Autism Criteria Critics Blasted by DSM-5 Leader

By John Gever, Senior Editor
MedPage Today
Origianlly Published May 8, 2012

The head of the American Psychiatric Association committee rewriting the diagnostic criteria for autism spectrum disorders took on the panel's critics here, accusing them of bad science.

Susan Swedo, MD, of the National Institute of Mental Health, said a review released earlier this year by Yale University researchers was seriously flawed. That review triggered a wave of headlines indicating that large numbers of autism spectrum patients could lose their diagnoses and hence access to services.

Swedo spoke at the American Psychiatric Association's (APA) annual meeting, in her role as chairperson of the work group developing new diagnostic criteria for neurodevelopmental disorders in DSM-5, the forthcoming fifth edition of the APA's Diagnostic and Statistical Manual of Mental Disorders.

She was especially incensed by reports in consumer media about the Yale group's study, led by a New York Times article with a "blaring" headline that read, "New Definition of Autism May Exclude Many, Study Suggests." The Yale study, according to the Times article, found that most patients with Asperger's syndrome and about 25% of those with overt autism would not qualify for those diagnoses under DSM-5.

The entire story is here.

Measuring the Prevalence of Questionable Research Practices With Incentives for Truth Telling

*Psychological Science* has scheduled an article for publication in a future issue of the journal: "Measuring the Prevalence of Questionable Research Practices With Incentives for Truth Telling."

The authors are Leslie K. John of Harvard University, George Loewenstein of Carnegie Mellon University, & Drazen Prelec of the Massachusetts Institute of Technology.

Here is the abstract:

Cases of clear scientific misconduct have received significant media attention recently, but less flagrantly questionable research practices may be more prevalent and, ultimately, more damaging to the academic enterprise. Using an anonymous elicitation format supplemented by incentives for honest reporting, we surveyed over 2,000 psychologists about their involvement in questionable research practices. The impact of truth-telling incentives on self-admissions of questionable research practices was positive, and this impact was greater for practices that respondents judged to be less defensible. Combining three different estimation methods, we found that the percentage of respondents who have engaged in questionable practices was surprisingly high. This finding suggests that some questionable practices may constitute the prevailing research norm.

Here's how the article starts:

Although cases of overt scientific misconduct have received significant media attention recently (Altman, 2006; Deer, 2011; Steneck, 2002, 2006), exploitation of the gray area of acceptable practice is certainly much more prevalent, and may be more damaging to the academic enterprise in the long run, than outright fraud.

Questionable research practices (QRPs), such as excluding data points on the basis of post hoc criteria, can spuriously increase the likelihood of finding evidence in support of a hypothesis.

Just how dramatic these effects can be was demonstrated by Simmons, Nelson, and Simonsohn (2011) in a series of experiments and simulations that showed how greatly QRPs increase the likelihood of finding support for a false hypothesis.

QRPs are the steroids of scientific competition, artificially enhancing performance and producing a kind of arms race in which researchers who strictly play by the rules are at a competitive disadvantage.

QRPs, by nature of the very fact that they are often questionable as opposed to blatantly improper, also offer considerable latitude for rationalization and self-deception.

Concerns over QRPs have been mounting (Crocker, 2011; Lacetera & Zirulia, 2011; Marshall, 2000; Sovacool, 2008; Sterba, 2006; Wicherts, 2011), and several studies--many of which have focused on medical research--have assessed their prevalence (Gardner, Lidz, & Hartwig, 2005; Geggie, 2001; Henry et al., 2005; List, Bailey, Euzent, & Martin, 2001; Martinson, Anderson, & de Vries, 2005; Swazey, Anderson, & Louis, 1993).

In the study reported here, we measured the percentage of psychologists who have engaged in QRPs.

As with any unethical or socially stigmatized behavior, self-reported survey data are likely to underrepresent true prevalence.

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The study "surveyed over 2,000 psychologists about their involvement in questionable research practices."

The article reports that the findings "point to the same conclusion: A surprisingly high percentage of psychologists admit to having engaged in QRPs."

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Most of the respondents in our study believed in the integrity of their own research and judged practices they had engaged in to be acceptable.

However, given publication pressures and professional ambitions, the inherent ambiguity of the defensibility of "questionable" research practices, and the well-documented ubiquity of motivated reasoning (Kunda, 1990), researchers may not be in the best position to judge the defensibility of their own behavior.

This could in part explain why the most egregious practices in our survey (e.g., falsifying data) appear to be less common than the relatively less questionable ones (e.g., failing to report all of a study's conditions).

It is easier to generate a post hoc explanation to justify removing nuisance data points than it is to justify outright data falsification, even though both practices produce similar consequences.

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Another excerpt: "Given the findings of our study, it comes as no surprise that many researchers have expressed concerns over failures to replicate published results (Bower & Mayer, 1985; Crabbe, Wahlsten, & Dudek, 1999; Doyen, Klein, Pichon, & Cleeremans, 2012, Enserink, 1999; Galak, LeBoeuf, Nelson, & Simmons, 2012; Ioannidis, 2005a, 2005b; Palmer, 2000; Steele, Bass, & Crook, 1999)."

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More generally, the prevalence of QRPs raises questions about the credibility of research findings and threatens research integrity by producing unrealistically elegant results that may be difficult to match without engaging in such practices oneself.

This can lead to a "race to the bottom," with questionable research begetting even more questionable research.

----------------------
Thanks to Ken Pope for this information.

The abstract and article are here.

Report Finds Academic Fraud Evidence in UNC Department

By Dane Kane
http://www.newsobserver.com/
Originally published May 6, 2012

An internal investigation into UNC-Chapel Hill’s Department of African and Afro-American Studies has found evidence of academic fraud involving more than 50 classes that range from no-show professors to unauthorized grade changes for students.

One of the no-show classes is the Swahili course taken by former football player Michael McAdoo that prompted NCAA findings of impermissible tutoring, and drew more controversy when the final paper he submitted was found to have been heavily plagiarized.

The investigation found many of the suspect classes were taught in the summer by former department chairman Julius Nyang’oro, who resigned from that post in September. The university now says Nyang’oro, 57, who was the department’s first-ever chairman, is retiring July 1.

“Professor Nyang’oro offered to retire, and we agreed that was in the best interest of the department, the college and the university,” said Nancy Davis, associate vice chancellor for university relations.

The entire story is here.

Suicide: The fourth-leading cause of American deaths abroad

By Gary Stoller
USA Today
Originally published May 4, 2012

Tom Miller jumped from the eighth floor of a hotel in the Philippines in February, and Gerhard Habel hanged himself in his apartment in Thailand last April.

These incidents aren't entirely unrelated. Suicide by an American in a foreign country is a more common occurrence than might be thought. It's the fourth-leading cause of death abroad from non-natural causes after road accidents, homicides and drowning, according to the Centers for Disease Control and Prevention.

The deaths of Miller and Habel stand out, though, because they were reported to the media by local police, and some information about the tragedies was made public.

Though more than 125 American suicides abroad are reported annually to the State Department, there is no public profile of most who commit the tragic act. For privacy reasons, the State Department will not provide victim information such as name, age, gender or addresses abroad.

"The travel medicine community could take preventative steps if there was more knowledge about risk factors and circumstances of those individuals who are committing suicide abroad," says Stephen Hargarten, director of the Injury Research Center at the Medical College of Wisconsin.

The entire story is here.

The Tragic Suicide Death of Junior Seau

By John M. Grohol, PsyD.

World of Psychology Blog

The evidence is in, and the death of NFL football player Junior Seau has been ruled a suicide. The speculation is that he suffered from depression as a result of the concussions he sustained as a pro football player in the U.S. Seau spent most of his football career as a San Diego Charger.

Many in the news media are portraying this as some sort of new news — that having your head repeatedly banged and bashed can cause long-lasting brain damage. Even with a padded helmet, there’s been a wealth of research demonstrating that head injuries still occur. The human head just wasn’t meant for years and years of such repeated abuse.

It’s also not the first time we’ve known of this link between football playing, concussions, and being at a much higher risk for depression (and even dementia). Perhaps this time the message will get through.

The entire blog is here.

Providers to Test Power of Apology in Malpractice Claims

By Robert Lowes

Medscape Medical News

Originally published April 27, 2012

The Massachusetts Medical Society (MMS) wants to prove that clinicians and hospitals can keep medical malpractice out of the courtroom by owning up to their mistakes with apologies — and sometimes cash as well.

The result, says the MMS, will be not only fewer lawsuits but also improved patient safety, less defensive medicine, and lower costs.

Earlier this month, the MMS and 5 other state healthcare organizations announced the start of a pilot program to promote a process called Disclosure, Apology, and Offer, or DA&O. It's a kinder and gentler approach to medical liability reform compared with measures such as caps on noneconomic (pain and suffering) and punitive damages, which are viewed in some quarters as abridging the legal rights of patients.

Like most of organized medicine, MMS supports these traditional liability reforms, but it also sees merit in avoiding the courts.

"The current liability system impedes open communication," says Alan Woodward, MD, a past MMS president and chair of its professional liability committee. "It creates a culture of blame, finger-pointing, and secrecy. We're trying to turn that around into an advocacy system that supports both patients and providers."

The entire article is here.

Thanks to Gary Schoener for this lead.

Insurers Embrace "Virtual" Doctor Visits

By Phil Galewitz
KHN Staff Writer
Originally published May 6, 2012

Tired of feeling "like the walking dead" but worried about the cost of a doctor's visit, Amber Young sat on her bed near tears one recent Friday night in Woodbury, Minn.

That's when she logged onto an Internet site, run by NowClinic online care, a subsidiary of UnitedHealth Group (which also owns UnitedHealthcare), and "met" with a doctor in Texas.

After talking with the physician via instant messaging and then by telephone, Young was diagnosed with an upper respiratory illness and prescribed an antibiotic that her husband picked up at a local pharmacy. The doctor's "visit" cost $45.

"I was as suspicious as anyone about getting treated over the computer," said Young, 34, who was uninsured then. "But I could not have been happier with the service."

Read the entire story here.

Yoo Can't Be Sued for Allegedly Authorizing Torture

By Scott Graham
The Recorder
Essential California Legal Content
Originally published May 2, 2012

John Yoo is off the hook.

John Yoo

A panel of the U.S. Court of Appeals for the Ninth Circuit that included two Democratic appointees ruled Wednesday that the former Bush administration lawyer cannot be sued personally for allegedly authorizing the torture and months-long detention of an American citizen deemed an enemy combatant.

 
The court ruled that 10 years ago, when Yoo was with Justice Department's Office of Legal Counsel, it was not "beyond debate" that suspected terrorists were entitled to the same constitutional protections as ordinary accused criminals. In fact, the court held, that law remains unsettled to this day.
 
Thus, Yoo, now a professor at UC-Berkeley School of Law, enjoys qualified immunity from a suit by Jose Padilla, who alleges he was brutalized by the government while being denied access to counsel or his family for 21 months. Although the government dropped the most serious charges against him, Padilla was ultimately convicted in 2007 of conspiring to murder, kidnap and maim people overseas, and was sentenced to 17 years in prison.

The entire story is here.

Thanks to Gary Schoener for this story.

Abbott Settles Marketing Lawsuit

By Michael S. Schmidt and Katie Thomas
The New York Times - Business Day
Originally published May 7, 2012

The pharmaceutical company Abbott Laboratories said on Monday that it had reached an agreement with the federal and nearly all state governments to pay $1.6 billion in connection with its illegal marketing of the anti-seizure drug Depakote.

The settlement comes as the Justice Department and the states have increased scrutiny of the sales and marketing practices of pharmaceutical companies, particularly in cases in which they market drugs for uses that are not approved by the Food and Drug Administration.

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Doctors may prescribe drugs for any purpose, but pharmaceutical companies are prohibited from promoting drugs for conditions that are not approved by the agency.

The entire story is here.