WEDNESDAY, JANUARY 4, 2023
Racists beneath every bed: In recent years, our blue tribe has developed a high-level skill. We've learned how to tag people as racist without being honest enough the use the actual term.
So it went when Professor Sabin described the shocking beliefs of the "white medical trainees" (the "white medical students") who participated in a widely-cited study at the University of Virginia.
Right at the very start of her essay about those white medical students, Sabin tagged the white students as racist without ever using the term.
As we noted yesterday, here's how her essay started:
SABIN (1/8/20): “Black people’s nerve endings are less sensitive than white people’s.” “Black people’s skin is thicker than white people’s.” “Black people’s blood coagulates more quickly than white people’s.”
These disturbing beliefs are not long-forgotten 19th-century relics. They are notions harbored by far too many medical students and residents as recently as 2016. In fact, half of trainees surveyed held one or more such false beliefs, according to a study published in the Proceedings of the National Academies of Science. I find it shocking that 40% of first- and second-year medical students endorsed the belief that “black people’s skin is thicker than white people’s.”
Professor Sabin said she was shocked by the white students' false beliefs. She said that their disturbing beliefs about physiological racial differences almost seemed like long-forgotten 19th-century relics.
Everyone knows what's being said when our flailing tribe's excited tribunes offer such colorful statements. According to Professor Sabin, those (white) medical trainees had signed on to various disturbing racist beliefs.
In our view, Professor Sabin was rather selective in her description of the 2016 UVa study in question. We'll examine that question in more detail in tomorrow's report.
We think that Sabin did a poor job in her account of this UVa study. In fairness, though, we have to ask this:
Is it possible that Professor Sabin was justified in her obvious insinuation—in the insinuation that these so-called students, all of them white, had given voice to racist beliefs?
In fairness to Professor Sabin, let's consider one of the beliefs to which quite a few of these all-white students were reported to have agreed.
Below, you see the statement in question. Would a student have to be a snarling racist to endorse this badly racist claim?
"Blacks have denser, stronger bones than whites."
"Blacks have denser, stronger bones than whites!" That was one of the fifteen statements the unsuspecting medical students were asked to assess in the UVa study.
Quite a few of the students actually said that they agreed with this racist statement! It's easy to construct tribally pleasing denunciations of the type of young (white) person who would endorse such a claim. (References to Mandingo are strongly recommended.)
Our question goes like this:
If these whites would endorse a statement like that, why shouldn't we call them racists? One possible reason quickly appears—according to the authors of the UVa study, this was one of the four accurate statements the all-white medical students were asked to assess!
"Blacks have denser, stronger bones than whites?" According to the authors of the UVa study, that statement is actually accurate.
Is that statement actually true? Is it true that "black people" (presumably, on average) really do have (somewhat) denser, stronger bones than their "white" counterparts?
For ourselves, we don't have the slightest idea whether that statement is accurate. We'll guess that quite a few of those first-year (white) medical students were located in the same boat.
That said, the authors of this UVa study didn't give these unsuspecting, targeted whites the chance to say that they simply didn't know if the statement in question was true. As we noted in this report, participants were forced to choose among six possible reactions to each of the fifteen statements in question—and none of the possible answers involved the simple statement that the participants didn't know if the statement in question was accurate.
For ourselves, we'll now assume that the statement in question really is true (to some extent, on average). That said, we had no idea of any such fact before we examined the contents of the UVa study.
According to the authors of that study, fewer than 30% of the white medical students said they believed the accurate statement about stronger, denser bones. Again, their study gave respondents no way to say that they simply didn't know one way or the other.
In the face of this background information, our question today is this:
According to the authors of the UVa study, there actually are certain physical differences which obtain between blacks and whites, presumably on average. Having acknowledged that fact, won't you please riddle us this:
If bone density might differ (presumably on average, to some extent) between black and white people, why is it impossible to imagine that other physical characteristics may differ somewhat on average?
More specifically, why would a white medical student be assailed for not knowing whether some such difference obtained, on average, concerning the thickness of skin? Why are these (white) students assailed for holding disturbing, 19th-century beliefs if they simply didn't know whether the statement about skin was accurate, just like the statement about bones?
In fact, very few of the (white) medical students stand charged, within the study, with believing or endorsing the claim about thicker skin. According to the study's actual data, only 16 of the 222 medical trainees said they agreed with that statement—and given the peculiar way the study was designed, it isn't clear that any of these white trainees actually said they agreed.
We'll review that point tomorrow. For today, our point is simple:
It's ugly, stupid and self-defeating to behave in the way Professor Sabin did—to toss around her ugly insinuations about a bunch of (white) medical students, even as the professor displayed her own obvious moral brilliance.
After that, along came the Washington Post's Michele Norris—and she misread what Sabin had actually said.
As a result, Norris put a wildly inaccurate factual claim into the Washington Post. Apparently, she did this without fact-checking her (wildly inaccurate) claim by looking at the actual study's actual data.
Norris' editors didn't bother fact-checking her claim either. The claim was wildly inaccurate, but it was also tribally pleasing. The crazy claim went like this:
NORRIS (12/9/20): 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 and were more likely to prescribe inadequate medical treatment as a result.
"A recent study of White medical students found that half believed that Black patients had a higher tolerance for pain?"
That isn't what Professor Sabin actually said in the essay which Norris cited as her source. That doesn't even come close to what the actual data in the actual study actually show about the actual responses of the white medical students.
Meanwhile, the authors of the actual study placed so many thumbs on so many scales that there's no way to know if any of those (all white) medical students actually said that they agreed with the claim in question. Sadly but unmistakably, these are the gong-shows our blue tribe keeps choosing as we continue the pleasing behavior of spotting racists beneath every bed.
Ther woods are lovely, dark and deep. Quite routinely, our vastly self-impressed blue tribe is lazy and ugly and stupid.
We're also vastly self-defeating. Beyond that, understand this:
Sadly, no! You can't trust the various things your favorite reporters and journalists say. You can't trust your highly performative favorite professors, and you can't place your faith in their studies.
Tomorrow: Thumbs on scales in support of Storyline? Let's (try to) count the ways!
Meanwhile, the Republican House of Representatives, who were elected by Republican voters who are economically anxious---and not at all just straight-up bigots (h/t Corporate-owned Right-wing media)---are preparing to gut the IRS to protect tax cheats.
ReplyDeleteThe Republican House has really done it now. I hope they're prepared to be yawned to death by the economically anxious voters who elected them.
Bob promises more on the race study tomorrow. Quite something that this goes on at the same time McCarthy sinks slowly in the West…. Twin studies in
Deletemayhem of redundancy.
ReplyDelete"You can't trust the various things your favorite reporters and journalists say. "
Horrors, horrors.
...incidentally, dear Bob, are you at all concerned that your tribal chiefs have brought the world closer to a total destruction than it was during the Cuban Missile Crisis (also brought to us by your tribal chiefs)?
Or, does the tin-foil hat you're wearing prevents your scull from being penetrated by such crimethink?
It’s as if you set out to find every way possible to be stupid and incorrect and ran the table. Nice going, stupid.
Delete"We've learned how to tag people as racist without being honest enough the use the actual term."
ReplyDeleteThis is an example of a "damned if you, damned if you don't" argument.
A study calls a bunch of students who endorsed misinformation uniformed about black people, but Somerby thinks that is the same as being called racist. What do you call it when students don't know something? Shall we pretend they are knowledgeable, just to avoid hurting Somerby's feelings?
correction: damned if you do, damned if you don't
Delete“why would a white medical student be assailed for not knowing whether some such difference obtained, on average, concerning the thickness of skin?”
ReplyDeleteThis reaction illustrates the problem … in Somerby’s head.
One assumes from Somerby’s writing that the sole purpose of the original study and Sabin’s article is to call white medical students racists. In Somerby’s world, the purpose is so that liberals can feel morally superior, according to his twisted view.
One assumes, therefore, that Sabin calls for the shaming of those white medical students and their ouster from medical school. Right?
Instead, she says this:
“Racial and ethnic disparities in pain treatment are not intentional misdeeds: “
And:
“Health care providers must prioritize the need to better assess and treat pain equally in all people, and educators who influence tomorrow’s physicians must ensure that any racist misinformation is dispelled. “
Wow. How tribal and morally superior and ugly she is, urging better medical training so that black patients in pain are treated better.
Also, she mentions a compendium of studies, not just the UVa study:
“a meta-analysis of 20 years of studies covering many sources of pain in numerous settings found that black/African American patients were 22% less likely than white patients to receive any pain medication”
That sounds like a genuine problem that any rational and caring person would want to correct, rather than taking offense because you are a white man and these studies hurt your feefees.
ReplyDelete"Quite a few of the students actually said that they agreed with this racist statement! It's easy to construct tribally pleasing denunciations of the type of young (white) person who would endorse such a claim. (References to Mandingo are strongly recommended.)"
In fairness, Sabin didn't say any of this. This is Somerby's construction. He is the only one referring to Mandingo. Is it right to be put words in other people's mouths and then denounce them for things they didn't say?
A study might discover why a percentage of white medical students believe such things about black people. But more important is educating them about the truth so that they do not go on and give inappropriate treatment to patients. That won't be added to their training if no one knows that quite a few white students hold mistaken beliefs to begin with. That makes this study an exercise in improving medical education, not a witch hunt to find racists. If this study is actually "widely cited" as Somerby claims, that seems like a good thing, because it makes more medical organizations aware of the need to correct misimpressions about black physiology. There is no need to call anyone racist in the process, as Somerby says there is (calling Sabin dishonest for omitting that word).
But Somerby is not problem-oriented. He doesn't care about black patients being mistreated. He is only, defensively, complaining about the identification of racism in our culture. Because it is far worse when racism is called out, than when black people are under-treated for their pain. Trampling on white feelings is the true crime, not failing to provide pain medication for black adults and children in medical settings.
What a way to start the New Year, Somerby! By showing callous disregard for real problems that deserve to be fixed.
Somerby said this previously:
ReplyDelete““Blacks’ nerve endings are less sensitive than whites’
According to Norris, half the (white) medical students in question had said they believed that statement.”
This statement remains false.
Will Somerby be honorable enough to correct it?
How is it false?
DeleteBecause Norris did not say that half the (white) medical students in question had said they believed that blacks’ nerve endings are less sensitive than whites’.
DeleteHere. Read her opinion piece and verify it for yourself:
https://www.washingtonpost.com/opinions/black-people-are-justifiably-wary-of-a-vaccine-their-trust-must-be-earned/2020/12/09/4cf5f18c-3a36-11eb-9276-ae0ca72729be_story.html
She never said anything of the kind.
No one is saying she said it.
DeleteIn order to say a "recent study of White medical students found that half believed that Black patients had a higher tolerance for pain", she has to believe that "half the (white) medical students in question had said they believed that “Blacks’ nerve endings are less sensitive than whites’.”
DeleteWasn't this all explained to you in detail yesterday? What's up man? Still don't get it?
No one except Somerby.
Delete“ According to Norris, half the (white) medical students in question had said they believed that statement.”
Can anyone take you seriously, including yourself?
This is my final response.
Yes, that is a true statement by Somerby. It is not a statement that she "said" it. It's a statement that she didn't understand the study and that saying a "recent study of White medical students found that half believed that Black patients had a higher tolerance for pain", necessarily includes a belief "half the (white) medical students in question had said they believed that “Blacks’ nerve endings are less sensitive than whites’.”
DeleteDoes that make sense?
Your lizard has taken full control I guess.
Delete@12:12
DeleteNo, it does not make sense. It is an example of Somerby putting words into Norris's mouth that she did not say and then complaining that she said something incorrect, when she actually quoted the study itself.
Against my better judgment, I'll jump into this again. anon 12:05 is correct. MH (and anon 12:12) - I have to wonder how it's possible to be so dense. Norris claimed the UVa study showed that 50% of the med students believed that blacks had a higher tolerance for pain (completely wrong, study said nothing of the kind). The only proposition in the study (out of 15) that had anything to do with blacks' tolerance of pain was a proposition that blacks had less sensitive nerve endings. In order point out how wrong Norris was, it was reasonable to look at the study itself to see where there was anything in it about blacks' tolerance to pain. The only question in the study analogous to whether blacks had more tolerance to pain was the question about Blacks' having less sensitive nerve endings. It's bizarre how dense you are, and your refusal or inability to address these arguments. Again - "more tolerance of pain" is equivalent of "less sensitive nerve endings."
Delete12:42 - He didn't say she said that.
DeleteAc, I’m really surprised at you. The statement about nerve endings was only one of numerous statements the students were asked to respond to. If you actually read the study, the conclusion was that half of the med students endorsed false beliefs, and that half rated the black patients pain (ie their level of pain) as lower, and thus prescribed less or no pain treatment. How do you see that as differing substantially from what Norris said? If you rate someone’s level of pain as lower, aren’t you basically saying they can tolerate something that would cause pain in, say, a white patient? Aren’t you essentially saying that the black patient has a higher tolerance for pain? Besides, you and Somerby are the ones equating “nerve endings” with “tolerance of pain.” Norris didn’t do that.
DeleteYes, he did. And she didn't say what Somerby attributed to her. What she did say has been quoted. Why is this still an issue?
DeleteAC/MA -- you are wrong. First, mh quoted where the study said exactly what Norris quoted. Second, 50% belief in an overall statement does not imply that 50% of the subjects would have endorsed any specific false statement on the survey (11 of which were true and 4 were false). That makes no sense at all. The overall study was about pain assessment of black people. The researchers were interested in the contribution of mistaken beliefs on pain treatment. The additional studies are all about pain -- the ones Somerby didn't bother telling you about. That does not justify Somerby grabbing a single sentence and changing Norris's statement to use that one item on the mistaken belief survey.
How do you think people sense pain? Through nerve endings. Sensitivity of the nerve ending implies a stronger pain sensation or the ability to readily detect a weaker stimulation of that nerve.
But Norris did not single out that one question on the survey and Norris DID correctly report the results for the med students, and yes, the entire study was about the relation of mistaken beliefs to pain undertreatment, so her summary was not only correct but was quoted from the study itself.
You are wrong about this. Your attempt to rehabilitate Somerby's deceptive misquote of Norris is noted, but it is not plausible. It is wrong and deceptive of Somerby to misquote Norris and to misrepresent the study itself, as he did when he left out a ton of info that makes what was done clearer and different than the way Somerby characterized it.
Your attempt to justify Somerby's mishandling of information strongly suggests a need to keep your faith in Somerby or to promote his own mistaken beliefs, including the one that says Norris was distorting the study, which she was not, the belief that racism was the whole point of the study, which it was not, and Somerby's belief that liberals only want to call everyone racist and not solve problems, such as the undertreatment of pain in anyone, due to mistaken information held by med students. Somerby didn't mention it, but women are also undertreated for pain. Until recently, physicians held mistaken beliefs about whether infants can feel pain and whether it should be treated or prevented. They do feel pain. As a result of research, treatment of babies undergoing medical procedures has changed to include better pain control.
The study doesn't conclude half of the med students endorsed false beliefs, and that half all rated the black patients pain (ie their level of pain) as lower, and thus prescribed less or no pain treatment. Another misreading.
Delete2:42:
Delete“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. Moreover, participants who endorsed these beliefs rated the black (vs. white) patient’s pain as lower and made less accurate treatment recommendations.”
https://www.pnas.org/doi/10.1073/pnas.1516047113
Since I have quoted from the study itself, perhaps you’d care to give us your very well-informed reading which somehow contradicts the clear statement of the findings.
It concludes that the students who endorsed false beliefs tended to under-rate the level of pain on the task where treatment judgments were made (which Somerby never talked about). Those results are correlational, not a %. The actual number of incorrect endorsements was inversely (negatively) correlated with the pain levels in the second task of treatment accuracy. The more false statements endorsed, the lower the pain assessed by the student.
DeleteIt said that there was a significant inverse correlation between holding false beliefs and rating pain. The 50% only applied to what was being talked about in the sentence in which that figure was used, both in the Norris quote and in the study itself, where it only referred to the endorsement of false beliefs by med students, not their subsequent judgment task. Norris quoted directly from the study. Somerby rewrote her quote to say something she didn't actually say, nor did the researchers themselves.
Correlation strength is measured by the correlation coefficient (r value) calculated using a formula for determining whether two variables are associated (vary together) or not. They are not measured in percentages. You can see the differences in the judgments of the better informed versus worse informed students in the graphs of their treatment task results (see Study 2).
The abstract doesn't say half of a sample of white medical students and residents rated the black (vs. white) patient’s pain as lower. The was a misreading on your part.
DeleteMh is oatmeal north of the eyebrows when it comes.to reading and understanding studies.
DeleteMH - you are misreading it. The study said half the students answered one or more of the questions "wrong." I'm not sure but this might have included students who answered questions wrong where the correct answer was that blacks did differ from whites, e.g., denser bones. And a "wrong" answer included saying that an incorrect statement was "possibly true." Only about 66 got the question about "nerve endings wrong, the only one that related to pain tolerance. The study did say that the 50% who got at least one answer wrong (including ones having nothing to do with tolerance of pain) prescribed less pain medication to blacks than deemed proper. First of all, the study doesn't say they prescribed anything; they responded to hypothetical situations, one involving a hypothetical patient with a "black" sounding name, and one with a "white" name. This was on average - it didn't apply to all students who answered one of the questions "wrong." So arguably the study showed that the 50% students who answered one or more of the 15 questions (only one of which related to tolerance of pain) wrong, tended on average to prescribe in hypothetical situations insufficient pain medication to hypothetical black patients. That's not the same as all of the 50% of medical student who answered one of the questions "wrong" prescribed not enough pain medication. On the other hand, the study also discusses how the other 50%, who answered all 15 questions correctly, did the opposite - they prescribed insufficient pain medication to white hypothetical patients. And Norris claimed that the study showed that 50%of the students believed that blacks had greater toleration of pain - which is totally bogus, which is the main point TDH makes.
DeleteShorter mh:
Delete"Hey there's two sentences in a study, the first one includes the phrase 'half of a sample of white medical students' and the second one includes the phrase 'rated the black patient’s pain as lower', therefore the study says half of white medical students rated the pain is lower!."
In her defense it ses like intentional misdirection on the part of the authors.
"Is that statement actually true? Is it true that "black people" (presumably, on average) really do have (somewhat) denser, stronger bones than their "white" counterparts?"
ReplyDeleteWhen a medical student fails to endorse a true statement, that is as much a form of misinformation as when they affirmatively endorse an incorrect statement. The problem is lack of knowledge, either way.
Somerby mocks this statement because he himself does not know the correct answer. But why should he? He has never taken a physiology course. Many first year med students start out with such a course. My daughter, who is a physician, majored in physiology as an undergrad before starting med school. They can be expected to have more knowledge than the first group of subjects in the UVa study, which consisted of non-medical participants. They averaged 73% incorrect, whereas the med students got 50% wrong.
And no, not all of the participants were white, as Somerby keeps mistakenly stating. At least in Somerby's case, we have some idea about why he cannot find correct answers. Motivated reading to find "hidden" examples of attributions of racism in a study that explicitly stated that finding racism was not its purpose.
To be specific, 73% held at least one incorrect belief, compared to 50% of med students and residents. Not 73% wrong vs 50% wrong. Apologies for careless wording.
Delete"Why are these (white) students assailed for holding disturbing, 19th-century beliefs if they simply didn't know whether the statement about skin was accurate..."
ReplyDeleteSabin actually says that these are NOT long-forgotten 19th century beliefs, but current ones:
"These disturbing beliefs are not long-forgotten 19th-century relics. They are notions harbored by far too many medical students and residents as recently as 2016. In fact, half of trainees surveyed held one or more such false beliefs, according to a study published in the Proceedings of the National Academies of Science."
There are similar long-forgotten 19th century beliefs that were held about women. They included things like education interfering with women's child-bearing abilities, and the idea that the uterus floats around in the body. These are no longer part of modern medicine. Isn't it fair that such beliefs held about black people should also be eradicated?
But notice how Somerby puts words in Sabin's mouth that he explicitly did not say -- he actually says the opposite of what Somerby attributes to him. Is this playing honest pool by Somerby? I find it shocking that Somerby would stoop to this kind of dirty trick.
If liberals are constantly busy finding racists under every bed, surely Somerby can find more than this single years-old example, a 7 year old study, and two 2-year-old opinion pieces, and surely he wouldn’t need to make false statements about the articles he is citing?
ReplyDelete"In fact, very few of the (white) medical students stand charged, within the study, with believing or endorsing the claim about thicker skin. According to the study's actual data, only 16 of the 222 medical trainees said they agreed with that statement—and given the peculiar way the study was designed, it isn't clear that any of these white trainees actually said they agreed."
ReplyDeleteThat is 7% (16/222). Should 7% of young doctors go into their practice believing something incorrect about black people's bodies? Will that help or hinder their treatment of black patients? The UVa study not only asked students about their knowledge but found that those who endorsed wrong statements made poorer judgments about treatment. Somerby never mentions that part of the study. Why not? It is the purpose of the study -- to show that false beliefs lead to wrong treatment of patients.
Should even one medical student go into the world under-prepared to treat black patients? Why would Somerby argue that such a thing would be OK? He has been working very hard to show that wrong beliefs are no big deal -- heck, he even has them himself. Where's the beef, Somerby asks. It is the FACT (demonstrated by many empirical studies involving chart review) that black patients ARE under-treated for pain in the real world, whether we are talking about dentists, broken limbs in the ER, cancer pain or children's pain. That makes this a real problem and this study an important step toward fixing that problem.
And it makes Somerby an ignorant asshole (at best) who should be ashamed to have written what he did today.
Delete"that black patients ARE under-treated for pain in the real world"
Nah, not in the real world. Thank God, nothing like that would ever happen in our fair country: the Democratic Republic of the Congo.
You're all invited. Welcome!
Mao, Maybe someday Uncle Vlad will promote you to a real troll and let you live in Russia instead of the DRC, bless your heart. Hang in there, Sloopy.
Delete
DeleteOh, dear. Are you suffering from monkeypox, with no painkillers? How sad.
Mao,
DeleteIt's typical of big government Republicans. (Are there any other kind?)
"After that, along came the Washington Post's Michele Norris—and she misread what Sabin had actually said.
ReplyDeleteAs a result, Norris put a wildly inaccurate factual claim into the Washington Post. Apparently, she did this without fact-checking her (wildly inaccurate) claim by looking at the actual study's actual data."
This is factually untrue. She quoted from the UVa story itself. It is Somerby who doesn't know what he is talking about. Note his insertion of the word "wildly" when he calls Norris inaccurate. That is a thumb on the scale. Norris was not wrong, much less "wildly" wrong.
It would be nice is Somerby were to stop, go back and review the article and what Norris said, and retract his wrong-headed essays, but that isn't going to happen. Instead he is doubling-down on this. As a consequence, he has lost his standing to identify Howlers for the credulous. Somerby keeps saying that folks should apologize when they are mistaken -- he should start with an apology himself because he has been wrong about this all along. His mistakes were pointed out in 2020, when he first discussed this research and he is wrong now as well. It is time for him to stop spreading this garbage against not only Norris, but also Sabin and the UVa study itself, which did not make mistakes, as Somerby mistakenly claims.
Bob is doubling-down on his bigotry, like all Right-wingers when Republicans are shitting all over themselves in public.
ReplyDeleteIt's their go to since Reagan/ Bush made being a racist okay again.
"Meanwhile, the authors of the actual study placed so many thumbs on so many scales that there's no way to know if any of those (all white) medical students actually said that they agreed with the claim in question. Sadly but unmistakably, these are the gong-shows our blue tribe keeps choosing as we continue the pleasing behavior of spotting racists beneath every bed."
ReplyDeleteThis is not factually true. The researchers did not put thumbs on any scales. The UVa study was peer-reviewed before publication in PNAS, a highly respected journal, which would have caught and required correction of defects in the study (or refused to publish it). The reviewers are experts in the topic of the paper. That is what scientific peer review is for -- to catch mistakes.
Somerby has no background at all in this topic, nor in research methodology, scaling (construction, use and scoring of questionnaires and rating scales), pain, physiology or medical education. He apparently has no background in what he calls "our brutal racial history" either, given his rejection of concerns about lingering racial misbeliefs. There is no reason to take seriously, much less believe, anything Somerby has said on this ongoing obsession in which he argues against fair treatment of black people in medical settings.
With a little tweaking, Somerby could submit this set of essays to any of the increasing number of right supremacist websites, eager for examples to justify their rallying of the stormtroops. He could repackage this as a talk and appear at Trump's forthcoming rallies (assuming he isn't in jail as 2024 approaches). Blaming the left for NOT calling white racists "racist" is a new twist. And they will love his call for not medicating black people by allowing mistaken med students to persist in their wrong beliefs.
And if you think I am being too hard on Somerby, he has not only been corrected many times, but he deliberately avoids knowing when he is wrong about things -- so he has earned every bit of criticism. Who writes this kind of stuff, year after year? Not anyone with genuine concern about black people or improving medicine for all. And what do we call people who hold hostile views toward black people because they are black and thus may have specific physiology? Wait, wait, don't tell me...let Somerby figure it out.
The authors of the study interpreted a response of 'possibly true' as 'believing' or 'endorsing a belief.' That is a thumb on the scale and I don't give a shit what PNAS thinks about it. If PNAS doesn't perceive that as a thumb on the scale, then PNAS is wrong. This is part of Somerby's point, or his entire point. If you can't see how that methodology is fucked because PNAS is okay with it, then you are elevating your obeisance to authority over your own common sense.
Delete1:36:
DeleteIf you think something is possibly true that is in fact false, you are wrong, and you will have a tendency to act upon that wrong belief.
By the way, the study actually shows that the pain rating is correlated to the strength of the endorsement. In other words, the stronger the med student agreed with a false belief, the lower the pain rating they gave the black patient.
But if you’re reduced to cussing, I guess you have shown your level of maturity. And your debating skills.
This comment has been removed by the author.
Delete@1:36
DeleteThe possibly true judgment was part of a scale that also included a possibly untrue judgment. "Possibly true" as a response has two parts: (1) the truth value of true or false/untrue, and (2) the degree of confidence felt by the rater about their truth vale judgment, possibly/probably/definitely. Expessing less confidence about the judgment doesn't change the truth value selected by the rater, but it does influence the treatment advocated. That is mh's point. Somerby has not described the treatment and pain ratings portion of the study at all. For all he has told you, that doesn't exist. The correlation of those false beliefs with the treatment judgments shows that instead of putting a thumb on the scales, as Somerby and you say, the researchers looked at the influence of confidence in one's belief on the subsequent treatment accuracy. It was not a confound or weakness of the study, but something the researchers explicitly examined.
Part of the problem may be that Somerby has left out huge amounts of info about what the study did. Another part is that even if you went and read the study yourself, you might not understand everything that was done. Perhaps Somerby himself didn't understand it -- but he has deliberately left out info before, so I think he was just being deceptive.
The thumbs you think are on some scale are not put there by the researchers but by Somerby himself. You are a fool to accept what he says, much less get mad about it.
mh and his twin, not-mh. The students could also characterize one of the "wrong" postulates as "possibly wrong." Those who did were deemed to have given a correct answer. Saying something is "possibly true" means you don't think so, but it's possible. Your expressing skepticism but aren't sure. Saying something is possibly false, means you thinks it probably true but you aren't sure. If this is the way scientists do these surveys, there is a major problem. And since, according to the study's methodology, all the students who answered "possibly true" were classified as "wrong", while those who answered the incorrect postulate as "possibly false" were classified as having responded correctly, the study got the whole thing ass-backward.
DeleteYou can make up ways that a person might react to such questions idiosyncratically. The way that subjects tend to use such scales is know from studies that examine rating behavior explicitly, not in the context of any particular study. I cited a bunch of that literature when Somerby first proposed this crap. You wouldn't use a ruler without knowing that it was accurate. People who use these scales know that they have been tested and they understand how people tend ot respond when using them.
DeleteIs it possible that some one person could have a weird way of interpreting what "possible true" means? Of course it. But that's why you don't use only one person in your study. When you recruit a group, the weird answers are overwhelmed by the answers that people give in reliable and consistent ways because we all use the same English language. The occasional weird answer becomes an outlier that doesn't have much impact on your data analysis because it is only one person. Because weirdness can happen in different ways, there will be other strange interpretations, but they will bei different from each other and thus will contribute to what we call "noise" in the data. Noise makes it harder to get a statistically significant result. When you still get a significant finding, despite the presence of weird uses of the rating scale, you know you have a stronger, more robust finding. These results were significant and possible weird interpretations of the survey questions were not a problem, or the study itself would not have been published.
It takes years to be trained as an experimental psychologist, spent learning methodology and statistics in order to avoid creating crap studies. You seem to think that your own "logic" is raising problems that invalidate this work. The actual situation is that neither you nor Somerby is qualified to critique a study -- you are raising objections that have already been addressed by the researchers and that do not actually compromise the study. Further, the experts who did peer review would have anticipated the things potentially wrong and addressed them with the authors. The study was published despite whatever they found, as experts. That means it is sufficiently reliable for other scientists and especially doctors, to consider what the study found out.
And no, we are not the dense ones here.
not mh - who said anything about "weird" answers. If someone is asked about whether a "false" proposition is true, and the person thinks it is false, but isn't completely sure, she might reasonably say it is "possibly true." No one knows everything, including I would think even you I would say its possibly true you are right and I am wrong her - I'm pretty sure I'm might, but I have to acknowledge I might be missing something (though nothing you've said leads me to think that.) Yet, the person in my example who answered "possibly true" is classified the same as someone who said the false statement was "definitely true." And (and this is "weird") someone who says the false statement is "possibly" false" - which means she thinks it's true, but acknowledges the possibility it could be false, is classified the same as someone who says the false statement is "definitely false." I'd add that a lot goes into how obvious it is that the statement is either true or false. I don't think any of the statements in the survey were either obviously true or obviously false. After all, it may be that not every human tolerates pain the same way; and it might be that on the whole, averaging out every black or every white, one or other of these 2 categories might have some greater tolerance of pain. This is common sense and logic. The issue we're debating has nothing to do with some outlier respondent giving a "weird" response.
Delete"Sadly, no! You can't trust the various things your favorite reporters and journalists say. You can't trust your highly performative favorite professors, and you can't place your faith in their studies."
ReplyDeleteThis kind of statement is why faith in science is so much lower on the right than among liberals. The decline started with Fox News and has been sharply downward since then. It is why more right wingers have died of covid than people on the left -- lack of trust in public health officials and media recommendations about masks and vaccines.
There is a special place in hell reserved for people, like Somerby, who urge that professors, researchers, and the media who report on studies, are unreliable and cannot be trusted, as Somerby has spent a great deal of time arguing for years now, while dishonestly suggesting that he is a member of the left when he plainly is not.
At a time when climate change requires urgent action, demanding knee-jerk disbelief of science will delay progress and cost many lives. Scientists are human beings, but science is our only method of empirically solving problems and accumulating knowledge to improve our lives. Urging people to disturst it is harmful to getting projects funded, implementing improvements derived from studies, and spreading information to protect people, such as in the far-from-over pandemic.
This isn't a game. Following Somerby's recommendations about disbelieving our best sources is destructive. The most gullible will be the most harmed by what Somerby is saying here. While I don't like the people who support Somerby's blathering, I wouldn't want to see them suffer by following Somerby's advice, but then, Somerby urges us to avoid our "favorite" sources, and the reliable voices are not favorites among the most vulnerable people here, so if they instead listen to their least favorites (e.g., liberal professors, Fauci, NY Times science articles), maybe they can protect themselves. Liberals aren't going to pay any attention to Somerby anyway -- we know better and can recognize bullshit when we hear it here.
Over and over again, for 20 plus years, Somerby has pointed out how poorly these 'journalists and reporters' reason. Norris is just one example, and it's a very good example. The fact is most of them cannot be trusted. Sorry if you think that's 'dangerous,' but the fault lies in the reporters and journalists and the system that elevates their incompetence. It's not the fault of Somerby for pointing it out and urging caution.
Delete"we know better and can recognize bullshit when we hear it here."
Apparently 'we' actually cannot recognize it when we hear it, from all over the place. Over on the liberal side we still cling to all kinds of false memes that have been fed to us by reporters and journalists.
Please, Liberals. I beg of you. Stop believing the media's lies that the GOP isn't fascist.
Delete1:19:
DeleteThat there is a racial bias in prescribing pain medication is not a false meme spread by journalists. It has been established in numerous studies over the years.
On the other hand, I suggest that Somerby , your favorite blogger/journalist, is pushing a meme: that the UVa study is trying to accuse white medical students of racism and shame them.
Your lizard may reject this possibility, but you should at least consider the possibility.
Welcome back to Big Bob’s Reverse Racism Jamboree. Where any bad national tendency can be proven over and over with a single example!!
ReplyDeleteSadly what the Trump Era proved
and continues to prove is that the level
of White Racism may have lowered a
lot less in recent years than a lot of
might have hoped/believed.
Has insufferable piety on the left
contributed to this sorry situation? I’m
willing to entertain arguments. But its
Impossible to take Bob seriously when
he will not acknowledge any example
of white racism in contemporary
America. When he ignores the Jan
6th example of the election workers
who were terrorized when Trump
made crude attacks on them,,he
shows he is part of the problem.
Bob needs to pick a lane. Either there is no racism, or exhort us to listen to "the Others". He'll never convince anyone of both.
ReplyDeleteThere is no reason matters of race can’t be talked about with moderate position that sticks to the facts of a given case. Bob had just illustrated he is only interested in the horrors of discrimination
Deleteagainst Whites.
Let's not forget, the point of the study was to try to explain a documented phenomenon, i.e., the under-prescribing of pain medication for black people. The study is being reported for its 'alarming' or 'disturbing' findings. That being said, does it provide a convincing hypothesis for the under-prescribing? Considering only something like 6% of the white med students 'believed' that black people have less sensitive nerve endings, then I would say that the study doesn't nearly provide a robust hypothesis. The study is ultimately a failure. This is not unusual in the research world where most hypotheses end up unsupported, and the fact that this study was a failure is not meant to disparage the researchers.
ReplyDelete1:49
DeleteThe study clearly says that half of the med students believed wrong things (or “endorsed false beliefs” as they put it.) You are aware that there were multiple statements the students were asked to consider weren’t you?
"This is not unusual in the research world where most hypotheses end up unsupported"
DeleteIn science, there are generally two hypotheses -- the one the researchers wish to test and the null hypothesis, which is that the researchers are wrong in their theory and their test shows nothing special is happening, the proposed hypothesis is wrong. The goal of the study is to disconfirm the null hypothesis that nothing much is going on with the phenomenon you are studying.
In this study the null would be that there is no difference in treatment of pain between those students with more misinformed beliefs compared to those with less misinformed beliefs. If that were the result, then the study would fail to find anything interesting to report, and the research would not be published.
However, what actually happened is that this study showed a significant difference in treatment judgments between those with more false info and those with less falso info (who were more accurate). Because the result was statistically significant, which means it was robust enough to have occurred for a cause (the mistaken beliefs) and not due to chance, it can be considered to have established the researchers' hypothesis that mistaken beliefs do affect pain treatment among med students.
In other words, the researchers' hypotheses were supported, because the null hypothesis of no difference was rejected and the statistics showed that such rejection was not likely to be due to chance. That means the study was not a failure. Failures are not published.
Somerby has been disparaging Norris, but when Somerby implies that the researchers are calling med students racist, he is definitely disparaging the researchers along with Norris.
This broken record in which you and Somerby and AC/MA all repeat the same incorrect things over and over, despite having been debunked repeatedly, is itself dishonest. Because it does not respond to any argument, it is a propaganda technique and has nothing to do with this subject at all. It is about undermining faith in the media, calling liberals names, making it seem like research is "woke" when it has said nothing about racism at all, and promoting the goals of the right wing, which are to win the hearts and minds of the unwary.
There has been a lot of lying in this thread. Somerby appears to be taking his cues from George Santos in this New Year.
Yes I am aware of everything you wrote. The other false beliefs provide much weaker explanatory power for the under-prescription of pain medication, if there is any explanatory power there at all. 'Blacks have a more sensitive sense of smell than whites,' no matter how many med students believe it, does not provide a good explanation of why black people are under-prescribed pain medication. 'Whites have a better sense of hearing than whites;' you are going to have to go very deep into the weeds to find any connection between this false belief and the phenomenon of under-prescribing pain medication.
DeleteNow it's my turn to ask obnoxious rhetorical questions. Did you even read the study? Right up front the authors say "Specifically, we test whether people—including people with some medical training—believe that black people feel less pain than do white people." One false belief is clearly meant to test for this, "Blacks’ nerve endings are less sensitive than whites’". You could possibly argue that some of the other beliefs e.g. about thick skin and a more robust immune system could provide some explanatory power, but it would be a stretch.
So the fact you pointed out, that 50% of the students endorse one or more false beliefs, is not at all a good argument that the researchers made a strong case for their hypothesis.
Indeed what the study DOES seem to show is that, over time, most med students are eventually disabused of almost all these false beliefs, and especially the false belief about nerve endings, until the time they are residents when very few of them believe any of them at all. Considering that out of this test population only residents can actually prescribe medication, and only 4 residents 'endorsed the false belief' (meaning they might have said it is 'possibly true'), I would say this study did not at all demonstrate that this false belief is responsible for the phenomenon in question.
not mh, the researchers are not merely claiming that the study shows that people with false beliefs tend to fuck up their treatments. It's interesting that you would point this out because it actually lends itself to another very popular Somerby trope, i.e., wtf is up with the academics and why are they testing for something that is obvious on its face. It's hard to believe that the hypothesis 'do false beliefs lend themselves to suboptimal treatments' would require testing.
DeleteThe researchers are actually making much broader, much more powerful claims that are not supported by the study: “Many previous studies have shown that black Americans are undertreated for pain compared to white Americans... Our findings show that beliefs about black-white differences in biology may contribute to this disparity.”
THIS disparity, not a possible disparity.
By the time they are ready to prescribe medication, 4 out of 222 participants maintained the false belief that black people have less sensitive nerve endings than white people. It would seem this false belief can't have much of an effect on the overall phenomenon because so few people believe it.
2:59 (and maybe 3:27): Whether you think the questions themselves all pertain to sensing pain or not, the results are clear: the more strongly the med students endorsed the false beliefs, the lower they rated the black patient’s pain, and therefore, made an improper treatment recommendation. There seems to be a correlation.
DeleteAnd, you are correct! Generally, A smaller percentage of residents endorsed false beliefs as the lower level medical students.
But, 3:27, you cite only the responses to the one question about nerve endings. 25% of residents believed (falsely) that blacks’ skin is thicker than whites! Do you think that might influence a treatment recommendation?
Also, remember that first year med students have already graduated from a four year college, where they would have had to take biology, physiology, etc. It isn’t very encouraging that first year med students would still harbor wrong views about blacks.
You say:
“It's hard to believe that the hypothesis 'do false beliefs lend themselves to suboptimal treatments' would require testing. “
That isn’t exactly right, is it? It’s much more specific and targeted.
The question is do false beliefs about black biology result in white medical students prescribing suboptimal treatment to black patients. That seems more worthy of testing than your oversimplification.
And the fact is that previous research has established that blacks are systematically improperly prescribed pain medication, so it doesn’t need to be described as a mere “possibility.”
I will give you credit at least for trying to make coherent, rational arguments and staying away from ad hominem.
Not MH - there were 15 postulates that the student had to rate as definitely true, probably true etc. Only one of these related to blacks' tolerance of pain, the one about nerve endings,. and only 6% of them got those wrong (which included those who essentially said they didn't know the answer, i.e. it was possibly true. None of the other postulated premises related to tolerance of pain. The study showed that the 50% who got any of the 15 postulates wrong were more likely in a hypothetical situation to under-prescribe pain medication to a hypothetical patient who had a "black" sounding first name, while the other 50
Delete% who answered all the questions "correctly" were more likely to under-prescribe pain medication to hypothetical patients with "white" sounding names. I'll stick with TDH on this. The study doesn't really prove anything, it's dumb.
AC/MA, it is your opinion that only one of the statements related to pain treatment. I don't think you know enough to say that, about physiology, about pain or about black people's bodies and medical experiences.
DeleteIf the other statements were uncorrelated with accurate pain treatment, there would be no significant correlation produced in the study overall and the inverse finding shown in the graph would not exist (the lines would look parallel in the graph). The graph rules out your suggestion that the way the other questions were answered produced the effect, and it rules out the idea that only one question produced it.
But consider this. Black people are known to be (by published chart-review studies) undertreated for pain when they visit an ER with a broken bone (verified by x-ray). Why would the belief that black people have stronger bones not contribute to giving a black person with a fracture less pain medication?
"The question is do false beliefs about black biology result in white medical students prescribing suboptimal treatment to black patients. That seems more worthy of testing than your oversimplification."
DeleteActually no I disagree, this does not seem worthy of study. This seems as obvious as my previous oversimplification because it basically is the same hypothesis: if you have false beliefs (about anything), you will likely come up with suboptimal outcomes. If you have false beliefs about how an economy works, your economic policies will likely be suboptimal. If you have false beliefs about climate, your climate policies will be suboptimal. If you have false beliefs about black physiology, your treatment plans for black people will likely be suboptimal. This seems too obvious to be worth mentioning, let alone studying.
So again I will point out that the researchers are making a much stronger claim than this hypothesis. The researchers are not merely saying that false beliefs about black physiology are correlated with suboptimal treatment (again: duh). The researchers are saying that this study helps explain a large phenomenon, i.e. that false beliefs about the physiology of black people is at least partly responsible for the documented under-prescription of pain medication for black people. I don't think the study supports this well at all. Less than 2% of the participants who are able to prescribe medication 'endorse' the belief that black people have less sensitive nerve ending than whites. This very small percentage of the professional pain-prescribing
community can't possible be responsible for the documented widespread under-prescribing of pain medication. In fact it is such a poor explanation that it does black communities a disservice. It has such terrible explanatory power that likely a better reason exists somewhere, but pseudo-libs are content with 'must be because white people and their disturbing false beliefs.' Pseudo-libs get to stroll down the street whistling 'White people gonna white' while actual black communities can go screw.
"I will give you credit at least for trying to make coherent, rational arguments and staying away from ad hominem."
I don't give a shit about your fucking credit, take your condescension and shove it up your ass.
"Why would the belief that black people have stronger bones not contribute to giving a black person with a fracture less pain medication"
DeleteAre you seriously asking this? You can't imagine how having that false belief WOULDN'T contribute to underprescribing pain medication? Clearly, it COULD result in this, but you can't see how it might not? Because there is no correlation between bone density and pain perception?
In fact, this might more easily lend itself to over-medicating black people with pain medication. If their bones are denser and tougher, then any injury resulting in a broken bone must have been a more serious injury, thus requiring more pain medication.
Now let's try to play the same game with 'Blacks have a more sensitive sense of smell than whites.' and maybe you will see why this was not a well-formed study.
I guess I spoke too soon, 6:27. I wasn’t trying to be condescending, but actually acknowledging that you were making valid points and engaging in a real discussion, rather than saying “Somerby is always right and if you disagree you’re an ignoramous.”
DeleteMy bad.
anon 6:17 Did you read table 1 of the study, where it lists 15 propositions, and the students' responses to each? Name which these, other than #2 (blacks have "less sensitive nerve endings") is relevant to blacks' tolerance of pain? The proposition that blacks have denser bones (#9) is actually 1 of the 4 propositions that are classified as "true." Are you saying that answering this one correctly means you are more likely to under-prescribe pain medication for blacks??
DeleteWhy did the study include only white medical students? Here's a true story. In 1973, I started a new job where one responsibility was to calculate the financial impact of certain changes in workers compensation benefits. I needed to use a mortality table. I was instructed to use a table of White mortality. I recall questioning this instruction, Why not look at total Mortality? Black workers also die on the job. IMO the instruction was based on the racist idea that black workers simply didn't matter.
ReplyDeleteBut, why exclude black and Asian medical students in a current survey? Surely, the surveyors don't believe that only whites matter. IMO the survey included only whites because was specifically designed to prove racism among whites.
It did not only include whites. The responses of nonwhite participants are included in a separate section. Go look for yourself.
DeleteWhy would you think the researchers were simply trying to prove racism? There is a body of research that shows that there’s a clear bias, that blacks are not properly prescribed pain medication.
My question is, why would you try to smear research that shows this genuine problem? If you claim to care about proper medical treatment for all, regardless of race, why are you so eager to denigrate research that points this out?
David, given that black people tend to have higher mortality than white people (tend to die at younger ages), your employer may have wished to minimize the impact of the changes to workman's compensation (or maximize the impact, depending on what the program under consideration was). Including black data would tend to bring down the average age of death. You need to understand the goals of your managers and company, in order to speculate about what such a change would mean for the changes under consideration. If you didn't insure any black people, then the exclusion of black data would make your calculations more accurate for your white customers. I think the instruction to exclude certain data was likely based on whether they wanted to make the changes or torpedo a proposal, rather than some generalized racial bias. You perhaps should have asked why the black deaths were being excluded and seen what they said, instead of jumping to such a conclusion.
DeleteUltimately, the reason for conducting a study like the one we have been discussing is to find out the impact of misinformation about black physiology. If the researchers wanted to just call people racist, they wouldn't need to do a bunch of work running a study. Name-calling is probably more effective with less data in hand, which is why Somerby is working so hard to discredit this particular study. It interferes with calling Norris a racist.
Black people are good, decent human beings.
ReplyDelete"Why would the belief that black people have stronger bones not contribute to giving a black person with a fracture less pain medication"
ReplyDeleteAre you seriously asking this? You can't imagine how having that false belief WOULDN'T contribute to underprescribing pain medication? Clearly, it COULD result in this, but you can't see how it might not? Because there is no correlation between bone density and pain perception?
In fact, this might more easily lend itself to over-medicating black people with pain medication. If their bones are denser and tougher, then any injury resulting in a broken bone must have been a more serious injury, thus requiring more pain medication.
Now let's try to play the same game with 'Blacks have a more sensitive sense of smell than whites.' and maybe you will see why this was not a well-formed study.
Except the study showed it resulted in less pain medication, all of your hypotheticals notwithstanding.
Delete"Clearly, it COULD result in this, but you can't see how it might not? "
DeleteYou are being a trifle excessively literal. Someone else said it was not about pain and wouldn't affect pain treatment at all. I gave a contrary example, that's all. I am not saying and did not intend to say that I couldn't imagine a situation where it wouldn't contribute to underprescribing -- that suggestion is contrary to everything else I said in my response.
But this is a good example of a gotcha type comment. I do appreciate that you have conceded that the question about bone density might have some relevance to pain, one way or the other. THAT is all I was addressing with this example, the idea that one and only one question was actually relevant to pain treatment.
I assume you know that undertreatment for pain is not a game for black people.