What's Statophobia ?

A fascinating condition that most doctor's suffer from, as explained in this excellent email from Dr Ronald E LaPorte

Supercourse Newsletter

6 January 2013

www.pitt.edu/super1/

Dear Friends

Stataphobia:

Stataphobia is a devastating disease which primarily afflicts scientists

world wide. It renders scientists unresponsive,  rejects their articles

and prevents  tenure. With the   Library of Alexandria we plan to cure

this horrible malady.  Please forward this to your friends and students

who now, or in the future will suffer from this debilitating disease.

Stataphobia is defined as a rapidly progressive disorder of scientists

caused by statistical ignorance and fear

Virtually all scientists across the world suffer from this.   I am a

Stataphobic.  Of the 500 articles I have published  in 300 my research

design and statistics were questioned  Almost every Nobel Prize winner,

professor, academic has had this disease. Darwin, Copernicus, and Einstein

had bouts of severe stataphobia. Stataphobia is the primary risk factor

for the death of scientific articles  and NIH Grants, it must be stopped

But every now and then I feel so insecure,

I know that I just need you like, I've never done before.( Beatles)

All of us in research  have symptoms of design insecurity  and need

research methods experts in oh so many ways  .  I am fortunate as 4 floors

down are friends in statistics. However, in research limited universities

and countries around the world, the only research expert might be half a

country away, a major determinant of Stataphobia.

The Cure to Stataphobia:  BA Superhelp desk

Help me get my feet back on the ground,

Won't you please, please help me? (to plan and analyze my research???)

(Beatles and me)

To prevent Stataphobia, every scientist should have your own virtual

research counselor.  A sure way to cure Stataphoia is to provide

counselors to show the irrationality of our fear of Stats.  This will lead

to enormous psychological improvement and better publications. The Library

of Alexandria SuperHelp desk will boost scientific productivity by giving

every scientist a virtual research methods counselor, and will help

prevent the global epidemic of Stataphobia.

Only 3% of the articles in international journals come from developing

countries, despite the fact that 25% of the researchers are from

developing countries and 80% of the people.  As we have indicated, over

80% of the time articles are rejected it is because of research methods

problems.  The reality is that no matter how good one’s hypothesis is from

any place in the world an article will never be published unless the

research methods are adequate. The BA SuperHelp desk can help stamp out

this ugly disease.

The BA SuperHelp virtual desk  will provide all of you a research methods

hotline.  Over 20 gray/no hair research experts have banded together to

help provide advice.  We will need other experts such as those having a

significant publication record, or statistical training please join the

Stataphobia vaccination team. We decided to start our effort in the

bastion of civilization, Egypt, and set up the help desk for researchers

in Egypt to see how it will work in February. In Egypt we of course have

the Library of Alexandria leading the effort. We have a research expert,

Eman Eltahlawy who has taken the lead.  We will see how our efforts work

in Egypt and then expand to other countries once we see the flow of

questions.

The door to the prevention of Stataphobia:

http://www.pitt.edu/~super1/ResearchMethods/indexlight.htm

Our door consists of 12 areas where there are likely going to be

questions, e.g. bias, power calculation, sampling, etc. We have a

Supercourse lecture and a wiki explanation.

It must be fate as the “ Door to Research methods” = LaPorte 2 RESRCH

This trial period is designed to provide us an idea as to how much traffic

we will receive.

From Euclid to BA SuperHelp desk

Headaches in Children Appear Unrelated to Vision Problems

Medscape Medical News from the:

• American Academy of Ophthalmology (AAO) 2012 Annual Meeting
• Vision and other eye problems are not linked to recurring headaches in children, even if the headaches strike while the child is doing schoolwork or other visual tasks, according to a study presented at the American Academy of Ophthalmology (AAO) and Asia-Pacific Academy of Ophthalmology 2012 Joint Meeting.
  The investigators conducted a retrospective review of 158 children 18 years old and younger who presented to a pediatric ophthalmology practice complaining of headaches between 2002 and 2011.
  "Our idea was to compare children for whom glasses were indicated to those who did not need glasses, and see if the headaches got better [with corrected vision]…. Ultimately, those 2 groups had the same outcomes. Whether or not the child had a refractive error that warranted correction, the presence or absence of headache remained the same. From this, we concluded that refractive error is not playing a large role in pediatric headaches," said Zachary Roth, MD, from the Albany Medical Center, New York, who presented the findings.
  "This information should be passed along to paediatricians," he added.
  All of the children had received complete eye exams by the clinic's ophthalmologists, and the results were compared with their previous medical records (eye exams and other medical care).
  No significant correlation was found between the presence of headache and the need for vision correction. For just over 75% of the children, eye health and vision test results remained normal or unchanged from earlier exams, Dr. Roth reported.
  Children who already wore glasses were not found to require new prescriptions at the time they presented with headaches. Although 14% reported that their headaches occurred while doing visual tasks such as homework, and 90% reported visual symptoms associated with their headaches, the researchers determined that a need for vision correction was not a significant factor.
  Approximately 30% of the children had ophthalmologic conditions that surpassed the need for simple vision correction, including strabismus, amblyopia, and other, more serious conditions. A family history of migraine was present in 17%.
  Most headaches resolved over time. By parental report, 76.4% of all subjects improved, including those with refractive correction (71.9%) and those without new prescriptions (78.2%), for an insignificant difference between these 2 groups of P = .38. The study did not assess the actual cause of the headaches.
  Similarly, children who received new prescriptions were not more likely than others to have resolution of their headaches, Dr. Roth reported.
  Parents Can Be Reassured
  "We hope our study will help reassure parents that in most cases their children's headaches are not related to vision or eye problems, and that most headaches will clear up in time," he said.
  Arlene V. Drack, MD, the Ronald V. Keech, MD, Associate Professor in Ophthalmic Genetics at the University of Iowa in Iowa City, commented that the findings "mirror what we see in practice, and that is that parents assume a child with headache must need glasses.
  "In my own practice, if a child with headache has any degree of refractive error I give him or her the glasses. Otherwise, the parents will keep bringing them back," she said. "Now, we can reference this study, showing evidence that it is very unusual that the need for glasses is the cause of headaches."
  Paul Joseph Rychwalski, MD, of the Cleveland Clinic, Ohio, agreed. "This study confirms what we know anecdotally. It dispels an urban myth."
  Dr. Roth, Dr. Drack, and Dr. Rychwalski have disclosed no relevant financial relationships.
  American Academy of Ophthalmology (AAO) and Asia-Pacific Academy of Ophthalmology 2012 Joint Meeting. Abstract #PO461. Presented November 12, 2012.
  Source
  Comment: Given the frequency of headaches in children, this is a valuable study. However given the lack of routine vision screening in India, and the high incidence of refractive errors requiring spectacles, it is still a good idea to get a vision assessment done for any child coming to us with headaches, even if they are not necessarily connected.

Menactra (Meningococcal Conjugate Vaccine - MCV) safe in infants

Medscape Medical News

Meningococcal Conjugate Vaccine Appears Safe in Infants

Emma Hitt, PhD

Nov 14, 2012

Quadrivalent meningococcal conjugate vaccine (MenACWY-D;Menactra, sanofi pasteur) appears to be safe and immunogenic when given as a 2-dose series in infants at the age of 9 months and 1 year, according to pooled data from 3 randomized trials.

L. Miriam Pina, MD, and colleagues from sanofi pasteur in Swiftwater, Pennsylvania, report their findings in an article published in the November issue of the Pediatric Infectious Disease Journal.

According to the researchers, MenACWY-D was licensed in the United States in 2005 to prevent meningococcal disease caused by Neisseria meningitidis serogroups A, C, Y, and W-135 in teenagers and adults. A second vaccine (MenACWY-CRM; Menveo, Novartis Vaccines and Diagnostics) is also currently indicated for the prevention of invasive meningococcal disease and is approved for children and adults between the ages of 2 and 55 years.

"The license [for MenACWY-D] was extended to children aged 2–10 years in 2007 and extended again in 2011 to infants aged 9 months and older based, in part, on results from 3 phase III studies presented herein," the authors note.

To further evaluate the safety, data from these 3 trials conducted between September 2006 and January 2009 were assessed. One study enrolled 1257 participants, another study enrolled 2289 participants, and a third study enrolled 1378 participants.

At 30 days after vaccination, immunogenicity, as measured by assays of human complement titer levels (titers ≥1:8), was demonstrated in between 86.4% and 100% of children receiving 2 doses of the vaccine at ages 9 and 12 months. A titer ≥1:4 to each serogroup was achieved by more than 91% of vaccinated children.

In addition, the vaccine did not appear to interfere with the measles, mumps, rubella, and varicella or heptavalent pneumococcal conjugate vaccines, with between 81% and 98% of participants receiving concomitant vaccinations achieving protective responses.

Antipneumococcal antibody levels were decreased when the meningococcal vaccine was given with the heptavalent pneumococcal conjugate vaccine but remained protective for all serotypes by enzyme-linked immunosorbent assay (98% - 100%, ≥0.35 μg/mL) and opsonophagocytic assay (99% - 100%, ≥1:8).

According to the authors, adverse events were generally mild and similar across groups. "Injection-site and systemic events were similar to those of currently licensed, routinely administered pediatric vaccines," they add. Of the participants, between 23.3% and 30.1% reported erythema and between 10.1% and 16.2% reported swelling. Most injection-site reactions were reported within 3 days of the vaccination and were mild and transient.

Serious adverse events were reported in between 3% and 5% of participants receiving MenACWY-D, but they were also reported in 2% and 4% of control patients. In the 3 studies combined, 4 serious adverse events were considered related to the study vaccine: insulin-dependent diabetes mellitus, respiratory distress, and 2 cases of febrile seizures.

"In summary, MenACWY-D offers the broad protection of a quadrivalent vaccine among children 9–23 months of age when administered as a 2-dose schedule, 3 months apart," Dr. Pina and colleagues conclude. "This schedule can protect infants with fewer doses than a classic 3+1 infant schedule, and it minimizes the risk of interference and the difficulties associated with the introduction of another vaccine into an already crowded infant vaccination schedule."

Independent commentator Doug Campos-Outcalt, MD, from the University of Arizona College of Medicine in Phoenix, told Medscape Medical News that the findings support previous data showing the safety with this vaccine, but the "numbers in the study are not enough to detect rare serious adverse events."

Dr. Campos-Outcalt pointed out that it remains to be determined whether there are rare serious adverse events, noting that "when the target disease is so rare, the issue of safety becomes paramount."

"At the moment, meningococcal vaccines are recommended only for high-risk infants," he added.

This research was funded by sanofi pasteur Inc, which employs and authors. Dr. Campos-Outcalt has disclosed no relevant financial relationships.

Pediatr Infect Dis J. 2012;31:1173-1183. Full text

Comment: This study has significant relevance to India. Why? Because Menactra has just been launched a couple of days back (Jan 2013) officially by Sanofi Pasteur in India. It is at present a vaccine of limited potential, given that IAP recommends it for 'high risk' group of children only. Also given that this is an expensive vaccine (around 4,500 to 5,000 Rs.), the uptake is likely to be limited at the present point of time. However, it would be of benefit to travelers to the African sub - saharan 'meningitis belt', and to children who have an immunodeficiency, and also during an epidemic situation, that occurs every 3-5 years in many places across the country including Delhi. I agree with the IAP that at present this vaccine is NOT meant for routine use in our country. It is also pertinent to note that we already have the Meningococcal Polysaccharide Vaccine (MPV- Quadrimeningo) which is safe & quite effective in children above the age of 2 years, and far cheaper too.