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Archive for the ‘Medicalization’ Category

If you have watched TV in the past few months you have probably seen the above commercial for 5-hour Energy that would provide a good introduction to misleading media deceptions in a research methods or statistics course. The commercial touts the fact that they surveyed over 3,000 doctors and what they found was amazing. What was apparently so amazing was the fact that 73% of doctors surveyed said that they would recommend 5-hour Energy. Wait, no, that’s not it. 73% of doctors surveyed said that they would “recommend a low-calorie energy supplement to their healthy patients who use energy supplements.” That’s not quite the same thing, is it?

Unlike those “look how great we are” commercials that say things like “four out of five dentists recommend Trident,” the claims made by 5-hour Energy seem more along the lines of “we spent a lot of money to do this survey and we’re going to advertise the results no matter what they show!” In fact, the small print (visible if you enlarge the ad above) is incredibly honest (for a commercial, at least) about the actual methods and findings. Here is the small print in order:

  • All doctors surveyed identified themselves as primary care physicians
  • Two surveys were conducted to determine the opinions of primary care physicians regarding energy supplements and 5-hour Energy: 1) an online survey of 503 participants; and 2) an in-person survey by 5-hour Energy representatives of 2,500 participants (50% of those approached). In both, participants agreed to review materials regarding 5-hour Energy consisting of label and basic description of its ingredients. Of the 503 online and 2,500 in-person, over 73% said they would recommend a low calorie energy supplement to their healthy patients who use energy supplements.
  • Of the 73% of primary care physicians who would recommend a low calorie energy supplement to their healthy patients who use energy supplements, 56% would specifically recommend 5-hour Energy for their healthy patients who use energy supplements.
  • Of all primary care physicians surveyed, 47% would specifically recommend 5-hour Energy for their healthy patients who use energy supplements.

So, 5-hour Energy has spent a lot of money on a survey and advertisements to tell people that 27% of doctors would not recommend low-calorie energy supplements to their healthy patients, even if they already use energy supplements. Furthermore, only 47% of the doctors surveyed would actually recommend 5-hour Energy. This is a far cry from the “four out of five dentists” claims. These results are amazing, all right. Amazingly unimpressive!

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When describing why Type II errors are preferable to Type I errors in class I often use the example of Andrew Wakefield’s discredited research on the link between vaccinations and autism, making the point that his false positive led to long-term changes in behavior. Recent revelations about Mike Daisey’s work on conditions in Apple factories overseas reinforce the ease with which a lie can become accepted:

There’s a popular online petition at Change.org which has amassed over 250,000 signatures. It begins:

You know what’s awesome? Listening to NPR podcasts through an Apple Airport, playing through a Mac laptop, while puttering about the kitchen. Do you know the fastest way to replace awesome with a terrible knot in your stomach? Learning that your beloved Apple products are made in factories where conditions are so bad, it’s not uncommon for workers to permanently lose the use of their hands.

Last week’s This American Life shined a spotlight on the working conditions in the Chinese factories where iPhones are made. Just one example of the hardships there: the men and women in these factories work very long days spent repeating the same motions over and over, which creates amped-up carpal tunnel syndrome in their wrists and hands. This often results in them losing the use of their hands for the rest of their lives. This condition could be easily prevented if the workers were rotated through different positions in the factory, but they are not. Why? Because there are no labor laws in China to protect these people.

No one other than Mike Daisey has reported about such repetitive stress injuries. And he made it up. 250,000 people believed him — in no small part because of the credibility of Ira Glass and This American Life — and signed a petition. There is no larger truth here. This is not a mistake. This is simply a lie, a lie that was told to draw attention and create sympathy at the expense of the actual truth.

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Continuing my medicalization kick (and because I haven’t talked about Huck Finn in a while), a recent post at Slate highlights the way that the behaviors that we have medicalized in children today, such as ADHD and Oppositional Defiant Disorder, likely existed long before our labels.  While this is not a surprise, the conclusion brings up an interesting point:

But if the children and the parents are familiar, the society surrounding them is not. In fact, Tom Sawyer turns out fine in the end. In 19th-century Missouri, there were still many opportunities for impulsive kids who were bored and fidgety in school. The very qualities that made him so tiresome—curiosity, hyperactivity, recklessness—are precisely the ones that get him the girl, win him the treasure, and make him a hero. Even Huck Finn is all right at the end of his story. Although he never learns to tolerate “sivilization,” he knows he can head out to “Indian territory,” to the empty West where even the loose rules of Missouri life won’t have to be followed.

Nothing like that is available to children who don’t fit in today. Instead of striking out into the wilderness like Huck Finn, they get sent to psychologists and prescribed medication—if they are lucky enough to have parents who can afford that sort of thing. Every effort will be made to help them pay attention, listen to the teacher, stop picking fights in the playground, and rightly so. Nowadays, there aren’t any other options.

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While I am not particularly old, I have been doing some adult-like things lately and even planning for my own demise.  Despite my relative youth, the recent health of my grandparents has me considering the negative aspects of long life.  A few years ago my grandmother had a heart attack, since which she has been on medications that may have contributed to the stroke she had last year.  Most recently, it was determined that one of her medications is preventing her heart from working effectively.  While I am not anti-medicine (or anti-vaccination, for that matter), there has to be a point at which the medicalization of old age becomes counter productive.  (Maybe we all need to think a bit more about the old woman who swallowed a fly.)  I recognize that it is easy to make these sorts of proclamations while one is healthy and relatively youthful, but I hope that in my old age I am willing to convince others to let me put aside the drugs and, if necessary, die.

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