I found this post and Part 1 incredibly interesting. I apologize for resurrecting an old post, but does anyone know what happened to DavidM and whether or not we will be waiting forever for Part 3? If he no longer frequents this site, does anyone know how to contact him?
aelephant
Is this comment anything more than playing on peoples’ emotions and an appeal to authority? Who is Mike Darwin and why should I believe anything he says? Is he a doctor? Should I trust him because his last name is Darwin? Does he cite any statistics or make any claims that can be fact-checked in this quote? Is it proven that Aspirin CAUSES Reye’s syndrome, as the quote claims? I usually appreciate your input gwern, but with this comment I’ve lost respect for you.
- 3 Apr 2013 20:34 UTC; 38 points) 's comment on Open Thread, April 1-15, 2013 by (
Actually I did google Mike Darwin, but that didn’t give me any reason to believe all of the claims he made. He’s the founder of some cryonics company that I’ve never heard of. How does that qualify him as an expert on aspirin? The Wikipedia page about him is also riddled with warnings, which make me skeptical of the other content I might find there.
I also googled aspirin and Reye’s syndrome. Apparently you did too, but didn’t read what popped up very carefully. Aspirin has been ASSOCIATED with Reye’s syndrome in EPIDEMIOLOGICAL studies. Epidemiological studies are not capable of proving causation.
I already know NSAIDs can increase the risk of having a GI bleed. You aren’t teaching me anything new. What is at question is whether the risks of taking aspirin outweigh the benefits.
In light of your comments and attitude, I plan to disregard your opinion as well from here on out.
Edit: I thought the Vioxx vs. NSAID death comparison sounded funny too, so I took a look at some of the numbers.
It is thought that Vioxx over 5 years caused between 88,000 to 140,000 serious cases of heart disease. Per year, that works out to 17,600 to 28,000.
Of those who developed heart disease, it is estimated that 30-40% died. That gives us 5,280 to 7,040 on the low end and 8,400 to 11,200 on the high end.
What about NSAIDs?
It is estimated there are about 60,000,000 NSAID users annually. 1-2% of people who take NSAIDs develop GI events, like a hemorrhage. That’s 600,000 to 1,200,000 people.
Estimates of deaths caused by NSAIDs are between 3,200 to 16,500 per year.
So we have, looking at Vioxx vs. NSAIDs:
5,280 to 11,200 deaths per year vs. 3,200 to 16,500 deaths per year
The low estimate puts NSAIDs ahead, the high estimate puts them below. They seem roughly comparable to me. When you take into account how widespread NSAID use is compared to Vioxx, I think you have a strong argument that NSAIDs are much safer than Vioxx.
At its peak, Vioxx was taken by about 20,000,000 Americans.
I asked if it was proven that aspirin causes Reye’s syndrome. The correct answer is, “No, it is not.”
Well, at least in the drug world it is more convincing if you have a rational mechanism by which a drug could cause some effect.
A plausible alternative hypothesis is that children who get sick sometimes are developing Reye’s syndrome and take Aspirin. The problem with epidemiological studies is that it is IMPOSSIBLE to control for other variables. This is why randomized controlled trials are essential and give you a kind of information epidemiological studies never can.
My point is not that Aspirin doesn’t cause Reye’s syndrome, but that it is impossible to say one way or the other. Maybe it does, maybe it doesn’t. The data is unavailable and likely never will be. So if you are an honest person who values the truth, you can’t say that it does.
We have a plausible mechanism (confirmed by massive amounts of science) by which slamming your face into the wall causes pain; for the link between Aspirin and Reye’s syndrome there is no such plausible mechanism.
Excellent explanation & examples; everything elucidated effectively.
I don’t understand the final example though. Is the memory device just to help you remember some of the letters in the name and the symptom or is there some connection my brain doesn’t make that yours does? HoMoNymous—HerMioNe, HemiAn—HArry, OPIa—OPIum?
I’m not trying to be pedantic and you probably might already be aware of this, but in one of the examples you gave (“If I don’t exercise...”) “doing nothing” sometimes might actually be better than doing something. For example, weightlifters who are trying to build muscles are well aware that muscles are not built during training, but during the rest periods between trainings. So in a sense, you could argue that you are ONLY getting more fit by “doing nothing”. It would be counterproductive to exercise all of the time and never give your body a chance to recover.
Aside from this small critique, I agree with the spirit of the post and I think it is an excellent point to bear in mind.
I have no evidence for this, but it seems plausible: What if people who are the recipients of altruism are more likely to be providers of altruism in the future? This would mean that altruism really is a form of investment. I would be curious to know if anyone has studied the effects of receiving altruism on future behavior.
Are you familiar with SOAP notes? The S and O are Subjective and Objective. One thing I don’t see from your description is a separation or clarification about what is subjective and what is objective. For example, the patient’s “self-concept mode” which I’m reading refers to “level of anxiety, involvement in self-care, relationship with family and friends and general outlook” sounds like it is all subjective (if we are simply talking asking the patient, “What is your level of anxiety?” and so forth). I think it is important to clearly distinguish what is subjective and objective, which seems to be lacking (at least from your description).
I find this post by Seth Roberts relevant: http://blog.sethroberts.net/2012/04/03/lack-of-repeatability-of-cancer-research-the-mystery/
Most people are aware that publication bias exists, but it could be much worse than we think. If researchers do an experiment 6 times and only get their P=0.05 result once, does P really equal 0.05? Who knows how many of the “statistically significant” studies published in the medical literature are being misrepresented this way.
This is a great suggestion and the practice dates back to Ancient Greece and the Stoic philosophers, if not before. It is often called “negative visualization”. You can read more about it here: http://gettingstronger.org/stoicism/ Scroll down to the “Meditation” section with the video of Tim Ferriss.
I’ve found materials both supporting and refuting this idea. It IS possible for diet to effect your blood pH, but whether or not that effects the bones is not clear. Here are two research papers that discuss the topic: http://www.ncbi.nlm.nih.gov/pubmed/21529374 and http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3195546/?tool=pubmed
Edit: I do think it is true that the words are correlated somehow, but I also think it is true our thoughts about the nature of that correlation are likely to be pareidolia. In this lecture by Sam Harris, around the 22:00 mark, he talks about how many studies have given us evidence that our stories about why we think what we think or why we did what we did are NOT correct—they are post hoc fabrications of the left hemisphere of the brain trying to make sense of things it doesn’t understand (ie the subconscious).
As someone living in China, I feel pretty confident saying that most Chinese are not skeptical or interested in rationality. Even “Science” in China is deficient. We think we have a problem with publication bias in the West; I heard a terrifying statistic that there are ZERO negative studies published in the field of TCM (Traditional Chinese Medicine). And while the country is atheist, huge numbers of people still go the Buddhist temples, bang their heads on the ground and worship statues with blue skin.
One thing that occurred to me reading this was that a somewhat effective (not 100% effective) way of “guarding” one’s status would be to solicit for help / advice in private rather than in pubic. Obviously you can’t guarantee that people will not disclose things, but if you are in a position like the CEO in your example, you could take measures to encourage your employees not to share the contents of confidential discussions and so forth.
Of course, this has costs and benefits as well: it is much easier to make one post on a public blog than it is to private message everyone on your Facebook. If you’re concerned about maintaining your status, it might be worth considering. For example, for someone with high status and a relatively “forgivable” question (difficult, not obvious) just posting it in public is probably better than going through the hassle to make the inquiry private; for someone with low status asking a less “forgivable” question (“He really should know better, did this guy not listen to what the prof said in lecture?”), the extra effort might well be worth it.
From the article you linked:
Within Asia, traditional Chinese medicine (TCM) is the system with the longest history. TCM was developed through thousands of years of empirical testing and refinement.
I cringed. Not only do I question what they are calling “empirical testing” but this Time Fallacy (I don’t know what else to call it, perhaps there is a better name) is everywhere in China. “Well, we’ve been doing it the wrong way for over 2000 years so it must be the right way!”
No, actually if you tell me 2+2=5 for 6 billion years, you will still be wrong and 2+2 will still equal 4.
The Economist recently had a much better, much more skeptical piece on TCM:
From the author profile:
Mattson traces his interest in aging back to his ninth-grade classroom. Asked then to write an essay on a scientific topic of his choice, he picked cryopreservation—the futuristic concept that humans can be resurrected after being suspended in the deep freeze for years. “I was grabbed with the idea of putting aging on hold,” he now says.
The question is, does he post on Less Wrong?
It could be people are voting you down because you didn’t include what they might consider to be a “mandatory disclaimer” about psychedelics, set & setting, underlying mental illness, etc. While psychedelics have shown positive effects like you mentioned, you have to take into consideration the environment and context in which they were used.
You can address the intellectual part of this, but it won’t solve the emotional part. You can even eliminate the intellectual part (by stopping your internal dialogue) but it will keep coming up again so long as the emotional issue underlying it is still lingering and unprocessed.
From your description, it sounds like you are doing a lot of things in attempt to suppress the emotion. Have you tried the opposite approach? Try to feel the emotion as fully and completely as you can. Preferably do it somewhere safe where you can be alone. You might find yourself crying, screaming, shaking, curling up into a ball… whatever your body feels like doing to really magnify and intensify the emotion is good. Sometimes it can take a long time to process the emotion completely, maybe up to 40 minutes to an hour. Try it and see how it works.