Posts by Marvin Shilmer

739

250,000 Jehovah's Witnesses have died refusing blood

by nicolaou in

80+ branch davidian cult members died in waco, texas.

250,000+ #jehovahswitnesses have died refusing blood.

stop this #cult!

Marvin Shilmer

-

“And it's exactly what the researchers were able to do in the controlled environment to create a matched comparison group (Group B) that I suspect is what most are objecting to: you are ASSUMING that Group B (the group of JWs who refused BT in the study) is similar to a third group, called Group C (the entire NZ population of JWs, which is a questionable extrapolation).”

Adamah,

My method has no dependency on a “Group C” except to have a total against which to establish a ratio. That is to say, the only dependency of the “Group C” you speak of in my method is to establish the number of JWs in New Zealand over the period of the study (1998-2007). This aggregate value for years 1998-2007 is: 126,989.

The number of preventable deaths is established solely on the basis of comparing Group A and Group B. The number established by Beliaev’s data is 19 over 10 years, or 1.9 per year for the 4 hospitals whose patient data was used. This aggregate value for years 1998-2007 is: 19.

Hence we have a ratio of 19-per-126,989 JWs over 10 years, or annually 1-per-6683 JWs.

If we adjust this ratio by assuming the 4 hospitals whose records were used were the only hospitals in those 2 regions with like mortalities, and that hospitals in the New Zealand’s other 2 regions had a similar mortality rate based on population then we have a ratio of 33-per-126,989 JWs over 10 years, or annually 1-per-3838 JWs.

“Then you want to extrapolate Globally, creating a group D (the Worldwide population of JWs), which is even MORE PROBLEMATIC, since you're willing to assume that it's a matched set, even though it's KNOWN that it isn't: all the factors you mentioned (eg ethinicity, comorbidities, hospital admission, treatment modalities, treatment protocols, etc) are KNOWN to be different for various hospitals Worldwide.”

I’ve not assumed any matched set against a world population. I’ve assumed that JW patients in New Zealand receive on average a better standard of care across the spectrum you cite compared with the average standard of care in the world. When it comes to comorbidities, hospital admission, treatment modalities, treatment protocols, etc. what we find among JWs in New Zealand is no different than the rest of the world overall, and I have not treated these as different. As for ethnicity, in the New Zealand region there is a factor to consider regarding Maori, but this is adjusted for within the Beliaev study and it’s the findings of the Beliaev study driving my extrapolation.

Otherwise I’ve made assumptions atop assumptions that, if anything, minimize the number of deaths due to Watchtower’s blood doctrine using the Beliaev data set. For instance, I assume there is not a single hospital in the 2 regions of New Zealand with even 1 more death of a JW refusing blood. This includes even the advanced and district trauma service hospitals. Given the fact that EACH of the 4 hospitals in Beliaev’s study incurred some of these deaths, this assumption of mine is very generous and it minimizes my findings.

“THAT'S the objection, and you assume it doesn't matter, but your methodology is built on unproven assumptions and is likely flawed, since it can only leads to a questionable figure. Is the actual figure too low? Is it too high? Who knows!”

Assumptions matter for one reason, so readers can understand what’s being said. From what I’ve read of your complaints you neither understand assumptions I’ve made nor care to. That’s why I’ve not responded to more often than I have to what you’ve said.

Marvin Shilmer

739

250,000 Jehovah's Witnesses have died refusing blood

by nicolaou in

80+ branch davidian cult members died in waco, texas.

250,000+ #jehovahswitnesses have died refusing blood.

stop this #cult!

Marvin Shilmer

-

“I had mentioned that I worked at a metropolitan hospital only to show I hear firsthand when JWs die from blood refusals (again, the numbers are very low).”

Steve2,

If, as you say, you have carefully considered what I’ve presented then you’d realize hearing reports from colleagues at a hospital of JWs who died over blood refusal would be a relatively rare event.

New Zealand has more than 80 hospitals. The adjusted rate of 3.3 deaths per year my article speaks of in the New Zealand healthcare service area means that any given hospital could go many years, perhaps decades, without a single instance of this preventable mortality. Hence what you share as your personal experience is what I’d expect, which makes me wonder why you think your experience is somehow at odds with that I’ve presented.

Furthermore, many of these deaths are not identified at the time for what they represent. Only after reviewing mortality over a period does frequency become apparent. The data set studied by Beliaev and his peers provide such a review. Again, without this retrospective the incidents would appear relatively rare. But these deaths add up over time. The only question is, how many have died due to Watchtower’s blood doctrine.

I maintain the numbers supplied by Beliaev et al are sufficient to extrapolate a minimum value based on certain assumptions. Assumptions such as 1) JWs around the world tend to accept/reject blood similar to JWs in New Zealand, 2) the frequency of JWs worldwide suffering severe anemia is similar to JWs in New Zealand (adjusted for Maori ethnicity), 3) New Zealand’s healthcare is not less than the rest of the world on average, and a few others spoken of throughout this discussion.

Scott77,

I think the value you’re looking for is P < 0.05.

Marvin Shilmer

739

250,000 Jehovah's Witnesses have died refusing blood

by nicolaou in

80+ branch davidian cult members died in waco, texas.

250,000+ #jehovahswitnesses have died refusing blood.

stop this #cult!

Marvin Shilmer

-

“Well, I am not going to argue with you any more, you just keep repeating the same things, and dismissing any other concerns. I don't have confidence in your numbers, but you won't or can't imagine you are not 100% correct, so there is no point in discussing it further.”

LisaRose,

I am unaware of any concerns raised that I have dismissed. In each case I’ve examined the concern and responded with content tailored to that concern. The idea that I “just keep repeating the same things” is a product of what’s presented to me as concerns. That is, similar concerns are expressed over and over again in this discussion using different language. I respond accordingly.

I’ve taken much time to address questions and concerns in this discussion. I think if readers spent a comparative pittance of time researching this subject as I have this one they’d hold a very different conclusion. I’d also advise readers who’re unfamiliar with the various means and methods to consult someone who is familiar with it in order to get some help on the subject.

It’s not my aim to convince anyone here of anything. My aim is to research and share what I find. If I’m wrong I want to know. I’m not interested in asserting bogus information or conclusions. I got my fill of that from Watchtower and want nothing to do with the practice.

Furthermore, I agree with sentiments of many here who find fault with spectacular assertions that cannot be supported. Spectacular claims must have support. Otherwise they have a counterproductive affect. In this case my extrapolation of deaths due to Watchtower’s blood doctrine does have support, and that support is only made stronger given the conservative approach. Those who disagree are free to say so, and have done so. What’s important is what we can support.

Any questions?

Marvin Shilmer

739

250,000 Jehovah's Witnesses have died refusing blood

by nicolaou in

80+ branch davidian cult members died in waco, texas.

250,000+ #jehovahswitnesses have died refusing blood.

stop this #cult!

Marvin Shilmer

-

“That is what makes me uncomfortable, it's hard to believe the US rates of Anemia are that much different than NZ, so again, are the numbers from the study useful in determining mortality in the US?”

LisaRose,

I have no reason to think mortality statistics related to severe anemia is much different between the United States and New Zealand, and you have not provided anything suggesting this.

You offered some numbers from the CDC. I asked for bibliographic information to consult these numbers to see if they can be directly compared with the statistics we’ve been discussing from the New Zealand study. You didn’t offer it so I could make no analysis.

I did look up the CDC records for year 2010 for deaths attributed to anemia. Those statistics are not based on the same criterion used in the New Zealand study. Hence we cannot responsibly compare one with the other.

The numbers we find in the New Zealand study are useful against populations in the United States assuming JWs in the United States accept or refuse blood transfusion at a rate similar to JWs in New Zealand.

Marvin Shilmer

739

250,000 Jehovah's Witnesses have died refusing blood

by nicolaou in

80+ branch davidian cult members died in waco, texas.

250,000+ #jehovahswitnesses have died refusing blood.

stop this #cult!

Marvin Shilmer

-

“LISA You say you are not asumming anything, but there you go. What if there were patients in the other hospitals that refused blood, but didn't die at the same rate? What if they didn't die by a higher ratio than the ones selected in the study? The purpose of the study was to get cost/benefit ratios, not determine mortality rates, so it may not be big enough to do that. I think that is what is making every one suspicious. Of course, I am not a statistician, so it's hard for me to say.”

LisaRose,

In the Beliaev study we have hard numbers from 4 large facilities and there is a mix of trauma services (advanced, district and basic).

From this mix of trauma centers we have over 3,000 patient records to populate the control group.

It’s hard to believe this is not representative of minimal mortality among JWs with severe anemia refusing blood.

Both groups had the same facilities and characteristics, with the sole exception that of refusing blood. We would not expect the comparative mortality statistics at other New Zealand facilities to be different than these because within each institution the healthcare capacity is equal for both those who accept and those who reject blood. If anything the institutional rate of mortality would worsen at lesser equipped hospitals among patients refusing blood because though most would have an ability to transfusion blood equal to larger facilities most would not have an ability to equally offer more exotic responses to anemia needed for patients who refuse blood transfusion.

Marvin Shilmer

739

250,000 Jehovah's Witnesses have died refusing blood

by nicolaou in

80+ branch davidian cult members died in waco, texas.

250,000+ #jehovahswitnesses have died refusing blood.

stop this #cult!

Marvin Shilmer

-

“In other words, a combination of lifting the ban on some prior treatment methodologies, as well as advancements in medical science, seems to be working.”

The study conducted by Beliaev was mostly of years since “lifting the ban on some prior treatment methodologies” hence to apply the resulting ratio of deaths per capita to historical numbers of JWs (prior to lifting the ban on some prior treatment methodologies) is to keep the extrapolation conservative.

Marvin Shilmer

739

250,000 Jehovah's Witnesses have died refusing blood

by nicolaou in

80+ branch davidian cult members died in waco, texas.

250,000+ #jehovahswitnesses have died refusing blood.

stop this #cult!

Marvin Shilmer

-

“Obvious guy asks an obvious question (and sorry if this has been asked before and answered, i.e. not ignored), but aren't your calculations used for extrapolation Worldwide assuming that ALL JWs with severe anemia will refuse blood transfusion?”

No.

My extrapolation assumes JWs in the rest of the world refuse or accept blood transfusion as frequently or infrequently as do JWs in New Zealand.

We know all JWs do not refuse blood transfusion. But this is beside the point when it comes to learning a ratio of deaths per capita based on Beliaev’s data set. To determine a minimum amount of deaths due to refusing blood we need only assume Beliaev’s data set represents all deaths of JWs in the 2 regions of New Zealand from which his data set was extracted.

Once we have a minimum amount of deaths we need only compare that number with the number of JWs in the same region. Then we have a ratio of deaths against a known number of JWs.

Marvin Shilmer

739

250,000 Jehovah's Witnesses have died refusing blood

by nicolaou in

80+ branch davidian cult members died in waco, texas.

250,000+ #jehovahswitnesses have died refusing blood.

stop this #cult!

Marvin Shilmer

-

“I think, it might have been done to eliminate researchers' bias. By using random selection, reseachers would claim that every segregaed subject in that group had a chance to be selected without bias.”

Scott77,

That’s correct. Once the authors had identified all patient records of treating severe anemia, and once they’d segregated for the issue of study (red cell transfusion treatment or not) then in order to achieve a matched comparison they had no choice but to segregate the red cell transfusion group into subsets to match characteristics of the control group (the JWs) and then randomly select on this basis. But the last step to achieving the 1-to-1 ratio with the control group had to be randomized in order to reduce bias and otherwise satisfy statistical rigor.

Marvin Shilmer

739

250,000 Jehovah's Witnesses have died refusing blood

by nicolaou in

80+ branch davidian cult members died in waco, texas.

250,000+ #jehovahswitnesses have died refusing blood.

stop this #cult!

Marvin Shilmer

-

“Why would they 'randomly' select patients from the segregated groups?”

Simon,

To achieve a 1-to-1 ratio for a matched comparison study.

“If they were dealing with such low numbers why not include them all?”

They included all they could and have and maintain a matched comparison.

“All this does is increase the chance that if you repeated the study you'd get very different results.”

Not at all for purposes of gaining a ratio of deaths per capita of JWs in New Zealand. Death’s per capita means only how many deaths for how many in a given population.

In this case the study by Beliaev established a minimum value (number) of deaths among JWs for refusing blood during years 1998 to 2007.

We have published statistics of JWs for New Zealand over the same period hence calculating the ratio of deaths due to refusing blood becomes simple arithmetic.

The sole liberty I took in my presentation was to prorate the number of deaths based on population distribution compared with the sources Beliaev got his data.

For purposes of learning the number of JWs who died for refusing blood during years 1998-2007 it would not matter whether Beliaev cherry-picked his comparison group because this would not change the number of deaths in the JW group for refusing blood, and it’s the number of deaths in the JW group used in my extrapolation.

Marvin Shilmer

739

250,000 Jehovah's Witnesses have died refusing blood

by nicolaou in

80+ branch davidian cult members died in waco, texas.

250,000+ #jehovahswitnesses have died refusing blood.

stop this #cult!

Marvin Shilmer

-

“I am sorry, but this is still confusing to me. That mortality percentage above is from the patients who died in the study, against the general population in that part of the country. But didn't you say there were other hospitals in that part of the country? If there are eighty hospitals, there must be more than four in the part of the country that has 57% of the population. So then might not the other hospitals have anemia deaths too?”

LisaRose,

There are loads of hospitals in the same 2 regions as the 4 whose patient records are part of this study. We’d be naïve to think none of these other hospitals in the same 2 regions had JW patients with severe anemia refusing blood who died as a result. But to keep my extrapolation conservative, for statistical purposes I assumed no such deaths at any of these many other facilities in the 2 regions.

When I was constructing the per capita deaths of JWs in New Zealand due to refusing blood I assumed the only deaths in the 2 regions were the ones reported by Beliaev.

Does that answer your question?

Oh, and by the way, I’m still not sure what your earlier statistic speaks to in terms of “severe anemia” but I did find the CDC report for deaths attributed to anemia in the United States and for year 2010 the adjusted number is 4,631 of a population of 308,745,538. This represents an annual mortality of 0.0014999%, which, based on the proration I used in my presentation is more than the annual mortality among New Zealanders by a factor of 170x. This makes my extrapolation conservative by comparison.

Marvin Shilmer