Having neglected this blog for several months I find myself suddenly swamped with things to write about. My book has been translated into Korean by Hyundeuk Cheon, Hwang Seung-sik, and Mr Jeon, and judging by their insightful comments and questions they have done a superb and careful job. Next week there is a workshop on Prediction in Epidemiology and Healthcare at KCL, organised by Jonathan Fuller and Luis Jose Flores, which promises to be exciting. Coming up in August is the World Congress of Epidemiology, where I’m giving two talks, hopefully different ones – one on stability for a session on translation and public engagement, and one on the definition of measures of causal strength as part of a session for the next Dictionary of Epidemiology. And I’m working on a paper on risk relativism which has been accepted by Journal of Epidemiology and Community Health subject to revisions in response to the extremely interesting comments of 5 reviewers – I think this is possibly the most rigorous and most useful review process I have encountered. Thus this is a promissory note, by which I hope to commit my conscience to writing here about risk relativism, stability and measures of causal strength in the coming weeks.
I surely should have posted this earlier, but it’s currently in progress, and very stimulating.
Yesterday I briefed the media on my work and recent book on philosophy of epidemiology, ahead of next week’s launch event at the University of Johannesburg, and today one piece appeared in the Times (here) and two (here and here) in the Star. All the pieces are reasonably fair, and the latter two in particular are more conceptually focused, and thus quite a nice reflection of what I try to do. But it’s interesting for me that what grabbed the most attention were largely empirical claims. A couple of radio stations picked up on the claim that the vitamin supplements industry is a “con”, appearing in the Times piece, and I was interviewed at lunchtime today by Talk 702 and RSG. Both homed in on my claims about vitamins. Talk 702 asked if I expected any defamation actions. I guess this is how the media works – you never quite know which part of what you say is going to be amplified over the rest. That said, I am very grateful to the Times journalist that the context of my “con” claim was included in the piece.
For interest, I thought I would upload the presentation I gave yesterday. Not much about vitamins in there, you will see: 2013-09-10 Media Briefing – Philosophy of Epidemiology
Next week I am part of a symposium at EuroEpi in Porto, Portugal with the title Achieving More Effective Translation of Epidemiologic Findings into Policy when Facts are not the Whole Story.
My presentation is called “The Myth of Translation” and the central thesis is, as you would guess, that talk of “translating” data into policy, discoveries into applications, and so forth is unhelpful and inaccurate. Instead, I am arguing that the major challenge facing epidemiological research is assuring non-epidemiologists who might want to rely on those results that they are stable, meaning that they are not likely to be reversed in the near future.
I expect my claim to be provocative in two ways. First, the most obvious reasons I can think of for the popularity of the “translation” metaphor, given its clear inappropriateness (which I have not argued here but which I argue in the presentation), are unpleasant ones: claiming of scientific authority for dearly-held policy objectives; or blaming some sort of translational failing for what are actually shortcomings (or, perhaps, over-ambitious claims) in epidemiological research. This point is not, however, something I intend to emphasize; nor am I sure it is particularly important. Second, the claim that epidemiological results are reasonably regarded by non-epidemiologists as too unstable to be useful might be expected to raise a bit of resistance at an epidemiology conference.
Given the possibility that what I have to say will be provocative, I thought I would try my central positive argument out here.
(1) It is hard to use results which one reasonably suspects might soon be found incorrect.
(2) Often, epidemiological results are such that a prospective user reasonably suspects that they will soon be found incorrect.
(3) Therefore, often, it is hard to use epidemiological results.
I think this argument is valid, or close enough for these purposes. I think that (1) does not need supporting: it is obviously true (or obviously enough for these purposes). The weight is on (2), and my argument for (2) is that from the outside, it is simply too hard to tell whether a given issue – for example, the effect of HRT on heart disease, or the effect of acetaminophen (paracetamol) on asthma – is still part of an ongoing debate, or can reasonably be regarded as settled. The problem infects even results that epidemiologists would widely regard as settled: the credibility of the evidence on the effect of smoking on lung cancer is not helped by reversals over HRT, for example, because from the outside, it is not unreasonable to wonder what the relevant difference is between the pronouncements on HRT and the pronouncements on lung cancer and smoking. There is a difference: my point is that epidemiology lacks a clear framework for saying what it is.
My claim, then, is that the main challenge facing the use of epidemiological results is not “translation” in any sense, but stability; and that devising a framework for expressing to non-epidemiologists (“users”, if you like) how stable a given result is, given best available current knowledge, is where efforts currently being directed at “translation” would be better spent.
Comments on this line of thought would be very welcome. I am happy to share the slides for my talk with anyone who might be interested.