The FREAKest Links: Terrorists, Phones, and Breast Exams Edition

Mirroring Levitt’s thoughts on doctors plotting terrorist attacks, the Wall Street Journal takes an in-depth look at Alan Krueger‘s findings that terrorists tend to come from high-income, high-education families.

David Pogue of the New York Times points out that, in the midst of last week’s iPhone mania, most of us missed T-Mobile’s announcement of a new plan under which all calls within a Wi-Fi network are free.

Via Rebecca Dube at the Globe and Mail: A study of 267,000 women appears to confirm several other long-term studies finding that breast self-exams do absolutely no good in detecting breast cancer, despite the conventional wisdom.


discordian

I read about the T-Mobile thing.
And it's supposed to be a seamless transition between wireless network and tower.

FWIW I also observed (just a cursory examination, not a study per se) that on Sunday and Monday most iPhones were not selling for more than $40 - $50 above retail on eBay.
Reserves were not being met, 8GB phones starting at $700 were getting no bids, etc.
Guess they weren't as popular as Xbox 360 or PS III after all.

Nathaniel

Or Apple simply made enough of them to supply demand. Both MS and Sony have been known to deliberately undermanufacture initially (or begin sales in more areas than they know they can supply), simply so they can brag that they "sold out".

Apple usually doesn't have enough stock when they announce a new device because they literally can't build the things fast enough. They had a lot more months to get ready with the iPhone, though (presumably because of the FCC requirements for approval -- you just can't manufacture cell phones at the last minute the way you can with other consumer electronics).

dbrick

Ms. Dube may be overstating her case when she asserts that "Breast self-exams don't work."

1) Without an experimental or quasi-experimental study design, the results of these sorts of studies might be systematically biased because women who are more likely to get (worse) breast cancer might also be more likely to do frequent and/or thorough self-exams. So the self-examiners might have a higher detection rate and/or death rate before anybody does any examining, and then the self-exams bring them even with the non-examiners.

2) Of the studies that Dr. Baxter's 2001 article cites (these are the "other studies in Canada, the United States, the United Kingdom, Russia and Finland" that Ms. Dubin mentions), only two are randomized experimental studies. One is the "267,000 Chinese women" study, and the other is a Russian study in which, according to Dr. Baxter and her co-authors, "Because of lower-than-expected compliance and cancer incidence, there was inadequate power to detect a 20% difference in mortality between the 2 groups." Wow.

3) Though the Chinese study used a randomized experimental design, it was meant to examine, and draw conclusions about, the effectiveness of a policy intervention - training women to do self-exams in a developing country without mammograms. It was NOT meant to examine whether or not women should examine themselves:

http://www.fhcrc.org/about/pubs/quest/win03/research.html
"Dr. David Thomas, who led the trial, said that more studies are needed to assess whether breast self-exam reduces breast-cancer mortality in women who perform the technique frequently and competently or in those who receive regular mammograms"...

..."`For public-health officials who have to make choices about how to spend prevention funds, breast self-exam instruction programs are an idea that shouldn't be pursued,' Thomas said. `Yet for a women with a mother and sisters who have had breast cancer, it's a different story. You would not want to discourage these women from practicing breast self-exam.'"

4) After reading Ms. Dubin's article, I had the impression that breast self-exams are supported only by regular folks who don't know about the science. However, the co-author of an accompanying editorial in the journal in which Dr. Baxter's article appeared disagrees with her conclusions:

http://www.cancer.org/docroot/NWS/content/update/NWS_1_1xU_Breast_Self_Exam_Is_Too_Valuable_to_Discard__Experts_Say.asp
"`Our view is that the recommendation [that BSE not be used or taught] is premature,' Larissa Nekhlyudov, MD, of Harvard Medical School's department of ambulatory care and prevention, tells ACS News Today. `The data they're basing their recommendations on are still incomplete,' she adds.

"`Women should be taught how to perform BSE, and should discuss it with their doctors,' she notes. `However, they should also be aware of its limitations,' she adds."

5) In 2001, the American Cancer Society's director of cancer screening also asserted that self-examination plays an important role (albeit secondary to that of mammograms and doctor examinations):

http://www.cancer.org/docroot/NWS/content/update/NWS_1_1xU_Breast_Self_Exam_Is_Too_Valuable_to_Discard__Experts_Say.asp
"There is considerable evidence suggesting a benefit to the use of BSE," says Robert Smith, PhD, director of cancer screening for the American Cancer Society (ACS).

"`Breast self-exam is useful before age 40 to help a woman learn what her breast feels like when it's normal,' notes Smith. `That way, she can have an idea of whether a lump she encounters is something that she should see her doctor about.'

"`And it can help with early detection of the small number of breast cancers found in that under 40 age group,' adds Smith. `After 40, we should not expect much added benefit from BSE, but we do expect a little, and that little is to provide a safety net for some women whose breast cancers aren't picked up by mammography,' explains Smith."

Read more...

lermit

I once met a terrorist tutor. His income was in the four-figure tier.

.lermit

frankenduf

holy hyperbole- BSE obviously does good- Mrs. Edwards was just on Oprah explaining how she palpated a lump which spurred her to go to the doctor and was subsequently diagnosed- thus that wording is irresponsible- perhaps better would be "if you're about to examine your breast for lumps- stop- and go get a mammogram"

discordian

I read about the T-Mobile thing.
And it's supposed to be a seamless transition between wireless network and tower.

FWIW I also observed (just a cursory examination, not a study per se) that on Sunday and Monday most iPhones were not selling for more than $40 - $50 above retail on eBay.
Reserves were not being met, 8GB phones starting at $700 were getting no bids, etc.
Guess they weren't as popular as Xbox 360 or PS III after all.

Nathaniel

Or Apple simply made enough of them to supply demand. Both MS and Sony have been known to deliberately undermanufacture initially (or begin sales in more areas than they know they can supply), simply so they can brag that they "sold out".

Apple usually doesn't have enough stock when they announce a new device because they literally can't build the things fast enough. They had a lot more months to get ready with the iPhone, though (presumably because of the FCC requirements for approval -- you just can't manufacture cell phones at the last minute the way you can with other consumer electronics).

dbrick

Ms. Dube may be overstating her case when she asserts that "Breast self-exams don't work."

1) Without an experimental or quasi-experimental study design, the results of these sorts of studies might be systematically biased because women who are more likely to get (worse) breast cancer might also be more likely to do frequent and/or thorough self-exams. So the self-examiners might have a higher detection rate and/or death rate before anybody does any examining, and then the self-exams bring them even with the non-examiners.

2) Of the studies that Dr. Baxter's 2001 article cites (these are the "other studies in Canada, the United States, the United Kingdom, Russia and Finland" that Ms. Dubin mentions), only two are randomized experimental studies. One is the "267,000 Chinese women" study, and the other is a Russian study in which, according to Dr. Baxter and her co-authors, "Because of lower-than-expected compliance and cancer incidence, there was inadequate power to detect a 20% difference in mortality between the 2 groups." Wow.

3) Though the Chinese study used a randomized experimental design, it was meant to examine, and draw conclusions about, the effectiveness of a policy intervention - training women to do self-exams in a developing country without mammograms. It was NOT meant to examine whether or not women should examine themselves:

http://www.fhcrc.org/about/pubs/quest/win03/research.html
"Dr. David Thomas, who led the trial, said that more studies are needed to assess whether breast self-exam reduces breast-cancer mortality in women who perform the technique frequently and competently or in those who receive regular mammograms"...

..."`For public-health officials who have to make choices about how to spend prevention funds, breast self-exam instruction programs are an idea that shouldn't be pursued,' Thomas said. `Yet for a women with a mother and sisters who have had breast cancer, it's a different story. You would not want to discourage these women from practicing breast self-exam.'"

4) After reading Ms. Dubin's article, I had the impression that breast self-exams are supported only by regular folks who don't know about the science. However, the co-author of an accompanying editorial in the journal in which Dr. Baxter's article appeared disagrees with her conclusions:

http://www.cancer.org/docroot/NWS/content/update/NWS_1_1xU_Breast_Self_Exam_Is_Too_Valuable_to_Discard__Experts_Say.asp
"`Our view is that the recommendation [that BSE not be used or taught] is premature,' Larissa Nekhlyudov, MD, of Harvard Medical School's department of ambulatory care and prevention, tells ACS News Today. `The data they're basing their recommendations on are still incomplete,' she adds.

"`Women should be taught how to perform BSE, and should discuss it with their doctors,' she notes. `However, they should also be aware of its limitations,' she adds."

5) In 2001, the American Cancer Society's director of cancer screening also asserted that self-examination plays an important role (albeit secondary to that of mammograms and doctor examinations):

http://www.cancer.org/docroot/NWS/content/update/NWS_1_1xU_Breast_Self_Exam_Is_Too_Valuable_to_Discard__Experts_Say.asp
"There is considerable evidence suggesting a benefit to the use of BSE," says Robert Smith, PhD, director of cancer screening for the American Cancer Society (ACS).

"`Breast self-exam is useful before age 40 to help a woman learn what her breast feels like when it's normal,' notes Smith. `That way, she can have an idea of whether a lump she encounters is something that she should see her doctor about.'

"`And it can help with early detection of the small number of breast cancers found in that under 40 age group,' adds Smith. `After 40, we should not expect much added benefit from BSE, but we do expect a little, and that little is to provide a safety net for some women whose breast cancers aren't picked up by mammography,' explains Smith."

Read more...

lermit

I once met a terrorist tutor. His income was in the four-figure tier.

.lermit

frankenduf

holy hyperbole- BSE obviously does good- Mrs. Edwards was just on Oprah explaining how she palpated a lump which spurred her to go to the doctor and was subsequently diagnosed- thus that wording is irresponsible- perhaps better would be "if you're about to examine your breast for lumps- stop- and go get a mammogram"