Wednesday, October 18, 2006

Lancet II/Should we trust this Report?

I hope to add more to this post later but for now a couple of quotes of note:

1. "Estimates of deaths in Iraq all suggest that the death rate has risen since the invasion. But they have been much lower than the latest figure. Iraq Body Count, a left-leaning website that compiles deaths from media reports, quotes a maximum of just under 49,000. US government officials have given figures of 30,000-50,000. And a household survey, conducted in May 2004 by the United Nations and published last year, concluded that the war had caused at least 18,000-29,000 deaths, mostly from violent causes. The only privious estimate of the same order of magnitude is a fugure of around 100,000 excess deaths in the first 18 months of the conflict, published in 2004 by Gilbert Burnham and his colleagues at John Hopkins University in Baltimore (L. Roberts et al. Lancet 364, 1857-1864;2004), the same researchers who are behind the new work."

Yes no coincidences here!!!
2. Yet despite the weakness of other measurements, the new figure has surprised researchers. Perhaps the most significant concern is the baseline rate for pre-invasion death reates used in the new study. The latest survey, which included questions about the situation before the invasion, put this at 5.5 deaths per 1,000 people per year, in line with figures on Iraq from the US Census Bureau. Iran, which has a well-run health system, has a similar rate, but Iraq was at the time suffering from years of sanctions. Some sources, including the United Nations Population Division, list a pre-invasion figure of 9.7

This is very important issue if the base rate was too low then Lancet is giving too much weight to EXCESS deaths.
The discrepancy does not invalidate the new result, and if the researchers underestimated the pre-war death rate, it's possible that they may have also underestimated the post-war rate. But some researchers say the paper should have been addressed the issue. "There should have been more intropection," says Beth Osborne Daponte, a demographer at Carnegie Mellon University in Pittsburg, Pennsyvalia. "That increased my discomfort."

Yes my discomfort also and maybe a touch more. But I think it is a more serious problem than just saying well they could have undercounted the post-war death rate. If the data was faulty to begin with then we can never know about pre or post death rates accuracy. And just because one is underestimated, does not signify that the other should also follow suit. As time drags on there is a tendency to forget or loose documents from the oldest data points. So that cavalier explanation does not hold water for me.
Other researchers share that discomfort. Debarati Guha-Sapir is director fo the Centre for Research on the Epidemiology of Disasters in Brussels, She has some methodological concerns about the paper, including the use of local people-who might have opposed the occupation-as interviewers. She also points out that the result does not fit with any she has recorded in 15 years of sudying conflict zones. Even in Darfur, where armend groups have wiped out whole villages, she says that researches have not recorded the 500 predominately violent deaths per day that the Johns Hopkins team estimates are occurring in Iraq.

So are we to believe that there is more deaths happening in Iraq than any other trajedy since the Pol Pot regime? Of course this is convenient for those that want to attack the idea of the freeing of Iraqi people from a dictator.
Some, such as Daponte, would have liked the authors to have better addressed their method's shortcomings before releasing a result with such political impact.

Yes they had to release it 3 weeks before an election. They say they wanted it debated which is a fair thing to say, but then you release it 6 months before the election and then follow up with the final draft report and supporting documentation later. Now we just have a summary and supposedly a complete report will come out later. So are we are to evaluate this without all the information before an election? Although I doubt that we will ever have the complete raw data report.
Burnham says he would now like to study patterns of migration in Iraq and the state of the health system. He would also like to estimate deaths based on a sample 4-5 times bigger than that used so far. But survey teams are in danger on the streets of Iraqi towns, and Burnham doubts whether the need for more detailed data justifies the risk.

I can sympathize with the risk, but then does this make it right to produce results with such wide margins that is known to stir up emotions? And for the next two years we will hear the 655,000 killed by USA, which is not the truth.

655,000 War Dead?


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