Redrant: The money quote: "The Helena, Montana study examined 304 heart attack admissions in one community over a period of six months. This study examined a total of 217,023 heart attack admissions and 2.0 million heart attack deaths in 468 counties in all 50 states over an eight-year period."
I recall reading and the Consumer report website about an IBM executive who complained of "chest pains" $150K of diagnostic work and testing it was finally determined that he had taken up yard work and was experiencing "weed wackier muscle strain", a common condition if you are not adapted to this type of "lifting". Also, we have to assume that if didn't balk at even the co-pays, he had a rather large residence that required a lot more weedwacking than my 40 foot city lot. I recently sniped at a doctor posting at http://minnpost.com who wrote that the Framingham heart study "contained few women" when the charter group was over 50% women. http://freedomtoact.blogspot.com/2009/03/minnpost-doctor-claims-framingham-heart.html
A glaring error but this doctor and it indicates a mindset. The charter Framingham group contained no minorities (Framingham, MA had a very low percentage of minorities in 1948, somewhat comparable to the Twin Cities at the time). If you use "victimology logic" you might conclude that the Framingham study charter group must not have included women because it didn't include minorities! Of course, a few seconds of fact checking on the Internet could dispel this.
That is point one. The mindset. If you think you are fighting "social injustice", evil corporations or whatever, you are not likely to question the idea that the the Framingham study contained few women.
Actually, the doctor writing this column is pretty good. He tends to write about how doctors don't tend to adapt to research and the huge disparities in diagnosis and treatment rates. I can't recall him taking on "heart attack" hospital admissions rates and I don't know if the aforementioned IBM executive was admitted there is wild inconsistency in hospital admission rates for "heart attacks". First off, these are for hospital admissions, not actual verified heart attacks. Someone complains of chest pain and someone calls the ambulance. (They don't call it "heartburn" for nothing.) For starters, except for a true serious heart attack where you are "down" an actual heart attack is very difficult to diagnose. Basically, an EKG, preferably with a past reference EKG. Also if heart tissue actually dies there is detectable blood and urine waste tracers which apparently are different for the typical "sore muscle" waste tracers.
That said, the Framingham heart study found that at least in males 25% of heart attacks were "silent". They did yearly EKG's so I would assume the diagnosis was done with EKG variances. On the other extreme I knew the late "Meet the Press" Tim Russert's family. I happened to know that Tim got "top notch" medical treatment, had an exercises regime and a there was an on site heart defillabrator.
For a second example a now retired co-worker (who was very "high strung") was basically forced to go to a doctor after he became totally tired after carry a rather heavy computer a couple of hundred feet (endurance and energy recovery are good hints). The doctors ordered him admitted and he had (as I recall) a quadruple bypass.
Basically, "walking wounded". He looked in rough shape but he took more asprin than I did (dollar stores have a bottle of 200 USP asprin for $1. Cheapest insurance around!) The Framingham study found the link between asprin and dramatically reduced heart attack risk. He could have gone a long time this way as walking wounded. If he had a massive heart attack and died that would not be a hospital admission. It would have been a "statistic".
The point here is that if a reduction in "admissions" occurs" after a smoking ban there could be a number of reasons. Smokers might stay home more or frequent more "smoke friendly" establishments (Minnesota Indian casinos, exempt from the smoking bans have greatly expanded smoking sections) and if at home, the person might take an aspirin or die in their sleep. I am wondering if nowadays the "patient harvesting" hospitals are advising the admission of more people for "heart attacks" with good insurance versus non-insured? We would have to look at initial hospitalisations recommendations versus actual hospitalisation.
Yet another variable. Basically, the Helena study was "cherry picking" data, a "gotcha" of sorts. This is a very large study where the "law of large numbers" applies.
Of course the anti-smoking "family" has no problem sacrificing science for "propaganda". They don't debate. I wonder why? Greg Lang
