Relevant and even prescient commentary on news, politics and the economy.

Best evidence pitfalls

The New England Journal of Medicine reports this abstract about unreported clinical trials of pharmaceutical companies.

Background Evidence-based medicine is valuable to the extent that the evidence base is complete and unbiased. Selective publication of clinical trials — and the outcomes within those trials — can lead to unrealistic estimates of drug effectiveness and alter the apparent risk–benefit ratio.
Methods We obtained reviews from the Food and Drug Administration (FDA) for studies of 12 antidepressant agents involving 12,564 patients. We conducted a systematic literature search to identify matching publications. For trials that were reported in the literature, we compared the published outcomes with the FDA outcomes. We also compared the effect size derived from the published reports with the effect size derived from the entire FDA data set.
Results Among 74 FDA-registered studies, 31%, accounting for 3449 study participants, were not published. Whether and how the studies were published were associated with the study outcome. A total of 37 studies viewed by the FDA as having positive results were published; 1 study viewed as positive was not published. Studies viewed by the FDA as having negative or questionable results were, with 3 exceptions, either not published (22 studies) or published in a way that, in our opinion, conveyed a positive outcome (11 studies). According to the published literature, it appeared that 94% of the trials conducted were positive. By contrast, the FDA analysis showed that 51% were positive. Separate meta-analyses of the FDA and journal data sets showed that the increase in effect size ranged from 11 to 69% for individual drugs and was 32% overall.
Conclusions We cannot determine whether the bias observed resulted from a failure to submit manuscripts on the part of authors and sponsors, from decisions by journal editors and reviewers not to publish, or both. Selective reporting of clinical trial results may have adverse consequences for researchers, study participants, health care professionals, and patients.

This may be good for sales, but witholding limitations from doctors at least in theory is bad medicine. Of course, there are other difficulties.

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Post flambe


OMB Watch has an article on talk of a stimulus package and what it should not do. Actually, it does propose an idea, but I left that out. To quote:

“During his speech at the Union League Club of Chicago on Jan. 7, Bush reiterated the importance of continuing his current policies to address what he calls recent economic “challenges.” However, he emphasized that new initiatives are unnecessary to address the damage from the housing and financial crises. Bush called for extending his first-term tax cuts, few of which, if any, would have any impact on current economic signals.

Meanwhile, Paulson, in his speech before the New York Society of Security Analysts, Inc., said the administration would consider an economic stimulus package but would not provide any details. This is why some speculated that Bush might announce something during the State of Union address.

It is important that policy makers ignore calls for a repetition of the failed 2001-2003 Bush tax cuts and adhere to sound economic principles as described by Summers and Orszag. Even worse would be calls for extension of those same tax cuts as a short-term solution for current fiscal problems. Permanent tax cuts for the wealthy and corporations would do little to immediately stimulate the economy or direct economic aid to those most affected by an economic slump while ultimately putting a drag on the economy in the long term through sustained budget deficits.

(The views expressed are those of mine alone and should not be attributed to the trustees, officers, or staff of the Brookings Institution or the Tax Policy Center. Much of this talk draws upon joint work with William Gale of Brookings, Robert Greenstein and Richard Kogan of the Center on Budget and Policy Priorities, Robert Rubin of Citigroup, and Allen Sinai of Decision Economics, Inc. I also thank Robert Cumby of Georgetown University, Peter Diamond of MIT, Doug Elmendorf and David Wilcox of the Federal Reserve, Robert Bixby of the Concord Coalition, and Maya MacGuineas of the New America Foundation for helpful discussions.)

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Psycological Kevlar


Psychological Kevlar Act of 2007
introduced by Patrick Kennedy was to help PTSD and brain trauma research expand.

It has come to my attention that the DoD is thinking about using propranolol as a prophylactic to help reduce ptsd symptoms during conflict and after. I had found this articlefrom a wife of a soldier who had killed himself, and who had testified in a Dec. 12, 2007 congressional hearing on suicide among veterans that is apparently on the rise. She has a strong and passionate viewpoint, but that is not for the post.

Propranolol (brand name Inde by Wyeth) is used for a number of diagnosis not related to ptsd. In addition it is used in the psychological Anxiety area as a beta blocker among other uses, for example for rape victims ptsd to help defuse the intensity of the experience in order to work in therapy. Its efficacy is still experimental and not encouraging.

Failing to locate such information, I am wondering if readers may have leads. While an econ blog, many here are also veterans. Thanks. Further information is coming if warranted. I have e-mailed relevant experts that I know.

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Democracy through smart bombs

The Asian Times carries an article and opinion about democratizing the ME.

This week, coinciding with President George W Bush’s two-day trip to Saudi Arabia, the Bush administration is expected to notify Congress about an arms package for Saudi Arabia. The sale is part of an overall package that was announced at the end of July 2007; a series of arms deals worth at least US$20 billion to Saudi Arabia and five other Persian Gulf states, as well as new 10-year military and economic aid packages to Israel and Egypt.

Even by the standard of past arms sales to the Middle East and Persian Gulf, traditionally one of the world’s largest arms-buying regions, these are major arms transfers with the potential to significantly affect the regional strategic balance. One of the more notable aspects is that the Bush administration plans to sell advanced satellite-guided bombs, such as the JDAM, which the United States has never before sold to Saudi Arabia, fighter aircraft upgrades, and new naval vessels to six Gulf Cooperation Council countries, including Kuwait, the United Arab Emirates, Qatar, Bahrain and Oman. Reportedly, the Pentagon asked the Saudis to accept restrictions on the range, size and location of the satellite-guided bombs, including a commitment not to store the weapons at air bases located near Israeli territory.

And unlike some past sales, no conditions are attached. In fact, when Rice visited the Middle East last July, she insisted that the Bush administration had not imposed demands on its allies in exchange for the arms and aid deals. “This isn’t an issue of quid pro quo,” Rice told reporters. “We are working with these states to fight back extremism.” And with no strings attached to the assistance – no democratic reforms, human-rights conditions or peace-making obligations – the arms sales do nothing to change the behavior of the authoritarian regimes in the region.

The article contains more than mentioned here. But if democracy is the goal overall, how does selling systems for large military assist asymetrical warfare. If the Saudis do not use the weapons to create an integrated defense force as mentioned in the article, what do we get out of it in relation to Saudi Arabia and democracy.

If McCain is right and it takes one hundred years, what measure of benefit is even applicable?

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Flamer

This blog seemed to provide a comprehensive list of technique. The following caught my eye of a couple hundred tacks. Live and learn. I am following CoRev’s lead that flamers are not trolls.

Short Term Versus Long Term:
this is a particular case of the Excluded Middle. For example, “We must deal with crime on the streets before improving the schools.” (But why can’t we do some of both?) Similarly, “We should take the scientific research budget and use it to feed starving children.”
Burden Of Proof:
the claim that whatever has not yet been proved false must be true (or vice versa). Essentially the arguer claims that he should win by default if his opponent can’t make a strong enough case.
There may be three problems here. First, the arguer claims priority, but can he back up that claim? Second, he is impatient with ambiguity, and wants a final answer right away. And third, “absence of evidence is not evidence of absence.”
Argument By Question:
asking your opponent a question which does not have a snappy answer. (Or anyway, no snappy answer that the audience has the background to understand.) Your opponent has a choice: he can look weak or he can look long-winded. For example, “How can scientists expect us to believe that anything as complex as a single living cell could have arisen as a result of random natural processes?”
Actually, pretty well any question has this effect to some extent. It usually takes longer to answer a question than ask it.

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WTO Doha, agriculture, and values

As I re-do templates for eventual updates to the site, I found this graphic on AB from the early days. I did misplace the link, sorry. But it appeared to be a great graphic for several thoughts:

1. The foundering of the Doha agreements was centered around agriculture protection.

2. Our beliefs about values are reflected where the money goes, perhaps. I think all of us agree certain government programs appear to be forever programs. But I would ask what drives it, and what are our values in letting it go on forever. Is it the private/government great divide, or does current mainstream economics as publicly descibed simply side step or cover the issue?

3. Why is the issue described in a so-called neutral frame? Does my auto mechanic tell me where I can go or not? He/she helps to get there, wherever there is, but the philosophy of mechanical service is not the point of auto use for me.

4. Are we being car-jacked, whether liberal and conservative? Without the media labels, how do we frame the issue without using the term class-warfare, which appears to simply close off discussion. If conservative, are you being car-jacked (many here can describe the left of center car-jacking)?

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Water in the works in December 07

The Great Lakes Water Resources Compact was signed last December by the governors of the eight states that border the lakes — Minnesota, Wisconsin, Illinois, Indiana, Ohio, Michigan, Pennsylvania and New York — and the premiers of the Canadian provinces of Quebec and Ontario. The agreement requires approval of state legislatures before it is sent to Congress for final approval. Ohio’s Legislature is expected this week to become the first to approve the pact. New York’s may approve it later this month.

“This is not a water grab,” says Sam Speck, director of the Ohio Department of Natural Resources. “It’s a commitment to protect a resource in the face of climate change and other challenges.”

The Great Lakes contain nine-tenths of the nation’s fresh water and supply drinking water to 30 million people in Chicago, Toronto, Buffalo and elsewhere. The lakes are an economic engine and the cultural centerpiece for much of the upper Midwest. But the fragile ecology of the lakes has suffered from pollution, invasive species of fish and the diversion of water to support Chicago and other cities.

The new agreement would control who can use the water and how much.

………………………………………………………………………

Grand Water Plan Downstream Pact” Last week’s agreement was truly significant, the most important changes since the first compact was drafted in 1922. And the manner in which it came about — no real winners or losers, but a cooperative regional effort to solve problems — was as surprising as it was refreshing.

“This is truly an historic moment,” said Interior Secretary Dirk Kempthorne. “Celebrate this day. This is huge.”

The new water deal has four basic elements to manage the water in the Colorado River and its tributaries.

1. The new guidelines establish rules for shortages – specifying who will take reductions and when they take them. This is essential for prudent water planning in times of drought.

2. The new operational rules for Lake Powell and Lake Mead will allow these two massive reservoirs to rise and fall in tandem, thereby better sharing the risk of drought.

3. The new guidelines establish rules for surpluses, so that if the basin is blessed with ample runoff, the Department of the Interior will have rules to distribute the extra water.

4. The new rules will address the ongoing drought by encouraging new initiatives for water conservation.

Previously, the compact divided the states into Upper and Lower Basins, with each to get equal allotments of 7.5 million acre feet per year. But some believe that the 1920s was a wet period, and the allocations were based on an assumption of 16.4 million acre in the basins. Today, the long-term average annual water flow is assumed at 13.5 million acre feet, so it is no surprise that increased demand, because of rampant population growth, had increased interstate tensions. The river provides water to utilities that serve 30 million people. (The eight states in the Southwest water sharing area).

I was hoping STR could post on the Great Lakes compact, and the very direct agreement not to ship water out of the current boundaries.

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Stuff and nonsense, or does it make sense

The Wellesley Dump has expanded even more to date. It is not my town, but is remarkable.

Wellesley’s recycling program was started in 1971 by local environmentalists and the Department of Public Works when the town incinerator failed to meet air emission standards. Unlike many of the earlier recycling centers around the nation, Wellesley’s is still in business andis thriving. Located at the town Recycling and Disposal Center, the operation has grown from collecting materials in 55-gallon drums to using 40-cubic-yard, open-top,transfer-haul containers plus a dual ram baler. It is now run by the town public works department and consists of a recycling facility, transfer station, and yard waste composting site.Wellesley has never had municipal curbside garbage collection. Its residents—at least 83% of them—take their refuse to the Recycling and Disposal Facility (RDF),which is free only to residents.

The center is proud of its park and social gathering setting.Picnic tables, well-maintained lawns, trees, flowers, and a circular drive contribute to the site’s popularity for GirlScout cookie sales as well as political events.The center is also unique in its wide acceptance by townspeople and its dedicated staff. Further, the Wellesley recycling center sponsors a recycling education program aimed at all Wellesley residents, including a curriculum for third graders in Wellesley public and private schools.“Recycle. Join the Team” is its theme. The center also actively promotes other recycling in the community. For instance, it helps spread the word about community-sponsored rummage sales.At the recycling center, a wide range of services can be found: a redemption center for bottles donated as asource of revenue for the center, a yard waste composting operation, and Goodwill depots. The book exchange is also a popular gathering place for residents.

Obstacles Overcome: The Wellesley recycling program works, and it has always worked! Nonetheless, there are the complaintsthat recycling takes too much time and that separate storagebins take up too much space in the home. To overcomethese complaints, the center relies on its information and education program. Not only does the public works staff go to the schools, they provide community presentations and promote recycling regularly.

875 pounds of re-cycling material per person for the year was the goal, and 892 pounds was the end of the year measure for 2007.

Now we know that Annie says for every barrel of stuff we dump as consumers there has been 70 barrels of stuff thrown away in the process of making the stuff.

I assume this does not include the stuff stored in lockers all over the country and not in use. Every American can stand shoulder to shoulder in the currently constructed storage space, and is one of the fastest growing industries today. This is called stored stuff, and can be read about in the next post.

Then there is the very profitable ‘ship your stuff’ to a Chinese labor intensive ‘recycle your stuff’ (now considered unAmerican) places to the port of Giyu, China as reported in USA Today. Trash picking at a profitable level, and insures that vessels do not have empty cargo holds on the three part journey of the US-China trade dependency. Reminds me of jolly England of old. And no healthcare costs to worry about, and no WTO to worry about. It is reassuring that no individual rights are violated as none have been established.

Plastic containers get turned into new products at a much lower rate than glass bottles or aluminum cans. The can you recycle today, for instance, will make its way back to the supermarket shelf in just six weeks. Because of health concerns, a plastic bottle will never become another plastic bottle. Recyclers often have a hard time making ends meet because the demand from manufacturers for recycled plastic — and, consequently, the money paid for it — is considerably less than for virgin material. Oh-plastics are not considered hazardous material. Currently there is little market for #3 to #7 plastics either.

Wellesley is rightfully proud of its dump. Citizen participation is quite amazing and helps provide the labor for sorting materials to a remarkable degree. Some of the other stories reminds me of how we do not pay for the cheap toasters and such from our major trading ally. More than we know.

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Reclaiming water

The LA Times reports on one way to deal with a shortage of drinking water:

As a hedge against water shortages and population growth, Orange County has begun operating the world’s largest, most modern reclamation plant — a facility that can turn 70 million gallons of treated sewage into drinking water every day.The new purification system at the Orange County Water District headquarters in Fountain Valley cost about $490 million and comprises a labyrinth of pipes, filters, holding tanks and pumps across 20 acres.

Almost four years after construction began, the facility is now purifying effluent from a neighboring sewage treatment plant run by the Orange County Sanitation District, a partner in the venture.The finished product will be injected into the county’s vast groundwater basin to combat saltwater intrusion and supplement drinking water supplies for 2.3 million people in coastal, central and northern Orange County.But before that can be done, state health officials must certify that the reclaimed water meets drinking water standards. Officials expect the approval to be granted before opening ceremonies Jan. 25.”Our sources from the delta and the Colorado River are becoming unavailable,” said Michael R. Markus, general manager of the water district. “This will help drought-proof the region and give us a locally controlled source of water.”Last month, for example, a federal judge in Fresno ordered a 30% reduction in fresh water pumped from the Sacramento-San Joaquin Delta to protect the tiny delta smelt, a threatened species. The region, which is facing myriad environmental problems, is the hub of California’s water system.If the reclamation plant’s full potential is realized, officials say, up to 130 million gallons a day could be added to the county’s fresh water supply, lessening the region’s dependence on outside sources.Basically, the facility takes treated sewage, which would have been discharged into the sea, and runs it through an advanced filtration system.

Update: Chuck sends this link to NPR and a more complete story.

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"Not by the hair on my chinny chin chin"

Lifted from comments on trolls:

I honestly don’t think there are any real “trolls” at this site. Trolls are malicious and their only intent is to sabotage websites. They might post hundreds of irrelevant posts with the only purpose of discouraging people from visiting that site.

I guess I’m more interested in how a discussion might influence a neutral third party who happens to “eavesdrop.” I’ve always thought that troll tactics always fail when judged by that test. Most people see through that kind of thing.

When somebody simply negates the interlocutor’s position and reiterates this until the other sides gives up responding, that’s perhaps “winning the argument” technically, but it’s not a discussion.

I think the summary of what defines a troll is pretty much (attempts of) derailing the discourse by a variety of tactics, including diversion, noise, and “draining” energy by engaging others in fruitless arguments, if need be repeatedly.

Treat trolls like cockroaches. Do as much as you can to squish the ones who pop up often, but don’t be surprised when another turns up later.

-like an itch they are hard to ignore, but made worse by scratching.i don’t believe the “highly intelligent” or exactly the “agenda” thing…because while their positions are predictable and seem to fit some political groups talking points, there logic runs from bad

So while it is a mistake to feed the trolls, sometimes you can drive them back under their bridge with a good logical clubbing.

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