meta:medicine   57

« earlier    

Plague of Frogs | West Hunter
For a few years the herpetologists were concerned yet happy. Concerned, because many frog populations were crashing and some were going extinct. Happy, because confused puppies in Washington were giving them money, something that hardly ever happens to frogmen. The theory was that amphibians were ‘canaries in a coal mine’, uniquely sensitive to environmental degradation.

...

It took some time for herpetologists to admit that this chytrid fungus is the main culprit – some are still resisting. First, it was a lot like how doctors resisted Semmelweiss’ discoveries about the cause of puerperal fever – since doctors were the main method of transmission. How did this fungus get to the cloud forests of Costa Rica? On the boots of herpetologists, of course.

The second problem is Occam’s butterknife: even though this chytrid fungus is the main culprit, it’s just got to be more complicated than that. Even if it isn’t. People in the life sciences – biology and medicine – routinely reject simple hypotheses that do a good job of explaining the data for more complex hypotheses that don’t. College taught them to think – unwisely.
west-hunter  scitariat  reflection  stories  troll  lol  science  low-hanging  occam  parsimony  bio  medicine  meta:medicine  ability-competence  explanans  disease  parasites-microbiome  spreading  world  nature  environment  climate-change  hypochondria  academia  questions  epidemiology  incentives  interests 
february 2018 by nhaliday
Behaving Discretely: Heuristic Thinking in the Emergency Department
I find compelling evidence of heuristic thinking in this setting: patients arriving in the emergency department just after their 40th birthday are roughly 10% more likely to be tested for and 20% more likely to be diagnosed with ischemic heart disease (IHD) than patients arriving just before this date, despite the fact that the incidence of heart disease increases smoothly with age.

Figure 1: Proportion of ED patients tested for heart attack
pdf  study  economics  behavioral-econ  field-study  biases  heuristic  error  healthcare  medicine  meta:medicine  age-generation  aging  cardio  bounded-cognition  shift  trivia  cocktail  pro-rata 
december 2017 by nhaliday
Health Services as Credence Goods: A Field Experiment by Felix Gottschalk, Wanda Mimra, Christian Waibel :: SSRN
A test patient who does not need treatment is sent to 180 dentists to receive treatment recommendations. In the experiment, we vary two factors: First, the information that the patient signals to the dentist. Second, we vary the perceived socioeconomic status (SES) of the test patient. Furthermore, we collected data to construct several measures of short- and long-term demand and competition as well as dentist and practice characteristics. We find that the patient receives an overtreatment recommendation in _more than every fourth visit_. A low short-term demand, indicating excess capacities, leads to significantly more overtreatment recommendations. Physician density and their price level, however, do not have a significant effect on overtreatment. Furthermore, we observe significantly less overtreatment recommendations for the patient with higher SES compared to lower SES under standard information. More signalled information however does not significantly reduce overtreatment.

How much dentists are ethically concerned about overtreatment; a vignette-based survey in Switzerland: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4474445/
Are Dentists Overtreating Your Teeth?: https://well.blogs.nytimes.com/2011/11/28/are-dentists-overtreating-your-teeth/
Have you had a rash of fillings after years of healthy teeth? The culprit may be “microcavities,” and not every dentist thinks they need to be treated, reports today’s Science Times.
How Dentists Rip Us Off: https://www.dentistat.com/ReaderDigestArticle.pdf

https://www.npr.org/templates/story/story.php?storyId=130356647
study  economics  micro  field-study  markets  trust  healthcare  dental  crooked  supply-demand  incentives  class  signaling  🎩  trivia  cocktail  europe  germanic  medicine  meta:medicine  integrity  ethics  free-riding  data  scale  inequality  news  org:rec  org:health  info-econ  pdf  org:mag  left-wing 
october 2017 by nhaliday
Evidence-based | West Hunter
The central notion of evidence-based medicine is that our understanding of human biology is imperfect. Some of the idea we come up with for treating and preventing disease are effective, but most are not, worse than useless. So we need careful, rigorous statistical studies before implementing those ideas on a wide scale. A good example of doing this the wrong way was when when doctors started recommending having babies sleep prone, which roughly doubled the incidence of sudden infant death syndrome for the next several decades.

It seems to me that our understanding of psychology, sociology, economics, political science, and education is at least as imperfect as our understanding of biomedicine.

https://westhunt.wordpress.com/2015/01/24/evidence-based/#comment-65904
“Measure twice, cut once” – can’t get much more elitist than that!

Carefully testing innovations on a small scale before widely implementing them is pretty much the opposite of what self-appointed elites have done. Are you deef or something?

https://westhunt.wordpress.com/2015/01/24/evidence-based/#comment-66035
To the extent that they diverge from accepted best practice, physicians, on average, add negative value. I’ve seen this in action, and statistical studies back it up. In other words, Gregory House is a fictional character.
west-hunter  scitariat  discussion  truth  westminster  social-science  academia  psychology  social-psych  sociology  economics  polisci  education  medicine  meta:medicine  evidence-based  empirical  elite  technocracy  cochrane  best-practices  marginal  multi  poast  vampire-squid  humility  reason  ability-competence  the-watchers 
september 2017 by nhaliday
Of mice and men: why animal trial results don’t always translate to humans
It showed that of the most-cited animal studies in prestigious scientific journals, such as Nature and Cell, only 37% were replicated in subsequent human randomised trials and 18% were contradicted in human trials. It is safe to assume that less-cited animal studies in lesser journals would have an even lower strike rate.
news  org:mag  org:edu  science  meta:science  medicine  meta:medicine  model-organism  human-study  homo-hetero  data  pro-rata  org:nat  replication  methodology 
september 2017 by nhaliday
Of Mice and Men | West Hunter
It’s not always easy figuring out how a pathogen causes disease. There is an example in mice for which the solution was very difficult, so difficult that we would probably have failed to discover the cause of a similarly obscure infectious disease in humans.

Mycoplasma pulmonis causes a chronic obstructive lung disease in mice, but it wasn’t easy to show this. The disease was first described in 1915, and by 1940, people began to suspect Mycoplasma pulmonis might be the cause. But then again, maybe not. It was often found in mice that seemed healthy. Pure cultures of this organism did not consistently produce lung disease – which means that it didn’t satisfy Koch’s postulates, in particular postulate 1 (The microorganism must be found in abundance in all organisms suffering from the disease, but should not be found in healthy organisms.) and postulate 3 (The cultured microorganism should cause disease when introduced into a healthy organism.).

Well, those postulates are not logic itself, but rather a useful heuristic. Koch knew that, even if lots of other people don’t.

This respiratory disease of mice is long-lasting, but slow to begin. It can take half a lifetime – a mouse lifetime, that is – and that made finding the cause harder. It required patience, which means I certainly couldn’t have done it.

Here’s how they solved it. You can raise germ-free mice. In the early 1970s, researchers injected various candidate pathogens into different groups of germ-free mice and waited to see which, if any, developed this chronic lung disease. It was Mycoplasma pulmonis , all right, but it had taken 60 years to find out.

It turned out that susceptibility differed between different mouse strains – genetic susceptibility was important. Co-infection with other pathogens affected the course of the disease. Microenvironmental details mattered – mainly ammonia in cages where the bedding wasn’t changed often enough. But it didn’t happen without that mycoplasma, which was a key causal link, something every engineer understands but many MDs don’t.

If there was a similarly obscure infectious disease of humans, say one that involved a fairly common bug found in both the just and the unjust, one that took decades for symptoms to manifest – would we have solved it? Probably not.

Cooties are everywhere.

gay germ search: https://westhunt.wordpress.com/2013/07/21/of-mice-and-men/#comment-15905
It’s hard to say, depends on how complicated the path of causation is. Assuming that I’m even right, of course. Some good autopsy studies might be fruitful – you’d look for microanatomical brain differences, as with nartcolepsy. Differences in gene expression, maybe. You could look for a pathogen – using the digital version of RDA (representational difference analysis), say on discordant twins. Do some old-fashioned epidemiology. Look for marker antibodies, signs of some sort of immunological event.

Do all of the above on gay rams – lots easier to get started, much less whining from those being vivisected.

Patrick Moore found the virus causing Kaposi’s sarcoma without any funding at all. I’m sure Peter Thiel could afford a serious try.
west-hunter  scitariat  discussion  ideas  reflection  analogy  model-organism  bio  disease  parasites-microbiome  medicine  epidemiology  heuristic  thick-thin  stories  experiment  track-record  intricacy  gotchas  low-hanging  🌞  patience  complex-systems  meta:medicine  multi  poast  methodology  red-queen  brain-scan  neuro  twin-study  immune  nature  gender  sex  sexuality  thiel  barons  gwern  stylized-facts  inference  apollonian-dionysian 
september 2017 by nhaliday
Medicine as a pseudoscience | West Hunter
The idea that venesection was a good thing, or at least not so bad, on the grounds that one in a few hundred people have hemochromatosis (in Northern Europe) reminds me of the people who don’t wear a seatbelt, since it would keep them from being thrown out of their convertible into a waiting haystack, complete with nubile farmer’s daughter. Daughters. It could happen. But it’s not the way to bet.

Back in the good old days, Charles II, age 53, had a fit one Sunday evening, while fondling two of his mistresses.

Monday they bled him (cupping and scarifying) of eight ounces of blood. Followed by an antimony emetic, vitriol in peony water, purgative pills, and a clyster. Followed by another clyster after two hours. Then syrup of blackthorn, more antimony, and rock salt. Next, more laxatives, white hellebore root up the nostrils. Powdered cowslip flowers. More purgatives. Then Spanish Fly. They shaved his head and stuck blistering plasters all over it, plastered the soles of his feet with tar and pigeon-dung, then said good-night.

...

Friday. The king was worse. He tells them not to let poor Nelly starve. They try the Oriental Bezoar Stone, and more bleeding. Dies at noon.

Most people didn’t suffer this kind of problem with doctors, since they never saw one. Charles had six. Now Bach and Handel saw the same eye surgeon, John Taylor – who blinded both of them. Not everyone can put that on his resume!

You may wonder how medicine continued to exist, if it had a negative effect, on the whole. There’s always the placebo effect – at least there would be, if it existed. Any real placebo effect is very small: I’d guess exactly zero. But there is regression to the mean. You see the doctor when you’re feeling worse than average – and afterwards, if he doesn’t kill you outright, you’re likely to feel better. Which would have happened whether you’d seen him or not, but they didn’t often do RCTs back in the day – I think James Lind was the first (1747).

Back in the late 19th century, Christian Scientists did better than others when sick, because they didn’t believe in medicine. For reasons I think mistaken, because Mary Baker Eddy rejected the reality of the entire material world, but hey, it worked. Parenthetically, what triggered all that New Age nonsense in 19th century New England? Hash?

This did not change until fairly recently. Sometime in the early 20th medicine, clinical medicine, what doctors do, hit break-even. Now we can’t do without it. I wonder if there are, or will be, other examples of such a pile of crap turning (mostly) into a real science.

good tweet: https://twitter.com/bowmanthebard/status/897146294191390720
The brilliant GP I've had for 35+ years has retired. How can I find another one who meets my requirements?

1 is overweight
2 drinks more than officially recommended amounts
3 has an amused, tolerant atitude to human failings
4 is well aware that we're all going to die anyway, & there are better or worse ways to die
5 has a healthy skeptical attitude to mainstream medical science
6 is wholly dismissive of "a|ternative” medicine
7 believes in evolution
8 thinks most diseases get better without intervention, & knows the dangers of false positives
9 understands the base rate fallacy

EconPapers: Was Civil War Surgery Effective?: http://econpapers.repec.org/paper/htrhcecon/444.htm
contra Greg Cochran:
To shed light on the subject, I analyze a data set created by Dr. Edmund Andrews, a Civil war surgeon with the 1st Illinois Light Artillery. Dr. Andrews’s data can be rendered into an observational data set on surgical intervention and recovery, with controls for wound location and severity. The data also admits instruments for the surgical decision. My analysis suggests that Civil War surgery was effective, and increased the probability of survival of the typical wounded soldier, with average treatment effect of 0.25-0.28.

Medical Prehistory: https://westhunt.wordpress.com/2016/03/14/medical-prehistory/
What ancient medical treatments worked?

https://westhunt.wordpress.com/2016/03/14/medical-prehistory/#comment-76878
In some very, very limited conditions, bleeding?
--
Bad for you 99% of the time.

https://westhunt.wordpress.com/2016/03/14/medical-prehistory/#comment-76947
Colchicine – used to treat gout – discovered by the Ancient Greeks.

https://westhunt.wordpress.com/2016/03/14/medical-prehistory/#comment-76973
Dracunculiasis (Guinea worm)
Wrap the emerging end of the worm around a stick and slowly pull it out.
(3,500 years later, this remains the standard treatment.)
https://en.wikipedia.org/wiki/Ebers_Papyrus

https://westhunt.wordpress.com/2016/03/14/medical-prehistory/#comment-76971
Some of the progress is from formal medicine, most is from civil engineering, better nutrition ( ag science and physical chemistry), less crowded housing.

Nurses vs doctors: https://westhunt.wordpress.com/2014/10/01/nurses-vs-doctors/
Medicine, the things that doctors do, was an ineffective pseudoscience until fairly recently. Until 1800 or so, they were wrong about almost everything. Bleeding, cupping, purging, the four humors – useless. In the 1800s, some began to realize that they were wrong, and became medical nihilists that improved outcomes by doing less. Some patients themselves came to this realization, as when Civil War casualties hid from the surgeons and had better outcomes. Sometime in the early 20th century, MDs reached break-even, and became an increasingly positive influence on human health. As Lewis Thomas said, medicine is the youngest science.

Nursing, on the other hand, has always been useful. Just making sure that a patient is warm and nourished when too sick to take care of himself has helped many survive. In fact, some of the truly crushing epidemics have been greatly exacerbated when there were too few healthy people to take care of the sick.

Nursing must be old, but it can’t have existed forever. Whenever it came into existence, it must have changed the selective forces acting on the human immune system. Before nursing, being sufficiently incapacitated would have been uniformly fatal – afterwards, immune responses that involved a period of incapacitation (with eventual recovery) could have been selectively favored.

when MDs broke even: https://westhunt.wordpress.com/2014/10/01/nurses-vs-doctors/#comment-58981
I’d guess the 1930s. Lewis Thomas thought that he was living through big changes. They had a working serum therapy for lobar pneumonia ( antibody-based). They had many new vaccines ( diphtheria in 1923, whopping cough in 1926, BCG and tetanus in 1927, yellow fever in 1935, typhus in 1937.) Vitamins had been mostly worked out. Insulin was discovered in 1929. Blood transfusions. The sulfa drugs, first broad-spectrum antibiotics, showed up in 1935.

DALYs per doctor: https://westhunt.wordpress.com/2018/01/22/dalys-per-doctor/
The disability-adjusted life year (DALY) is a measure of overall disease burden – the number of years lost. I’m wondering just much harm premodern medicine did, per doctor. How many healthy years of life did a typical doctor destroy (net) in past times?

...

It looks as if the average doctor (in Western medicine) killed a bunch of people over his career ( when contrasted with doing nothing). In the Charles Manson class.

Eventually the market saw through this illusion. Only took a couple of thousand years.

https://westhunt.wordpress.com/2018/01/22/dalys-per-doctor/#comment-100741
That a very large part of healthcare spending is done for non-health reasons. He has a chapter on this in his new book, also check out his paper “Showing That You Care: The Evolution of Health Altruism” http://mason.gmu.edu/~rhanson/showcare.pdf
--
I ran into too much stupidity to finish the article. Hanson’s a loon. For example when he talks about the paradox of blacks being more sentenced on drug offenses than whites although they use drugs at similar rate. No paradox: guys go to the big house for dealing, not for using. Where does he live – Mars?

I had the same reaction when Hanson parroted some dipshit anthropologist arguing that the stupid things people do while drunk are due to social expectations, not really the alcohol.
Horseshit.

I don’t think that being totally unable to understand everybody around you necessarily leads to deep insights.

https://westhunt.wordpress.com/2018/01/22/dalys-per-doctor/#comment-100744
What I’ve wondered is if there was anything that doctors did that actually was helpful and if perhaps that little bit of success helped them fool people into thinking the rest of it helped.
--
Setting bones. extracting arrows: spoon of Diocles. Colchicine for gout. Extracting the Guinea worm. Sometimes they got away with removing the stone. There must be others.
--
Quinine is relatively recent: post-1500. Obstetrical forceps also. Caesarean deliveries were almost always fatal to the mother until fairly recently.

Opium has been around for a long while : it works.

https://westhunt.wordpress.com/2018/01/22/dalys-per-doctor/#comment-100839
If pre-modern medicine was indeed worse than useless – how do you explain no one noticing that patients who get expensive treatments are worse off than those who didn’t?
--
were worse off. People are kinda dumb – you’ve noticed?
--
My impression is that while people may be “kinda dumb”, ancient customs typically aren’t.
Even if we assume that all people who lived prior to the 19th century were too dumb to make the rational observation, wouldn’t you expect this ancient practice to be subject to selective pressure?
--
Your impression is wrong. Do you think that there some slick reason for Carthaginians incinerating their first-born?

Theodoric of York, bloodletting: https://www.youtube.com/watch?v=yvff3TViXmY

details on blood-letting and hemochromatosis: https://westhunt.wordpress.com/2018/01/22/dalys-per-doctor/#comment-100746

Starting Over: https://westhunt.wordpress.com/2018/01/23/starting-over/
Looking back on it, human health would have … [more]
west-hunter  scitariat  discussion  ideas  medicine  meta:medicine  science  realness  cost-benefit  the-trenches  info-dynamics  europe  the-great-west-whale  history  iron-age  the-classics  mediterranean  medieval  early-modern  mostly-modern  🌞  harvard  aphorism  rant  healthcare  regression-to-mean  illusion  public-health  multi  usa  northeast  pre-ww2  checklists  twitter  social  albion  ability-competence  study  cliometrics  war  trivia  evidence-based  data  intervention  effect-size  revolution  speculation  sapiens  drugs  antiquity  lived-experience  list  survey  questions  housing  population  density  nutrition  wiki  embodied  immune  evolution  poast  chart  markets  civil-liberty  randy-ayndy  market-failure  impact  scale  pro-rata  estimate  street-fighting  fermi  marginal  truth  recruiting  alt-inst  academia  social-science  space  physics  interdisciplinary  ratty  lesswrong  autism  👽  subculture  hanson  people  track-record  crime  criminal-justice  criminology  race  ethanol  error  video  lol  comedy  tradition  institutions  iq  intelligence  MENA  impetus  legacy 
august 2017 by nhaliday
Low-Hanging Fruit: Nyekulturny | West Hunter
The methodology is what’s really interesting.  Kim Lewis and Slava Epstein sorted individual soil bacteria into chambers of a device they call the iChip, which is then buried in the ground – the point being that something like 98% of soil bacteria cannot be cultured in standard media, while in this approach, key compounds (whatever they are) can diffuse in from the soil, allowing something like 50% of soil bacteria species to grow.  They then tested the bacterial colonies (10,000 of them) to see if any slammed S. aureus – and some did.

...

I could be wrong, but I wonder if part of the explanation is that microbiology – the subject – is in relative decline, suffering because of funding and status competition with molecular biology and genomics (sexier and less useful than microbiology) . That and the fact that big pharma is not enthusiastic about biological products.
west-hunter  scitariat  discussion  ideas  speculation  bio  science  medicine  meta:medicine  low-hanging  error  stagnation  disease  parasites-microbiome  pharma  innovation  info-dynamics  the-world-is-just-atoms  discovery  the-trenches  alt-inst  dirty-hands  fashun 
july 2017 by nhaliday
Vioxx | West Hunter
The Vigor study was submitted in February 2001. The New England Journal of Medicine, a few months later, found that the authors had failed to mention some strokes and heart attacks near the end of the trial. The authors used a cutoff for cardiovascular effects (bad news) that was earlier than the cutoff for gastrointestinal effects (good news). why? Because they were weasels, of course. There was a lot of money riding on this drug’s success.

Other people began to notice the increased heart risks – looking at data from HMOs and such. Merck fought back. There was an MD at Stanford that was concerned about Vioxx: Merck called up the dean of Stanford Medical School at home and warned him about possible loss of financial support: he told them to go fuck themselves.

...

Now it is true that there were studies that showed greater efficacy: 21 such were reported by Scott S. Reuben, former chief of acute pain at Baystate medical Center in Springfield Mass. But as it turns out, he made them all up. There’s is no evidence that Merck knew about this, but it does perhaps say something about the general climate in big pharma.

Merck knew the gist of this for four years before they pulled the plug on the drug. They had their their drug reps lie about cardio risks, threatened researchers and sued journals that talked about the emerging cardio risks. Few physicians were aware of these risks, even though a close reading of the journals would have suggested it – because hardly any physicians read the journals.

Epidemiologists think that Vioxx caused something like 40,000 deaths.

...

In the 70s corporations were the bad guys, whether they were or not. Today, billionaires are your friend.
west-hunter  scitariat  discussion  reflection  stories  history  mostly-modern  drugs  medicine  meta:medicine  rent-seeking  cardio  public-health  epidemiology  vampire-squid  corporation  madisonian  domestication  pharma  track-record  randy-ayndy  aphorism  interests 
july 2017 by nhaliday
Alzheimers | West Hunter
Some disease syndromes almost have to be caused by pathogens – for example, any with a fitness impact (prevalence x fitness reduction) > 2% or so, too big to be caused by mutational pressure. I don’t think that this is the case for AD: it hits so late in life that the fitness impact is minimal. However, that hardly means that it can’t be caused by a pathogen or pathogens – a big fraction of all disease syndromes are, including many that strike in old age. That possibility is always worth checking out, not least because infectious diseases are generally easier to prevent and/or treat.

There is new work that strongly suggests that pathogens are the root cause. It appears that the amyloid is an antimicrobial peptide. amyloid-beta binds to invading microbes and then surrounds and entraps them. ‘When researchers injected Salmonella into mice’s hippocampi, a brain area damaged in Alzheimer’s, A-beta quickly sprang into action. It swarmed the bugs and formed aggregates called fibrils and plaques. “Overnight you see the plaques throughout the hippocampus where the bugs were, and then in each single plaque is a single bacterium,” Tanzi says. ‘

obesity and pathogens: https://westhunt.wordpress.com/2016/05/29/alzheimers/#comment-79757
not sure about this guy, but interesting: https://westhunt.wordpress.com/2016/05/29/alzheimers/#comment-79748
http://perfecthealthdiet.com/2010/06/is-alzheimer%E2%80%99s-caused-by-a-bacterial-infection-of-the-brain/

https://westhunt.wordpress.com/2016/12/13/the-twelfth-battle-of-the-isonzo/
All too often we see large, long-lasting research efforts that never produce, never achieve their goal.

For example, the amyloid hypothesis [accumulation of amyloid-beta oligomers is the cause of Alzheimers] has been dominant for more than 20 years, and has driven development of something like 15 drugs. None of them have worked. At the same time the well-known increased risk from APOe4 has been almost entirely ignored, even though it ought to be a clue to the cause.

In general, when a research effort has been spinning its wheels for a generation or more, shouldn’t we try something different? We could at least try putting a fraction of those research dollars into alternative approaches that have not yet failed repeatedly.

Mostly this applies to research efforts that at least wish they were science. ‘educational research’ is in a special class, and I hardly know what to recommend. Most of the remedial actions that occur to me violate one or more of the Geneva conventions.

APOe4 related to lymphatic system: https://en.wikipedia.org/wiki/Apolipoprotein_E

https://westhunt.wordpress.com/2012/03/06/spontaneous-generation/#comment-2236
Look,if I could find out the sort of places that I usually misplace my keys – if I did, which I don’t – I could find the keys more easily the next time I lose them. If you find out that practitioners of a given field are not very competent, it marks that field as a likely place to look for relatively easy discovery. Thus medicine is a promising field, because on the whole doctors are not terribly good investigators. For example, none of the drugs developed for Alzheimers have worked at all, which suggests that our ideas on the causation of Alzheimers are likely wrong. Which suggests that it may (repeat may) be possible to make good progress on Alzheimers, either by an entirely empirical approach, which is way underrated nowadays, or by dumping the current explanation, finding a better one, and applying it.

You could start by looking at basic notions of field X and asking yourself: How do we really know that? Is there serious statistical evidence? Does that notion even accord with basic theory? This sort of checking is entirely possible. In most of the social sciences, we don’t, there isn’t, and it doesn’t.

Hygiene and the world distribution of Alzheimer’s disease: Epidemiological evidence for a relationship between microbial environment and age-adjusted disease burden: https://academic.oup.com/emph/article/2013/1/173/1861845/Hygiene-and-the-world-distribution-of-Alzheimer-s

Amyloid-β peptide protects against microbial infection in mouse and worm models of Alzheimer’s disease: http://stm.sciencemag.org/content/8/340/340ra72

Fungus, the bogeyman: http://www.economist.com/news/science-and-technology/21676754-curious-result-hints-possibility-dementia-caused-fungal
Fungus and dementia
paper: http://www.nature.com/articles/srep15015
west-hunter  scitariat  disease  parasites-microbiome  medicine  dementia  neuro  speculation  ideas  low-hanging  todo  immune  roots  the-bones  big-surf  red-queen  multi  🌞  poast  obesity  strategy  info-foraging  info-dynamics  institutions  meta:medicine  social-science  curiosity  🔬  science  meta:science  meta:research  wiki  epidemiology  public-health  study  arbitrage  alt-inst  correlation  cliometrics  path-dependence  street-fighting  methodology  nibble  population-genetics  org:nat  health  embodied  longevity  aging  org:rec  org:biz  org:anglo  news  neuro-nitgrit  candidate-gene  nutrition  diet  org:health  explanans  fashun  empirical  theory-practice  ability-competence  dirty-hands  education  aphorism  truth  westminster  innovation  evidence-based  religion  prudence  track-record  problem-solving 
july 2017 by nhaliday
Genomic analysis of family data reveals additional genetic effects on intelligence and personality | bioRxiv
methodology:
Using Extended Genealogy to Estimate Components of Heritability for 23 Quantitative and Dichotomous Traits: http://journals.plos.org/plosgenetics/article?id=10.1371/journal.pgen.1003520
Pedigree- and SNP-Associated Genetics and Recent Environment are the Major Contributors to Anthropometric and Cardiometabolic Trait Variation: http://journals.plos.org/plosgenetics/article?id=10.1371/journal.pgen.1005804

Missing Heritability – found?: https://westhunt.wordpress.com/2017/02/09/missing-heritability-found/
There is an interesting new paper out on genetics and IQ. The claim is that they have found the missing heritability – in rare variants, generally different in each family.

Some of the variants, the ones we find with GWAS, are fairly common and fitness-neutral: the variant that slightly increases IQ confers the same fitness (or very close to the same) as the one that slightly decreases IQ – presumably because of other effects it has. If this weren’t the case, it would be impossible for both of the variants to remain common.

The rare variants that affect IQ will generally decrease IQ – and since pleiotropy is the norm, usually they’ll be deleterious in other ways as well. Genetic load.

Happy families are all alike; every unhappy family is unhappy in its own way.: https://westhunt.wordpress.com/2017/06/06/happy-families-are-all-alike-every-unhappy-family-is-unhappy-in-its-own-way/
It now looks as if the majority of the genetic variance in IQ is the product of mutational load, and the same may be true for many psychological traits. To the extent this is the case, a lot of human psychological variation must be non-adaptive. Maybe some personality variation fulfills an evolutionary function, but a lot does not. Being a dumb asshole may be a bug, rather than a feature. More generally, this kind of analysis could show us whether particular low-fitness syndromes, like autism, were ever strategies – I suspect not.

It’s bad new news for medicine and psychiatry, though. It would suggest that what we call a given type of mental illness, like schizophrenia, is really a grab-bag of many different syndromes. The ultimate causes are extremely varied: at best, there may be shared intermediate causal factors. Not good news for drug development: individualized medicine is a threat, not a promise.

see also comment at: https://pinboard.in/u:nhaliday/b:a6ab4034b0d0

https://www.reddit.com/r/slatestarcodex/comments/5sldfa/genomic_analysis_of_family_data_reveals/
So the big implication here is that it's better than I had dared hope - like Yang/Visscher/Hsu have argued, the old GCTA estimate of ~0.3 is indeed a rather loose lower bound on additive genetic variants, and the rest of the missing heritability is just the relatively uncommon additive variants (ie <1% frequency), and so, like Yang demonstrated with height, using much more comprehensive imputation of SNP scores or using whole-genomes will be able to explain almost all of the genetic contribution. In other words, with better imputation panels, we can go back and squeeze out better polygenic scores from old GWASes, new GWASes will be able to reach and break the 0.3 upper bound, and eventually we can feasibly predict 0.5-0.8. Between the expanding sample sizes from biobanks, the still-falling price of whole genomes, the gradual development of better regression methods (informative priors, biological annotation information, networks, genetic correlations), and better imputation, the future of GWAS polygenic scores is bright. Which obviously will be extremely helpful for embryo selection/genome synthesis.

The argument that this supports mutation-selection balance is weaker but plausible. I hope that it's true, because if that's why there is so much genetic variation in intelligence, then that strongly encourages genetic engineering - there is no good reason or Chesterton fence for intelligence variants being non-fixed, it's just that evolution is too slow to purge the constantly-accumulating bad variants. And we can do better.
https://rubenarslan.github.io/generation_scotland_pedigree_gcta/

The surprising implications of familial association in disease risk: https://arxiv.org/abs/1707.00014
https://spottedtoad.wordpress.com/2017/06/09/personalized-medicine-wont-work-but-race-based-medicine-probably-will/
As Greg Cochran has pointed out, this probably isn’t going to work. There are a few genes like BRCA1 (which makes you more likely to get breast and ovarian cancer) that we can detect and might affect treatment, but an awful lot of disease turns out to be just the result of random chance and deleterious mutation. This means that you can’t easily tailor disease treatment to people’s genes, because everybody is fucked up in their own special way. If Johnny is schizophrenic because of 100 random errors in the genes that code for his neurons, and Jack is schizophrenic because of 100 other random errors, there’s very little way to test a drug to work for either of them- they’re the only one in the world, most likely, with that specific pattern of errors. This is, presumably why the incidence of schizophrenia and autism rises in populations when dads get older- more random errors in sperm formation mean more random errors in the baby’s genes, and more things that go wrong down the line.

The looming crisis in human genetics: http://www.economist.com/node/14742737
Some awkward news ahead
- Geoffrey Miller

Human geneticists have reached a private crisis of conscience, and it will become public knowledge in 2010. The crisis has depressing health implications and alarming political ones. In a nutshell: the new genetics will reveal much less than hoped about how to cure disease, and much more than feared about human evolution and inequality, including genetic differences between classes, ethnicities and races.

2009!
study  preprint  bio  biodet  behavioral-gen  GWAS  missing-heritability  QTL  🌞  scaling-up  replication  iq  education  spearhead  sib-study  multi  west-hunter  scitariat  genetic-load  mutation  medicine  meta:medicine  stylized-facts  ratty  unaffiliated  commentary  rhetoric  wonkish  genetics  genomics  race  pop-structure  poast  population-genetics  psychiatry  aphorism  homo-hetero  generalization  scale  state-of-art  ssc  reddit  social  summary  gwern  methodology  personality  britain  anglo  enhancement  roots  s:*  2017  data  visualization  database  let-me-see  bioinformatics  news  org:rec  org:anglo  org:biz  track-record  prediction  identity-politics  pop-diff  recent-selection  westminster  inequality  egalitarianism-hierarchy  high-dimension  applications  dimensionality  ideas  no-go  volo-avolo  magnitude  variance-components  GCTA  tradeoffs  counter-revolution  org:mat  dysgenics  paternal-age  distribution  chart  abortion-contraception-embryo 
june 2017 by nhaliday
Is Pharma Research Worse Than Chance? | Slate Star Codex
Here’s one hypothesis: at the highest level, the brain doesn’t have that many variables to affect, or all the variables are connected. If you smack the brain really really hard in some direction or other, you will probably treat some psychiatric disease. Drugs of abuse are ones that smack the brain really hard in some direction or other. They do something. So find the psychiatric illness that’s treated by smacking the brain in that direction, and you’re good.

Actual carefully-researched psychiatric drugs are exquisitely selected for having few side effects. The goal is something like an SSRI – mild stomach discomfort, some problems having sex, but overall you can be on them forever and barely notice their existence. In the grand scheme of things their side effects are tiny – in most placebo-controlled studies, people have a really hard time telling whether they’re in the experimental or the placebo group.

...

But given that we’re all very excited to learn about ketamine and MDMA, and given that if their original promise survives further testing we will consider them great discoveries, it suggests we chose the wrong part of the tradeoff curve. Or at least it suggests a different way of framing that tradeoff curve. A drug that makes you feel extreme side effects for a few hours – but also has very strong and lasting treatment effects – is better than a drug with few side effects and weaker treatment effects. That suggests a new direction pharmaceutical companies might take: look for the chemicals that have the strongest and wackiest effects on the human mind. Then see if any of them also treat some disease.

I think this is impossible with current incentives. There’s too little risk-tolerance at every stage in the system. But if everyone rallied around the idea, it might be that trying the top hundred craziest things Alexander Shulgin dreamed up on whatever your rat model is would be orders of magnitude more productive than whatever people are doing now.
ratty  yvain  ssc  reflection  psychiatry  medicine  pharma  drugs  error  efficiency  random  meta:medicine  flexibility  outcome-risk  incentives  stagnation  innovation  low-hanging  tradeoffs  realness  perturbation  degrees-of-freedom  volo-avolo  null-result 
june 2017 by nhaliday
I hate every ape I see | West Hunter
Chimpanzees, although expensive, are really useful for medical research, since they’re much closer to humans than any other experimental animal. Yet the Feds are phasing out chimp research, and are sending them off to Club Chimp. Francis Collins, director of NIH, says that “new scientific methods and technologies have rendered their use in research largely unnecessary.” Collins is full of crap, as usual.
west-hunter  scitariat  rant  ideas  science  medicine  model-organism  meta:medicine  realness  westminster  kumbaya-kult  is-ought  people  track-record  commentary  current-events  ethics 
may 2017 by nhaliday
Germ theory of disease - Wikipedia
The germ theory was proposed by Girolamo Fracastoro in 1546, and expanded upon by Marcus von Plenciz in 1762. Such views were held in disdain, however, and Galen's miasma theory remained dominant among scientists and doctors. The nature of this doctrine prevented them from understanding how diseases actually progressed, with predictable consequences. By the early nineteenth century, smallpox vaccination was commonplace in Europe, though doctors were unaware of how it worked or how to extend the principle to other diseases. Similar treatments had been prevalent in India from just before 1000 A.D.[2] [N 1] A transitional period began in the late 1850s as the work of Louis Pasteur and Robert Koch provided convincing evidence; by 1880, miasma theory was struggling to compete with the germ theory of disease. Eventually, a "golden era" of bacteriology ensued, in which the theory quickly led to the identification of the actual organisms that cause many diseases.[3][4] Viruses were discovered in the 1890s.
concept  disease  parasites-microbiome  bio  science  medicine  meta:medicine  spreading  history  iron-age  medieval  early-modern  europe  mediterranean  the-classics  germanic  britain  dataviz  stories  being-right  info-dynamics  discovery  innovation  wiki  reference  the-trenches  public-health  big-peeps  epidemiology  the-great-west-whale 
may 2017 by nhaliday
Low-Hanging Poop | West Hunter
Obviously, sheer disgust made it hard for doctors to embrace this treatment.  There’s a lesson here: in the search for low-hanging fruit,  reconsider approaches that are embarrassing, or offensive, or downright disgusting.
west-hunter  scitariat  stories  discussion  medicine  meta:medicine  being-right  info-dynamics  epistemic  emotion  sanctity-degradation  education  low-hanging  error  bounded-cognition  embodied  policy  ideas  the-trenches  alt-inst  innovation  discovery 
may 2017 by nhaliday
Vavilovian mimicry - Wikipedia
Rye started out as a weed
https://westhunt.wordpress.com/2014/07/23/secondary-crops/
It seems to me that there may be some social parallels: bandits turning into governments, alchemists into chemists, Galenic doctors into almost-scientific medicine.
cocktail  trivia  bio  agriculture  evolution  unintended-consequences  selection  wiki  reference  cool  multi  west-hunter  scitariat  ideas  leviathan  broad-econ  north-weingast-like  medicine  meta:medicine  domestication  interests  feudal  roots 
april 2017 by nhaliday

« earlier    

related tags

2016-election  2016  2017  :/  ability-competence  abortion-contraception-embryo  academia  age-generation  age-of-discovery  aging  agriculture  ai  albion  alt-inst  analogy  analysis  anglo  anglosphere  anthropology  antidemos  antiquity  aphorism  apollonian-dionysian  applications  arbitrage  archaeology  asia  audio  authoritarianism  autism  automation  barons  behavioral-econ  behavioral-gen  being-right  best-practices  biases  big-peeps  big-surf  bio  biodet  bioinformatics  books  bounded-cognition  brain-scan  britain  broad-econ  business  cancer  candidate-gene  canon  cardio  causation  censorship  chart  checklists  china  civil-liberty  civilization  class  classification  climate-change  cliometrics  cochrane  cocktail  comedy  commentary  comparison  complex-systems  concept  confluence  conquest-empire  contrarianism  cool  core-rats  corporation  correlation  corruption  cost-benefit  counter-revolution  cracker-econ  crime  criminal-justice  criminology  critique  crooked  curiosity  current-events  darwinian  data  database  dataviz  death  decentralized  deep-materialism  definite-planning  degrees-of-freedom  dementia  demographics  density  dental  developing-world  diet  dimensionality  dirty-hands  discovery  discussion  disease  distribution  domestication  drugs  dysgenics  early-modern  economics  econotariat  education  effect-size  efficiency  egalitarianism-hierarchy  elections  elite  embodied-cognition  embodied  emotion  empirical  endo-exo  endogenous-exogenous  enhancement  environment  epidemiology  epistemic  error  essay  estimate  ethanol  ethics  europe  evidence-based  evolution  experiment  expert-experience  expert  explanans  farmers-and-foragers  fashun  fda  fermi  feudal  fiction  field-study  fitsci  flexibility  free-riding  frontier  gcta  gedanken  gelman  gender  generalization  genetic-load  genetics  genomics  germanic  gilens-page  gotchas  government  gray-econ  gwas  gwern  hanson  harvard  health  healthcare  heterodox  heuristic  high-dimension  higher-ed  history  hmm  hn  homo-hetero  housing  hsu  human-capital  human-study  humility  hypochondria  ideas  identity-politics  ideology  illusion  immune  impact  impetus  incentives  inequality  inference  info-dynamics  info-econ  info-foraging  innovation  insight  institutions  integrity  intel  intelligence  interdisciplinary  interests  intervention  interview  intricacy  ioannidis  iq  iran  iraq-syria  iron-age  is-ought  journos-pundits  justice  knowledge  kumbaya-kult  labor  latin-america  leadership  left-wing  legacy  len:long  len:short  lens  lesswrong  let-me-see  leviathan  linearity  links  list  lived-experience  lol  longevity  longform  low-hanging  machiavelli  machine-learning  madisonian  magnitude  management  marginal-rev  marginal  market-failure  markets  martial  media  medicine  medieval  mediterranean  mena  mendel-randomization  meta-analysis  meta:research  meta:rhetoric  meta:science  metabolic  metabuch  methodology  micro  minimalism  missing-heritability  model-organism  money  mostly-modern  multi  mutation  nature  neuro-nitgrit  neuro  news  nibble  nihil  nitty-gritty  nl-and-so-can-you  no-go  nonlinearity  north-weingast-like  northeast  null-result  nutrition  obesity  occam  optimism  org:anglo  org:biz  org:bv  org:data  org:edu  org:health  org:lite  org:mag  org:mat  org:med  org:nat  org:ngo  org:rec  org:sci  organization  organizing  outcome-risk  parasites-microbiome  parsimony  paternal-age  path-dependence  patience  pdf  people  personality  perturbation  pessimism  pharma  physics  poast  podcast  policy  polisci  politics  pop-diff  pop-structure  population-genetics  population  pre-ww2  prediction  preprint  pro-rata  problem-solving  profile  proposal  prudence  psychiatry  psychology  public-health  puzzles  q-n-a  qtl  questions  quixotic  race  random  randy-ayndy  rant  rationality  ratty  realness  reason  recent-selection  recommendations  recruiting  red-queen  reddit  reference  reflection  regression-to-mean  regularizer  regulation  religion  rent-seeking  replication  revolution  rhetoric  ritual  roots  s:*  sanctity-degradation  sapiens  scale  scaling-up  science  scifi-fantasy  scitariat  search  selection  sex  sexuality  shift  sib-study  signaling  social-psych  social-science  social  society  sociology  space  spearhead  speculation  speedometer  spreading  ssc  stackex  stagnation  state-of-art  statesmen  stats  stories  strategy  street-fighting  study  stylized-facts  subculture  summary  supply-demand  survey  taxes  technocracy  technology  techtariat  the-bones  the-classics  the-great-west-whale  the-trenches  the-watchers  the-world-is-just-atoms  theory-practice  thick-thin  thiel  thinking  todo  top-n  track-record  tradeoffs  tradition  trends  tricks  trivia  troll  trump  trust  truth  twin-study  twitter  unaffiliated  unintended-consequences  usa  vampire-squid  variance-components  video  virginia-dc  visualization  volo-avolo  war  water  west-hunter  westminster  wiki  wonkish  workflow  world-war  world  x-not-about-y  xenobio  yvain  🌞  🎩  👽  🔬  🤖 

Copy this bookmark:



description:


tags: