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HalfMooner
Dingaling

Philippines
15831 Posts

Posted - 10/12/2006 :  16:48:22   [Permalink]  Show Profile Send HalfMooner a Private Message
The figure of a half million or so Iraqis dying in the conflict is extraordinary to me, and so requires extraordinary evidence. If that evidence is sound, though, I'll believe it. I can't say I'm quite convinced yet, as I've not yet seen real evidence that my speculations have been discounted thoroughly by the sampling and interview methodology. I think my speculations were fair, in suggesting ways that the study might have been flawed.

The sampling and interview part of this study is what I question. With the best of scientific processing after that, errors or bias at the initial stage would only be amplified in the final result. I'd like to know what actual percentage of the reported deaths were backed up by death certificates, for instance, and how these were verified.

Edited to add: Sorry, Mab. I missed that you gave the 92% figure for death certificates. That, if true, would be strong evidence.


Biology is just physics that has begun to smell bad.” —HalfMooner
Here's a link to Moonscape News, and one to its Archive.
Edited by - HalfMooner on 10/12/2006 16:50:49
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marfknox
SFN Die Hard

USA
3739 Posts

Posted - 10/12/2006 :  17:54:29   [Permalink]  Show Profile  Visit marfknox's Homepage  Send marfknox an AOL message Send marfknox a Private Message
quote:
The figure of a half million or so Iraqis dying in the conflict is extraordinary to me, and so requires extraordinary evidence.
Spoken like any good skeptic. However, given that this is the first estimate done through a scientific method, why is it extradordinary? I know it is a far cry from the other estimates, but it was clearly reached by a much more reliable method than any previous estimate.

And are the death certificates and credentials of the people who conducted the study not evidence enough?

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Edited by - marfknox on 10/12/2006 17:54:56
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HalfMooner
Dingaling

Philippines
15831 Posts

Posted - 10/12/2006 :  18:59:42   [Permalink]  Show Profile Send HalfMooner a Private Message
quote:
Originally posted by marfknox

quote:
The figure of a half million or so Iraqis dying in the conflict is extraordinary to me, and so requires extraordinary evidence.
Spoken like any good skeptic. However, given that this is the first estimate done through a scientific method, why is it extradordinary? I know it is a far cry from the other estimates, but it was clearly reached by a much more reliable method than any previous estimate.

And are the death certificates and credentials of the people who conducted the study not evidence enough?

The reason the results of this study seem "extraordinary" to me is that the numbers are more than ten times that compiled by the anti-war group, Iraq Body Count. That in itself does not make the results incorrect, only extraordinary.

I am not sure who it was who saw those death certificates, and verified that they were death certificates in Arabic, and not bicycle registration certificates. Are copies on record?

Also, what "credentials"? According to the study's "appendix" document that I linked to above, the Iraqi doctors taking part in the survey are anonymous, for the stated (and very good) reason that this was to protect their lives. The curriculum vitae of anonymous physicians are unlikely to be available. I agree that they would need this protection, but I cannot see how anyone can come back to them and ask them questions about the conduct of the survey.

Did the anonymous doctors act as translators for the survey teams? Were these doctors introduced to one another prior to the survey? Did one doctor recommend others to be part of the survey? Could they have met, and made plans, separately from the Americans conducting the survey? What exactly was the little speech that was given to overcome suspicion?

These are not trivial questions, as they relate to matters that could wildly skew the survey results. I don't know the answers. Perhaps someone can find the answers to them.

If any of these questions can't be answered, even for good reasons such as the security of the Iraqi doctors, then one vital link in the study's chain cannot be proven to be accurate, and the results cannot be considered accurate. On the other hand, when and if I see the extraordinary evidence, I will accept it. Until then, I remain unconvinced.


Biology is just physics that has begun to smell bad.” —HalfMooner
Here's a link to Moonscape News, and one to its Archive.
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Dr. Mabuse
Septic Fiend

Sweden
9666 Posts

Posted - 10/12/2006 :  20:26:05   [Permalink]  Show Profile  Send Dr. Mabuse an ICQ Message Send Dr. Mabuse a Private Message
quote:
Originally posted by HalfMooner
I am not sure who it was who saw those death certificates, and verified that they were death certificates in Arabic, and not bicycle registration certificates. Are copies on record?
The interviews were conducted by doctors fluent in both Arabic and English, and they had training in how to conduct the interview and how to handle the questionaire.
They also collected copies of the death certificates.

Please do read the report in Dude's link. It's very informative. I just scanned it for the verification that death certificates were used as documentation.


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Dude
SFN Die Hard

USA
6891 Posts

Posted - 10/12/2006 :  20:49:58   [Permalink]  Show Profile Send Dude a Private Message
half said:
quote:
but I cannot see how anyone can come back to them and ask them questions about the conduct of the survey.



Well, the US and British researchers of MIT and Johns Hopkins who conducted the study should have their references freely available.

Here's those links again:
http://web.mit.edu/cis/

http://web.mit.edu/cis/pdf/Human_Cost_of_War.pdf


Ignorance is preferable to error; and he is less remote from the truth who believes nothing, than he who believes what is wrong.
-- Thomas Jefferson

"god :: the last refuge of a man with no answers and no argument." - G. Carlin

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Dude
SFN Die Hard

USA
6891 Posts

Posted - 10/12/2006 :  23:57:50   [Permalink]  Show Profile Send Dude a Private Message
halfmooner asked: (hehe typed in, at first, "half asked:")

quote:
Did the anonymous doctors act as translators for the survey teams? Were these doctors introduced to one another prior to the survey? Did one doctor recommend others to be part of the survey? Could they have met, and made plans, separately from the Americans conducting the survey?


The survey teams were composed (each team) of 2 male and 2 female Iraqi doctors, all fluent in English. They probably did know each other prior to this survey, since they are all from the same hospital/university in Baghdad. They conducted the survey, as it is entirely unsafe for westerners to be wandering around Iraq. The Johns Hopkins researchers planned the survey.

Basically what you are implying could have happened is that all the doctors that comprised the survey teams wanted to fake the result, were capable of consistently faking the results for the entire survey length and fake it so well that Johns Hopkins and MIT statisticians and researchers and peer review at the Lancet wouldn't notice.

For the moment, as much as I don't want to, I have to consider the results reliable and accurate.


Ignorance is preferable to error; and he is less remote from the truth who believes nothing, than he who believes what is wrong.
-- Thomas Jefferson

"god :: the last refuge of a man with no answers and no argument." - G. Carlin

Hope, n.
The handmaiden of desperation; the opiate of despair; the illegible signpost on the road to perdition. ~~ da filth
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HalfMooner
Dingaling

Philippines
15831 Posts

Posted - 10/13/2006 :  00:33:57   [Permalink]  Show Profile Send HalfMooner a Private Message
Dude wrote, in part:
quote:
Basically what you are implying could have happened is that all the doctors that comprised the survey teams wanted to fake the result, were capable of consistently faking the results for the entire survey length and fake it so well that Johns Hopkins and MIT statisticians and researchers and peer review at the Lancet wouldn't notice.
Yup, that about sums up my thoughts.

A group of Iraqi physicians working together in the field, unsupervised there by the Johns Hopkins/MIT folks, could indeed easily fake their data. Almost any sane Iraqi would be biased against the American invaders.

They might not have even risked their lives by going into the field. And how would the American statisticians know the data was faked? What possible reality checks did they, or could they, perform on the data? I am generously assuming nobody noticed the numbers they were crunching were coming out more than ten times larger than even anti-war groups had estimated.

And who might be in a better position to create fake death certificates than a group of doctors?

Now, I'm even more strongly suspicious of the survey. Fake data in, fake data out. Easy-peasy.



Biology is just physics that has begun to smell bad.” —HalfMooner
Here's a link to Moonscape News, and one to its Archive.
Edited by - HalfMooner on 10/13/2006 00:36:41
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filthy
SFN Die Hard

USA
14408 Posts

Posted - 10/13/2006 :  03:35:52   [Permalink]  Show Profile Send filthy a Private Message
Yeah, but are those data faked....? For the life of me, I can't see what reason The Lancet, a highly respected journal,would have to publish any false conclusions. If it had come from any of our popular media, such as Fox, I'd dismiss it for another pile of crap without a second thought. But The Lancet...?

I'm not entirely convinved yet, but the more I read, the closer I get. Here's something of a run-down on it.

They're finding sixty and seventy bodies at a clip so often that it's no longer news. Homebrewed explosive rig-ups are taking out multiple Iraqis almost every day. Indeed, here in my chair, far from the madness that is currently Iraq, I find it hard to get my mind around it.

As I said before, that's a lot of carnage, an extraordinary amount of carnage, but the number is certainly possible.




"What luck for rulers that men do not think." -- Adolf Hitler (1889 - 1945)

"If only we could impeach on the basis of criminal stupidity, 90% of the Rethuglicans and half of the Democrats would be thrown out of office." ~~ P.Z. Myres


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HalfMooner
Dingaling

Philippines
15831 Posts

Posted - 10/13/2006 :  06:18:20   [Permalink]  Show Profile Send HalfMooner a Private Message
quote:
Originally posted by filthy

Yeah, but are those data faked....? For the life of me, I can't see what reason The Lancet, a highly respected journal,would have to publish any false conclusions. If it had come from any of our popular media, such as Fox, I'd dismiss it for another pile of crap without a second thought. But The Lancet...?

I'm not entirely convinved yet, but the more I read, the closer I get. Here's something of a run-down on it.

They're finding sixty and seventy bodies at a clip so often that it's no longer news. Homebrewed explosive rig-ups are taking out multiple Iraqis almost every day. Indeed, here in my chair, far from the madness that is currently Iraq, I find it hard to get my mind around it.

As I said before, that's a lot of carnage, an extraordinary amount of carnage, but the number is certainly possible.





Yes, the results are possible, but they are also extraordinarily large. I think the present real numbers, which I suspect are nearer to 50,000, are horribly, criminally high. And certainly if given enough time, the real numbers of war deaths will match those projections -- regardless of whether we stay or leave Iraq. (But if the US left tomorrow, further deaths could be counted as "Iraq Civil War deaths," not "US Invasion and Occupation of Iraq deaths.")

I think both the Johns Hopkins/MIT people and The Lancet journal were probably doing credible work. I believe those conducting the non-data-gathering part of the survey were honest and thought the raw input data was valid. Honest, scientific people processing false data can do so with the best statistical analyses, and yet still get false results.

The data all apparently came from a fairly tight-knit group of Iraqi doctors. Note that those doctors weren't risking their reputations by being caught lying -- they had already been promised anonymity! Nor would any of them worry about criminal prosecution. First, they are anonymous, and second, providing false data for a survey of this sort is probably not a crime under Iraq's laws.

But let's pretend, for the sake of argument, that providing false data were criminal, and look at the doctors as though we were criminal prosecutors.

Means: As physicians, they already had knowledge of how scientific studies were conducted, and certainly knew how someone might skew such studies by falsifying data. They could presumably sign death certificates themselves, or get other colleagues to do it for them.

Motive: To sway world and American opinion to get the invaders out of Iraq. (A powerful, even commendable, motivation, in and of itself!)

Opportunity: A group of doctors who already knew one another were supposed to go into the field and interview Iraqis. They in fact brought back a limited amount of data and documents which, when statistically extrapolated, was magnified into a huge estimate of Iraqi deaths due to the US invasion and occupation.

In my mind, this all adds up to a vast, echoic room for doubt.


Biology is just physics that has begun to smell bad.” —HalfMooner
Here's a link to Moonscape News, and one to its Archive.
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filthy
SFN Die Hard

USA
14408 Posts

Posted - 10/13/2006 :  06:45:02   [Permalink]  Show Profile Send filthy a Private Message
Agree that there's room for doubt, but I think the actual number is much higher than 50G and have well before this study came along. I'm not quite ready to accept 600G+, but at this point, I wouldn't be all that astonished.

What we hear and see in the news is, I 'm sure, only a portion of the actual deaths throughout the country. We really have no way of knowing beyond what is passed along to us by for-profit organizations with their own agendas, and whose trustworthyness has been often demonstrated to be dubious, at best.

In any event, more will eventually come to light and the matter will be settled at not all. The polititions and blithering heads already have hold of it, and it will soon be spinning like a dervish on some really good shit.




"What luck for rulers that men do not think." -- Adolf Hitler (1889 - 1945)

"If only we could impeach on the basis of criminal stupidity, 90% of the Rethuglicans and half of the Democrats would be thrown out of office." ~~ P.Z. Myres


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Dude
SFN Die Hard

USA
6891 Posts

Posted - 10/13/2006 :  08:03:55   [Permalink]  Show Profile Send Dude a Private Message
From appendix C of the report:
quote:
The figure below shows trend lines from three different accounts—our mortality survey, Iraq Body count,
and the Department of Defense report. Although the numbers we estimate through population-based
methods are substantially greater than the numbers of deaths counted by the other two, the figure shows
that over time the trends are almost identical. This is clear evidence that the three studies have measured
the same events, and further reinforces the results of the population based data. This difference in
numbers but similarity in trends is typical of the differences between active and passive public health
surveillance seen in many conditions.


I find the idea that the Iraqi survey teams could fake the data so well that it exactly matched the specific trends noted in two other accounts cited to be a stretch, putting it mildly.

I also find the idea that statisticians at MIT and Johns Hopkins who created the survey and are publishing it, and the peer review at the Lancet, could be so easily fooled by faked data to be unrealistic... unless you are also suggesting that they were in on it?

The report is only 25 pages long, shouldn't take more than a couple minutes to read through.


Ignorance is preferable to error; and he is less remote from the truth who believes nothing, than he who believes what is wrong.
-- Thomas Jefferson

"god :: the last refuge of a man with no answers and no argument." - G. Carlin

Hope, n.
The handmaiden of desperation; the opiate of despair; the illegible signpost on the road to perdition. ~~ da filth
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Dave W.
Info Junkie

USA
25973 Posts

Posted - 10/13/2006 :  20:52:32   [Permalink]  Show Profile  Visit Dave W.'s Homepage Send Dave W. a Private Message
If I were one of the people publishing this sort of paper, I would have included some statistical tests to ensure that the original, raw data weren't "too" random or "too" perfect. You know, you predict what the data would be in a scientific utopia where there exists the mythical 4/10ths of a person, and then check to see how well the raw data matches up. In a survey of less than 2,000 households, extrapolating to over half-a-million deaths, the raw data shouldn't match the predictions too well. Do some simulations with random-but-reasonable answers, and be able to say "we are 95% confident that this data has not been tampered with. (Or at least, if it has been faked, it's been done with such expertise that there's no way to tell it from real data.)"

Having not read the report yet, did the authors check the data in this sort of way? And I'm not saying that if they didn't, the numbers should be dismissed. I'm just pointing out that there are ways to detect some sorts of statistical fraud. And you know, even defense lawyers don't get to pull the "maybe the evidence has been tampered with" card all that often - usually, they have to present reasonable evidence of their own that the evidence is fraudulent before a judge will entertain such notions.

I also have little doubt that this study is going to receive much competent, professional criticism over the coming months. There's little cause for speculation now.

- Dave W. (Private Msg, EMail)
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beskeptigal
SFN Die Hard

USA
3834 Posts

Posted - 10/15/2006 :  14:11:59   [Permalink]  Show Profile Send beskeptigal a Private Message
Here are some relevant excerpts from the paper regarding validity of the conclusions.
quote:

Pre-invasion mortality rates were 5·5 per 1000 people per year (95% CI 4·3–7·1), compared with 13·3 per 1000 people per year (10·9–16·1) in the 40 months post-invasion. We estimate that as of July, 2006, there have been 654#8200;965 (392#8200;979–942#8200;636) excess Iraqi deaths as a consequence of the war, which corresponds to 2·5% of the population in the study area. Of post-invasion deaths, 601#8200;027 (426#8200;369–793#8200;663) were due to violence, the most common cause being gunfire.
Interpretation

The number of people dying in Iraq has continued to escalate. The proportion of deaths ascribed to coalition forces has diminished in 2006, although the actual numbers have increased every year. Gunfire remains the most common cause of death, although deaths from car bombing have increased.


Aside from violence, insufficient water supplies, non-functional sewerage, and restricted electricity supply also create health hazards.9,10 A deteriorating health service with insecure access, and the flight of health professionals adds further risks. People displaced by the on-going sectarian violence add to the number of vulnerable individuals. In many conflicts, these indirect causes have accounted for most civilian deaths.11,12


A sample size of 12#8200;000 was calculated to be adequate to identify a doubling of an estimated pre-invasion crude mortality rate of 5·0 per 1000 people per year with 95% confidence and a power of 80%, and was chosen to balance the need for robust data with the level of risk acceptable to field teams. Sampling followed the same approach used in 2004,8 except that selection of survey sites was by random numbers applied to streets or blocks rather than with global positioning units (GPS), since surveyors felt that being seen with a GPS unit could put their lives at risk. The use of GPS units might be seen as targeting an area for air strikes, or that the unit was in reality a remote detonation control. By confining the survey to a cluster of houses close to one another it was felt the benign purpose of the survey would spread quickly by word of mouth among households, thus lessening risk to interviewers.


The SE for mortality rates were calculated with robust variance estimation that took into account the correlation between rates of death within the same cluster over time.14 The log-linear regression model assumed that the variation in mortality rates across clusters is proportional to the average mortality rate; to assess the effect of this assumption we also obtained non-parametric CIs by use of bootstrapping.13,15 As an additional sensitivity analysis, we assessed the effect of differences across clusters by extending models to allow the baseline mortality rate to vary by cluster. We estimated the numbers of excess deaths (attributable rates) by subtraction of the predicted values for the pre-war mortality rates from the post-war mortality rates in the three post-invasion periods.


Our estimate of the pre-invasion crude or all-cause mortality rate is in close agreement with other sources.18,19 The post-invasion crude mortality rate increased significantly from pre-invasion figures, and showed a rising trend. The increasing number of violent deaths follows trends of bodies counted by mortuaries, as well as those reported in the media and by the Iraq Body Count.1,5,20

Application of the mortality rates reported here to the period of the 2004 survey8 gives an estimate of 112#8200;000 (69#8200;000–155#8200;000) excess deaths in Iraq in that period. Thus, the data presented here validates our 2004 study, which conservatively estimated an excess mortality of nearly 100#8200;000 as of September, 2004.

Our estimate of excess deaths is far higher than those reported in Iraq through passive surveillance measures.1,5 This discrepancy is not unexpected. Data from passive surveillance are rarely complete, even in stable circumstances, and are even less complete during conflict, when access is restricted and fatal events could be intentionally hidden. Aside from Bosnia,21 we can find no conflict situation where passive surveillance recorded more than 20% of the deaths measured by population-based methods. In several outbreaks, disease and death recorded by facility-based methods underestimated events by a factor of ten or more when compared with population-based estimates.11,22–25


All surveys have potential for error and bias. The extreme insecurity during this survey could have introduced bias by restricting the size of teams, the number of supervisors, and the length of time that could be prudently spent in all locations, which in turn affected the size and nature of questionnaires. Further, calling back to households not available on the initial visit was felt to be too dangerous. Families, especially in households with combatants killed, could have hidden deaths. Under-reporting of infant deaths is a wide-spread concern in surveys of this type.29,30 Entire households could have been killed, leading to a survivor bias.


Large-scale migration out of Iraq could affect our death estimates by decreasing population size. Out-migration could introduce inaccuracies if such a process took place predominantly in households with either high or low violent death history.


In the Vietnam war, 3 million civilians died; in the Democratic Republic of the Congo, conflict has been responsible for 3·8 million deaths; and an estimated 200#8200;000 of a total population of 800#8200;000 died in conflict in East Timor.33–35 Recent estimates are that 200#8200;000 people have died in Darfur over the past 31 months.36 We estimate that almost 655#8200;000 people—2·5% of the population in the study area—have died in Iraq.


13. McCullagh P, Nelder J. Generalized linear models. London: Chapman and Hall, 1989:.

14. Diggle PJ, Heagerty P, Liang KY, Zeger SL. The analysis of longitudinal data. Oxford: Oxford University Press, 2002:.

15. Efron B. Bootstrap methods: another look at the jackknife. Ann Stat 1979; 7: 1-26.


I included the references validating methodology that Dave was questioning. Other measures of validation are in the paragraphs above such as comparing this data to the previous data, the trend compared to trends in The Iraq Body Count, variation between collected data from different locations and so on.

It's free to register at the Lancet and access the study directly.

Other notes of interest from the report:

50,000 or so excess deaths were not from violence but from lack of infrastructure such as access to hospital care.

The number of deaths from coalition forces is decreasing but the rate of violent deaths was increasing.

~60% of the deaths were from gunshot.

Welcome to the new murder capital of the world.
Edited by - beskeptigal on 10/15/2006 14:15:44
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Ghost_Skeptic
SFN Regular

Canada
510 Posts

Posted - 10/15/2006 :  22:31:53   [Permalink]  Show Profile Send Ghost_Skeptic a Private Message
Did this survey cover the the Kurdish north? The survey may have been geographically biased towards areas where there has been a much greater breakdown of social order after the invasion.

Unfortunately I don't think it will make much difference whether the real total is 60,000 or 600,000. Those who still support the war won't care since the deaths aren't Americans. For those opposed to the invasion and those who feel that it was criminally bungled, 60,000 enough boot thse responsible out of office and in an ideal world send them to prison.

"You can lead a horse to water but you can't make him drink. / You can send a kid to college but you can't make him think." - B.B. King

History is made by stupid people - The Arrogant Worms

"The greater the ignorance the greater the dogmatism." - William Osler

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filthy
SFN Die Hard

USA
14408 Posts

Posted - 10/16/2006 :  03:48:07   [Permalink]  Show Profile Send filthy a Private Message
quote:
Originally posted by Ghost_Skeptic

Did this survey cover the the Kurdish north? The survey may have been geographically biased towards areas where there has been a much greater breakdown of social order after the invasion.

Unfortunately I don't think it will make much difference whether the real total is 60,000 or 600,000. Those who still support the war won't care since the deaths aren't Americans. For those opposed to the invasion and those who feel that it was criminally bungled, 60,000 enough boot thse responsible out of office and in an ideal world send them to prison.





"What luck for rulers that men do not think." -- Adolf Hitler (1889 - 1945)

"If only we could impeach on the basis of criminal stupidity, 90% of the Rethuglicans and half of the Democrats would be thrown out of office." ~~ P.Z. Myres


"The default position of human nature is to punch the other guy in the face and take his stuff." ~~ Dude

Brother Boot Knife of Warm Humanitarianism,

and Crypto-Communist!

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