Scientists Now Sure That Processed Meats
Cause a Small Increase in the Risk of Cancer

As for Mrs. S, she died of lung cancer. It was the cigarettes* that finally did her in, not the hot dogs – or the Ho Hos, brownies, and chocolate candy that usually followed.

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* Cigarettes have long been in the category of causes that we’re certain about. The raising of  processed meats to that same category led some news sources to the utterly wrong interpretation.
“Just two rashers of bacon a day raises your risk of cancer: Health chiefs put processed meat at same level as cigarettes” said the Daily Mail

The Guardian was worse: “Processed meats rank alongside smoking as cancer causes – WHO”

Technically defensible but totally misleading.
 
Other headlines around the Internet were just plain wrong. To cite one of many,
“World Health Organization: Bacon, sausage as bad a cigarettes” WRAL.com (a Raleigh, NC radio station).

Nonsense. Cigarettes are far more harmful. They increase the risk of lung cancer not by 18% but by 2500%.

The Front Page is the Stage for Moral Outrage

October 13, 2015
Posted by Jay Livingston

The world of the tabloids is a constant drama of moral clarity. Usually the plot centers on a moral outrage – what bad guys do and get away with – but sometimes the good guys win. The point is that the moral boundary is unmistakable, and the characters are clearly on one side or the other. The specifics can vary, and either side may win, just so long as there are black hats and white hats.

In sport, we root root root for the home team, and when they are also on the good side of a moral conflict, and when they win, that’s the story that gets the front page.  In today’s episode, the white hats and the black hats are both actually blue, but the only shades of grey are the visitors’s uniforms.

Yesterday’s playoff game between the Mets and the Dodgers at Citi Field was not just about winning and losing. It was about justice. In the previous game, Shane Utley had broken the leg of Mets shortstop Ruben Tejada on a slide aimed clearly at Tejada and not at second base. The Post abandoned the usual sports euphemism of “hard” (when basketball announcers say that a player has  given “the hard foul,” they mean that the player has done something like smashing his elbow into another player’s body or face) and used the old-fashioned, morally charged term “dirty.”

Baseball officials had suspended Utley for his crime, so he was not in the game last night. But he played a key position in the tabloid headlines.* “Mets bash LA; Utley,” said the Post. The News was even more punishing of the Dodger who was nowhere to be seen, bashed, or kicked: “Kicked ’em in the Uts.”

In the tabloids, justice in absentia is better than no justice at all.

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* New York’s broadsheet, the Times, seems not to have noticed this triumph of Good over Evil. The front page is devoid of sports news, and if there is a moral angle in any of the stories, it rests subtly between the lines. 

Science as a Bendable Vocation

October 10, 2015
Posted by Jay Livingston

Maybe it’s a coincidence, but the New York Times has three items today suggesting that greed, for want of a better word, isn’t always so good – not for the public and not for science. These articles suggest that corporations sometimes deliberately distort science in order to subvert the general welfare so that they can increase their profits. I hear you gasping in disbelief.

You’re right. It would seem a commonplace observation except that so many people in such influential positions think that the profit-seeking efforts of huge investment funds and energy companies and chambers of commerce all bring unalloyed good to everyone.

1.  In an op-ed, Luigi Zingales warns about scientists nudging their research in directions favored by the people who bankroll them. Would scientists risk their reputations for a few pieces of silver? Under some conditions, yes.

A paper can be misleading or economical with the truth even when not blatantly false. . . . And reputational concerns do not work as well with sealed expert-witness testimony or paid-for policy papers that circulate only in small policy groups.

Then there is what Zingales calls “a scarier possibility”

that reputational incentives do not work because the practice of bending an opinion for money is so widespread as to be the norm.

Zingales does not give any estimate of the location of norm’s current boundary or the prevalence of such bending.

What triggered Zingales’s op-ed is Congressional testimony by economist Robert Litan and Litan’s related paper on consumer protection regarding retirement plans. It turns out that the paper was commissioned by the Capital Group, a trillion-dollar investment group not notably favorable towards consumer protection. The Capital Group generally underwrote Litan’s research, as Litan acknowledged; but they also commissioned this specific project, a fact Litan did not deem important enough to mention. Not surprisingly, the paper found that protecting consumers vis-a-vis retirement-plan brokers would be too costly.

(Zingales, by the way, is no lefty. He teaches at a business school, the Booth School of Management at the U. of  Chicago. I expect that neither he nor Booth see his mission as radicalizing future MBAs.)

It’s not just economists. For a long time we’ve known that research sponsored by drug companies finds drugs much safer and more effective than does independent research (see here, for example).. But government-sponsored research has decreased, and research by Big Pharma has grown. As Marcia Angell, former editor of The New England Journal of Medicine said in 2009,

It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of The New England Journal of Medicine.

2. Also on the op-ed page (here), Naomi Oreskes discusses the efforts of Exxon (later Exxon-Mobil) to undermine the findings of climate scientists. Internal Exxon documents going back forty years show that the company’s own scientists were telling them that carbon-based energy would change the global climate.

In 1989, the company helped to create the Global Climate Coalition to question the scientific basis for concern about climate change and prevent the United States from signing on to the international Kyoto Protocol to control greenhouse gas emissions. . . . Journalists and scientists have identified more than 30 different organizations funded by the company that have worked to undermine the scientific message and prevent policy action to control greenhouse gas emissions.

Oreskes likens the Exxon-Mobil tactics with those of tobacco companies decades earlier – a strategy to “promote a message of scientific uncertainty” where the science was in fact settled.  Of course today, tobacco companies today wouldn’t take such drastic efforts to undermine anti-smoking policies, would they?

3. The front page of the Times has a story about the Chamber of Commerce becoming the champion of the tobacco industry. The Chamber has traditionally worked for the interests of business in general regarding tax policy and regulation. Under new management in the person of Thomas J. Donohue, the Chamber is taking up the cause of smoking at home and especially abroad. And you thought “Thank You For Smoking” was a comedy.

True, their second-highest official has said, “The chamber is not opposed to tobacco regulation. Declarative statement. We don’t support smoking. Declarative statement.” Declarative but false.

The chamber’s own letters, many of which have been published in The New York Times, show the extent of the tobacco campaign, including an attack on excise tax in the Philippines, cigarette advertising bans in Uruguay and restrictions on smoking in public places in Moldova.

Needless to say, the tobacco industry and the Chamber also do research. Guess what the research finds.

During his first stint with the chamber in the early 1980s, [Donohue] was called on to calm restive cigarette makers, who were angered by a chamber health booklet that said smoking increases absenteeism. Mr. Donohue invited the tobacco industry to “supply some additional data” for a revised version, according to a letter later made public. Within a few years, the industry was citing chamber research that found “smoking has no influence on an employee’s likelihood of being absent.” Philip Morris directed the chamber’s work on a polling project surveying attitudes about government-funded litigation. The chamber took the lead in public, while “PM stays in the background,” a Philip Morris memo outlined. The cigarette maker selected the polling firm and reviewed the questions.

Three articles in one day (and I haven’t read the whole newspaper). Maybe the Times save all its tilted-science articles for Saturday. Or maybe it’s just the Times, and if I had instead looked at the Wall Street Journal I would have found articles about all the unbiased research done by virtuous corporate-sponsored scientists.

How Do You Know If You’re Really a Conservative?

October 7, 2015
Posted by Jay Livingston

Are Conservative Republicans a breed apart? And are they getting even farther apart?

A recent Pew survey compared attitudes a year ago and last month on the subject of abortion. The 2015 survey was done in the immediate wake of those now-famous videos of Planned Parenthood officials, videos shot surreptitiously and edited tendentiously. The demographic that showed the largest swing in opinion was Conservative Republicans.*

Among people who identified themselves as Conservative Republicans, opposition to abortion rose from 65% to 79%. Four out of five Conservative Republicans now oppose abortion. No other group in the survey comes in at more than half.

(Click on the image for a slightly larger view.)

The obvious explanation is that in the past year, an additional 14% of Conservative Republicans have become more conservative on abortion. The hardliners are becoming even harder. But there’s another possibility – that many of the Conservative Republicans who did not oppose abortion a year ago no longer call themselves Conservative Republicans.

That’s not as unlikely as it might seem. 

The Gallup poll shows that among Republicans, those who identified themselves as conservative on both economic and social issues – the largest segment of the faithful – dropped from 51 to 42 percent.  What if all the dropouts were abortion moderates?

I did some simple math.  I imagined 100 Republicans in 2014. Of those, 51 were self-identified conservatives, and of those 65% opposed abortion. That makes 33 who thought abortion should be illegal nearly all the time.

Last month, only 42 of those 100 Republicans said they were thoroughly conservative, 9 fewer than a year ago.  Of those left, 79% were anti-abortion. That makes 33. In my scenario, these were the same 33 as a year ago. The 9 who defected to the less-than-fully-conservative camps were the ones who were wishy-washy about making abortion totally illegal. Perhaps this is our old friend social comparison. These nine people looked at the hardcore, and the next time that a pollster asked them about where they stood politically, they thought, “If being a Conservative Republican means wanting all abortions to be illegal, maybe I’m not so conservative after all.”

	Conservative Republicans	%Anti- Abortion	Number Anti- Abortion
2014	51	65%	33
2015	42	79%	33

I’m speculating of course. Besides, the data and calculations here are surely too simplistic; I am not a political scientist. But maybe the party purists are indeed forcing others who used to be close to them politically to rethink their identification as Conservative Republicans.

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* The drop in support among those 30-49 and 50-64 does fall just outside the confidence interval of 5.5 points, but is only half as large as the change among conservative Republicans.