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Old 26th January 2013, 07:57 PM   #81
Skeptic Ginger
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Originally Posted by Jodie View Post
You should question the validity of all research. If you know your statistics you can tell whether the conclusions are accurate or not.
I'm pretty sure the Cochrane Reviews have drawn conclusions based on the evidence. The question is why don't the conclusions correlate with such an overwhelming body of additional evidence? And is it a coincidence or not that the lead reviewer has such strong views on influenza and the vaccine? There's more here than just the statistical analyses.
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Old 26th January 2013, 09:44 PM   #82
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Originally Posted by Skeptic Ginger View Post
Thread progress summary:

I'm glad there are a lot of views of the thread. I hope people are interested. I don't want to be talking to myself.

I still intend to look at Jefferson's and Doshi's dismissal of the flu burden.

I think we can say the evidence shows the vaccine to be less effective than some numbers used, it'll be interesting to see what numbers the ACIP uses for the vaccine next season. The CIDRAP review came out too late for this season's update.

But the evidence still shows the vaccine has an effect of 60%, just not 70-90%. 60% is not negligible. And we are talking about the benefit of flu vaccine in healthy people between the ages of 5-65 yrs. At least from the age of 5 to ~40yrs the vaccine efficacy was higher.

I haven't seen anything supporting the CDC uses ILIs as a direct number for flu cases. I have no explanation for how Jefferson would make this mistake. No one I know in the field believes ILIs are a direct count of the flu burden. It's an indicator of flu activity in the area, and you always have to see what % of the ILI reports are culturing positive for flu. More than that, you look to see what % of the cases are a strain match for the vaccine.

And 3 studies were published in the other thread (I'll cite them after I walk my dogs if I haven't already) that looked at pediatric flu deaths and found a fair number had no preexisting risk factors.

We know healthy people die from flu. The numbers may be small, but they are not zero. In addition Jefferson seems to have dismissed the mortality in younger people in the 2009 pandemic as trumped up. That's a common false belief people hold who look at total numbers instead of the shifted demographics of the fatalities. Also some people think public health agencies were responsible for fear mongering because those people falsely attribute the news media's sensationalizing to the public health. PHD messages their news releases were consistently considerably calmer than the mass media.

The thread question remains, shouldn't we be just as critical reviewing science even if it is supposed to be unquestionably superior, like a meta-analysis of RCTs? This has been a useful exercise for me because I would have, before this thread, not been likely to question a Cochrane Review.
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Old 27th January 2013, 06:39 AM   #83
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Originally Posted by Skeptic Ginger View Post
I'm pretty sure the Cochrane Reviews have drawn conclusions based on the evidence. The question is why don't the conclusions correlate with such an overwhelming body of additional evidence? And is it a coincidence or not that the lead reviewer has such strong views on influenza and the vaccine? There's more here than just the statistical analyses.
Reviews are no different from any other paper. They are written by individuals who have biases. The most important question to ask is, why did this person write this paper?
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Old 27th January 2013, 07:54 AM   #84
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Originally Posted by Skeptic Ginger View Post
I'm pretty sure the Cochrane Reviews have drawn conclusions based on the evidence. The question is why don't the conclusions correlate with such an overwhelming body of additional evidence?
Take a bunch of stuff in which you have a high degree of confidence and bundle it with a bunch of other stuff in which you have less confidence (and maybe even some in which you have very little confidence), with the hope that when the whole thing is treated as a single package, the value of the high confidence stuff will compensate for the lack of value in the low confidence stuff. In finance, such packages are known as "derivatives". Mechanics have a saying which I think may be applied here: "One quart of dirty oil plus five quarts of clean oil equals six quarts of dirty oil".

Is my take on it.
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Old 27th January 2013, 08:16 AM   #85
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Originally Posted by pgwenthold View Post
Reviews are no different from any other paper. They are written by individuals who have biases. The most important question to ask is, why did this person write this paper?
No it isn't. One of the most important questions is did the author's bias affect their work. Jefferson isn't a likeable person at all and his associations and public statements are profoundly mockable; that isn't in dispute. How do his methods in the Cochrane reviews withstand scrutiny? That is a very basic task which the person disputing them has not done.

Dymanic, beautifully stated.

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Old 27th January 2013, 01:47 PM   #86
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Originally Posted by pgwenthold View Post
Reviews are no different from any other paper. They are written by individuals who have biases. The most important question to ask is, why did this person write this paper?
I know but in this case we are talking about the lead reviewer of the Respiratory Disease section of the Cochrane Reviews, who has headed several reviews on influenza vaccine benefits for healthy children and adults. The findings of the reviews are in stark contrast to equally credible agencies like the WHO and the CDCs in several developed countries. Cochrane Reviews are not just any review.

OTOH, I'm not disagreeing with you. I've found by looking closer at this issue that my assumptions about the neutrality of the Cochrane Reviews have been seriously challenged.
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Old 27th January 2013, 01:49 PM   #87
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Originally Posted by Dymanic View Post
Take a bunch of stuff in which you have a high degree of confidence and bundle it with a bunch of other stuff in which you have less confidence (and maybe even some in which you have very little confidence), with the hope that when the whole thing is treated as a single package, the value of the high confidence stuff will compensate for the lack of value in the low confidence stuff. In finance, such packages are known as "derivatives". Mechanics have a saying which I think may be applied here: "One quart of dirty oil plus five quarts of clean oil equals six quarts of dirty oil".

Is my take on it.
So with that analogy in mind, add in something that makes you question the high confidence stuff. Now what do you have?
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Old 27th January 2013, 01:54 PM   #88
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Originally Posted by Estellea View Post
No it isn't. One of the most important questions is did the author's bias affect their work. Jefferson isn't a likeable person at all and his associations and public statements are profoundly mockable; that isn't in dispute. How do his methods in the Cochrane reviews withstand scrutiny? That is a very basic task which the person disputing them has not done.

Dymanic, beautifully stated.

Este
Did you notice the CR summary that in "plain language" said no benefit, while in the same paper in the findings said some benefit?

How do you feel about the CR saying the vaccine 'caused' cases of GBS despite the fact in the review in question, it was not something they found in evidence?

And how do you feel about the review summary pointing out drug company funded studies have disproportionately positive findings, while not bothering to test that conclusion by comparing the RCTs that were and were not drug company funded?
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Old 27th January 2013, 02:39 PM   #89
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Originally Posted by Skeptic Ginger View Post
Did you notice the CR summary that in "plain language" said no benefit, while in the same paper in the findings said some benefit?

How do you feel about the CR saying the vaccine 'caused' cases of GBS despite the fact in the review in question, it was not something they found in evidence?

And how do you feel about the review summary pointing out drug company funded studies have disproportionately positive findings, while not bothering to test that conclusion by comparing the RCTs that were and were not drug company funded?
You appear to be talking about multiple Cochrane reviews; please specify which concern and the applicable review.

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Old 27th January 2013, 03:09 PM   #90
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Originally Posted by Estellea View Post
You appear to be talking about multiple Cochrane reviews; please specify which concern and the applicable review.

Este
I pointed out the specifics of these particular claims in post #71.
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Old 27th January 2013, 03:42 PM   #91
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Originally Posted by Skeptic Ginger View Post
Did you notice the CR summary that in "plain language" said no benefit, while in the same paper in the findings said some benefit?
If you are referring to Influenza vaccination for healthcare workers who work with
the elderly (Review)
, it doesn't say that.

Quote:
How do you feel about the CR saying the vaccine 'caused' cases of GBS despite the fact in the review in question, it was not something they found in evidence?
Do you have the full text of Vaccines for preventing influenza in healthy adults (Review)?

Quote:
And how do you feel about the review summary pointing out drug company funded studies have disproportionately positive findings, while not bothering to test that conclusion by comparing the RCTs that were and were not drug company funded?
Again, do you have a full text of this study?

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Old 27th January 2013, 04:01 PM   #92
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I'm not a biologist or immunologist so please correct me if I'm wrong...

My understanding is the contents of the 'flu vaccine are determined annually by worldwide trends. The three most likely strains are then made into the vaccine. Therefore, it is still possible to get flu even if you have been vaccinated, although less likely. If there were universal vaccination I'm just wondering how this would work - how would they know which strains to use, would they still be clear if whole populations were vaccinated? It's also my understanding that pandemic flu is a different kettle of fish from regular flu and happens when an animal flu suddenly develops the ability to spread to humans. I'm not sure regular vaccination programmes would work in this instance?

I wonder how other strategies rate in comparison to, or alongside vaccination? For example, regular hand washing or avoiding crowded places, especially during seasonal high risk periods.

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Old 27th January 2013, 04:13 PM   #93
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Originally Posted by Estellea View Post
If you are referring to Influenza vaccination for healthcare workers who work with
the elderly (Review)
, it doesn't say that.


Do you have the full text of Vaccines for preventing influenza in healthy adults (Review)?


Again, do you have a full text of this study?

Este
I highlighted the differences in the plain language summary and the findings. Are you trying to distract from that issue?

The point was to show clear evidence suggesting Jefferson's personal opinion is seeping into his flu vaccine reviews. It's right there on that page.

I'm happy to discuss other issues with the CRs. I think I took an honest look at the CIDRAP review. This is not a simple matter of dueling posts. I'm trying to take the issue a bite at a time.

Post 71 is not meant to be comprehensive evidence of my position. It's a single piece of evidence.


If you'd care to show some explanation for why the plain language summary in that particular review differs from the findings of that review, by all means propose an explanation.

As for not comparing the drug company funded studies to the non dc funded studies, thats right there in the summary and findings. It wasn't done. Yet Jefferson still felt the need to suggest it could be affecting the meta-results. I'm pointing out the contrast of mixing strictly what the evidence supports when it comes to vaccine effect, but then using something less to claim vaccine risk and influenced research outcomes.
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Old 27th January 2013, 04:18 PM   #94
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Originally Posted by keyfeatures View Post
I'm not a biologist or immunologist so please correct me if I'm wrong...

My understanding is the contents of the 'flu vaccine are determined annually by worldwide trends. The three most likely strains are then made into the vaccine. Therefore, it is still possible to get flu even if you have been vaccinated, although less likely. If there were universal vaccination I'm just wondering how this would work - how would they know which strains to use, would they still be clear if whole populations were vaccinated? It's also my understanding that pandemic flu is a different kettle of fish from regular flu and happens when an animal flu suddenly develops the ability to spread to humans. I'm not sure regular vaccination programmes would work in this instance?

I wonder how other strategies rate in comparison to, or alongside vaccination? For example, regular hand washing or avoiding crowded places, especially during seasonal high risk periods.
There are two meanings for "universal vaccination". In this case we are talking about recommending the vaccine for everyone vs only recommending it for targeted high risk groups.

You are talking about a vaccine that no longer needs annual changes to keep up with genetic drift of influenza. That's a separate issue.
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Old 27th January 2013, 04:29 PM   #95
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You haven't read Vaccines for preventing influenza in healthy adults (Review) have you? Reading studies you are criticising are not a "distraction", it is central to the discussion. Let me know when you can be arsed to read them or keep talking through yours.

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Old 27th January 2013, 04:55 PM   #96
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Originally Posted by Estellea View Post
You haven't read Vaccines for preventing influenza in healthy adults (Review) have you? Reading studies you are criticising are not a "distraction", it is central to the discussion. Let me know when you can be arsed to read them or keep talking through yours.

Este
So you're going to dodge the questions? Check.

Originally Posted by SG
Did you notice the CR summary that in "plain language" said no benefit, while in the same paper in the findings said some benefit?

How do you feel about the CR saying the vaccine 'caused' cases of GBS despite the fact in the review in question, it was not something they found in evidence?

And how do you feel about the review summary pointing out drug company funded studies have disproportionately positive findings, while not bothering to test that conclusion by comparing the RCTs that were and were not drug company funded?

I am questioning the whole body of work because one of the lead reviewers has a non-neutral opinion AND because the CR results contradict a huge body of research. And I'm trying to find out why the results contradict so much research and logic, and questioning the methodology of the meta-analysis is not the issue. I am questioning the conclusions the findings support.

I don't intend to leave your questions unanswered. But continuing to ask "Did I read the full [X] CR" is not furthering the discussion. I explained, I have read some of the full reviews in the past and don't have current free online access. I am well aware of the CR findings. Both flu vaccine for healthy people as well as for health care workers is within my medical specialty and has been for two decades. Believe me, the move to require nurses to get flu shots encountered a hell of a lot of resistance. One needs to read the research when you are addressing the issue with educated health care professionals.

But I'm not trying to use that expertise as an argument. I am, though, tired of the dodge the issue question, did I look at the full CR report, when you don't have a specific point to make. If there's something in the full CR that supports your position, point it out. Otherwise you are just tossing out non-specific challenges to see what sticks.
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Old 27th January 2013, 05:10 PM   #97
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Originally Posted by Skeptic Ginger View Post
So you're going to dodge the questions? Check.
Not at all but it's pointless to continue this discussion when you haven't even read them; there is information contained in them that directly answers your questions which is why I'm confused that you are asking them. The citation list and how the studies were evaluated are all in there too.

Quote:
I am questioning the whole body of work because one of the lead reviewers has a non-neutral opinion AND because the CR results contradict a huge body of research. And I'm trying to find out why the results contradict so much research and logic, and questioning the methodology of the meta-analysis is not the issue. I am questioning the conclusions the findings support.
How can you question a body of work that you don't even have?

Quote:
I don't intend to leave your questions unanswered. But continuing to ask "Did I read the full [X] CR" is not furthering the discussion. I explained, I have read some of the full reviews in the past and don't have current free online access. I am well aware of the CR findings. Both flu vaccine for healthy people as well as for health care workers is within my medical specialty and has been for two decades. Believe me, the move to require nurses to get flu shots encountered a hell of a lot of resistance. One needs to read the research when you are addressing the issue with educated health care professionals.
Why wouldn't you, a self-professed expert, not have those saved and continue to keep current on the literature that your profession relies upon?
Quote:
But I'm not trying to use that expertise as an argument. I am, though, tired of the dodge the issue question, did I look at the full CR report, when you don't have a specific point to make. If there's something in the full CR that supports your position, point it out. Otherwise you are just tossing out non-specific challenges to see what sticks.
Am I really the one dodging here? I wonder if anyone would agree that it is fine to critique studies that you may or may not have read a couple of years ago. I have all of the reviews open right now and can't understand how you are asking the questions you are when it's all right there. And I am dodging? Your double-standards are a wonder to observe.

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Old 27th January 2013, 05:39 PM   #98
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Este, you seem to be missing the core issue here.

The Cochrane Reviews are well respected, no one is saying they aren't. I'm not questioning the review methodology. But there is mounting evidence that doesn't correlate with the lack of flu vaccine benefits the CRs found. And what a coincidence the lead investigator in the CRs in question has an extreme view relative to the rest of the medical community.

All of the reviews headed by Jefferson, that address flu vaccine benefit in healthy people, consistently contradict the opinions of a large segment of the community of scientists and health care providers. IOW, the Cochrane Reviews are anomalous for some reason.

In addition, there should be a benefit in healthy people even with a vaccine that is only 60% effective. The flu has PROVEN morbidity and mortality in people without identified risk factors. The vaccine has PROVEN efficacy. You should see a benefit on that basis alone.

So we have two valid lines of evidence (a mountain of research and the proven benefit on the individual level) that say the flu vaccine should show an effect and one valid line of evidence (a number of CRs) that says it does not. One valid line of evidence is apparently not valid.

It's not the methodology of the CR that is the problem here. But something's wrong. I think the line of evidence that is PROVEN: the vaccine works even if it isn't 100% effective and the flu causes morbidity and mortality in healthy people: is the best evidence of the three lines of evidence. Given that I have to question the findings of the CRs.

That doesn't mean my current position is fixed in stone or I'm dismissing valid evidence because of confirmation bias. But so far, I have not found evidence the CRs trump the other two lines of evidence.
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Old 27th January 2013, 05:47 PM   #99
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Originally Posted by Skeptic Ginger View Post
I highlighted the differences in the plain language summary and the findings. Are you trying to distract from that issue?
Again, if you are referring to the Cochrane Review on HCWs and Influenza Vaccines then you are not reading it correctly. I know you have that full text because you linked to it.

Quote:
The point was to show clear evidence suggesting Jefferson's personal opinion is seeping into his flu vaccine reviews. It's right there on that page.
That isn't in the Cochrane Review on HCWs and Influenza Vaccines; it appears in the Healthy Adults and Influenza Vaccine Review. And how can you say it's merely his personal opinion when it is discussed with supporting evidence in the body of the text? Right there starting on page 5.
Quote:
I'm happy to discuss other issues with the CRs. I think I took an honest look at the CIDRAP review. This is not a simple matter of dueling posts. I'm trying to take the issue a bite at a time.
Well that would mean you would actually have to read them and you don't seem to think that's necessary.

Quote:
If you'd care to show some explanation for why the plain language summary in that particular review differs from the findings of that review, by all means propose an explanation.
If you think I'm going to spoon-feed you excerpts because you can't be bothered to read them but still think your criticism is justified, you are mistaken. I'm not going to assist with your BS bluffing.

Quote:
As for not comparing the drug company funded studies to the non dc funded studies, thats right there in the summary and findings. It wasn't done. Yet Jefferson still felt the need to suggest it could be affecting the meta-results. I'm pointing out the contrast of mixing strictly what the evidence supports when it comes to vaccine effect, but then using something less to claim vaccine risk and influenced research outcomes.
Really? It wasn't done? And you know this how from reading, basically, an abstract?

As much as you tried to disparage Kellyb, in all of the years I've known her and debated with her, she has never ever tried to pull a stunt like this; she has always been honest and told me that she didn't read a study because didn't have access to it. Think on that.

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Old 27th January 2013, 08:18 PM   #100
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No, I'm not missing the core issue here; you presented it in your OP. You are doing this discussion a grave disservice by not having even read the literature that is at the centre of your criticisms. So I would suggest the following:
Step 1: Step away from this thread until you have done steps 2-4.
Step 2: Read http://www.ncbi.nlm.nih.gov/pubmed/22032844
http://onlinelibrary.wiley.com/o/coc...269/frame.html and http://onlinelibrary.wiley.com/o/coc...187/frame.html at the very least.
Step 3: Analyse the methods and results and access the studies accepted and rejected from the reviews that appear to be discordant.
Step 4: List the citations that you feel support your conclusions.
Step 5: Come back to this thread.

Este
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Old 27th January 2013, 09:52 PM   #101
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Can someone help me find Jefferson's reference in his CR: "An earlier systematic review of 274 influenza vaccine studies published up to 2007 found industry funded studies were published in more prestigious journals and cited more than other studies independently from methodological quality and size."

I've looked in Google, Google Scholar, the Cochrane Review site and PubMed and I can't seem to find it.

I'm thinking maybe it's within another study.

Thanks.

Found it: Relation of study quality, concordance, take home message, funding, and impact in studies of influenza vaccines: systematic review.

What a pain.
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Old 27th January 2013, 10:27 PM   #102
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Originally Posted by Skeptic Ginger View Post
Gee thanks, I made a mistake. There were several links on a Google search that said he believed vaccines caused HIV and cancer. He wouldn't be the first respected scientist that went off with some woo belief at some time in his career.
Your mistake was to use "Natural News" as a source. Nothing they say can be trusted.
(#1 in the Top 10 Worst Anti-Science Websites in Brian Dunning's ranking.)
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Old 27th January 2013, 11:16 PM   #103
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Originally Posted by Puppycow View Post
Your mistake was to use "Natural News" as a source. Nothing they say can be trusted.
(#1 in the Top 10 Worst Anti-Science Websites in Brian Dunning's ranking.)
That mistake has been addressed in this thread.
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Old 28th January 2013, 07:56 AM   #104
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Originally Posted by Skeptic Ginger View Post
There are two meanings for "universal vaccination". In this case we are talking about recommending the vaccine for everyone vs only recommending it for targeted high risk groups.

You are talking about a vaccine that no longer needs annual changes to keep up with genetic drift of influenza. That's a separate issue.
No, I mean if everyone was immunised how would the genetic drift identification work? Presumably it takes time to manufacture and distribute the vaccine. So where and when would the newly mutated germs manifest themselves and how effectively could a new jab be offered before many people had caught the new bug?
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Old 28th January 2013, 09:35 AM   #105
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Originally Posted by Estellea View Post
No it isn't. One of the most important questions is did the author's bias affect their work. Jefferson isn't a likeable person at all and his associations and public statements are profoundly mockable; that isn't in dispute. How do his methods in the Cochrane reviews withstand scrutiny? That is a very basic task which the person disputing them has not done.
If I knew enough about the field to know whether Jefferson has reviewed it properly, I wouldn't need a review to tell me what is going on.

Meanwhile, others who are in the field, though (Mark Crislip, for example, and the members of the ACIP), are saying that his review does not accurately reflect the state of knowledge.

Given that, the agendas of the individuals absolutely matter, because it is going to color what they tell me.
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Old 28th January 2013, 09:50 AM   #106
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Originally Posted by pgwenthold View Post
If I knew enough about the field to know whether Jefferson has reviewed it properly, I wouldn't need a review to tell me what is going on.

Meanwhile, others who are in the field, though (Mark Crislip, for example, and the members of the ACIP), are saying that his review does not accurately reflect the state of knowledge.

Given that, the agendas of the individuals absolutely matter, because it is going to color what they tell me.
Why don't you apply the same criteria to Dr. Crislip and the ACIP? Are they not biased and agendised as well? But just as importantly, Jefferson is not the only one who has found this to be the case. In fact the scope of the CCIV report covers a lot more territory and has found that the ACIP influenza vaccine recommendations are not evidence-based at all and the promotion of the vaccine has relied upon misinformation. I'd rather be served high-quality evidence by a jerk then spoon-fed crap by nice people.

Este
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Old 28th January 2013, 09:55 AM   #107
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Originally Posted by keyfeatures View Post
No, I mean if everyone was immunised how would the genetic drift identification work? Presumably it takes time to manufacture and distribute the vaccine. So where and when would the newly mutated germs manifest themselves and how effectively could a new jab be offered before many people had caught the new bug?
If universal vaccination worked so well that it eradicated currently circulating flu viruses, genetic drift for those viruses would cease to happen. They'd just be gone. We'd only have to watch out for new, emergent flus coming from animals, and it would go like it went with making the swine flu vaccine. Except faster, since there would be more vaccine manufacturing plants up and running.

If universal vaccination only has a medium-level impact on the circulation of flu, it could be monitored and changed seasonally (or constantly) like it is now.
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Old 28th January 2013, 10:13 AM   #108
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Originally Posted by Estellea View Post
As much as you tried to disparage Kellyb, in all of the years I've known her and debated with her, she has never ever tried to pull a stunt like this; she has always been honest and told me that she didn't read a study because didn't have access to it. Think on that.
My experience with Kelly has been the same. She and I have often disagreed, but she has my utmost respect. I have occasionally found myself having to work pretty hard to defend my position, and I think I may even have been forced to concede a point or two here or there (minor ones, I'm sure; can't recall any specifics; prolly blocked them out). She has matched me point-for-point through excrutiatingly detailed examination of some lengthy and complex material, but never once, in any discussion with Kelly, have I found myself buried under a massive link dump provided by a person who very obviously had not read the material she herself had just linked to, and when confronted on it, consistently retreated behind her own self-proclaimed authority. Unless I have time to throw away, I am reluctant to even attempt to engage in a meaningful dialogue with a person with a penchant for such tactics.
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Old 28th January 2013, 10:17 AM   #109
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Originally Posted by Estellea View Post
Why don't you apply the same criteria to Dr. Crislip and the ACIP?
Who said I didn't?
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Old 28th January 2013, 10:25 AM   #110
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Originally Posted by pgwenthold View Post
Who said I didn't?
I could be interpreting this wrong (along with some of your other statements on the matter) but:
Quote:
Meanwhile, others who are in the field, though (Mark Crislip, for example, and the members of the ACIP), are saying that his review does not accurately reflect the state of knowledge.
indicated to me that you are agreeing with Dr. Crislip and the ACIP. If that was a mistake then you have my apology.

OK Dymanic, knock it off with the eloquence; you're making me feel inadequate here. Seriously however, well-stated and I concur completely.

Este
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Old 28th January 2013, 11:23 AM   #111
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Originally Posted by keyfeatures View Post
No, I mean if everyone was immunised how would the genetic drift identification work? Presumably it takes time to manufacture and distribute the vaccine. So where and when would the newly mutated germs manifest themselves and how effectively could a new jab be offered before many people had caught the new bug?
Goodness, we will not in any foreseeable future ever eliminate all influenza even if we vaccinated every human on the planet. The virus would just drift within the animal populations and reinfect humans later.
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Old 28th January 2013, 11:55 AM   #112
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Originally Posted by Skeptic Ginger View Post
So you're going to dodge the questions? Check.


...


But I'm not trying to use that expertise as an argument. I am, though, tired of the dodge the issue question, did I look at the full CR report, when you don't have a specific point to make. If there's something in the full CR that supports your position, point it out. Otherwise you are just tossing out non-specific challenges to see what sticks.
I, like many others, have no intention of reading the full CR report. so how about providing some idea of exactly what supports Estellea's position? In discussions about scientific issues, I expect specific arguments citing supporting data, not general directives to read some report.
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Old 28th January 2013, 12:05 PM   #113
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Originally Posted by Estellea View Post
Why don't you apply the same criteria to Dr. Crislip and the ACIP? Are they not biased and agendised as well? But just as importantly, Jefferson is not the only one who has found this to be the case. In fact the scope of the CCIV report covers a lot more territory and has found that the ACIP influenza vaccine recommendations are not evidence-based at all and the promotion of the vaccine has relied upon misinformation. I'd rather be served high-quality evidence by a jerk then spoon-fed crap by nice people.

Este
I hi-lighted a false claim that you have not supported and I refuted in post #69.

What makes you think we don't apply the same criteria to other sources?

It's not just that Jefferson has strong anti flu vaccine views but you seem to keep ignoring that point.

Why do you think so many scientists and health care professionals with expertise in influenza don't agree with Jefferson? This is the typical, "they're all duped and he isn't" that woo believers argue.

Sometimes scientists with these kinds of outlier views turn out to be pioneers that eventually win over their peers. Sometimes they turn out to be wrong, often clinging to their initial hypotheses despite overwhelming evidence against it. As the evidence accumulates, the answer emerges. The evidence is accumulating and it does not favor Jefferson's outlier views.
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Old 28th January 2013, 12:18 PM   #114
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SG, This is what's called 'argument by assertion' and 'appeal to popularity' and you also perpetrated these fallacies "refuting" the claim that ACIP's flu vaccine policy is not evidence-based when a thorough review was conducted on all of the minutes that went into flu vaccine policy and all of the "evidence". This review concluded that the policy was NOT based upon solid evidence at all but rather "expert opinion", good-intentions, circular arguments and low-quality studies. Chapter 7, pp. 51, CCIV report.

You haven't offered a shred of actual evidence to refute this finding. What evidence have you offered that is "accumulating" against Dr. Jefferson's Cochrane Review findings? Some simple citations will do, preferably ones that you have actually read.

Este
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Old 28th January 2013, 12:24 PM   #115
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Originally Posted by Perpetual Student View Post
I, like many others, have no intention of reading the full CR report. so how about providing some idea of exactly what supports Estellea's position? In discussions about scientific issues, I expect specific arguments citing supporting data, not general directives to read some report.
You want me to support a position I don't support?

It's time consuming. I have so far addressed the CIRDAP review Este linked to in very specific detail. I pointed to very specific language in one of Jefferson's CRs that appeared to reflect bias.

I'm currently looking at Jefferson's CR that he cites again and again, the 274 studies that supposedly show this Big Pharma influence in the results. I have a very complex post pending.

One of the big issues here has been the claim the vaccine is not as effective as it's promoted to be. That is a completely different claim than the vaccine does not work at all. The CIDRAP review felt the efficacy was 60% and there will of course be a wide range from person to person and flu strain to flu strain. While not ideal, a vaccine that is 60% effective will nonetheless decrease the disease burden and prevent some spread.

So how do you go from that fact which the CRs and other reviews are not refuting, to the claim there is no benefit in healthy people, something the CRs are the only reviews with that conclusion?

Early in the thread I cited Jefferson claim's we don't have culture based flu epidemiology. I linked to the very evidence Jefferson claims doesn't exist. Why people think we count ILIs as flu cases is beyond me as it's such a no brainer that is not what the CDC does.

I intend to explore Jefferson's dismissal of influenza morbidity and mortality further but one thing at a time.
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Old 28th January 2013, 12:40 PM   #116
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Originally Posted by Estellea View Post
SG, This is what's called 'argument by assertion' and 'appeal to popularity'
No this is not: Sometimes scientists with these kinds of outlier views turn out to be pioneers that eventually win over their peers. Sometimes they turn out to be wrong, often clinging to their initial hypotheses despite overwhelming evidence against it. As the evidence accumulates, the answer emerges. The evidence is accumulating and it does not favor Jefferson's outlier views.


Originally Posted by Estellea View Post
and you also perpetrated these fallacies "refuting" the claim that ACIP's flu vaccine policy is not evidence-based when a thorough review was conducted on all of the minutes that went into flu vaccine policy and all of the "evidence". This review concluded that the policy was NOT based upon solid evidence at all but rather "expert opinion", good-intentions, circular arguments and low-quality studies. Chapter 7, pp. 51, CCIV report.
You are not addressing any part of my very specific discussion of the CIDRAP review of the ACIP recommendations. I again point you to post 71 and the several prior posts where I cited CIDRAP news reports re the review and the fear of the reviewers that people would draw the wrong conclusion they were saying the vaccine was not useful.

post 63
post 66
post 69

Originally Posted by Estellea View Post
You haven't offered a shred of actual evidence to refute this finding. What evidence have you offered that is "accumulating" against Dr. Jefferson's Cochrane Review findings? Some simple citations will do, preferably ones that you have actually read.

Este
Among other sources, I cited the evidence that the Canadian province of Ontario implemented universal flu vaccinations while the other provinces continued to only promote the vaccine to targeted populations. Ontario saw a large reduction in influenza morbidity and mortality compared to the other provinces. See post #45


It doesn't help your case to dismiss all my posts here with specific evidence, quotes, and citations claiming I haven't offered a shred of actual evidence. That does nothing to further this discussion.
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Old 28th January 2013, 12:55 PM   #117
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Originally Posted by Skeptic Ginger View Post
It's time consuming. I have so far addressed the CIRDAP review Este linked to in very specific detail. I pointed to very specific language in one of Jefferson's CRs that appeared to reflect bias.
You haven't addressed the CCIV report in 'specific detail' at all. Invoking Dr. Crislip doesn't cut it.

Quote:
One of the big issues here has been the claim the vaccine is not as effective as it's promoted to be. That is a completely different claim than the vaccine does not work at all. The CIDRAP review felt the efficacy was 60% and there will of course be a wide range from person to person and flu strain to flu strain. While not ideal, a vaccine that is 60% effective will nonetheless decrease the disease burden and prevent some spread.
The pooled efficacy (not effectiveness in one age group was estimated at 59% so please represent that properly. It is not overall efficacy. And in some years with some age and risk groups the vaccine efficacy and effectiveness was absent.
Quote:
Eight studies were done in adults aged 18–64 years,
covering nine influenza seasons. The random-effects
pooled vaccine efficacy was 59% (95% CI 51–67; figure 2)
and the median vaccine efficacy was 62% (range
16–76).21,24–30
Quote:
There are no randomised controlled trials showing
efficacy of TIV in people aged 2–17 years or adults aged
65 years or older. For LAIV, there are no randomised
controlled trials showing efficacy for people aged
8–59 years.
Quote:
Vaccine effectiveness was shown in one of two studies in adults
aged 65 years or older.44,45 In one study of adults aged
50 years or older, vaccine effectiveness for prevention of
hospital admission due to influenza was 56–73% in each of
three seasons, but the CI crossed 0 for each season.47
Quote:
So how do you go from that fact which the CRs and other reviews are not refuting, to the claim there is no benefit in healthy people, something the CRs are the only reviews with that conclusion?
Are they? If there are no decent data to include in systematic reviews and/or meta-analyses then what does that tell you about the quality of the data? And these very same studies are the ones used to decide policy.

Quote:
Early in the thread I cited Jefferson claim's we don't have culture based flu epidemiology. I linked to the very evidence Jefferson claims doesn't exist. Why people think we count ILIs as flu cases is beyond me as it's such a no brainer that is not what the CDC does.
I don't see that citation for Jefferson's claim, would you kindly link to that directly? And yes, counting ILIs is exactly what the CDC does to estimate flu prevalence, hospital admissions and mortality.
Quote:
I intend to explore Jefferson's dismissal of influenza morbidity and mortality further but one thing at a time.
Good luck with that.

Este
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Old 28th January 2013, 01:20 PM   #118
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Originally Posted by Skeptic Ginger View Post
No this is not: Sometimes scientists with these kinds of outlier views turn out to be pioneers that eventually win over their peers. Sometimes they turn out to be wrong, often clinging to their initial hypotheses despite overwhelming evidence against it. As the evidence accumulates, the answer emerges. The evidence is accumulating and it does not favor Jefferson's outlier views.
Of course, bolding the same statement doesn't make it an argument by assertion at all no no. "Overwhelming evidence" please.


Quote:
You are not addressing any part of my very specific discussion of the CIDRAP review of the ACIP recommendations. I again point you to post 71 and the several prior posts where I cited CIDRAP news reports re the review and the fear of the reviewers that people would draw the wrong conclusion they were saying the vaccine was not useful.

post 63
post 66
post 69
Oh squeeee! A news report that quotes Dr. Osterholm said he got the vaccine; all must be right in your world now. So how about the parts where he says this:
Quote:
Last month,, in a step tantamount to heresy in the public health world, scientists at the Center for Infectious Disease Research and Policy at the University of Minnesota released a report saying that influenza vaccinations provide only modest protection for healthy young and middle-age adults, and little if any protection for those 65 and older, who are most likely to succumb to the illness or its complications. Moreover, the report's authors concluded, federal vaccination recommendations, which have expanded in recent years, are based on inadequate evidence and poorly executed studies.
Huh, fancy that.
Quote:
Among other sources, I cited the evidence that the Canadian province of Ontario implemented universal flu vaccinations while the other provinces continued to only promote the vaccine to targeted populations. Ontario saw a large reduction in influenza morbidity and mortality compared to the other provinces. See post #45
Oh goody, Dr. Crislip likes that one so you should too. Shall we discuss the numerous confounders in that study which make any hard conclusions uninterpretable? By the by, the authors did a good job of discussing these confounders (but were unable to control for them) and were relatively conservative in their interpretation of the results. You're reading what you want to see, not what is actually there.

Quote:
It doesn't help your case to dismiss all my posts here with specific evidence, quotes, and citations claiming I haven't offered a shred of actual evidence. That does nothing to further this discussion.
I'm not being dismissive at all; it simply doesn't help when you didn't even read your own citations and arguing from the abstracts.

Este

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Old 28th January 2013, 05:45 PM   #119
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Quote:
Originally Posted by Perpetual Student
I, like many others, have no intention of reading the full CR report. so how about providing some idea of exactly what supports Estellea's position? In discussions about scientific issues, I expect specific arguments citing supporting data, not general directives to read some report.
Originally Posted by Skeptic Ginger View Post
You want me to support a position I don't support?
No, sorry for the confusion. I worded my post poorly. I am still waiting for Estellea to do so. Concerning the over 65 population, what I did see in the summary was a vague reference to the fact that older people who get the vaccine tend to take better care of themselves. Is that all they've got? Can Estellea tell us a little more about this meta-analysis that provides strong evidence of the vaccine's ineffectiveness?
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Old 28th January 2013, 06:17 PM   #120
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Originally Posted by Perpetual Student View Post
No, sorry for the confusion. I worded my post poorly. I am still waiting for Estellea to do so. Concerning the over 65 population, what I did see in the summary was a vague reference to the fact that older people who get the vaccine tend to take better care of themselves. Is that all they've got? Can Estellea tell us a little more about this meta-analysis that provides strong evidence of the vaccine's ineffectiveness?
It's called the "Healthy Vaccinee Effect" and you can read about it and the poor quality of data along with overall poor performance of influenza vaccines for yourself in Section: Impact of Influenza Vaccination on Influenza-Related Morbidity and Mortality among Persons 65 Years of Age and Older starting on pp. 24.

Este
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