Food For Thought

Considering consistency by the news media: CBS This Morning has a regular series, "What’s Working," which investigates innovations in America that seem to be paying off. On one particular episode a few weeks ago they went to the University of Vermont to highlight a program to discourage the use of drugs and alcohol and move students toward more healthy activities.

Near the end of the piece the professor who designed the program explained that the brains of college students are not yet fully developed. "You couldn't come up with a worse age to send someone to college than when they're 18.” The reporter feeds back the notion, “The brains are not done developing at 18?” He responds, “Not even close.” 

This was not the only report emphasizing the immaturity of college students, and is not confined to CBS, with some saying the brain is not done developing until the early twenties. Some sources put the age of a fully developed frontal cortex closer to 25. Such statements have been fairly common when discussing various crimes and indiscreet tweets. Then why were these same reporters so excited just ten months ago about the apparent wisdom of a group of high school students lecturing the country on gun policy?

Considering income inequality: If we didn’t have rich people, there would be no designer goods. Nobody would be able to show off for their friends by buying the cheap knock-offs.

Considering trusting medical information based only on endorsements: Bloodletting was a common practice among doctors for thousands of years up to about one hundred years ago. Today bloodletting has been shown to be ineffective and mostly harmful. (A controlled variation is used today only in the treatment of a few very rare diseases.)

Since there would have been no opportunity for controlled experiments, the only way it could have continued to be practiced for so long would be through endorsements and by doctors hyping their own successes. “Marie-Antoinette, for instance, seemed to benefit from a healthy dose of bloodletting while giving birth to her first child, Marie-Thérèse, in 1778” – an endorsement from the Queen! 

Doesn’t this same practice of celebrity and friends’ endorsements and doctors hyping their own successes sound like anything we might see on TV or read on the Internet today for any number of miracle cures?

Considering the cancer conspiracy: Did you know that doctors, Big Pharma and the FDA are working together to suppress cancer research for fear that discovery of a cure will put them out of business? They also try to undermine real cures provided by alternative medicine. Many Americans do believe this conspiracy theory. Wired reported on a video that came out last July on the Internet about a miracle cancer cure derived from moss and available online. It “quickly racked up millions of views.” The video used the usual lure of “what the pharmaceutical companies don’t want you to know.”

The problem was the video was intentionally faked for the purpose of education, “teaching people to be skeptical of videos exactly like this one.” Do the same people who endorse this cancer-conspiracy myth also believe that firefighters want more fires and do not promote the use of smoke alarms and the practice of fire safety? Do they think dentists don’t want you to brush and floss? All this is equally hard to believe.

It doesn’t take much research (and critical thinking) to find obvious distortions and contradictions in the news and social media. As always the bad information flies around the world at lightning speed, while the truth struggles to catch up (often just in time to be slapped down by committed advocates or enterprising charlatans).

Don’t Just Shrug

So often, especially on TV, a news story can go flashing by so fast that we hear the main point and don’t pay much attention to the rest and don't think too much about implications. Before we know it, they've moved on.

Last week the news came out with such a story, that the FDA has approved an exciting new cancer drug. According to an NBC report: “While several drugs are approved to treat a variety of different cancers based on genetic mutations, Vitrakvi, known generically as larotrectinib, is the first that is approved from the beginning to treat cancers solely based on the mutation.” Instead of being approved to treat specific cancers that arise in certain parts of the body, Vitrakvi goes after the genetic characteristic of a cancer arising anywhere in the body. Although it doesn’t work for all types of cancer, this appears to be a significant breakthrough.

But there is a huge downside. In the sub-headline NBC mentions that the wholesale cost is expected to be $393,000 a year.

Another website discussed the cost in a little more detail. “The wholesale cost for the children's syrup is $11,000 for a month's supply and the oral capsules for adults wholesales for $32,000 per month. With insurance, most patients would pay $20 or less for a 30-day supply.” (This last comment is the part that I think would blow past most people causing them either to shrug or to decide that the downside was minimal.) 

But it’s not, and it should make everyone slow down and ask where that money to pay the difference, that is, $31, 980 per month, is coming from. Initially it comes from the insurance companies, but ultimately it would come from premium payers, you and me - either directly or indirectly when employers count the benefit costs as part of total compensation.

Assuming that the estimate is correct and that this drug could benefit up to 3000 people a year, that’s $90 million a year that has to come from somewhere. And neither the insurance companies nor Bayer, the manufacturer, is going to foot the bill out of the goodness of their hearts. The cost will be distributed. Everyone must understand that this is true for all drugs that are covered in part by insurance. As newer, better and more expensive drugs are developed to treat or cure a wider variety of diseases, that same pattern is followed every time. This is basic economic understanding; there is no magic money tree.

This is the kind of information that slides by when we shrug it off without thinking it through.

Side comments: 

Is there any irony in the fact that the same company that makes this new cancer drug also makes RoundUp, a substance many people believe causes cancer and that some lawyers are now advertising about to solicit clients?

How would a member of the if-you-can’t-pronounce-it-don’t-eat-it crowd react if the cure to their cancer turned out to be larotrectinib? 

In other words, why clutter the courtroom and the dinner table with real science when you can rely on misinformation and Internet memes for guidance?

Why Do We Even Pay Attention?

So many scientific studies make the news that it’s hard to keep track of them all. Many of them contradict earlier studies and some don’t make much sense at all. I have given examples of both in the past, but here is one more in the nonsense category.

This headline appears in the UPI Health News section and reads, “Study: Morning people less likely to develop breast cancer.” Researchers from the University of Bristol in England analyzed data from over 400,000 women. That’s a very large sample size, in fact, it includes "the largest collection of genetic data on women with breast cancer obtained so far.” Unfortunately the first paragraph of the story is completely misleading. “If a woman regularly wakes up early in the morning, she has up to a 48 percent lower risk of developing breast cancer.”

That would seem to be something to pay attention to, but not without looking into the details.

A little later in the article, the utility of the information quickly breaks down. The study found “approximately one less person per 100 will develop breast cancer if they have a morning preference compared with people who have an evening preference.”

Suddenly they are no longer talking about actually waking up early. The subject has changed to having a preference for mornings versus a preference for evenings. It's a kind of energy-level situation rather than an alarm clock situation. And the 48 percent lower risk is now expressed as one less person in 100. Calculating that out comes to about 25 in 1000 who are not morning people versus 15 in 1000 who are. This is a minor risk either way, with a 975 in 1000 chance of it not applying at all.

Further on it mentions two additional pieces of information worth noting: the findings have not been peer reviewed and much of the data was based on self-reporting. 

Peer review occurs before publication in reputable journals. Fellow scientists review and approve data collection methods, the mathematics used in the analysis and the experimental design. And one of the least reliable data collection methods is self-reporting where, for any number of reasons, subjects have been known to embellish, exaggerate and misrepresent their actual habits.

Finally, what can an individual woman do about this? Remember, the study was actually about preferences. If you are not a morning person, is it possible to change? It seems as likely as hearing that left-handed people are more creative and suddenly deciding to become left handed. So the information may be useful to scientists who can further study genetic differences, but it’s pretty worthless to the general public.

Why, then, would news media bother to report on this? After all, I got every piece of the above information from one of several articles, all blaring the same eye-catching headline. Other than causing some people to needlessly worry, it serves no purpose.

They do it because it’s easy. They receive a press release from scientists motivated by the need for publicity to ensure a continuation of funding. Then they simply add a snappy, but not necessarily accurate headline, and their work is done. Throw in the scary word "cancer" and everybody wins - except for the unsuspecting public!

Any question about why critical thinking is more important than ever?