lancet

Apparently I am on “mea culpa watch” from Tyler Cowen, Picture me at present pursing my lips and flapping my wrist in the international signal for “ooh! Get her!”. I have looked at the NEJM study, had a look at some of the online discussion of it, and I think that few of my friends and few of my enemies will be disappointed to learn that my response is not so much “mea culpa” as “pogue mahone”. In particular, see below the fold for a list of apologies not forthcoming, additional castigation, and new heretics who need to be squelched.
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A new study estimates violence-related mortality in Iraq between 2003 and 2006:

Background Estimates of the death toll in Iraq from the time of the U.S.-led invasion in March 2003 until June 2006 have ranged from 47,668 (from the Iraq Body Count) to 601,027 (from a national survey). Results from the Iraq Family Health Survey (IFHS), which was conducted in 2006 and 2007, provide new evidence on mortality in Iraq.

Methods The IFHS is a nationally representative survey of 9345 households that collected information on deaths in the household since June 2001. We used multiple methods for estimating the level of underreporting and compared reported rates of death with those from other sources.

Results Interviewers visited 89.4% of 1086 household clusters during the study period; the household response rate was 96.2%. From January 2002 through June 2006, there were 1325 reported deaths. After adjustment for missing clusters, the overall rate of death per 1000 person-years was 5.31 (95% confidence interval [CI], 4.89 to 5.77); the estimated rate of violence-related death was 1.09 (95% CI, 0.81 to 1.50). When underreporting was taken into account, the rate of violence-related death was estimated to be 1.67 (95% uncertainty range, 1.24 to 2.30). This rate translates into an estimated number of violent deaths of 151,000 (95% uncertainty range, 104,000 to 223,000) from March 2003 through June 2006.

Conclusions Violence is a leading cause of death for Iraqi adults and was the main cause of death in men between the ages of 15 and 59 years during the first 3 years after the 2003 invasion. Although the estimated range is substantially lower than a recent survey-based estimate, it nonetheless points to a massive death toll, only one of the many health and human consequences of an ongoing humanitarian crisis.

150,000 violent deaths in three years is a lot. You’ll recall that the Lancet study estimated about 655,000 excess deaths, which is a lot more. The two numbers aren’t directly comparable because excess deaths due to violence are only one component of all excess deaths (e.g., from preventable disease or other causes attributable to the war). Deaths due to violence rose from a very small 0.1 per 1000 person years in the pre-invasion period to about 1.1 per 1000py afterwards, or 1.67 adjusting for estimated underreporting. This is where the authors get their 151,000 number. The overall death rate rose from about 3.2 per 1000 person years to about 6, an increase of just over 2.8. Depending on whether you use the raw or adjusted estimated rate of violent death this would work out to an overall excess death total of just under 400,000 or just over 250,000. (But this is just a back-of-the-envelope calculation, as the overall death rate isn’t reported.)

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A bunch of rightwing blogs are getting excited yet again about Scott Beauchamp. For those who haven’t followed the story, Beauchamp is a US soldier in Iraq who wrote some pieces for The New Republic which, among other things, described bad behaviour by US troops, such as deliberately running over stray dogs and taunting a woman disfigured by burns. The pro-war lobby has worn out dozens of keyboards seeking to discredit Beauchamp, his story and the very possibility of running over dogs in an armoured vehicle. Now it appears the US Army has denied Beauchamp’s claims. (To reiterate, I don’t care about or intend to debate, or even to link to, the details of this case).

Some might suggest that the truth or falsity of these stories doesn’t matter much in the light of this. or this or this or this, to list just a few of the disasters have taken place while the wingnutosphere has been defending the US Army’s commitment to animal welfare.

But that would miss the point. What matters, in the world of rightwing postmodernism, is not reality but the way the media reports it. One bogus memo is enough to turn George W. Bush from a scrimshank who used his family connections to line up a cushy billet to avoid war service, and then shirked even that, into a war hero.

So, lets stick to media criticism. Not long after Beauchamp’s piece ran in a single magazine of modest circulation, all the major MSM outlets ran a story by well known critics of the war, Michael O’Hanlon and Kenneth Pollack whose intrepid journey through recently pacified parts of Iraq had convinced them that the surge was working. Here, for example, is their piece in the NY Times.

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Good news readers! I’ve gone mad! I don’t know what it was that tipped me over the edge but I’m now a signed up 27%er and I’ve decided to start applying my new grasp of the scientific method! After all, our scientific institutions are being destroyed by the leftist politicised science of global warming and the Lancet study, and that’s just not on. Luckily my cheerful attitude and can-do approach to statistics survived my trip to the dark side so I’ve been hard at work all morning applying the sort of tenacious scientific critique that my new status as a crazy person allows me to carry out with no qualifications whatever.

I started with the UK Census. I’ve always thought that there were maybe a few more, or possibly less, ethnic minorities in Camden than the census said, so I phoned them up and asked for the data. The woman on the end of the line pointed me toward their website and noted that there was quite a lot of county-level data there which might be helpful. I explained that no, I wanted the data, by which I meant the actual census forms. They won’t release the data! Really! I shouted that this was a fundamental building block of the scientific method, and that her sinister refusal to hand over the forms to any random person who asked was the equivalent of the Catholic Church burning Galileo[1]. While she was on the line, I asked for the last month’s death figures for Central London – after all, since she’s the central registering authority for births and deaths, she ought to have them at her fingertips as they must magically update every time a hospital morgue writes a certificate. I think she was in tears by the time she slammed the phone down, so Advantage: Blogosphere!

Next on to the Dow Jones Industrial Average people. Did you know that there are three entire missing days from their figures, which suspiciously enough[2] just “happen” to be September 12-15, 2001???????Q? I suppose we are meant to assume that this “missing cluster” was selected at RANDOM Some chance. Clearly the leftist MSMs of Dow Jones International censored these numbers, because they would have added so much to the variance of the DJIA that we could no longer be sure that it wasn’t 36,000! Perfidy! Wal-Mart are releasing their Q2 earnings numbers next week, or at least I should say “releasing” their “numbers”, because as I found out, when you go down to Bentonville demanding a look at the till rolls, you don’t even get let into the car park. Scientific method, my ASS!

Stay tuned for more science, readers, because until this case of Red Bull runs out, I am going to be a blogoscientific force of nature!

[1] Galileo was not actually burned, but I am now a right wing crazy person, so this kind of factul nitpicking no longer bothers me.

[2] The fonts are a lot more fun on this side of the political divide too.

The rightwing blogosphere, with assistance from the usual MSM types like Howard Kurtz has spent the last week or two trying to discredit a soldier, Scott Beauchamp, who wrote a “Baghdad Diary” for The New Republic, which included various examples of casually callous behavior on the part of US soldiers (nothing on the scale of Abu Ghraib or other proven cases).

For the wingers, this is a continuous pattern. Before this, there was a flap about a report that failures by contractors were resulting in troops in the field not getting adequate food. Before that, it was the Jamil Hussein case, a months-long brawl with AP arising from a report by a stringer about attacks on mosques. Before that, it was reports from Lebanon of ambulances being hit by Israeli fire. And so on.[fn1] There’s too much of this to try and give comprehensive coverage, and I’m not interested in debating the details, but a search on Instapundit will usually get you started.

The Beauchamp case fits the general pattern pretty well. First, the wingers claimed that the Diary was a fabrication and that “Scott Thomas” was the creation of a writer who’d never been near Iraq. Then, when it became evident he was a real person, they rolled out the slime machine to discredit him. Then they engaged in amateur forensics to discredit particular items in his account (acres of screen space have been devoted to the question of whether the driver of a Bradley fighting vehicle can run over a dog). Then they got to the central point – true or false, material like this is bad for the cause and shouldn’t be printed.

All of this, of course, is an attempt to replicate the one undoubted triumph of the blogospheric right, Rathergate. For those who somehow missed it, Dan Rather and CBS fooled by a bogus memo purportedly from Bush’s National Guard commander, and Rather eventually lost his job as a result.

As I said, I’m not interested in, and won’t debate, the details of these stories. The main question is: How anyone could imagine that this kind of exercise can have any value?

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(Initial bad temper warning: I am a little bit cross as I write this, because I think that the distribution of the paper on the Michelle Malkin website was both silly (because the paper has huge flaws that a mass audience can’t possibly be expected to understand) and rude (because at the time when he gave permission for it to be distributed, David was soliciting comments, seemingly in good faith, from the Deltoid community, aimed at improving it before distribution). The Malkin link has meant that this paper has metastatised and I will therefore presumably be dealing with cargo-cult versions of it by people who don’t understand what they’re talking about from now to the end of time. I see that Shannon Love of the Chicago Boyz website is claiming to have been “sweetly vindicated”, FFS. Ah well, the truth has now got its boots on, and big clumpy steel toe-capped boots they are too. C’mon boots, let’s get walking.)
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Really rather shameful. Riyadh Lafta, one of the co-authors of the Johns Hopkins/Lancet studies on excess deaths in Iraq, has been refused a transit visa for his flight to Vancouver to make a presentation on alarming increases in child cancer. He was apparently meant to be passing on some documentation to some other medical researchers who are going to write a paper with him on the subject; the presentation was happening in Vancouver because Dr. Lafta had already been refused a visa to visit the USA.

What on earth can be in this data? Presumably the UK and US authorities have reasoned that Dr Lafta is an ex Ba’ath Party member (as he would have had to have been to hold a position in the Iraqi Health Ministry), and thus the data he is carrying is not really about child cancer at all. Perhaps he is involved in some sort of “Boys from Brazil” type plot to clone an army of super-soldiers from Saddam Hussein’s DNA, and for this reason the UK cannot be exposed to this deadly information for even four hours in the Heathrow transit lounge.

The alternative – that Dr Lafta is being intentionally prevented from travelling in order to hush up his research on post-war deaths (research which even the Foreign Office have now more or less given up on trying to pretend isn’t broadly accurate), or to hush up the news about paediatric cancer for political convenience – is too horrible to contemplate. I’d note that there isn’t an election on in the USA at present, so the denialist crowd can shove that little slur up their backsides this time too.

(thanks to Tim Lambert as always)

In semi-related news, and with apologies to the person who gave me the tip for taking so long to post it, it appears that Professor Michael Spagat, the author of the “main street bias” critique, has a bit of previous form when it comes to making poorly substantiated and highly inflammatory statements about other people’s research. His involvement with the general issue came about because he’d been using some of the IBC data in support of a power law hypothesis[1] about the scaling of violent deaths. This carried on from previous work he’d done on Colombia, where he had also defended his own somewhat tendentious interpretation on the data by slagging off Human Rights Watch. I sense something of a pattern here; I noted in a previous post that although the “main street bias” critique appeared in the Lancet colloquium on the Burnham et al paper, Prof. Spagat himself did not, and I thought at the time it might be because of this habit.

[1] And one of Prof Spagat’s co-authors on the main street bias paper, and a few others in the power law of violence series was Neil Johnson of Oxford University, who was also a co-author of that paper about the Eurovision Song Contest that we had a go at a while ago, and so the circle of minor irritation is complete.

The Times has published a really quite bad piece of science journalism on the subject of the Lancet study. When the topic is sampling theory, your heart really does sink when you see something like this:

Several academics have tried to find out how the Lancet study was conducted; none regards their queries as having been addressed satisfactorily. Researchers contacted by The Times talk of unreturned e-mails or phone calls, or of being sent information that raises fresh doubts.

Yes indeed, out of the population of people with outstanding questions, none of them have had their questions resolved.
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When you make a bad prediction, you need to be sure that you don’t lose your nerve. The best thing to do is to assess your new information, pluck up your courage, and make a brand new prediction about something else …

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Here I am, talking about the Lancet study on “Counterspin”, the American radio program. Fans of incoherent mumbling, strangely reminiscent of the interviews that ended Shaun Ryder’s career, tune in. Or alternatively, copy one of my blog posts into Word and add the phrases “kind of”, “like” and “you know” every three words, to get a similar effect.

Daniel wrote a piece for the Guardian’s blog saying that critics who wanted to reject the findings of Burnham et al.’s Lancet paper and believe the Iraq Body Count estimate (or similar-sized numbers) were going to have to come out and claim that the paper was fraudulent, “and presumably to accept the legal consequences of doing so.” Well, now David Kane has floated that balloon.

Update: Kane’s accusations have been removed from the front page of the SSS blog. In a follow-up, Amy Perfors apologises for the error of judgment and says they removed the post because the “tone is unacceptable, the facts are shoddy, and the ideas are not endorsed by myself, the other authors on the sidebar, or the Harvard IQSS.” Good for them.

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Here are some comments from Andrew Gelman on the Burnham et al. paper. People who’d like (or ought) to learn more about statistics could do worse than read Gelman and Nolan’s terrific Teaching Statistics: A Bag of Tricks. I am slightly embarrassed to admit that I am awaiting the publication of Gelman and Hill’s Data Analysis Using Regression and Multilevel/Hierarchical Models with a degree of anticipation that seems indecent (or unhealthy) to direct at a statistics textbook. (More about the book here. Note the blurb from a well-known blogger.)

Not surprisingly, the publication by the Lancet of new estimates suggesting that over 600 000 people have died (mostly violently) in Iraq, relative to what would have been expected based on death rates in the year before the war, has provoked violent controversy. A lot of the questions raised about the earlier survey, estimating 100 000 excess deaths in the first year or so appear to have been resolved. In particular, the lower bound estimate is now around 400 000, so that unless the survey is rejected completely, there can be no doubt about catastrophic casualties.

One number that is striking, but hasn’t attracted a lot of attention is the estimated death rate from air strikes, 13 per cent of the total or between 50 000 and 100 000 people. Around half the estimated deaths in the last year of the survey, from June 2005 to June 2006. That’s at least 25 000 deaths, or more than 70 per day.

Yet reports of such deaths are very rare. If you relied on media reports you could easily conclude that total deaths from air strikes would only be a few thousand for the entire war. The difference between the numbers of deaths implied by the Lancet study and the reports that shape the “gut perceptions” that the Lancet must have got it wrong are nowhere greater than here. So are the numbers plausible?

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Look, can we knock these two on the head, please, gang? I realise that we have no chance of stamping out these fallacies all over the internet – it’s almost as if there were a whole network of right-wing talking points sites out there all taking in each other’s washing! – but we can at least stop regurgitating them ourselves.

1. Iraq is a young country. Therefore, it has a low “crude” death rate. “Crude” in this case means “not adjusted for demographic structure and therefore not meaningfully comparable across countries”. Therefore, it is not surprising that pre-war Iraq had a crude death rate similar to that of Denmark, any more than it is surprising that any other two completely non-comparable statistics might happen to be the same number.

2. When someone dies, you get a death certificate from the hospital, morgue or coroner, in your hand. This bit of the death infrastructure is still working in Iraq. Then the person who issued the death certificate is meant to send a copy to the central government records office where they collate them, tabulate them and collect the overall mortality statistics. This bit of the death infrastructure is not still working in Iraq. (It was never great before the war, broke down entirely during the year after the invasion when there was no government to send them to and has never really recovered; statistics agencies are often bottom of the queue after essential infrastructure, law and order and electricity). Therefore, there is no inconsistency between the fact that 92% of people with a dead relative could produce the certificate when asked, and the fact that Iraq has no remotely reliable mortality statistics and quite likely undercounts the rate of violent death by a factor of ten.

Go on and sin no more, or at least not on our Lancet comments threads.