Comments on: Nobel

By: James Wimberley

James Wimberley — Wed, 05 Oct 2005 10:56:34 +0000

A rejoinder in the little subthread I started on the economic value of M&W’s discovery. In 22 ogmb writes: “Well, it maintained the level of (health) benefit at roughly $10bn less cost.”
That can’t be quite right. M&W isn’t a panacea and I believe drugs are still used alongside it, so there is a mix of complementarity and substitution. Clearly the range of effective treatments has increased. The other problem is that the Zantac patent has expired and Glaxo’s rent has gone, so the cost would have collapsed anyway.
Perhaps it’s best to reason in terms of consumer’s surplus: €10bn is a lower bound (not a central estimate) for Zantac, ergo for M&W.

By: John Quiggin

John Quiggin — Wed, 05 Oct 2005 07:16:34 +0000

Thanks for the Sagan reference, brendan, it looks interesting.

By: ogmb

ogmb — Wed, 05 Oct 2005 06:31:12 +0000

negative economic value: that is, it reduced the income of pharmaceutical companies by $10bn while only maintaining the level of benefit to patients.

Well, it maintained the level of (health) benefit at roughly $10bn less cost.

By: antirealist

antirealist — Wed, 05 Oct 2005 03:06:52 +0000

And another thing.

At least half of the western population is infected with H pylori – probably a lot more – but the prevalence of peptic ulcer disease is only around 10%. Nothing in the brilliant and paradigm-shifting work of Warren and Marshall alters or explains the facts that peptic ulcers are commoner in smokers, boozers, people with blood group O, and people in stressful situations.

Popular accounts which treat peptic ulcer disease as just an infectious disease caused by H pylori are simplistic misrepresentations of what is known about this disorder.

By: antirealist

antirealist — Tue, 04 Oct 2005 21:31:11 +0000

Whatever else we think or know about stress, it seems clear that it is something experienced. So it’s hard to see quite how the concentration of a chemical can be at the centre of the stress concept cluster. To me, this seems like a kind of category mistake.

By: Daniel

Daniel — Tue, 04 Oct 2005 20:07:27 +0000

I daresay I will survive

By: antirealist

antirealist — Tue, 04 Oct 2005 20:02:42 +0000

…the physical symptom at the centre of the cluster is elevated levels of the hormone cortisol…

The word “symptom” does not means what you think it does.

By: Daniel

Daniel — Tue, 04 Oct 2005 19:36:54 +0000

Is anyone aware of a definition in the medical/psychological literature of ‘stress’?

It is a sort of cluster concept, but the physical symptom at the centre of the cluster is elevated levels of the hormone cortisol AFAICT.

By: Slocum

Slocum — Tue, 04 Oct 2005 16:33:22 +0000

It is interesting the things that the medical establishment ‘knows’ with certainty until somebody bothers to check. When my daughter was born (not so long ago in 1989) I was soundly chewed out by a nurse in the hall while wheeling my newborn daugher back to the nursery because I’d laid her on her back (she was awake and looking up at me at the time), “We NEVER lay babies on the backs here!”. And then just a few years later, somebody actually did a bit of empirical research and found the risk of crib-death was highest when babies were on their stomachs. Ooops.

By: SeanD

SeanD — Tue, 04 Oct 2005 15:44:20 +0000

Is anyone else completely at a loss as to ‘stress’ is supposed to be? It is, I think, supposed to have something to do with being busy, and, as the post mentions, not having control over why one is busy or what one is busy doing. But I think it would be widely agreed that not being busy can be stressful—chronic unemployment is, after all, hardly restful, even if one manages to get by economically.

Medically, stress seems to be a catch-all: go see your doctor with practically any non-specific system, and the diagnosis will be stress or some stress-induced condition. And though stress-related stomach problems are no longer chalked up to ulcers, that catch-all has been replaced by IBS and GERD as manifestations of stress. In my experience these diagnoses are in practice interchangeable- one doctor’s IBS is another man’s GERD, with drugs to match.

Is anyone aware of a definition in the medical/psychological literature of ‘stress’? My feeling would be that it’s a sort of cluster concept, like ‘game’- though it lacks defining characteristics, everyone knows its there.

By: bob

bob — Tue, 04 Oct 2005 15:30:36 +0000

For what it is worth, ISI has “predicted” the 2005 Nobels based on citation analysis. (So far they’ve been zero for two, despite guessing three different possible awards in each category. The same thing happened in 2004). See http://scientific.thomson.com/news/newsletter/2005-08/8289814/

By: Peter Clay

Peter Clay — Tue, 04 Oct 2005 13:10:36 +0000

What’s a fair economic value for Marshall and Warren’s discovery?

If you take the arguments commonly made for expanding patentability and apply them, it is possible to argue that it had negative economic value: that is, it reduced the income of pharmaceutical companies by $10bn while only maintaining the level of benefit to patients. In the pro-patent world, mere techniques like this should be patentable so that all of the economic value recieved by patients can be expropriated by the inventor of the technique.

By: John Emerson

John Emerson — Tue, 04 Oct 2005 13:01:16 +0000

“The prevalence of stress-related diseases increases as you go down hierarchies of authority, status and so on.”

In the same way that physically dangerous or debilitating work is passed down the chain of command to the peons, so is stress.

I don’t know if statistics are kept, but heads of state seem to live longer than anyone else. Being catered to and flattered, having people doing what you tell them to do, and having people available to take on all the unpleasant tasks—these are all good for your health.

The exceptions prove the rule. For example, Nicolae Ceaucescu only lived to the age of 71, but I’m sure he would have lived to 90 if he’d succeeded in maintaining his status.

By: Walt Pohl

Walt Pohl — Tue, 04 Oct 2005 12:32:56 +0000

The fact that Daniel beat me to the joke I was just about to make is the sign of a sinister conspiracy.

By: Daniel

Daniel — Tue, 04 Oct 2005 12:20:33 +0000

by the way, the reason JQ is being so coy about his predictions is presumably that he has won it but has been told not to spoil the announcement.