In the New York Times, a writer named Kira Piekoff, a graduate student in Bioethics, tells how she sent her blood to three different companies, including 23andMe, for genetic analysis and got back results that differed greatly. As usual, none of the companies told her anything about the error of measurement in their reports, judging from what she wrote. So she’s naive and they’re naive (or dishonest). Fine.
I’m unsurprised that a graduate student in bioethics has no understanding of measurement error. What’s fascinating is that the experts she consulted didn’t either, judging by what they said.
A medical ethicist named Arthur L. Caplan weighed in. He said:
The ‘risk is in the eye of the beholder’ standard is not going to work.We need to get some kind of agreement on what is high risk, medium risk and low risk. [Irrelevant — Seth] If you want to spend money wisely to protect your health and you have a few hundred dollars, buy a scale, stand on it, and act accordingly.
As if blood sugar and blood pressure measurements aren’t useful. A good scale costs $15.
A director of clinical genetics named Wendy Chung said:
Even if they are accurately looking at 5 percent of the attributable risk, they’ve ignored the vast majority of the other risk factors — the dark matter for genetics — because we as a scientific community haven’t yet identified those risk factors.
She changed the subject.
J. Craig Venter, the famous gene sequencer, does not understand the issue:
Your results are not the least bit surprising. Anything short of sequencing is going to be short on accuracy — and even then, there’s almost no comprehensive data sets to compare to.
The notion that “anything short of [complete] sequencing” cannot be helpful is absurd, if I understand what “short on accuracy” means. He reminds me of doctors who don’t understand that a t test corrects for sample size. They believe any study with less than 100 subjects cannot be trusted.
I told a friend recently that I have become very afraid of doctors. For exactly the reason illustrated in these quotes, from well-known experts who are presumably much more competent than any doctor I am likely to see. The experts were unable to comment usefully on something as basic as measurement error. Failing to understand basics makes them easy marks — for drug companies, for example — just as the writer of the article was an easy mark for the experts, who managed to be quoted in the Times, making them appear competent. Surely almost any doctor will be worse.