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“He's friendly, and doesn't bite....”
Yes. I’ve had many discussion with him. In person he comes across even better!
Marvin Shilmer
Marvin Shilmer
JoinedPosts by Marvin Shilmer
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739
250,000 Jehovah's Witnesses have died refusing blood
by nicolaou in80+ branch davidian cult members died in waco, texas.
250,000+ #jehovahswitnesses have died refusing blood.
stop this #cult!
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Marvin Shilmer
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739
250,000 Jehovah's Witnesses have died refusing blood
by nicolaou in80+ branch davidian cult members died in waco, texas.
250,000+ #jehovahswitnesses have died refusing blood.
stop this #cult!
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Marvin Shilmer
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“So Marvin, you haven't responded the the problems discussed by Isbister in "Apples and Oranges" . I thought I would at least get a comment on why you don't think his criticisms are invalid.”
LisaRose,
I advised readers to get it from the horse’s mouth. Beliaev and his colleagues wrote a response to Isbister and it should speak for itself to anyone who cares to read it.
Marvin Shilmer
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739
250,000 Jehovah's Witnesses have died refusing blood
by nicolaou in80+ branch davidian cult members died in waco, texas.
250,000+ #jehovahswitnesses have died refusing blood.
stop this #cult!
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Marvin Shilmer
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“Marvin, with all due respect, you have thrown in the towel on this one.”
Suraj Khan,
Not necessarily thrown in the towel, but I have tired of participants complaining of lack of responses when the problem is they failed to read the response when they were made. In short, I tire of repeating things to people who don’t want to read and research for themselves.
At the end of the day, my work on the question of how many JWs have died the result of Watchtower’s blood doctrine is the first of its kind with any bases in hard facts. Those facts many not be as extensive as we’d like them to be, and they may not be as readily transposed onto a world scale as we’d like them to be, but they’re there nevertheless, and they’ve never been there before.
This is an aspect of Beliaev’s work I think not a single person here realizes for what it is. If they did, and if they understood things they say they understand, then they’d be seeking ways to make use of the data (regardless of Beliaev's finding on costs etc!) in relation to JWs suffering increased mortality due to refusing blood.
Anemia is the result of a broad spectrum of disorders, and JWs are just as susceptible to these as the rest of the population. Only when it comes to these disorders JWs have an increased risk because they are taught to refuse a therapy known to lower the risk.
In addition to the above, JWs have multiple risks of developing anemia because they refuse blood in response to any and all medical presentations. Hence JWs have the additional risk of developing anemia purely because of a religious doctrine!
For JWs these layers push morbidity and mortality risks through the roof! Has anyone here taken a look at mortality risk for JWs due to due to obstetric hemorrhage? Guess what? Hemorrhage leads to severe anemia, and people die from this whether obstetric or otherwise! Only, before Beliaev’s study we didn't have a broad review of severe anemia combined with blood refusale. We only had, for instance, research on mortality risk increase due to blood refusal combined with severe anemia related to obstetrics. Well, guess what? As it turns out you don’t have to deliver a baby to have increased risk of dying from anemia by refusing blood.
Marvin Shilmer
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739
250,000 Jehovah's Witnesses have died refusing blood
by nicolaou in80+ branch davidian cult members died in waco, texas.
250,000+ #jehovahswitnesses have died refusing blood.
stop this #cult!
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Marvin Shilmer
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“We're getting somewhere by getting you to see that you're making assumptions”
Adam,
Respectfully, it’s blather like that coming from you that led me to ignore nearly all your postings in this discussion. If you took time to read my article you’d see that assumption is presented as part of the extrapolation.
Otherwise, I don’t see anything new from you.
Marvin Shilmer
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739
250,000 Jehovah's Witnesses have died refusing blood
by nicolaou in80+ branch davidian cult members died in waco, texas.
250,000+ #jehovahswitnesses have died refusing blood.
stop this #cult!
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Marvin Shilmer
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“You have done what no other researcher has ever done - and in that regard your methodology is unique:
“Extrapolated from one country - New Zealand - to worldwide estimates, ignoring the variability of health treatment utilization both within countries and between them.”
steve2,
Of course I’ve done what no researcher has done before, and I’ve done it for one reason and one reason only:
The study by Beliaev is the only one known to me that allows any opportunity at all to extrapolate a worldwide statistic on deaths due to Watchtower’s blood doctrine!
I don’t like this any more or less than anyone else, but it’s the only one with a population sufficiently captured that also shares mortality of JWs in that population suffering death due to refusing blood. Hence my approach to maintain conservative assumptions at every turn in order to avoid making an overstatement.
“The "danger" is your conclusions have the superficial appearance of being well thought through until the reader looks squarely at the assumptions regarding accessibility of health care treatment.”
Readers who do not look squarely at the assumptions stated with the extrapolation have only themselves to blame for reading something into an extrapolation that’s not there. Stating assumptions, whether implicitly or explicitly is done for a purpose. This is what communicates the extrapolation made.
Otherwise you fail to account that the JW patients in the Beliaev group are just as likely to come from an array of socio-economic circumstances as are JWs anywhere else in the world who enter a given healthcare system, only in New Zealand we have a higher tide floating socio-economic boats because of a better than average healthcare system.
Marvin Shilmer
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739
250,000 Jehovah's Witnesses have died refusing blood
by nicolaou in80+ branch davidian cult members died in waco, texas.
250,000+ #jehovahswitnesses have died refusing blood.
stop this #cult!
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Marvin Shilmer
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“I requested a copy of a reply to this study and got it this morning. It is called "Apple and Oranges" by J.P Isbister.”
LisaRose,
I was wondering when someone would finally do at least a small bit of research.
Yes, Isbister wrote a letter to the editor criticizing Beliaev et al’s work and he gave his reasons.
Another well respected researcher named Aryeh Shander wrote his own letter, again criticizing Beliaev’s work.
What I found odd about these two responses was that these two men did not see the same supposed mistakes.
I recommend readers interested in this rather unique work authored by Beliaev and colleagues take time to review the original presentation in whole, and also their response to criticisms leveled by Shander and Isbister. Readers can find this response in the same journal of Vox Sanguinis as the criticisms were offered, the November 2012 journal issue.
Marvin Shilmer
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739
250,000 Jehovah's Witnesses have died refusing blood
by nicolaou in80+ branch davidian cult members died in waco, texas.
250,000+ #jehovahswitnesses have died refusing blood.
stop this #cult!
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Marvin Shilmer
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“So Marvin, as besty mentioned, what is the confidence interval and/or margin of error associated with your estimates?”
slimboyfat,
I have not calculated this and don’t intend to spend time doing it. If it’s important to you, you can spend your time doing it yourself based on what’s made available in my blog article, if you know how.
My work is not to predict how many have died but, rather, to offer a minimum value by using conservative assumptions at every turn.
Marvin Shilmer
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739
250,000 Jehovah's Witnesses have died refusing blood
by nicolaou in80+ branch davidian cult members died in waco, texas.
250,000+ #jehovahswitnesses have died refusing blood.
stop this #cult!
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Marvin Shilmer
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“These assumptions are naive in the extreme. You keep repeating them without an evident awareness of variations in accessibility of health care from country to coutnry.
“There are huge variations in the accessibility of health care not just from country to country but within countries.
“The clinical literature on health care utilization treats these issues as fundamentals - you gloss over them.”
Steve2,
I think you need to take another look at my assumption you complain of.
It is: New Zealand’s healthcare is not less than the rest of the world on average.
Do you seriously think that assumption is questionable as stated?
“The asumption about the frequency (or to use a better term. "the incidence") of JWs wordlwide suffering from severe anemia to JWs in New Zealand is laughably naive. How do you know? For goodness sake, Marvin, right here iwthin New Zealand the incidence of anemia differs widely across socio-economic groups.”
Assumptions are stated for individuals to understand what the estimate represents. When I compare socio-economics prevalent in New Zealand with the rest of the world I find it conservative to think JWs in New Zealand are no more likely to suffer severe anemia than JWs in the rest of the world on average. Particularly when it comes to JWs and severe anemia I see a commonality of refusing blood that should tend to drive a similarity since refusing red cell transfusion when needed increases risk of anemia.
“It is unsafe to make the kinds of extrapolations you have.”
That’s silly. Presenting extrapolations based on a data set combined with stated assumptions is standard issue. it's how extrapolations are presented.
“Yes, New Zealand has 80 hospitals but only 6 or 7 District Health Boardswhich individually govern several hospitals accroding to region and who disseminate information on "sentinel events".”
Point?
“A confidence level of 0.05 means nothing if the extrapolations are in question - as they definitely are in this case.”
P < 0.05 was of Beliaev’s results; not mine. So, point?
Marvin Shilmer
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739
250,000 Jehovah's Witnesses have died refusing blood
by nicolaou in80+ branch davidian cult members died in waco, texas.
250,000+ #jehovahswitnesses have died refusing blood.
stop this #cult!
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Marvin Shilmer
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An Observation
During this discussion it amazes me what little attention is given to substantive issues that impinge estimates of deaths due to Watchtower’s blood doctrine, and particularly due to anemia.
Anemia has many causes. But when it comes to JWs anemia has increased frequency versus the rest of the population for one simple reason: refusal of red cell transfusion.
This creates a vicious cycle. Refusing red cell transfusion puts a patient at greater risk of severe anemia. Severe anemia puts a patient at greater risk of mortality. Refusing red cell transfusion puts a patient with severe anemia at an even greater risk of mortality.
This added risk due to refusal of red cell transfusion represents a cascading event, and it presents a tremendous driver for increased mortality among JWs refusing red cell transfusion. This risk assessment was identified and quantified in the Beliaev study.
Yet among readers here claiming varying expertise in the healthcare field I’ve yet to see even one recognize and discuss this cascading event and how it drives numbers upward.
Marvin Shilmer
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739
250,000 Jehovah's Witnesses have died refusing blood
by nicolaou in80+ branch davidian cult members died in waco, texas.
250,000+ #jehovahswitnesses have died refusing blood.
stop this #cult!
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Marvin Shilmer
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“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