The Need for Detail

A quick post tonight.

When it comes down to it, Epidemiology depends upon detail. By that I mean counting incidences. Big studies, such as Doll’s  Doctors Study, start off with very big numbers of individuals. It is generally supposed that the very big number of individual to start with justifies conclusions which apply to the whole population. But there is a problem. The reality is that the vast majority of individuals survive or die, for various reasons, randomly. They die randomly both in time and in cause of death. Thus, what seems to be a very large number of people actually becomes a random set of individuals. It would not matter if the number involved was one hundred or one million.

Take thalidomide. The FACTS were that some pregnant women who used thalidomide produced deformed children. It matters that most pregnant women who took thalidomide did not produce deformed children. The effect of using thalidomide was specific to those women and fetuses who were susceptible. Note, not for a moment am I defending thalidomide. It was an abomination. What I mean is that there may have been other factors which rendered some pregnant women at risk.


The important thing is, “What renders some people to be more at risk?” Thus, it is not sufficient to say that smoking causes lung cancer. You have to ask who are the individuals who are most ‘at risk’. But would those people who are most at risk of developing LC do so even if they did not smoke? No one knows. Why? Because no one knows what the risk of developing LC is. LC accounts for only some 7% of deaths. The Doctors Study only showed only that most LC deaths occurred among smokers, but that such deaths were infrequent from that cause. Given that almost everyone smoked, and SHS was everywhere, it is easy to attribute LC deaths to smoking. That is the easy conclusion. It is easy, and easily acceptable.


But the reality is that LC deaths continue, although not as much as previously.

Half a million people die every year in this country. Each individual who dies, does so from a specific cause. But that specific cause does not really describe what factors were involved in that person’s death. There are many factors, such as heredity. Those factors cannot be ignored.

But they have been, and, the more that knowledge expands, the more that such factors are ignored. That is a contradiction, and can only come from idealism.


2 Responses to “The Need for Detail”

  1. michaeljmcfadden Says:

    The Angel is in the details!

  2. garyk30 Says:

    Lung cancer deaths are down; but, the incidence rate of lung cancer is higher.
    That modern medicine can prevent some such deaths is a tribute to medicine; not,in any way, to the anti-smokers.

    All people die and all people have almost exactly the same probability of NOT dying from one disease or another.

    Doll’s Doctor Study did show the 85% of deaths were from the diseases ’caused’ by smoking, regardless of one’s smoking habits or lack thereof.

    Antis strive for a ‘smoke free world’; but, in that world everyone would still die and 85% of those deaths would still be from the diseases ’caused’ by smoking.

    The antis egos will not admit error; so, blame will be laid on salt, sugar, obesity,or something else.

    That has already begun, seems that they have noticed the reality of the World.

    Reality does have a cruel way of intruding on the ‘Visions of the Annointed /Elite’.

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