I wrote earlier how it seems that you must fail a qualifying exam before you can write on a topic at Tech Central Station. Now the errors in Fumento’s critique of the Lancet study.aren’t errors in epidemiology—they seem to result from not having read the study. Indeed, in comments at TCS, Fumento seems to be asking for help to find out what it said:

You imply rather strongly that you’ve read the report. If so, please inform us of what the extrapolation was that DID NOT rely on the Falluja cluster. I’m waiting.

and then:

I asked the wrong question. I meant to say how many were in the extrapolation that DID include the Falluja cluster?

and also:

We also know there is absolutely no way to randomly select 33 clusters.

Again, if he had read the study, he would have known that they did randomly select 33 clusters, and that they explained the randomization procedure in great detail.

But now, in a comment on my blog, Fumento has proved that he meets the TCS requirement to write about epidemiology—he demonstrates ignorance of a basic epidemiological principle:

The alleged 100,000 deaths were those above the pre-war baseline. That baseline was predicated on a figure of 5.0 deaths per 1,000. BUT the figure for the US at the time was 8.3 deaths per 1,000. Obviously Iraq was one of the safest countries on the face of earth prior to the Yankee imperialist invasion. In fairness, the CIA Worldbook uses a 5.6 per 1,000 figure for Iraq but what was it’s source? Saddam’s ultra-trustworthy government, of course. Thus The Lancet is using figures even lower than the Land of Baghdad Bob was putting out.

OK, some basic epidemiology:

Comparing Mortality in Different Populations: an important use of the rates—recall that the populations may differ in regard to many factors which affect mortality, of which age distribution is the most important—so to compare, we hold the factor (age) constant.

Consider:

Death Rates by Age and Race, Baltimore City, 1965
	All	<1yr	1-4yr	5-17yr	18-44yr	45-64yr	>65yr
White	14.3	23.9	0.7	0.4	2.5	15.2	69.3
Black	10.2	31.3	1.6	0.6	4.8	22.6	75.9

Overall [this is called CRUDE or UNADJUSTED mortality], the death rate for blacks is LOWER than it is for whites. This is unexpected given the conditions at the time for blacks with respect to health care access and living situations. Why would this happen? Well, if we look at the stratified rates by age, we see that the rate for blacks is HIGHER at every age level. This seeming conundrum is explained by the fact that, while the rates increase markedly for both races in the over 65 bracket, there are more whites left in that age group. So many, in fact, that the overall mortality for whites overwhelmingly occurs in the over 65 age group, while the same is NOT the case for blacks.

Hmmm, so do you think Iraq and the US have the same age distribution? From the CIA Factbook—the very source that Fumento cited—we find that the US has a very different age structure with a much larger proportion of old people. And notice that neighbouring Syria has a similar age structure to Iraq and a death rate of 4.96, consistent with the Lancet study.

Fumento’s argument that the 5.66 number for Iraq was falsified by Saddam’s regime makes no sense. If Saddam was cooking the numbers he would have made them higher and claimed that the sanctions were killing vast numbers of people.

And his claim that the Lancet number of 5.0 is inconsistent with the CIA Factbook number of 5.66 is also wrong, since he ignores the fact that the 95% confidence interval for the Lancet study was 3.7–6.3, and 5.66 lies in that interval.

Also of interest might be this Chris Mooney post on Fumento’s book on biotechnology.

Update: Fumento replies:

Much of what you write is simply idiotic, as in saying the clusters were “randomly sampled.” How is that even possible, aside from throwing darts at a dartboard? It also implies you can read the researchers’ minds. Ah, The Amazing Lambert. But at least I’ve found one person who really does believe we’ve been violently killing civilians at a rate of over 180 per day. I was afraid the Lancet propagandists weren’t going to get away with that. You can blog all you want, but my next column is also on this. It goes out to over 350 newspapers and lots of websites that each have more traffic than yours. You occupy the pitiful place of the harmless blogger who blogs because nobody in his right mind would punish him. Rant, rant, rant. The world careth not.

Looks like Fumento flunks statistics as well as epidemiology. Random sampling is a fundamental concept in statistics and despite Fumento’s incredulity it is actually possible to carry it out. I didn’t have to read the researchers’ minds to find out how they randomized the clusters; I just had to read their paper, something that Fumento still has not done. And no, I don’t believe that we are killing civilians at over 180 a day—that isn’t what the paper found. I do believe that Fumento’s critiques of it are worthless, if that is any help.

Update 2: Fumento replies again:

You cannot randomly choose physical households in a place like Iraq. Those data are not in a computer. Do you think it’s like campaign polling in the States?

Here is the methodology that is beyond Fumento’s comprehension:

We assigned clusters to individual communities within the Governorates by creating cumulative population lists for the Governorate and picking a random number between one and the Governorate population. Once a town, village, or urban neighbourhood was selected, the team drove to the edges of the area and stored the site coordinates in a global positioning system (GPS) unit. We assumed the population was living within a rectangle, with the dimensions corresponding to the distances spanned between the site coordinates stored in the GPS unit. The area was drawn as a map subdivided by increments of 100 m. A pair of random numbers was selected between zero and the number of 100 m increments on each axis, corresponding to some point in the village. The GPS unit was used to guide interviewers to the selected point. Once at that point, the nearest 30 households were visited.

And if you are interested in more of the Fumento follies, look here and here.