Contra media reports, there is no “loneliness epidemic” among older adults; contra previous literature, loneliness may not have cardiometabolic implications; such nonreplications are increasingly common

Loneliness does (not) have cardiometabolic effects: A longitudinal study of older adults in two countries. Social Science & Medicine, https://doi.org/10.1016/j.socscimed.2018.10.021

Highlights
•    Contrary to media reports, there is no “loneliness epidemic” among older adults.
•    Opposing previous studies, loneliness may not be linked to cardiometabolic outcomes.
•    Such nonreplications are common in the growing “biosocial science” literature.
•    More rigorous methods are available, and urgently need incorporation.

Abstract

Objectives: Mass media increasingly report a “loneliness epidemic.” A growing academic literature claims downstream effects of this experience on surrogate markers of cardiometabolic risk. Evidence on such influences is based on flawed samples and methodologies, rendering inferences questionable. The current study tested these claims.

Methods: Analysis was based on three-wave data on older adults from two national probability samples—the U.S. Health and Retirement Study (HRS) and the English Longitudinal Study of Ageing (ELSA). Models were gender-differentiated. Cardiovascular states were indexed by systolic and diastolic blood pressure, and metabolic condition by hemoglobin A1c. Fixed effects models were used for initial investigation, and subsequent triangulation was through a first-differencing approach with instrumental variables.

Results: Loneliness had no linkage with any of the three outcomes. Nor were prevalences indicative of an epidemic of this affective state. Both gender and cross-national variations emerged: women were lonelier than men in each sample, while ELSA participants of both genders were less so than their HRS counterparts.

Discussion: Contra previous literature, loneliness may not have cardiometabolic implications. Such nonreplications are increasingly common in the emerging “biosocial science” literature. Potential sources are discussed. More rigorous methods are available and urgently need incorporation to root out flawed inferences and conceptual models.

Despite vast increases in the time and money spent on research, progress is barely keeping pace with the past. What went wrong?

Science Is Getting Less Bang for Its Buck. Patrick Collison, Michael Nielsen. The Atlantic, Nov 16, 2018
https://www.theatlantic.com/science/archive/2018/11/diminishing-returns-science/575665/

Despite vast increases in the time and money spent on research, progress is barely keeping pace with the past. What went wrong?

https://scientificreturns.org/diminishing-returns

What’s causing the productivity slowdown? The subject is controversial among economists, and many different answers have been proposed. Some have argued that it’s merely that existing productivity measures don’t do a good job measuring the impact of new technologies. Our argument here suggests a different explanation, that diminishing returns to spending on science are contributing to a genuine productivity slowdown.

We aren’t the first to suggest that scientific discovery is showing diminishing returns. In 1971, the distinguished biologist Bentley Glass wrote an article in Science arguing that the glory days of science were over, and the most important discoveries had already been made:

It’s hard to believe, for me, anyway, that anything as comprehensive and earthshaking as Darwin’s view of the evolution of life or Mendel’s understanding of the nature of heredity will be easy to come by again. After all, these have been discovered!

In his 1996 book The End of Science, the science writer John Horgan interviewed many leading scientists and asked them about prospects for progress in their own fields. What he found was not encouraging. Here, for instance, is Leo Kadanoff, a leading theoretical physicist, on recent progress in science:

The truth is, there is nothing—there is nothing—of the same order of magnitude as the accomplishments of the invention of quantum mechanics or of the double helix or of relativity. Just nothing like that has happened in the last few decades.

Horgan asked Kadanoff whether that state of affairs was permanent. Kadanoff was silent, before sighing and replying: “Once you have proven that the world is lawful to the satisfaction of many human beings, you can’t do that again.”

But while many individuals have raised concerns about diminishing returns to science, there has been little institutional response. The meteorologist Kelvin Droegemeier, the current nominee to be President Donald Trump’s science adviser, claimed in 2016 that “the pace of discovery is accelerating” in remarks to a U.S. Senate committee. The problem of diminishing returns is mentioned nowhere in the 2018 report of the National Science Foundation, which instead talks optimistically of “potentially transformative research that will generate pioneering discoveries and advance exciting new frontiers in science.” Of course, many scientific institutions—particularly new institutions—do aim to find improved ways of operating in their own fields. But that’s not the same as an organized institutional response to diminishing returns.

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Check also Are Ideas Getting Harder to Find? Nicholas Bloom, Charles I. Jones, John Van Reenen, and Michael Webb. NBER Working Paper No. 23782. https://www.bipartisanalliance.com/2017/09/are-ideas-getting-harder-to-find.html

How does nature exposure make people healthier?: Evidence for the role of impulsivity and expanded space perception

How does nature exposure make people healthier?: Evidence for the role of impulsivity and expanded space perception. Meredith A. Repke, Meredith S. Berry, Lucian G. Conway III, Alexander Metcalf, Reid M. Hensen, Conor Phelan. PLOS One, Aug 22 2018, https://doi.org/10.1371/journal.pone.0202246

Abstract: Nature exposure has been linked to a plethora of health benefits, but the mechanism for this effect is not well understood. We conducted two studies to test a new model linking the health benefits of nature exposure to reduced impulsivity in decision-making (as measured by delay discounting) via psychologically expanding space perception. In study 1 we collected a nationwide U.S. sample (n = 609) to determine whether nature exposure was predictive of health outcomes and whether impulsive decision-making mediated the effect. Results indicated that Nature Accessibility and Nature Exposure From Home significantly predicted reduced scores on the Depression, Anxiety, Stress Scales (DASS) (p < .001, p = .03, respectively) and improved general health and wellbeing (p < .001, p < .01, respectively). Nature Accessibility also predicted reduced impulsive decision-making (p < .01), and Nature Accessibility showed significant indirect effects through impulsive decision-making on both the DASS (p = .02) and general health and wellbeing (p = .04). In Study 2, a lab-based paradigm found that nature exposure expanded space perception (p < .001), and while the indirect effect of nature exposure through space perception on impulsive decision-making did not meet conventional standards of significance (p < .10), the pattern was consistent with hypotheses. This combination of ecologically-valid and experimental methods offers promising support for an impulsivity-focused model explaining the nature-health relationship.

Sex workers sell information gleaned from their customers—specifically, corrupt police officers—to al-Shabaab; “If you want information here, you use the prostitutes and street kids"

al-Shabaab’s Mata Hari Network. Katharine Petrich. War on the Rocks, Aug 14 2018. https://warontherocks.com/2018/08/al-shabaabs-mata-hari-network/

Excerpts:

I recently spent several weeks in the slum districts of Nairobi, researching al-Shabaab’s criminal activities in the Horn of Africa. I expected to learn about the traditional criminal practices of terrorist groups: drugs, arms, money laundering, and perhaps even a regional particularity like sugar smuggling. What I wasn’t expecting to discover was a highly structured, hierarchical network in which sex workers sell information gleaned from their customers — specifically, corrupt police officers — to al-Shabaab. As one interviewee noted, “If you want information here, you use the prostitutes and street kids — they see everything, go everywhere, and nobody notices them.”

The strength and depth of this sex worker-militant network surprised me and many terrorism experts in the West I spoke with, but it’s an open secret among Nairobi residents. My first interview subject didn’t understand why I wanted more details — surely everyone knew about it? Many of my interviewees were neighbors of, or otherwise friendly with, the sex workers involved. They described an arrangement in which al-Shabaab offered money to women who picked up interesting information in the course of their regular sex work — pillow talk from politicians, police officers, and businessmen. One local memorably opined: “Of course! Half the reason these men go to [sex workers] is to complain about their lives. Why not get paid for listening?”

The co-option of sex workers as intelligence officers suggests that al-Shabaab is a rational actor willing to circumvent its highly public ideological stances when there is significant operational benefit to be gained. This calculating, bottom-line mentality runs counter to much of the international narrative about the group. The “Mata Hari” network also shows that al-Shabaab is an innovative organization that looks for unconventional solutions and is actively seeking to survive and expand, despite the long-running efforts by the African Union Mission in Somalia (AMISOM) and its international military partners. Al-Shabaab has increased its resilience to counter-terrorism operations by leveraging the safe haven of neighboring Kenya, a sanctuary of sorts created by porous borders, weak government integrity, and sympathetic communities. Finally, this is a group interested in working “behind the lines” deep in adversarial territory that has learned how to exploit human weakness and failures of integrity in its area of operation.

[...]

The rational choice to leverage sex workers’ access to powerful government and law enforcement figures offers a window into al-Shabaab’s cost-benefit calculations. The group imposes strict restrictions on female sexuality in Somalia, its primary area of operation: It bans independent sex work, has imposed the death penalty for adultery, considers sexual assault to be adultery (and thus punishable by stoning to death), and utilizes forced marriages and rape as a reward system for its male soldiers. Given this deeply conservative position inside Somalia, its willingness to cooperate with and reward sex work in Nairobi, where the group is more constrained in its activities, suggests al-Shabaab is a limited, rational organization with concrete territorial aims. It is not a maximalist extremist group prioritizing ideological principles over tangible benefits, and because the group has a state-based goal, it is comfortable supporting or at least engaging with activities that contravene sharia law. An informant remarked wryly, “Al-Shabaab likes [that group of sex workers] very much. They are worth many sins.” Other interviewees described how group members publicly banned and beat sex workers in one neighborhood, decrying their “wickedness,” while simultaneously protecting the sex workers involved in the intelligence network. Immorality seems to be a reasonable price to pay for real-time intelligence.

[...]

The strength of Nairobi’s “prostitute spy” network demonstrates al-Shabaab’s organizational innovation, rationality, and broad geographic range. If the militia has learned the effectiveness of co-opting sex work in Nairobi, organizational learning theory argues it will attempt to replicate that success in other areas. Indeed, media reports indicate similar gambits of using “very beautiful women” as intelligence officers have also occurred in Kenya’s Lamu, Tana River, and Garissa counties. This evolution suggests al-Shabaab may be permanently incorporating sex work into its portfolio of intelligence operations.

[...]

Full text with much more and many links in War on the Rocks, link above.

Paperwork burdens, “sludge,” reduces access to important licenses, programs, & benefits; its defenses turn out to be more attractive in principle than in practice; a form of cost-benefit analysis is essential

Sunstein, Cass R., Sludge and Ordeals (November 20, 2018). Duke Law Journal, Forthcoming. http://dx.doi.org/10.2139/ssrn.3288192

Abstract: In 2015, the United States government imposed 9.78 billion hours of paperwork burdens on the American people. Many of these hours are best categorized as “sludge,” reducing access to important licenses, programs, and benefits. Because of the sheer costs of sludge, rational people are effectively denied life-changing goods and services; the problem is compounded by the existence of behavioral biases, including inertia, present bias, and unrealistic optimism. In principle, a serious deregulatory effort should be undertaken to reduce sludge, through automatic enrollment, greatly simplified forms, and reminders. At the same time, sludge can promote legitimate goals. First, it can protect program integrity, which means that policymakers might have to make difficult tradeoffs between (1) granting benefits to people who are not entitled to them and (2) denying benefits to people who are entitled to them. Second, it can overcome impulsivity, recklessness, and self-control problems. Third, it can prevent intrusions on privacy. Fourth, it can serve as a rationing device, ensuring that benefits go to people who most need them. In most cases, these defenses of sludge turn out to be more attractive in principle than in practice. For sludge, a form of cost-benefit analysis is essential, and it will often argue in favor of a neglected form of deregulation: sludge reduction. Various suggestions are offered for new action by the Office of Information and Regulatory Affairs, which oversees the Paperwork Reduction Act; for courts; and for Congress.

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My comment:

This was the most cited legal and constitutional scholar in the US, almost as much as the next two guys combined (between 2009 and 2013)... It is difficult to overstate how harmful has been the kind of theories Mr Sunstein supported in his work for the previous federal president, justifying in many occasions laws and regulations of great cost with abandon. Partially compensating this, he acknowledges in a paper devoted for the first time to law/regulations costs and how unfair they are, that:

1  the costs of paperwork are enormous; 2  rational people are effectively denied life-changing goods and services; 3  the problem is compounded by the existence of behavioral biases, including inertia, present bias, and unrealistic optimism; 4  defenses of paperwork burden are specious (are more attractive in principle (!) than in practice); 5  a form of cost-benefit analysis is essential, and 6   analysis will often argue in favor of paperwork burden reduction, "neglected form of deregulation."

Welcome to sanity, all of you guys that most of the time payed so little attention to regulation costs and the rights of the people, and how our cognitive defects, our biases, make lots of regulatory actions not only unworkable, but damaging in big ways.

Choosing a meal to increase your appeal: How relationship status, sexual orientation, dining partner sex, and attractiveness impact nutritional choices in social dining scenarios

Choosing a meal to increase your appeal: How relationship status, sexual orientation, dining partner sex, and attractiveness impact nutritional choices in social dining scenarios. Michael Baker, Andie Strickland, Nicole D. Fox. Appetite, https://doi.org/10.1016/j.appet.2018.11.023

Abstract: The impact of social context on dining choices was investigated via an online experiment. Participants were assigned to different hypothetical dining partners of the same or opposite sex and varying levels of attractiveness (or no partner in a control condition) and were then asked to indicate what foods they would order if they were dining with this individual. Following a food selection task, the attractiveness of the hypothetical partner was rated, followed by the measurement of personal characteristics such as current relationship status, participant sex, and sexual orientation. Results revealed that among heterosexual participants, relationship status, partner sex, and partner attractiveness interacted to influence the total number of calories ordered. Heterosexual male and female participants who were not currently in a relationship and had been assigned to an opposite-sex dining partner tended to order fewer calories the more attractive that they perceived their partner to be. The findings of this study build upon previous research on social influences on dining behavior by examining the roles of relationship status and dining partner attractiveness on nutritional decision-making.

Social media as a source of political information do not reduce the compatibility of individual issue horizons: they are not caught in an 'echo chamber' or reduce issue diversity, top issue focus or issue overlap with others

Stefan Geiß, Melanie Magin, Birgit Stark, Pascal Jürgens, „Common Meeting Ground” in Gefahr? Selektionslogiken politischer Informationsquellen und ihr Einfluss auf die Fragmentierung individueller Themenhorizonte in: M&K Medien & Kommunikationswissenschaft, Seite 502 - 525, Jahrgang 66 (2018), Heft 4, https://doi.org/10.5771/1615-634X-2018-4-502

Abstract: The diversification of the political information supply has raised concerns about social integration and collective democratic self-determination. Automatically personalised media content on social network sites such as Facebook which make use of individual online behaviour are often suspected of facilitating fragmentation. People with extreme political attitudes are particularly seen as vulnerable and likely to losing touch with society as a whole, for instance, if they are caught in an ‘echo chamber’. We draw on data from an innovative operationalisation of issue fragmentation using individual-level data, investigating whether the use of such content reduces the compatibility of individual issue horizons; i.e. reduced issue diversity, top issue focus, and issue overlap with others. We also investigate how this contributes to the fragmentation of society, both generally and among political extremists. Empirically, we rely on data from a two-week daily diary study with 333 participants, who provided information on the two political issues they found most important on that day. Participants also specified which sources they relied on for political information about the relevant issue. Our results show that social media as a source of political information do not reduce the compatibility of individual issue horizons. However, relying on these media outlets increases the compatibility of issue horizons, particularly among those with extreme political attitudes. In conclusion, we discuss the implications of these findings for the self-determination of individuals and society in the digital world.

Sumatran orangutan mothers suppressed alarm calls up to 20 min until the model was out of sight in function of perceived danger for themselves & for an infant, suggesting high-order cognition

Time-space–displaced responses in the orangutan vocal system. Adriano R. Lameira and Josep Call. Science Advances, Nov 14 2018, Vol. 4, no. 11, eaau3401. DOI: 10.1126/sciadv.aau3401

Abstract: One of the defining features of language is displaced reference—the capacity to transmit information about something that is not present or about a past or future event. It is very rare in nature and has not been shown in any nonhuman primate, confounding, as such, any understanding of its precursors and evolution in the human lineage. Here, we describe a vocal phenomenon in a wild great ape with unparalleled affinities with displaced reference. When exposed to predator models, Sumatran orangutan mothers temporarily suppressed alarm calls up to 20 min until the model was out of sight. Subjects delayed their vocal responses in function of perceived danger for themselves, but four major predictions for stress-based mechanisms were not met. Conversely, vocal delay was also a function of perceived danger for another—an infant—suggesting high-order cognition. Our findings suggest that displaced reference in language is likely to have originally piggybacked on akin behaviors in an ancestral hominid.

Reward retroactively prioritizes memory for objects closest to the reward; there is a 24-hour delay & is stronger for mazes followed by a longer rest interval, suggesting a role for post-reward replay & overnight consolidation

Retroactive and graded prioritization of memory by reward. Erin Kendall Braun, G. Elliott Wimmer & Daphna Shohamy. Nature Communications, volume 9, Article number: 4886 (2018). https://www.nature.com/articles/s41467-018-07280-0

Abstract: Many decisions are based on an internal model of the world. Yet, how such a model is constructed from experience and represented in memory remains unknown. We test the hypothesis that reward shapes memory for sequences of events by retroactively prioritizing memory for objects as a function of their distance from reward. Human participants encountered neutral objects while exploring a series of mazes for reward. Across six data sets, we find that reward systematically modulates memory for neutral objects, retroactively prioritizing memory for objects closest to the reward. This effect of reward on memory emerges only after a 24-hour delay and is stronger for mazes followed by a longer rest interval, suggesting a role for post-reward replay and overnight consolidation, as predicted by neurobiological data in animals. These findings demonstrate that reward retroactively prioritizes memory along a sequential gradient, consistent with the role of memory in supporting adaptive decision-making.

Ovulation, Sex Hormones, and Women’s Mating Psychology: No increase in preference for uncommited sex with men displaying putative fitness cues during the high-fertility phase of the menstrual cycle

Jones, Benedict C., Amanda Hahn, and Lisa M. DeBruine. 2018. “Ovulation, Sex Hormones, and Women’s Mating Psychology.” PsyArXiv. November 24. doi:10.1016/j.tics.2018.10.008

Abstract: The Dual Mating Strategy hypothesis proposes that women’s preferences for uncommitted sexual relationships with men displaying putative fitness cues increase during the high-fertility phase of the menstrual cycle. Results consistent with this hypothesis are widely cited as evidence that sexual selection has shaped human mating psychology. However, the methods used in most of these studies have recently been extensively criticized. Here we discuss (1) new empirical studies that address these methodological problems and largely report null results and (2) an alternative model of hormonal regulation of women’s mating psychology that can better accommodate these new data.

People evaluate their own voices as more attractive than the voices of others & that the self‐enhancement bias of voice attractiveness can be generalised to similar & familiar versions of self‐voice

One's own and similar voices are more attractive than other voices. Zhikang Peng, Yanran Wang, Linghao Meng, Hongyan Liu. Zhiguo Hu. Australian Journal of Psychology, https://doi.org/10.1111/ajpy.12235

Abstract

Objective: The aim of the present study was to explore whether people consider their own voice to be more attractive than others and whether the self‐enhancement bias of one's own voice could be generalised to other variants of self‐voice.

Method: Two experiments were conducted. In Experiment 1, female and male participants were asked to rate the attractiveness of three types of audio recordings (numbers, vowels, words) from same‐sex participants. In Experiment 2, the participants were instructed to rate the attractiveness of six types of audio signals: their own original voice, their recorded voice, a “pitch+20 Hz” audio recording, a “pitch−20 Hz” audio recording, a “loudness+10 dB” audio recording, and a “loudness−10 dB” audio recording. The participants also rated the similarity between the given audio signals and their own voices.

Results: Experiment 1 showed that the participants rated their own audio recordings as more attractive than others rated their audio recordings, and they rated their own audio recordings as more attractive than those of others. Experiment 2 revealed that the participants rated the recorded voices and the “loudness+/−10 dB” audio recordings as more attractive and similar than the “pitch+/−20 Hz” audio recordings.

Conclusions: The present study demonstrates that people evaluate their own voices as more attractive than the voices of others and that the self‐enhancement bias of voice attractiveness can be generalised to similar and familiar versions of self‐voice.

Response to Baron and Jost's False Equivalence: Are Liberals and Conservatives in the U.S. Equally “Biased”?

Partisan Bias and Its Discontents. Peter Ditto et al. Perspectives on Psychological Science, Nov 2018. https://www.researchgate.net/publication/328916374

Abstract: Baron and Jost (this issue) present three critiques of our meta-analysis demonstrating similar levels of partisan bias in liberals and conservatives: 1) that the studies we examined were biased toward finding symmetrical bias among liberals and conservatives, 2) that the studies we examined do not measure partisan bias but rather rational Bayesian updating, and 3) that social psychology is not biased in favor of liberals but biased instead toward creating false equivalencies. We respond in turn that: 1) the included studies covered a wide variety of issues at the core of contemporary political conflict and fairly compared bias by establishing conditions under which both liberals and conservatives would have similar motivations and opportunity to demonstrate bias, 2) we carefully selected studies that were least vulnerable to Bayesian counterexplanation and most scientists and laypeople consider these studies demonstrations of bias, and 3) there is reason to be vigilant about liberal bias in social psychology, but this does not preclude concern about other possible biases, all of which threaten good science. We close with recommendations for future research and urge researchers to move beyond broad generalizations of political differences that are insensitive to time and context.

Response to  False Equivalence: Are Liberals and Conservatives in the U.S. Equally “Biased”? Jonathan Baron and John T. Jost. Invited Revision, Perspectives on Psychological Science,

Abstract: On the basis of a meta-analysis of 51 studies, Ditto, Liu, Clark, Wojcik, Chen, et al. (2018) conclude that ideological “bias” is equivalent on the left and right of U.S. politics. In this commentary, we contend that this conclusion does not follow from the review and that Ditto and colleagues are too quick to embrace a false equivalence between the liberal left and the conservative right. For one thing, the issues, procedures, and materials used in studies reviewed by Ditto and colleagues were selected for purposes other than the inspection of ideological asymmetries. Consequently, methodological choices made by researchers were systematically biased to avoid producing differences between liberals and conservatives. We also consider the broader implications of a normative analysis of judgment and decision-making and demonstrate that the “bias” examined by Ditto and colleagues is not, in fact, an irrational bias, and that it is incoherent to discuss bias in the absence of standards for assessing accuracy and consistency. We find that Jost’s (2017) conclusions about domain-general asymmetries in motivated social cognition, which suggest that epistemic virtues are more prevalent among liberals than conservatives, are closer to the truth of the matter when it comes to current American politics. Finally, we question the notion that the research literature in psychology is necessarily characterized by “liberal bias,” as several authors have claimed.

Here is the end:
If academics are disproportionately liberal—in comparison with society at large—it just might be due to the fact that being liberal in the early 21st century is more compatible with the epistemic standards, values, and practices of academia than is being conservative.

Predispositions and the Political Behavior of American Economic Elites: Technology entrepreneurs support liberal redistributive, social, & globalistic policies but conservative regulatory policies

Predispositions and the Political Behavior of American Economic Elites: Evidence from Technology Entrepreneurs. David E. Broockman, Gregory Ferenstein, Neil Malhotra. American Journal of Political Science, https://doi.org/10.1111/ajps.12408

Abstract: Economic elites regularly seek to exert political influence. But what policies do they support? Many accounts implicitly assume economic elites are homogeneous and that increases in their political power will increase inequality. We shed new light on heterogeneity in economic elites' political preferences, arguing that economic elites from an industry can share distinctive preferences due in part to sharing distinctive predispositions. Consequently, how increases in economic elites' influence affect inequality depends on which industry's elites are gaining influence and which policy issues are at stake. We demonstrate our argument with four original surveys, including the two largest political surveys of American economic elites to date: one of technology entrepreneurs—whose influence is burgeoning—and another of campaign donors. We show that technology entrepreneurs support liberal redistributive, social, and globalistic policies but conservative regulatory policies—a bundle of preferences rare among other economic elites. These differences appear to arise partly from their distinctive predispositions.

Biased Study: Krebs et al.'s “Effect of Opioid vs Nonopioid Medications on Pain-Related Function in Patients With Chronic Back Pain or Hip or Knee Osteoarthritis Pain

Uncritical Publication of a Biased Study Leads to Misleading Media Reports. Lynn R Webster. Pain Medicine, pny234, https://doi.org/10.1093/pm/pny234

Excerpts:
On March 6, 2018, the Journal of the American Medical Association (JAMA) published a manuscript titled “Effect of Opioid vs Nonopioid Medications on Pain-Related Function in Patients With Chronic Back Pain or Hip or Knee Osteoarthritis Pain: The SPACE Randomized Clinical Trial,” by Krebs et al. [1]. The authors concluded that treatment with opioids was not superior to treatment with nonopioid medications for improving pain-related function over 12 months. The national interest in this topic and the putative results of the study led to headlines in major news outlets touting proof that opioids were not effective for chronic noncancer pain. The article is in the top 5% of all research outputs measured by Altmetric: As of this writing, 313 news stories from 191 outlets, 2 278 tweeters, 45 Facebook pages, nine blogs, and seven Redditors have reported on the study [2]. This much media reach could influence social and political policy for the better if the understanding of the research is valid. Unfortunately, the conclusions of the article were widely mischaracterized so that the extensive reporting could instead lead to harm. Four Letters to the Editor of JAMA, along with a reply by Krebs et al., were published, demonstrating that others also had concerns about the manuscript [3–7]. We as researchers and reviewers of manuscripts can better help people to understand this type of complicated research on controversial topics. Here is my analysis of how the journal authors, reviewers, and media got it wrong.

[...]

Here is a simple analogous illustration of how the pragmatic study design was compromised. In Scenario A, a market research study with the strict inclusion criteria of an RCT is conducted among ice cream consumers to determine their preferred ice cream flavor: chocolate, vanilla, or no preference. The average result will almost surely be either chocolate or vanilla.

Scenario B, in contrast, is a pragmatic trial that would include all consumers, both those who eat ice cream and those who do not, so the inference to consumers as a whole can be made. If the majority of study participants do not even eat ice cream, the average result will almost surely be no preference. The inference is wider, and yet the pragmatic study conclusion does not apply to the relevant market research question: If a consumer is going to buy ice cream (which will only happen with consumers who eat ice cream), which flavor will they choose? A reasonable person would realize that the pragmatic study approach is not useful in this situation.

A more extreme Scenario C would exclude ice cream consumers altogether, so the foregone conclusion is no preference. Now the study is so ludicrous that there is a legitimate question as to whether the study should be conducted. This scenario no longer represents pragmatic research because it violates the central principle of “little or no selection beyond the clinical indication of interest.” It is merely a poorly designed study with participant selection bias so extreme that it has no scientific validity.

What if after conducting the Scenario C study, the investigators did not point out the selection bias to the reader and the impact it had on the results (ice cream consumers were excluded, masking that chocolate is the more popular ice cream flavor)? What if, further, the investigators did not report the additional finding that consumers reported that they prefer chocolate over vanilla in other foods, misleading by omission? [...]

These omissions describe the errors in the JAMA article. By specifically excluding patients who had tolerated and presumably benefitted from opioids (ice cream consumers), the investigators studied only participants 1) who had previously tried opioids and discovered they did not respond to them and 2) patients who had never tried opioids because they had previously responded adequately to nonopioid medications. In the words of the analogy, they studied only people who do not consume ice cream.

Naturally, therefore, the JAMA study achieved the only finding possible: that both opioids and nonopioids reduced pain equally well in patients in whom opioids were not medically indicated. Unfortunately, and probably unintentionally, the authors’ conclusion underplayed the selection bias: “Treatment with opioids was not superior to treatment with nonopioid medications for improving pain-related function over 12 months. Results do not support initiation of opioid therapy for moderate to severe chronic back pain or hip to knee osteoarthritis pain.” This is not a false conclusion, but it is misleading. [...]

The study authors could have partially ameliorated these problems by informing JAMA readers of the serious selection bias. To accomplish this, the JAMA article should have contained a more complete description of how opioid users were identified and how they were excluded from the study. [...]

Inverse association between caffeine intake and depressive symptoms in US adults

Inverse association between caffeine intake and depressive symptoms in US adults: data from National Health and Nutrition Examination Survey (NHANES) 2005–2006. Sohrab Iranpour, Siamak Sabour. Psychiatry Research, https://doi.org/10.1016/j.psychres.2018.11.004

Highlights
•    We used the 9-item Patient Health Questionnaire to examine the association between caffeine consumption and depressive symptoms
•    Data derived from 4737 individuals aged ≥18 years who participated in the 2005–06 National Health and Nutritional Examination Surveys.
•    A multiple logistic regression analysis suggested that caffeine's psychostimulant properties protect against depressive symptoms.

ABSTRACT: The objective of this study was to examine the association between caffeine consumption and depressive symptoms. We used data from the 2005–06 National Health and Nutritional Examination Surveys (NHANES). A total of 4737 individuals aged ≥18 years who answered the caffeine intake and PHQ-9 questionnaires were selected for this study. Depressive symptoms were assessed using the 9-item Patient Health Questionnaire (PHQ-9) with total scores between 0 and 27. Those with PHQ-9 total scores ≥10 were considered as having clinically relevant depression. To investigate the association of caffeine intake and PHQ-9 scores, a multiple logistic regression was used in different models. The overall weighted prevalence of depression was 5.5% (4.3% in men and 6.6% in women). After controlling for potential confounders (age, sex, family PIR, education, marital status, disease history, sleep disorders, thyroid problems, physical activity, social support, smoking, total energy, and cholesterol, retinol, vitamin A, beta-carotene, beta-criptoxanthin, vitamin B1, iron, and phosphorus levels), a significant nonlinear inverse association between caffeine consumption and PHQ-9 scores was observed. In conclusion, caffeine's psychostimulant properties appear to protect against depressive symptoms; however, additional prospective studies are required to ascertain whether or not caffeine consumption can lead to a decrease in depressive symptoms.