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Joseph Marine, MD's avatar

Well done! I learned a lot from this analysis. Too much sloppy research out there designed to grab headlines and confirm preconceived notions. JAMA should publish this.

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Ernest N. Curtis's avatar

Unfortunately, much of the general public thinks the AMA is some kind of official organization that speaks for the bulk of medical practitioners. It has never been much more than a political action group whose purpose was to lobby for policies that would benefit their members. I don't know the current numbers but during my many years of medical practice it was often said that about 10% 0f M.Ds were members. Nobody that I knew or worked with paid any attention to what they said or did.

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Edward  H Livingston, MD, FACS's avatar

You are correct-Probably less thab 15% of physicians belong to the AMA. Even when I worked there, they never gave those numbers out.

You could tell there were very few members by how few showed up at the annual meeings-Many of the meeting rooms were nearly empty.

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prakash Sankaran's avatar

Wonder if transport of the pollutants through local weather circulations may have caused similar death rates in the control areas specified,need to exclude this possibility by reference to a meteorological review of the affected days in question.

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Edward  H Livingston, MD, FACS's avatar

The fires were caused by Santa Ana winds. Those wind conditions persisted throughout the month of January when the fires were active.

Below is a description of what Santa Ana winds are. when I grew up, they were called the east wind because they came from the east and blue towards the ocean on the west.

“Santa Ana winds originate from high-pressure air masses in the Great Basin region (including parts of Nevada, Utah, and the Mojave Desert) and the inland deserts of the southwestern U.S

They blow towards the coastal areas of Southern California and offshore, typically from the northeast or east direction, channeling through mountain passes and accelerating as they descend to the ocean.”

Edward H. Livingston, MD, FACS, AGAF

Health Sciences Professor of Surgery

On Aug 28, 2025, at 9:41 PM, prakash Sankaran <forum@mg1.substack.com> wrote:

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prakash Sankaran commented on your post No, The LA Fires Did Not Cause Excess Deaths as Reported in JAMA.

Wonder if transport of the pollutants through local weather circulations may have caused similar death rates in the control areas specified,need to exclude this possibility by reference to a meteorological review of the affected days in question.

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Steve Cheung's avatar

Great post.

Really makes you wonder where peer review has disappeared to at JAMA.

Also makes you wonder what the editor at JAMA is doing, rather than his/her job. Mind boggling that causal language is even permitted based on data of this type, irrespective of the common sense/local knowledge issues that the authors lacked in this case.

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Edward  H Livingston, MD, FACS's avatar

Apart from the problem of using causal language to describe findings from observational studies – which should never be done – the data used to support the study were labeled by the CDC as “provisional”.

Provisional data should not be used to make definitive statements about any relationships let alone ones that are causal.

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Janine Melnitz's avatar

JAMA was terrible in the 90’s during my residency and continues to this day. The AMA needs to be disbanded and redone from scratch.

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Barry's avatar

It seems like the next step is to see how large the area of excess deaths might be. Perhaps a lot of people affected by the fires moved temporarily north and east and some died there. But it definitely seems to be a signal worth investigating in its own right. Also, by my perusal of a map, it seems Santa Ana winds are northeast winds, moving south westerly, not south easterly as declared in the post.

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Dr. K's avatar

This is a marvelous and appropriate analysis. I hope the authors will attempt to get this printed in JAMA as, sadly, their reach is far beyond yours.

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Adam Cifu, MD's avatar

Amazingly, an article with an average read here is read by more people than any article (save one) that I ever published in JAMA.

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Edward  H Livingston, MD, FACS's avatar

I can attest that since I lived, ate and breathed JAMA performance statistics for many years. Sensible Medicine has many more readers than JAMA does. You’d be surprised how small the readership of JAMA really is.

That is why my preferred venue for this article was Sensible Medicine rather than JAMA.

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Maria Ines Azambuja's avatar

Very good observations.

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Rudy P Briner,MD's avatar

I appreciate "COD reports are not reliable!" Seems to be such low lying fruit for study to improve "Medicine!"

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