A large painting by Regina Holliday called “Give Us Our Dammed Data” shows 17 book authors, each holding the book they’d written about struggle with the health care system. For example, Lisa Lindell, who wrote 108 Days, which describes
her successful campaign to keep her husband alive. She was astounded when she read her husband’s medical record. The nurse’s notes specified that she had an “unreasonable” belief that her husband should live.
A Duke University associate professor named Anil Potti who does cancer research turns out to have fabricated numerous details on applications for research money. The first fabrication to be noticed was that he had received a Rhodes Fellowship.
This is interesting because Duke had previously investigated him:
Late last year [2009], there was a crescendo that caused Duke to stop clinical trials on three of his research programs, two involving lung cancer and one involving breast cancer. In each program, Potti was giving patients chemotherapy — determining what drugs might work best and in what dosage — based upon his genome research.
In January Duke let these programs resume after an internal review. [emphasis added] And these are the precise programs where Duke — for the second time — has now suspended new [emphasis added] enrollments. . . . In an official statement on the winter review, Duke said it had determined Potti’s approaches were “viable and likely to succeed.”
Someone who appears to be a total fraud is called to Duke’s attention — and they find him innocent! This is what happened with the SEC and Madoff and Memorial University and Ranjit Chandra. Chandra’s research assistant, a nurse, told Memorial something was wrong and Memorial did nothing, or very little. Chandra then sued the nurse. He went on to write the paper that Saul Sternberg and I investigated.
Someone lies on his resume — it happens. That a prestigious institution like Duke let him continue to get away with it, possibly endangering patients and surely wasting vast resources, after it’s brought to their attention — not so well-known. So far, the New York Times has only covered the false-resume side of the story. You may recall how poorly Duke responded to charges against its lacrosse team.
As this unfolded, Duke had the following headline on its website: “Crisis management 101: What can BP CEO Hayward’s mistakes teach us”. From a CNN story in which a Duke expert was quoted.
Duke.Fact.Checker notes that Potti’s papers have at least 26 co-authors! Many with M.D.’s, who have or will tell thousands of trusting patients “you should take Drug X”. The patient endangerment is not trivial.
The Cancer Letter on Potti. Another issue of The Cancer Letter about it.
I came across the Potti scandal while trying to find out about the trouble faced by a woman named Joan Evans because a statistical analysis couldn’t be reproduced. Robert Gentleman had mentioned this in a talk at the Joint Statistical Meetings in Vancouver. Look for The Cancer Letter, Gentleman said.
I now realize that Joan Evans is Joe Nevins, who co-authored a major paper with Potti.
Speaking of Potti, members of the Duke administration are said to “have warned people not to even Google the name ‘Anil Potti.’”
The FBI recently sent a letter to the Wikipedia Foundation saying it should take down an image of the FBI shield — that is, a picture of an FBI badge — and threatened legal action. Supposedly the Wikipedia Foundation was breaking a law by posting it.
The Wikipedia Foundation responded that
The law cited in the F.B.I.’s letter is largely about keeping people from flashing fake badges or profiting from the use of the seal
If nobody knows what an authentic badge looks like it becomes easier to fool people with a fake badge.
I’m in Vancouver for the Joint Statistical Meetings. The local Whole Foods sells a small bottle of kombucha for $22. It’s in a refrigerator in the health section, next to flaxseed oil. I asked an employee how this kombucha was different than the kombucha sold in the drinks section. More potent, she said. The next time I give someone homemade kombucha I’ll say that it sells for $22 in Canada.
Kombucha, let me repeat, is extremely easy to make. Tea + sugar + store-bought kombucha + three weeks.
Thanks to Paul Sas, Ryan Holiday, and Casey Manion.
In this interviewer Craig Venter says that sequencing the human genome has had “close to zero” medical benefits so far. I thought this comment was even more interesting:
The human genome project was . . . supposed to be the biggest thing in the history of biological sciences. Billions in government funding for a single project — we had never seen anything like that before in biology. And then a single person comes along and beats scientists who have been working on it for years.
The government-funded people used inferior methods, said Venter:
Initially, Francis Collins and the other people on the Human Genome Project claimed that my methods would never work. When they started to realize that they were wrong, they began personal attacks against me.
The government-funded research was high in quantity (“billions”) but low in quality.
A similar story emerged from the Netflix Prize competition. Netflix had in-house researchers who had tried to do the same thing as the competitors for the prize: predict ratings. The algorithm they’d developed took two weeks to run. According to my friend David Purdy, one of the competitors for the prize managed to compute the same thing in an hour, the same sort of speed-up that Venter is talking about. The in-house research was high in quantity (it had been going on for years) but low in quality.
From my point of view, a similar story comes from my self-experimentation. Working alone, with no funding, I found several ways to improve my sleep — avoiding breakfast, standing a lot, standing on one foot, eating pork fat, etc. In contrast, professional sleep researchers have found nothing that has helped me improve my sleep. There are hundreds of sleep researchers and they’ve received hundreds of millions of dollars in funding.
Why such big differences in outcome? I think it has to do with the price of failure. When the government-funded genome researchers used inferior methods, nothing happened. They’d already gotten the grant. In contrast, Venter’s group got nothing until they succeeded. In the case of the Netflix in-house researchers, use of inferior methods cost them nothing; they still got paid. Whereas the prize competitors didn’t get paid unless they won. Use of inferior methods would cause them to lose. In the case of the sleep researchers, lack of practical results cost them nothing. They could still have a successful career. Whereas to me, without practical results I had nothing.
Thanks to Paul Sas.
I discovered via self-tracking that I could get my fasting blood sugar much closer to optimal by walking an hour per day. This took me a year to figure out and I discovered it by accident. Phil commented that I could have learned the same thing more quickly by searching websites or asking my doctor.
Whether I was rediscovering the fairly obvious is important to me. This website by Janet Ruhl, who has diabetes, is named “How to get your blood sugar under control”. Its advice says nothing about exercise, much less walking. Here’s one reason why:
I [Ruhl] currently control my own diabetes using a fairly low carbohydrate diet and very low doses of fast acting insulin at meal time. . . . At one point I exercised daily for a year and got my body fat down to 24%, which put me into the “Fitness” category for a woman my age. Despite what my doctors had told me, weight loss and intense fitness didn’t do a thing for my blood sugars, which got worse.
Emphasis added. I too did recommended amounts of aerobic exercise. I too found my blood sugar was nevertheless unpleasantly high. The usual recommendation of aerobic exercise may make it less likely you will do the long low-intensity exercise (ordinary walking) that my results suggest works. You may think: I’ve already exercised. I’m tired.
I could watch these video clips (also here) all day. You may have learned about Doug Lemov from this NY Times Magazine article. The quote “without great teachers, nothing else matters” is from the website of the organization (Uncommon Schools) that Lemov founded. The clips show techniques he has isolated that great teachers use in elementary school.
My research is fundamentally about deficiency diseases. I find things present in Stone Age life but absent now whose absence causes problems. Sometimes I work backwards (from present to past): why am I not sleeping well? This turned out to have a Stone-Age-related answer. Sometimes I work forwards: I study something present in Stone-Age life but not now and learn it makes things better: standing (better sleep), morning faces (better mood).
So I know a lot about deficiency diseases. One curious thing about them is the opportunity they present. Without scurvy, we wouldn’t have discovered Vitamin C. Once we’ve discovered Vitamin C, we can figure out the optimal amount, possibly leaving us better off than before scurvy became a problem.
This is what I thought as I watched these clips. Formal education is unnatural. No wonder it’s so hard. These clips, however, show that with considerable understanding of psychology you can solve the problems it presents. And perhaps leave us better off than before formal schooling began.
Susan Allport, having written The Queen of Fats, unsurprisingly eats a diet high in omega-3 and low in omega-6. For one month, however, she ate a diet with more omega-6 and less omega-3 and wrote about it– like Supersize Me, except far more realistic.
O magazine commissioned a story about it but didn’t run it. “My weight gain was only 0.5 pounds and they thought their readers wouldn’t see the importance of that,” says Allport. Her draft is here. There were three striking changes over the month: the omega-6/omega-3 ratio in her blood doubled (implying that this ratio is controlled by diet rather than by stored fat); her belly fat noticeably increased; and the elasticity of her arteries decreased by 20%. This supports Allport’s belief (and mine) that omega-6 is dangerous when consumed in large amounts, as it is if you eat a lot of food cooked in vegetable oil.
The American Heart Association recommends that Americans eat more omega-6. The justification of this recommendation says nothing about the Israeli Paradox, which to me is the best reason to avoid a diet high in omega-6. Allport’s experience is another reason.
Allport is also the author of Explorers of the Black Box, about neuroscience research.