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Marshall E. Deutsch at TAM??

He didn't write his own book; he's just promoting a book by Ravnskov. He's also a member of the International Network of Cholesterol Skeptics. They have a website, if you're interested. So far I haven't heard him say anything positive; he seems only interested in debunking.

As for personal medical advice, doctors don't have crystal balls and can only predict risk of heart attack based on statistics for known risk factors. This is best sorted out with your personal physician. Generally, the evidence shows that whether your cholesterol level is high or relatively low, you can probably reduce your chances of a heart attack by lowering your cholesterol further. The greater your overall risk, the greater the benefit of lowering cholesterol. See the thread on "Cholesterol Myths."
 
Indeed, apologies; I didn't mean to insinuate he was selling his own book. He was clear about a number of other books, most particularly "The Cholesterol Myth", not being his own.

That said, it would not surprise me if that is in his plans. I do think that alternate or opposing viewpoints are valuable and should be included in skeptical events, but it does concern me that this guy will be getting a lot of mileage out of "I was published in Skeptic Magazine" and "I gave my paper at TAM4", as if those were endorsements.

My last post was running waaaay too long already, so I'll just say that apart from the other thread and The SkepDoc's excellent summary above, it wasn't that hard to see what was wrong with the guy's arguments. He did a lot of citing of articles and then used the results as arguments for entirely different and unwarranted conclusions; he used obfuscatory jargon (continually referring to 'total blood cholesterol', for example, when it is now considered to be HDL/LDL ratios that are more significant) and he did a lot of setting up of straw men. It was a truly classic performance.
 
I saw his lecture (because I remembered Eos posting this thread).

What I particularly remember was:
The guy was picking highly inaccurate numbers (like death rates from heart attack?) out of an encyclopedia I think, and then picking more inaccurate numbers from another source. And then he proceeded to plot those on a graph trying to show how apparently death rates and cholesterol levels didn't seem related.
Then what also really struck me was when during his flustered response to Dr. Hall's (?) question, he at one point started saying how his own cholesterol was really high but he'd never had a heart attack before. I mean, wow, anecdotal evidence, a sample size of one. On a skeptics convention that's the equivalent of shooting yourself in the foot repeatedly.

Perhaps there were some valid observations in his presentation, but he lost most of his credibility along the way just with all the fallacies he made.
 
Really good observations exarch, and the most detailed one we've seen here on how he presented. It sounds rather unusual, to plot a graph based on those kinds of data sets in front of an audience. I would be left to think the guy doesn't know to, or doesn't choose to take relevant data from a clinical study with a discussion relevant to his subject?

It would be like myself taking disease rates for malaria from a book, and then saying the vaccination doesn't work...ignoring the fact that the folks haven't had the vaccine because it doesn't exist yet. You just have no way to assess the variables when someone takes on random numbers like that.

I'm just glad this guy didn't get away with quietly blathering on to an audience that would have been left scratching their heads as to what his point actually was in all that. I would think his "published" material in the one magazine is what got him a spot to present?

Thanks to all those who went and got to experience a rather unusual situation. It's an exercise in evaluating what is presented, no matter when and where.
 
Marshall E. Deutsch replies

Eos of the Eons; The doctor who wrote this will be at TAM. I would hope she fires off some questions to Deutsch.[/QUOTE said:
Dr. Hall and I have been corresponding about her criticisms of my talk, and she has not yet replied to my pointing out that the recent widely publicized study from the Journal of the American Medical Association on 48835 women, some of whom were fed a low-fat diet high in vegetables, fruits and grains and the rest of whom continued their usual diets showed the following results. The low-fat diet group showed a significant reduction (by 3.55 mg/dl) in LDL (the so-called bad cholesterol). The low-fat group showed "no significant effects on incidence of CHD [coronary heart disease]". This, the largest study of its kind, shows no relationship between LDL and CHD.
The first thing that Dr. Hall pounced on was a statement in my talk that you cannot produce atherosclerosis in rabbits (which normally eat a cholestero-free diet) simply by feeding them cholesterol; you also have to give them an antithyroid drug. I should have said that you can't produce atherosclerosis in rabbits by feeding them any amount of cholesterol which can be obtained in a normal diet. The food with the highest cholesterol content is egg yolk, which contains slightly less than 1.5% cholesterol. To give rabbits atherosclerosis, they are fed 2% cholesterol, more that would be supplied by a diet of only egg yolks.
I expect that the few criticisms which my SKEPTIC article elicited will be answered in the next edition of SKEPTIC. I invite dialogue with those who have actually read the article and can make substantive criticisms of my facts and reasoning. I have no economic stake in this unlike the pharmaceutical companies and the beneficiaries of their extensive "educational" programs.
Click to expand...
 
Thank you for the clarification again SkepDoc.

I'm working on another analogy for that scenairo to see if I understand this.

Let's say we take a group of people from the population with a low incidence of milk allergies, and see if not drinking milk decreases their chances of getting a rash.

Since the non-allergic folks had a low rate of rashes, and got rashes for reasons other than milk allergies, then we would EXPECT that not drinking milk would have no significant reduction in rash rates.

Now take a group of people with known milk allergies who currently drink milk and have rashes. Then get 1/2 of them to stop drinking milk. We would EXPECT a significant decrease in the amount of rashes they get, especially if the rashes are caused by the milk ingestion.

So a better CHD study would include people with high fat diets of similar ages and see if their decreased fat intake lowered cholestrol and rate of CHD? If a person already has a healthy and balanced diet, then a reduced fat diet may not show much of an effect. This shows the importance of a control group, so you can see what exactly is different in the two study groups. We don't know if the women if the "non-reduced" fat intake group had any significantly higher intake of fat or cholesterol, to the rate that they would have a higher CHD risk than the women on the reduced fat diet. Maybe the other half were all younger than the reduced fat diet group, and at lower risk of CHD no matter what their diet was. It just wasn't a good study, and really is useless to draw conclusions from.

A good study would take a population with the same risk of CHD, same age, and same starting LDL levels, and same dietary habits in both groups. Then see if the dietary change in one group from high fat to low low fat decreased their rates of CHD. That way only one variable is changed, and you can get relevant data.
 
You have pinned down the essence of good science: control for as many variables as possible. And don't try to draw conclusions about a question that the study was not designed to answer.
 
I responded to this issue in another forum from which I learned about the exchange at TAM. I read the SkepDic News Letter #55 and the CSICOP Commentary by Lewis Jones, 1995, and this, and This, Dr Hall's rebuttals to the TAM presentation. I have not yet read the Skeptic article nor did I hear the TAM lecture but I will and will comment further if need be.

The CSICOP article relies heavily on the work of McCormick and Skrabanek. McCormick and Skrabanek have some impressive publications. In fact, after I looked at Peter Skrabanek; James McCormick; Follies and Fallacies of Medicine; third edition, 12/98, I plan to buy a copy. It's out of print but there are copies around. The concepts put forth in the work of these two researchers have the utmost validity and importance in medicine today.

However, their work on coronary artery disease, CAD, risk factors is 20 years old!!!!! Even in the researchers' 12/98 edition of the book I cited above, the chapter on CAD relies on the 1988 investigations. Not knowing all of med41's cited research I need to see what he has to offer. But of all the research I've looked at, the evidence for taking a statin, along with good medical monitoring is very strong.

Bandolier, a web site for evidence based medicine based in the UK, has Statin outcome trials update, a meta analysis of statins trials. You can review their staff members and connections here. The results are unequivocal.

So with that said, I take a statin. Side effects are managed by having a few blood tests every 6 months. Most people don't have side effects and if one does then you simply stop the drug. I expect the drug to not only decrease the chance I will have coronary artery disease (like Mr Randi, BTW) but also to have the same effect of decreasing the arterial plaques in the arteries in my brain. Those of you who know me might guess, I thoroughly researched optimum lipid blood levels, outcomes, risks and side effects of taking a statin before I started one.

My second point is to reiterate, it's nonsense to believe all medical research on CAD is either done by or controlled by pharmaceutical companies, and even worse, to believe those of us in the medical profession are either all drug company puppets or too stupid to recognize and take into account conflict of interest issues in medical research we review.

Dr Hall also noted the similarities between this 'cause du jour' and the anti-vaccine campaign. In my observation, both groups are characterized by people who only consider valid the evidence which agrees with their preconceived convictions and by people who have an unrealistic view of the influence of the pharmaceutical companies. But lest I be guilty of the same thing I will look further at the questions raised here.

And the third point I wish to make is I advocate looking at the correct outcome when reviewing any medical research. The fact Listerine and Lysol kill germs is not evidence either decreases the risk of infectious diseases, which neither does, BTW. So even if I disagree with the conclusions of med41, I don't disagree with the principles involved. In looking at overall decreases in death rates vs decreases in disease, keep in mind as well who cares about the information. If I am deciding to allocate public health investments I may care about decreasing death rates. If I am deciding what to do about my personal health, the outcomes I choose to look at might be considerably different.
 
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