Wednesday, 31 October 2007

More minority report

More from the Minority Report (Ben Goldacre is currently hosting the reports):
"Dr Joel Brind and Dr Greg Gardner submitted detailed evidence to this inquiry that claims there is a causal link between breast cancer and abortion. They are critical of Beral’s meta-analysis because it omitted some studies which they considered valid and included others that he considered invalid. Dr Sam Rowlands made a similar accusation of Dr Brind’s submission, pointing out that several key papers were missing."
But here is what the main report has to say:
"Dr Richards told us that “if you compare women who keep their pregnancy with those who have an induced abortion, those who have an induced abortion are more likely to get breast cancer later on”.197 This is the comparative group that Dr Brind favours and the result is expected, since carrying a first pregnancy to birth is protective against breast cancer.198 However, if you look at the rates of cancer between women who have had an abortion and those who have not had children, the effect disappears."
Brilliant! Tell women that having an abortion will give them breast cancer because having a child is protective against breast cancer, and then 'protect' them by making terminations more difficult. And don't stop there, early childbirth will protect all women against breast cancer so ban contraception. Only one more step to the Handmaid's Tale and forced child bearing.

Here's some more:
"We are most concerned that no expert in foetal ultrasound was called upon to give answers to questions posed in this section, and that instead the committee relied on testimony from neurobiologists and paediatricians. Why was Professor Stuart Campbell, who pioneered this work, not called? This cannot be justified on the basis that he did not submit evidence because Fitzgerald was summoned to give oral evidence without submitting written evidence. This appears to be a serious omission. We hope that the reason was not because Campbell does not personally support a liberalisation agenda, whereas both Derbyshire and Fitzgerald do."
And from the main report:

"While 4D imaging is a useful technology in terms of identifying anatomical abnormalities,71 there have been no published scientific papers marking a contribution of 4D images to the scientific understanding of the neurobiology of foetal development and consciousness. Professor Maria Fitzgerald, from University College London, told us that “In terms of 4D imaging, I do not think it has told us anything about the development of the nervous system. An image of a body tells you nothing about the nervous system.”72 Professor Marlow added that “[4D imaging] is helpful in terms of prediction of abnormality and therefore one is able to see structures that one would not see in ordinary, two dimensional, real time, 3D ultrasound. I do not think it tells us any more about foetal development than we probably knew already.”73 This position is further supported by Professor Wyatt: “at the moment I think the consensus is they do not add a great deal in terms of the science.”"
Yep, rather than a great conspiracy to silence the 'pioneering' 4D king Prof. Campbell, the fact is they add nothing to the debate about foetal pain because they are just pictures.

How about Anand where the Minority Report said:
"The RCOG...are ‘unaware of the work of Dr Anand or any other work that contradicts the basic findings of (their) review’. For the RCOG to report the studies of researchers who share their own official position, whilst ignoring research published by other leading researchers with contrary views, is at the very least misleading and at worst a serious abuse of power. It seems bizarre that the RCOG has not made more of an effort to find out more about contrary evidence before making such a bold public statement. It surely owes both Anand and Parliament a formal apology and explanation of why it has apparently ‘cherry picked’ the scientific evidence to support its opposition to a lowering of the 24 week upper limit for abortion."

Here's the main report:
"Although we did not receive evidence from Professor Sunny Anand, nor did any of those originally submitting evidence refer to his work or publications, we did consider a review article co-authored by him which was published recently,53 together with submission from Dr Stuart Derbyshire which offers commentary upon it and refers to Dr Anand’s earlier work in this area.54 We note that the main thrust of his important previous work has been to show neonates have better outcomes when provided with anaesthesia and analgesia during surgery and other stressful procedures and that noxious stimuli during gestation can have a detrimental impact on the long-term development of an infant; we have been unable to see the direct relevance of this work to the question of abortion."

Yep, the Committee were unable to find what this important work Anand is supposed to have done is, other than writing a review article which makes no sense.

It is interesting to compare the Minority Report to the Dispatches documentary, all the same faces crop up, Campbell, Anand, none of whom actually have anything scientific to say, I wonder if there might have been some coordination going on?

More abortion

Via Badscience, the Commons Science and Technology Committe report on abortion is out today, (as is the minority report):
"The Committee concludes that while survival rates at 24 weeks (the current upper limit for abortion) and over have improved since 1990, survival rates (viability) have not done so below that gestational point. The Committee concludes that there is no scientific basis - on the grounds on viability - to reduce the upper time limit.

The Committee supports the removal of the requirement for two doctors signatures before an abortion can be carried out. The Committee is concerned that the requirement for two signatures may be causing delays in access to abortion services and found no evidence of its value in terms of safety.

Nurses and midwives with suitable training and professional guidance, should not be prevented by law from carrying out all stages of early medical and early surgical abortion. The Committee says that it found there is no evidence that this would compromise patient safety or quality of care.

On the issue of foetal pain, the Committee says the evidence suggests that while foetuses have physiological reactions to stimuli, this does not indicate that pain is consciously felt, especially not below 24 weeks. It further concludes that these factors may be relevant to clinical practice but do not appear to be relevant to the question of abortion law.

While new 4D imaging techniques are a useful tool in diagnosis of foetal abnormality, there is no evidence they provide any scientific insights on the question of foetal sentience or viability."

I haven't had time to read the whole report yet, but I was naturally drawn by morbid curiosity to the Minority Report (one of the two MPs writing it has a blog on it):
"We may never know for certain when foetuses first start to feel pain and there is no clear consensus amongst experts in the field. There are two main schools of thought. The first, represented to this enquiry byFitzgerald, Derbyshire and the RCOG, is that foetuses cannot feel pain until 26 weeks gestation, because that is the stage of development at which mature neural connections between the thalamus and cerebral cortex are first present. The second view, expounded in a review article by Anand et al published in Seminars in Perinatology in October 2007 (and also presented by the same author to the US Congress in 2005), is that foetuses feel pain using different neural mechanisms than adults and that these are present at earlier than 20 weeks gestation. Both schools are however agreed that conscious perception of pain cannot e inferred from observing anatomy, stress hormone levels and movements alone.
The alternative view supported by Anand et al argues that the more traditional Fitzgerald/Derbyshire/RCOG view ignores significant evidence, specifically that: a) sensory processing in the human brain develops well before birth;b)the subplate zone is functional well before the cerebral cortex develops; c) the key mechanisms of consciousness are located below the cortex (in areas that develop in early gestation); d) fetal behaviors suggest memory and learning as the highest-order evidence for perceptual function; and e) other lines of emerging evidence in the field of neuroscience."
Note that the two main schools of thought basically represent Anand on one side (published on the 31st of October, today, the first time this view has been published explicitly), and everyone else in the field on the other side, to claim that "there is no clear consensus amongst experts in the field" is simply false on this issue. I'm particularly intrigued by the claim, central to Anand's paper, and the minority report, that the mainstream view "..presupposes that cortical activation must be necessary for fetal pain perception. This reasoning, however, ignores clinical data that ablation or stimulation of the somatosensory cortex does not alter pain perception in adults, whereas thalamic ablation or stimulation does. If cortical function is not a necessary standard for adult pain perception, why must fetal pain be held to a higher standard?"

Note that it is obviously possible, as the thalamus represents the input tract to the cortex for thalamic damage to alter cortical activity and to cause pain even if the conscious perception of pain is mediated by the cortex (so called thalamic pain, an intractable and severe neuropathic pain) - after all, we know that damage to peripheral nerves can modulate pain too, but we don't think that pain is therefore perceived in peripheral nerves!

We also know that cortical pain circuits consist of much more than simply primary somatosensory cortex, including the insula (where direct stimulation can cause pain), and cingulate (where stimulation can relieve pain) and we know that cortical stimulation/inactivation, particularly to the motor cortex can relieve pain, including neuropathic and thalamic pain. So the whole point is simply invalid, the existence of pain/pain relief caused by thalamic damage does not prove that this is where conscious pain perception is mediated, nor does the failure of primary somatosensory cortex damage to modulate pain perception prove that it is not mediated by the cortex. This is such fundamental misunderstanding of the neuroscience that you have to wonder why they even bother making the point at all!

Here's some more:
"The RCOG in response to comments by Anand in a Channel Four Dispatches programme has issued a press release claiming they keep a 76 Scientific Developments Relating to the Abortion Act 1967 ‘watching brief on new scientific developments and advancements in fetal medicine, and continue to examine emerging evidence from the international scientific community about fetal awareness and fetal pain’ but are ‘unaware of the work of Dr Anand or any other work that contradicts the basic findings of (their) review’.
For the RCOG to report the studies of researchers who share their own official position, whilst ignoring research published by other leading researchers with contrary views, is at the very least misleading and at worst a serious abuse of power. It seems bizarre that the RCOG has not made more of an effort to find out more about contrary evidence before making such a bold public statement. It surely owes both Anand and Parliament a formal apology and explanation of why it has apparently ‘cherry picked’ the scientific evidence to support its opposition to a lowering of the 24 week upper limit for abortion."
Anand has not published any research on the issue of preterm foetal pain at all as far as I can see, although he has been an advocate of foetal pain in the media. Note that I have pretty much reported the entire foetal pain section of the Minority Report here, and the only reference is Anand's review, so it is unclear what this research that the RCOG has ignored is. Hopefully they don't think that Anand's utterly unsupported theorising on putative foetal specific pain circuits constitutes evidence?

Here's some more from Anand's review to get an idea of the quality, after claiming that cortex is not needed to experience pain:
"Some argue that activation of the sensory cortex is a necessary criterion for pain “perception” to occur in the fetus, citing the lack of evidence for pain-specific thalamocortical connections in fetal life...If cortical activity is not required for pain perception in adults, why should it be a necessary criterion for fetuses?"
As analysed above, they go on to say:
"Despite this caveat, robust cortical activity occurs in preterm neonates exposed to tactile or painful stimuli,30 which may be correlates of sensory content or its context and certainly imply conscious perception."
Given that we know that those scientists saying that cortex is necessary to percieve pain argue that it is not until about 28-29 weeks that this is possible surely the claim here must be that cortical activity is associated with pain before then? Nope, follow the link, "haemodynamic changes associated with activation of the primary somatosensory cortex. Forty preterm neonates at 28-36 weeks of gestation (mean=32.0)". I'm not sure how they reconcile the claim that somatosensory activity "certainly impl[ies] conscious perception" with their argument a few lines before that "cortical activity is not required for pain perception" but I suppose it fits with their next line of argument that:
"The subplate zone appears earlier in the somatosensory than in the visual area and reaches four times the width of the somatosensory cortex in the human fetus (2:1 in the monkey), implying that this embryonic structure expanded during evolution to subserve important sensory functions."
So, while somatosensory cortex is not necessary for pain perception, the existence of subplate cells in it proves that foetuses perceive pain? Ah well, I guess consistency isn't Anand's strong point. I think I fairly accurately summed up the subplate position before:
"the claim (based on currently no evidence at all) that the subplate mediates foetal pain, and then dies off in development, and the cortex then takes over pain perception (so foetuses have a special bit of the brain that only lasts a few months but is designed so they can feel pain whilst in the womb, but that then largely disappears to be replaced by a whole other neural system to serve the same purpose when the baby is actually born). So there is no reason to believe that this is the case, unless you happen to need to believe that there must be a mechanism that underlies foetal pain because you already believe that foetuses feel pain - can you say post hoc rationalisation?"

Belatedly here's a link to Ben Goldacre's Badscience column covering the provenance of some of the figures about preterm viability:
"I don’t blame Prof Wyatt, but the figure has taken on a life of its own. There may have been yet another mistake here, about the denominator. I don’t know. I’m quite prepared to believe that UCL may have unusually good results. But science is about clarity and transparency, especially for public policy. You need to be very clear on things like: what do you define as a “live birth”, how do you decide on what gestational age was, and so on. Even if this data stands up eventually, right now it is non-peer reviewed, non-published, utterly chaotic, personal communication of data, from 1996 to 2000, with no clear source, and with no information about how it was collected or analysed. That would be fine if it hadn’t suddenly become central to the debate on abortion."

Friday, 26 October 2007

Breast cancer and abortion

Orac's Respectful Insolence has a good post on the non-relationship between breast cancer and abortion:
"Although there are studies that claim a link between abortion and breast cancer, they are almost all weaker case control studies, which are prone to recall bias. It's been shown that healthy women are less likely to reveal that they have had an abortion to an interviewer, while women with cancer are more likely to do so, primarily because they are searching for causes of their cancer. (This is not unlike the problem with Generation Rescue's dubious vaccination phone survey.) Nearly all the better designed prospective studies have found no link. Indeed, now there are numerous studies that have failed to find a link between breast cancer and abortion. Given the preponderance of evidence, although it is still possible that there may be a link between abortion and breast cancer, it is highly unlikely that there is. In this, it is not unlike the state of evidence regarding vaccines and autism. Current evidence
does not support such a link, and there are enough studies to allow us to conclude that there probably is none. That's as good as it gets in epidemiological studies."
Note that a case control study takes a bunch of women with breast cancer and a matched (for age etc.) group of women without it and ask if they have ever had an abortion. As Orac says, there is a risk of recall bias. A prospective study follows a group of women through their lives so abortions are recorded before breast cancer has developed, preventing recall bias. Case control studies are a good way to generate hypotheses, and the hypothesis that abortions increase breast cancer risk was plausible, it is just that the evidence did not bear that out.

Thursday, 25 October 2007

Zen parking meters

I went to put my money into the parking meter today and on the front it said:
"Change is possible"
I thought that was rather sweet and I'm not going to think about whether it is just a dodgy translation.

Wednesday, 24 October 2007

Propaganda for the day

On this morning's Today programme we heard from Reverend Joel Edwards for Thought for the Day (18:28 in). Now I'm not the biggest fan of theists being given propaganda time in the middle of the country's premiere morning news programme, but it is normally a fairly innocuous slot (even if highly irritating for occurring when I want to listen to the news and not dull homilies).

But today's broadcast was breathtaking in its partisan political sermonising. Edwards, director of the Evangelical Alliance, was given the the slot to campaign against abortion:
"...the emerging evidence of scientists and respected journalists who lay before us clear indicators that foetuses can survive at an earlier age. It is evidence which is making the law obsolete. In this complicated life and death debate a woman's womb has become one of the most politicised places on the planet. But, had we known 40 years ago, that today 186,000 unborn would be terminated every year, would we have said yes? And would we have been prepared to live with our consciences in making[?] that decision in the light of these facts. Would we have signed up had we realised that in 40 years we would have destroyed the equivalent of London's population, and that, in the vast majority of cases, we had legislated to make abortion a choice of convenience rather than the safety of a woman's life. I doubt that parliament would have done it then, why should it continue to do it now?" [transcribed by pj]
I don't want to prevent the evangelicals from having a voice in this debate, but is it really the purpose of the Thought for the Day slot to use the nation's main morning news and current affairs programme, broadcast to millions of people, as uncritical propaganda time for a religious group to intervene in an important contemporary political debate?

Want to complain? Try here.

Saturday, 20 October 2007

Shalizi on IQ again

It is always interesting to follow the Crooked Timber threads about IQ, and, following on from Watson's little outburst they are discussing another post (and now also here) by Cosma Shalizi on g. As before I think they're split into the more leftwing and right-on who are just a little bit too dismissive of claims such as that people in Africa might have lower intelligence on average due to poor nutrition or somesuch, and the more rightwing and willfully anti-PC who are a bit too keen to attribute the problems of Africa to low intelligence rather than the myriad other factors it has to face. [it is interesting to consider, re: the Flynn effect, how European populations of the past, with much lower IQs than we have now, seem to have managed just fine]

Again I think Shalizi has nicely, if a little convolutedly, explained how the existence of correlations between different cognitive tests inevitably leads to a common factor such as g, and does not tell us anything about whether that factor represents some underlying physical reality.

This sort of thing highlights a general problem with psychological science which is not grounded in more basic physiological science - often the explanations given are simply redescriptions of the phenomenon described - and there is thus no actual explanatory value in the models.

Shalizi also makes some valid complaints about those investigating IQ differences between racial groups and their generally poor methodology looking at just means, variance and correlations, which rather poorly control for covariates with simple regressions, rather than looking at the whole distribution. He also refers to an interesting paper that shows that racial differences are reduced when prior knowledge is controlled for. My concerns with claims to have controlled for all relevant socioeconomic factors and the racial IQ difference persisting stem from objections like this - you'd think a rather more comprehensive attempt would be made to find additional covariates, and rather better attempts at matching for them, rather than naive linear regression, would be used before categorical claims like this were made.

I think I would like to take exception to Shalizi's claims about the modularity of cognitive domains:
"If we must argue about the mind in terms of early-twentieth-century psychometric models, I'd suggest that Thomson's is a lot closer than the factor-analytical ones to what's suggested by the evidence from cognitive psychology, neuropsychology, functional brain imaging, general evolutionary considerations and, yes, evolutionary psychology (which I think well of, when it's done right): that there are lots of mental modules, which are highly specialized in their information-processing, and that almost any meaningful task calls on many of them, their pattern of interaction shifting from task to task....But the major supposed evidence for it is irrelevant, and it accords very badly with what we actually know about the functioning of the brain and the mind."
I think the evidence for separate cognitive, as opposed to perceptual, modules is rather over egged.

Thursday, 18 October 2007

Dispatches on abortion II

Something's come up so I haven't got time to comprehensively go through this, but actually the programme was pretty similar to the Mail article, which I've already talked about.

The programme basically followed the standard bad science documentary by having 'amazing new research' that everyone has ignored/has only just come to light that is actually nothing of the sort. It also ended on a rather jarring partisan note with first the anti-abortionists making their claims, Sunny Anand is allowed to say something like 'the balance of scientific evidence shows that foetuses feel pain at 20 weeks and below', despite there being no evidence that this is the case, and only a single pro-choice advocate is presented, who says nothing about the science at all, (and no sign of Stuart Derbyshire who is the only scientist who appears to argue the scientific consensus earlier in the documentary)

The primary flaw was to imply that they had discovered brand new research from Sunny Anand that shed light on the question of foetal pain - in fact he has been making the same arguments for years, and has no scientific evidence to support him (he doesn't even do research in this area). There's some nice euphemistic talk about the 'top bit of the brain' that people think supserves emotional and other higher cognitive processes - somehow I think most people would understand reference to the 'cerebral cortex', but then that would probably draw out the contrast with the claim (based on currently no evidence at all) that the subplate mediates foetal pain, and then dies off in development, and the cortex then takes over pain perception (so foetuss have a special bit of the brain that only lasts a few months but is designed so they can feel pain whilst in the womb, but that then largely disappears to be replaced by a whole other neural system to serve the same purpose when the baby is actually born). So there is no reason to believe that this is the case, unless you happen to need to believe that there must be a mechanism that underlies foetal pain because you already believe that foetuses feel pain - can you say post hoc rationalisation?

They also rather slyly try to imply that this 'new evidence' (that isn't) was ignored by the RCOG panel when they came up with their advice on the issue (that's right, not just magic new science, but also suppressed science - these documentaries write themselves!) There was also constant reference to bringing the limit down to 12 weeks (as in many places in Europe) without any explanation as to why this age might be chosen given the discussions around viability or pain at 20-24wks. They showed what they called a foetus that was 'at least' 24 weeks old but implied that this was representative of foetuses earlier than 24wks, which I thought was rather misleading.

There was one amusing moment where the interviewer points out to Prof. Campbell with his 4D images of foetuses that they aren't really smiling or crying because they don't have the requisite neural connections, and he pauses for a long time and essentially says, 'yes, but look at them, they're cute, this'll stop people having abortions', scientific debate-tastic. There was also an interesting point made that before about 22 weeks the lung is too immature to function so that would represent something of a hard limit on foetal viability for the forseeable future.

The Royal College of Obstetricians and Gynaecologists (RCOG) respond to the dispatches programme:
"We are unaware of the work of Dr Anand or any other work that contradicts the
basic findings of the review. Perhaps Dr Anand could direct us to the work he is
referring to. "
Heh, what an understated way to call bullshit.

A few other reactions, mostly of the 'in last night's TV' variety, such as in the Times:

"Abortion: What We Need to Know was “what we needed to know” if we were as keen, as the programme obviously was, about advocating that the time limit on having an abortion should be reduced from 26 weeks to 20 weeks."

and the Guardian:
"Like most viewers, I think, the arguments and spokespeople marshalled by the documentary team in Dispatches: Abortion - What We Need to Know (Channel 4)have probably been largely obliterated by the footage (filmed by US anti-abortion activists) of bloody foetal sacs being pulled from vaginas and dozens of tiny, jellied crimson limbs spread before us, a massacre of the innocents laid out on a hospital towel. It was shocking as an image, and arguably shocking as an inclusion in a documentary purporting to be an unbiased look at the controversies surrounding the issue of terminations before MPs gather to discuss possible changes to the law in a few months' time. "

Thanks to an anonymous commenter, Stuart Derbyshire responds to the documentary:

"The programme was a dreadful mess. Anyone who was hoping to be enlightened on the question of fetal pain will have been disappointed. If American researcher Sunny Anand has new evidence demonstrating that pain is possible due to activation in the brainstem, which fetuses possess, I would have liked to see it. But that evidence was not forthcoming in the programme.
I didn’t fare any better in my appearance, being reduced to stating that nothing in the past 10 years changes the view that the biologically necessary components for pain are not in place until about 26 weeks’ gestation. My arguments about the importance of the cortex relative to the brainstem and the necessity to understand pain as a conceptually driven, rather than a biologically driven, experience were all cut.

Ultimately the Dispatches programme was flat-out biased. In the online forum discussion after the show, Davies claimed the show was not biased because all the comments were balanced by objections from the experts being interviewed (8). The problem, however, is that Davies’ voiceover controlled the show and she was evidently keen to get the law changed. Towards the end, Dr Evan Harris, a UK Liberal Democrat MP who is a member of the Science and Technology Committee currently considering abortion legislation, was berated by Davies for having already made his mind up about viability and fetal pain (9). Harris defended himself well, but in case you missed the point about him having already made his mind up, the programme makers helpfully cut in Sunny Anand to explain that there are ‘none so blind as he who refuses to see’."

Wednesday, 17 October 2007

Watson the racist

In the Independent:
"James Watson, a Nobel Prize winner for his part in the unravelling of DNA...He said there was a natural desire that all human beings should be equal but "people who have to deal with black employees find this not true"."

Via GNXP here's Watson's non-retraction:
"Rarely more so than right now, where I find myself at the centre of a storm of criticism. I can understand much of this reaction. For if I said what I was quoted as saying, then I can only admit that I am bewildered by it. To those who have drawn the inference from my words that Africa, as a continent, is somehow genetically inferior, I can only apologise unreservedly. That is not what I meant. More importantly from my point of view, there is no scientific basis for such a belief."
The rest of the article fails to retract or clarify what he is reported as saying, but neither is it clear whether he did in fact say it.

Monday, 15 October 2007

Dispatches on abortion

I intend to use this post to keep track of the coverage that the Dispatches report on abortion is going to generate, as well as the Commons enquiry:

Sounds like Deborah Davies has been doing the rounds, promoting her Dispatches programme.

The Today programme had a discussion between Prof. Campbell (who wants to reduce the age limit for abortion) and David Steel (who also wants to lower the limit) so was obviously very balanced - and, contrary to gimpy, the debate was again framed in terms of viability and 4D ultrasound images. To the credit of the interviewer she at least challenged the scientific merit of 4D ultrasound over the emotive aspects. Also reported by the Mail on Sunday.

Yesterday's news contained the revelation that members of anti-abortion campaign groups have been asked to declare their affiliation when they give evidence to the Commons committee:

"Evan Harris MP, the Liberal Democrats' science spokesperson, said:
"This inquiry is specifically about the scientific evidence not moral or religious arguments and our witnesses need to be evidence-led not ideologically or theologically driven. The CMF [Christian Medical Fellowship] risk undermining the inquiry by getting people called as expert scientific witnesses when they are not."

Two witnesses who will give evidence today, Chris Richards, a paediatrician and honorary clinical lecturer at Newcastle University, and John Wyatt, a neonatal paediatrician at University College London, are members of CMF, but did not disclose that on their original submission."

As with a number of outlets the Observer focuses on the Dispatches programme showing footage of abortion, as well covering calls for nurses to perform early stage abortions.

The Telegraph reports that:

"A row has broken out over the 24-week time limit for abortion after conflicting scientific studies clashed over the survival rate for babies born at that stage.

Epicure 2, a nationwide report from a Government-linked organisation, revealed that the chance of survival lay between 10 and 15 per cent, according to evidence submitted to the Science and Technology Committee at the House of Commons.

But other evidence given to the committee - which will make the decision whether to recommend a change in the limit - contradicted the findings and claimed survival rates were as high as 42 per cent at 23 weeks and 72 per cent at 24 weeks gestation."

The Guardian reports that the RCOG (in line with the BMA) want to keep the 24wk limit and abolish the need for 2 doctors to approve.

The Times reports that:

"Marie Stopes International, which carries out 60,000 abortions a year at its nine clinics in Britain, says the 24-week limit ought to lowered to 20 weeks because of evidence that the foetus is “potentially viable” before 24 weeks. This shift in policy leaves opponents to a reduction in the time limit, who include Tony Blair and many Labour MPs, increasingly isolated.

"As part of any reform, however, Marie Stopes would also want women to be eligible for abortions up to 12 weeks without having to gain permission from doctors — two must now give their written consent for the procedure. It says women seeking a termination between 13 and 20 weeks should have the signature of one doctor."

The Telegraph likewise, also saying:
"A Telegraph poll last month showed that most
people, including a large majority of women, agree with him that the upper limit
should be cut back. It found that 55 per cent of voters of both sexes would
welcome new laws reducing the time limit."
According to Channel 4:
"The survey by Marie Stopes International (MSI), the leading abortion services provider outside of the NHS, found 52% of GPs want women to be able to request an abortion in the first 14 weeks of pregnancy.
Currently, two doctors must give written consent before a woman can go ahead with an abortion.
The poll of 1,000 registered GPs across Britain found 80% described themselves as broadly "pro-choice", while 20% said they were "anti abortion".
Almost two thirds of doctors (65%) thought the current 24-week time limit for abortion should be reduced. Of those who wanted a reduction, 62% agreed with a 20 to 23-week limit.
Three in five doctors (62%) said current guidelines allowing under-16s to have an abortion ithout the consent or knowledge of their parents were satisfactory.Findings from the survey will feature in Channel 4's Dispatches: Abortion: What We Need To Know, which screens on Wednesday. The documentary will also look at scientific research into foetal pain and pre-term infant viability."

There have been some fairly divergent figures reported for foetal viability at 20 weeks plus (25% have a normal life according to the Today programme, whereas I reported 30% survival at 24 weeks) so I though I'd have a look at the literature (these are articles listed as related by medline to the Belgian source I used in the previous post, and where the abstract looked relevant, and I could get data for 24 weeks or less, and it came up before I got bored - remember that infants born premature may conceivably be less viable than aborted infants at the same age):

Belgium 1999-2000 (previously mentioned study): 22 wks 0%; 24wks 29% survival to discharge (hmm, looks like it may include some late abortions though!)
22-23 wks 7%; 24wks 35% of NICU admissions discharged alive
24 wks 4% NICU admissions survive with no major sequelae of prematurity ('intact')

German tertiary centres 1999-2003: 22-23 wks 52%; 24 wks 70% survival to 8 days
22-23wks 56-76%; 24 wks 74-88% survive to discharge with life support at all gestational ages 36% have no major complications of prematurity

Japan 1991-2000: 22wks 40%; 24wks 50% 1 year survival
22wks 0%; 24wks 74% free of handicap

Canada 1996-1997: 22wks 15%; 24 wks 54% survival to discharge

Austria 1999-2001: 22wks 17%; 24wks 57% 1 year survival
22wks 6%; 24 wks 14% survival with no major complications

This gives us a range of survival at 22 wks of 0%-17%, for 24wks 29%-88%; and a range of disability at 22wks of 94%-100%, 24wks 26%-96%.

Saturday, 13 October 2007

The abortion debate II

Further to this, Channel 4's Dispatches has a programme called Abortion - What We Need to Know on Wednesday at 10.40pm. There's a preview in the Daily Mail (!) by the Dispatches reporter Deborah Davies***:

"In next Wednesday's Dispatches programme on Channel 4 we reveal the deep concern among many doctors who, like Dr Argent, work within the abortion service and are passionate supporters of a woman's right to choose, yet who still believe the current law urgently needs changing."

Sounds like we have a nice sensationalist documentary, but we'll have to see*:
"In the mid-Nineties, partly in response to growing public concern about such issues, he RCOG put together a panel of experts who came to the reassuring conclusion that the foetus couldn't feel pain until 26 weeks gestation - safely beyond the abortion time limit.
But we found disturbing research in America that directly contradicts this established view. It came from Dr Sunny Anand, who has a distinguished record in helping to prove that very young babies can feel pain. When he was based at Oxford University in the 1980s his work helped to ensure that newborn babies were routinely given pain relief for surgical procedures.
He's found similar changes in their hormones and their blood flow, suggesting that foetuses can indeed respond to pain.
Note the distinction between a physiological response to noxious stimuli and feeling pain is elided here.
"He says that while the adult uses the very top section of the brain, the foetus has the first flickerings of sensation in the area below that. Crucially, this part of the brain develops before 26 weeks.

His conclusions could have enormous consequences for the abortion debate. He told Dispatches: "I believe that foetuses can feel pain very likely by 20 weeks of gestation and possibly even earlier.""
I'm not sure how great the consequences of his work are for the abortion debate. In actual fact I can't find any evidence that Anand has done any research in this particular area, rather this follower of guru Sathya Sai Baba has been a high profile advocate for the view that foetuses feel pain in the media**. Presumably he's talking about pain fibre projections to the subplate (rather than the thalamus, which I've never heard anyone claim in any way mediates the feeling of pain). It is highly controversial to say the least to claim that these cells, never previously shown to have any role in pain, and generally believed to have a developmental, but not cognitive role, might mediate foetal pain. As Anand and colleagues said themselves only this year (in the only reference I can find on medline for 'subplate' and 'pain'):
"Connections to the thalamus begin at 14 weeks and are completed by 20 weeks, and thalamocortical connections are present from 13 weeks and are more developed by 26 to 30 weeks. However, it is not possible to measure evoked potentials from the cortex before 29 weeks. Thus, many scientists suggest that it is not until 29 weeks gestational age that there is objective evidence that a peripheral stimulus can cause cortical activation."
There is also further discussion of viability in the article - I wonder if there is a basis for their figures? I wonder how many of the surviving infants could be considered 'intact'?

"Back in July, we filmed a newborn baby named Hope in the neo-natal intensive care unit of Liverpool Women's Hospital. In her incubator, Hope was almost invisible under a pink blanket, surrounded by wires and bleeping monitors.

She had been born at 23 weeks - one week before she could have still been legally aborted. And here she was, three weeks later, still clinging to life with the frailest of grips.

Hope lived for two months, with her parents constantly at her side, before she died. In Britain, modern drugs and high-tech treatment meant she had about a 25 per cent chance of survival - hich would have doubled if she'd been born a week later. The odds were against her from the outset.

But those statistics are changing all the time. In America the chances of her survival would have been better, and what happens over there will inevitably filter through to Britain."

* I'm not confident the way that the reporter for the programme chooses to frame the article. I predict a combination of "but then, Sunny Anand discovered..." and 'he said', 'she said' equivalence of opposing views with no attempt to establish any kind of overview of the scientific consensus. In short, journalists fuck up one more science story, only this time it has repercussions in the real world.

Abortion Review has a good article on the background to this debate.

** Spiked has an interesting article on the partial birth abortion debate in the US, and Anand's role in it:

"...the trials will have a lasting consequence because of multiple damaging testimonies from Dr Kanwaljeet (Sunny) Anand on the issue of fetal pain. The potential for fetal pain was already becoming a common part of the argument against abortion but it is now guaranteed to form a more central role.
It was this evidence that enabled Anand to make the following claim during the course of the trial in New York: ‘I can state my opinion to a degree of medical certainty that all fetuses beyond 20 weeks of gestational age will experience severe pain by the partial-birth abortion

But the statement is pure hyperbole and nonsense, for many reasons (12).
Anand has made this mistake again and again and again and has now done so to the detriment of women seeking abortion. Distressingly these points were never made at trial, and the Plaintiffs might even have made the situation worse by pointing out that if D&X is painful then D&E must be excruciating. Moreover, in his concluding decision, Judge Casey was able to state that Dr Anand’s testimony went unrebutted by the Plaintiff’s, and provided ‘credible evidence that D&X abortions subject fetuses to severe pain’.

While Anand has done much to advance the clinical treatment of neonates and to preserve early life, he has also done much to confuse the understanding of pain and has now damaged the credibility of medicine. His testimony in California, Nebraska and New York, for which he was paid $450 an hour, plus expenses, by the current US government, was based on an evidently dubious and shaky claim of ‘medical certainty’.

It is understandable and proper for physicians and medical experts to wield their expertise in defence of practices that they believe to enhance clinical care, but it is quite another to wield
expertise against clinical care and in defence of hypothetical and unproven experiences. Unfortunately Anand has long interchanged what he believes with what he can prove and now he has done this in the service of reactionary political objectives.

Anand’s testimony has spawned the ‘Unborn Child Protection Act’, which is a Congressional-sponsored attempt to curtail late abortion on the basis of protecting the fetus from pain (21). Similar attempts to introduce fetal pain legislation have already occurred at the State level. In
2003, for example, Minnesota successfully introduced legislation requiring women to be informed of the possibility of fetal pain when seeking a second-trimester termination (22). The state of Virginia attempted to introduce similar legislation in 2004 but the proposal was defeated (23).

Sponsors of the Unborn Child Protection Act have cited Anand’s testimony and those on the
pro-life side of the debate believe that this legislation will replace the Partial-Birth Abortion Act as the main focus of anti-abortion activity, especially now that George Bush has returned to the White House (24)."

*** Oh dear, looks like Deborah Davies also did the Dispatches report on liver disease which diagnosed liver disease in 50% of people tested using an ultrasound and garnered much press coverage (Metro, Daily Mail, Sun, you know, the quality press). This had me shouting at the TV at the time for its sensationalism and scientific and medical flaws:

"Professor Chris Day, professor of liver medicine at the University of Newcastle, said there was no published study that verified a fibroscan could pick up early signs of disease caused by alcohol.

'In really heavy drinkers about 10% will get liver cirrhosis. The test can only really pick up when the liver is badly damaged – which, if they're picking up half, makes you realise the test must be rubbish.'"

CBT vs. psychoanalysis

Heh, a psychoanalyst moaning about the rolling out of CBT in the NHS:
"...why has the government bought into CBT? The answer is simple: it produces results on paper that keep NHS managers happy...Therapy trials tend to follow the medical model, with two groups of patients who have the same profile and the same symptom. Treatments are then standardised to rule out the influence of the therapist."
Yep, CBT interventions seem to work, they don't take that long to do, and are cost effective, how dare they use them to treat psychological disorders instead of sentencing them to years of expensive psychotherapy wich lacks evidence of effectiveness?

The abortion debate

The F Word reports that the abortion debate seems to be back. It is a disingenuous field where agendas are hidden and reasoning is often obscure and irrational.

I'm reminded of the debate over emergency contraception, involving many of the same faces, where, despite scientific evidence showing that it works by preventing fertilisation, not implantation, it is still opposed by religious groups who pretend that it is a form of abortion to hide their anti-contraception agenda.

There appears to be a growing acceptance in the public, driven primarily by the media, that the limit for abortion should be lowered below the current 24 weeks. The origin of this consensus is the coverage given to 4D ultrasound images of foetuses 'smiling' and 'waving' in the womb circulated by Prof. Stuart Campbell (the lack of interest in what stage of gestation these images were taken tells us much about just how rational this conclusion is - the 'smile' was apparently at 22 weeks gestation) and improved survival of preterm infants.

Actually they weren't smiling or waving at all but on a loop which made it look like they were. Which we shouldn't be surprised by since newborn babies don't smile until around 6 weeks of age (no, I'm sorry, that wasn't a smile, that was a grimace you saw in your newborn), and even then it is likely a reflex.

We can expect a lot of this sort of stuff to get another airing in the media, with the anti-abortionists having the best of it, because the public are pretty stupid, because the anti-abortionists use rhetorical sleight of hand, and because the pro-choice movement has traditionally shied away from engaging the scientific arguments head on, instead focusing on the 'right' to choose.

So what is the scientific evidence? For a start, the vast majority of abortions are performed before 12 weeks, and a tiny minority (under 2%) after 20 weeks before which many congenital abnormalities cannot be detected (the majority of abortions for congenital abnormalities incompatible with life such as anencephaly are performed after 24 weeks - the limit doesn't apply in these cases for obvious reasons), even in Britains slow and restrictive system.

I don't understand why the UK debate is framed in terms of viability, but before 22 weeks this is minimal, rising to 30% survival at discharge by 24 weeks where, of those admitted to neonatal ICU (54%), less than 5% survived intact (i.e. without major prematurity associated abnormalities), and even children born outside the 'grey zone' of foetal viability (22-25 weeks, the period where viability so low enough that it is controversial whether to initiate aggressive therapy) take a considerable hit in cognitive function when they grow up.

You'd think if people really cared about viability they'd press for making it easier to obtain an abortion early (such as removing the need to have 2 doctors approve), rather than trying to limit access, but funnily enough this doesn't seem to be their approach.

Despite all the crap about foetuses 'opening their eyes' propagated by Campbell, at 22-24 weeks the foetus does not have a connection between the retina and the cortex, so isn't able to 'see' anything, similarly, while peripheral pain pathways are present by 10-15 weeks, and spinal pathways by 20 weeks, cortical innervation is not present until around 24 weeks, and functional responses in cortex by around 30 weeks i.e. noxious stimuli just don't get to the bits of the brain that mediate the perception of pain until the baby reaches term.

Anti-abortion campaigners like to pretend it is about the science, and that is how they seem to have successfully framed the latest 'debate', but that's bollocks, its about having the most effective rhetorical devices for them - that is why they only focus on the 'evidence' that is emotive and sways the ignorant public, rather than seriously engaging with the science - here's Campbell:

"Pain is a very difficult thing to measure in an unborn baby. Foetuses have no memory of pain, and no anticipation of it. But if you stuck a pin into a foetus, I believe it would make a crying face and flinch. Clearly, that's an experiment we can't carry out, but we can weigh up the evidence we have and make the best judgment possible.

Babies born at 22 weeks are never treated without analgesics. Why, if there is scientific evidence to prove their brains are too under-developed to feel pain or distress, would they be given medication to protect them from pain? And if we accept that these babies may feel pain, why is it so difficult to imagine they would feel the same sensation inside the womb?"
Why indeed? Perhaps because we know that peripheral pathways can be damaged or sensitised even without central pain being perceived*, and that hormonal stress responses can be activated even without cortical activation, which could have physiological repurcussions later in life.** Disingenuous bastard trying to gloss over the science with ill-posed rhetorical questions - and this is only the start of it. There's plenty of scientific misrepresentation to come.

* Compare with phantom limb pain in people who have their limbs amputated. Damage to the nerve endings causes sensitisation and leads to persistent pain after the surgery, despite no pain being felt under general anaesthesia during the procedure itself.

**Pain pathways to subcortical structures could also still represent pain perception on a parr with that of 'lower' animals, even if not of the sophistication of fully grown humans, which is a consideration for those of us of a more utilitarian bent.

Sexualisation of children

Cath Elliott on Comment is Free has a post that nicely articulates the concerns I have with the creeping sexualisation of children that seems to be taking place in the UK. The playboy branded stuff targetted at little girls is just the tip of a disturbing iceburg:
"...Cardiff Council has announced its latest wheeze to encourage family fitness - pole dancing classes for 11 year olds.
And earlier this year Asda was condemned for stocking lacy black underwear aimed at girls as young as nine, although perhaps we shouldn't be too surprised at this move, when their parent company Wal-Mart is busy selling US teens a T-shirt bearing the hilarious slogan "Some call it stalking - I call it love". The clothing store Next also got in on the game with their T-shirt for 5-6 year olds, emblazoned with the immortal line: "So many boys, so little time"."

Friday, 12 October 2007

"The madness of feeding this ravenous NHS"

Whilst reading yesterdays Times today (it was sitting around at lunch) I came across an article by Camilla Cavendish arguing that the NHS is "...swallowing more and more resources, at the expense of virtually everything else":

"The NHS is Britain’s last big state monopoly. It is the largest employer in the developed world. Its 1.4 million staff outnumber the private and public healthcare workforce of Germany, a country with 25 per cent more people and better health outcomes.[*]
In the 1990s it was possible to argue that the NHS was starved of cash. But not any more. Britain is now spending at about the European average, but lags behind too many other European countries in terms of results.
That is the real price of having built a bloated State. No one dares speak the truth, because there are so many vested interests to offend. But the writing is on the wall: a tax-funded free healthcare system is looking ever less sustainable. Politicians always fear the “popularity” of our health service. But that popularity will wane if the NHS comes to be seen as the enemy of every other public service."

Take a look at UK health spending compared to the rest of the OECD. Looks to me like we are getting the health outcomes we'd expect for the money we're putting in. Seems like rather than being a problem with tax-funded free healthcare, the problem is with people like Camilla Cavendish who pretend that we spend a disproportionate amount of money on the NHS when we clearly don't, and who pretend that privatising this system, or shifting to an insurance based system will magically decrease the health spend. It seems to me that it is people like her pretending that we are over taxed and downplaying the real costs of healthcare that cause other public services to lose out.

* I doubt this is true, it isn't clear where her figures are from, but given higher German healthcare expenditure, and e.g. figures like "In December 2003, 4.2 million people were employed in the health care sector, constituting 10.7% of the German workforce, according to data from the Federal Statistical Office (Federal Statistical Office 2003a).", I call bullshit.

The Society of Homeopaths can kiss my arse

Via DC’s Improbable Science, gimpy, badchemist, orac, and others, I see that the quackometer blog has taken down a post on "The Gentle Art of Homeopathic Killing" due to legal threats from the Society of Homeopaths. The alternative medicine crowd are remarkably keen using the "chilling effect" of legal threats based on overly broad interpretations of libel law to get their way (cf. Prof. Colquhoun's trouble), probably because they know they can't win the argument based on the evidence, and because they are essentially just another business sector, albeit one without any regulation.

Sod them:

The Gentle Art of Homeopathic Killing
by Le Canard Noir

The Society of Homeopaths (SoH) are a shambles and a bad joke. It is now over a year since Sense about Science, Simon Singh and the BBC Newsnight programme exposed how it is common practice for high street homeopaths to tell customers that their magic pills can prevent malaria. The Society of Homeopaths have done diddly-squat to stamp out this dangerous practice apart from issue a few ambiguously weasel-worded press statements.

The SoH has a code of practice, but my feeling is that this is just a smokescreen and is widely flouted and that the Society do not care about this. If this is true, then the code of practice is nothing more than a thin veneer used to give authority and credibility to its deluded members. It does nothing more than fool the public into thinking they are dealing with a regulated professional.

As a quick test, I picked a random homeopath with a web site from the SoH register to see if they flouted a couple of important rules:

• Advertising shall not contain claims of superiority.
• No advertising may be used which expressly or implicitly claims to cure named diseases.

72: To avoid making claims (whether explicit or implied; orally or in writing) implying cure of any named disease.

The homeopath I picked on is called Julia Wilson and runs a practice from the Leicestershire town of Market Harborough. What I found rather shocked and angered me.

Straight away, we find that Julia M Wilson LCHE, RSHom specialises in asthma and works at a clinic that says,

Many illnesses and disease can be successfully treated using homeopathy, including arthritis, asthma, digestive disorders, emotional and behavioural difficulties, headaches, infertility, skin and sleep problems.

Well, there are a number of named diseases there to start off. She also gives a leaflet that advertises her asthma clinic. The advertising leaflet says,

Conventional medicine is at a loss when it comes to understanding the origin of allergies. ... The best that medical research can do is try to keep the symptoms under control. Homeopathy is different, it seeks to address the triggers for asthma and eczema. It is a safe, drug free approach that helps alleviate the flaring of skin and tightening of lungs...

Now, despite the usual homeopathic contradiction of claiming to treat causes not symptoms and then in the next breath saying it can alleviate symptoms, the advert is clearly in breach of the above rule 47 on advertising as it implicitly claims superiority over real medicine and names a disease.

Asthma is estimated to be responsible for 1,500 deaths and 74,000 emergency hospital admissions in the UK each year. It is not a trivial illness that sugar pills ought to be anywhere near. The Cochrane Review says the following about the evidence for asthma and homeopathy,

The review of trials found that the type of homeopathy varied between the studies, that the study designs used in the trials were varied and that no strong evidence existed that usual forms of homeopathy for asthma are effective.

This is not a surprise given that homeopathy is just a ritualised placebo. Hopefully, most parents attending this clinic will have the good sense to go to a real accident and emergency unit in the event of a severe attack and consult their GP about real management of the illness. I would hope that Julia does little harm here.

However, a little more research on her site reveals much more serious concerns. She says on her site that 'she worked in Kenya teaching homeopathy at a college in Nairobi and supporting graduates to set up their own clinics'. Now, we have seen what homeopaths do in Kenya before. It is not treating a little stress and the odd headache. Free from strong UK legislation, these missionary homeopaths make the boldest claims about the deadliest diseases.

A bit of web research shows where Julia was working (picture above). The Abha Light Foundation is a registered NGO in Kenya. It takes mobile homeopathy clinics through the slums of Nairobi and surrounding villages. Its stated aim is to,

introduce Homeopathy and natural medicines as a method of managing HIV/AIDS, TB and malaria in Kenya.

I must admit, I had to pause for breath after reading that. The clinic sells its own homeopathic remedies for 'treating' various lethal diseases. Its MalariaX potion,

is a homeopathic preparation for prevention of malaria and treatment of malaria. Suitable for children. For prevention. Only 1 pill each week before entering, during and after leaving malaria risk areas. For treatment. Take 1 pill every 1-3 hours during a malaria attack.

This is nothing short of being totally outrageous. It is a murderous delusion. David Colquhoun has been writing about this wicked scam recently and it is well worth following his blog on the issue.

Let's remind ourselves what one of the most senior and respected homeopaths in the UK, Dr Peter Fisher of the London Homeopathic Hospital, has to say on this matter.

there is absolutely no reason to think that homeopathy works to prevent malaria and you won't find that in any textbook or journal of homeopathy so people will get malaria, people may even die of malaria if they follow this advice.

Malaria is a huge killer in Kenya. It is the biggest killer of children under five. The problem is so huge that the reintroduction of DDT is considered as a proven way of reducing deaths. Magic sugar pills and water drops will do nothing. Many of the poorest in Kenya cannot afford real anti-malaria medicine, but offering them insane nonsense as a substitute will not help anyone.

Ironically, the WHO has issued a press release today on cheap ways of reducing child and adult mortality due to malaria. Their trials, conducted in Kenya, of using cheap mosquito nets soaked in insecticide have reduced child deaths by 44% over two years. It says that issuing these nets be the 'immediate priority' to governments with a malaria problem. No mention of homeopathy. These results were arrived at by careful trials and observation. Science. We now know that nets work. A lifesaving net costs $5. A bottle of useless homeopathic crap costs $4.50. Both are large amounts for a poor Kenyan, but is their life really worth the 50c saving?

I am sure we are going to hear the usual homeopath bleat that this is just a campaign by Big Pharma to discredit unpatentable homeopathic remedies. Are we to add to the conspiracy Big Net manufacturers too?

It amazes me that to add to all the list of ills and injustices that our rich nations impose on the poor of the world, we have to add the widespread export of our bourgeois and lethal healing fantasies. To make a strong point: if we can introduce laws that allow the arrest of sex tourists on their return to the UK, can we not charge people who travel to Africa to indulge their dangerous healing delusions?

At the very least, we could expect the Society of Homeopaths to try to stamp out this wicked practice? Could we?

Friday, 5 October 2007

Sex and IQ

So, if I accept that it is possible for genetically driven differences in IQ, why do I not trust the evidence?

Well I'm not a psychometrician, but I have looked into the data a few times, and been far from impressed. Let's take a study which received some considerable press:

"A study to be published later this year in the British Journal of Psychology says that men are on average five points ahead on IQ tests.
Their research was based on IQ tests given to 80,000 people and a further study of 20,000 students."
Naturally the paper hadn't yet been published, but I deliberately sought the paper out when it was, it is the "study of 20,000 students":

Irwing & Lynn (2005). British Journal of Psychology 96(4): 505-24.

A meta-analysis is presented of 22 studies of sex differences in university students of means and variances on the Progressive Matrices. The results disconfirm the frequent assertion that there is no sex difference in the mean but that males have greater variability. To the contrary, the results showed that males obtained a higher mean than females by between .22d and .33d, the equivalent of 3.3 and 5.0 IQ conventional points, respectively. In the 8 studies of the SPM for which standard deviations were available, females showed significantly greater variability (F(882,656)=1.20, p<.02), whilst in the 10 studies of the APM there was no significant difference in variability (F(3344,5660)=1.00, p>.05).
Richard Lynn is a stalwart of the IQ and race/sex field, and the credibility of his work goes to the heart of the matter.

This paper has been critiqued elsewhere, but there are a few fundamental aspects of the paper that really strike a scientist coming to this from outside the field, and I want to talk about a few of them.

Where does the "five points ahead on IQ tests" figure come from? Well it comes from taking the standard deviation normalised IQ difference between males and females determined by the meta-analysis (0.31), and multiplying it by what is generally taken as the population IQ standard deviation (15 points) to estimate a 4.65 point difference between men and women.

It is always a bit dodgy taking a difference detected in your study sample and then extrapolating your effect size out into the general population. There are good reasons to think that the standard deviation in the sample is less than the general population (since university students are selected to some degree), but we can get an idea of how bad that idea is by looking at the papers involved in the study where the standard deviations are reported (note the scores given are on the progressive matrices, not IQ scores, my understanding is that you need to approximately double the values to get the IQ difference) - one study reports actual IQ standard deviations of around 10 points, and since the largest study doesn't have standard deviations reported, looking at the next two largest studies, these also have values around 10.

So how did they get this 0.31 figure? Well the first thing they do is exclude half of all the subjects as an 'outlier'. We can see in the list of studies that as well as a large number of small studies, there is a large Mexican study with 45% of the total number of subjects in the whole meta-analysis. But it only showed a male advantage of .06 of a standard deviation (that's about 1 IQ point assuming standard deviation of 15). It isn't quite clear how this study can be an outlier if it contains half of all the subjects.

Ok, we've now upped out estimate of the mean difference between men and women from .14 (95% CI .11-.27) including the Mexican study (which we've moved from a 1.4 IQ point difference to a 2.1 point difference by assuming a standard deviation of 15 rather than 10 points), to .21 (95% CI .18-.28) by excluding the Mexican study. But that isn't 5 IQ points yet, we've only got to 3!

So now we need to do something really bad, instead of weighting the studies by sample size (because, you know, tiny studies are crapper, have much higher variance, and are much more likely to be positive and have a larger effect size due to publication bias, and because that is just how you estimate overall effect size when combining together results from studies of differing sample size) we'll just look at median effect size. That's right, instead of weighting all the results by how many subjects there were in each study we're going to line up all the studies in order of effect size, don't worry about how many subjects were in each one, and find the study in the middle - that's our effect size. I don't think we need to justify this approach at all, let's just do it and report all our results in that form. Way hey, that gives us .31 of a standard deviation difference, that's 4.65 IQ points if we assume standard deviation of 15, that's practically 5 IQ points - go men!

As Steve Blinkorn points out:

"The ten studies with estimated differences above the median cover a total of only 2,591 participants, whereas the ten studies with differences below the median account for 15,735 participants — the four largest differences come from samples of 111, 173, 124 and 300, the four smallest from samples of 844, 172, 9,048 and 1,316. Choosing to use the median is a flawed and suspect tactic."
Now we need to put the icing on the cake, let's make an outragious claim that is contradicted by our own data:

"These results are clearly contrary to the assertions of a number of authorities including Eysenck (1981), Court (1983), Mackintosh (1996, 1998a, 1998b) and Anderson (2004, p. 829). These authorities have asserted that there is no difference between the means obtained by men and women on the Progressive Matrices. Thus, the tests 'give equal scores to boys and girls, men and women' (Eysenck, 1981, p. 41); 'there appears to be no difference in general intelligence' (Mackintosh, 1998a, ); and 'the evidence that there is no sex difference in general ability is overwhelming' (Anderson, 2004, p. 829). Mackintosh in his extensive writings on this question has sometimes been more cautious, e.g. 'If I was thus overconfident in my assertion that there was no sex difference… if general intelligence is defined as Cattell's Gf, best measured by tests such as Raven's Matrices… then the sex difference in general intelligence among young adults today …is trivially small, surely no more than 1-2 IQ points either way' 1998b, p. 538). Contrary to these assertions, our meta-analyses show that the sex difference on the Progressive Matrices is neither non-existent nor 'trivially small' and certainly not '1-2 IQ points either way', that is, in favour of men or women. Our results showing a 4.6 to 5 IQ point advantage for men is testimony to the value of meta-analysis as compared with impressions gained from two or three studies."
That's right, even though the correct analysis of our data shows a 1.4 IQ point advantage for men let's claim that anyone suggesting a difference of '1-2 IQ points either way' is totally wrong and that only our completely dodgy analysis is the correct interpretation. One in the eye for you hairy lesbian feminists!

No attempt is made to estimate publication bias naturally, it is just asserted that there cannot be a file drawer effect because none of the studies was directly comparing male and female IQ in their primary study design. Blinkhorn again:

"My own file drawer turned out to contain an analysis of data from...the advanced matrices...This yielded an advantage of 0.07 standard deviations for females. The sample is larger than all but five of those found by Irwing and Lynn."

In my own research, if I don't detect a difference between men and women (you ought to check) then I probably wouldn't report the data split by gender - but of course this immediately introduces a publication bias - as only those studies where a difference has been found will have data suitable for including in a meta-analysis - and thus any effect will be overestimated.

If these are the kind of shenanigans people like Lynn can get up to right in front of our eyes, then what's going on behind the scenes? I cannot trust the data of these people because I do not respect them as scientists.

[interestingly, this study did not support the claim that men have a higher standard deviation in IQ scores than women - which is often posited to contend that while men and women may have equal mean IQs, there are more men in the extremes of the distribution, thus making more 'geniuses' men. Presumably they'd have tried harder to push that result if they hadn't been so happy with their "five points ahead on IQ tests" figure.]

Irwing and Lynn have replied to Blinkhorn's criticisms, and consequently many of mine, here, and Blinkhorn replies (thanks to potentilla in the comments). I'm unimpressed by their excuses but I'll repeat them here. They start off by saying:

"We believe that the principal error of Blinkhorn’s criticism is that he does not consider our result in the context of several other studies showing that adult males have an IQ advantage of around 4–6 IQ points."
That is disingenuous the say the least, Blinkhorn criticises the study's methodology, you cannot resort to the results of other studies to support your conclusions, it must stand or fall on its own merits.

They go on to say:

Blinkhorn criticizes us for not adopting the principle of weighting results by sample size, and for excluding the very large study from Mexico. This misses a central point of metaanalysis. We carried out a number of tests for moderator variables (factors that cause underor overestimates of the sex difference) and found strong evidence for two: these were the type of test and the tendency of some universities selectively to recruit either brighter men or brighter women. In the presence of strong moderators, many of the studies in the sample provide biased estimates of the sex difference in IQ score. It is clear from the box plot (Fig. 1) that the Mexico results conform to estimates from the most male-biased samples, which provide substantial underestimates of the sex difference in IQ. Given the strong probability of bias in this sample, to weight it by its sample size (9,048) would risk a serious underestimate of the population sex difference in IQ. For this reason, we followed the advice of a definitive article on meta-analysis10 and took the median of estimates, including Mexico, which equated to 4.6 IQ points." [PJ - note that the median is unaffected by inclusion or exclusion of the Mexico study since it is nearer the low extreme values and only the value of the middle study affects the median]
Now I confess, I don't quite see what they are saying here. The talk of sex-selection refers to studies which found either higher variance in males or females - they hypothesise that these differences in variance are the result of greater selection for males or females (lower variance, smaller standard deviations, means that the gender was more highly selected at that university, and thus shows less variance). But, and this is a fucking great big but, the Mexican study doesn't report variance by gender - what Irwing & Lynn are saying is that if you look at the figure the effect size for the Mexico study is more like the studies with a 'pro-female' selection bias (this is difficult to figure out as an analysis because this paper lists 10 studies, whereas only 6 studies were identified as pro-female in the original paper***) i.e. they are asserting that it had pro-female bias without any evidence that this was actually so. As Blinkhorn says:

"Their argument here is circular: the sex difference is vanishingly small compared with their sample of smaller, less representative groups, so therefore there must be a bias."
But, of course, they aren't just excluding the Mexico study (note no other studies are excluded as outliers), sticking with means still gives a lower estimate of effect size than Irwing and Lynn report even without the Mexico study - so taking the median makes a big difference. They claim this is necessary due to heterogeneity in the sample but this is inapproriate given the range of study sizes from 30 subjects to nearly 10,000.

Looking at my plot of log transformed variance ratios* against effect sizes suggests that there may be a relationship between the difference in standard deviations between men and women (interpreted by Irwing & Lynn as due to differing selectivity of universities), although the regression is only significant at alpha=.05 if you exclude the far right value**. They could easily have incorporated this relationship into their analysis and run a regression model if they were worried about this effect. Look at the point of no difference between variance (when standard deviations are the same, log ratio 0.0), the effect size is about .2, we can see from this that their overall sample is actually biased towards male-selective studies (reflected in their estimate of 6 female-selective, and 13 male-selective), and by Irwing & Lynn's interpretation their overall sample is biased in favour of studies where men are over selected and thus biased against women! This regression line doesn't take into account study size and only includes studies with available variance data, but if differential variance was the only effect at play here the effect size would still be smaller than the median estimate (and more like the mean exc. Mexico) as we can see from the estimated effect size (about .2, 2-3 IQ points depending on population variance) when there is zero difference in variance between men and women. This rather highlights why the median does not trump the mean when data is heterogeneous, instead you have to explore the effect of modifier variables, as Rosenthal (who Irwing & Lynn reference as justification for using medians) says:

"When several approaches to central tendency yield different results, the
reasons for such differences need to be explored."
But we know why they are discrepant, because so many studies were tiny, and by having more pro-male studies the median is almost guaranteed to fall in the high end of estimates because that is where the mid-point will fall.

With reference to generalising the findings to the population at large, they say:

"Many of Blinkhorn’s difficulties stem from his assumption that our focus was on university students. This makes little sense, because the IQ difference in students is dependent on which population is considered, whereas the sex difference in the general population, our actual focus of interest, is highly stable."

But, of course, this is no explanation, their study was of university students whatever their self proclaimed focus was on, and they should at least have reported what the IQ differences they actually found were - before then generalising to a population that they had no evidence for.

* You need to log transform ratios to make them symmetrical - take women with a 10x greater variance than men, the same as men, or men having 10x the variance of women - straight ratios gives you figures of 10, 1, and 0.1 but log ratios gives you 1, 0, -1. Think about how they'll look when plotted on a line, the raw ratio data will crowd the oints where men have higher variance than women in between 0 and 1, while when women have a higher variance than men it will stretch from 1 to 100, or 1000, or infinity. But when the data is log transformed men having a higher variance is treated just the same as women having a higher variance, but with a negative sign - i.e. it is symmetrical.

** I've substituted a regression line that takes into account study size, and it looks a lot nicer than the original fit too. But just look at how the studies are skewed to the pro-male side, suggesting that there may be serious over estimation of the effect size - I don't think that was what Irwing & Lynn wanted us to conclude!

*** There's somemething funny going on here but I'm not sure what. How can the original paper have found 13 pro-male (I assume they exclude the study where the difference in standard deviation is only at the second decimal place), and 6 pro-female studies, consistent with the data in the table, yet their reply to Blinkhorn has 10 pro-male and 10 pro-female studies? It just makes me even more concerned about their methodology.

A reader points out the following from Lynn & Irwing (2004):

"The second kind of poor quality study consists of those with small sample sizes that are liable to produce anomalously large chance effect sizes that obscure the true relationship. Some meta-analysts ignore differences in sample sizes and accord all studies equal weight irrespective of sample size. This is reasonable for certain data sets where all the studies have about the same sample sizes. Where this is not the case, some meta-analysts deal with this problem by ignoring studies with samples below a certain size, while others weight the studies by the sample sizes. These two solutions amount to much the same thing because weighting by sample size dilutes and may effectively eliminate the contribution of studies with small samples. Where the meta-analyst has a number of large samples, the simplest procedure is to ignore small samples and confine the analysis to studies where sample sizes are considered acceptable." [my emphasis]

Hoist by their own petard methinks.