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.

11 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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  6. Continued from above...
    "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)."

    A phenomenon that I observe consistently with circumcision advocates is their incorrigible problem with projection. They deny and explain away science presented to them, but we intactivists are the "denialists."

    There is a difference in denying the evidence, and questioning it. It is the very definition of skepticism. If we hadn't questioned the claim that the world was flat, we would have never found out that it was round. What's crazy is framing your own cherished beliefs with science; that is what the creationists do.

    The following question is very telling of your apriorism:

    "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."

    I would ask you, would there ever be enough "evidence" to cause you to consider female circumcision? What if female circumcision could be correlated with a lowered STD of some sort without any causal link? What if there was a stack of similar "studies" showing this "correlation?" (Even though it was written by the same group of people?) Would you then say "I'll consider cutting my girls, and the WHO should recommend the cutting of all girls?"

    No. You wouldn't. And if you say you would, you are lying through your teeth.

    If I could be shown the mechanism, if it could be visualized for me, HIV invading the body through the foreskin, and that cutting it off "reduces the risk," I would accept it as fact.

    But even so, I would still say that there is something wrong with the notion that the circumcision of infants is the most logical conclusion.

    I would question why, instead at arriving and stopping at circumcision, scientists aren't trying to use their findings to find a better, more effective, non-invasive solution. Finding a way to block HIV for example. Finding a way to deactivate the Langerhans cells. (No, those don't "facilitate" HIV transmission either.)

    Genital mutilation, whither it be wrapped in culture, religion or “research” is still genital mutilation.

    It is mistaken, the belief that the right amount of “science” can be used to legitimize the deliberate violation of basic human rights.

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  7. Perhaps the oldest hypothesis on the mechanism whereby circumcision prevents the transmission of HIV is the theory that suggests that the keratinized surface of the penis in circumcised male resists infection, while the mucosa of the glans and inner of the intact male are ports of entry, which was purported by Aaron J. Fink.

    The hypothesis failed, and scientists had to find another explanation.

    They then tried to argue that the Langerhans cells acted as "the main point of entry" for HIV, arguing that they "take in HIV" and "present" it to the immune system.

    Scientific evidence proves quite the opposite: Not only do the Langerhans cells act as a natural barrier for HIV, they actually secrete Langerin, which destroys HIV on contact.

    de Witte, Lot; Alexey Nabatov, Marjorie Pion, Donna Fluitsma, Marein AW P de Jong, Tanja de Gruijl, Vincent Piguet, Yvette van Kooyk, Teunis B H Geijtenbeek (2007-03-04). "Langerin is a natural barrier to HIV-1 transmission by Langerhans cells" (PDF). Nature Medicine. doi: 10.1038/nm1541. http://www.circumcisionandhiv.com/files/de_Witte_2007.pdf.

    Additionally, the same cells can be found in the mucosa of the female vulva, which then raises the question, why didn't the "researchers" consider female circumcision as a "possible" prevention method for HIV?

    The answer is because they weren't interested in "finding a better way to prevent HIV," they were interested in legitimizing circumcision.

    The constant in this "research" is that circumcision is assumed to "provide a protective effect" apriori.

    And we all know that there is something wrong with "science" or "research" produced to support a particular belief...

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  8. The "research" being used by the WHO to endorse circumcision as HIV prevention is horrendously flawed. One of the most thorough demolitions of the "studies" can be found here:

    http://circumstitions.com/HIV-SA.html

    And there have been three different papers that thoroughly and conclusively destroy them. One must wonder what kind of boobs they have working at the WHO, that they managed to pass such highly flawed rubbish off as “science.”

    How the circumcision solution in Africa will increase HIV infections
    http://www.publichealthinafrica.org/index.php/jphia/article/view/jphia.2011.e4/html_9?mid=54866

    Not a surgical vaccine: there is no case for boosting infant male circumcision to combat heterosexual transmission of HIV in Australia
    http://onlinelibrary.wiley.com/doi/10.1111/j.1753-6405.2011.00761.x/full

    African clinical trials into male circumcision and HIV transmission: Methodological, ethical and legal concerns
    http://xa.yimg.com/kq/groups/23477339/1441224426/name/JLM_boyle_hill.pdf

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  9. Make no mistake; the science is stacked against circumcision.

    But here’s the thing; we’ve got to stop buying into the idea that human rights can be bargained with “science” and “research.”

    When was the last time we saw the same vigor poured into male circumcision “studies” in trying to find the “benefits” of female circumcision?

    Even IF we lent any credibility to the latest twaddle some people dare to call “science,” we have got to ask, why is the solution always circumcision?

    Is there any reason why “researchers” are not looking for non-destructive ways to prevent HIV transmission, and instead facilitating male circumcision which just happens to be a cherished ritual tradition?

    Consider this: There would never be enough “science” or “research” to endorse the promotion of female circumcision to prevent ANYTHING.

    It wouldn’t matter if female circumcision were made “painless,” “bloodless,” and it didn’t affect a girl’s sexuality. It wouldn’t matter if female circumcision were performed in the clean environment of the hospital, by a trained professional, using pain killers and the most pristine, and most “advanced” utensils. Why do “researchers” grope for reasons to promote male circumcision?

    The Bottom Line
    The foreskin is not a birth defect. Neither is it a congenital deformity or genetic anomaly akin to a 6th finger or a cleft. Neither is it a medical condition like a ruptured appendix or diseased gall bladder. Neither is it a dead part of the body, like the umbilical cord, hair, or fingernails. The foreskin is normal, natural, healthy, FUNCTIONING tissue with which all boys are born.

    Unless there is a medical or clinical indication, the circumcision of healthy, non-consenting individuals is a deliberate wound; it is the destruction of normal, healthy tissue, the permanent disfigurement of normal, healthy organs, and by very definition, infant genital mutilation, and a violation of the most basic of human rights.

    Genital mutilation, whither it be wrapped in culture, religion or “research” is still genital mutilation.

    We’ve got to stop giving credibility to the idea that deliberate child abuse and the violation of basic human rights can be justified with “science.”

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  10. Genital mutilation, whither it be wrapped in culture, religion or “research” is still genital mutilation.

    It is mistaken, the belief that the right amount of “science” can be used to legitimize the deliberate violation of basic human rights.

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  11. ¡Excellent article! All they have are a few methodologically flawed studies.

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