Pure Pedantry

Benefits of Acupuncture Do Not Require Actually Inserting Needles

Mon, 01 Dec 2008 12:22:26 -0500

For acupuncture to work, you don't actually have to put in the needles:

The acupuncture study of 215 patients who were undergoing radiation treatment in the abdomen or pelvic region chose by lot one of these two acupuncture types.
109 received traditional acupuncture, with needles penetrating the skin in particular points. According to ancient Chinese tradition, the needle is twisted until a certain 'needle sensation' arises. The other 106 patients received a simulated acupuncture instead, with a telescopic, blunt placebo needle that merely touches the skin.

The acupuncture was performed by physiotherapists two or three times a week throughout the five-week radiation period.

Afterwards 95 percent of the patients in both groups felt that the acupuncture treatment had helped relieve nausea, and 67 percent had experienced other positive effects such as improved sleep, brighter mood, and less pain.

The final study shows that patients that received traditional or simulated acupuncture felt considerably better than the group that had only received care following ordinary routines. The difference, 37 percent compared with 63 percent of nauseous patients, is statistically significant. On the other hand, there was no difference between the two acupuncture groups.

The effects therefore seem not be due to the traditional acupuncture method, as was previously thought, but rather a result of the increased care the treatment entails. Patients could converse with the physiotherapists, they were touched, and they had extra time for rest and relaxation. (Emphasis mine.)

It would appear that acupuncture works by giving the patients some extra TLC, rather than stabbing metal into your chakras or chi or whatever other mumbo jumbo is used to justify this nonsense. Placebo, anyone?

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Drug Trial Publication Bias and the FDA

Mon, 01 Dec 2008 11:57:47 -0500

Drug companies are not publishing all the trial data that they submit to the FDA, and those trials that are published are more likely to show positive results.

Rising et al. compared all the New Drug Applications (NDAs) (the vehicle for initiating a new clinical trial) given to the FDA in 2001 and 2002 to subsequent published literature. They found that only about 3/4 of the trials were later published in journals, and those that were published were 5 times as likely to show favorable results for the drug being tested by the drug company as those that were not:

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The Economy is Rough All Over: Mistress Edition

Fri, 28 Nov 2008 11:55:24 -0500

The economy is rough for everybody. The super-rich are cutting back on their mistress subsidies:

According to a new survey by Prince & Assoc., more than 80% of multimillionaires who had extra-marital lovers planned to cut back on their gifts and allowances. Still, only 12% of the multimillionaire cheaters said they plan to give up on their lovers altogether for financial reasons.
"Rich people are getting hit, and they're all expressing the need to curtail unnecessary spending," said Russ Alan Prince, president of Prince & Assoc., a wealth-research firm based in Connecticut. "Lovers are part of the same calculation."

Of course, any study of millionaires and their mistresses should be taken with a large grain of salt. The survey -- a subset of a larger wealth study -- polled 191 individuals with a minimum net worth of $20 million who said they had lovers of at least a year or more (this to screen out the one-night stands, etc.). About two thirds of the respondents were men and one third women. All were married and all had personal control over their finances, meaning the women and men surveyed were the primary wealth holders in their homes.

The most surprising stats in the study relate to gender and what might be termed "length of service." Fully 82% of men in the study said they planned to lower the allowances to their mistresses, while more than three quarters planned to provide fewer gifts, less expensive gifts and fewer perks, like jet rides, resort vacations and top restaurant meals.

Women were far more generous to their paramours in the face of financial crises. Less than 20% planned to lower allowances, gifts and perks, while more than half planned to raise them.

Looks like the men are substantially less generous to their mistresses than the women are to their manstresses...histresses...is there even a word for that?

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Video of a Rare Giant Squid

Fri, 28 Nov 2008 11:52:40 -0500

Check out this crazy video of a rare "elbowed" giant squid recorded from a Shell Oil remote operated vehicle in the Gulf of Mexico.

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Thanksgiving Dinner with a Side of ER

Thu, 27 Nov 2008 11:14:53 -0500

Happy Thanksgiving, everyone!

I was reading the Web this morning, and this story reminded me of a Thanksgiving a couple years ago.

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Should everyone take vitamins?

Sun, 23 Nov 2008 20:28:15 -0500

Over at the NYTimes Well blog they have a really good summary of studies about vitamins and improvements to health.

Everyone needs vitamins, which are critical for the body. But for most people, the micronutrients we get from foods usually are adequate to prevent vitamin deficiency, which is rare in the United States. That said, some extra vitamins have proven benefits, such as vitamin B12 supplements for the elderly and folic acid for women of child-bearing age. And calcium and vitamin D in women over 65 appear to protect bone health.
But many people gobble down large doses of vitamins believing that they boost the body's ability to mop up damaging free radicals that lead to cancer and heart disease. In addition to the more recent research, several reports in recent years have challenged the notion that megadoses of vitamins are good for you.

Read the whole thing.

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Why are we bailing out Detroit?

Tue, 11 Nov 2008 02:55:39 -0500

I agreed (reluctantly) with the need to bailout banks because they constitute a special case in the financial system -- the overall health of banks is linked to the overall health of the economy. I am not against bailouts per se, but the devil is in the details. There are a lot of ways that they can make recessions worse by putting inefficient companies on life support. This view of recessions is explained well on Economist Democracy in America blog:

A dialectic model of the business cycle suggests that in prosperity, inefficiencies are allowed to build up alongside innovations until the expansion becomes overburdened. Then a recession attacks both the productive and unproductive, until inefficient firms are eliminated and the resources they once wasted turn up in the hands of smarter competitors. In other words, the recovery begins when companies like GM stop wasting metal and labour.
Any stimulus programme might moderate some of the pain of the recession in the short term. But where the programme interferes with the reorganisation of private labour and capital, it will more likely extend the recession needlessly. The programme Barack Obama endorsed to speed up infrastructure construction and repair could do more good than harm. The proposal to lend money to American auto manufacturers, on the other hand, seems likely to prolong current problems.

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Must Read Article on the Limits of Brain Scans

Wed, 05 Nov 2008 18:19:19 -0500

Michael Shermer, editor of Skeptic magazine, has a great article in Scientific American about the limits of interpreting fMRI scanning studies -- particularly how they are presented in the media. The biggest point is that the brain is not a collection of modules isolated from one another; rather, it is a collection of interconnected systems with diverse roles in diverse tasks:

A number of interconnected neural networks may in some cases be localized and bundled into modulelike units, but in most ways they are better described as being splayed out over, under or through the brain's crevasses. The metaphor of "distributed intelligence" -- sometimes used to describe the World Wide Web's power -- more closely matches the network distribution of tasks in the brain than the module metaphor does.
Of course, there are areas that specialize in certain types of processing, such as the visual cortex at the back of the brain and Broca's area for language in the left frontal lobe. And roughly speaking, reason and rationality happen in the cortical areas, whereas emotion and irrationality are experienced in the limbic system.

Nevertheless, as many neuroscientists now believe, the metaphor of "neural networks" is superior to that of mental modules. The latter forces us to think of the brain as a kludge of encapsulated organs specialized for one function and no other, whereas the former more accurately reflects what modern neuroscience tells us is actually happening during cognition. Brain-scanning technologies such as fMRI will continue to generate copious data for our metaphorical theories -- and as long as our skeptical networks are active, we should be able to better map neural networks and their accompanying functions onto the landscape of our behaviors.

Read the whole thing. I have talked about this subject here.

Hat-tip: Marginal Revolution

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Why do we vote?

Tue, 04 Nov 2008 11:58:41 -0500

I always get in arguments with mathematically-inclined people about whether to vote or not. The mathematically-inclined point out very reasonably that the chances of your vote being decisive are perishingly slim.

(These mathematics are explained clearly in this PBS video by economist Gordon Tullock explaining why he does not vote. Hat-tip: Marginal Revolution)

But there is always a part of me that believes there has to be more to the story. My intuition is that if there really was no practical purpose, people wouldn't do it. The behavioral scientist in me argues that if a behavior has no rewards, people will have no motivation to do it.

Anyway, there are probably many reasons why people vote aside from the likelihood of actually changing the election. There could be psychological factors such as the desire to fit in. There could also be strategic factors like creating a perception of support for your candidate to lure other voters in.

In light of it being election day, I thought I would post two of the more interesting theories I have seen about why rational people should vote.

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Professors Aren't Changing Their Students' Politics

Mon, 03 Nov 2008 19:14:03 -0500

Professors are not effective at indoctrinating their students with their own politics -- or so says a study in the journal PS as reported in the NYTimes:

A study of nearly 7,000 students at 38 institutions published in the current PS: Political Science and Politics, the journal of the American Political Science Association, as well as a second study that has been accepted by the journal to run in April 2009, both reach similar conclusions.
"There is no evidence that an instructor's views instigate political change among students," Matthew Woessner and April Kelly-Woessner, a husband-and-wife team of political scientists who have frequently conducted research on politics in higher education, write in that second study.

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Daylight Savings Time Affects Heart Attack Incidence

Fri, 31 Oct 2008 09:37:19 -0500

This Sunday you are slightly less likely to have a heart attack.

Swedish researchers, publishing in the NEJM, looked at a registry of heart attacks from 1987 to 2006. They found that the incidence of heart attacks slightly increases for the three days following the Spring daylight savings time where we lose an hour. The incidence of heart attacks slightly decreased on the day after Fall daylight savings time:

We used data from the Swedish registry of acute myocardial infarction, which provides high-quality information on all acute myocardial infarctions in the country since 1987. The incidence ratios, as measures of relative risk, and exact 95% confidence intervals were calculated.
The incidence of acute myocardial infarction was significantly increased for the first 3 weekdays after the transition to daylight saving time in the spring (Figure 1A). The incidence ratio for the first week after the spring shift, calculated as the incidence for all 7 days divided by the mean of the weekly incidences 2 weeks before and 2 weeks after, was 1.051 (95% confidence interval [CI], 1.032 to 1.071). In contrast, after the transition out of daylight saving time in the autumn, only the first weekday was affected significantly (Figure 1B); the incidence ratio for the whole week was 0.985 (95% CI, 0.969 to 1.002).

The authors attribute the change to getting one less hour of sleep during the Spring and one more hour of sleep during the Fall.

While the effect sizes are super-small and I am a bit skeptical about their ideas for mechanism (changes in pro-inflammatory cytokines due to changes in circadian rhythm), this is still a funny and cool story.

Hat-tip: NPR

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The Ethics of Using Placebos

Fri, 24 Oct 2008 10:51:27 -0500

A survey of American internists and rheumatologists has revealed that over 50% of them regularly prescribe placebos.

Tilburt et al. surveyed internists and rheumatologists to see whether they were prescribing placebos, and if so how and what kind they were using. The study, published in BMJ, found the following:

679 physicians (57%) responded to the survey. About half of the surveyed internists and rheumatologists reported prescribing placebo treatments on a regular basis (46-58%, depending on how the question was phrased). Most physicians (399, 62%) believed the practice to be ethically permissible. Few reported using saline (18, 3%) or sugar pills (12, 2%) as placebo treatments, while large proportions reported using over the counter analgesics (267, 41%) and vitamins (243, 38%) as placebo treatments within the past year. A small but notable proportion of physicians reported using antibiotics (86, 13%) and sedatives (86, 13%) as placebo treatments during the same period. Furthermore, physicians who use placebo treatments most commonly describe them to patients as a potentially beneficial medicine or treatment not typically used for their condition (241, 68%); only rarely do they explicitly describe them as placebos (18, 5%).

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Uninsured are not the problem in ED overcrowding

Thu, 23 Oct 2008 12:28:28 -0500

Whenever you are having a debate -- particularly a policy debate -- it is always important to check your premises. That is why I found this article in the Journal of the American Medical Association refreshing.

Emergency Department utilization is clearly on the rise in the US, and this rise in use is leading to longer wait times and diminished quality of care. One assumption that the cause of this problem are the uninsured, i.e. the uninsured are using the ED as an alternative to primary care and causing overcrowding.

However, Newton et al., in what will likely be a provocative article, reject this assumption. After surveying the literature with respect to ED and the uninsured, they found the uninsured are not using the ED at a disproportionate rate to the insured.

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Brain to Muscle Link in the Monkey

Tue, 21 Oct 2008 12:03:34 -0500

I am a little late to this party, but I do want to talk about this paper in Nature Neuroscience.

Moritz et al. implanted an electrode into a monkey's motor cortex. The electrode was designed to only record from a single neuron at a time. Then the output of that cell -- after a little amplification and transformation in a computer -- was connected to a muscle in the monkey's wrist. Finally, the nerves that innervated that muscle were temporarily anesthetized. The monkey was trained to play a little game that involved moving the wrist muscle to get a reward.

The researchers wanted to know whether the monkey could use the link up from a single neuron to coordinate the motions of their wrist. This is of particular interest to neural prostheticists who would like to invent ways to work around spinal injuries that prevent the brain from talking to the muscles.

Surprisingly, the researchers found that not only was one neuron enough, it didn't matter which one you picked. For nearly all the neurons, the animal figured out how to move their wrist using the machine.

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Economy Update

Tue, 21 Oct 2008 11:26:57 -0500

I have been a bit lax on the blogging, but here is what I have been reading on the economy.

Tyler Cowen attributes the financial bubble to three main causes:

The current financial crisis comes from a conjunction of three major trends, common to many countries and to a wide variety of financial institutions.
The first trend was a positive one: an enormous growth in wealth that needed to be moved into investments. Before he became chairman of the Federal Reserve, Ben S. Bernanke wrote of a "global savings glut," particularly from Asia. Furthermore, over the last 20 years, many countries have modernized their financial systems and created new channels that linked savings and investment. In Spain, Iceland, Ireland and Britain, the real estate boom was without recent precedent.

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