Crémieux Profile picture
Sep 16, 2024 14 tweets 4 min read Read on X
I have a pretty major update for one of my articles.

It has to do with Justice Jackson's comment that when Black newborns are delivered by Black doctors, they're much more likely to survive, justifying racially discriminatory admissions.

We now know she was wrong🧵 Image
So if you don't recall, here's how Justice Jackson described the original study's findings.

She was wrong to describe it this way, because she mixed up percentage points with percentages, and she's referring to the uncontrolled rather than the fully-controlled effect. Image
After I saw her mention this, I looked into the study and found that its results all seemed to have p-values between 0.10 and 0.01.

Or in other words, the study was p-hacked. Image
If you look across all of the paper's models, you see that all the results are borderline significant at best, and usually just-nonsignificant, which is a sign of methodological tomfoolery and results that are likely fragile.

With all that said, I recommended ignoring the paper. Image
Today, a reanalysis has come out, and it doesn't tell us why the coefficients are all at best marginally significant, but instead, why they're all in the same direction.

The reason has to do with baby birthweights.
So, first thing:

(A) At very low birthweights, babies have higher mortality rates, and they're similar across baby races;

(B) At very low birthweights, babies have higher mortality rates, and they're similar across physician races. Image
Second thing: Black infants tend to have lower birthweights.

MIxed infants tend to birthweights in-between Blacks and Whites, and there's a mother effect, such that Black mothers have smaller mixed babies than White mothers (selection is still possible)

Third thing:

(A) Black babies with high birthweights disproportionately go to Black doctors;

(B) The Black babies sent to White doctors disproportionately have very low birthweights. Image
If you control for birthweight when running the original authors' models, two things happen.

For one, they fit a lot better.

For two, the apparently beneficial effect of patient-doctor racial concordance for Black babies disappears:Image
At this point, we have to ask ourselves why the original study didn't control for birthweight. One sentence in the original paper suggests the authors knew it was a potential issue, but they still failed to control for it.Image
PNAS also played an important role in keeping the public misinformed because they didn't mandate that the paper include its specification, so no one could see if birthweight was controlled. If we had known the full model details, surely someone would have called this out earlier.
Ultimately, we have ourselves yet another case of PNAS publishing highly popular rubbish and it taking far too long to get it corrected.

Let me preregister something else:

The original paper will continue to be cited more than the correction with the birthweight control.
The public will continue to be misled by the original, bad result. PNAS should probably retract it for the good of the public, but if I had to bet, they won't.

So people like Justice Jackson will continue to cite it to support their case for racial discrimination.
They'll continue doing that even though they're wrong.

To learn more and to find the article linked, check out my post on this: cremieux.xyz/p/missing-fixe…

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More from @cremieuxrecueil

Mar 13
Today's deregulatory news is pretty big.

The White House is taking aim at the housing shortage by deregulating housing construction🧵 Image
A big part of the American Dream was created by a massive housing boom when the troops came home

Since the Great Financial Crisis, practically everywhere has reduced the number of permits they issue for new housing

This has resulted in housing cost growth outpacing wage growth: Image
To revive the American Dream, we need to build more homes.

If we want to build more homes, we'll have to overcome a lot of different regulatory burdens.

One step is to get rid of federal regulatory burdens that straddle homebuilders and owners with lots of random costs. Image
Read 10 tweets
Mar 13
In my latest article, I documented that the only RCT for functional medicine methods appears fraudulent🧵

Before getting into it, what's functional medicine?

It's a pseudoscience used to bilk patients by getting them on an unending cycle of tests, supplements, and more tests. Image
Functional medicine's practitioners claim that they can reveal and treat so-called "root causes" of people's health problems

These are proposed to be things like gut health, toxin burdens, and various chemical and hormonal imbalances

They find these things with unproven tests Image
If you run enough tests, you will be able to find something that looks 'off' about a patient, and if you're a functional medicine doctor, that's your 'A-ha!' moment, even if—as is usually the case—the result is just a false-positive and treating it is unlikely to do anything. Image
Read 15 tweets
Mar 12
What you see here is called "lying"

It's what happens when someone's anti-competitive protections are under attack

CON laws are insane. Basically:

If you want to open a new medical practice somewhere, you have to get your potential competitors to sign off, saying you're needed Image
If you want to add beds to a hospital, build facilities, purchase diagnostic scanners, but you live somewhere with CON laws, then you have to prove you're not creating competition for other medical facilities in the area, which is often the whole state.

No. Competition. Allowed. Image
The idea behind these laws is that people will spend excessively on healthcare, so to combat that, we'll have people report if there's more spending needed before approving it.

'A bed built is a bed filled' is the old adage.

But no one considered the obvious bad incentives. Image
Read 7 tweets
Mar 11
Nutrition science is the area of science that's suffered the most in the replication crisis. It is a graveyard of theories and pseudoscientific bullshit.

Now:

The HHS is going to make doctors to sit through 40 hours of classes where they'll have to take that bullshit seriously. Image
This reads like a list of the things that fared the worst in all of nutrition science and stuff with NO EVIDENCE.

When I read through this, my mouth was agape.

Whoever wrote this trash needs fired for incompetence. Mentally retarded people should not hold keep government posts.
'What did you learn in your mandatory nutrition misinformation class?'

'Well, if a patient comes in with a migraine, I'm supposed to sell them a WHOOP bracelet or an Oura ring so I can help them figure out their health age.'
Read 12 tweets
Mar 10
You should be flexible and you should be strong.

Strength training is a highly effective way to improve your flexibility, and I've made a graphic to put this into understandable terms: Image
This is from a meta-analysis of strength training trials.

What makes that so useful is that there's major publication bias for strength outcomes (pictured).

But, since authors weren't looking at it, there's no publication bias for flexibility outcomes.Image
Studies made their way into this meta-analysis because they had a flexibility outcome, but they made their way into the literature because they showed positive strength results.

This could indirectly biased the flexibility results because of selection on a correlated outcome.
Read 7 tweets
Mar 9
State IQ maps are interesting because they mostly reflect racial demographic mix.

The much more interesting maps are the race-specific ones🧵

Here's a thread of county-level IQ maps by race. First up? Whites: Image
The next-biggest group? Hispanics: Image
The next group is Blacks: Image
Read 6 tweets

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