Friday, January 7, 2011

So many studies, so few experiments

The African circumcision trials have yielded new data and analysis; Remember those? Foreign researchers attracted African men who wanted to be circumcised and get free health care, counselling, and follow-ups. Circumcision was immediate or in a couple years, at random. Great deal if you want the surgery. Thousands did.

The researchers collected so much data they've been able to mine it over the course of half a decade--and there's no indication they're done--for subsets with which to publish a paper, make news, and give press interviews. Let's face it--The researches want circumcision to work as much as the participants want a free circumcision--or more. They designed the tests and questions, collected the results, and are probing the data for evidence of efficacy.

Sound familiar?

Circumcision helps stop wart virus, study finds

Will the datamining ever end?

Bad methodology is supposed to be moderated by the understanding that you don't rely too heavily on any one experiment. But what if one experiment can be portrayed as dozens of studies, and publicized over a period of many years, giving the impression of many different experiements pointing in the same direction?

If researcher bias and experiment design can shave just a few percent off a measure in an intervention group, then an impressive looking relative reduction can be announced. Why waste that on just one event?

The researchers who so strongly hoped circumcision could be an answer to anything or everything were fortunate to lack the resources to publish all the results of their Ugandan genital cutting experiment expeditiously. That might have influence just one news cycle. Due to slowly dripping out their data, a poorly informed public fed by uncurious journalists will believe they are distinct experiments with independent findings when in fact there was just one experiment.

And all the ways they looked at the data and found the opposite effect, or no effect? They are under no obligation to publish them. Only confirmations of their grand hypothesis, that millions of years of evolution of male genitalia are a dangerous mistake requiring massively funded surgical campaigns, make it out of the desk drawer. Or, perhaps the data which they don't care for will be published, but as a lower priority. They'll get to at in a few decades, after they've circumcised every man in Africa and every newborn child in the United States.

5 comments:

  1. Well said, it does get very tiring having to refute this pro-circ propaganda all the time....

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  2. I saw a television call-in show where a man claimed that those studies were faked. The data were manipulated to get the results they wanted.

    I wouldn't be surprised. There is a lot of money to be made on AIDS research and there are reputations to be upheld. What I've noticed is that the same few people are co-authors on each other's studies. It is as if they were members of a group or 'cabal' dedicated to promoting genital cutting upon baby boys.

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  3. Not sure whether fake is true but biased and invalid probably are.

    Why biased? The Circumcision groups had greater attention more health care more education and greater emphasis on condom use, and abstinence for 6 weeks. Intact group did not have this.

    Nearly 10 times as many men dropped out as were infected. The trials were ended early, 18 months does not reflect a lifetime of protection.

    Why invalid, well results dont reflect real world. Africa has high viral loads in population America & EU dont. Behaviour changes as soon as you remove something. Real world wont have so much follow, education and care as controlled srudies. High circumcision USA has higher HIV than low circumcision Europe. Men are lining up to be circumcised in false belief they will be protected from HIV with false belief they no longer need to use condoms.

    Also if u remove human tissue you do remove a potential viral entry point and disease site. But are there less invasive methods which get superior results ? Yes Education Hygeine Condoms Safe sex less sex partners. Remember when they have done correlations of female circumcision they also find lower HIV coz they have less human tissue & less viral entry sites.. But no campaign to Circumcise females coz not culturally acceptable in the west.

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  4. Well said indeed. I was noticing the same thing when going through these circ studies the other day. I'm glad I'm not the only one who finds them hugely biased and set up toward a predetermined conclusion. -@ApolloForever

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  5. The fact that circumcision prevents sexually transmitted diseases is robust in my opinion. I consider something robust when its backed by basic science, epidemiological data and randomized trials. Epidemiological data in the US first suggested circumcision might be preventive for STD's. RCT then confirmed this. Also we have a basic science explanation: the inner prepuce is thinner and more susceptible to trauma, providing an easier barrier to brake for the virus/bacteria. I worry when a single study finds something for which no reasonable explanation can be found and which has not being replicated but this is certainly not the case for circumcision and STD's.

    I you want to oppose circumcision trying to deny it prevents STD's might not be the way to go, cause is similar to denying the holocaust or the existence of HIV, or being a republican candidate these days (=crazy).

    You might be more successful at getting people to not circumcise their boys with things like the trauma to the children, the issue of no consent, decrease sensation, premature ejaculation, "being natural", "being intact", how europeans love their foreskin and do just fine, complications from circumcision etc....

    By the way, what kind of evidence would convince you that circumcision is beneficial at say, preventing STD's? I would suspect none, since you will always say the study was flawed, the researchers were in the pockets of Big Circ or other conspiracy.

    But you know what? I think it is great people can voice this opinions in this country, so keep up the good work, cheers!

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