Survey of Sloppy Analysis

It has been said that circumcision is the most common surgery in the United States. It is perhaps also one of the most researched medical procedures. For well over a century, study after study has groped for justification and re-enforcement of a procedure which by and large was never widely practiced by Americans until the introduction of modern medicine in America.

The foreskin has been blamed with scant evidence for a stunning number of diseases and conditions, including "nocturnal emissions," masturbation (when it was bad), syphilis, epilepsy, paralysis, bed wetting (and not the cause as in a common circumcision complication, meatal stenosis), curvature of the spine, "paralysis of the bladder," clubfoot, crossed eyes, blindness, deafness, "dumbness," urinary incontinence, "rectal incontinence," tuberculosis, penile cancer, prostate cancer, STIs of every variety, a great number of cancers affecting many different often unrelated parts of the body, urinary track infection (a rather new foreskin related malady), and now from the rooftops, AIDS. The dubious studies have eventually been discredited while the myth often has lingered to take the foreskins of children without consent.

Science as a human endeavor is, of course, subject to bias and mistake. A recent survey published in the PLoS Medicine Journal in August, 2005, and in last month's Journal of the American Medical Association, found most science studies appeared to be tainted by sloppy analysis.  Although for the most part most studies were not intentionally flawed, flaws appeared to be stunningly common. The author of the survey, Dr. John Ioannidis, an epidemiologist, who studies research methods at the University of Ioannina School of Medicine in Greece and Tufts University in Medford, Massachusetts, concluded after an analysis of 432 published works concerning gender and genes, that almost none of the results held up under closer scrutiny.

In an interview with the Wall Street Journal, Dr. Ioannidis said in part, "Overeager researchers often tinker too much with the statistical variables of their analysis to coax any meaningful insight from their data sets. People are messing around with the data to find anything that seems significant, to show they have found something that is new and unusual." Generally most errors were attributed to one or more of three factors: miscalculation, poor study design, and self-serving data analysis.

Journals typically rely on peer review to root out mistakes before publication, but the large volume of submitted works can frustrate those efforts leading to rushed analysis which increases the possibility of missing problems with submissions.  According to the Wall Street Journal, nearly 12,000 papers were submitted annually to the weekly peer-reviewed journal Science alone. One of the most troubling consequences of mistakes getting published is their propensity to linger long after the results are discredited, even being cited in future works.

Nowhere is this more evident than in circumcision research over the last 100 years. That isn't to say that all such research is wrong all of the time. However, considering the past claims and the need of United States' medical researchers to justify and continue infant circumcision, we must be vigilant about prophylactic claims which are frequently so far down in the noise as to often be worthless.

THANKS to Joe Pellegrino for this contribution.

Comments

[Joe in CA]

"Generally most errors were attributed to one or more of three factors: miscalculation, poor study design, and self-serving data analysis."

A-HAH!

Circumcision practices are largely culturally determined and as a result there are strong beliefs and opinions surrounding its practice. It is important to acknowledge that researchers' personal biases and the dominant circumcision practices of their respective countries may influence their interpretation of findings.

History. The theory that male circumcision may be protective against HIV infection was invented and developed in North America. According to Professor Valiere Alcena, MD, he originated the theory that removing the foreskin can prevent HIV infection in an article1 in August 1986. The late Aaron J. Fink, MD, a noted North American advocate of male circumcision, then promoted Alcena's theory in letters to medical journals. North American Gerald N. Weiss, MD, who operates a website to promote circumcision, and others contributed to the development of the theory through a paper, which was published in Israel (1993), identifying the prepuce as a possible entry point for HIV. North American circumcision enthusiasts have further promoted male circumcision with opinion pieces in medical journals. Stephen Moses, Daniel T. Halperin, and Robert C. Bailey are other well known North American promoters of male circumcision.

An excerpt from: Doctors Opposing Circumcision HIV Statement

Who is behind all the recent circumcision/HIV studies? What is their history? Do they really care about HIV prevention, or is their interest merely to justify and propagate infant genital mutilation?