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Statistical poser (aka fact checking is hard)

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Robert Holmes-3

Statistical poser (aka fact checking is hard)

Early this week I came across a recent press release from NM Dept of Health: "Governor Martinez Announces Continued Improvement in Drug Overdose Death Rankings". I've been tinkering round with opioid statistics, so thought it might be worth fact checking the release. The results were… interesting. If nothing else they've shown me how difficult it must be to communicate public health statistics.

So here are some of the key figures from the release:

New Mexico’s national ranking has improved from the second highest death drug overdose death rate in the United States in 2014 to 17th highest in 2017
New Mexico previously reported a 4 percent decline in death rates in 2017 due to overdose of commonly prescribed opioids such as oxycodone compared to 2016. In addition, deaths due to heroin decreased by 9 percent and deaths due to synthetic opioids such as fentanyl decreased by 6 percent over the same time period.

The first of these claims passed my sniff test: I know NM's ranking has been improving, even though individual counties rank the wort in the nation. And sure enough, if you pull the underlying CDC data you can confirm these exact numbers (ignoring DC).

The second claim is the one that gave me pause. Those reductions in individual opioids look kinda high. Yes, NM's ranking is improving but it's because our rate is essentially stable while other states rocket past. And when I check the above CDC data, yes the reduction in death rate appears to be about 2%

So there's the poser: if NM's reduction in opioid deaths (2016-2017) is 2%, how can this be consistent with individual opioid reductions of 9% (heroin), 4% (natural & semi synthetic, inc. oxycodone), and 6% (synthetic, inc. fentanyl)?

—Robert

P.S. I'll post my best guess later. Oh, and it's not that they omitted methadone: deaths due to that are down 19% in the same period.

============================================================
FRIAM Applied Complexity Group listserv
Meets Fridays 9a-11:30 at cafe at St. John's College
to unsubscribe http://redfish.com/mailman/listinfo/friam_redfish.com
archives back to 2003: http://friam.471366.n2.nabble.com/
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Brent Auble

Re: Statistical poser (aka fact checking is hard)

I can come up with a couple of possibilities. First, that some of the opioid deaths are counted in other causes of death to get to the 2% number. The second, is that there is another category of opioids beyond the "heroin", "natural & semi synthetic, inc. oxycodone", "synthetic, inc. fentanyl", and "methadone" buckets, where the decrease was less than 2% (i.e. an increase or a decrease between 0 and 2% but a high n).

Brent

From: Robert Holmes <[hidden email]>
To: The Friday Morning Applied Complexity Coffee Group <[hidden email]>
Sent: Wednesday, January 2, 2019 12:16 PM
Subject: [FRIAM] Statistical poser (aka fact checking is hard)

So here are some of the key figures from the release:

New Mexico’s national ranking has improved from the second highest death drug overdose death rate in the United States in 2014 to 17th highest in 2017
New Mexico previously reported a 4 percent decline in death rates in 2017 due to overdose of commonly prescribed opioids such as oxycodone compared to 2016. In addition, deaths due to heroin decreased by 9 percent and deaths due to synthetic opioids such as fentanyl decreased by 6 percent over the same time period.

—Robert

P.S. I'll post my best guess later. Oh, and it's not that they omitted methadone: deaths due to that are down 19% in the same period.

Marcus G. Daniels

Re: Statistical poser (aka fact checking is hard)

In reply to this post by Robert Holmes-3

Dumb question: Is there anything behind this besides an burst of legal prescriptions that created a self-reinforcing trend?

Or are people actually going crazy?

From: Friam <[hidden email]> on behalf of Robert Holmes <[hidden email]>
Reply-To: The Friday Morning Applied Complexity Coffee Group <[hidden email]>
Date: Wednesday, January 2, 2019 at 10:16 AM
To: The Friday Morning Applied Complexity Coffee Group <[hidden email]>
Subject: [FRIAM] Statistical poser (aka fact checking is hard)

So here are some of the key figures from the release:

New Mexico’s national ranking has improved from the second highest death drug overdose death rate in the United States in 2014 to 17th highest in 2017
New Mexico previously reported a 4 percent decline in death rates in 2017 due to overdose of commonly prescribed opioids such as oxycodone compared to 2016. In addition, deaths due to heroin decreased by 9 percent and deaths due to synthetic opioids such as fentanyl decreased by 6 percent over the same time period.

—Robert

P.S. I'll post my best guess later. Oh, and it's not that they omitted methadone: deaths due to that are down 19% in the same period.

Marcus G. Daniels

Re: Statistical poser (aka fact checking is hard)

http://theconversation.com/suicide-nation-whats-behind-the-need-to-numb-and-to-seek-a-final-escape-98137

“Americans stand out from people in other countries with respect to their focus on individualism. Americans believe that success is determined by our own control and that it is very important to work hard to get ahead in life. Perhaps it is this focus on our own achievements, successes and work culture that have created an environment that is no longer sustainable – it has become too stressful.”

Apoptosis is the word that comes to mind.

From: Friam <[hidden email]> on behalf of Marcus Daniels <[hidden email]>
Reply-To: The Friday Morning Applied Complexity Coffee Group <[hidden email]>
Date: Wednesday, January 2, 2019 at 10:45 AM
To: The Friday Morning Applied Complexity Coffee Group <[hidden email]>
Subject: Re: [FRIAM] Statistical poser (aka fact checking is hard)

Dumb question: Is there anything behind this besides an burst of legal prescriptions that created a self-reinforcing trend?

Or are people actually going crazy?

So here are some of the key figures from the release:

New Mexico’s national ranking has improved from the second highest death drug overdose death rate in the United States in 2014 to 17th highest in 2017
New Mexico previously reported a 4 percent decline in death rates in 2017 due to overdose of commonly prescribed opioids such as oxycodone compared to 2016. In addition, deaths due to heroin decreased by 9 percent and deaths due to synthetic opioids such as fentanyl decreased by 6 percent over the same time period.

—Robert

P.S. I'll post my best guess later. Oh, and it's not that they omitted methadone: deaths due to that are down 19% in the same period.

Robert Holmes-3

Re: Statistical poser (aka fact checking is hard)

"Dreamland" by Sam Quinones has a good description of the history of our current epidemic. Highly recommended.

Estimates vary by source, but fraction of opioid deaths that are suicide is around 20-30%

On Wed, Jan 2, 2019 at 11:01 AM Marcus Daniels <[hidden email]> wrote:

http://theconversation.com/suicide-nation-whats-behind-the-need-to-numb-and-to-seek-a-final-escape-98137

“Americans stand out from people in other countries with respect to their focus on individualism. Americans believe that success is determined by our own control and that it is very important to work hard to get ahead in life. Perhaps it is this focus on our own achievements, successes and work culture that have created an environment that is no longer sustainable – it has become too stressful.”

Apoptosis is the word that comes to mind.

From: Friam <[hidden email]> on behalf of Marcus Daniels <[hidden email]>
Reply-To: The Friday Morning Applied Complexity Coffee Group <[hidden email]>
Date: Wednesday, January 2, 2019 at 10:45 AM
To: The Friday Morning Applied Complexity Coffee Group <[hidden email]>
Subject: Re: [FRIAM] Statistical poser (aka fact checking is hard)

Dumb question: Is there anything behind this besides an burst of legal prescriptions that created a self-reinforcing trend?

Or are people actually going crazy?

From: Friam <[hidden email]> on behalf of Robert Holmes <[hidden email]>
Reply-To: The Friday Morning Applied Complexity Coffee Group <[hidden email]>
Date: Wednesday, January 2, 2019 at 10:16 AM
To: The Friday Morning Applied Complexity Coffee Group <[hidden email]>
Subject: [FRIAM] Statistical poser (aka fact checking is hard)

Early this week I came across a recent press release from NM Dept of Health: "Governor Martinez Announces Continued Improvement in Drug Overdose Death Rankings". I've been tinkering round with opioid statistics, so thought it might be worth fact checking the release. The results were… interesting. If nothing else they've shown me how difficult it must be to communicate public health statistics.

So here are some of the key figures from the release:

New Mexico’s national ranking has improved from the second highest death drug overdose death rate in the United States in 2014 to 17th highest in 2017
New Mexico previously reported a 4 percent decline in death rates in 2017 due to overdose of commonly prescribed opioids such as oxycodone compared to 2016. In addition, deaths due to heroin decreased by 9 percent and deaths due to synthetic opioids such as fentanyl decreased by 6 percent over the same time period.

The first of these claims passed my sniff test: I know NM's ranking has been improving, even though individual counties rank the wort in the nation. And sure enough, if you pull the underlying CDC data you can confirm these exact numbers (ignoring DC).

The second claim is the one that gave me pause. Those reductions in individual opioids look kinda high. Yes, NM's ranking is improving but it's because our rate is essentially stable while other states rocket past. And when I check the above CDC data, yes the reduction in death rate appears to be about 2%

So there's the poser: if NM's reduction in opioid deaths (2016-2017) is 2%, how can this be consistent with individual opioid reductions of 9% (heroin), 4% (natural & semi synthetic, inc. oxycodone), and 6% (synthetic, inc. fentanyl)?

—Robert

P.S. I'll post my best guess later. Oh, and it's not that they omitted methadone: deaths due to that are down 19% in the same period.

============================================================
FRIAM Applied Complexity Group listserv
Meets Fridays 9a-11:30 at cafe at St. John's College
to unsubscribe http://redfish.com/mailman/listinfo/friam_redfish.com
archives back to 2003: http://friam.471366.n2.nabble.com/
FRIAM-COMIC http://friam-comic.blogspot.com/ by Dr. Strangelove

Marcus G. Daniels

Re: Statistical poser (aka fact checking is hard)

Robert writes:

“Estimates vary by source, but fraction of opioid deaths that are suicide is around 20-30%”

What I’d really like to know is how the fraction of opioid deaths occur with individuals that have no historical sign of mental illness at all, and would be described by their friends and colleagues as effective and engaged prior to their initial prescription. I would expect that mental illness is massively underdiagnosed in this country, and especially in the blue collar mid-west where it is considered a taboo topic and people have not had adequate health insurance to use to diagnose it. I strongly suspect a structural cause of all this is the idea that free will exists, combined with the inevitable evolution of the economy toward more automation. Millions of people, maybe hundreds of millions of people, have what amounts to a mistaken view of the world. Similar arguments apply to the ongoing outbursts of gun homicide (instead of suicide).

Marcus

Nick Thompson

Re: Statistical poser (aka fact checking is hard)

Marcus,

Forgive me if I am entering this party late, but what exactly means “mental illness”

I would expect that mental illness is massively underdiagnosed in this country, and especially in the blue collar mid-west where it is considered a taboo topic and people have not had adequate health insurance to use to diagnose it.

So, is a young person who hears voices, but who integrates those voices into a well-organized and effective life mentally ill? Is the homeless person who prefers to sleep on a subway grate than go into a shelter mentally ill? I had a colleague once who famously checked himself into a mental hospital making a vague claim to hearing voices and then, once on the ward, behaved absolutely as he would have otherwise. His only aberrant behavior was that he constantly took notes. Explaining that he was doing a study of the ward. When, after a few weeks, he got bored of it and tried to check himself out, he could not get out! He had to use his “fail-safe” (the chairman of his department, if I remember) to extract himself. Was he mentally ill?

Is trump mentally Ill? WAS he mentally ill before he became president? Or was he promoted to his level of mental illness. (CF, Peter Principle.) (In a political hierarchy a politician will rise to his level of insanity.) (cf, All the Kings Men, a fabulous novel, by the way). Not clear to me how a libertarian of any stripe can allow the concept of mental illness into a conversation. A mentally ill individual is one whose behavior is so annoying that other individuals are willing to cooperate to put him away?

Nick

Nicholas S. Thompson

Emeritus Professor of Psychology and Biology

Clark University

http://home.earthlink.net/~nickthompson/naturaldesigns/

From: Friam [mailto:[hidden email]] On Behalf Of Marcus Daniels
Sent: Wednesday, January 02, 2019 11:44 AM
To: The Friday Morning Applied Complexity Coffee Group <[hidden email]>
Subject: Re: [FRIAM] Statistical poser (aka fact checking is hard)

Robert writes:

“Estimates vary by source, but fraction of opioid deaths that are suicide is around 20-30%”

Marcus

Marcus G. Daniels

Re: Statistical poser (aka fact checking is hard)

Nick writes:

“A mentally ill individual is one whose behavior is so annoying that other individuals are willing to cooperate to put him away?”

Sure, in that case the “mentally ill individual” may have failed to connect their actions with the consequences. Or maybe they wanted lodging in a psychiatric facility on the family dime -- probably a bad call if your name was Rosemary Kennedy.

Marcus

From: Friam <[hidden email]> on behalf of Nick Thompson <[hidden email]>
Reply-To: The Friday Morning Applied Complexity Coffee Group <[hidden email]>
Date: Wednesday, January 2, 2019 at 12:15 PM
To: 'The Friday Morning Applied Complexity Coffee Group' <[hidden email]>
Subject: Re: [FRIAM] Statistical poser (aka fact checking is hard)

Marcus,

Forgive me if I am entering this party late, but what exactly means “mental illness”

Nick

Nicholas S. Thompson

Emeritus Professor of Psychology and Biology

Clark University

http://home.earthlink.net/~nickthompson/naturaldesigns/

Robert writes:

“Estimates vary by source, but fraction of opioid deaths that are suicide is around 20-30%”

Marcus

Steve Smith

Re: Statistical poser (aka fact checking is hard)

It is to this point that I prefer to think in terms of "neurodiverse" rather than "mentally ill". Your definitions here respond more to my idea of "sociopathy". I don't think of sociopaths as being mentally ill, just not good members of the society they find themselves in. Most *L*ibertarians I know seem to be on the verge of sociopathy as a matter of honor.

There has been a move afoot to recognize the selection value of neurodiversity in a group and to de-stigmatize or de-pathologize what was previously considered dis-ease or dys-function.

https://www.nytimes.com/2015/08/23/books/review/neurotribes-by-steve-silberman.html

On 1/2/19 12:33 PM, Marcus Daniels wrote:

Nick writes:

“A mentally ill individual is one whose behavior is so annoying that other individuals are willing to cooperate to put him away?”

Sure, in that case the “mentally ill individual” may have failed to connect their actions with the consequences. Or maybe they wanted lodging in a psychiatric facility on the family dime -- probably a bad call if your name was Rosemary Kennedy.

Marcus

From: Friam [hidden email] on behalf of Nick Thompson [hidden email]
Reply-To: The Friday Morning Applied Complexity Coffee Group [hidden email]
Date: Wednesday, January 2, 2019 at 12:15 PM
To: 'The Friday Morning Applied Complexity Coffee Group' [hidden email]
Subject: Re: [FRIAM] Statistical poser (aka fact checking is hard)

Marcus,

Forgive me if I am entering this party late, but what exactly means “mental illness”

I would expect that mental illness is massively underdiagnosed in this country, and especially in the blue collar mid-west where it is considered a taboo topic and people have not had adequate health insurance to use to diagnose it.

So, is a young person who hears voices, but who integrates those voices into a well-organized and effective life mentally ill? Is the homeless person who prefers to sleep on a subway grate than go into a shelter mentally ill? I had a colleague once who famously checked himself into a mental hospital making a vague claim to hearing voices and then, once on the ward, behaved absolutely as he would have otherwise. His only aberrant behavior was that he constantly took notes. Explaining that he was doing a study of the ward. When, after a few weeks, he got bored of it and tried to check himself out, he could not get out! He had to use his “fail-safe” (the chairman of his department, if I remember) to extract himself. Was he mentally ill?

Is trump mentally Ill? WAS he mentally ill before he became president? Or was he promoted to his level of mental illness. (CF, Peter Principle.) (In a political hierarchy a politician will rise to his level of insanity.) (cf, All the Kings Men, a fabulous novel, by the way). Not clear to me how a libertarian of any stripe can allow the concept of mental illness into a conversation. A mentally ill individual is one whose behavior is so annoying that other individuals are willing to cooperate to put him away?

Nick

Nicholas S. Thompson

Emeritus Professor of Psychology and Biology

Clark University

http://home.earthlink.net/~nickthompson/naturaldesigns/

From: Friam [[hidden email]] On Behalf Of Marcus Daniels
Sent: Wednesday, January 02, 2019 11:44 AM
To: The Friday Morning Applied Complexity Coffee Group [hidden email]
Subject: Re: [FRIAM] Statistical poser (aka fact checking is hard)

Robert writes:

“Estimates vary by source, but fraction of opioid deaths that are suicide is around 20-30%”

What I’d really like to know is how the fraction of opioid deaths occur with individuals that have no historical sign of mental illness at all, and would be described by their friends and colleagues as effective and engaged prior to their initial prescription. I would expect that mental illness is massively underdiagnosed in this country, and especially in the blue collar mid-west where it is considered a taboo topic and people have not had adequate health insurance to use to diagnose it. I strongly suspect a structural cause of all this is the idea that free will exists, combined with the inevitable evolution of the economy toward more automation. Millions of people, maybe hundreds of millions of people, have what amounts to a mistaken view of the world. Similar arguments apply to the ongoing outbursts of gun homicide (instead of suicide).

Marcus
============================================================
FRIAM Applied Complexity Group listserv
Meets Fridays 9a-11:30 at cafe at St. John's College
to unsubscribe http://redfish.com/mailman/listinfo/friam_redfish.com
archives back to 2003: http://friam.471366.n2.nabble.com/
FRIAM-COMIC http://friam-comic.blogspot.com/ by Dr. Strangelove

Marcus G. Daniels

Re: Statistical poser (aka fact checking is hard)

Depression, bipolar disorder, and OCD are examples of the kind of mental illnesses I had in mind. They make life hard for those that have it. More downsides than upsides. As for sociopathy, for most people, just being too damned irritating will eventually create a cost for them too. Others become the president, at least for a while.

From: Friam <[hidden email]> on behalf of Steven A Smith <[hidden email]>
Reply-To: The Friday Morning Applied Complexity Coffee Group <[hidden email]>
Date: Wednesday, January 2, 2019 at 12:47 PM
To: "[hidden email]" <[hidden email]>
Subject: Re: [FRIAM] Statistical poser (aka fact checking is hard)

There has been a move afoot to recognize the selection value of neurodiversity in a group and to de-stigmatize or de-pathologize what was previously considered dis-ease or dys-function.

https://www.nytimes.com/2015/08/23/books/review/neurotribes-by-steve-silberman.html

On 1/2/19 12:33 PM, Marcus Daniels wrote:

Nick writes:

“A mentally ill individual is one whose behavior is so annoying that other individuals are willing to cooperate to put him away?”

Sure, in that case the “mentally ill individual” may have failed to connect their actions with the consequences. Or maybe they wanted lodging in a psychiatric facility on the family dime -- probably a bad call if your name was Rosemary Kennedy.

Marcus

From: Friam [hidden email] on behalf of Nick Thompson [hidden email]
Reply-To: The Friday Morning Applied Complexity Coffee Group [hidden email]
Date: Wednesday, January 2, 2019 at 12:15 PM
To: 'The Friday Morning Applied Complexity Coffee Group' [hidden email]
Subject: Re: [FRIAM] Statistical poser (aka fact checking is hard)

Marcus,

Forgive me if I am entering this party late, but what exactly means “mental illness”

I would expect that mental illness is massively underdiagnosed in this country, and especially in the blue collar mid-west where it is considered a taboo topic and people have not had adequate health insurance to use to diagnose it.

So, is a young person who hears voices, but who integrates those voices into a well-organized and effective life mentally ill? Is the homeless person who prefers to sleep on a subway grate than go into a shelter mentally ill? I had a colleague once who famously checked himself into a mental hospital making a vague claim to hearing voices and then, once on the ward, behaved absolutely as he would have otherwise. His only aberrant behavior was that he constantly took notes. Explaining that he was doing a study of the ward. When, after a few weeks, he got bored of it and tried to check himself out, he could not get out! He had to use his “fail-safe” (the chairman of his department, if I remember) to extract himself. Was he mentally ill?

Is trump mentally Ill? WAS he mentally ill before he became president? Or was he promoted to his level of mental illness. (CF, Peter Principle.) (In a political hierarchy a politician will rise to his level of insanity.) (cf, All the Kings Men, a fabulous novel, by the way). Not clear to me how a libertarian of any stripe can allow the concept of mental illness into a conversation. A mentally ill individual is one whose behavior is so annoying that other individuals are willing to cooperate to put him away?

Nick

Nicholas S. Thompson

Emeritus Professor of Psychology and Biology

Clark University

http://home.earthlink.net/~nickthompson/naturaldesigns/

From: Friam [[hidden email]] On Behalf Of Marcus Daniels
Sent: Wednesday, January 02, 2019 11:44 AM
To: The Friday Morning Applied Complexity Coffee Group [hidden email]
Subject: Re: [FRIAM] Statistical poser (aka fact checking is hard)

Robert writes:

“Estimates vary by source, but fraction of opioid deaths that are suicide is around 20-30%”

What I’d really like to know is how the fraction of opioid deaths occur with individuals that have no historical sign of mental illness at all, and would be described by their friends and colleagues as effective and engaged prior to their initial prescription. I would expect that mental illness is massively underdiagnosed in this country, and especially in the blue collar mid-west where it is considered a taboo topic and people have not had adequate health insurance to use to diagnose it. I strongly suspect a structural cause of all this is the idea that free will exists, combined with the inevitable evolution of the economy toward more automation. Millions of people, maybe hundreds of millions of people, have what amounts to a mistaken view of the world. Similar arguments apply to the ongoing outbursts of gun homicide (instead of suicide).

Marcus
============================================================
FRIAM Applied Complexity Group listserv
Meets Fridays 9a-11:30 at cafe at St. John's College
to unsubscribe http://redfish.com/mailman/listinfo/friam_redfish.com
archives back to 2003: http://friam.471366.n2.nabble.com/
FRIAM-COMIC http://friam-comic.blogspot.com/ by Dr. Strangelove