The Anchorage Daily News has published a new version of Michael Fumento's attempt to debunk the Lancet study on deaths in Iraq. How does it differ from his previous attempt? Well his key argument was that their estimate was skewed by the inclusion of the Falluja cluster. But it is perfectly clear from the report that Falluja was excluded from their estimate. Fumento knows this because he responded to my post with a comment, and he specifically asked questions about the inclusion of Falluja in the comments to his TCS article. In his new version he tacitly admits his error by quietly dropping his false claim. Of course, he hasn't corrected his TCS article. He also aware that they did look at death certificates, so it is dishonest for him to repeat his claim that "the researchers didn't feel bound by anything official like death certificates".
Unfortunately he has replaced his bogus claim about Falluja with something worse---his ridiculous comparison of crude death rates between the US and Iraq. (I have explained what is wrong with that here.)
It is disgraceful that someone so wilfully ignorant of basic science has published a column on a scientific question in a newspaper. You can send a letter to the editor at the Anchorage Daily News here. (Leave a comment if you do write a letter.) Contact information for Scripps Howard News Service is here. I think it would be particularly helpful if any epidemiologists in my readership contacted SHNS.
Update: Fumento replies:
Actually, the major changes were additions -- including quite legitimately pointing out that The Lancet insisted on using as its baseline pre-war mortality a number far lower than Saddam had used. That gave a range in the paper is inconsequential; the figure they used for their all-important 100,000 figure was five per 1,000.
5.0 is not "far lower" than 5.66. The post-war mortality rate was 7.9 (that's excluding Falluja---if you include Falluja it was 12.3), so whether the pre-war rate was 5.0 or 5.66, it is still a substantial increase. I notice you offered no defence of your ridiculous comparison of crude death rates between the US and Iraq.
I pulled the section about Falluja being included because it confused people -- like you. Find in the paper where they provide an equivalent to the 100,000 figure but exclude Falluja deaths. You can't, because it's not there. The Lancet has lied and you support it because you happen to like its conclusions, not because those conclusions where arrived at scientifically.
I already gave the exact quote from the paper---it was from the same paragraph that Fumento quoted in his TCS piece. Here it is again, with extra emphasis:
We estimate that 98 000 more deaths than expected (8000 194 000) happened after the invasion outside of Falluja and far more if the outlier Falluja cluster is included.
And no, I do not like the conclusions. I find them most unpalatable. But rather than inventing specious grounds for dismissing the study, I think it is better to face up to reality.
Actually, the major changes were additions -- including quite legitimately pointing out that The Lancet insisted on using as its baseline pre-war mortality a number far lower than Saddam had used. That gave a range in the paper is inconsequential; the figure they used for their all-important 100,000 figure was five per 1,000. I pulled the section about Falluja being included because it confused people -- like you. Find in the paper where they provide an equivalent to the 100,000 figure but exclude Falluja deaths. You can't, because it's not there. The Lancet has lied and you support it because you happen to like its conclusions, not because those conclusions where arrived at scientifically.
The CIA factbook numbers are interesting. They are estimates for the year ... 2004, not the year 2002.
WHO and Unicef give figures of 102 for infant mortality in 2002 and 8 for crude death rate.
Take these sources at face value amd 100,000 people have been saved by the liberation of Iraq.
I've been following the discussion on this Lancet study for a bit now, and both sides have managed to argue rather poorly at times.
Me personally, I come down rather harshly on the Lancet study. I think it's politically motivated, and in so far as you can extract anything at all from their poor data, it rather supports the notion that most violent death has been confined to combatants or has been caused by ordinary crime.
The authors do NOT exclude Fallujah for their conclusion that most of those 100,000 supposed deaths have been caused by coalition bombing and were of women and children. Outside of Fallujah they've got reports of 4 children and 2 women killed.
They do not make it at all clear in their summary that they are INCLUDING Fallujah for their conclusion that most of those killed by coalition bombing were women and children.
That's a misrepresentation that comes very close to lying.
A lot of data I would want to have, they do not report on. I want to know which deaths have been verified (like any of those 24 children in Fallujah for example?), and what people outside of Fallujah died from (or is it a fair assumption that all reported deaths in Fallujah were caused by the coalition? and then work one's way from there?).
The study reports an infant mortality before the invasion that is much lower than the Unicef number, over 70% lower. The authors caution that some of their increase may come from underreporting of deaths further removed in time, and that their infant mortality numbers may therefore be too low and the increase overstated.
Their household methodology as they say may exclude a lot of military deaths, but it may also exclude victims of Saddam's regime killed in prison, and I easily see how the shifting composition of households over time, or the fact that a lot of combatants now live with their families rather than in barracks, could introduce a similar bias as for infant mortality.
I would therefore:
1. Completely discount the supposed increase in infant mortality as baseless
2. Completely discount the data for Fallujah
a) because I doubt they asked for anything like 50 death certificates in Fallujah (maybe none?)
b) many people in Fallujah have every reason to lie to them
c) the ratio of child to women deaths is so out of kilter that it raises suspicion
3. Discount the comparison of death rates before and after as likely meaningless.
IF one assumes most of the violent deaths ex Fallujah after the invasion are actually real, and distributes those between combatants and non-combatants based on the sex ratio, and an assumption that violent death would inherently be more likely for men (say twice as likely as with accidents), and if one assumes the number for ordinary crime is correct,
we get down to estimates similar to those made by other sources and supported by other evidence, ie something like a few thousand civilians killed by coalition forces, and of the order of 90% of violent death being either combatants, or due to terrorist/criminal activity.
I'm baffled at your question about where in the paper they provide an equivalent to the 100,000 figure excluding Falluja. The 100,000 figure (actually 98,000) is the number that excludes Falluja. The authors are repeatedly explicit about this. From the abstract:
We estimate that
98 000 more deaths than expected (8000 -194 000)happened after the invasion outside of Falluja and far more if the
outlier Falluja cluster is included. (emphasis added)
From the body of the paper:
Evidence suggests that the mortality rate was higher
across Iraq after the war than before,even excluding
Falluja.We estimate that there were 98 000 extra deaths
(95%CI 8000 -194 000)during the post-war period in the
97%of Iraq represented by all the clusters except Falluja.
The Lancet has lied and you support it because you happen to like its conclusions, not because those conclusions where arrived at scientifically.
Note to self: stay on message. Must. Stay. On. Message.
End note to self. --Mike
I haven't done a very good job here arguing about the Lancet study. Deadlines. Maybe I have elsewhere.
But anyone who has written a paper and/or who has read many papers can easily see that the Lancet study can be replicated and bias can be [and has been] eliminated. When a half-dozen results are published and the data points are plotted, the Lancet study will be among those data points, as it is a good paper.
We have NO WAY of knowing whether the study result is an outlier or whether it is under the big part of the curve. NO WAY. Chattering and ululating about ridiculous results is, simply, uninformed opinion.
Get your butt out there and do your own study if you don't like this one. Report the results. Have your editor shut their mouth and not toot-toot the results. Plot the results against others. THEN state your opinion about where the Lancet study lies along the spectrum.
Until then, you don't know whether the results are statistically valid. And don't pretend you do.
Except for Michael, whose job it is to pretend so.
Another quote from the paper:
As mentioned above, the Falluja cluster is an obvious outlier and might not belong with the others. When included, we estimate that the risk of death increased 2.5-fold after the invasion (relative risk 2.5 (95% CI 1.6-4.2). When excluded, we estimate the relative risk of death for the country was 1.5 (95% CI 1.1-2.3).
And another one:
In our Fallujah sample, we recorded 53 deaths when only 1.4 were expected under the national pre-war rate. This indicates a point estimate of about 200,000 excess deaths in the 3% of Iraq represented by this cluster. However, the uncertainty in this value is substantial and implies additional deaths above those measured in the rest of the country.