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Re: Radon - county linear model and LNT



> As Dr. Lubin's pointed out, "Cohen's claims are based on his linear (or 

> linear- quadratic) model for county lung cancer rates, are therefore built on 

a false premise, and his continual reference to the `scientific method' is 

fatuous.

 

Cohe replied  	--I do not use any such model, and don't know what he is talking

 about. 



Dr. Cohen, are you now saying you are not using a linear model to test the LNT?

You previously said you derived a LNT model that was equivalent to the BIER IV 

model.  Do you recall the discussions we had concerning the validity of your 

assumptions you used for your model?

---------------------



I would like to see a point-by-point response to his paper. But, how can you 

adequately respond to Lubin if you don't understand his points?

------------------------------------

------------------------------------------------------------------------>



 On Tue, 24 Jun 2003 epirad@mchsi.com wrote:

> 

> > I am pointing out a response by Lubin that I am in agreement with

> >

> > Cohen wrote: --My response to that paper, Jour. Rad. Prot. 22(2002)305-307, is

> > > available on the web at    http://www.iop.org/EJ/toc/0952-4746/22/3  The

> > > problem is that it contains no consideration of plausibility. For example.

> > > it hypothesizes that the ratio of radon exposures for smokers/non-smokers

> > > in a county varies with county average radon levels, r, from 7.0 for r=30,

> > > to 1.0 for r=75, to 2.2 for r=90, to 0.36 for r=150; all this at a time

> > > when nothing was known about radon levels.

> > --------------

> >

> > As Dr. Lubin's pointed out, "Cohen's claims are based on his linear (or 

> linear-

> > quadratic) model for county lung cancer rates, are therefore built on a false

> > premise, and his continual reference to the `scientific method' is fatuous.

> 

> 	--I do not use any such model, and don't know what he is talking

> about. In any case, what does this have to do with my above comments?

> 

>  One

> > could equally fit and reject a sinusoidal relationship for county lung cancer

> > rates and radon concentrations; the factual basis of an inadequate model is

> > true, but of little inferential value for evaluating risk."

> 

> 	--Again, I have no idea of what he is talking about.

> 

> > Reply to Cohen's letter on `The potential for bias in Cohen's ecological

> > analysis of lung cancer and residential radon'

> 

> 	--I was not given an opportunity to respond to this pile of BS. He

> completely ignores my tightly reasoned justification for my procedures, as

> given in item #7 on my web site. He completely ignores issues of

> plausibility. He completely ignores the fact that my study is not designed

> to determine risks, but only to test LNT. He shows no understanding of my

> new and novel approach to solving a scientific problem. If anyone wants a

> response on any one point, please ask.

> 

> > Dear Sir

> >



> > In the above letter, Cohen [1] repeats arguments that he as made in the past;

> > however, the thrust of those comments indicates a fundamental misunderstanding

> > of the point of my article [2] and indeed of my prior articles on this topic.

> > It was not and has never been my goal to identify a specific factor (or 

> several

> > factors) that induced the negative correlation between the estimates of 

> county-

> > level mean radon concentration and county lung cancer mortality rates. Other

> > investigators have offered powerful examples, both theoretical and practical,

> > that Cohen's results are indeed an artifact of ecological regression [3-9]. 

> The

> > primary purpose of my contributions to this topic has been to demonstrate the

> > fundamental deficiencies of the methodology itself, in particular the

> > unboundedness of the bias [10]. The current article [2] demonstrates that the

> > ecological fallacy always applies, that the addition of county-level 

> adjustment

> > variables does not reduce bias and increase validity, and that an observed

> > ecological risk pattern can differ markedly from the true risk pattern. 

> Because

> > of these deficiencies, epidemiologists have never used ecological regression 

> as

> > a tool for confirmatory analysis. For radon and lung cancer, results of 25-30

> > analytic studies of individuals clearly prove the deficiency of the method.

> >

> > There are numerous risks factors for lung cancer, including smoking, age,

> > various occupational exposures, air pollution, previous lung diseases, and so

> > on. In [2], I take an extremely simplified model for lung cancer in radon and

> > smoking status, and demonstrate that the induced county-level model is non-

> > linear. A more realistic, and complex, model for lung cancer would include all

> > principal risk factors, and would also generate a non-linear model at the

> > county level. Cohen's claims, which are based on his linear (or linear-

> > quadratic) model for county lung cancer rates, are therefore built on a false

> > premise, and his continual reference to the `scientific method' is fatuous. 

> One

> > could equally fit and reject a sinusoidal relationship for county lung cancer

> > rates and radon concentrations; the factual basis of an inadequate model is

> > true, but of little inferential value for evaluating risk.

> >

> > Given two counties with equal proportions of smokers and equal patterns of

> > smoking, I showed that a positive association for radon and lung cancer at the

> > individual level can be easily transformed into an observed negative

> > relationship between lung cancer rates and mean radon levels at the county

> > level through simple manipulations of the within-county correlation between

> > smoking and radon [10]. Moreover, the within-county correlations can be

> > extremely small, on the order of 0.05 to 0.10 (see table 1 in [10]). The

> > current paper [2] extends that two-county analysis, and shows that the 

> reversal

> > in trend can be extended to all 1,599 counties in Cohen's regression, even 

> when

> > the ecological regression is assumed to perfectly fit the data with no 

> residual

> > variation. Those results demonstrate the potential for extreme distortion of

> > any ecological regression.

> >

> > A relatively simple within-county adjustment was needed to show the

> > compatibility of Cohen's regression with the BEIR VI extrapolation of risk.

> > Contrary to Cohen's view, the vast majority (84 per cent) of within-county

> > correlation coefficients for radon and smoking were between -0.3 and 0.3. In

> > addition, those correlations are artificially elevated due to measurement

> > error. The implicit assumption is that all covariates are measured without

> > error. However, it is clear cigarette smoking is very poorly measured. A total

> > of 85-90 per cent of all lung cancers are attributed to cigarette consumption,

> > while Cohen's smoking variable explains only about 25 per cent of the 

> variation

> > in lung cancer rates among counties. Equation (3) in [2] defines the risk-

> > adjusted radon concentration for a county (denoted w) as represented in the

> > true county-level regression. The risk-adjusted mean radon depends on the

> > proportion of smokers and the relative risk of smoking for the county. Thus,

> > even if errors in smoking status and residential radon concentration were

> > independent at the individual level, equation (3) shows that the proportion of

> > smokers and w are correlated. Thus, county-level correlations between smoking

> > and radon are further distorted by the joint misclassification of two factors.

> >

> > Finally, as a practical matter, it is worth noting that Puskin has recently

> > offered a plausible explanation for Cohen's negative correlation [11] that

> > agrees with the possible role of correlated errors. Puskin conducted 

> ecological

> > regressions of radon and smoking for several strongly smoking-related cancers

> > (cancers of the lung, oesophagus, larynx, nasopharynx and oral cavity), weakly

> > smoking-related cancers (cancers of the bladder and pancreas) and cancers

> > unrelated to smoking (cancers of the colon, breast and prostate). He found

> > strong negative correlations between county radon concentrations and cancers

> > strongly linked to cigarette smoking, weaker correlations between radon and

> > cancers weakly associated with smoking, and essentially no correlation between

> > radon and cancers not linked to smoking. Puskin concludes that the negative

> > trend reported by Cohen for lung cancer is very likely explained by a negative

> > correlation between smoking and radon levels across counties.

> >

> > Yours faithfully,

> >

> > J H Lubin

> >

> > [1] Cohen B L 2002 Response to `The potential for bias in Cohen's ecological

> > analysis of lung cancer and residential radon' J. Radiol. Prot. 22 305-7

> > IOP Article

> >

> > [2] Lubin J H 2002 The potential for bias in Cohen's ecological analysis of



> > lung cancer and residential radon J. Radiol. Prot. 22 141-8

> > IOP Article

> >

> > [3] Greenland S 1992 Divergent biases in ecologic and individual-level studies

> > Stat. Med. 11 1209-23

> > PubMed Abstract | Buy at Infotrieve

> >

> > [4] Greenland S and Robins J 1994 Invited commentary: ecologic studies -

> > biases, misconceptions, and counterexamples Am. J. Epidemiol. 139 747-60

> > PubMed Abstract | Buy at Infotrieve

> >

> > [5] Morgenstern H 1995 Ecologic studies in epidemiology: concepts, principles,

> > and methods Ann. Rev. Public Health 16 61-81

> > CrossRef Link | Buy at Infotrieve

> >

> > [6] Muirhead C R, Butland B K, Green B M R and Draper G J 1991 Childhood

> > leukaemia and natural radiation (letter) Lancet 337 503-4

> > ChemPort Abstract | PubMed Abstract | Buy at Infotrieve

> >

> > [7] Piantadosi S, Byar D P and Green S B 1988 The ecologic fallacy Am. J.

> > Epidemiol. 127 893-904

> > ChemPort Abstract | PubMed Abstract | Buy at Infotrieve

> >



> > [8] Stidley C A and Samet J M 1994 Assessment of ecologic regression in the

> > study of lung cancer and indoor radon Am. J. Epidemiol. 65 234-51

> > Buy at Infotrieve

> >

> > [9] Smith B J, Field R W and Lynch C F 1998 Residential Rn-222 exposure and

> > lung cancer: Testing the linear no-threshold theory with ecologic data Health

> > Phys. 75 11-7

> >

> > [10] Lubin J H 1998 On the discrepancy between epidemiologic studies in

> > individuals of lung cancer and residential radon and Cohen's ecologic

> > regression Health Phys. 75 4-10

> > Inspec Abstract | ChemPort Abstract | PubMed Abstract | Buy at Infotrieve

> >

> > [11] Puskin J S 2002 Smoking as a confounder in ecological correlations of

> > cancer mortality rates with average county radon levels Health Phys.

> > >

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> >

> >

> 



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