Starting a blog

Maybe I could use a space to put things up which will be searchable and linkable and which people can comment on. I'll try posting things here and see how it all goes.

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Nailing Hunt's lies

Here is the soundbite which Hunt has been repeating ad nauseam: "And at the moment we have an NHS where if you have a stroke at the weekends, you're 20% more likely to die. That can't be acceptable." Sounds quite impressive? I tweeted him to ask for evidence and got no reply so I decided to look for my own. It wasn't hard to find. I'll deal with the best and most recent example. The headline finding from this paper is that patients admitted at weekends with a stroke diagnosis have an increased 7-day mortality of 19%, apparently just as Hunt claims: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4487251/ The 7-day mortality for week-end admissions is 12.9% and for week-day admissions is 11.1% and if you factor in comorbidities etc. this gives you an adjusted mortality odds ratio of 1.19. Just as Hunt says. But let's look more closely. At some numbers buried in the text of the paper and not even given a p value, even though they are probably the most st...
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Sex and gender

This post is just here because I find myself having to make the same arguments again and again on twitter so in future I'm just going to link to this. Do I know what I'm talking about? I was a psychiatrist in the National Health Service for thirty years. That means I qualified as a medical doctor and then had post-graduate training, which naturally included some material on human development and sex and gender. I also have two doctoral degrees in human genetics, an MD and a PhD, and have been an author on hundreds of peer-reviewed papers, mostly on human genetics. Because of my research in genetics I am an Honorary Professor at two different London universities. My bio is here: http://www.davecurtis.net/dcurtis.html and the publications can be viewed here: https://scholar.google.co.uk/citations?hl=en&user=Vrr4Ig0AAAAJ&view_op=list_works&sortby=pubdate Do I do research in sexual development in humans? No. Do I understand it? Yes. I've read the stuff that ...
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SITUATIONAL JUDGEMENT TEST - example ranking question

Example Ranking Question You are in charge of a large national organisation responsible for assessing the abilities of all the country's newly qualified doctors and matching them to appropriate employment. Shortly before distributing the results and final allocations you become aware that there is a problem with the marking system which you have outsourced. Rank in order the following actions in response to this situation (1= Most appropriate; 5= Least appropriate) A. Cross your fingers and hope it will all be OK. Probably nobody will mind too much. B.  Send out the incorrect marks and allocations then follow with an email saying you will get medical schools to check all the papers and have another go at it. C.  As above but attempt to shift some of the blame onto one of the candidates by implying that their smudgy pencil confused the marking machine so really it's all their fault. D.  Admit that things may not have been perfect but undertake to try to do better ...
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Why GWAS's are evil

OK, yes, I know that genome-wide association studies have identified some important genetic effects but there are some important downsides too. I truthfully do not know whether the benefits have outweighed the costs. Why am I saying this? (None of this is supposed to be original. Conversely, I am not going to go to the trouble to find the myriad of people who may have said the same thing first. So sue me. I think that's what blogs are for?) Here are some pertinent points: Nobody believes anything if it's not in a GWAS Studies which would previously have been judged to give perfectly respectable evidence to implicate a candidate gene are nowadays completely ignored because the stupid GWAS missed said gene. People don't believe a candidate gene study which yields a corrected p value of 0.001 derived from 20 markers but they do believe a GWAS which produces one p value of 10^-8. There is no logic in this position. But a lot of people take this attitude. At a recent confe...
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The "omnigenic" model for schizophrenia - why it's even worse than you think.

I'm happy to see the article by Boyle, Yang and Pritchard (Boyle et al, 2017)  getting so much attention. Quite justifiably, many people are commenting on it and I thought I would add my two pence worth. To summarise, I think the main claim they are making is that for a complex disease there will be a relatively small number of "core" genes whose functioning is related to disease mechanisms but that a very large number of polymorphisms will impact to a small extent on these core genes through gene expression networks. This then leads to a phenomenon whereby GWAS hits are very widely scattered through the genome. Most of these hits will not be anywhere near genes involved in disease mechanisms, they'll just reflect impacts on generic expression networks in one way or another. Here, I'd like to add another dimension, taking schizophrenia as an example. My claim will be that as well as the core genes there will be many other genes which do have an effect on risk,...
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