[ RadSafe ] Re: Han Kang's epidemiology

[Steven Dapra]

March 7, 2007

Steven Dapra wrote:

James -- why don't you answer *my* question about Han Kang's alleged 2.2 
increased risk? Remember? The one he made in Gulf War Review. See my e-mail 
to RADSAFE of Feb. 28. Did his claim ever pass peer review, was it 
published, and if so, what is the citation?

         My reply, paragraphy by paragraph, Salsman, then Dapra.


JS  (James Salsman):
Think about it: Kang publishes a 1.8 risk ratio (2.8 for children of female 
1991 combat-deployed troops) in Annals of Epidemiology in 2001, and critics 
say that the self-reported surveys must have been mistaken -- our fighting 
men and women, the critics say, must have been lying about their own kids 
health.


SD  (Steven Dapra)

         This is another example of James Salsman's resounding 
dishonesty.  Kang et al. reported a 1.80 crude Odds Ratio for moderate to 
severe adverse outcomes among liveborn infants to male Gulf War 
veterans.  He reported a 2.80 adjusted Odds Ratio for moderate to severe 
adverse outcomes among liveborn infants to female Gulf War veterans.  Why 
is JS playing pick-and-choose?  Could it be because these are the highest 
Odds Ratios in the moderate to severe category?  What's the matter, 
James?  Have you no sense of decency at long last?

         Self-reported studies must be verified by examining medical 
records.  NOBODY is accusing anybody of lying about anyone's health.

JS
Dr. Margaret Ryan, whose DoD Birth and Infant Health Registry at the Naval 
Health Research Center is charged with publication of the reproductive 
health records which Kang and Araneta had been summarizing independently of 
each other, abruptly stops publishing tabulated statistics in 2001, writes 
a letter in response to Araneta's article (which echoed Kang's claims), 
saying that Araneta's methodology was flawed without saying why, and then 
co-authors a whitewash with Pat Doyle -- who detected the same increase, by 
the way, but discounted it as "reporting error" in her own paper --
calling the 80% increase in birth defects "modest."

SD

         Where was Ryan's letter published?  Please give a citation, and a 
citation to the germane article by Araneta.  Give the citation to the paper 
by Doyle that you call "her own paper."  The Ryan-Doyle "whitewash" paper 
appears to be "Reproductive health of Gulf War veterans" (Doyle et al. 
2006).  On p. 574, Doyle et al. refer to the paper by Kang et al. in Annals 
of Epidemiology, and to a 2004 paper by Doyle et al.  Continuing on p. 574, 
Doyle et al. then write, "Both reported some evidence of a modest increase 
in risk of birth defect for male veterans' offspring born after the war, 
although cautious interpretations were offered because of concern about 
reporting bias."

         I can't comment directly on your (JS's) "80% increase" claim 
because as far as I have not read that paper.  However, Doyle, Ryan, and 
their co-author wrote that there was a modest increase in "risk," NOT an 
increase in actual birth defects.

JS
So Dr. Kang goes back and reviews 700+ medical records, and finds that the 
number of birth defects has increased 20%. He publishes that in his agency 
newsletter.

SD

         According to "Gulf War Review," (GWR) (Nov. 2003, p. 7), Kang is a 
"VA researcher."  I think it's stretching things a little to call GWR 
Kang's "agency newsletter."  By the way, above you said someone (I can't 
tell who) reported an "80% increase" in birth defects.  Now, you (JS), are 
waving around Kang and his mere 20%.  Are you going to fulminate about an 
80% increase, or about a 20% increase?  Why don't you get your story 
straight, or at least decide what will be the object of your blustering.

         Furthermore, Kang did not publish any 20% increase in GWR, at 
least not in the Nov. 2003 issue.  According to a footnote to an article 
with no byline, " . . . Dr. Kang and his colleagues concluded that the risk 
of birth defects in children of deployed male veterans still was about 2.2 
times that of non-deployed veterans."  (p.10)

         To reiterate, Kang did not publish anything.  And now you (JS), 
have gone from Kang's 2.2 increased risk to saying he found "the number of 
birth defects has increased 20%."  What are you doing, James?  Is this 
Modern Math?  Are you reading any of this stuff before you write about 
it?  Do you proofread what you write?  Or are you so confused you don't 
know what you are doing?

         Finally, what is the basis for your claim that Kang reviewed "700+ 
medical records"?

JS
Then Eric Daxon lies that Kang actually found a decrease after medical 
records review, not an increase.

SD

         Can't you do anything but call people liars?

JS
I spoke to Dr. Kang not too long ago, and yes, he is seeking publication of 
his most recent findings in the peer reviewed medical literature. Please 
phone him yourself and ask about it if you are curious. His telephone 
number is 202-745-8249.

SD

         It has been over three years since the footnote said Kang 
concluded there was a 2.2 increase in risk.  According to GWR (Nov. 2003), 
his research was "currently undergoing peer review."  Kang's Annals paper 
took seven months to make it into print, Araneta in Birth Defects Research 
took eight months, and Penman in Military Medicine took five months.  If 
Kang can't get his 2.2 (or 20%) published in three years, perhaps his claim 
has no merit.

Steven Dapra
sjd at swcp.com

REFERENCE

Doyle, P., Maconochie, N., and Ryan, M.  Reproductive health of Gulf War 
Veterans.
Philosophical Transactions of the Royal Society B (2006); 361, 571-584.



At 08:29 PM 3/6/07 -0800, James Salsman wrote:
>Steven Dapra wrote:
>
>>James -- why don't you answer *my* question about Han Kang's
>>alleged 2.2 increased risk?  Remember?  The one he made in Gulf War
>>Review.  See my e-mail to RADSAFE of Feb. 28.  Did his claim ever
>>pass peer review, was it published, and if so, what is the citation?

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