What I’m Reading: July 2019

As always, Our World in Data provides some interesting numbers to think about, this time with food supply and caloric intake by country.

This article on chronic lyme disease and the whole “medical issue as personal identity” phenomena was REALLY good and very thought provoking.

Ever want to know where the Vibranium from Black Panther would land on the periodic table of elements? Well, now there’s a paper out to help guide your thinking. More than just a fun paper to write up, the professors involved here actually asked their students this on an exam to see how they would reason through it. I’m in favor of questions like this (provided kids know to have watched the movie) as I think it can engage some different types of critical thinking in a way that can be more fun than traditional testing.

I mentioned to someone recently that I have a white noise app on my phone, but after testing it out I found that brown noise tends to be more effective in helping me sleep than white noise. They asked what the difference was, and I found this article that explains different color noises. In my experience the noises that tend to be loudest and most likely to interfere with sleep tend to hang out at the low end of the spectrum, YMMV.

A new study “Surrogate endpoints in randomised controlled trials: a reality check” gives an interesting word of warning to the cancer world. It’s common in clinical trials to use surrogate endpoints like “progression free survival” or “response rate”to figure out if drugs are working. This is done because overall survival can take a long time to get and researchers/patients/drug companies want results faster and it seems like if the surrogate markers are good the drugs can’t possibly hurt.

Unfortunately, it appears this isn’t the case. A new drug venetoclex was studied and patients on it were eventually found to have better progression free survival, but eventually twice as many deaths as those treated with regular treatment. Ugh. The lead author has a great Twitter thread on his paper here, where he suggests this means that either the drug is a “double edge sword” with both better efficacy and higher toxicity than alternatives, or that it’s a “wolf in sheep’s clothing” that makes things look good for a while but causes changes that means relapse is swift and deadly. Lots to think about here.

Finally, SSC has a good post up on bias arguments here. I especially like his points about when they are relevant.

One thought on “What I’m Reading: July 2019

  1. Excellent links. That first one had me wondering what went wrong in Europe and the Caribbean around 1990.

    The reasoning on Chronic Lyme was interesting. I have had patients who thought they had Morgellons, as well as a number of other conditions that are not recognised. I tend to the side that sees these as psychiatric symptoms. The argument that mainstream doctors have been wrong before is not a strong one. It is rather like saying that “Women have rejected some suitors who turned out to be great husbands, Therefore you should marry me.”


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