{"id":608,"date":"2011-10-16T14:00:51","date_gmt":"2011-10-16T18:00:51","guid":{"rendered":"http:\/\/www.patheos.com\/blogs\/unequallyyoked\/?p=608"},"modified":"2012-11-20T17:18:23","modified_gmt":"2012-11-20T22:18:23","slug":"bringing-a-stat-book-to-a-culture-fight","status":"publish","type":"post","link":"https:\/\/www.patheos.com\/blogs\/unequallyyoked\/2011\/10\/bringing-a-stat-book-to-a-culture-fight.html","title":{"rendered":"Bringing a Stat Book to a Culture Fight"},"content":{"rendered":"\n<\/head>

\"\"<\/a><\/p>\n

Comments are still a little bit in flux here. \u00a0Because Disqus was causing problems, it\u2019s been stripped off and we\u2019re back to plain old wordpress comments until things get sorted out. \u00a0On the plus side, this means that all the previously vanished comments are back!<\/p>\n

Oh, and speaking of comments, today I want to point you to a conversation that\u2019s going on over at Marc\u2019s Bad Catholic<\/a> blog here at Patheos. \u00a0Marc wrote a post called \u201c10 Reason the Pill Sucks<\/a>\u201d and, although I disagree with several of the listed reasons, my epidemiological background makes me focus on claim one: The Pill doubles a woman\u2019s chance of breast cancer.<\/p>\n

It\u2019s always a bad idea to cite only<\/em> the percent increase in risk, especially if you\u2019re talking about a rare disease. \u00a0It\u2019s done all the time, even by science journalists, and it\u2019s always misleading. \u00a0Here\u2019s why.<\/p>\n

Imagine there\u2019s some disease that naturally occurs in 20% of the population. \u00a0If a certain exposure doubles the risk, 40% of people exposed will get sick. \u00a0Yikes!<\/p>\n

Or imagine a\u00a0disease that naturally occurs in 0.02% of the population. \u00a0If a certain exposure doubles the risk, 0.04% of people exposed will get sick. \u00a0Depending on what you\u2019re using the exposure for, it may not be worth it to give it up.<\/p><\/blockquote>\n

Talking only about the percent increase in risk (which you may also see referred to as a twofold or n-fold increase) doesn\u2019t help me make accurate choices to mitigate risk. \u00a0I need to know what the risk normally is, without the exposure, so I can think about the magnitude of the increase.*<\/strong><\/p>\n

\"\"<\/a>The best way to talk about increased risk is just to tell me the baseline incidence rate and then the incidence rate among exposed people. \u00a0It can also be helpful to talk about the population attributable risk<\/a> \u2013 a way of estimating how many cases of the disease wouldn\u2019t exist if it weren\u2019t for the exposure.<\/p>\n

You\u2019ll notice, after all this stat talk, I still haven\u2019t weighed in on the question Marc originally brought up \u2013 whether the risk of breast cancer conditional on hormonal contraception use is too high<\/em>. \u00a0To a certain extent, that\u2019s a subjective question \u2014 individuals may weight the positive effects of the Pill differently and have different risk tolerances. \u00a0But there\u2019s no way to get into that discussion until you have better risk parameters on hand than percent increase.<\/p>\n

I said all of this in the comment thread of Marc\u2019s post<\/a>, so you can see some of the responses there or discuss his other reasons for being anti-contraception.<\/em><\/p>\n

\u00a0<\/p>\n

*[One commenter on Mark\u2019s post thought the doubling number was helpful because it could just be applied to the usual estimates of breast cancer incidence. \u00a0I went through the paper fulltext<\/a> and found that the doubling only applied to one subtype of breast cancer (triple negative). \u00a0All the other kinds they looked at had no significant increase in risk. \u00a0I have no idea what the incidence rate is for the triple negative subtype, so the doubling number is still not helpful.<\/p>\n

This confusion highlights another flaw in citing percent increase; people may become confused about what incidence rate it applies to. \u00a0Always cite your baseline.]<\/p>\n<\/body><\/html>\n","protected":false},"excerpt":{"rendered":"

Comments are still a little bit in flux here. \u00a0Because Disqus was causing problems, it\u2019s been stripped off and we\u2019re back to plain old wordpress comments until things get sorted out. \u00a0On the plus side, this means that all the previously vanished comments are back! Oh, and speaking of comments, today I want to point […]<\/p>\n","protected":false},"author":127,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[22,38,21,20],"class_list":["post-608","post","type-post","status-publish","format-standard","hentry","category-uncategorized","tag-contraception","tag-feminism-and-the-family","tag-healthmedicine","tag-statistics"],"yoast_head":"\nBringing a Stat Book to a Culture Fight<\/title>\n<meta name=\"description\" content=\"Comments are still a little bit in flux here. \u00a0Because Disqus was causing problems, it's been stripped off and we're back to plain old wordpress comments\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.patheos.com\/blogs\/unequallyyoked\/2011\/10\/bringing-a-stat-book-to-a-culture-fight.html\" 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