WEDNESDAY, DECEMBER 23, 2020
Four researchers' slippery text: Way, way back in 2016, a group of four researchers conducted an alleged study. They asked a bunch of (white) medical students and residents to evaluate the accuracy of fifteen different statements.
As we noted yesterday, it seems to us that the problem began with certain aspects of the study's basic design. But the problem got much worse with the slippery text of the researchers' Abstract.
You can see the full text of the study here. The Abstract starts like this:
Abstract
Black Americans are systematically undertreated for pain relative to white Americans. We examine whether this racial bias is related to false beliefs about biological differences between blacks and whites (e.g., “black people’s skin is thicker than white people’s skin”). Study 1 documented these beliefs among white laypersons and revealed that participants who more strongly endorsed false beliefs about biological differences reported lower pain ratings for a black (vs. white) target. Study 2 extended these findings to the medical context and found that half of a sample of white medical students and residents endorsed these beliefs...
"Half of a sample of white medical students and residents endorsed these [false] beliefs?" Unless we're dealing with simple incompetence, that's first-class slippery work!
From the highlighted statement, a reader might get the impression that half the "medical students and residents" had endorsed all the inaccurate statements. As we saw yesterday, such an impression would be grossly inaccurate.
In fact, very few of these medical students and residents "endorsed" the false statement concerning tolerance of pain among black patients. As we noted yesterday, the (false) statement in question was this:
"Black people’s nerve-endings are less sensitive than White people’s nerve-endings."
As we saw yesterday, only 16 out of the 222 (white) medical students and residents rated that false statement true. Indeed, given the slippery way the study was conducted, some or all of those 16 subjects may only have said that the statement was possibly true.
It gets worse—or in this case, better—among (white) respondents who had completed at least two years of medical school. Of third-year students and residents, only one (1) respondent out of 87 in all rated that false statement true, and that one person might have said that the statement was possibly true!
In short, very few of these (white) respondents rated that false statement true. That said, given the slippery way the researchers' abstract had been written, a careless reader might have gotten the impression that half the (white) medical students and residents had rated the false statement true.
That impression would be grossly inaccurate. But given the slippery language of the abstract, a gullible reader could easily be so misled.
Back on December 10, the Washington Post's Michele Norris conveyed that grossly false impression to her readers. In the column in question, Norris wrote this about These White People Today:
NORRIS (12/10/20): We are not just tussling with historical wrongs. A recent study of White medical students found that half believed that Black patients had a higher tolerance for pain [than white patients] and were more likely to prescribe inadequate medical treatment as a result.
Norris' statement was grossly inaccurate. On the brighter side, it coincided with current preferred Storyline.
Where do egregious howlers come from? As a guess, we'll guess that Norris never saw that slippery Abstract. We'll guess that she never looked at the original study at all.
Tomorrow, we'll show you where the relevant link in Norris' column led. We'll show you where she probably got the false impression she then conveyed to Post readers.
Nothing will turn on the error Norris published that day—an error which will go uncorrected down through the annals of time. That said, Norris should have examined the original study before composing her groaner. Her editors should have fact-checked her claim before they put it in print.
That said, where do howlers come from? In the case of a groaner like this, we thought it was worth letting you know.
We've looked at the original study's design. We've looked at the original study's grossly misleading Abstract.
Tomorrow, we'll show you where the link in Norris' column led. Can anybody here play this game? Or again and again, is our nation's upper-end journalism really just Storyline?
"That said, where do howlers come from?"
ReplyDeleteThey come from liberalism, dear Bob: a hilerian cult turning humyns into brain-dead zombies. And that's all there is to it.
If liberalism is Hitlerian, why did Trump have a book of Hitler's speeches on his night-stand as bedtime reading material? Why is Trump now decreeing that public buildings be a certain architectural style, as Hitler did? Why is so much of Trump's time in office patterned on what Hitler did during the Nazi regime, from his alliance with Russia, his abrogation of all treaties, to his use of men in unmarked cars and uniforms as personal storm troopers?
DeleteYou aren't confusing anyone but gullible conservatives with this attempt to label liberals as fascists. Fascism originates on the right.
"Trump had some good ideas, but he went too far."
Delete
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Norris' statement was accurate. A recent study of White medical students did find half believed that Black patients had a higher tolerance for pain and were more likely to prescribe inadequate medical treatment as a result.
ReplyDeleteThe study did find that to be true.
The Abstract was grossly misleading. That's Somerby's point. You and everyone else are quoting from the Abstract.
DeleteRead the actual study.
When you read the actual study, it supports the statements in the abstract.
Delete“In fact, very few of these medical students and residents "endorsed" the false statement concerning tolerance of pain among black patients. As we noted yesterday, the (false) statement in question was this:”
ReplyDeleteSomerby is either a fucking idiot or he is deliberately misstating the study. Here is how study 2 (the one with the medical students) is described by the researchers:
“In study 2, we used a within-participants design in which medical students and residents provided pain ratings and treatment recommendations for both a black and a white target. In addition to pain ratings, we measured beliefs about biological differences between blacks and whites using 15 items”
https://www.pnas.org/content/113/16/4296
In other words, it was a two-part study. The false beliefs were correlated with separately assigned pain ratings. Somerby either misunderstands, or pretends that the study only involved the 15 questions, and reduces it to a single (in his addled mind) relevant question.
Is Somerby engaging in propaganda? We can’t say for sure.
The main finding of Study 2 is that increased likelihood of endorsement of beliefs about biological differences resulted in decreased pain treatment among med students and residents. The point was not to show the incidence of such beliefs but to establish that wrong beliefs may lead to undertreatment of black patients for pain.
DeleteSomerby introduced the red herring about how many students held such beliefs by singling out one statement about half of the students endorsing incorrect beliefs (based on the composite measure), disputing it by using a single statement with low endorsement by the students with the most training. Somerby then used that to call Norris a liar (e.g., narrative-following liberal performative empathy racism-calling media tart) when Norris's statement is supported by the study.
Somerby seems to think that if he can pull a single statement (or finding) out of a study and dispute that, then the entire research unravels and can be discounted -- nothing in the study (which had two parts) is then believable. It doesn't work that way. Such studies do not stand or fall on a single disputed statement within it, nor on any criticism a person might make without evidence behind it. To discredit a study, a researcher must propose a flaw and then conduct another study to demonstrate that the flaw is valid and that it does produce contradictory results to those claimed in the original study. That is how science works.
This isn't like the theatre, where a critic's remarks can doom a show. It is put-up or shut-up and a critic must come up with findings to support the criticism once a study has been published (deemed worth adding to the literature by a panel of experts in various aspects of that type of research), as this study was.
There is no way that 50 percent of white medical students think this. They may feel this way about undertreatment, but not genetics.
DeleteBtw, a point long forgotten. For the last 30 years or so the new generation of doctors and dentists will NOT hand out pain medication like they used to. The prescription reporting laws are also much stricter, especially in NYS. So people who rely upon clinics and managed care may very well NOT get a lot of pain medication. Of all colors.
Denial. You think you know everything there is to know about pain treatment and you are an ignorant jerk who is spouting off the top of your head. You have your dates wrong about both the inclusion of pain as an additional vital sign in hospitals and also the concern over opioid abuse.
DeleteThese studies compare white and black prescribing using chart review under the same prescribing circumstances within the same time period. There is no reason there should be a racial difference due to anything you mention, but there is, documented, and published in the pain literature.
But nothing is going to convince you because you are sure about your beliefs and don't let evidence change them. Good luck in the real world.
Slippery Somerby adds the word ALL to make it sound like the researchers were lying in their abstract. The endorsement of the beliefs was based on a composite measure that included 9 statements. Somerby only wants to focus on the one with the lowest endorsements and then make it seem like the researchers were exaggerating, when their statement was based on the composite measure (across a variety of statements) not a single statement.
ReplyDeleteNorris's statement was not inaccurate, much less grossly inaccurate. Somerby doesn't know what he is talking about. He owes Norris a big fat gross apology.
Narrative emerges from research, not vice versa. Somerby is being a gross asshole today (and yesterday too).
Somerby is unqualified to "look at" the study's design. He makes basic errors that no undergrad student in a research methods class would make. And yet he speaks so confidently! Don't let that fool you. He doesn't have a clue about psychology (subjective experience and expression of pain) or medical research, or what is involved in a study like this one. And because he never reads his comments (afraid of feedback), he keeps repeating the same nonsense and sounding like the gross bigot he probably is. Scientists aren't afraid to expose their research to peer critique. Does Somerby imagine that peer review would have permitted a grossly flawed study to enter the literature? Hubris makes him think he knows something that the other researchers and journal editor may have missed -- only an ass behaves like this in order to malign Norris, who said nothing wrong.
I agree. With crystal clarity the study found half of a group of Med students believed black patients had a higher tolerance for pain and were more likely to prescribe inadequate medical treatment as a result.
DeleteThis is an important excerpt from the study. The researchers say:
ReplyDelete“Racial bias in perceptions of pain (and possibly treatment) does not appear to be borne out of racist attitudes. In other words, it is likely not the result of racist individuals acting in racist ways.”
That won’t stop conservatives like Tucker Carlson saying “Recent liberal study accuses white medical students of being stone cold racists.”
And then Somerby would be here gaslighting about those sorry race-baiting liberals, saying “see why they don’t like us?”
Madame, I believe Norris cited the study as an example of "medical racism".
DeleteNo. She says this: “a successful distribution of a vaccine in the United States will be won and lost on a battlefield with a long history of medical racism. Government-approved medical experiments from the past have undermined Black America’s trust in this moment.”
DeleteAnd then she discusses Henrietta Lacks, the Holmesburg prison experiment, J Marion Sims, and the Tuskegee syphilis study as examples. These are the medical racism she is referring to.
But nice try deflecting from my actual comment, which remains true.
No, you're wrong. Of course she was including it as an example of "medical racism". Why else would she cite it? What other reason would there possibly be?
DeleteShe relates the study of white medical students who withhold pain medication from blacks to the government-approved medical experiments from the past when she puts the study and its under-medicating-based-on-race aspiring doctors in league with her laundry list of "historical wrongs", doesn't she?
Delete"We are not just tussling with historical wrongs. A recent study of White medical students found that half believed that Black patients had a higher tolerance for pain and were more likely to prescribe inadequate medical treatment as a result."
What do you think about that? Why did she cite the study?
Where in the study does it show half of the white medical students believe black patients had a higher tolerance for pain than whites?
DeleteThis is stated in the 1st Paragraph under the subhead "Study 2":
Delete"We again averaged the 11 items that captured our variable of interest (α = 0.92) (see Table 1 and Table S1 for descriptive information; analyses for the composite with all items can be found in Table S4). On average, participants endorsed 11.55% (SD = 17.38) of the false beliefs. About 50% reported that at least one of the false belief items was possibly, probably, or definitely true (Table 1). These percentages are noticeably lower compared with those in study 1 (50% vs. 73%); however, given this sample (medical students and residents), the percentages for false beliefs are surprisingly high."
To find the study, follow Somerby's link above.
Can you asswipes read? My comment had nothing to do with Norris.
DeleteThe following paragraph is found immediately after the mediation analysis for Study 2:
Delete"Study 2 demonstrates that, similar to white laypersons in study 1, many white medical students and residents hold beliefs about biological differences between blacks and whites, many of which are false and fantastical in nature, and that these false beliefs are related to racial bias in pain perception. Furthermore, study 2 also reveals that white medical students and residents who endorsed false beliefs showed racial bias in the accuracy of their pain treatment recommendations. Specifically, participants who endorsed more of these beliefs reported that a black (vs. white) target patient would feel less pain and they were less accurate in their treatment recommendations for the black (vs. white) patient."
This comes from the researchers and is based on their data analysis. It does not come from Norris.
This is an example of medical racism, in my opinion. Norris is correct to call it that, as does the study she cited. These are racist beliefs. People may acquire them in innocent ways through participation in a racist culture, but that doesn't make the beliefs any less racist, nor does it prevent the undertreatment of black people for pain.
DeleteWhen people are not helped by their doctors, they complain to their friends and relatives. That repeated experience leads to a general suspicion that physicians do not treat black people well, and that will ultimately affect acceptance of the vaccine among black people.
This isn't rocket science.
The problem is the study doesn't back up Norris' claim that half of the whites believe black patients had a higher tolerance for pain than whites. The 50% statistic above certain does not come close to backing up that claim. The 'false belief' questions did not all have to do with pain. Even then, it is not saying half the students held the false beliefs. So, the interesting issue is Norris' 50% claim. Somerby is right that it is grossly inaccurate. Why make inaccurate, unsupportable claims when discussing important issues in a high profile paper?
Delete7:45 PM: The quoted text you provided does not show half of the white medical students believe black patients had a higher tolerance for pain than whites.
DeleteNorris cited the study as an example of "medical racism" and used an inaccurate, unsupportable misinterpretation of the study as her basis.
DeleteThese are simple facts.
Plus, it doesn't make sense anyway. Thinking for one minute half of white medical students believe black patients have a higher tolerance for pain than whites would be totally daft. Even for you!
@8:52
DeleteNo, she didn't do that. Go read the study or stop repeating garbage here. Insisting over and over on something doesn't make it true, not even when Republicans do it. Or Somerby.
The text I cited does show that. It is a summary of the results and references the tables and figures relevant. You wouldn't know how to read that study if lightning hit you and made you smart.
When someone answers a question for you, it isn't their fault that you cannot understand the response. Now you are just being an annoying troll.
But you are illustrating the connection between lack of education and refusal to accept reality when it smacks you in the face. Now you are just wasting people's time here.
Where in the study does it show half of the white medical students believe black patients had a higher tolerance for pain than whites? The study shows nothing of the sort. Show me where. You can't because it doesn't.
Delete"50% reported that at least one of the false belief items was possibly, probably, or definitely true" is not "50% reported black patients had a higher tolerance for pain than whites." Not even anywhere near close. So don't scold me sister. You are wrong and can not show me where the study proves 50% of white student reported black patients had a higher tolerance for pain. There's nothing in the study that supports that claim. If there is, show it. There's nothing of the sort there. You are completely wrong.
It's a totally stupid study anyway that got their respondents for Study One on Mturk for God's sake. What a joke.
I have already answered these questions. Like I said, you don't know how to read that study.
DeleteDo you feel like that claim is accurate? In general, across the country? Do think half of America's white medical students today think blacks have a higher tolerance for pain? You think that is a remotely accurate representation of life today?
DeleteShow me where the study backs up the claim by Norris and I will acknowledge I misread it.
The only mention you made of the 50% claim was cutting and pasting an irrelevant clip from the study. "50% reported that at least one of the false belief items was possibly, probably, or definitely true".
DeleteThat has nothing to do with the claim 50% reported blacks had a higher tolerances for pain than whites.
Are you confusing this medical student study with the fact that most police officers think blacks have super-human strength and quickness?
DeleteNo. I'm speaking about the study the lady commenter lied about understanding and accurately interpreting and on which Norris based her grossly inaccurate claim.
DeleteThis is what it looks like when a conservative denies reality. No argument, no evidence, no proof will convince. It is a waste of time trying to discuss anything with such people. They know what they want to believe and nothing changes their minds.
DeleteThe only way to "beat" Conservatives in a debate is to agree with them.
DeleteAs an example, say you wanted Congress to enact a law, forgiving student debt, or providing universal healthcare and a free college education for everyone paid for by the federal government. You'll get pushback from Mitch and the boys about the deficit. Instead of arguing about whether the deficit is important, just agree with them that it is. When Conservatives are offering the big stick called "the deficit" for you to beat them with, take it.
Let ALL defense contractors know ALL capital defense expenditures are immediately frozen until we get our arms around this "deficit" problem.
330 million American citizens marching in the streets don't have the power to move Mitch and the GOP. But you can be damn certain the board members of General Dynamics and Northrup-Grumman do.
An inability to understand science is not an argument against it.
DeleteFound on facebook: "Just because they know, like, science and stuff doesn't mean they know better than me. It's a free country."
DeleteExcept, reality punishes those who try to ignore it. Like the idiots who won't wear masks because they know better than Fauci, and because the abstracts of those studies just can't be right because liberals are making up shit about racism (Somerby's phrase for that is 'following a pleasing narrative').
Where does the study show half of the white medical students believe black patients had a higher tolerance for pain than whites?
DeleteAgain, where does the study find half of the medical students believed black patients had a higher tolerance for pain than white patients?? Where exactly is that finding in the study?
DeleteAs you know, it's not in the study. So you say, "Well, it's 'indicated'".
In that case it would be more accurate for you and Norris to say "From a study that suggests some medical students 'hold and may use false beliefs about biological differences between blacks and whites to inform medical judgments, which may contribute to racial disparities in pain assessment and treatment', I am inferring that half those students think blacks have a lower tolerance for pain."
That would be more accurate because the study does not "find" half of the medical students believed black patients had a higher tolerance for pain than white patients or even mention anything of the sort.
The question is did the study find half of the medical students believed black patients had a higher tolerance for pain than whites? A study on abusers can clearly state its findings. This study does not clearly state anything close to the assertion of Norris that half of the medical students believed black patients had a higher tolerance for pain than white patients.
Delete11:24, Somerby omits the next sentence from the abstract. Here is the fuller version: “Study 2 extended these findings to the medical context and found that half of a sample of white medical students and residents endorsed these beliefs. Moreover, participants who endorsed these beliefs rated the black (vs. white) patient’s pain as lower and made less accurate treatment recommendations.”
DeleteThose who endorsed false beliefs, half of the sample, rated the black patient’s pain lower. You see, the students were asked to respond to a set of questions that were beliefs about black people, and were then asked to rate the black patient’s pain. The pain rating was then correlated to the beliefs. The finding was as stated.
Again, where does the study find half of the medical students believed black patients had a higher tolerance for pain than white patients??
DeleteYour highlighted statement says nothing remotely of the sort.
"Endorsing" one false belief about blacks and whites, rating a patient's pain as lower and making a less accurate treatment recommendation is not a "finding" that indicates the student believes black patients had a higher tolerance for pain than white patients. That's your and Norris's inference. And a totally absurd one. There's nothing about it in the study. At all. And there never would be because the claim is absurd. No one but a deluded fool would think that accurately represents half of today's medical students.
"The finding was as stated." It isn't stated in the study as Norris stated it. At all. Nothing anywhere close.
DeleteThere is a meaningful difference between the study and Norris' claim. It won't help to concoct some fantasy scenario that bears no resemblance to the issue being discussed.
DeleteIs there no meaningful difference between:
1) 50% reported that one or more of the false beliefs were possibly, probably, or definitely true
and
2) 50% think blacks have a higher threshold for pain.
I'd say so. If you think there isn't a meaningful difference between Norris's claim and (1) or any part of the study, feel free to cite that part of the study and say why. If you think (1) and (2)state the same conclusion in different ways, that is your business, not mine.
As in the past, you are full of beans. If a study found you have the traits of an asshole and behave like an asshole, yet did not specifically call you an asshole, and then an article paraphrasing the study called you an asshole, the article would be appropriate.
DeleteThe study in question says that those that held false beliefs gave lower pain ratings and less pain meds to black people.
The article appropriately summarizes the conclusion of the study.
This is trivial, yet you insist on playing your willful ignorance/excessive literalism game. Do as you like, more power to you, I am not here to change you mind, I am just pointing out your utter nonsense bad faith argument.
This is the conclusion of the study: "Some medical students hold and may use false beliefs about biological differences between blacks and whites to inform medical judgments, which may contribute to racial disparities in pain assessment and treatment."
DeleteThere is nothing declarative about their beliefs about higher tolerance for pain for blacks. It is hedged with "may", they "may" use their false beliefs and that "may" contribute to disparities. Of course there is no declarative claim about their beliefs about their tolerance. That would be idiotic. The whole point is Norris' claim is idiotic and absurd. Anyone who thinks half of today's medical students think blacks have a higher tolerance for pain is a lost person. That is simply stupid. That's the whole point. It's lost on you I know but that's the point. Norris made an insanely stupid claim that is not backed up by the study. And the study is stupid anyway. But go for it. Believe what you want. I don't judge you.
"The study in question says that those that held false beliefs gave lower pain ratings and less pain meds to black people."
DeleteThat doesn't say they believe all black people have a higher tolerance for pain.
Does it???
No, it doesn't.
Norris:
Delete"A recent study of White medical students found that half believed that Black patients had a higher tolerance for pain"
Norris' claim is accurate and appropriate.
The study says that about half the sample of white medical students believed in false beliefs that then led to lower pain ratings and less pain meds for the black people they were "treating".
There is no such thing as absolute truth for human beings, people who do studies have the maturity and the responsibility to recognize such a state.
Those that lack that maturity, and instead devolve to willful ignorance and excessive literalism, and use them as weapons in bad faith arguments are doomed to be stuck in their rat wheel chasing their empty goals. More power to you.
But a recent study of white medical students didn't find that half believed that black patients had a higher tolerance for pain. That is false. It didn't show half believed that all black patients have a higher tolerance for pain. That is SO stupid.
DeleteWhat the truth is is this: "A recent study found some medical students hold and may use false beliefs about biological differences between blacks and whites to inform medical judgments, which may contribute to racial disparities in pain assessment and treatment."
Norris makes it sound like the medical students think all blacks have a higher tolerance for pain and that this is an example of medical racism but that is not what the study shows. At all.
There is nothing at all in there about medical racism and these students believing half of all black patients have a higher tolerance for pain.
"The study says that about half the sample of white medical students believed in false beliefs that then led to lower pain ratings and less pain meds for the black people they were "treating"."
Yes, and that is not what Norris claimed, is it? No, it's not?
Sorry, you're obviously wrong.
Norris' claim describes what the study found.
DeleteDenying this rather trivial point only reveals the denier's bad faith motive, or perhaps a mental disorder - if this is the case, it is only responsible to advise to seek out professional help.
Furthermore, there are many studies that detail medical racism; a congressional committee issued a publication a few years ago compiling all the research.
Taking willful ignorance and excessive literalism to such a degree may also suggest some kind of performance art, maybe some kind of ironic humor, who knows, but it has become, intentionally or not, quite risible.
Norris' claim does not accurately describe the study. At the very best, it's grossly misleading. Don't you think people could interpret it to mean the group of students thinks all black people have a lower tolerance?
DeleteEven if the study did make that claim, it would only be notable because it is an absurd claim. It would mean that the study is clearly and obviously flawed. There is no way anyone would think that half of today's medical students think all blacks have a lower tolerance for pain.
The way Norris summarized the study was correct, internal biases can lead anyone to misinterpret something valid.
DeleteMedical racism is supported by various studies, the one in question is valid and adds to the greater context of the issue.
Those that prefer an alternate map of reality are free to do their own research. More power to them.
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