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Unfocused debate from 9 years ago. Not relevant.

survival after cancer diagnosis

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The article now says, in response to a previous section that says "one canmot conclude that Americans have a significantly better chance of surviving prostate cancer than Britons"

Data from the respected medical journal Lancet Oncology paint a different picture of cancer survival rates in Europe. According to the Lancet, American men have a 66 percent chance of living at least five years after a cancer diagnosis, compared with only 47 percent for European men. American women have a 63 percent five-year survival rate, compared with 56 percent for European women.

I think the editor that has added this text has not really understood the reasoning and is engagaing in synthesis.

Suppose that the U.S. screened all men at age 55. The data will include a large number of people who would be alive at age 60 even if they were not treated, because prostate cancer is slow growing, and not always fatal. Also, those in the UK diagnosed with prostate cancer will include a significantly higher percentage of older men for whom prostate cancer is live threatening, but has hit at a later age (which prostate cancer mostly does). Lets suppose the average age is 75. Even without the presence of prostate cancer, the 5 year survival rate for men aged 75 will be much less than that for those aged 55. For sure, there will be some people in the U.S. who will have had life threatening forms of the disease who, had they been living in the U.K. would not have been picked up until much later and who might have survived longer had they been screened at an earlier age. But survival statistics after diagnosis do not tell us this number. These are some of the reasons why the statistical experts say the data (on survival following diagnosis" cannot be compared to reach conclusions about survival rates for diseases in one country against another. It is therefore wrong to insert a statement that a respected medical journal paints a different picture. I have therefore intend to delete this section. --Tom (talk) 11:56, 8 July 2008 (UTC)[reply]

Re-reading my earlier edits to this page, the same point has already been made. In fact, the death rates from prostate cancer are identical in the U.S. and in Great Britain.
Reading the Commonwealth Fund statement issued in reply to the claim made by Gratzer, it says that their report showed the incidence rate in the U.S. as being higher than in the U.K., but even this has to be interpreted carefully because incidence is the number of findings per 100,000 of population, and as we know, doctors in the U.S. go looking for this disease whereas doctors in the UK do not, so early screening effectively pushes up the incidence rate in the U.S. Because the incidence of prostate cancer is known to be higher in older men, one might imagine, all other things being equal, that the incidence rate in U.S. group sample (which should be younger due to screening practise) would be lower than that in the U.K. (where prostate cancers tend to be discovered much later in life). But in fact, the incidence rate is actually higher in the U.S. group. But this does not mean that U.S. males are genuinely more likely to contract this cancer. It could equally be that U.S. doctors are very adept at finding cancers that are not very life threatening (there being a certain number of British men who die each year of things other than prostate cancer, but who also would have shown as positive for prostate cancer had they been screened at the same age as their american counterparts). This is of course the main reason why British doctors do not usually screen. --Tom (talk) 17:01, 8 July 2008 (UTC)[reply]


Tom -- Your points about differences in population sample are well-taken. But I believe it's relevant to show that other scholars (like Goodman, Musgrave, and Herrick) arrive at conclusions similar to Gratzer regarding prostate cancer mortality ratios. With that in mind, I'm planning to insert a quote from Lives At Risk with comparative prostate-cancer mortality ratios.

'inserted comment': Well of course other people can make the same mistake, especially if they are not experts in the field. Goodman is an economist and not an epidemiologist and has a penchant for exagerated claims... try reading his much quoted and very misleading "five myths about socialized medicine" and you'll see what I mean!

Anderson and Hussey's own data show that 57 percent of those who are diagnosed with prostate cancer in the U.K. die from it. By contrast, 19 percent of those diagnosed with prostate cancer in America die from it. (This is on page 73 of Lives at Risk.)

'inserted comment': That is not the point. The issue is the interpretation of data. I don't think Lives at Risk is a very good source for information about medical practice because it has been written from a point of view by authors, at least one of which to my certain knowledge, writes from a pre-conceived and non-partisan viewpoint.--Tom (talk) 04:59, 11 July 2008 (UTC)[reply]

On a different matter, the article currently concludes with the quote from Anderson and Parnes about the impossibility of drawing conclusions about the comparative likelihood of Britons and Americans surviving prostate cancer. But the Lancet Oncology paper did just that, in a comprehensive and definitive fashion (news account here: http://news.bbc.co.uk/2/hi/health/6955545.stm -- check out the chart at the bottom). The authors of that article looked at prostate cancer when doing their international comparison and even acknowledged that the early screening of prostate cancer popular in America lended controversy to their conclusions. But they nonetheless felt it important to include the dataset. I think it's fair to present a point of view from a source as reputable as Lancet to counter the Anderson/Parnes statement.

'inserted comment': You seem to make a definitive assertion about the Lancet Oncology paper that I am unsure is justified. Lanet Oncology was, as far as I can see, publishing the raw data collected in several countries and of course the prostate stat was in that set, and of course the data has been collected to enable international comparisons. Interpreting the data requires some understanding- The BBC article quotes Professor Mike Richards as saying "The poor results from the UK were attributable mainly to patients having more advanced disease at diagnosis than patients in other European countries", which in the case of prostate cancer is undoubtedly going to be the case. And whilst it is true that survival rates for MOST cancers is going to be better the sooner it is found, the jury is still out on whether the benefits of finding prostate cancer earlier is worth the risks and worry of earlier screening, because the majority of prostate cancers are not the cause of death in most individuals who have them. It has undoubtedly been true that cancer care in the UK had a lower priority than perhaps in some other countries, but that is now changing. But the main point is that the interpretation of data needs to be informed, and the interpretations by Gratzer, Goodman et. al. all seem distinctly ill-informed and over simplistic. --Tom (talk) 04:59, 11 July 2008 (UTC)[reply]

Much of the article is devoted to spreading the notion prostate cancer statistics are irrelevant because patients could die of something else. But isn't it equally likely that the British system is biased against early detection because of the associated costs? It could plausibly be argued that Britons are under-diagnosed and therefore deaths from prostate cancer are under-reported in the U.K.

'inserted comment': I think that is unlikely that there is an under diagnosis because all deaths where the cause of death is unclear will be independently autopsied. --Tom (talk) 04:59, 11 July 2008 (UTC)[reply]

Treatment practices are indeed different in each country, and it is difficult to draw definitive conclusions without more data. In a few years, cancer centers in North America and Europe are slated to release data on 10-year outcomes, not the conventional 5. The Lancet Oncology paper includes some of the data from those centers. Therefore, I think it's important to capture the uncertainty of the debate in the article.

BWesley (talk) 22:56, 10 July 2008 (UTC)[reply]

Reinstatement of deleted material

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User:Uroborus has deleted material with the edit summary I find it astonishing that somebody would create an article to launch a personal attack. I deleted the personal attack. As I created the article I take this rather personally.

The deleted material was not a peronal attack by me but reported the critical view of a number of experts about claims for which Gratzer was the source, and the use of which was a matter of national (U.S.) and international controversy. It (the deleted material) reported well sourced material some of which happened to be critical of Gratzer. That does not make it an attack by me! Not only was it well sourced it was also balanced because it reported Gratzer's own response to the crticisms. Gratzer is employed by think tanks to write on the subject of medicine (amongst other things) about which some experts have criticized him. Because he informs politicians and political debate, his writings are therefore fair game for critical analysis and the inclusion of these analyses (positive or otherwise) is material worthy of inclusion in WP. I therefore will add the material back.--Tom (talk) 14:04, 25 July 2008 (UTC)[reply]

This article is not for his C.V. and´his book promo!

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This article is beginning to read more like Gratzer' curriculum vitae (or resumé) and the stuff copied from the dust jacket is pure promo material. It's a puff piece and not at all encyclopedic. Wikipedia does not exist for this purpose.

We need to know who Gratzer is, and why he has been in the public eye. We don't need to know what he did in each year at university, what his brother has achieved (unless that is remarkable), where his father came from (unless that is any way relevant to his fame), or even what his publisher has selectively chosen to appear on the dust jacket of his books.--Tom (talk) 19:29, 26 October 2008 (UTC)[reply]

Drive-by tagging with Advert tag

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In the past week, J.R. Hercules (talk), who has never contributed to this article nor made a comment on this talk page, has repeatedly engaged in WP:DRIVEBY tagging of this article with an Advert tag, with no discussion of their concerns on this talk page. Hauskalainen (talk), who originally created this article and removed almost all of my contributions to it nine months ago along with the promotional material added by G.h.szylowskyphd, has also engaged in WP:DRIVEBY tagging with an Advert tag with no discussion of their concerns on this talk page:

  1. 06:30, 21 July 2009 J.R. Hercules (talk | contribs) (added advert template)
  2. 21:57, 23 July 2009 Hauskalainen (talk | contribs) (Undid revision 303458894 by Apatens It does indeed read like an advert!)
  3. 12:31, 27 July 2009 J.R. Hercules (talk | contribs) (Houston: We have a shill -- shilling on behalf of an unctious shill's Wikipedia bio page. (reinserted 'advert' template))
  4. 20:21, 27 July 2009 J.R. Hercules (talk | contribs) (I look forward to bringing this arbitration, as there will lots of chuckles over the use of the word "unwarranted")

On July 24, 2008, I expanded this biography to answer the question: Who is this guy? [1]

  • For Gratzer's three books, I listed whom Gratzer thanked in his books' acknowledgements for helping him write his books
  • This is important since Gratzer's first book was published when he was a 24-year-old medical student, his second book when he was a 27-year-old resident in training to become a psychiatrist, and his third book when he was a 32-year-old newly-board-certified psychiatrist, and because several of the people he thanked were (or went on to be) notable and/or were helpful in Gratzer's subsequent career

On October 26, 2008, G.h.szylowskyphd (talk): made 63 edits to this article, adding:

  • "From the Introduction:
    This book argues for meaningful choice and competition in health care. Americans ought to make decisions about their health care – and live with the consequences. In order for this to succeed, Americans ought to have choices when it comes to their doctors, their hospitals, and their insurance which, incidentally, ought to be portable from job to job."
    (the above does not appear in the Introduction of the hardcover edition, I do not know if it appears in the paperback version)
  • the entire back of the dust jacket of Gratzer's 2006 book The Cure, with five promotional blurbs (including ones by the late Milton Friedman and by National Center for Policy Analysis senior fellow Thomas R. Saving, whom I had listed as two of the seven people whom Gratzer said in his acknowledgements section had helped him "understand the nuances of the issues")
  • a long "Selected major articles" section with a list of 33 "Selected major articles" (from Gratzer's Manhattan Institute webpage, to which a link was already provided in the "External links" section)
  • a "Testimonies" section with three testimonies before the U.S. House and Florida legislature (from Gratzer's Manhattan Institute webpage, to which a link was already provided in the "External links" section)

On October 27, 2008, Hauskalainen (talk):

  • retained G.h.szylowskyphd's "Selected major articles" section listing 33 articles from Gratzer's Manhattan Institute webpage
  • retained G.h.szylowskyphd's "Testimonies" section listing 3 testimonies from Gratzer's Manhattan Institute webpage
  • removed G.h.szylowskyphd's promotional material taken verbatim from the back of the dust jacket of The Cure (retaining only G.h.szylowskyphd's uninformative description: "This book argues for meaningful choice and competition in health care.")
  • removed almost all of the expanded biographical material that I had added three months earlier, calling it "superfluous"

On July 17, 2009, I:

  • removed G.h.szylowskyphd's "Selected works" ("Selected major articles") section [2]
  • removed G.h.szylowskyphd's" Testimonies" section [3]
  • restored a revised/updated version of the expanded biographical material I had added a year earlier, and that Hauskalainen had subsequently removed three months later along with G.h.szylowskyphd's promotional blurbs [4]
  • replaced the uninformative "This book argues for meaningful choice and competition in health care" with a summary of Gratzer's three key recommendations in his 2006 book, The Cure [5]
  • renamed the "Allegations regarding the misuse of statistics" indictment section to a chronological title: "Giuliani advisor and cancer statistics" and replaced its content with that from a revised section from the Health care reform in the United States presidential election, 2008 article [6]

Please indentify which specific portions of this article you believe constitute advertising, indentify what you believe they are advertising, and explain why you believe they constitute advertising. Thank you. Apatens (talk) 03:34, 28 July 2009 (UTC)[reply]

Oh very simply, the whole article reads more like this gentleman's Curriculum Vitae (or resumé). As far as I know he is famed only for his problems with statistics. But this got watered down quire remarkably recently. I am not sure who did that (I cannot be bothered to go back and look) but it was more an attempt not to spoil the CV. I know that he has written books but I am not sure that these are widely read. I have not seen any criticism of them. I just want the article to be more encylopaedic.--Hauskalainen (talk) 16:06, 28 July 2009 (UTC)[reply]
H, I think you may be misunderstanding how notability works on Wikipedia. As WP:NNC states, The notability guidelines determine whether a topic is notable enough to be a separate article in Wikipedia. They do not give guidance on the content of articles, except for lists of people. [emph. added] Given the many independent reliable sources that substantively discuss Gratzer's work, we can be pretty sure that he is notable. It isn't up to us to decide that only certain portions of his work are notable. We should just strive to write a neutral, well-sourced biography that explains who Gratzer is. I think every biography should list all non-self-published books authored or edited by the article subject. In Gratzer's case, there may be selected articles that should be listed (any articles that have themselves been widely debated, for example). Our readers may encounter Gratzer's name in citation and want to confirm that our article is talking about the same person. DickClarkMises (talk) 18:55, 30 July 2009 (UTC)[reply]
I haven't misunderstood anything! The content goes way beyond what is justifiable. I do not think that this should be a biography because he is only midly notable and that, as far as I can see, is for his testimony as a supposed expert on health care in Canada before the U.S. congress and for his involvement in the Rudy Giulliani misuse of statistics. Sure, his book is referred to by people opposed to public involvement in health care and THAT is why he is famous. I have never seen a respected (neutral) academic health care analyst quoting his books as a reliable source. Much of what is here in this WP article is boring and irrelevant volumonous stuff that, it seems to me, has only one purpose, and that is to hide or bury the fact that Gratzer has twice been caught out wrongly using statistics to mislead, despite being regarded as an "expert". --Hauskalainen (talk) 20:06, 30 July 2009 (UTC)[reply]

I removed the acknowledgments from Better Medicine (2002) and The Cure (2006), since they are less biographically important than the acknowledgments from Gratzer's first book, Code Blue (1999).
I restored the acknowledgments from Gratzer's first book, Code Blue (1999), because they are biographically important:

  • David Frum—the only person thanked in the acknowledgments of all three of Gratzer's books—was thanked in the acknowledgments of The Cure (2006), where Gratzer said of Frum, that he was "deeply in his debt" for introducing him to Manhattan Institute president Larry Mone, who hired Gratzer to be a senior fellow at the Manhattan Institute in 2002, where Gratzer has worked for the past seven years.
  • Adrienne Snow's conservative Donner Canadian Foundation awarded Code Blue (1999) its $25,000 second annual Donner Prize in 2000, garnering publicity for 25-year-old fourth-year medical student in Canada's largest circulation national newspaper, The Globe and Mail and in Canada's top general medical journal, the Canadian Medical Association Journal. The conservative Donner Canadian Foundation also provided financial support for Gratzer's second book, Better Medicine (2002).
  • Stephen Harper went on to become Leader of the Opposition in 2002 and subsequently Prime Minister of Canada in 2006.
  • Arnold Aberman's—then Dean of the Faculty of Medicine at the University of Toronto—association with the National Citizens Coalition and John Goodman, president and founder of the National Center for Policy Analysis in support of medical savings accounts should be noted to explain why the highest-paid academic in Canada would take time to read a book manuscript by a 24-year-old third-year medical student advocating medical savings accounts.
  • Cynthia Ramsay, then senior health economist at the Fraser Institute, is thanked again in the acknowledgments of The Cure (2006) for teaching Gratzer much about health economics.

Apatens (talk) 05:52, 29 July 2009 (UTC) Apatens (talk) 04:04, 30 July 2009 (UTC)[reply]

Apatens, I am not sure that these acknowledgments are helpful to us here. If we were talking about an infobox on, say, Cynthia Ramsey's article, we could use this credit to list Gratzer under "influenced" in the infobox. We could, perhaps, work this into this article, but I would feel better about it if it were only a supporting source. (If we had a source saying that Gratzer worked for one of those people, we could supplement this part of the bio with a note that "Gratzer later acknowledged his former employer in his book...") DickClarkMises (talk) 19:00, 30 July 2009 (UTC)[reply]

BLP concerns

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Controversial claims about living persons should be clearly attributed. WP:BLP requires that such claims be sourced to multiple independent reliable sources. While it is certainly important for this article to cover the critical exchanges that Gratzer has taken part in, it is wholly inappropriate to assert, in the encyclopedic voice, that Gratzer might have gotten such and such statistic from "Goodman" or anyone else. If someone has made this argument, we can say that. WP:SYN states, Do not combine material from multiple sources to reach a conclusion not explicitly stated by any of the sources. Editors should not make the mistake of thinking that if A is published by a reliable source, and B is published by a reliable source, then A and B can be joined together in an article to reach conclusion C. This would be a synthesis of published material that advances a new position, and that constitutes original research. "A and B, therefore C" is acceptable only if a reliable source has published the same argument in relation to the topic of the article. Please note that, as WP:BLP states, Contentious material about living persons that is unsourced or poorly sourced—whether the material is negative, positive, or just questionable—should be removed immediately and without waiting for discussion.... The burden of evidence for any edit on Wikipedia rests with the person who adds or restores material, and this is especially true for material regarding living persons. DickClarkMises (talk) 20:27, 14 July 2009 (UTC)[reply]

Gratzer quoted Goodman himself when responding to the allegation in order to justify himself. It seemed to me perfectly reasonable to see whether Goodman did make such a claim and it seems he did. In this case I think the article was being fair to Mr Gratzer by demonstrating that Goodman had twice made the same error (even though Gratzer did not acknowledge that it was potentially erroneous). Your argument about WP:SYN does not seem to hold water. The fact that Gratzer had mentioned Goodman and we can demonstrate that Gratzer is telling the truth in what he says about the Goodman claims. I do not think that fits SYN. I accept that the statement "Gratzer may have been referring to..." was perhaps going too far which was why I removed it. --Hauskalainen (talk) 20:50, 14 July 2009 (UTC)[reply]
Your conception of "fairness" does not trump the very important policy on biographies of living persons. WP:SYN is likewise very clear. Unless you can cite a reliable source for your actual assertion, and not just for the premises that lead to your conclusion, you are synthesizing sources rather than summarizing them. As WP:SYN advises, Carefully summarizing or rephrasing source material without changing its meaning is not synthesis—it is good editing. Best practice is to write Wikipedia articles by taking material from different reliable sources on the topic and putting those claims on the page in your own words, with each claim attributable to a source that explicitly makes that claim. Your claim about the Goodman source is not attributable to any reliable source--it is your synthesis of other sources, and is totally out of line in a biography about a living person. DickClarkMises (talk) 21:07, 14 July 2009 (UTC)[reply]
You have not said which element in the text you have removed is considered to be "unsourced" or "poorly sourced". I note that you claimed the congressional testimony was a not properly sourced, but I have seen the clip and the exhange definitely took place. The exchange is also visible on video at the congressional web site (though you have to view the whole testimony). The You Tube clip is not edited.--Hauskalainen (talk) 20:50, 14 July 2009 (UTC)[reply]
If the exchange between Kucinich and Gratzer was in the context of a congressional committee hearing, why is it the case that only Kucinich's comments and not those of the other committee members are cited in the article? The video linked in the footnote for that exchange does not explain when this committee meeting took place, who took part in it, or what else happened. I think that Gratzer's congressional testimony, as well as questions, comments, and critiques directed at Gratzer by other participants, are all notable and worthy of being summarized in this article. However, the linked video is inadequate. Could you provide a link to the full video, so we can see what is there to work with? More generally, why is the whole section detailing Gratzer's work described as being about his "alleged misuse of statistics"? A neutral article should cover Gratzer's work without giving undue weight to either side of the debate. By characterizing every critical exchange he has participated in as somehow calling his character or expertise into question, rather than as being indicative of an active discussant in heated policy debates, the article clearly adopts a non-neutral point of view. As Wikipedia:Neutral point of view#Impartial tone says, A neutral characterization of disputes requires presenting viewpoints with a consistently impartial tone, otherwise articles end up as partisan commentaries even while presenting all relevant points of view. Even where a topic is presented in terms of facts rather than opinions, inappropriate tone can be introduced through the way in which facts are selected, presented, or organized. Neutral articles are written with a tone that provides an unbiased, accurate, and proportionate representation of all positions included in the article. The tone of Wikipedia articles should be impartial, neither endorsing nor rejecting a particular point of view. Try not to quote directly from participants engaged in a heated dispute; instead, summarize and present the arguments in an impartial tone. DickClarkMises (talk) 21:57, 14 July 2009 (UTC)[reply]
In answer to why only the Kucinich exchange is mentioned, I would have thought the answer was obvious. Its again in the context of the use of statistics. Kucinich asked him about national statisitics for MRI wait times and Gratzer wanted to talk about something else and gave a wait time that did not reflect the true wait time in Canada as reported by the nation's statistical body and as asked for by the committee. The fact is that Kucinich basically accused Gratzer of misleading the committee. That makes the incident noteworthy and why its included here. Gratzer is often called to give expert testimony in these matters and its rather serious if he misinforms rather than informs. For this reason it is IMHO something that justifies a section of its own. Putting all the other non-noteworthy stuff from that hearing in the article would be distracting. I do not think that this us WP:UNDUE given the allegations that Kucinich made and the fact that Gratzer and his employers regards him to be an expert in these matters. And of course ot is not a one-off because of the earlier issue regarding the relevance of comparison of 5 year prostate cancer survival rates. (I noticed on C-span that the GOP in their press conference today trotted out the same false prostate cancer survival comparison yet again!! You would think they would have learned from the Giulliani episode last year!!) I am sorry but you will have to go to the congressional web site to find that video. Look under the relevant committee and you'll find it. --Hauskalainen (talk) 00:22, 15 July 2009 (UTC)[reply]
H, it is not the mission of Wikipedia to pick out who is "right" in public policy disputes. This encyclopedia article should summarize the information about Gratzer that is available in reliable sources. The article should not propound the point of view of any of the parties, and it should not pass judgment on Gratzer's work or on that of his critics. Our job as contributors to Wikipedia is to present the information in a neutral tone and with sufficient sources to facilitate further study by those of our readers who are so inclined. As for the video, it isn't immediately clear from the cited video when this committee hearing took place or what committee it involved. I would very much like to review the content of the original video, complete with the essential information about when it took place and who participated. I am not asserting that everything that was said in the committee hearing would be relevant to this article, however it is important to view the content in its context to avoid misrepresenting the source material. While I have no doubt that the YouTube video is authentic, it is not complete, and it was posted by someone who clearly opposes Gratzer's position. DickClarkMises (talk) 01:22, 15 July 2009 (UTC)[reply]
I have placed a request for help at the BLP noticeboard. http://en.wikipedia.org/wiki/Wikipedia:Biographies_of_living_persons/Noticeboard#David_Gratzer

Here is the link where Gratzer himself, justifying his own position, refers to Goodman as being a person who had earlier come to the same conclusion. http://www.ibdeditorials.com/IBDArticles.aspx?id=279237711504195 I guess we will never know whether these two people independently did this analysis from the same data, though I doubt it. Goodman runs his own libertarian think tank and Gratzer works for another similar think tank.--Hauskalainen (talk) 21:47, 14 July 2009 (UTC)[reply]

The link is interesting, and would be useful to support an assertion that "Gratzer cited economist John Goodman as having drawn similar conclusions about X." It is not a good source for making the claim that "Gratzer probably got the data from Goodman," which is what the earlier article version at least implied. DickClarkMises (talk) 21:58, 14 July 2009 (UTC)[reply]

False statistics and non-peer-reviewed opinion pieces

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I am reverting the following inappropriate edits for the reasons outlined below:

  1. 14:06, 14 July 2009 Hauskalainen (talk | contribs) (add back but drop "peer reviewed". The article did appear and did contain the statistic even if the used of the statistic had not been peer reviewed)
  2. 14:10, 14 July 2009 Hauskalainen (talk | contribs) (misleading maybe but false is maybe too strong. Use of survival rates was not meaningful and easily misleading. Gratzer not wholly responsible for Giulliani)
  3. 14:15, 14 July 2009 Hauskalainen (talk | contribs) (Disputed is perhaps better. Less offensive and more reflective of Gratzer's own opinion as expressed as per WP:NPOV)
  4. 14:19, 14 July 2009 Hauskalainen (talk | contribs) (I only recall one statistican. "foreign" > British,)
  • 14:10, 14 July 2009 Hauskalainen (talk | contribs) (misleading maybe but false is maybe too strong. Use of survival rates was not meaningful and easily misleading. Gratzer not wholly responsible for Giulliani)
    • This article cites three WP:RELIABLE fact-checking websites:
Two of the fact-checking websites:
1) FactCheck.org, a project of the Annenberg Public Policy Center[13][14][15]
2) PolitiFact.com, a Pulitzer Prize-winning[16] project of the St. Petersburg Times[17]
described Gratzer's cancer statistics as false and misleading.

The third fact-checking website:
3) "The Fact Checker," a department of The Washington Post [18][19][20]
described Gratzer's cancer statistics as wrong and awarded them four Pinocchios—reserved for Whoppers (slang for a blatant or outrageous lies).
  • 14:19, 14 July 2009 Hauskalainen (talk | contribs) (I only recall one statistican. "foreign" > British,)
    • Four medical statisticians and cancer epidemiologists are cited by name in articles by the three WP:RS fact-checking websites cited in this article:
  1. Marie Diener-West, professor of biostatistics at the Johns Hopkins Bloomberg School of Public Health[31]
  2. Milton Eisner, health statistician for the National Cancer Institute SEER program[32]
  3. Lorelei Mucci, assistant professor of medicine and epidemiology at Harvard Medical School and the Harvard School of Public Health[33]
  4. Andrew Vickers, associate attending research methodologist in epidemiology and biostatistics at the Memorial Sloan-Kettering Cancer Center[34]
    • Three leading prostate cancer urologists are cited by name in articles by the three WP:RS fact-checking websites cited in this article:
  1. Peter Albertsen, professor and chief of urology at the University of Connecticut[35]
  2. Brantley Thrasher, professor and chairman of the urology department at the University of Kansas and a spokesman of the American Urological Society[36]
  3. Patrick Walsh, professor of urology at the Johns Hopkins Brady Urological Institute[37]
    • Two leading prostate cancer medical oncologists are cited by name in articles by the three WP:RS fact-checking websites cited in this article:
  1. Otis Brawley, chief medical officer of the American Cancer Society [38]
  2. Howard Parnes, chief of the National Cancer Institute Prostate Cancer Research Group [39][40][41][42]

Apatens (talk) 23:56, 14 July 2009 (UTC)[reply]

False and misleading versus "disputed"

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  • When all of the most WP:Reliable sources call Gratzer's fabricated "five-year survival rates" false and misleading nonsense numbers, and not a single WP:Reliable source says they are true, it is our obligation as editors to follow what all of the most WP:Reliable sources say—especially when even Gratzer admits his fabricated nonsense numbers were not actually the "five-year survival rates" he labeled them as in his "Ugly Truth" City Journal opinion article, were not actually any type of "survival rates" at all, but were instead something he calls "snapshots" not used by any cancer expert, statistician or epidemiologist, who call Gratzer's "snapshot" calculations "complete nonsense" for which "you would get an F in epidemiology."
  • We do not call Gratzer's false and misleading fabricated "five-year survival rates" "disputed" when no WP:Reliable sources support Gratzer's nonsense numbers and even Gratzer says they are not actually "survival rates."
  • When, as in this article, we are describing the perpetration of a hoax, we must be careful when reporting the false and misleading fabricated nonsense numbers cited as statistics in this hoax, that we clearly and unambiguously indentify them as incorrect statistics and contrast them with actual reliable statistics provided by WP:Reliable sources. To do otherwise, Wikipedia would be perpetrating a hoax, which in the case of something as serious as cancer statistics would be irresponsible and unethical.
  • The article already provides appropriate balance by citing and providing links to:
    • Gratzer's original "Ugly Truth" City Journal opinion article
    • Gratzer's follow-up "Malignant Rumor" City Journal Online opinion article citing:
  • even though neither Gratzer, nor Goodman, nor O'Neill, nor McCaughey are WP:Reliable sources on cancer statistics.

Apatens (talk) 05:08, 5 August 2009 (UTC)[reply]

Apatens, Wikipedia is not a soapbox. It is not a place for you to advance your particular point-of-view about healthcare policy, statistics, or anything else. We must write encyclopedia articles that are written neutrally. You seem really passionate about this issue, and that is great. However, when we are working on this project, Wikipedia, we need to have the common goal of improving the encyclopedia, based on the policies and guidelines that the community has put together. If there is an issue discussed in an article for which one side of the debate has many sources that are obviously superior, as you claim is the case here, we can rest assured that our readers, at least those who are interested, can decide for themselves who is right. It is not our job to say over and over again "false and misleading," "false and misleading," "false and misleading." That is character assassination, not encyclopedia writing. Additionally, you should note that an article subject's writings, when their authenticity is undoubted, are often reliable sources for claims about what that person has said, or for non-controversial facts about themselves. See WP:SELFPUB. DickClarkMises (talk) 19:09, 6 August 2009 (UTC)[reply]
It was misleading in many different ways and many of the later cited articles are equally misleading because it invites the reader to make a wrong conclusion when none on fact should be drawn. They do not "balance the article" as Apotens claims. Five year survivial rates do not make any sense when detecting relatively unlethal cancers at a very early stage and treating them (American practice) compared to leaving sleeping dogs lie and only treating cancers when they become symptomtic or the patient asks for a screen and a cancer is detected (British practice). One costs a lot of money and puts many healthy men at risk from non essential treatment and the other is much cheaper and less risky for the healthy men whose cancer may never have been lethal but has equally troublesome problems of not detecting truly lethal cancers at an earlier stage. Recent research has not demonstrated that one system is any better or worse than the other in terms of medical outcomes, but it has shown that it is fairly meaningless to draw comparisons based on 5 year survival rates, which ARE BOUND to be higher when fairly non-lethal cancers are detected at an early age. Mortalilty rates are much the same in both countries. For this reason the statistics were indeed misleading. And this ignores the statistical howler that was classed as warranting an "F" in an epimedmiology examination.--Hauskalainen (talk) 19:35, 6 August 2009 (UTC)[reply]
H, everything you say may be true. It doesn't change the fact that these claims have not been recanted, and are still hotly debated, as our sources /*inserted comment by Hauskalainen -what sources?*/ demonstrate. It is not the job of an encyclopedia to take sides in an ongoing dispute. It is our job to lay out the notable positions in the debate and to let our readers draw their own conclusions. DickClarkMises (talk) 19:38, 6 August 2009 (UTC)[reply]

After first attacking me with lectures that:

  1. Wikipedia is not a soapbox
  2. Wikipedia is not the place for me to advance my particular point-of-view about:
    1. healthcare policy
    2. statistics
    3. anything else
  3. and that it is "character assassination," not encyclopedia writing to say:
    1. in the WP:LEDE that Gratzer was "the source of false and misleading cancer statistics repeated for months by Giuliani"
    2. in the "Giuliani advisor and false cancer statistics" section that:

      FactCheck.org, The Washington Post, and PolitiFact.com consulted leading prostate cancer experts and cancer statisticians who found Giuliani's cancer survival rates to be false and misleading fabricated nonsense numbers obtained from an opinion article by Gratzer in the Summer 2007 issue of the Manhattan Institute's City Journal that had said: "Five-year cancer survival rates bear this out... The survival rate for prostate cancer is 81.2% here, yet 61.7% in France and down to 44.3% in England—a striking variation."

DickClarkMises (talk) says[44] that I am inserting "lurid wording", "POV-pushing" and engaging in "name-calling" that "clearly violates WP:NPA" for saying in an edit summary that he is advocating a fringe theory in maintaining that Giuliani and Gratzer's 2007 false and misleading cancer "survival rates" are still "disputed" and "are still hotly debated, as our sources demonstrate." Huh? Where? In what sources? In what parallel universe? Please provide a WP:Reliable source that says that Giuliani and Gratzer's 2007 false and misleading "survival rates" are still "in dispute" and still "hotly debated" by anyone other than DickClarkMises.

I am not:

  1. using Wikipedia as a WP:SOAPBOX
  2. advancing any particular point-of-view about healthcare policy
  3. advancing any particular point-of-view about statistics other than the point-of-view of statisticians cited in WP:Reliable sources
  4. stating or claiming to know whether Giuliani, Gratzer, Goodman, O'Neill and McCaughey fabricated their false and misleading cancer "survival rates" out of ignorance or dishonesty
  5. engaging in character assassination by accurately and fairly representing facts:

    WP:Reliable sources unequivocally state that Giuliani, Gratzer, Goodman, O'Neill and McCaughey fabricated false and misleading cancer "survival rates" from invalid calculations dividing mortality rates by incidence rates resulting in numbers that are "complete nonsense."

Four un-reliable sources on cancer survival rates:

  1. John Goodman—libertarian Texan economist, co-founder and president of the conservative NCPA—in:
    1. Lives at Risk: Single-Payer National Health Insurance Around the World (2004) Lanham: Rowman & Littlefield, p. 73
  2. David Gratzer—libertarian Canadian psychiatrist and senior fellow at the conservative Manhattan Institute—in:
    1. The Cure: How Capitalism Can Save American Health Care (2006) New York: Encounter Books, p. 177
    2. "The Ugly Truth About Canadian Health Care" (Summer 2007) City Journal, Manhattan Institute
  3. June O'Neill—Republican New York free-market economist—in:
    1. "Health Care, Health Status, and Inequality: Canada vs. the U.S." (September 2007) NBER Working Paper 13429, pp. 13, 35
  4. Betsy McCaughey—U.S. Constitutional historian, former Manhattan Institute John M. Olin fellow, and New York self-described health policy expert—in:
    1. "U.S. Cancer Care Is Number One" (October 11, 2007) NCPA Brief Analysis No. 596

calculated cancer "survival rates" as: 1 - mortality / incidence.


Three WP:Reliable sources:

  1. FactCheck.org,[45][46]
  2. washingtonpost.com's The Fact Checker,[47][48]
  3. PolitiFact.com (2009 Pulitzer Prize-winner),[49]

consulted leading cancer experts, statisticians, and epidemiologists who said:

survival rates cannot be calculated from cancer mortality and incidence statistics and that such calculations produce nonsense numbers.


No WP:Reliable sources say such calculations can produce survival rates.


Even Gratzer admits that his calculations do not produce survival rates but instead what he calls "snapshots"—that no WP:Reliable sources report ever being used by any cancer expert, statistician or epidemiologist.


An un-reliable source:

David Gratzer's opinion article "The Ugly Truth About Canadian Health Care" (Summer 2007) City Journal said:

"Five-year cancer survival rates bear this out... The survival rate for prostate cancer is 81.2% here, yet 61.7% in France and down to 44.3% in England—a striking variation."


An un-reliable source:

2008 Republican presidential front-runner Rudy Giuliani unveiled his health care plan in Rochester, New Hampshire on July 31, 2007, attacking the plans of Democratic presidential candidates as "socialized medicine" that was European and socialist and—citing his health care advisor Gratzer's incorrect numbers—said his:

chances of surviving prostate cancer had been 82% in the United States, but would have only been 44% in England under "socialized medicine,"[50]

which he repeated in campaign speeches for three months,[51][52][53][54][55][56] before making them into a radio advertisement.[57][58]


Three WP:Reliable sources:

  1. the U.K. National Health Service,[59]
  2. the U.S. National Cancer Institute,[60]
  3. the Canadian Cancer Society and Statistics Canada,[61]

reported five-year relative survival rates of:

  • 100% in the U.S. ( for diagnoses in 1996–2004) and 98.6% in England (for diagnoses in 1999–2002) of possibly curable, localized prostate cancer (the stage at which Rudy Giuliani was diagnosed in 2000)
  • 31.7% in the U.S. (for diagnoses in 1996–2004) and 32.6% in England (for diagnoses in 1999–2002) of incurable, metastatic prostate cancer
  • 98.9% in the U.S. (for diagnoses in 1996–2004) and 81.0% in England (for diagnoses in 1999–2002) of all stages combined of prostate cancer
  • 98.9% in the U.S. (for diagnoses in 1996–2004) and 95% in Canada (for diagnoses in 2001–2003) of all stages combined of prostate cancer

Apatens (talk) 05:56, 7 August 2009 (UTC)[reply]

To DickClarkMises: What "sources" are you referring to in your comment in reply to my observation? I disagree that informed people are disputing or debating this as you seem to claim.--Hauskalainen (talk) 12:57, 7 August 2009 (UTC)[reply]
Suggestion: restore accurate, sourced version but replace "false and misleading" with "incorrect" in the lead. KillerChihuahua?!?Advice 14:58, 7 August 2009 (UTC)[reply]
KC, perhaps I am misreading you here, but what sources are you claiming that I've purged? BTW, I think your proposed revision is certainly a step in the right direction (insofar as it at least doesn't impute ill will to the progenitor of the stats), but it is still non-neutral insofar as it pushes a POV. Gratzer still argues that his stats are correct, right? Others do too, right? It is a dispute that Wikipedia isn't in a position to end. DickClarkMises (talk) 15:18, 7 August 2009 (UTC)[reply]
Yeah, and last I heard, Hovind is still claiming he doesn't owe taxes because he works for God, and the Discovery Institute and its fellows are claiming Intelligent design is science - all of these are bullshit, lies, inaccurate, false, misleading, wrong - and that's the NPOV view, the accurate view, and what WP has in its articles. You are confusing NPOV with EQUAL - fringe or vanishing minority viewpoints are emphatically not given the same weight as mainstream and expert views. Jason Gastrich can put "Ph.D." in front of his name, but he mail-ordered his diploma and if he were actually notable enough for us to have kept his auto-bio-article here, we would not be referring to him as Dr. Gastrich, but making it clear that although he refers to himself as Dr., he has no diploma from any sanctioned center of higher learning. That's not BLP violation, that's NPOV enforcement. To make it clear: there is no dispute. Just like there is no dispute about ID being pseudo scientific teleological argument, inherently religious and not scientific, no matter how many times Michael Behe claims it is. He can say it, but it isn't true, and there is no debate in any meaningful sense. KillerChihuahua?!?Advice 15:48, 7 August 2009 (UTC)[reply]

The word "incorrect":

  1. does not faithfully and adequately represent the actions of Gratzer and Giuliani—who made no attempt to correct their false and misleading statements (and instead defiantly—citing zero WP:Reliable sources—insisted they were absolutely "correct")
  2. does not faithfully and adequately represent the cited WP:Reliable sources which all use the word "false":
    1. FactCheck.org [62][63]
    2. PolitFact.com [64]
    3. The New York Times [65][66]

Apatens (talk) 15:37, 14 August 2009 (UTC)[reply]

Then the source verbiage stands; we should reflect what an RS uses if possible, and not rewrite to mean something else. KillerChihuahua?!?Advice 20:07, 14 August 2009 (UTC)[reply]
I don't think it is ever appropriate for us to use the encyclopedic voice to impute bad faith to a living person. Gratzer's work has been widely disputed for methodology, that is, other experts don't believe that Gratzer's statistics convey the accurate picture that other methods of analysis would. But again, saying that someone promulgated "misleading" statements is an ambiguous thing to say. "Misleading" might imply to some readers that Gratzer was intentionally trying to deceive. In the context of a disagreement between scientists about statistical methodology, "misleading" probably just means that they believe Gratzer's framing of the data will cause people to draw the wrong conclusions. Simply saying that "Gratzer published false and misleading cancer statistics that Rudy Giuliani talked about a lot" is less accurate and less informative than saying something like
"Gratzer published a comparative analysis of international cancer statistics that was heavily cited by Rudy Giuliani in his campaign for the 2008 Republican Party nomination. Gratzer's presentation of the data, methodology, and conclusions were notably criticized by Person MentionedInBody, Person2 MentionedInBody, and others (also mentioned or at least footnoted in body).citecitecite"
I absolutely think that notable criticisms belong in the article, and indeed that they are perhaps the primary support for this subject's notability. However, this should be an encyclopedia article, not a hit piece. DickClarkMises (talk) 04:02, 3 September 2009 (UTC)[reply]

False and misleading nonsense numbers

[edit]

False and milseading nonsense numbers = a number that is meaningless = an F in epidemiology if you did that calculation (numerators and denominators have to be the same population) = such calcuations are complete nonsense:

  • A Tale of Bad Math. What we find truly striking is Gratzer’s lack of thoroughness in checking his facts. His source, he says, is a 2000 report for the Commonwealth Fund by Gerard F. Anderson and Peter S. Hussey, of Johns Hopkins. When we checked with Hussey, now with the RAND Corp., he said Gratzer made inappropriate use of his report and was simply wrong. Hussey says the math that was performed on data in his report produces a number that is meaningless.[67]
  • "You would get an F in epidemiology at Johns Hopkins if you did that calculation," said Johns Hopkins professor Gerard Anderson, whose 2000 study "Multinational Comparisons of Health Systems Data" has been cited by Gratzer as a source for his statistics. "Numerators and denominators have to be the same population."[68]
  • Peter Albertsen, professor and chief of urology at the University of Connecticut Health Center, calls such calculations a “very dangerous thing to do” and “complete nonsense.”[69]

Apatens (talk) 16:27, 23 December 2009 (UTC)[reply]

Apatens, no one is suggesting that we not describe the numbers as "false and misleading." What I am suggesting is that we need to keep the tone of the text encyclopedic. We have a paragraph further down in the section that says:
The Washington Post[38] and FactCheck.org[39] again consulted leading prostate cancer experts and cancer statisticians who found no merit in Gratzer's response. Peter Albertsen, professor and chief of urology at the University of Connecticut Health Center called calculations of "survival rates" from cancer mortality and incidence statistics such as those by Gratzer, Goodman, O'Neill, and McCaughey "complete nonsense" and a "very dangerous thing to do."[39] Gerard Anderson, professor of health policy and management at the Johns Hopkins Bloomberg School of Public Health said: "You would get an F in epidemiology at Johns Hopkins if you did that calculation."[38]
That's a very appropriate way to bring in the phrase "complete nonsense." It uses the source's exact words, it clearly identifies who is speaking, and seems to do a reasonable job of setting the context. Let's be honest with ourselves, though - Dr. Albertsen is using some rather strong, quite informal language here that would not typically be used in an encyclopedia. "Encyclopedic language" would use more measured terms such as "incorrect," "wrong," "inaccurate" - in other words, language such as "false and misleading."
Bottom line, for us as editors to say "false and misleading" is completely adequate to convey that the sources say the numbers were completely wrong. To then have a paragraph that quotes experts saying "complete nonsense," "very dangerous," and "would get an F" conveys - in a neutral and encyclopedic way - the tone of those sources. What is not encyclopedic is for us to stick in the word "nonsense" every time we want to say the numbers were wrong. To keep the tone encyclopedic, we need to use more neutral terms ourselves, such as "false," "misleading," "incorrect," and explicitly quote sources when we want to bring in more colorful language such as "nonsense." EastTN (talk) 16:43, 23 December 2009 (UTC)[reply]

"Nonsense number" is used once and only once in this article—not stuck in "every time we want to say the numbers were wrong."
"Nonsense number" is not being used in this article or the cited sources to inject "unencyclopedic tone" as "quite informal language" or "colorful language"—it is being used to make clear that Gratzer's calculations produce a number that is literally and formally a meaningless pure nonsense number:

Apatens (talk) 16:53, 24 December 2009 (UTC)[reply]

"Nonsense" is used twice to describe these statistics. Once, quite appropriately, in a properly attributed quotation from Peter Albertsen. The other time it is used on top of the adjectives "false and misleading." This changes the tone of the section without adding anything to the content. The quotes from Dr. Albertsen make the point better than we can. More than that, it is not our role as editors to drive home that point in our own voice. Our role is to report, as dispassionately as possible, that the numbers are incorrect - and to equally dispassionately report what the sources have to say about it. I don't argue with your reasoning above. It is, however, original research - and "nonsense" is not an encyclopedic way of stating that a number is incorrect or meaningless. EastTN (talk) 17:35, 31 December 2009 (UTC)[reply]

Error in citation

[edit]

There is a mistake in the "Obama health care reform opponent" section. The article cited the Toronto Star for the front page news item regarding David Gratzer. This is incorrect. The citation 56 refers to the National Post, a newspaper known for conservative leanings. I have fixed this.

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