33 Comments
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daniel corcos's avatar

Confounding can also hide a relationship, as in this example:

https://twitter.com/daniel_corcos/status/1559922528021266435

Even professional epidemiologists can be misled.

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Dan's avatar

Or in other words; people in good health tend to live longer.

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HardeeHo's avatar

So the Japanese tubs avoid the issue. Good to know, but haven't seen many in houses I've lived in. Wonder if adding a sauna is easier?

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Laura Henze Russell's avatar

The Finns are, of course, the happiest country in the world. Again. (couldn't resist)

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Hans VanderLugt's avatar

The prime contributor to their unbearable happiness being the easy access to saunas of course.

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Ruth Butros's avatar

Thanks for this. If I hear one more conversation about diet and exercise at a family function (where everyone is an "expert ") I'm going to vomit. This is borderline idolatry and becomes a measure of your level of "positive-ness" and willingness to avoid all conversation about more serious, and possibly more challenging, issues. In fact, doesn't churnalism encourage this superficial interaction?

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Danielle Skaggs's avatar

“Our inner curmudgeon.” Now that made me smile.

Appreciative of the way you are systematically laying out what has always driven me nuts about these studies.

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Larry Hubbard's avatar

Kid comes home from school and tells dad he thinks he flunked his math test. Dad immediately fires back, "that's negative thinking son, stay positive." Son pauses for a bit and then says, " Dad, I'm positive I flunked my math test".

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Adam Cifu, MD's avatar

Love it.

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Karen's avatar

I'm an old white female who's curious. This post made me smile. As summer turns to fall in the PNW, I may buy a sauna. Thanks for your work.

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Purav Mody's avatar

Great article! I am more curious to know if Vinay and Adam are F1 fans like me ? and if yes who do they support

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Adam Cifu, MD's avatar

Yes and I've a got a serious soft spot for Carlos Sainz.

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Kristin's avatar

Can you provide analysis on all of the supplemental vitamin D claims, not only with covid, but in general?

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Tom Hogan's avatar

Could you guys provide some analysis of the following article about

"The Effects of Postprandial Exercise on Glucose Control in Individuals with Type 2 Diabetes: A Systematic Review"?

https://link.springer.com/article/10.1007/s40279-018-0864-x

The data is behind a paywall.

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Faye Flam's avatar

I'm not sure why you're looking a studies from so many years ago. One way to make this more relevant would be to pinpoint common statistical and logical errors in pre-pandemic health journalism and connect them to stories that led to unrealistic beliefs about universal masking or other pandemic mitigation measures.

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Adam Cifu, MD's avatar

Thanks. We'll get there.

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Faye Flam's avatar

I worked at a newspaper, and still write a column that appears in newspapers, so I know why these misleading stories keep getting published. The underlying problem might not be as obvious as you think.

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Adam Cifu, MD's avatar

I imagine that a lot of it is that the articles generate clicks. Maybe some is pay to play?

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Faye Flam's avatar

There's more to it than that. For one thing, many newspaper editors have the misguided idea that the amount of time a reporter should spend on a story is proportional to the story length. So they assign short items and don't want the reporter to spend much time on them. That's why short items are often shallow and poorly researched while the same publication will often run very thoroughly investigated and carefully written long stories.

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Dan's avatar

However, we see from many reporters conclusions & commentary there is a severe lack of critical thinking skills.

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Indigo B's avatar

“Because you are dealing with medical problems, like being sick or overweight—even if you do not yet carry formal medical diagnoses—you might be less optimistic than someone lucky enough to be in exceptional health.”

Or perhaps social biases, revealed in sentences such as the above, in which being “overweight”, whatever you mean by that, is described as a medical problem but somehow different from being sick, contribute to pessimism among the “overweight”?

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Ben's avatar

The obvious implication is that they are talking about having excess body fat, which is not good for health. However, Vinay does regularly make the same mistake that most people do by often talking about losing weight as opposed to becoming more physically fit. There's some overlap, but they're not always the same thing.

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Indigo B's avatar

I am aware of the obvious implication. However, there are other potential reasons for a correlation between overweight and pessimism, and negative stereotypes of people who are overweight should certainly be considered along with concerns about health.

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Ben's avatar

That's true. Shaming also plays a role, no doubt.

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Lucy's avatar

Ive been overweight and it is not healthy or fun. It indeed contributes to pessimism, or less upbeat outlook, as compared to my baseline being a healthy weight. Enough of the language policing please. It helps no one.

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Indigo B's avatar

“Language policing”, or merely expression of another potential reason for a correlation between overweight and pessimism? And how can you possibly know that my comment helps no one simply because you disagree?

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Laura Henze Russell's avatar

Perhaps you will move onto more consequential topics?

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Adam Cifu, MD's avatar

Just laying the groundwork for critiques of current stories. One more of these and then off to the races.

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Laura Henze Russell's avatar

Perhaps you could critique some the rosy journal articles about medical devices for which FDA has incredibly low standards for approval, which devices later had to be withdrawn from the market, and from many patients' bodies as well. Or for those who haven't yet seen Dopesick, the amazing documentary on the Sackler family's role in fueling the opioid crisis, the spin that Perdue Pharma put on a short letter in a medical journal and its relentless campaigns for pushing it out to physicians and patients. Churnalism is nothing compared to Devicenalism or Pharmaspinalism.

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Lucy's avatar

Substack is a large place. If you wish to read on different medical topics, im sure you can search and find. I think this newsletter is designed for a curious layperson ( such as myself) and broader topics as it relates to medicine/health. I for one am thoroughly enjoying and learning ( ie the sins of churnalism) as well as the varied essays ( ie Cifu’s personal essays).

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Andy Davis, MD, MPH's avatar

Good piece though my guess is the potential for reverse causality bias in the Optimism article was less than your discussion suggests. That would be the case if relatively few developed chronic disease in the 1-2 year window. Perhaps a sensitivity analysis could help gauge the threat to validity.

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J Lee MD PhD's avatar

Brilliantly done. Perhaps you could issue in synoptic fashion a numbered "List" of the Sins of Churnalism.

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