Wednesday, 20 May 2015

How to kill rabbits and other medical research tricks

Dr Malcolm Kendrick used the analogy of sexual abuse in a new interview.  Victims who spoke out were disbelieved and told they were making mischief and should shut up.

He compares this to modern day medical 'heretics', who challenge government health statements and guidelines, that have no basis in science.

A simple, logical narrative that is easy to understand, becomes a fixed idea in public perception, even if it is wrong.  This makes it difficult to change people's minds.

One example Dr Kendrick gives is the contention that a high saturated fat diet causes heart disease.  Researchers feed rabbits such a diet and they die.  Rabbits are vegetarian and not designed to eat a high animal fat diet.  If we ate the same diet as a koala bear (ie eucalyptus leaves), we'd eventually die, because humans are designed to eat other animals.

Scientific evidence has no impact on erroneous, but deeply ingrained ideas, such as the cholesterol hypothesis.  Evidence seems only to make it stronger, as it bends out of shape to accommodate and neutralise contradictory data.

Listen to the full interview here.

Sunday, 26 April 2015

Weak maths can seriously damage your health

Here's a typical news story quoting alarming figures about risk of death from eating red meat.

'The researchers analysed data from 37,698 men between 1986 and 2008 and 83,644 women between 1980 and 2008.
They said that during the study period, adding an extra portion of unprocessed red meat to someone's daily diet would increase the risk of death by 13%, of fatal cardiovascular disease by 18% and of cancer mortality by 10%. The figures for processed meat were higher, 20% for overall mortality, 21% for death from heart problems and 16% for cancer mortality.
The study, published in Archives of Internal Medicine, said: "We found that a higher intake of red meat was associated with a significantly elevated risk of total, cardiovascular disease, and cancer mortality.'
The study is refuted here and here and here.

The focus of this post is not on any particular health problem.  I'm looking at mathematics and how medical science journalists and doctors tend not to understand the difference between relative and absolute risk.  Researchers and their publicists may grasp the distinction but blur it with alarming numbers so that their work sounds more significant.  This in turn can lead members of the public to accept prescriptions and treatment that won't improve their health or increase their lifespan.
The above article includes a number of percentages used to express risk of death by heart disease and cancer.  

Dr Malcolm Kendrick was recently interviewed on a health blog to discuss his latest book, 'Doctoring Data': 
'Say you do a study of blood pressure lowering medication with groups of 100 people.  You give one group the medication and the other group a placebo.  At the end of the year 2 people have died in the placebo group and 1 person has died in the treatment group.  The relative risk reduction is 50%.  The absolute risk reduction is 1 in 100 or 1%.  You can keep increasing the group size and the relative risk stays the same (2 versus 1 or 50% difference in the end), but the abolute risk drops:  eg in a group of 1000 the absolute risk reduction is 0.1%.  10,000 people = 50% relative risk and 0.01% absolute risk.'
How ever good the research, the news headline becomes:  "50% fewer people died on blood pressure medication."
'Saying that there is a 50% risk reduction is meaningless and pointless.  What matters is did you have a 1 in 10,000 risk to start with, a 1 in a million risk to start with or 1 in 2 risk.  If your risk is 1 in 2, then a 50% reduction is pretty damn good.  If your risk is 1 in a million, then a 50% reduction is so unimportant that it doesn't matter'.
'Medical researchers come out with relative risk reduction when talking about the benefits of a drug.  "This drug will reduce your risk of heart disease by 30%."  Well 30% of what?   Is it 30% of a really big number or a really small number?  So unless you know the underlying risk was, the relative risk is meaningless.  You can't work out what that means to you.'

This is especially important in dealing with drugs with significant side effects, such as statins.  Understanding the numbers can help you weigh up the risks and benefits of a course of treatment and help you decide what's best for you.

Dr Kendrick states that he wasn't brilliant at maths, but his father taught him a healthy level of scepticism towards the printed page.  He has found that his medical colleagues seem ignorant of the distinction between relative and absolute risk, asking him to explain the concept to them.  
If you want to be healthy and enjoy life for as long as possible, read the book and watch the video.  Learn enough maths to distinguish between risks and benefits of various treatments for you, rather than blindly accepting the advice of your doctor.  It's your life.

Sunday, 5 April 2015

The Big Fat Surprise

I've just listened to a radio play about the astronomer Patrick Moore.  He hosted a tv show on astronomy on UK television from 1957 that inspired generations to look to the skies and take up astronomy.  The play revealed the amount of backstabbing in the scientific community, which dismissed him as an enthusiastic amateur.  Yes he was largely self taught and had an exceptional ability to communicate complex ideas to a general audience.

I was reminded of this when reading about Nina Teicholz and her book 'The Big Fat Surprise'.  Already I can imagine the medical community, Big Pharma lobbyists and associated people dismissing her efforts.  Nina is a journalist and food writer, married mother of two living in New York City.

Dr Mike Eades has written an extensive review of the book.

She describes her journey in discovering the information that was included in the book and her discovery of personal health and weight loss through eating animal fats.

Here's the deal:  if you believe the cholesterol myth and associated edicts issued by government health departments, then you won't believe Nina or any writers that came before her (including Gary Taubes).  If you're interested in boosting your own health and DO NOT have familial hypercholesterolemia, it's worth listening to her.

Do your own research.

Monday, 30 March 2015

Lloyds Bank CEO £11.5 million bonus

I have written before about Lloyds Bank's attempts to cheat bondholders out of their savings.  The case is now likely to be determined in court.  I wrote to the CEO, MPs and regulators.  I have yet to receive a reply from Mr António Horta-Osório.  

Today we hear that the Chief Executive is in line for a £11.5 million bonus.  It has to be agreed at the annual meeting on 14 May.

The bank has sacked 50,000 members of staff and now boasts a rising share price (after years of zero dividends for shareholders.)  As one investor points out, the rise in share price is due more to Quantitative Easing than his skill as a banker.  His bonus is paid in shares, so he is one of the biggest beneficiaries of the debasement of our currency.

I have seen a steady decline in the standard of retail service at Lloyds Bank.  I am unsure what the CEO thinks he has contributed to the bank during his time in post.  He had an extended period of leave because of stress, presumably on full pay.

I wonder what the unemployed former employees think about his value to the bank?

It seems that the Bank of England is out of synch with the European Banking Authority's ruling against top-up payments.  The EBA will issue formal guidelines on bonuses, with which all bank regulators in the EU must comply.  Andrew Bailey has argued against the fixed cap, saying it will force up fixed pay levels.  

Thursday, 26 March 2015

Lloyds Bank ECNs and 21st century Robin Hood

I've written before about Lloyds Bank and the attempt to boost its finances by redeeming ECNs.  These are a new financial instruments forced on bondholders when the bank was bailed out by the Treasury.  Lloyds plans to pay less than the going rate for ECNs.

Our modern Robin Hood is Mark Taber.  He voluntarily stepped in when bondholders were about to be fleeced by institutions such as Bank of Ireland (running Post Office banking) and the Co-operative Bank.  These banks decided that their customers could be pushed around.  Successive politicians have relaxed regulations on banks, so that they no longer depend on the relationship with retail customers and small investors, but generate more income from speculative investments.  The regulators ensure that the Treasury gets its money back with interest, but seem to ignore malpractice and actions on the edge of the law against customers.

Mark Taber has mounted campaigns to rally bondholders, worked tirelessly with banks and regulators behind the scenes and done what he can to ensure elderly savers and investors do not lose their savings when no one stands up to the City of London.  He does NOT steal from the rich, but helps protect the poor and those who were deceived into believing that banks would honour the contract they signed.

Today Mark Taber announced that a leading QC has studied the case and told him that Lloyd's plan to redeem the 'enhanced capital notes' for less than their market value had 'no proper basis for a redemption'.  Taber is seeking a 'declaratory judgement' in court, so that a decision is made in a contractual dispute before any action is taken.  The decision of the court is binding.

Court costs may affect the action, as Lloyds could claim £10 million + in legal fees.  This would be absurd if it applied to misselling of Payment Protection Insurance, for example, and should be ruled out in the instance too.

This is not limited to Lloyds Bank, but another financial institution is planning to pull the same stunt and would not hesitate to follow if Lloyds were allowed to proceed and effectively steal from its customers.

After my previous post, I wrote to the regulators, various MPs on the Treasury Select Committee and the Lloyds Bank CEO, António Horta-Osório.  I received standard replies from 2 of these people.  However from Lloyds Bank CEO - answer came there none.

Friday, 13 March 2015

How statins make you stupid

Imagine this conversation between me and Mr Big the Property Developer over dinner:

Mr Big:  Sorry I just have to take my tablet.

Me:  Let me have a look... mmm statins.  So tell me, when did you have the heart attack?

Mr Big:  What?  I haven't had one.

Me:  Oh I see... so the stroke, when did that happen?

Mr Big:  What stroke?  I haven't had one.

Me:  Right, so when were you diagnosed with Familial Hypercholesterolaemia?

Mr Big:  With what?  Never heard of it and I haven't got it, as far as I know.

Me:  Tell me then, why is your doctor prescribing statins?

Mr Big:  Because my cholesterol is too high.

Me:  If your site foreman came and said 'You have too much building material' what would you say?

Mr Big:  I'd want to know what building material specifically.  Is there too much sand, cement, bricks, piping, tiles, slabs... or what.  If there was too much of something, we could send it back or divert it to another project.  Sometimes it's useful to have some stuff in reserve in case there are problems.

Me:  Right, then why don't you ask your doctor to specify what is meant by 'cholesterol'?  What's the reading for your HDL, LDL and triglycerides?  Some of that is helpful and some not.  Trigs can vary wildly, so it's not a great idea to reach for drugs after one reading.

Mr Big:  Are you a doctor?

Me:  No.

Mr Big:  Why should I listen to you?

Me:  You shouldn't listen to me or anyone else without checking the facts.  Let me run a couple of scenarios by you.  Let's imagine you have a building site for a new block of flats.  It's a wealthy area but notorious for thefts from building sites.  How do you secure the site?

Mr Big:  If I could erect secure fencing on site, I'd do that.  I might have a camera and alarm system.  The most useful is to have a watchman on site from dusk to dawn.

Me:  What if your doctor suggested installing Exocet missiles at the perimeter?

Mr Big:  What!!!!??? That would be way over the top and not very effective.  Anyway we'd never get it past planning and building control in the local council.

Me:  Let's imagine when you were younger you had an offer to migrate with your young family to South Africa.  You'd have a bigger home, great climate and opportunities to increase you wealth.  On the other hand you might face the risk of attack to you, your family and home.  How would you secure your property?

Mr Big:  I'd erect a secure fence, install burglar alarms and good locks, have a camera system.  I might have guard dogs and live in help to act as security guards also.

Me:  What if your doctor suggested installing nuclear warheads around the property?

Mr Big:  You're crazy!  They're not appropriate for the job and would damage my family as much as any burglars or attackers as well as wiping out half of South Africa.

Me:  That is crystal clear to you because it's in an area you know and understand well.  Your doctor is doing the equivalent of this in managing your health, but you don't recognise it.  Statins may help prevent thrombus formation in the lining of your blood vessels, but the side effects are drastic.  Other drugs can achieve the same effect without such bad side effects, not to mention implementing simple dietary and lifestyle changes.

Mr Big:  My doctor wouldn't prescribe these drugs unless he thought they were necessary.

Me:  Hmm have you ever heard of a plumber called to sort out a central heating problem, who sucked his teeth and said the whole system would have to be renewed, when in fact a single part needed changing?

Mr Big:  Yes, there are cowboys in the building trade who want to make a quick buck.

Me:  Do you know what NICE is?

Mr Big:  The government health body that oversees health care standards.

Me:  In theory yes.  In practice they seem to be the mechanism by which drug companies make a load of money from the NHS.  At present doctors are heavily incentivised to prescribe statins to healthy people and patients who will not benefit from them.  In other professions, such as finance, advisers are supposed to disclose the fees they make from selling products.  Doctors don't have to tell you about the cut they make from prescribing drugs on the NICE guidelines.

Mr Big:  Oh.

Me:  As I said before, do your own research.  I imagine you wouldn't let someone rip out a perfectly good central heating system, just because they said it was necessary.  Then why would you let your doctor persuade you to take damaging drugs that may not lengthen your life by one year, just because he says it's a good idea.

Mr Big:  How do I keep my heart healthy?

Me:  Everyone is different.  This is what I'd do in your situation:  Have some more butter and lay off the sugar, bread and pasta.  Reduce your stress, take some enjoyable exercise and get enough good quality sleep.

Thursday, 12 February 2015

'Racist UKIP'

I had a conversation with a friend just before the local elections.  She was angry about the rise of UKIP and dismissed the party as racist and bigoted.  I told her some of things I'd written in a previous post, describing circumstances that may have led to rising support for Nigel Farage and his colleagues.  She was genuinely surprised and told me she didn't know.

My friend comes from a distant continent.  She married an Englishman and now works in a white collar job.  She lives with her family in a quiet suburb.  She is aware of the multi cultural composition of London and works with some migrants as clients in her job.

Unfortunately what she and most media pundits, including Radio 4 and BBC tv comedians, do not know is how life is for people in other regions of the UK.  Some areas of the country are powerhouses of the modern economy, others face high unemployment and economic downturn.

Now the BBC has broadcast a radio programme about asylum seekers.  Unless  you download the podcast, it won't be available for very long.

Here's the blurb:

'Around 28 thousand people are claiming asylum in the UK. They're accommodated in some of the nation's most deprived areas while their cases are considered. Now, with numbers on the rise, some communities saytthey're struggling to cope. 

Allan Urry reports from the Northwest of England where, in some areas, there's concern about growing pressures on health services and schools. In Liverpool the City's Mayor, Joe Anderson, talks of an asylum "apartheid" and says other towns and cities need to take a fairer share. In Rochdale in Greater Manchester, there are more asylum seekers than the whole of the south east of England. The local MP Simon Danczuk says he's worried the pressures could undermine the good community relations that have always existed in the town.

Recent stories of asylum seekers living in fancy hotels have led to outraged newspaper headlines but are they a symptom of bigger failings in the UK's system for housing those who come here seeking refuge?'ey'

Why did the government reduce the number of organisations dealing with asylum seekers to 3 private providers (G4S, Serco and Clearel, only one of which had experience in the field)?

Could it be that donations to party funds and sophisticated lobbying may have helped?  G4S made a modest £50K donation in 2012, compared with Serco's £300,000.  Conflict of interest amongst politicians may be a factor, given that 2 Conservative and 2 Labour peers have shares in Serco, for example.  Some politicians obtain consultancies and directorships (after Westminster) with companies that have benefitted from government contracts.

Why would the government dump most asylum seekers in North West of England and Rochdale on the outskirts of Manchester rather than dispersing them more widely round the country (so the South East of England, excluding London, had 441 asylum seekers compared with 6298 in the North West)?

One of the official reasons is that housing in these areas is cheaper, making it easier to accommodate people.  There are some cheaper areas in other parts of England, including the South East, but housing is a highly contentious issue.  Successive governments have allowed the UK economy to rest on inflated house prices, putting them out of the reach of youngsters and ordinary people.

North West England and Rochdale are traditional Labour voting territory and unlikely to change, unless they swing to UKIP.  South East England is a traditional Conservative voting area.  2015 is the year of a general election and polling suggests there will be no overall winner.
Why did the government remove local government from involvement in this process, having little say in who is moved into their areas?

Local government in these areas, with long experience in dealing with migrants.  If government removes their power, they have little recourse.  These 3 private companies have a bad reputation in outsourced services.  Only local councils could call them to account, IF they were still involved.

What effect does this have on local people?

Local residents have less time to see their doctor, public housing is no longer available to them as asylum seekers (once allowed leave to remain) take priority, schools are full.

Some of my readers have assumed I'm a UKIP supporter, which I'm not.

However they have opened a discussion that most people (especially politicians cosily cosseted in the Westminster bubble and valuable houses in London, who hold down a well paid job and have expectations of lucrative contracts after their Parliamentary career) wish to avoid.

Gordon Brown tried to stifle the debate in Rochdale, when he refused to address the concerns of an elderly woma in 2010, giving her an election address and later referring to her as a 'bigoted woman'.

Gordon Brown remained an MP, though rarely appeared in the House of Commons (except to claim his allowances).  He and his wife ran a charity, which amassed large sums of money from his speaking tours, but strangely never seemed to disburse them to any charitable work.  He claimed £10,000 per week in expenses, but have less than £1million to charity.  He told this elderly widow that no one should claim benefits for more than 6 months, but get out to work.  Effectively Gordon Brown was a benefit claimant from the taxpayer, given how little he did as an MP in his last years.  Brown has resigned as an MP.

ng to cope. Allan Urry reports from the Northwest of England where, in some areas, there's concern about growing pressures on health services and schools. In Liverpool the City's Mayor, Joe Anderson, talks of an asylum "apartheid" and says other towns and cities need to take a fairer share. In Rochdale in Greater Manchester, there are more asylum seekers than the whole of the south east of England. The local MP Simon Danczuk says he's worried the pressures could undermine the good community relations that have always existed in the town.
Recent stories of asylum seekers living in fancy hotels have led to outraged newspaper headlines but are they a symptom of bigger failings in the UK's system for housing those who come here seeking refuge?