against method

A vitriolic tribune in Le Monde this weekend by the microbologist Didier Raoult, head of the Institut Hospitalo-Universitaire Méditerranée Marseille, campaining for the immediate use of the hydroxychloroquine sulfate drug for coronavirus patients. Arguing that the major emergency of the coronavirus pandemic calls for this use without waiting for confirmation from clinical trials, without controlled comparison with other drugs or a placebo. Solely a study of patients being administered the drug, outside the usual practice of clinical trials.

“Enfin, l’envahissement des méthodologistes amène à avoir des reflexions purement mathématiques.” [At last, the invasion of methodologists leads to purely mathematical reasonings.]

“Ce modèle, qui a nourri une quantité de méthodologistes, est devenu une dictature morale.” [This model, which has fed quantity of methodologists, has become a moral dictatorship.]

“…il faut nous débarasser des mathématiciens, des metéorologistes [sic] dans ce domaine.” [we must get rid of mathematicians and meteorologists in this domain]

“…conseil scientifique dans lequel on trouvait deux modélisateurs de l’avenir (qui pour moi représentent l’équivalent de l’astrologie), des maniaques de la méthodologie. Les médecins confrontés au problème du soin représentaient une minorité qui n’avait pas nécessairement l’habitude de s’exprimer et qui se trouvait noyée par cet habillage pseudo-scientifique.” […scientific committee including two modelisators of the future (equivalent in my opinion to astrologers), manics of methodology. Physicians facing treatment problems were a minority not necessarily used to intervene, overwhelmed by this pseudo-scientific babbling.]

Obviously I have no expertise in drug development or even in epidemiology, but the name-calling tone of this tribune, as illustrated by the above quotes, is appalling and populist, more in the spirit of Trump than of a rational search for scientific evidence. On the opposite, the arguments therein are a-scientific and reject the use of mathematical and statistical methodology for being… mathematical. And resort to name-calling, while not considering the more than philosophical aspect that opting for this drug rather than another one may be reducing survival chances for some groups of patients. (While the title chosen for this post reflects the title of Raoult’s tribune, with its philosophical pretenses, let me stress that Feyerabend’s book is not mentioned therein and that the article contains no indication that the author relates to Feyerabend’s views.)

poor statistics

I came over the weekend across this graph and the associated news that the county of Saint-Nazaire, on the southern border of Brittany, had a significantly higher rate of cancers than the Loire countries. The complete study written by Solenne Delacour, Anne Cowppli-Bony, amd Florence Molinié, is quite cautious about the reasons for this higher rate, even using a Bayesian Poisson-Gamma smoothing (and the R package empbaysmooth), and citing the 1991 paper by Besag, York and Mollié, but the local and national medias are quick to blame the local industries for the difference. The graph above is particularly bad in that it accumulates mortality causes that are not mutually exclusive or independent. For instance, the much higher mortality rate due to alcohol is obviously responsible for higher rates of most other entries. And indicates a sociological pattern that may or may not be due to the type of job in the area, but differs from the more rural other parts of the Loire countries. (Which, like Brittany, are already significantly above (50%) the national reference for alcohol related health issues.), and may not be strongly connected to exposition to chemicals. For instance, the rates of pulmonary cancers are mostly comparable to the national average, if higher than the rest of the Loire countries and connect with a high smoking propensity. Lymphomas are not significantly different from the regional reference. The only type of cancer that can be directly attributed to working conditions are the mesothelioma, mostly caused by asbestos exposure, which was used in ship building, a specialty of the area. Among the many possible reasons for the higher mortality of the county, the study mentions a lower exposure to medical testings (connected with the sociological composition of the area). Which would indicate the most effective policies for lowering these higher cancer and mortality rates.

bad graph of the day

A fairly meaningless graph in Le Monde about the comparative costs [per patient per year] of orphan and non-orphan diseases along the year. The evolution is impossible to capture and the ratio of the costs should be interpreted in terms of areas, when the cubic representation suggests volume…