Getting Risk Right

Understanding the Science of Elusive Health Risks

[Amazon Link]

Another pick obtained for me via the Interlibrary Loan folks at the University Near Here. Thanks, folks!

I've been interested for a while about the general topic of risk, and how it might best be regulated in a free society. I'm still in the weeds, but maybe if I keep reading…

The author, Geoffrey Kabat, is an epidemiologist at the Albert Einstein College of Medicine; he's deep in the field of quantifying health risks. This book outlines the pitfalls and biases that researchers investigating causes of disease can fall prey to. And the realities of funding and publication pressures on researchers can, and does, incentivize a lot of bad, misleading, and unreproducible results. (For more on that topic, see the recent Wired article about John Arnold.) The discussion here is technical and valuable.

Kabat then turns to four recent case studies, two bad, two good. The bad: efforts to show that cell phone usage causes brain cancer, and the notion of "endocrine disruptors" in the environment. Both areas were sensationalized, and wasted a lot of funding that could have been spent on more productive areas.

The good: research into dangerous "Chinese herbal supplements" containing aristolochic acid; and how varieties of human papillomavirus (HPV) can result in various cancers, mostly cervical. These are heroic stories, as the scientists involved i-dotted and t-crossed their studies in order to tease out valid results, exposing disease processes that can take decades to actually kill you.

Kabat's prose is unfortunately wooden and to-be-sure mannered, and he's mind-numbingly diligent about dropping names and professional affiliations of the researchers he discusses. Fine, but that gets in the way of the narrative. (He's no Daniel Kahneman, sorry.) But, even given that, the book is a good discussion on how to do research right, and also wrong.

He (also unfortunately) doesn't get close to my main concern: once you've identified and quantified a risk, what's the proper policy response, especially given that people have widely varying tolerance for risky behaviors?

Also, a pet peeve: he refers to "socioeconomic inequality" (p. 179) when he almost certainly means "poverty".

URLs du Jour

2017-02-10

Instead of getting out there and clearing my driveway, let us consider Proverbs 29:8:

Mockers stir up a city, but the wise turn away anger.

What do you think? My thoughts:

  • I kind of like mockers, if they're also funny.
  • But if they're not funny, they're just stupid.
  • Wait a minute, they had mockers back then?
  • How funny could they have been?
  • Isn't the "but…" part kind of a non sequitur?
  • Maybe the concept of non sequitur hadn't been invented yet?
  • Ah! Maybe mockers invented the non sequitur!
  • Maybe, just maybe, a mocker wrote this proverb!

We now return you to your regularly scheduled programming:

  • The great Kevin D. Williamson offers a modest proposal: "Make Bureaucracy Great Again".

    Americans do not much trust their government, for good reason. And this has immediate, important real-world consequences. For example: It can be difficult to distinguish between hysteria about Islam and well-founded concern about Muslim immigration into the United States, but who seriously thinks that our public institutions are up to the job of properly investigating tens of thousands (or more) refugees, asylum-seekers, and ordinary immigrants every year? If Donald Trump’s temporary order seems to you unreasonable, ask yourself what the next-best option is and how much confidence we should have in it. The U.S. government has been flubbing the problem of radicals crossing our borders since Lee Harvey Oswald was simmering in Minsk. How many terrorists and school shooters were already on the authorities’ radar, and had been for years, before they committed spectacular atrocities? A half-dozen examples come to mind.

    It's really not too much to ask of our "public servants" that they be held to standards of competence and efficiency that we get from the private sector.

  • At the WSJ, John J. Miller asks the musical question: "Who’s Afraid of Student Journalists?". As it turns out, the answer is: the American Association of University Professors (AAUP).

    In a 1,000-word statement released last month, the AAUP bemoaned “new efforts by private groups to monitor the conduct of faculty members,” which it likened to “witch hunts.” Then it named names: Professor Watchlist, Campus Reform and the College Fix.

    The AAUP would like avoid scrutiny of political professorial antics in the classroom, and pressure journalistic whistleblowers to Just Shut Up. Not surprising, and fortunately likely to fail.

    John J. Miller is the founder and executive director of The College Fix, a good read.

  • Is Federal infrastructure spending a good deal? Find out the shocking answer from Veronique de Rugy at Reason: "Federal Infrastructure Spending Is a Bad Deal"

    Well, the headline is not quite accurate. It can be a bad deal. As Obama demonstrated, it's not great at "stimulating the economy" in the short term. And politicians are spectacularly lousy at picking projects that make economic sense in the long term. But:

    On the bright side, Trump wants to address the "mountain of red tape" that slows down construction projects. His plan would link spending to reforms that "streamline permitting and approvals, improve the project delivery system, and cut wasteful spending on boondoggles."

    He shouldn't stop there. A new report by Michael Sargent at the Heritage Foundation encourages the president-elect to reduce the federal role in highway construction and mass transit. I would go further: He should put an end to the whole idea that infrastructure should be centrally planned, taxpayer-funded, and the responsibility of the federal (as opposed to state or local) government. The current system obliterates the discipline that comes from knowing a project needs to pay for itself to survive.

    I'm never optimistic about Trump doing sensible things, but maybe. The referenced Michael Sargent report can be found here.

  • Ryan Bourne watched the recent debate between Ted Cruz and Bernie Sanders about socialized medicine, and found both to be long on anecdotes, short on data. And he offers a remedy. Much of the debate whirled around comparing the US with the UK. Surprising (to me): although "everybody knows" that the US spends a lot of money for a system that supplies inferior health outcomes, for example:

    In the United States, the age-adjusted breast cancer 5-year survival rate is 88.9 percent, compared with just 81.1 percent in the UK.

    Similarly for prostate cancer, lung cancer, bowel cancer, leukemia, ovarian cancer, stomach cancer, liver cancer, and strokes. Bourne's amusing conclusion:

    All of which is to show that your probability of dying from a range of common conditions is much higher in the UK than here. Perhaps that’s why (with no hint of irony) The Guardian’s write-up of a Commonwealth Fund Report suggesting the UK’s health system was “the best in the world” said “the only serious black mark against the NHS was its poor record on keeping people alive.”

    OK, maybe not that amusing if you're at the mercy of the NHS.

  • Matt Ridley examines the issue of whether NOAA has its Thumb on the Scale of Temperature Trends. It's quite a dustup. The usual storm of nasty charges and counter-charges. But:

    This is more than just a routine scientific scandal. First, it comes as scientists have been accusing President Trump and other politicians of politicising science. Second, it potentially contaminates any claim that climate science has been producing unbiased results. Third, it embarrasses science journalists who have been chronicling the growing evidence of scientific misconduct in medicine, toxicology and psychology, but ignored the same about climate science because they approve of the cause, a habit known as noble-cause corruption.

    Just waiting for the dust to settle. Been waiting for a couple decades now.

  • David Harsanyi has an interesting idea: "Republicans Should Make Elizabeth Warren The Voice Of Democrats"

    […] few things are more unintellectual, irrational, or un-American than demanding people comport their political worldviews to their skin color, sex, or ethnicity. And if a Warren candidacy — or anyone else’s — ensures that Democrats will spend another four years accusing half the country of being moral troglodytes while waiting for demographics to win them elections, Republicans should support their efforts.

    As Harsanyi himself admits, this isn't an ironclad strategy: a lot of Democrats thought Trump would be the form of GOP's destructor. Before the election.