Re: Put your babies on statins

From: Herman Rubin (hrubin_at_odds.stat.purdue.edu)
Date: 07/28/04 

Date: 28 Jul 2004 11:34:19 -0500

In article <0M2Nc.29$Z56.8@newssvr33.news.prodigy.com>, Bill <xxx@yy.zz> wrote:

>"Zee" <zwalanga@yahoo.com> wrote in message
>news:e5f4a9c2.0407252304.3c542074@posting.google.com...
>> "Bill" <xxx@yy.zz> wrote in message
>news:<yPXMc.2593$dM2.2022@newssvr17.news.prodigy.com>...
>> > "Zee" <zwalanga@yahoo.com> wrote in message
>> > news:e5f4a9c2.0407250247.73e6eed9@posting.google.com...
>> > > We can prove statins lower cholesterol but we have not proven they
>> > > affect all cause mortality.

>> > This is untrue and you know it is untrue. For certain classes of people -
>i.e.
>> > those with heart problems or diabetes - studies have shown a drop in all
>cause
>> > mortality over the course of the study - which is an affect on all cause
>> > mortality. I have cited several instances of this to you before and yet
>you
>> > chose to ignore them.

The studies all have ignored factors which should have been
considered. I suspect that if I had the information of
what was actually done in the studies, such as details of
what happened when patients had to drop out, details about
not quite matching in all respects (impossible to do; 20
respects, more than one million categories), etc. For
highly inbred rats, such procedures can be used, but for
humans, it is necessary to use statistical procedures which
I have never seen used in medicine.

>> > Bill

>> I disagree with you. I don't have anything more to say on this Bill.

>> Zee

>You disagree, but you will not say why? That makes you appear to be one who
>argues from emotion rather than reason. Here is a quote from a recent study
>which YOU originally cited - not me.

>"Results showed that the participants who took Zocor decreased their odds
>of overall mortality by 1.8% in the next five years, compared to those
> who were untreated (placebo group)"

See my above reasons for disagreeing.

>What precisely do you disagree with. Again you provided the source.

>Here is another one:

>Conclusions Our meta-analysis indicates that reduction in LDL-C associated
>with statin drug treatment decreases the risk of coronary heart disease and
>all-cause mortality. The risk reduction was similar for men and women and for
>elderly and middle-aged persons.

Meta-analysis is fraught with grave danger. It can be
valid if all studies are used, including the negative ones,
which I doubt the investigators even knew about. Otherwise,
it MAY be possible to use highly sophisticated methods,
and these have their problems.

There are other studies which do not agree; overall death
rates for those over 80 were lower for those with higher
cholesterol, and a followup on that showed that it was at
least to some extent due to higher cholesterol people
having a lower rate of infection, even in younger people.
I do not know if this study broke it down further.

If people were dropped from the study because of infections,
the whole analysis would be affected if the proportion was
different in the two groups.

>There could be qualifiers. But why do you believe that statins do not help
>some classes of people - in the sense of all-cause mortality?

>Bill

As I have stated before, if all the information is whether
a person has the factors as stated, I would agree that
statins at least should be recommended. However, that is
not the case, and the religious use of statistics in
medicine is definitely not what should be done. There
are a few places where sound statistics is used in medicine,
but this is not one of them. See my .signature. 

-- 
This address is for information only.  I do not claim that these views
are those of the Statistics Department or of Purdue University.
Herman Rubin, Department of Statistics, Purdue University
hrubin@stat.purdue.edu         Phone: (765)494-6054   FAX: (765)494-0558

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