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Peer Review and the Scientific Process

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superboyac:
This may be off topic, but I wouldn't mind some of your input here.
Recently, a lot of people around me have been getting worked about about the anti-vaccination issues.  I've been listening to the arguments, and I must say that I'm legitimately confused.  Politics or beliefs aside, the question I want to answer is, "Should I vaccinate?  How do I make this decision wisely?"
The closest I've been able to come to an answer is along these lines:
Let's say there's a disease where I have 5% chance of dying.  The vaccine is available, and with it there is the 1% risk of dying.  So in that case, the gamble is mathematically worth the risk.

But it's just not that simple.  Do we know these percentages?  What if the vaccine is for a non-lethal disease, like a cold or mild flu?  Are these risk quantification reliable?  I don't know the answer at all, to be honest.  And it's a sensitive issue in my circles as there actually are cases of life-altering mental problems that have been attributed to vaccination.  I never ask, but I want to ask how do we know it was the vaccines? 

tomos:
So I can't really see where it's off-topic to raise questions about people's behaviors, or their unsupported assertions and arguments, as they relate to the larger issue. Nor do I see where doing so should automatically point the discussion towards the basement.
-40hz (February 09, 2015, 04:44 PM)
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good points :up:

40hz:
@superboyac - In the interests of not derailing this thread, I sent you a PM with my input.  8) :Thmbsup:

IainB:
Just to be pedantic: a good deal of the foregoing comments over the last day or so seem to be related to WHO (some pundit or other) said WHAT (POV or argument) about something scientific or pseudo-scientific. I could be wrong, of course, but in some of those comments, and in some of the linked articles, what seems to be important is proving one's position (bias) as being closer to the "truth" than someone else's position/bias.
That does not necessarily seem to be entirely relevant to adding to our understanding of Peer Review and the Scientific Process.

I would suggest that what is relevant is the observational data and results of experiments/trials and the falsifiability of those experiments/trials - be it wind speeds, global temps, numbers of infections/vaccinations, the incidence of caries in certain age groups, or something else.

For example, let's take a case in point - vaccination:
Let me comment on the vaccination issue, drawn from my own experience. Some years back, the then NZ Director of Public Health (Dr. Colin Tukuitonga) sponsored a new project to set up a NIR (National Immunisation Register) database, to record and track all candidates for vaccinations, and I (as an external consultant) was appointed as project manager to set it all up and initiate the project, and then hand over to a yet-to-be-selected project manager for the duration of the rest of the project lifecycle. This was a big and important project within the Ministry of Health and critical to the objective of the MoH for maintaining/improving the public health and especially that section of it called "children".
In setting up the project, I focussed initially on the solidity of the business case and an analysis of the potential risks of failure of this project.
The business case was straightforward and compelling: Children were dying needlessly. The project had been given some urgency due to the increasing incidence of then epidemic proportions of a disease called "Meningococcal B".  This dreadful disease was killing mostly children, and was preventable. Vaccination trials and programmes showed that vaccination had sharply reduced the incidence of the meningococcal disease in other developed countries, and so a vaccine for the prevalent strain in NZ (pathogen type "B") was developed and scheduled to fit in with the NIR development project.
The NIR database enabled the potential candidates (children) to be tracked and monitored to ensure that all children were vaccinated. The target population data was built from birth records and doctors' records of their family/child patients, and updated by doctors who recorded children as they moved (with their families/guardians) into other geographic practice areas and registered with new GPs there.

My involvement with the project finished after handover, but about 2 years later I bumped into the project sponsor whilst waiting in a bank queue. I asked him how the project had gone. He said with some exasperation that it had run about 8 months over its planned 18 months (I think it was) due largely to risks which eventuated - some of which I had predicted, but some of which I would not have been able to anticipate at the time. He added that it was now successfully vaccinating/covering all the at risk target population and the disease statistics were in rapid decline - so it was a success.

A few years later, I took my then 8 y/o daughter to an appointment at our local doctor's surgery for her to have her scheduled vaccinations. My daughter has an irrational fear of needles/vaccinations, and had been dreading this visit, but she kept a brave face on things.
As we were sitting in the waiting area, I noticed a magazine (I think it may have been "North & South"). The magazine had a striking picture on the front cover: it was a photo of a little smiling blond girl aged about 5, sat on a chair, but she had no arms or legs (they terminated in stumps at her elbows and knees). I read the article inside. Apparently, her parents had moved from one area to another shortly before what would have been her scheduled meningococcal B vaccination, but had not thought it important to get around to registering with their new local GP, so the child's current whereabouts was not on the NIR database. Had they been, then she would have had her meningococcal B vaccination on schedule, but instead she fell foul of the statistical risks and caught meningococcal B, and would have died had not the doctors amputated her limbs in order to save her life - meningococcal B causes progressive massive internal haemorrhage and destroys the body parts.

I showed the story to my daughter, and pointed out that this was exactly what I had been telling her - that vaccinations reduced the risk of her dying or being disabled by some horrible but preventable disease. The bad luck of the little blond girl was a sobering and very real thing. You can't fight the statistical odds.
Yet I am amazed at the number of times I have read of or heard people saying "I'm not having my child vaccinated. It's too dangerous - just look at such-and-such" or "Just look at what [insert name of anti-vaccination pundit] says about vaccination risks".

It reminds me of a case in the UK where a highly experienced police dog handler had 2 superbly trained Alsatian police dogs, which lived at his home as much-loved and trusted members of the family. One day, he was out of the house and his wife was in an upstairs room or something, and their 5 y/o daughter was playing downstairs in the kitchen, where the dogs were. When the mother came downstairs, she found that the dogs had killed the child.
A newspaper reported the father as saying later that he couldn't understand why the dogs had killed her - he was absolutely sure that they would be safe with the child - he would have "staked his life on it".
Well, of course, he didn't stake his life on it at all. He all-too-easily staked her life on it, and without even asking her if that was OK.
If parents had to suffer punishment with the direct consequences of their irrational decisions made on behalf of their innocent and trusting children, then they might think twice about such things. Or then again, maybe not (say) if they believed "it was God's will" or something equally idiotic, thus enabling them to sublimate the blame into something else. Anything but my fault, please God.

I imagine how the parents of that little girl pictured in the magazine must shudder at what they have done, seeing every day the needlessly hacked-up body of their beautiful little girl as she grows up. Try living with the consequences of that.

Renegade:
And there are far more options than the false dilemma/excluded middle fallacy you're introducing.
-40hz (February 09, 2015, 10:55 AM)
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I was wondering if I'd get called out on that~! ;D  :tease:

It's by obstetrician gynecologist Dr. Amy Tuteur M.D. And the rest can be found on her blog The Skeptical OB.
-40hz (February 09, 2015, 11:28 AM)
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Regarding the article there, it was a nicely done bit of name calling, and not much more.

The vax debate is pretty toxic. Nobody actually tries to communicate. It's nothing more than a yelling match with lots of name calling in the VAST majority of cases.

The most toxic people are the rabid pro-vaccine people that do their utmost to alienate the exact people whose behaviour they want to change. It's counter-productive at best. Then there's the crowd screaming for governments to make them mandatory... like that'd ever work out well...

This is not a scientific crisis. It's a people problem.
-40hz (February 09, 2015, 04:44 PM)
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Yep. That.

Nor do I see where doing so should automatically point the discussion towards the basement.
-40hz (February 09, 2015, 04:44 PM)
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Because the topic is toxic. People are not even remotely rational about it. It would degenerate quickly.

Now, a discussion about the discussion, that can probably be had much more sanely.

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