Comments on: “Surrogate Outcome Proves Something Beyond All Reasonable Human Doubt” http://www.badscience.net/2007/03/surrogate-outcome-proves-something-beyond-all-reasonable-human-doubt/ Ben Goldacre's Bad Science column from the Guardian and more... Fri, 12 Mar 2010 06:09:22 +0000 http://wordpress.org/?v=2.9.1 hourly 1 By: sicknotstupid http://www.badscience.net/2007/03/surrogate-outcome-proves-something-beyond-all-reasonable-human-doubt/comment-page-2/#comment-21235 sicknotstupid Tue, 24 Jun 2008 19:53:22 +0000 http://www.badscience.net/?p=384#comment-21235 I suspended usual cynicism and tried Vegepa. For 6 months. No difference in my condition. Apparently dr Puri thinks we should take 8 a day to kick over the "active energy barrier" - so that's quite expensive then. Then i read his book, expecting some decent science,and MRI scans, it's just a shameless advert that says Vegepa can cure everything. Gone back to my cod liver oil (i still hate fish after all)Sick people are desperate and tired to trawl through the literature. What's he doing at Imperial College? I suspended usual cynicism and tried Vegepa. For 6 months. No difference in my condition. Apparently dr Puri thinks we should take 8 a day to kick over the “active energy barrier” – so that’s quite expensive then. Then i read his book, expecting some decent science,and MRI scans, it’s just a shameless advert that says Vegepa can cure everything. Gone back to my cod liver oil (i still hate fish after all)Sick people are desperate and tired to trawl through the literature. What’s he doing at Imperial College?

]]> By: ak http://www.badscience.net/2007/03/surrogate-outcome-proves-something-beyond-all-reasonable-human-doubt/comment-page-2/#comment-18620 ak Sat, 24 Nov 2007 18:36:58 +0000 http://www.badscience.net/?p=384#comment-18620 Well said. As part of the Consultation on prostate cancer for the WHO, it was my task to examine PSA as a surrogate for mortality in <a href="http://www.laprp.com/question_answer.php?aid=99" rel="nofollow">prostate cancer</a>. We used a very simple definition for surrogates: 1) correlates with true outcome and 2) varies as outcome varies. We found specific evidence that PSA does not fulfill the criteria for a surrogate endpoint in prostate cacner, which was ultimately our <a href="http://www.laprp.com/question_answer.php?aid=223" rel="nofollow">published position</a>. Well said. As part of the Consultation on prostate cancer for the WHO, it was my task to examine PSA as a surrogate for mortality in prostate cancer. We used a very simple definition for surrogates: 1) correlates with true outcome and 2) varies as outcome varies. We found specific evidence that PSA does not fulfill the criteria for a surrogate endpoint in prostate cacner, which was ultimately our published position.

]]> By: Robert Carnegie http://www.badscience.net/2007/03/surrogate-outcome-proves-something-beyond-all-reasonable-human-doubt/comment-page-2/#comment-12393 Robert Carnegie Sun, 01 Apr 2007 17:46:55 +0000 http://www.badscience.net/?p=384#comment-12393 Oh, here's the discussion on "our" forum. Still murky - dark hints of naughtiness that may or may not be proved. http://badscience.net/forum/viewtopic.php?t=2067 Oh, here’s the discussion on “our” forum. Still murky – dark hints of naughtiness that may or may not be proved.
http://badscience.net/forum/viewtopic.php?t=2067

]]> By: Robert Carnegie http://www.badscience.net/2007/03/surrogate-outcome-proves-something-beyond-all-reasonable-human-doubt/comment-page-2/#comment-12391 Robert Carnegie Sun, 01 Apr 2007 15:06:30 +0000 http://www.badscience.net/?p=384#comment-12391 The programme represents, I should think, hundreds of thousands of pounds of television-making money. Evidently it wasn't shown because of the very bad publicity and perhaps they also found that broadcasting codes would be breached by showing it. maybe one of the kids died. Maybe a major league baseball game came up that they wanted to show instead. I think I read somewhere that Five muttered something about it not being rigorous scient , but it's quite murky. Maybe someone is suing someone? The programme represents, I should think, hundreds of thousands of pounds of television-making money. Evidently it wasn’t shown because of the very bad publicity and perhaps they also found that broadcasting codes would be breached by showing it. maybe one of the kids died. Maybe a major league baseball game came up that they wanted to show instead.

I think I read somewhere that Five muttered something about it not being rigorous scient , but it’s quite murky. Maybe someone is suing someone?

]]> By: evidencebasedeating http://www.badscience.net/2007/03/surrogate-outcome-proves-something-beyond-all-reasonable-human-doubt/comment-page-2/#comment-12370 evidencebasedeating Sat, 31 Mar 2007 10:37:34 +0000 http://www.badscience.net/?p=384#comment-12370 er, where did the programme go? and is it ever going to be shown - or is this the new way of gaining publicity for woo? plan a virtual programme, gain tv listings, exploit the non-discerning pre-publicity to gain oodles of exposure at zero expense , then pull programme at the last minute. a novel way of gaining something for nothing? er, where did the programme go?
and is it ever going to be shown – or is this the new way of gaining publicity for woo?
plan a virtual programme, gain tv listings, exploit the non-discerning pre-publicity to gain oodles of exposure at zero expense , then pull programme at the last minute. a novel way of gaining something for nothing?

]]> By: Jo http://www.badscience.net/2007/03/surrogate-outcome-proves-something-beyond-all-reasonable-human-doubt/comment-page-2/#comment-12064 Jo Wed, 21 Mar 2007 16:01:25 +0000 http://www.badscience.net/?p=384#comment-12064 Wasn't there a very robust study showing that women wearing bikinis couldn't concentrate because they were too busy holding their tummies in? That's my theory as to why this 'works'. The kids lost a bit of weight and their school uniforms fitted them better leaving them free to get on with their education without worrying about buttons bursting and whatnot. Wasn’t there a very robust study showing that women wearing bikinis couldn’t
concentrate because they were too busy holding their tummies in? That’s my
theory as to why this ‘works’. The kids lost a bit of weight and their school
uniforms fitted them better leaving them free to get on with their education
without worrying about buttons bursting and whatnot.

]]> By: evidencebasedeating http://www.badscience.net/2007/03/surrogate-outcome-proves-something-beyond-all-reasonable-human-doubt/comment-page-2/#comment-12007 evidencebasedeating Mon, 19 Mar 2007 22:15:32 +0000 http://www.badscience.net/?p=384#comment-12007 #27 Dr Aust says: "On Amazon I see that due out later this year are two MORE books by Prof Puri, “Natural Energy” and its companion “The Natural Energy Cookbook” thats OK then. So its 'natural' energy being touted - so guess its a cookbook with oodles of fat, sugar, alcohol and protein - ie those 'natural energy' products in our diet. Phew. glad its 'natural' energy wouldn't want a book on 'unnatural' energy - or even 'supernatural' energy.... #27 Dr Aust says:

“On Amazon I see that due out later this year are two MORE books by Prof Puri, “Natural Energy” and its companion “The Natural Energy Cookbook”

thats OK then. So its ‘natural’ energy being touted – so guess its a cookbook with oodles of fat, sugar, alcohol and protein – ie those ‘natural energy’ products in our diet.
Phew. glad its ‘natural’ energy
wouldn’t want a book on ‘unnatural’ energy – or even ’supernatural’ energy….

]]> By: kim http://www.badscience.net/2007/03/surrogate-outcome-proves-something-beyond-all-reasonable-human-doubt/comment-page-2/#comment-11988 kim Mon, 19 Mar 2007 13:03:40 +0000 http://www.badscience.net/?p=384#comment-11988 There's a big feature in the Telegraph today about hyperactivity that contains a fairly uncritical account of Robin Pauc's use of diet etc. to treat hyperactivity and other conditions. There’s a big feature in the Telegraph today about hyperactivity that contains a fairly uncritical account of Robin Pauc’s use of diet etc. to treat hyperactivity and other conditions.

]]> By: dynamo http://www.badscience.net/2007/03/surrogate-outcome-proves-something-beyond-all-reasonable-human-doubt/comment-page-2/#comment-11914 dynamo Sat, 17 Mar 2007 11:04:37 +0000 http://www.badscience.net/?p=384#comment-11914 Re #55. Yes, it seems that neurons can change their shape and connectivity. (http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=16366735) However, what NAA is measuring is roughly-speaking (because I'm not an expert and no-one is sure anyway) the density of normally-functioning neurons. So that gives a high figure in adults, and a considerably lower one in babies: but infant brains are doing a lot more 'growing' than those of adults. In summary, changes in NAA concentrations could be used as a marker for neuronal development but with fairly low sensitivity, and with quite a few doubts as to interpretation. As Ben pointed out, it's extremely unlikely that a study of four people could come to a meaningful conclusion. Re #55. Yes, it seems that neurons can change their shape and connectivity. (http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=16366735)
However, what NAA is measuring is roughly-speaking (because I’m not an expert and no-one is sure anyway) the density of normally-functioning neurons. So that gives a high figure in adults, and a considerably lower one in babies: but infant brains are doing a lot more ‘growing’ than those of adults.
In summary, changes in NAA concentrations could be used as a marker for neuronal development but with fairly low sensitivity, and with quite a few doubts as to interpretation. As Ben pointed out, it’s extremely unlikely that a study of four people could come to a meaningful conclusion.

]]> By: Robert Carnegie http://www.badscience.net/2007/03/surrogate-outcome-proves-something-beyond-all-reasonable-human-doubt/comment-page-2/#comment-11901 Robert Carnegie Fri, 16 Mar 2007 22:21:44 +0000 http://www.badscience.net/?p=384#comment-11901 The recent view is that brain tissue does grow, surely? The recent view is that brain tissue does grow, surely?

]]> By: dynamo http://www.badscience.net/2007/03/surrogate-outcome-proves-something-beyond-all-reasonable-human-doubt/comment-page-2/#comment-11899 dynamo Fri, 16 Mar 2007 16:34:14 +0000 http://www.badscience.net/?p=384#comment-11899 More information for simongates #52: You can't see individual cells and synapses. NAA is normally used as a surrogate for 'functioning neurons and synapses', certainly not for growing neurons. Levels start out low at birth and have probably pretty much reached adult levels by about 18 y.o. A back-of-the-envelope calculation based on Pouwels et al. (Pediatric Research volume 46 p474 1999) shows that for these kids, brains '3 years older' would have about 3% more NAA. Unfortunately that's about the same sort of difference as you'd typically expect to see if you scanned someone two days in a row (i.e. noise). In other words if there really was that kind of difference, you'd struggle to see it with just four patients. If the research showed an 'astonishing' difference, then the kids brains were either abnormal before the treatment, or afterwards. Either way such a study could not possibly justify the claim that 'Scientists believe the results are powerful evidence of the harm “junk food” is doing to Britain’s children.' More information for simongates #52:

You can’t see individual cells and synapses. NAA is normally used as a surrogate for ‘functioning neurons and synapses’, certainly not for growing neurons. Levels start out low at birth and have probably pretty much reached adult levels by about 18 y.o. A back-of-the-envelope calculation based on Pouwels et al. (Pediatric Research volume 46 p474 1999) shows that for these kids, brains ‘3 years older’ would have about 3% more NAA. Unfortunately that’s about the same sort of difference as you’d typically expect to see if you scanned someone two days in a row (i.e. noise). In other words if there really was that kind of difference, you’d struggle to see it with just four patients.

If the research showed an ‘astonishing’ difference, then the kids brains were either abnormal before the treatment, or afterwards. Either way such a study could not possibly justify the claim that ‘Scientists believe the results are powerful evidence of the harm “junk food” is doing to Britain’s children.’

]]> By: Camp Freddie http://www.badscience.net/2007/03/surrogate-outcome-proves-something-beyond-all-reasonable-human-doubt/comment-page-2/#comment-11897 Camp Freddie Fri, 16 Mar 2007 15:50:25 +0000 http://www.badscience.net/?p=384#comment-11897 So the real non-story is: "A healthy diet, regular excercise and extra adult supervision increases the 'cleverness' of lazy fat kids." Perhaps if they said the lords prayer at bedtime, we'd get headlines saying that christainity makes people brainier... On second thoughts, it probably best not to give those nutters any ideas! So the real non-story is:
“A healthy diet, regular excercise and extra adult supervision increases the ‘cleverness’ of lazy fat kids.”

Perhaps if they said the lords prayer at bedtime, we’d get headlines saying that christainity makes people brainier…
On second thoughts, it probably best not to give those nutters any ideas!

]]> By: simongates http://www.badscience.net/2007/03/surrogate-outcome-proves-something-beyond-all-reasonable-human-doubt/comment-page-2/#comment-11894 simongates Fri, 16 Mar 2007 10:29:03 +0000 http://www.badscience.net/?p=384#comment-11894 And on the same line as #51; "Leading neuroscientist Basant Puri..." He's a psychiatrist isn't he? That's not the same as a neuroscientist is it? And as for "more connections and greater density of nerve cells", I'm not sure you can see individual cells and synapses on an MRI. All they're really saying here (with the absence of a control group) is that the brain scans didn't look quite how they expected. Which may have been something to do with their expectation. And on the same line as #51;

“Leading neuroscientist Basant Puri…” He’s a psychiatrist isn’t he? That’s not the same as a neuroscientist is it?

And as for “more connections and greater density of nerve cells”, I’m not sure you can see individual cells and synapses on an MRI. All they’re really saying here (with the absence of a control group) is that the brain scans didn’t look quite how they expected. Which may have been something to do with their expectation.

]]> By: Idolator http://www.badscience.net/2007/03/surrogate-outcome-proves-something-beyond-all-reasonable-human-doubt/comment-page-2/#comment-11893 Idolator Fri, 16 Mar 2007 03:00:49 +0000 http://www.badscience.net/?p=384#comment-11893 Don't know if anyone else has said so yet, but... [i]“It was as if these were the brains of children three years older. It means you have more connections and greater density of nerve cells, in the same way that a tree grows more branches.”[/i] [b]WRONG!!![/b] You're born with as many synapses ("connections") as you'll ever have. The total number [b]decreases[/b] with age. (Of course, there's no reason to think a professor of neuroscience should know that...) Don’t know if anyone else has said so yet, but…

[i]“It was as if these were the brains of children three years older. It means you have more connections and greater density of nerve cells, in the same way that a tree grows more branches.”[/i]

[b]WRONG!!![/b] You’re born with as many synapses (“connections”) as you’ll ever have. The total number [b]decreases[/b] with age. (Of course, there’s no reason to think a professor of neuroscience should know that…)

]]> By: Robert Carnegie http://www.badscience.net/2007/03/surrogate-outcome-proves-something-beyond-all-reasonable-human-doubt/comment-page-1/#comment-11892 Robert Carnegie Fri, 16 Mar 2007 02:36:48 +0000 http://www.badscience.net/?p=384#comment-11892 If I was told right, the kids were only advised to take a healthy diet, and are believed not to have done?? If this stuff is just sold as a weight cure then it serves everyone right, I think. If I was told right, the kids were only advised to take a healthy diet, and are believed not to have done??

If this stuff is just sold as a weight cure then it serves everyone right, I think.

]]> By: j http://www.badscience.net/2007/03/surrogate-outcome-proves-something-beyond-all-reasonable-human-doubt/comment-page-1/#comment-11881 j Thu, 15 Mar 2007 15:03:59 +0000 http://www.badscience.net/?p=384#comment-11881 Worryingly, some sensible organisations (e.g. MIND) have affiliated themselves to food for the brain, too. Worryingly, some sensible organisations (e.g. MIND) have affiliated themselves to food for the brain, too.

]]> By: gadgeezer http://www.badscience.net/2007/03/surrogate-outcome-proves-something-beyond-all-reasonable-human-doubt/comment-page-1/#comment-11874 gadgeezer Thu, 15 Mar 2007 12:04:53 +0000 http://www.badscience.net/?p=384#comment-11874 #47 and then some when one looks at the "Who Are We?" http://www.foodforthebrain.org/content.asp?id_Content=1604 All the usual suspects on the Advisory Board. The list of people/organisations who have donated time/money/resources is interesting (Equazen, Yorktest, Dr. Portwood). #47 and then some when one looks at the “Who Are We?”

http://www.foodforthebrain.org/content.asp?id_Content=1604

All the usual suspects on the Advisory Board. The list of people/organisations who have donated time/money/resources is interesting (Equazen, Yorktest, Dr. Portwood).

]]> By: standing_here http://www.badscience.net/2007/03/surrogate-outcome-proves-something-beyond-all-reasonable-human-doubt/comment-page-1/#comment-11871 standing_here Thu, 15 Mar 2007 10:51:32 +0000 http://www.badscience.net/?p=384#comment-11871 # 46 there's also a link straight from Portwood to Holford's Food for the Brain organisation. Apparently Portwood's part of Food for the Brain's team. http://www.foodforthebrain.org/content.asp?id_Content=1658 the whole nutritional woo business is beginning to look more inbred than the hapsburgs. # 46

there’s also a link straight from Portwood to Holford’s Food for the Brain organisation. Apparently Portwood’s part of Food for the Brain’s team.

http://www.foodforthebrain.org/content.asp?id_Content=1658

the whole nutritional woo business is beginning to look more inbred than the hapsburgs.

]]> By: j http://www.badscience.net/2007/03/surrogate-outcome-proves-something-beyond-all-reasonable-human-doubt/comment-page-1/#comment-11869 j Thu, 15 Mar 2007 01:53:24 +0000 http://www.badscience.net/?p=384#comment-11869 btw, as well as a link to Portwood, Prof. Puri's listed on the board of Holford's Food for the Brain organisation. Lots of fish in a small pond ;) btw, as well as a link to Portwood, Prof. Puri’s listed on the board of Holford’s Food for the Brain organisation.

Lots of fish in a small pond ;)

]]> By: Nickynockynoonoo http://www.badscience.net/2007/03/surrogate-outcome-proves-something-beyond-all-reasonable-human-doubt/comment-page-1/#comment-11860 Nickynockynoonoo Wed, 14 Mar 2007 20:02:55 +0000 http://www.badscience.net/?p=384#comment-11860 Thanks wewillfixit. I have posted on the forum. Cheers. Thanks wewillfixit. I have posted on the forum. Cheers.

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