Risk and Uncertainty: measurement, management and understanding
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Daily diet of almonds is no magic solution for weight loss - Health News - NHS Choices

Daily diet of almonds is no magic solution for weight loss - Health News - NHS Choices | Risk and Uncertainty: measurement, management and understanding | Scoop.it
Wednesday February 24 2016 Almonds contain a range of nutrients "Desperate to lose weight?" asks the Mail Online. "Eat almonds! Handful a day 'wards off hunger and replaces empty calories from junk food'," it says, without any justification. It's hard to see where the headline's over-excited promises of weight loss or reduced hunger come from. The study they write about showed an improvement in diet quality for a small number of people asked to eat almonds daily for three-weeks. However, it did not measure the effect of almonds on weight loss, dieting or hunger pangs. The study, funded by the Almond Board of California, failed in its aims of showing improved bowel function, better bacteria in the gut, and signs of improved immune status.  While the study did show improvements of seven to eight points on a healthy eating scale (range 1 to 100), this was based on questionnaires for just 28 adults and 28 children, during a short period of eating almonds. Healthy changes to diets need to last for years, not weeks, to make a difference to health. Like other so-called superfoods, there is no evidence in this study to suggest that almonds have any particular powers of helping people to lose weight. However, they are a good source of fibre and nutrients. The NHS Choices weight loss guide can help you lose weight in a sensible way through a combination of diet and exercise.   Where did the story come from? The study was carried out by researchers from the University of Florida and was funded by the Almond Board of California, which has a clear interest in promoting the health benefits of almonds.  The study was published in the peer-reviewed journal Nutrition Research on an open-access basis, so you can read it for free online. The quality of reporting by the Mail Online and the Daily Express was below par. In addition to the Mail Online's over-enthusiastic headline, the Daily Express suggested that eating almonds "could work wonders". Neither newspaper included any information about the study's failure to prove its hypothesis about immune function. The basic facts given in the stories were mainly correct, although uncritically and selectively reported. The Mail claimed that people eating almonds "increased their protein and lowered their salt intake", although protein only increased on one measure (total protein foods) and not another (protein as a percentage of energy). Salt consumption was only lower for adults, with borderline statistical significance. The obvious conflict of interest in terms of the study's funding was not reported.   What kind of research was this? This was a randomised crossover study, where people were assigned to eat almonds or no almonds for three weeks, then switched to the opposite intervention after a wash-out period. The study was not blinded, meaning people knew when they were in the "almond" or "no almond" part, and there were no substitutes offered for almonds (such as another type of nut).   What did the research involve? Researchers studied 28 parents and 28 children (one child per parent). They measured their bowel function (how many stools they passed in a week), any symptoms like constipation or bloating, the composition of bacteria in the gut (from stool samples), markers of immune function in blood and saliva tests, and overall diet quality (from questionnaires). The tests were repeated regularly during the study.  People were asked to eat 1.5 ounces (42g) of almonds (adults) or 0.5 ounces (14g) of almonds (children) for one of two three-week study periods, and no almonds in the other three-week study period. Researchers then compared the test results for the periods when they did or didn't eat almonds, to see if there were any differences. The researchers aimed to recruit 30 pairs of parents and children, but only managed 29, and one pair dropped out of the study early on. They had calculated that they'd only need 15 individuals to show a change in gut bacteria, but it is not clear whether 28 pairs was enough to reliably show a change in diet quality or bowel function. Dietary quality was measured by questionnaires about food eaten in the past 24 hours, which people filled out several times throughout the study, including while eating almonds, while not eating almonds, at the start of the study and the end. Results were mapped against a healthy eating scale to give a score from 1 to 100, and comparisons drawn between the scores while eating almonds and not eating almonds.   What were the basic results? Both adults and children had an overall average dietary score of 53.7 while not eating almonds, and a score of 61.4 when eating almonds. Looking at individual parts of the healthy eating index, while eating almonds they consumed on average more total protein foods, seafood and plants protein, and fatty acids. Adults ate fewer foods classed as being "empty calories".  The researchers also reported "trends" for less empty calories for children and less salt for adults, but these differences were so small they could have been due to chance. The researchers found no difference for any of their other planned measures – bowel function, gut symptoms, phyla of bacteria in stool samples, or immune markers. They say they found some difference in bacteria types, but not at the level they planned to measure. We don't know whether the small differences they found would have any effect on human health.   How did the researchers interpret the results? The researchers said they had "rejected" their hypothesis that eating almonds would improve bowel function, because overall fibre levels did not rise and adults ate less fruit while eating almonds. They say their failure to find differences in gut bacteria or immune markers may be because the "dose" of almonds was too low. However, they claim the study results, "confirm that incorporating almonds into a daily diet promotes improved diet quality".   Conclusion Despite the excitement in the tabloid headlines, this is a very small study with not particularly surprising results. You would expect that adding a food with known nutritional value to a daily diet would increase the overall quality of that diet, for the time that people continued to eat the food in question. The researchers' more ambitious aims – to show that nuts improved immune system and bowel function – were not met. In addition to its small size, the study had other limitations. As the people in the study were not blinded to the intervention period, this could have affected their answers to questionnaires. Also, the parents filled in the questionnaires for their children, which may have been appropriate, but has not previously been tested as an accurate method for these specific questionnaires. Most of the children were at child care or school, so the parent may not have known what they’d eaten during the day. It is also reported that many children were less than enthusiastic about having to eat almonds, with complaints that they were "boring" and "dry and bland". Whether they would stick to the diet on a long-term basis is uncertain. A major problem with this type of study is that changes to improve the quality of diet need to be long term if they are to have a significant effect on life-long health. Measuring the effects of adding one food to the diet for three weeks does not tell us anything about the potential effects of eating that food regularly for many years. While this study may not have much to tell us about healthy eating, there are still plenty of good reasons to eat nuts, such as walnuts, brazil nuts, hazelnuts and almonds. Nuts and seeds contain healthy oils, protein and fibre. They make a good addition to a balanced diet, along with fresh vegetables, wholegrains, fruit, dairy products and fish. Choose unsalted nuts, so as not to eat too much salt. Read more about the benefits of eating a balanced diet.  Analysis by Bazian. Edited by NHS Choices. Follow NHS Choices on Twitter. Join the Healthy Evidence forum.
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Organic milk 'is healthier' than conventional milk, study says - Health News - NHS Choices

Organic milk 'is healthier' than conventional milk, study says - Health News - NHS Choices | Risk and Uncertainty: measurement, management and understanding | Scoop.it
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What does it mean to understand statistics?

What does it mean to understand statistics? | Risk and Uncertainty: measurement, management and understanding | Scoop.it
It is possible to get a passing grade in a statistics paper by putting numbers into formulas and words into memorised phrases. In fact I suspect that this is a popular way for students to make their way through a required and often unwanted subject. Most teachers of statistics would say that they would like students to understand what they are doing. This was a common sentiment expressed by participants in the excellent MOOC, Teaching statistics through data investigations (which is currently running again in January to May 2016.) Understanding This makes me wonder what it means for students to understand statistics. There are many levels to understanding things. The concept of understanding has many nuances. If a person understands English, it means that they can use English with proficiency. If they are native speakers they may have little understanding of how grammar works, but they can still speak with correct grammar. We talk about understanding how a car works. I have no idea how a car works, apart from some idea that it requires petrol and the pistons go really, really fast. I can name parts of a car engine, such as distributor and drive shaft. But that doesn’t stop me from driving a car. Understanding statistics I propose that when we talk about teaching students to understand statistics, we want our students to know why they are doing something, and have an idea of how it works. Students also need to be fluent in the language of statistics. I would not expect any student of an introductory or high school statistics class to be able to explain how least squares regression works in terms of matrix algebra, but I would expect them to have an idea that the fitted line in a bivariate plot is a model that minimises the squared error terms. I’m not sure anyone needs to know why “degrees of freedom” are called that – or even really what degrees of freedom do. These days computer packages look after degrees of freedom for us. We DO need to understand what a p-value is, and what it is telling us. For many people it is not necessary to know how a p-value is calculated. Ways to teach statistics There are several approaches to teaching statistics. The approach needs to be tailored to the students and the context of the course. I prefer a hands-on, conceptual approach rather than a mathematical one. In current literature and practice there is a push for learning through investigations, often based around the statistical inquiry cycle. The problem with one long project is that students don’t get opportunities to apply principles in different situations, in such a way that will help in transfer of learning to other situations. There are some people who still teach statistics through the mathematical formulas, but I fear they are missing out on the opportunity to help students really enjoy statistics. I do not propose to have all the answers, but we did discover one way to help students learn, alongside other methods. This approach is to use a short video, followed by a ten question true/false quiz. The quiz serves to reinforce and elaborate on concepts taught in the video, challenge students’ misconceptions, and help students be more familiar with the vocabulary and terminology of statistics. The quizzes we develop have multiple questions that randomise to give students the opportunity to try multiple times which seems to help understanding. This short and entertaining video gives an illustration of how you can use videos and quizzes to help students learn difficult concepts. And here is a link to a listing of all our videos and how you can get access to them. Statistics Learning Centre Videos We have just started a newsletter letting people know of new products and hints for teaching. You can sign up here. Sign up for newsletter
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Pushy or rude patients 'more likely' to be misdiagnosed - Health News - NHS Choices

Pushy or rude patients 'more likely' to be misdiagnosed - Health News - NHS Choices | Risk and Uncertainty: measurement, management and understanding | Scoop.it
Thursday March 17 2016 Doctors have feelings too "'Difficult' patients are more likely to get the wrong diagnosis," The Daily Telegraph reports. A Dutch study suggests that patients who are aggressive or argumentative may lead doctors to lose focus when trying to come to a diagnosis. The study included more than 60 young doctors. They didn't see actual patients, but they reviewed six different consultation scenarios as laid out in a booklet. The scenarios were written to reflect certain "difficult patient archetypes", such as patients who demand more treatment, are aggressive, or who question their doctor’s competence. They were asked to make the diagnosis and rate the patient's likeability. The researchers found that when faced with the more "difficult" patients, a mistake in diagnosis was significantly more likely. The main limitation is that we cannot be sure whether this study design reflects real clinical practice. The use of scenarios in booklets can’t really be compared to the effect of a real patient who the doctor can speak to themselves. The results shouldn't suggest that we all return to the paternalistic "doctor knows best" deferential attitude common in previous generations. There is nothing wrong with expressing concerns or asking about alternative treatment or diagnostic options. There is an important difference between being assertive and being rude – doctors have feelings too.  Questions to ask your doctor If you are unsure about the information you have received, the following questions may be useful.   Tests, such as blood tests or scans What are the tests for? How and when will I get the results? Who do I contact if I don’t get the results? Treatment Are there other ways to treat my condition? Are there any side effects or risks? If so, what are they? How long will I need treatment for? How will I know if the treatment is working? What will happen if I don't have any treatment? What next What happens next? Do I need to come back and see you? If so, when? Who do I contact if things get worse? Do you have any written information? Read more questions to ask your doctor Where did the story come from? The study was carried out by researchers from Erasmus University, Erasumus Medical Center, and Admiraal de Ruyter Hospital, all in The Netherlands. No funding was provided for this study and no competing interests have been declared.  The study was published in the peer-reviewed medical journal BMJ Quality and Safety. The findings of this study have been reported accurately in the UK media. However, it should have been made clearer that these results are based on booklets containing scenarios and not real doctor-patient interaction.   What kind of research was this? This experimental study aimed to study the effects of difficult patient behaviour on diagnostic accuracy in the general practice consulting room.  However, it is difficult to model the real repercussions of a "pushy" patient in the consulting room and the effect this may have on the doctor. This study assessed this by asking doctors to review written patient scenarios in a booklet. It could have been more useful to assess this more realistically by using live patient actors for the doctors to consult with.   What did the research involve? Researchers recruited doctors from family practices in Rotterdam. Six clinical situations were prepared in booklets to model behaviours of hypothetical pushy patients in the consulting room. These were as follows: frequent demander aggressive patient patient who questions his doctor's competence a patient who ignores his doctor's advice a patient who has low expectations of his doctor's support a patient who presents herself as utterly helpless Doctors were required to diagnose simple and complex conditions. These were: community-acquired pneumonia pulmonary embolism brain inflammation hyperthyroidism appendicitis  acute alcoholic pancreatitis The first three of this list were considered simple cases and the last three complex. Doctors each received a booklet containing the six clinical situations: three presented as difficult and three as neutral. Different versions of the booklets were prepared with a different order and version of cases, then distributed at random. Doctors were asked to carry out the following three tasks: Reading the case, then writing down the most likely diagnosis as fast as possible while maintaining accuracy. Reflecting on the cases, writing down the diagnosis previously given and listing the findings in the description that support the diagnosis, those that do not, and the findings they would expect in a true diagnosis. The patient was then rated on a likability scale. Diagnostic accuracy was evaluated by considering the confirmed diagnosis, which was scored (by a diagnostic accuracy score) as correct, partially correct or incorrect (scored as 1, 0.5 or 0 points, respectively). If the core diagnosis was mentioned, this was considered a correct diagnosis, and partially correct when the core diagnosis was not given, but an element of the condition was mentioned.   What were the basic results? A total of 63 doctors were assessed in this study. The findings of this research were that the accuracy of diagnosis was significantly lower for difficult patients than neutral patients (diagnostic accuracy score 0.54 versus 0.64). Simple cases were more accurately diagnosed than complex ones. All diagnostic accuracy scores increased after reflection, regardless of case complexity and of patient behaviours (Overall difficult versus neutral, 0.60 vs 0.68). Amount of time needed to diagnose the case was similar across all situations and, as might be expected, the average likability ratings were lower for difficult than for neutral patient cases.   How did the researchers interpret the results? The researchers conclude that, "Disruptive behaviours displayed by patients seem to induce doctors to make diagnostic errors. Interestingly, the confrontation with difficult patients does however not cause the doctor to spend less time on such case. Time can therefore not be considered an intermediary between the way the patient is perceived, his or her likability and diagnostic performance."   Conclusion This study aimed to investigate the effect of difficult patient behaviour on diagnostic accuracy in the general practice consulting room.  The findings suggested that when faced with difficult patients, a doctor is more likely to make a mistake in diagnosis; however, with a little time to reflect, more accurate diagnoses are made. The main limitation is that we cannot be sure whether this study reflects real clinical practice. The use of text-based situations can’t really be compared to the effect of a real patient in the consulting room, who the doctor can speak to themselves. In reality, what may seem to be more challenging consultations may be resolved by finding out the patient's concerns and discussing them, for example. Patients will always have valid health concerns or anxieties underlying any behaviour that may be perceived as "difficult" or "pushy". What may have been more useful is to use a study design where the GP actually consults with a live patient actor. The research included a small number of doctors who were nearing the end of their GP training, but may not have the same level of experience at diagnosing or managing more challenging patients or consultations, compared with someone who has been practicing for some time. That being said, the findings are in agreement with other research which suggests that "disruptive" or "difficult" patients fuel negative emotions in the consulting room. Media reports suggest that more research is on the way, looking at further scenarios. This will be valuable, as it is important that all doctors are aware of their emotional responses to different patient presentations. This may further our understanding of the effect this might have on the accuracy of their diagnosis, with a knock-on effect on patient safety. Remember: you have every right to change your GP, and you don't have to give a reason for your decision. Read more about changing your GP.  Analysis by Bazian. Edited by NHS Choices. Follow NHS Choices on Twitter. Join the Healthy Evidence forum.
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Government plans to stop publicly funded researchers influencing… · News · Sense about Science

Government plans to stop publicly funded researchers influencing… · News · Sense about Science | Risk and Uncertainty: measurement, management and understanding | Scoop.it
News and Comment Government plans to stop publicly funded researchers influencing policy. Yes, really 16 March 2016 Please raise your voice now From May, the government plans to add a new anti-lobbying clause to all public funding, to prevent it being used for “activity intended to influence or attempt to influence Parliament, Government or political parties, or attempting to influence the awarding or renewal of contracts and grants, or attempting to influence legislative or regulatory action”. It follows a report in 2014 that government funds go to some groups who use them more to influence policy than to do what they’re intended for. That may be true. But you need only give a moment’s thought to the breadth of this new clause to realise that in an attempt to get rid of a small irritant, the government is causing far more damage. This is not the behaviour of a government at ease with itself. It is defensive and paranoid. There is no need for a sweeping clause. If some organisations are not conducting the work they’re funded to do officials can deal with it. But if they’re doing that work and also stepping up to take responsibility for what happens in public life – the decisions we’re taking, the policies government writes and the research they’re based on – then thank goodness for that! It is a bonus, a public service whether we agree with what they say or not, and one that we need much more of. It’s already hard enough to get some of our best publicly funded researchers to contribute to difficult debates about policy and to submit to government’s and parliament’s time-consuming calls for evidence. Does the government or anyone really believe that policy and law will be better if everyone shuts up? Do they think they’ll spot every problem and identify every solution in isolation from the world? A few years ago Sense about Science achieved desperately needed change to the libel laws in England and Wales. All parties supported it… when they eventually heard the alarm that scientists, medics, writers and many others were raising. We weren’t publicly funded but many of those scientists were. And with AllTrials we are changing policies to stop people hiding the results of drug trials, so that doctors can make better, cost effective decisions. AllTrials doesn’t receive government funds but the doctors and researchers pressing for these life-saving changes do. And what of all the other times that people in receipt of public funds have guided policy and regulation? If measures for containing disease could be improved – think BSE, Foot and Mouth Disease, Ebola, H1N1 - should researchers sit on their hands? Should medics and engineers not have contributed to the Hillsborough inquiry? Should energy experts stay silent about the poor value that DECC is getting from some of its energy saving incentives, or would the government like to know? If drug rehab funding will backfire in some communities, don’t we want the social scientists to say so? In an analysis of the recent national research evaluation exercise, the Engineering and Physical Sciences Research Council found that half of the impact case studies for research it funded were about contributing to policy. This is surely part of what we’re all paying for – not for researchers to quietly notch up more publications, but for a public life informed by more evidence and expertise. So what can you do? Apparently some individuals in government say this was not the intention of the clause and have mumbled some things behind closed doors about looking into it. They’re still looking, and doing nothing. The clause is being implemented in May. We all need to act now. Please write to the Prime Minister, to your MP and to Matt Hancock, the Minister for the Cabinet Office who is responsible for the clause. Tell them to drop this clause because it won’t work and it will cause damage. We can think of hundreds more examples where publicly funded researchers, experts and research have contributed to policy, law and regulation, and so can you – please tell them. Tell us too – @senseaboutsci or enquiries@senseaboutscience.org – so we can start a rolling list. Send this message and the links on Twitter to everyone you know. Read pieces from David Nutt, Ben Goldacre, Nature and CaSE/CfSS on problems with the proposed clause. Fiona Fox has also written about it in The Times (£) and Research Fortnight (£). < Back
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The mismeasure of scientific significance - STATS

The mismeasure of scientific significance - STATS | Risk and Uncertainty: measurement, management and understanding | Scoop.it
M arch brings St. Patrick’s Day, the true significance of which has been lost in the froth of green beer and blarney. But without Patrick bringing Christianity to Ireland, Ireland could not have returned it through a rich Insular culture—the written word and the book—to Europe. Now, there is another auspicious moment in the history of learning to add to the month’s calendar of anniversaries: March 7, Significance Day, or—if you will—P Day. The American Statistical Association—a clerisy for our quantified times—has issued a statement clarifying what a P-value means—or rather doesn’t mean. Indeed, it could be said that by adding up all the things a P-value isn’t you end up with an alarming sense of science in thrall to an absence—P-dolatory­—the worship of false significance. As long as your study comparing X and Y ends up with P<0.05, it has found something that is unlikely to be unreal. Science could move forward; your career as an experimentalist had measurable success. The problem begins with Ronald Alymer Fisher, who, in the 1920s at the Rothamsted Experimental Station in England, laid many of the statistical foundations for designing scientific experiments. Fisher was indubitably brilliant, capable of solving complex mathematical and statistical problems in his head through geometry; but he was sometimes parsimonious when it came to explaining to the less gifted just what those solutions meant or how they might be justified by mathematical proof (it would take years of diligent work by other statisticians to prove, mathematically, why his models worked). The virtue of his landmark book, Experimental Methods for Research Workers, was that you didn’t need a lot of math to use his models to conduct experiments; so too its vice. As the statistician and science writer Regina Nuzzo notes in a superlative Nature essay on the problem, Fisher intended a P-value to be “an informal way to judge whether evidence was significant in the old fashioned sense: worthy of a second look. The idea was to run an experiment, then see if the results were consistent with what random chance might produce. Researchers would first set up a null hypothesis that they wanted to disprove, such as there being no correlation or no difference between two groups. Next, they would play the devil’s advocate and, assuming that this ‘null hypothesis’ was in fact true, calculate the chance of getting results at least as extreme as what was actually observed. This probability was the P-value. The smaller it was, suggested Fisher, the greater the likelihood that the straw-man null hypothesis was false.” Unfortunately, as a tool, the P-value became a hammer to a great many experimental nails, and the disputes within statistics—often bitter—over what it actually meant, or whether it meant much at all, were mostly lost on science. The need for ‘evidence’ had found its measure in a rapidly modernizing world; and nothing seemed to succeed in providing publishable evidence quite so much as a P-value smaller than 0.05. Without statistical or mathematical training, statistical significance became a way of foreclosing the difficult task of determining whether a study’s design could actually answer the question a researcher wanted to answer; it was the path of least difficulty in an otherwise highly complex topography of statistical methods, illuminated by software and vouchsafed by academia and scholarly publishing. The consequence, as Boston University epidemiologist Kenneth Rothman points out in a vigorous essay accompanying the ASA’s statement, is that scientists have “embraced and even avidly pursued meaningless differences solely because they are statistically significant, and have ignored important effects because they failed to pass the screen of statistical significance. These are pernicious problems, and not just in the metaphorical sense. It is a safe bet that people have suffered or died because scientists (and editors, regulators, journalists and others) have used significance tests to interpret results, and have consequently failed to identify the most beneficial courses of action.” To be fair, statisticians have long been sounding an alarm on P-dolatory in science; but the increasing sense that ‘significance doping’ was behind so many winning results in science—winning results that could not be replicated—spurred the ASA to action; and it is the association’s first time to take a policy position on such a core issue of statistical practice. “We hoped,” the ASA’s statement reads, “that a statement from the world’s largest professional association of statisticians would open a fresh discussion and draw renewed and vigorous attention to changing the practice of science with regards to the use of statistical inference.” As Ron Wasserstein, ASA executive director, says, the goal is “to steer research into a post P<0.05 era.” The implications are profound for research, academic publishing, scientific funding, and even the daily journalism of  “a new study says”… variety. The statement demands a fundamental rethink in the process of experimental design across many disciplines, and how those designs may be held accountable. As Stanford’s John Ioannidis notes, the real challenge is not simply about getting rid of P-values (for they may yet have some valuable use): it is about creating a scientific culture that embraces “transparency in study design, conduct, and reporting.”
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Playground equipment contains toxic levels of lead paint - Health News - NHS Choices

Playground equipment contains toxic levels of lead paint - Health News - NHS Choices | Risk and Uncertainty: measurement, management and understanding | Scoop.it
"Paint on playground equipment has been found to contain high amounts of the toxin lead – up to 40 times recommended levels," BBC News reports.
Researchers sampled levels at 26 playgrounds in the south of England and the results are worrying.
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Calls for research into health effects of ultrasound exposure - Health News - NHS Choices

Calls for research into health effects of ultrasound exposure - Health News - NHS Choices | Risk and Uncertainty: measurement, management and understanding | Scoop.it
"Ultrasound in public places could be triggering sickness," the Daily Mail reports.
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Exercise is 'most effective' method of preventing lower back pain - Health News - NHS Choices

Exercise is 'most effective' method of preventing lower back pain - Health News - NHS Choices | Risk and Uncertainty: measurement, management and understanding | Scoop.it

"Exercise is the best medicine to banish back pain and stop people taking sick days," reports the Daily Mirror. While this may be true, the research in question did not look at treatments for existing back pain.

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Treating absolute and relative data simultaneously - Junk Charts

Treating absolute and relative data simultaneously - Junk Charts | Risk and Uncertainty: measurement, management and understanding | Scoop.it

A friend asked me to comment on the following chart: Specifically, he points out the challenge of trying to convey both absolute and relative metrics for a given data series. This chart presents projections of growth in the U.S.

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Behind the Headlines' 2015 Quiz of the Year - Health News - NHS Choices

Behind the Headlines' 2015 Quiz of the Year - Health News - NHS Choices | Risk and Uncertainty: measurement, management and understanding | Scoop.it
In 2015, Behind the Headlines covered more than 500 health stories that made it into the mainstream media. If you've been paying attention, you should find this quiz easy and fun...
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Jeremy Hunt, the Guardian, and the importance of getting the stats right | Understanding Uncertainty

Jeremy Hunt, the Guardian, and the importance of getting the stats right | Understanding Uncertainty | Risk and Uncertainty: measurement, management and understanding | Scoop.it
On Thursday November 19th the printed version of the Guardian had the headline “Experts dispute Hunt's claim on weekend hospital treatment“ [online version here].
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It's difficult for journalists to get statistics right: the real estate edition

It's difficult for journalists to get statistics right: the real estate edition | Risk and Uncertainty: measurement, management and understanding | Scoop.it
A friend pointed me to a good article on the buoyant real-estate market in Boston (link). The journalist tells us the median home sale price in Suffolk County has gone up 31 percent in the five years since the 2010 crash. The article makes some excellent points. When it comes to talking about median house prices, it fails basic statistics. Here is a quote (maybe a misquote) from Barry Bluestone, whom the reporter describes as a "go-to mind" on Boston housing. He complains that "median home sale prices--the metric by which many people judge the market--can be misleading." How so?...
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Air pollution 'kills 40,000 a year' in the UK, says report

Air pollution 'kills 40,000 a year' in the UK, says report | Risk and Uncertainty: measurement, management and understanding | Scoop.it
Tuesday February 23 2016 Air pollution has been linked to a range of chronic diseases What is the issue? "Air pollution is contributing to about 40,000 early deaths a year in the UK," BBC News reports. The figures are the conclusion of a report assessing the impact of air pollution on public health in the UK. The report, published by the Royal College of Physicians and the Royal College of Paediatrics and Child Health, discusses the lifelong impact of air pollution. It presents a number of recommendations to the public, businesses and governments to make changes and reduce air pollution. The expert panel states: "Real change will only occur when everyone accepts this responsibility, and makes a concerted effort." BREATH for better air The Royal College of Physicians recommends six steps you can take to tackle the problem of air pollution: Be aware of the air quality where you live Replace old gas appliances in your home Ensure you have an energy-efficient home Alter how you travel. Take the active travel option: bus, train, walking and cycling Talk to your MP Harness technology to stay informed and monitor air pollution effectively   Who produced the report? The report was produced by the Royal College of Physicians and the Royal College of Paediatrics and Child Health, and aimed to look at changes in the sources of air pollution over time, both indoors and outdoors.  The report also looks to the future in assessing the impact of an ageing population and climate change, and the effect this has on society. The two Royal Colleges formed a group of experts from medicine and environmental sciences to discuss current evidence, found through a search of the literature, and came up with some recommendations.   What does the report say? The report suggests that every year in the UK, outdoor pollution is linked to around 40,000 deaths, and more with indoor pollutants. Air pollution can have a damaging effect from when a baby is in the womb and continue throughout life to older age, playing a role in many chronic conditions such as cancer, asthma, heart disease, and neurological changes linked to dementia. The expert panel feels the concentration limits set by the government and the World Health Organization are not safe for the whole population and leave certain groups vulnerable. The panel therefore provides a number of recommendations for action.   What did they look at? The experts discussed: changes occurring over the years in air pollution composition of the air we breathe effect of air pollution on early human development, including vital organs effects of air pollution over a lifetime identifying vulnerable groups the cost of air pollution how to change our future   What evidence did they find? The report found there have been a number of factors, including legislation that has changed the composition and level of air pollution we are exposed to today. Air pollution is not a new problem in the UK, but over the years our perspective on the health risks has changed. There had previously been a focus on pollution from solid fuel burning, such as coal – which, as a result, fell dramatically. However, this has been replaced by concerns about exposure to pollutants from transport sources, especially cars. Even the "cleanest" of engines can produce nitrogen oxides, ozone and particulates – small specks of matter, such as soot. All three may have a potentially harmful effect on health. Evidence from the literature discussed the public health burden of air pollution and methods for better management for health improvements, cost savings and increases in quality of life. Indoor sources of air pollution are not always considered; however, the report found a number of sources emitting a variety of substances, such as: gas cookers cleaning products damp and mould cigarette smoke carbon monoxide They concluded that indoor pollutants may cause several thousand deaths per year in the UK, and the experts felt this was an area to be studied further. There was evidence that exposure to pollutants throughout life, from pregnancy to older age, can have lasting influences. However, the evidence of harm to unborn babies and the young child is not as strong as it is for adults. The experts suggest this is because the topic is relatively new and has not been so heavily researched, or that the effects on the baby and child may be subtle and take longer to appear. In some cases, damage caused by exposure to pollutants in early childhood may not become apparent until adulthood. Evidence was found to suggest that long-term exposure to air pollution is linked to: decline in lung function in adults – which can be a risk factor for chronic obstructive pulmonary disease asthma type 2 diabetes problems with brain development and cognition (thinking ability) cardiovascular diseases – conditions that can affect the heart and blood vessels, such as coronary heart disease cancer The report also found evidence that poorer people tend to live in lower-quality environments and are more exposed to air pollution. This does not necessarily mean they are at increased risk, so long as concentrations do not exceed regulations.   What does the report recommend? The report provides a number of recommendations for action and also further research. These are described below: We are encouraged to act immediately to protect the health, wellbeing and economic sustainability for our generation and those of the future. Governments are urged to work with local authorities and industry to make long-term changes. Educate professionals and the public of the serious harms of air pollution. Promote alternative transport to cars fuelled by petrol and diesel; this may be walking, cycling, and use of public transport or electric/hybrid cars. Regulations to be put in place so that those causing the pollution are required to take responsibility for harming health. This should be at a local, national and EU level. Effective monitoring of air pollution levels, ensuring that serious incidents are reported. Local authorities to act in protecting public health where air pollution levels are high, this may involve road closures and other traffic control. Regulators and local governments to ensure there is no inequality in exposure to pollutants between deprived and more affluent communities. Protect groups that are at increased risk of health problems. This includes children, older adults, and people with chronic health problems. Benchmarking for clean air and safe workplaces; that is seeking to set a gold standard for clean air and regularly checking that the standard is met. Carrying out further research into the economic impact of air pollution and the benefits of tackling the issue. Strengthen our understanding of the relationship between indoor air pollution and health, including the key risk factors. Improve our understanding of how global social and economic trends are affecting air quality. Improve air pollution monitoring through use of better technology. Research into the effects of air pollution on health. These recommendations are likely to cost the taxpayer money, but the report makes a compelling case that they will save money in the long term.  The report's authors estimate that the adverse impact on public health caused by pollution costs the UK economy more than £20bn per year, which is just under 16% of the current annual NHS budget of around £116bn. Analysis by Bazian. Edited by NHS Choices. Follow NHS Choices on Twitter. Join the Healthy Evidence forum.
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Organic milk 'is healthier' than conventional milk, study says - Health News - NHS Choices

Organic milk 'is healthier' than conventional milk, study says - Health News - NHS Choices | Risk and Uncertainty: measurement, management and understanding | Scoop.it
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Probability and Risk: Turning poorly structured data into intelligent Bayesian Network models for medical decision support

Probability and Risk: Turning poorly structured data into intelligent Bayesian Network models for medical decision support | Risk and Uncertainty: measurement, management and understanding | Scoop.it
Medical data is very often badly structured, incomplete and inconsistent. This limits our ability to generate useful models for prediction and decision support if we rely purely on machine learning techniques. That means we need to exploit expert knowledge at various model development stages. This problem - which is common in many application domains - is tackled in a paper** published in the latest issue of Artificial Intelligence in Medicine. The paper describes a rigorous and repeatable method for building effective Bayesian Network (BN) models from complex data - much of which comes in unstructured and incomplete responses by patients from questionnaires and interviews. Such data inevitably contains repetitive, redundant and contradictory responses; without expert knowledge learning a BN model from the data alone is especially problematic where we are interested in simulating causal interventions for risk management. The novelty of this work is that it provides a rigorous consolidated and generalised framework that addresses the whole life-cycle of BN model development. The method is validated using data from forensic psychiatry. The resulting BN models demonstrate competitive to superior predictive performance against the data-driven state-of-the-art models. More importantly, the resulting BN models go beyond improving predictive accuracy and into usefulness for risk management through intervention, and enhanced decision support in terms of answering complex clinical questions that are based on unobserved evidence. The method is applicable to any application domain involving large-scale decision analysis based on such complex and unstructured information. It challenges decision scientists to reason about building models based on what information is really required for inference, rather than based on what data is available. Hence, it forces decision scientists to use available data in a much smarter way. **The full reference for the paper is: Constantinou, A. C., Fenton, N., Marsh, W., & Radlinski, L. (2016). "From complex questionnaire and interviewing data to intelligent Bayesian Network models for medical decision support".Artificial Intelligence in Medicine, Vol 67 pages 75-93. DOI http://dx.doi.org/10.1016/j.artmed.2016.01.002 For those who do not have access to the journal a pre-publication draft can be downloaded: http://constantinou.info/downloads/papers/complexBN.pdf
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Common antibiotic for children 'ineffective in half of cases'

Common antibiotic for children 'ineffective in half of cases' | Risk and Uncertainty: measurement, management and understanding | Scoop.it
Wednesday March 16 2016 Ampicillin is used to treat urinary tract infections in children "Antibiotics used to treat common infections in children could soon be rendered useless," the Daily Mail reports. A major review of existing data found worryingly high levels of resistance to widely used antibiotics such as ampicillin, which is used to treat urinary tract infections (UTIs) in children. Researchers specifically looked at UTIs caused by E. coli, a very common bacteria. In the UK and other developed countries, around a quarter to half of E. coli infections were resistant to the common antibiotics trimethoprim and ampicillin (or amoxicillin), though resistance was lower against other drugs. Researchers say prescribing guidelines need to be updated to take account of their findings. The researchers also found bacteria carried by individual children were more likely to be antibiotic resistant for up to six months after the child had taken antibiotics. An editorial published alongside the study suggests doctors should avoid prescribing a child the same antibiotic more than once in six months. The study found antibiotic resistance was much more common in less developed countries, where antibiotics are more often available over the counter, rather than by prescription. This research is a stark reminder of the importance of using antibiotics only when necessary, and to take the full course when they are used, to avoid giving bacteria the chance to develop resistance to a drug. Read more about how to combat antibiotic resistance. Where did the story come from? The study was carried out by researchers from the University of Bristol, University Hospital of Wales, and Imperial College London. It was funded by the National Institute of Health Research. The study was published in the peer-reviewed British Medical Journal (BMJ) on an open access basis, so it is free to read online. The Guardian seems to place the blame on family doctors, saying the researchers "blame GPs for prescribing antibiotics to children too often". However, the study authors pointed out that children with urine infections are prone to serious complications and "require prompt appropriate treatment". They point to the unregulated use of antibiotics without prescription as one reason for higher antibiotic resistance in less developed countries. The Daily Telegraph, confusingly, reported: "Half of children are now resistant to some of the most common antibiotics". It's not children that are resistant, but bacteria. This is an important distinction – drug resistance changes over time, and antibiotics that don't work for a child with one infection may work for another.  What kind of research was this? Researchers carried out a systematic review of observational studies from all over the world, which calculated the proportion of antibiotic-resistant E. coli urinary infections in children under 18. They also carried out a meta-analysis of studies that calculated how likely children were to carry antibiotic-resistant bacteria in their urine after being prescribed antibiotics. Systematic reviews and meta-analyses are good ways to summarise and pool information about a topic. However, they're only as good as the studies they include. What did the research involve? Researchers searched for studies that measured antibiotic resistance to a selection of commonly used antibiotics among E. coli urine infections in children. They divided the studies into those carried out in Organisation for Economic Co-operation and Development countries (OECD) – countries such as the UK and France are regarded as developed – and non-OECD (less developed) countries. They then pooled the data to come up with estimates of what proportion of E. coli were resistant to different antibiotics. The data collected was used to see if children were more likely to harbour antibiotic-resistant E. coli if they'd been prescribed antibiotics in the previous six months. The researchers included 58 studies, of which 33 were from developed countries. Only five studies, all from developed countries, included information about whether children had previously been prescribed antibiotics. Some, but not all, of the studies included information about how the urine samples were collected and tested, or which guidelines had been used. The researchers looked to see if these factors affected the results, or whether the results were affected by the children's age or sex. What were the basic results? More than half the infections were resistant to ampicillin, one of the most commonly used antibiotics for urinary tract infections worldwide. Resistance to ampicillin – or its derivative, amoxicillin – was found in 53.4% of cases in developed countries and 79.8% of cases in less developed countries. Ampicillin is one of the drugs recommended by NICE for use in childhood urine infections in the UK. Another recommended drug, trimethoprim, was ineffective in 23.6% of cases in developed countries. Other commonly used antibiotics with resistance rates above 20% – the recommended level above which a drug should not be routinely used – included co-trimoxazole, and co-amoxiclav in less developed countries. None of the routinely used antibiotics in less developed countries had resistance rates below 20%. The drug with lowest resistance in developed countries was nitrofurantoin (1.3%), which was only recorded in one study from less developed countries. Children were more than eight times more likely to have bacteria in their urine resistant to an antibiotic if they'd been prescribed that antibiotic one month earlier (odds ratio 8.38, 95% confidence interval 2.84 to 24.77). Because studies looked at overlapping time periods, it wasn't possible to do an overall summary of all time periods up to six months. But a study that measured antibiotic-resistant bacteria in children who'd been prescribed an antibiotic at regular intervals showed it declined over time, with no increased chance of antibiotic resistance a year or more after taking a drug.   How did the researchers interpret the results? The researchers said their findings show that guidelines need to be updated: "Our review suggests ampicillin, co-trimoxazole and trimethoprim are no longer suitable first line options for urinary tract infection in many OECD countries." They suggest that nitrofurantoin "might be the most appropriate first line treatment for lower urinary tract infection" and suggest that doctors should take a child's previous antibiotic use into account when choosing antibiotics for further infections. They said antibiotic resistance in less developed countries might be tackled by better primary care facilities, better access to medical help, and regulation of the supply of antibiotics.   Conclusion This is an important study that may mean doctors need to change the way they treat one of the most common childhood illnesses. Because urine infections can be painful and can damage the kidneys in young children, it's important they are treated quickly and effectively. Current guidelines for doctors, which were published nine years ago, say children over three months of age with urine infections should be treated for three days with an antibiotic "directed by locally developed guidance", which might include trimethoprim, nitrofurantoin, cephalosporin or amoxicillin. Only if the antibiotic does not work does the guidance recommend sending a urine sample for analysis. Infants with a suspected urine infection below three months of age require immediate referral and investigation. There are some uncertainties about the study results. For example, there are too few studies looking at bacteria resistance to antibiotics over time to be sure about how long resistance lasts. As these are observational studies, we don't know whether other factors might have influenced the results. Also, the studies covered age ranges from infants up to young people aged 17 years. As highlighted in the accompanying editorial, there is quite a difference between a young adult presenting to the doctor with clear symptoms of a urine infection and a young child with more non-specific symptoms, such as a temperature and abdominal pain. There may be more uncertainty about diagnosis in younger children. Nevertheless, the review is large and the overall results seem compelling enough that it should be taken seriously. The results suggest doctors should use a different antibiotic as a first choice, and also check which antibiotics the child has taken in the previous six months and avoid using those. The study highlights the growing importance of resistance to antibiotics by bacteria. Everyone has a part to play in preventing this spread. Bacteria become resistant because they mutate and adapt, so certain antibiotics no longer kill them. We need to avoid using antibiotics for illnesses that don't need them – for example, colds and flu, which are not caused by bacteria – and use them properly when they are necessary. That means finishing a course of antibiotics, even if you feel better before they're finished. Leaving a course unfinished means some bacteria survive and can mutate and develop resistance. Authorities such as the National Institute for Health and Care Excellence (NICE) will need to take account of this research when updating guidelines on how antibiotics should be used to treat urine infections in children.   Analysis by Bazian. Edited by NHS Choices. Follow NHS Choices on Twitter. Join the Healthy Evidence forum.
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Ban academics from talking to ministers? We should train them to do it! – Bad Science

Ban academics from talking to ministers? We should train them to do it! – Bad Science | Risk and Uncertainty: measurement, management and understanding | Scoop.it
The Cabinet Office has come up with a crazy plan to ban academics like me from talking to politicians and civil servants. In this piece I explain why that is an almost surreally stupid idea. I also describe how I hustle, in Whitehall, to try and get government policy changed on open data, scientific transparency, and evidence based policy. Readers with a weaker constitution should be forewarned that this piece contains lurid descriptions of very positive experiences I have had with Oliver Letwin, and other popular right-wing hate figures. There is no apology for that, in the name of pragmatism and democracy: we should train academics to talk to ministers, and encourage them to do it. www.timeshighereducation.com/comment/i-talk-to-ministers-mps-and-wonks-is-that-lobbying-you-decide (Sorry, I keep forgetting to post things on badscience.net, this will change shortly, I have a big backlog of posts and will splurge over the next month or two!).
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Can aspirin reduce bowel cancer risk? - Health News - NHS Choices

Can aspirin reduce bowel cancer risk? - Health News - NHS Choices | Risk and Uncertainty: measurement, management and understanding | Scoop.it
Friday March 4 2016 Aspirin can have some nasty side effects "Taking two aspirin a week could protect against cancer," reports the Daily Telegraph. The Express suggests we should take it daily. In a study of more than 130,000 US health professionals, who were followed up every two years for around 32 years, researchers found that aspirin use twice or more per week was associated with a 3% reduction in cancer risk. However, when analysed by cancer type, there was only one significant link – for bowel cancer – with a 19% risk reduction for aspirin use. For protection against bowel cancer, it seemed that a 0.5 to 1.5 standard dose of tablets (325mg) per week (roughly equivalent to a daily low-dose aspirin), for more than five years, was required. There are several limitations to this research, including the potential for unmeasured health and lifestyle factors confounding the results, and inaccurate recall about aspirin use. But, most importantly, regular aspirin use carries the risks of stomach irritation, bleeding and ulceration. For people prescribed aspirin for cardiovascular disease, the benefits are considered to outweigh these risks. However, it is a different matter for those taking aspirin for possible cancer protection. Until this risk-benefit balance is better understood, no recommendation can be given for everyone to take daily aspirin to reduce cancer risk.  Where did the story come from? The study was carried out by researchers from the School of Public Health and Harvard Medical School, Boston; Brigham and Women’s Hospital; and Massachusetts General Hospital. The study was published in the peer-reviewed medical journal JAMA Oncology and was funded by the National Institutes of Health. You can read the study for free online. The study was, on the whole, well covered by the UK media, hailing aspirin as a cheap drug that will cut cancer risk. Most stories did reflect the researchers' caution that people should be informed about the potential side-effects of regular aspirin treatment. They also warned that aspirin use should not be viewed as a substitute for bowel cancer screening. What kind of research was this? This was a study of two US cohorts that aimed to examine the effects of aspirin on the risk of cancer – both overall and by specific cancer type. Aspirin is a well-established drug for the treatment and prevention of cardiovascular disease. Many large trials of people taking regular aspirin for cardiovascular disease have also suggested that it may reduce the overall risk of cancer as well. There was limited data to give reliable risk information by cancer type, with the exception of a link with colorectal (bowel) cancer. As such, the US Preventive Services Task Force recently recommended the use of aspirin to prevent bowel cancer and cardiovascular disease for many US adults. However, questions remain on optimal dose and duration of use, and whether there may be effects on other cancers. This study aimed to examine this. The main limitations with observational cohort studies are the possibility that other health and lifestyle characteristics of the individuals may be involved in any link.   What did the research involve? The research involved 135,965 men and women taking part in two large US cohort studies: The Nurses’ Health Study (NHS), which recruited 121,700 female nurses aged 30 to 55 in 1976 The Health Professionals Follow-up Study (HPFS), which included 51,529 male health professionals aged 40 to 75 in 1986 Both studies followed participants, with questionnaires every two years assessing health and lifestyle factors, including any diseases. Aspirin use was assessed from the start of the HPFS study in 1986, and from 1980 in the NHS study, and every two years subsequently in both studies. The questions on aspirin use varied. For example, in HPFS from 1986, people were asked whether they took aspirin twice or more a week, then from 1992 they were asked to quantify the number of tablets per week. Both cohorts were asked about standard dose (325mg) aspirin until 2000 onwards, when they were asked to separately report low-dose or standard-dose aspirin. Cancer outcomes were assessed up to 2014/15 using the questionnaires, and by checking with the US National Death Index. They analysed the link between aspirin use and any cancer or by specific cancer site, taking into account various potential confounders, including ethnicity, height, body mass index (BMI), smoking, diet and alcohol use. What were the basic results? The total follow-up period was 32 years. During this time, 20,414 cancers were found in 88,084 women, and 7,571 cancers were found among 47,881 men. Compared with non-regular aspirin use (taking no aspirin or less than twice a week), regular use was associated with a 3% reduced risk of any cancer (relative risk [RR], 0.97, 95%; confidence interval [CI] 0.94 to 0.99). By cancer type, a significant risk reduction from regular aspirin was only observed for colorectal cancer (RR 0.81, 95%; CI 0.75 to 0.88) or those defined as gastrointestinal (digestive) tract cancers (RR 0.85, 95%; CI 0.80 to 0.91). However, there was no significant link between aspirin and risk of cancer of the throat and stomach, pancreas, prostate, breast, lung, "other gastrointestinal tract", or "non- gastrointestinal tract". The apparent benefit of aspirin for bowel cancer appeared to be dose-dependent. The risk reduction was observed from a dose of 0.5 to 1.5 standard-dose tablets per week, and decreased further with 2 to 5 or greater tablets per week. Aspirin needed to have been taken for more than five years to observe a risk reduction. The researchers calculated that if everyone were taking regular aspirin, then this would reduce the number of overall cancer cases by 1.8%, and the number of bowel cancer cases by 10.8%. How did the researchers interpret the results? The researchers conclude: "Long-term aspirin use was associated with a modest but significantly reduced risk for overall cancer, especially gastrointestinal tract tumours. Regular aspirin use may prevent a substantial proportion of colorectal cancers and complement the benefits of screening." Conclusion This study has made use of long-term follow-up data from two large US studies to examine the link between regular aspirin use and risk of cancer. The research did find that regular use of aspirin was associated with a very small reduction in the overall risk of cancer. When looking by cancer type, the only cancer with a clear risk reduction from aspirin use seems to be bowel cancer. There were no significant links for any other cancer type (the definitions of a reduced risk for "gastrointestinal tract cancers" but no link for "other gastrointestinal tract cancers" seem rather unclear).  The risk reduction for bowel cancer seems to start from taking 0.5 to 1.5 standard-dose tablets (325mg) per week, which is roughly equivalent to a daily low-dose aspirin. It seems you need to take it for more than five years to get the benefit. Before everyone in the country reaches for the aspirin, there are several important limitations to keep in mind: There does seem to be a link with reduction in bowel cancer risk, but we don’t know why this is. The researchers have taken into account many health and lifestyle factors that could be associated with the link, such as smoking, alcohol and diet. However, we don’t know that the effects of these have been fully taken into account, or whether there may be other unmeasured factors influencing the link. Aspirin use, frequency and dose were all self-reported by questionnaire, which increases the possibility of inaccurate recall. Any links with specific aspirin dose are likely to be less reliable in an observational study such as this than they would be in a trial – for example, where people are given a specific dose to take and investigators have better knowledge of what people are actually taking. This is a large sample size, but they are all US health professionals who may have specific characteristics, meaning that the results can’t be applied to all populations.  Probably most importantly – aspirin isn’t without side effects. Regular use can cause stomach irritation, bleeding and ulceration, with groups such as the elderly being at higher risk of these side effects. For those prescribed aspirin for cardiovascular disease, the benefits in terms of reducing risk of heart and vascular disease events are considered to outweigh the risks of the medication. However, when it comes to everyone in the population taking aspirin for possible cancer protection, this is a completely different matter. Overall, the link between aspirin and cancer risk – bowel cancer, in particular – definitely needs further consideration. But it needs to be clarified exactly which dose and frequency would give the best balance of effectiveness against safety, and for which population groups the benefits would outweigh the risks. Until this risk-benefit balance is better understood, no recommendation can be given for everyone to start taking daily aspirin to reduce cancer risk.  Analysis by Bazian. Edited by NHS Choices. Follow NHS Choices on Twitter. Join the Healthy Evidence forum.
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Seasonal affective disorder 'may be a myth', study argues - Health News - NHS Choices

Seasonal affective disorder 'may be a myth', study argues - Health News - NHS Choices | Risk and Uncertainty: measurement, management and understanding | Scoop.it
"Stop blaming SAD for your bad mood – it doesn't exist! Seasonal changes have 'NO effect on depression,'' the Daily Mail reports.
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The failure to replicate scientific findings

The failure to replicate scientific findings | Risk and Uncertainty: measurement, management and understanding | Scoop.it
Andrew Gelman and I have published a piece in Slate, discussing the failure to replicate scientific findings, using the recent example of the so-called power pose. The idea of the "power pose" is that people develop psychological and hormonal changes by making this "power pose" before walking into business meetings, whereupon these changes make them more powerful. As you often read here and at Gelman's blog, the fact that someone got a paper published in a scientific journal, based on a statistically significant result, doesn't automatically make it a believable result. Here, a different group of scientists tried to replicate...
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Sugary drinks linked to increased fat levels around vital organs - Health News - NHS Choices

Sugary drinks linked to increased fat levels around vital organs - Health News - NHS Choices | Risk and Uncertainty: measurement, management and understanding | Scoop.it

"People who consume sugary drinks are more likely to develop dangerous fat that becomes wrapped around internal organs," the Daily Mail reports after a US study found a link between the consumption of sugary drinks and increased visceral...

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“Best and Worst” of 2015 · News · Sense about Science

“Best and Worst” of 2015 · News · Sense about Science | Risk and Uncertainty: measurement, management and understanding | Scoop.it
Sense about Science ? Equipping people to make sense of science and evidence
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Failure to fortify flour with folic acid 'led to 2,000 birth defects' - Health News - NHS Choices

Failure to fortify flour with folic acid 'led to 2,000 birth defects' - Health News - NHS Choices | Risk and Uncertainty: measurement, management and understanding | Scoop.it
"UK experts are backing the call for flour to be fortified with folic acid – a move which they say would have prevented about 2,000 cases of serious birth defects since 1998," BBC News reports.
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Misleading conclusions from alcohol protection study | Understanding Uncertainty

Misleading conclusions from alcohol protection study | Understanding Uncertainty | Risk and Uncertainty: measurement, management and understanding | Scoop.it
The Daily Mail today declared that "Drinking is only good for you if you are a woman over 65", while the Times trumpeted that "Alcohol has no health benefits after all".
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