Asthma waiver denied

[MullenLE]

Lilly....keep your day job as an MD, because you'll go broke quickly as a punster Thx for the input!

 

[shellz]

I know these things can be hard to parse out for the non medically trained

Please don't assume that people without an MD are incapable of understanding the nuances of statistical analysis.

but the statistics you quote from the NIH about a 7.5% incidence of asthma in kids are "self reporting" asthma folks, in other words these are people who think they have asthma and are answering a questionnaire given to the general population.

Fair enough, the data could be skewed. If it is only "self reported" the true number could also be much higher if more respondents had asthma but were unaware or intentionally deceptive.

That really has nothing at all to do with false positives of the methacholine test in normal ROTC cadets with no history of respiratory problems. You've got to be careful what kind of message you think you are giving when you quote statistics, you've got to know what the statistics are all about in the first place.

Indeed.

Folks are used to the sensitivity and specificity of something like a pregnancy test where if the lab comes back that you are pregnant, then you are pregnant. So, they think, "well the test says I have it, so I have it."

You are making unfounded assumptions about how they will interpret the statistics. Just maybe they are more capable of reasoned analysis than you give them credit for.

That's it for me. I don't have a dog in this fight anymore, so I'll step back and resume spectating.

 

[Lilly]

Me thinks Shellz doth protest too much!!

Sometimes people spout out a "statistic" like your NIH number and say, "There, gotcha." Drill down on the number and you realize it's all puffery and the number means very little, if anything, to the subject at hand and may actually be misleading.

As far as my "unfounded assumptions" about how people will interpret statistics as related to medical tests, in my case they aren't unfounded assumptions, my opinions are the result of dealing with patients and helping them interpret medical tests for the last 30 years.

Shellz, you do, or at least did, have a dog in this fight: your cadet!!! Just like me. We have both come out on the other side with our cadets where they want to be.

Fleiger83 is right on track with the crux of the problem. Kids with a history of asthma will frequently have a period during adolescence and young adulthood when the asthma goes into remission only to return as an adult. The military hopes the methacholine challenge will be predictive of those people likely to have their symptoms return as an adult or when put in environments like the Middle East. But, it's not very good at that either. But, as I've said before, it's about all they've got, though they are working on other tests.

And Mr. Mullen, I'll quit my puntificating, just for you!!!

 

[shellz]

Me thinks Shellz doth protest too much!!

And just like the queen in Shakespear's (misquoted) Hamlet, this line says more about the speaker than the lady referenced.

Sometimes people spout out a "statistic" like your NIH number and say, "There, gotcha." Drill down on the number and you realize it's all puffery and the number means very little, if anything, to the subject at hand and may actually be misleading.

The same could be said of your numbers for the percentage of cadets failing the test. Your "drilling down" on the NIH numbers has not convinced me that they are "puffery" or have no meaning.

As far as my "unfounded assumptions" about how people will interpret statistics as related to medical tests, in my case they aren't unfounded assumptions, my opinions are the result of dealing with patients and helping them interpret medical tests for the last 30 years.

Again, please don't assume that the cognitive abilities of people without MD's will match your experience. I have had both extremes, and believe me, I much prefer dealing with doctors who don't feel the need to talk down to their patients.

Shellz, you do, or at least did, have a dog in this fight: your cadet!!! Just like me. We have both come out on the other side with our cadets where they want to be.

Hence the use of the word "anymore". And having "come out the other side" resulted in an experience to relate which seemed relevant to the discussion at hand. I am sorry it has ruffled your feathers (or should I say rubbed your fur the wrong way) so much.

Fleiger83 is right on track with the crux of the problem. Kids with a history of asthma will frequently have a period during adolescence and young adulthood when the asthma goes into remission only to return as an adult. The military hopes the methacholine challenge will be predictive of those people likely to have their symptoms return as an adult or when put in environments like the Middle East. But, it's not very good at that either. But, as I've said before, it's about all they've got, though they are working on other tests.

No argument here. I don't think anyone is disputing this.


[del]

 

[Lilly]

OK, alright, I'm done. I'm going to take my pearlz Shellz (get it? pearlz -Shellz) stop casting them about like the Good Book says.

[del]

But I am going to tuck my tail between my legs and run home.

 

[kp2001]

Wow, a DODMERB thread spinning around the drain.

Thread closed as it's had it's due.