If you go to the study, you'll see that quite a few confounders are controlled for - this is good news! However, there are few measures of socio-economic status, and none for ethnicity, which is a potential issue
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Granted, this study was conducted in Sweden, so ethnicity may be less of a bias, but it's still concerning not to see it mentioned
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On the second point - we look at baseline characteristics, and now it seems that we may have a problem People in the high-scored group seem to be MUCH healthier than people in the low grouppic.twitter.com/qfAsRqcmsk
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They exercise more, they smoke less, they have lower BMIs, take more dietary supplements, are more educated, etc This means that there is almost certainly residual confounding that this study cannot address
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Now on to our final quick check And it is a biggie Calculate those absolute risks!
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For reference: RELATIVE risk - as reported most often by the media - is (risk of eventA)/(risk of eventB) ABSOLUTE risk - which is more useful, generally - is (risk of eventA) - (risk of eventB)
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In this case, the RELATIVE risk reported on in most media stories is 18%, which sounds big The ABSOLUTE risk? Well...
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The highest quartile of intake in this study had 2523 cases in 180896 person-years, or a rate of 1.4% The lowest quartile of intake had 7308 cases in 472726 person-years, or a rate of 1.5% That is an ABSOLUTE risk difference of 0.1% Not very impressivepic.twitter.com/4rHgOZDQfy
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So, to recap: 1. Decent controlling for confounders, but some issues 2. Likely residual confounding 3. Very large difference between absolute and relative risk Even without further analysis, this is enormously problematic
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If you add on some of the other issues - for example, the score that this study calculated to determine 'anti-inflammatory food intake' was a bit slim - the media noise becomes that much harder to believe
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As with so many other studies, this is an interesting piece of work that may have implications at the population level - although I'm skeptical - but definitely is not very applicable to everyday life Blog to come!
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P.S. worth mentioning that the 'quartiles' of intake were super weird: 0-5, 6, 7, 8-13 With such large bottom and top groups, I'd guess that the analysis was problematic although not my area of expertise
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