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Thread: Response: How one surgeon discusses BrAIST

  1. #46
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    On the expected long-term results from bracing.

    From everything I've read, once one has stopped bracing, your chances of progression in adulthood are figured from your ending curve. And the risks are the same as any other person with that size curve.

    So, assuming a <6 degree increase in brace (the expected average) - if you brace at 30 degrees and wear your brace as prescribed, the most likely outcome is that you'll enter adulthood at <36 degrees. You then have the same chance of progressing in adulthood as a kid who didn't brace and enters adulthood at 36 degrees.

    If you want to know *before* you brace what your risk of progressing in adulthood is, the best numbers are to take your current (pre-brace) curve, add 6, and then figure out the risk that adults with that curve face of progression. Obviously, no one knows how it will turn out for a specific kid, but this gives you some sense of what you might expect.

  2. #47
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    Quote Originally Posted by hdugger View Post
    The only other topics I've seen the experts talk about are: overtreatment (from most experts), long-term effectiveness (from Dr. Hey). But the central finding of the study - that braces are effective in keeping teens off of the operating table - has been accepted by every expert I've read..

    The only place where I've seen that aspect of the report questioned is in these discussions.
    If you would be someone wanting to confuse parents, trying to hide/distort important facts showed in braist studies, wanting to convince them than surgery is the only valid scoliosis treatment, what would you do? EXACTLY WHAT POOKA1 IS DOING OF COURSE! or helping her to do what she does in this forum.. the most visited scoliosis forum of the world. May someone imagine a better way to promote scoliosis surgery? I can't.
    Last edited by flerc; 01-14-2014 at 02:20 PM.

  3. #48
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    This are issues researchers discuss. Cautionary comments have been posted by Dr. Hey among others.

    Lay people cannot be expected to be interested or even follow along as we have seen in this thread.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  4. #49
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    Quote Originally Posted by Pooka1 View Post
    Lay people cannot be expected . . .
    Yes, I understand that you do not believe the participants of this forum are capable of making sense of the research. Hence my confusion as to why you keep discussing the research here.

    But, back to the post of mine you were responding to. My point was that the experts were not reaching the same conclusion as *you* - regardless of whether they were talking amongst themselves or talking to patients. Because of that, I am attending to the expert consensus. That was my only point.

  5. #50
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    Quote Originally Posted by hdugger View Post
    Yes, I understand that you do not believe the participants of this forum are capable of making sense of the research. Hence my confusion as to why you keep discussing the research here.

    But, back to the post of mine you were responding to. My point was that the experts were not reaching the same conclusion as *you* - regardless of whether they were talking amongst themselves or talking to patients. Because of that, I am attending to the expert consensus. That was my only point.
    There is a bunch of inside baseball that you have no idea about. This happens in every field of research. You are getting what is for public consumption aside my comments and those of Dr. McIntire and a few other researchers. And look at the confluence of my comments and Dr. McIntire's comments. I mean look at it honestly this time, not the nonsense you previously spewed. That is a hint of what I'm talking about.

    We have people here who think most landmark studies are able to be repeated with the same results. This is an example of how cluelessness is elevated to operative levels on fora like this and why having a research section for lay people is an oxymoron. This thread is a case in point.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  6. #51
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    I should had to talk with pooka1 talking into account she has not really idea about probablistic concepts or calculus At least is what she showed just only since the first discussion we had about this braist study.
    When I said the same result would be obtained I was refering to the high percentage of succesful cases with brace, certainly I mentioned a Chenau study showing close the double effectiveness of that study, clearly not the same. Of course I should had not to expect she could understand me when I said I shoud to do the calculus to have a real idea about the real probability of obtaining the same outcome. Of course is posible to do and of course it should to be assumed some conditions probably not possible to achieve, as the same age, risser, time in brace, kind of curve, reduction in brace, flexibility, kind of brace, percentage of reduction.. in every particular case.
    I not need to explain nothing of this to someone having enough idea about this Maths area of course..

  7. #52
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    Quote Originally Posted by Pooka1 View Post
    There is a bunch of inside baseball .
    Yes, of course. We all enter these conversations knowing that we're trying to make sense of information that is beyond our training.

    Except, I will note, that for reasons which aren't clear to me, you seem to think that you are part of this inside circle of experts - "aside my comments and those of Dr. McIntire and a few other researchers."

    That conceit is precisely the reason why I take the time to participate in these conversations. Because it's important to counter some of these notions and conjectures, so emphatically stated, with evidence.

    For the rest of your argument, I point you back to the "ad hominem" chart, formally titled the hierarchy of disagreement - http://en.wikipedia.org/wiki/File:Gr...sagreement.svg

    At the pinnacle of good discussion is directly engaging the central facts and then it drops down through less and less engagement with the central argument. One step above name-calling (which I've also experienced a lot of), is the ad hominem - "attacks the characteristics or authority of the writer without addressing the substance of the argument."

    The bulk of your post falls into this category. Basically, I can't be right because I don't have the appropriate training. I'd add that, again, kind of amusingly to me, I actually have an advanced degree in interpreting medical research unlike I think anyone else on this forum. But, that's not really the point. I've seen lots of people on this forum make intelligent assessments of research without any training at all. And, even that, is not the point. The point is, either you have some comment on the central argument, or you're engaging in some lower level of argumentation (such as, in this case, an ad hominem attack), in order to substitute that for an actual counter to the central point.

    My response: Engage with the central idea in some substantive way - present evidence (not conjecture) or support - or find someone else to talk to. I will continue to correct things that need correcting, but I've no interest at all in sliding down the hierarchy of disagreement.

    On a side note, I do not share your opinion that my fellow participants are clueless, or that patients and parents (your "lay people") are just not savvy enough to make sense of research. I hope that anyone who wants to take ownership of their condition does not feel scared off by the idea that they can't make sense of this stuff. It's really not rocket science - if you go into it with an open mind and some measure of restraint, you'll come away knowing a little more then when you went in. For a life-long condition like scoliosis, where you deal with it mostly away from a specialist, some kind of familiarity with the field is helpful and attainable for anyone with an interest.

  8. #53
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    Quote Originally Posted by flerc View Post
    I not need to explain nothing of this to someone having enough idea about this Maths area of course..
    Certainly only a CARADURA (sorry I don't know the translation) as Pooka1 can 'discuss' about these issues without that knowledge.
    But none parent or anyone thinking in bracing must to have it in order to understand what the Braist study implies. Trust in what researchers are saying there. The BIG PROBLEM arise if are trying to get sense about what Pooka is saying at least since I posted this study some months ago.

  9. #54
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    Quote Originally Posted by hdugger View Post
    Except, I will note, that for reasons which aren't clear to me,
    Nothing is clear to you.

    you seem to think that you are part of this inside circle of experts - "aside my comments and those of Dr. McIntire and a few other researchers."
    For the elebenty billionth time, I am talking about general science issues, things like medians versus averages. Had you really been following along you would know that was what I was talking about.

    Re-read my exchanges with Dr. McIntire. Those are general issues. Not that that would help you.
    Last edited by Pooka1; 01-14-2014 at 05:50 PM.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  10. #55
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    Quote Originally Posted by hdugger View Post
    I actually have an advanced degree in interpreting medical research unlike I think anyone else on this forum.
    I'm talking about choices in graphing data and stats and what is appropriate for various audiences and other issues I discussed with Dr. McIntire. All this went right past you.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  11. #56
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    Quote Originally Posted by hdugger View Post
    At the pinnacle of good discussion is directly engaging the central facts
    No the pinnacle is intellectual honesty. You still don't get it.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  12. #57
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    Quote Originally Posted by Pooka1 View Post
    "not that that would help you"
    "all this went right past you"
    "intellectual honesty"
    "you still don't get it".
    Congratulations! We've arrived at the bottom of the disagreement hierarchy. Get your casual name calling here.

    Again, if you have a central argument, feel free to share it. Otherwise, find someone else to talk to.

  13. #58
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    Quote Originally Posted by hdugger View Post
    Except, I will note, that for reasons which aren't clear to me, you seem to think that you are part of this inside circle of experts
    Who knows.. I said her many times I was wanting see the end of the demonstration she began at the begining of the braist discussion, that would prove how wrong are current probabilistic concepts.. probably we are discussing with an incredible kind of genious coming to the earth to teach the real science, not the bullshit teached in Universities.. why she choose this forum to do that.. who knows..

  14. #59
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    Quote Originally Posted by hdugger View Post
    Congratulations! We've arrived at the bottom of the disagreement hierarchy. Get your casual name calling here.

    Again, if you have a central argument, feel free to share it. Otherwise, find someone else to talk to.
    I treat you the way I do because you have not been honest in these exchanges (e.g., accusing me of ad hom towards other researchers and accusing Dr. McIntire of being "uncharitable" towards other reseachers) and now you are pretending to follow along. Have fun.
    Last edited by Pooka1; 01-14-2014 at 06:19 PM.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  15. #60
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    For the rest of your arguments which appear to be that you're more able to analyze and present the results of the BrAIST study then are Weinstein, Dolan, et al, I've found Dr. Weinstein to be very responsive. He got back to me in 20 minutes at 8PM his time. If you want to know why he did it that way, or you want to make a suggestion, try contacting him. He seemed like a decent guy - if your suggestions are helpful, maybe he'll implement them in his next study.

    For myself, I am not at all interested in deciding how other researchers ought to be presenting their data. Although I have training in medical research, I'd have to spend a lot of time with the material before I felt certain that I had more knowledge then the study author about how they should present their data, and I'm not planning on spending that time. For the point they were trying to study, I thought the presentation was fine. Your mileage may differ.

    I will just mention, again, that I've seen no studies outside of the conservative treatment area which are subjected to this kind of scrutiny. Weinstein and Dolan don't know how to present research, Mooney is unethical, McIntire's paper should never have been published. Maybe it's just a coincidence, maybe every idiot in research has decided to study conservative treatments. Or maybe you should ask yourself why, exactly, it is that these papers/authors get your ire up.

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