Tuesday, June 22, 2021

Development of public health policy and clinical recommendations is complex and needs to be evidence-based rather than belief-based

It reads like like a hit piece against critics and one long plaint.  A lot of inside ball.  From The obesity wars and the education of a researcher: A personal account by Katherine M. Flegal.  From the Abstract:

A naïve researcher published a scientific article in a respectable journal. She thought her article was straightforward and defensible. It used only publicly available data, and her findings were consistent with much of the literature on the topic. Her coauthors included two distinguished statisticians. To her surprise her publication was met with unusual attacks from some unexpected sources within the research community. These attacks were by and large not pursued through normal channels of scientific discussion. Her research became the target of an aggressive campaign that included insults, errors, misinformation, social media posts, behind-the-scenes gossip and maneuvers, and complaints to her employer. The goal appeared to be to undermine and discredit her work. The controversy was something deliberately manufactured, and the attacks primarily consisted of repeated assertions of preconceived opinions. She learned first-hand the antagonism that could be provoked by inconvenient scientific findings. Guidelines and recommendations should be based on objective and unbiased data. Development of public health policy and clinical recommendations is complex and needs to be evidence-based rather than belief-based. This can be challenging when a hot-button topic is involved.

I have no special insight into this spat.  I do not know the players.  I know CDC has, in this time period, received a lot of criticism from the right side of the political spectrum for straying into sociology and not being prepared for their primary mission which is disease spread.  An argument that has taken on particular saliency in the past eighteen months.

The other areas of CDC research which attracted criticism were gun deaths, obesity, and some other topical sociological issues.  If you accept the strong hypothesis expounded in 2011 in Connected: The Surprising Power of Our Social Networks and How They Shape Our Lives -- How Your Friends' Friends' Affect Everything You Feel, Think, and Do by James H. Fowler PhD and Nicholas A. Christakis, then there is a basis for the CDC's actions.  If you don't accept the strong version of Fowler and Chistakis's argument, then it looks like bureaucratic overreach with a strong negative ideological aspect.

Gun research can be seen as a means of advancing gun control, i.e. an infringement on the Second Amendment.

The point here is that whether or not obesity is within the purview of the CDC, there seemed to be a multi-decadal campaign to overturn or undermine evidentiary findings but with little or no basis for the criticisms being advanced.  It sounds like an ideological butting of heads between those who wish obesity to be a national health crisis versus those whose data analysis indicates that it is not.  

You could look at this as one set of scientists simply waging a personal vendetta against another out of malice.  Or you can see it as an example of one group of scientists trying to keep their gravy train of obesity crisis afloat and financially sound.  Or you can see it as an ideological war - we need an obesity crisis in order to issue orders for everyone to obey.

I have no idea what the balance of probabilities is here but having read Stuart Ritchies' Science Fictions, a comprehensive and detailed discussion of chronic scientific malpractice in the science research community, it is hard not to assume that Dr. Flegal has the better argument.   


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