Archive for December, 2007

I looked up celiac disease and autism on pubmed the other day.  My mother’s secretary has a daughter recently diagnosed with autism, and diagnosed several years with celiac disease.  So we were sitting in the dining room and I’m snacking and looking up stuff on pubmed.

“There’s not much research, but the two studies I’ve found on autism and celiac did not find a link, except for this one quack guy,” I say, meaning Andrew Wakefield.

“Okay,” my mom says.  “So they haven’t done the research confirming it yet.”

“No,” I say.  “There are two existing studies that have looked, and they did not find evidence of a link.  I’m looking on pubmed, so if there were more studies they would very likely be there.”

“Ah,” my mom says. “So all we’ve got now to go on is anecdotal evidence.”

“No,” I say again.  “Studies looked.  They looked for a link, and they didn’t find a link, suggesting there’s not a link.”

I think at that point we detected mutually incompatible approaches to uncovering truth, and dropped the conversation.

——–

It’s a normal human thing to figure out what you believe is true (often by assuming anecdotes are representative of overall reality), and then seek out social back-up to help convince others of it.  In this approach to truth (which drives scientists up the wall), if science is used, it is used to support one’s own truth claims to others.  If someone is not trying to make truth claims to others, then there is no need for science; it doesn’t tell you anything you don’t already know.

In contrast, the role of science as-generally-agreed-upon is to test what we believe to be true to see whether it really is true. In this approach to science, science can disconfirm anecdotes, and its role is to drive what people believe, not just to back what they already do believe.  So it’s much less useful for normal human goals.

Frustrating, that.   Also frustrating that we don’t have much research on a lot of things.  It could be true that the two studies on autism and celiac disease didn’t pick up on an actual connection…but the point is, two studies that show no connection are a lot more meaningful than no studies that show no connection.

A lot of kids diagnosed with autism would previously have been diagnosed with general mental retardation.  Now genetic testing is finding that some kids with autism diagnoses have specific genetic deletions/duplications.  Does that mean that they’re not really autistic and “autism” was a misdiagnosis? Or that “autistic” will turn out to be a useful umbrella term for a bunch of different things?  My vote is for the latter…

Searching for similar diagnoses through DNA testing

The article stresses both the relief families find at meeting other families with similarly affected kids, and the distress they experience at seeing the degree of impairment that older children with the same problems (still) have. And there’s a demonstration of the way gender roles play in to who can back out of their responsibilities and who can’t – note the one father who decided to pick up and leave a week after a conference for families with affected kids, leaving the mom to raise their affected daughter alone.

Ok, probably only partly.

ADHD kids have higher levels of lead in their blood than normal kids – even though their levels are higher than “safe” levels.

It would be great if  ADHD turned out to have an avoidable (or at least reducible) cause.  Seriously great.

Some stuff we still need to know (and the kind of questions you should ask yourself whenever you see a claim about etiology (cause of a disorder) based on a correlational study):

Is it causation: Are kids with ADHD more often from homes with lead-based paint?   (Or lots of toys from China, maybe?) If not, that suggests some other cause for higher levels of lead in their blood.  For example, they may be more likely to lick the walls.  (Not joking – kids with ADHD, at least those who are hyperactive, tend to seek stimulation.  And a major cause of higher lead levels in blood is licking lead paint because it tastes good.)

Are there kids with ADHD who don’t have higher levels of lead in their blood: It could be a cause, but not *the* cause.  It’s entirely possible ADHD has more than one cause.  As a quick analogy, take pneumonia – it’s a condition that can be caused by bacteria, viruses, physical injury…  We only have so many pathways in the body (including in the brain), and pathways can be interrupted by more than one cause.

And, of course, does it replicate?

I’m glad that bullying is getting national attention.  It seems weird that it has to piggyback on our fears of new technology to do so, though – like the lesson is “new technology is dangerous and we need to protect our children from it” rather than “kids can be mean as fuck and maybe we should pay more attention to that.”

We tend to use technology for the same old human kinds of things.  Staying in touch with each other; hurting each other; scamming each other; etc.  Technology facilitates some ways of doing these things, but the real problem is not kids using technology, it’s abuse and lack of social support for victims.

A study finds that women with bipolar disorder are poorer at identifying emotions based on prosody (vocal pitch, tone, word stress, etc.) than people without bipolar disorder. This was particularly true for fear and surprise.   The study was on people in remission, so it is difficult to attribute it to mood problems.
Here’s the weirder thing, though: men with bipolar disorder, on the other hand, look like people without bipolar disorder.

This is one of those areas where normal but not popularly-known areas of research send a little spike up into the news media, and it’s exciting and weird because you don’t know why they chose that measure or expected that finding.

Like the research on lesbians and finger-length ratios a number of years ago – seemed out of the blue at the time, but actually it came out of some reasonable hypotheses about (prenatal?) hormone levels, as represented in finger-length ratio, which is a common (albeit contested) way to measure that kind of thing.

Checklists are often simple and straightforward, and very short checklists can carry the unfortunate implication that the person using the checklist can’t remember to do simple things. But sometimes they can’t. Or don’t. The NY Times has an article discussing the rewards – in lives saved – of medical professionals using checklists, sometimes very simple one, to ensure that they don’t forget – or skip out on (do you wash your hands every single time you go to the bathroom?) – important steps under pressure, particularly those that may not seem as important as others.

The practice of medicine gets a little more scientific here , and rewards clinical intuition a little less, by reducing the human element involved in medicine. I’d bet you money that most patients would think that a doctor who uses a checklist is less competent than one that doesn’t, because they’re following delineated steps set up by someone else.

And that’s the dilemma: you can get the best healthcare available, or you can get healthcare that feels intuitively right.

If we keep going, healthcare may wind up being executed by health professionals but determined by information professionals. Good news for us science of info people…although I could just be expecting this potential from based on personal bias…
Using checklists (NYT article).

A follow-up on JasophrenicsWhat “Psychopath” means.  I think it’s interesting to note that sociopaths can do massive amounts of damage to other people in non-physically-violent ways, and if you could measure damage along the same scale, you’d probably find that the amount of interpersonal damage well exceeds the amount of physical damage.  But violent killing gets all the attention…

And a followup on  some posts I’ve made on culture and evolution: Gene-culture co-evolution. A (very, very) quick primer.  Worth the read unless you’re familiar with it already.

The actual headline is “Fever can unlock autism’s grip“, which is catchier but inaccurate.  Autism is not some external thing that has ahold of of a child or adult; it’s a developmental disorder that causes autistic kids’ brains to develop in ways that differ from how normal kids’ brains develop.  Consequently, they show features of autism like impaired social skills and upset in response to change.

I don’t know what to make of this overall.  They say fever “restores” nerve communication in the brain, enabling autistic kids to act like normal kids.  Without real clear evidence that kids with autism initially have normal nerve communication, then they don’t, then they get a fever and they do, I’d vote for “alters” nerve communication.

In the same way that brains of people with mental disorders are not normal brains minus adequate practice, brains of autistic children (as far as we know at this point) are not normal brains with autism added on.

Be pretty intriguing if that turned out to be wrong, though.