From: rockwell@socrates.umd.edu (Raul Deluth Miller-Rockwell)
Subject: Re: ECT References (Brian Wenger's)
Organization: Traveller
	<Brru7C.IM@ssr.com> <1992Jul22.225852.7064@samba.oit.unc.edu>
Date: Thu, 23 Jul 1992 14:12:42 GMT

Elizabeth Mccoy:
   >   >At *least* give the Purification Rundown the same efficacy as
   >   >you would give voodoo dolls.
   >
   >Well, I did. The efficacy of a treatment which does not differ
   >from a placebo is exactly 0, which is exactly the efficacy of a
   >voodoo doll.

Elizabeth Mccoy:
   Okay. So long as you're being consistant. I would give even a
   placebo a >0% efficacy, but then I'm an English major.

Hmmm.....  If I have a bone to pick, it's that I don't think Scott
Ballantyne is being consistent.  For example, although he apparently
normalizes benefits against those of a placebo he does not normalize
risks that way.  Consider this statement by Scott:

   "Instead of going to all the trouble to whittle a near zero value
   "closer to zero (you will never get it to zero, because the risk of
   "death is not zero - we went through this with the niacin wars -
   "remember those?) might I suggest that a better approach would be
   "to raise the value of zero in the benefits column?"

If the risk of death were normalized, it could even be less than zero.

Other inconsistencies I noticed were:

   (*) Although he stated he picked the figures most damaging to ECT
         he had a bit of a problem picking out the highest and lowest
         figures from within that range.

   (*) For some reason he was comparing "complications of ECT" with
         "side-effects of niacin treatments on patients receiving
         cholesterol treatments".  There are several contradictions I
         see here:

         (*) niacin therapy for cholesterol patients is not the same
               as the purification rundown.

         (*) There is a strong probability that these side effects are
               not due to niacin but are due to it's packaging.  [For
               example, I saw a recent article in the Journal of the
               AMA which indicates that aluminum may be more toxic
               that previously expected.  Time release niacin
               preparations have been shown to have problems even
               without an aluminum content, of course, but it's
               significant that the body delivers [concentrates] 
               niacin into the liver.]

         (*) It's not immediately obvious that the severity of these
               side effects were comparable to the complications of
               ECT therapy.

         (*) There has been a change of several orders of magnitude in
               the incidence of complications from ECT.  Yet, as
               presented, there is no such change in the rate of side
               effects from cholesterol therapy.  I feel this is
               significant, because: 

   (*) Statistics, such as those presented by Scott, are a way of
         collecting information about their sample population.
         Statistics do not, in and of themselves, show any
         relationship between their populations.  That must be shown
         from a complete description of these populations.  Yet, as
         presented, there is not even a complete description of how
         these statistics were gathered.  [What was included, what was
         excluded, and why.]

Now, my personal opinion: It is likely that some of these "apparent
contradictions" are due to simple carelessness on Scott's part,
perhaps a reliance on some "professional standards" which are assumed
within psychiatric publications.  It is also possible that some of
these "apparent contradictions" are due to a carelessness on my part,
though I'm not in a good position to identify such carelessness.  But
there is an underlying theme to these contradictions: the numbers
being compared are not the same kind of numbers.

On the other hand, to be fair, I have not gotten a copy of his report
from the NIH to read for myself.  This ought to be my next step in
ascertaining the extent of these contradictions.  A step I've been
avoiding, up to this point, due to lack of interest.

Now, I dunno... I'm probably being tedious.  I suspect that most of
you saw where I was heading and what I was talking about long before
this point.  On the other hand, maybe not?

On the fourth hand, if I pursued this thread, what would it
accomplish?  The niacin thread didn't seem to accomplish a whole lot,
and this ECT thread is not as interesting to me.  Straw poll: who out
there thinks this thread is worth me researching and posting about?
If I see a good reason to proceed, I suppose I could.

[Note: "to advance the cause of the Church of Scientology" is not a
good reason.  I'm interested in, and curious about Scientology, but I
don't see that I'm going to learn much about it by reading reports on
ECT.]

-- 
Raul Deluth Miller-Rockwell                   <rockwell@socrates.umd.edu>