If you think about it, large effects are often implausible, there are only a handful of scenarios where there have been large effects (smoking lung cancer). If anything large effects may simply be strong bias or bad estimation.
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Smoking and lung cancer is not a good comparison because it’s an incredibly rare outlier
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Lun cancer-smoking connection came from observational evidence backed by mechanistic studies that formed the consensus. Animal protein is in the same boat.
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Replying to @kevinnbass @dailyzad and
You say it's impossible to establish effect with observational studies with animal protein, and consistency would demand you do the same with smoking and lung cancer.
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Replying to @kevinnbass @whsource and
Kevin, the lung cancer-smoking example is never used as an example to promote the prowess of epidemiological data. Its an outlier where the increased risk was nearly 20x
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Replying to @dailyzad @kevinnbass and
Now that I don't agree with. There are quite a few examples aside from smoking with similar - although not quite as high - risks. Mesothelioma/asbestos and hepatocellular carcinoma/HBV spring to mind
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Actually, from memory the initial risks identified for meso/asbestos were even higher than lung cancer because it's otherwise so rare. I think some of the initial studies found RRs of 30+
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Replying to @GidMK @kevinnbass and
Wasn't that also because of the additive effects of smoking? https://www.atsjournals.org/doi/abs/10.1164/rccm.201302-0257OC …
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Seems so from this cohort "The joint effect of smoking and asbestos alone was additive (rate ratio = 14.4 [95% CI, 10.7–19.4]) and with asbestosis, supra-additive (rate ratio = 36.8 [95% CI, 30.1–45.0])."
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But that's looking at asbestos' impact on lung cancer. I think the impact of smoking on mesothelioma is also not inconsiderable, but this paper gives you an idea of the early work and how massive the risk ratios arehttps://onlinelibrary.wiley.com/doi/abs/10.1002/1097-0142(19801001)46:7%3C1650::AID-CNCR2820460726%3E3.0.CO;2-Y …
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Part of that's because mesothelioma is incredibly rare without asbestos exposure. I think there's a theory that silicates are basically the only way to develop the disease, and that all cases without exposure are actually exposed we just don't know how
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