Hello everyone! Thanks so much for all these questions. We'll leave it a couple more days before we start replying properly, but we'll try to answer all of them. And we'll discuss between us which ones we want to address in a future episode! Keep them coming. Thanks again!
Related to something I saw Stuart post on twitter. What do studies show regarding the behavior/safety of different breeds of dogs? I've heard lots of people say that Pit Bulls are not dangerous or aggressive unless they are raised to be, but they don't seem impartial.
I think you guys are off to a strong start. Engaging content and your episodes are generally of Goldilocks length.
I would encourage you to have guests on occasion. It is good to spice things up, you two are good at asking questions (your day jobs), and then you don't have to be the total experts on every topic.
Please consider doing a round two on nicotine and vaping and invite Prof Ann McNeill of KCL's Nicotine Research Group. She has led the teams preparing the PHE/OHID evidence reviews and is highly regarded in the field. Measured, respectful, and just knows everything about these topics, including having contributed to a lot of the primary research.
Keep up the good work and thank you!
Joe
Disclosures: My employer, PinneyAssociates, Inc., provides consulting services on tobacco harm minimization for JUUL Labs, Inc., on an exclusive basis. I also own an interest in a novel nicotine gum that has not been developed nor commercialized.
PS to answer another part of your question: yes, it would be wonderful to have guests on, particularly those who cite or carried out the relevant research, so they can also comment on drawbacks. One thing that I honestly would *love* to see is a forum for a long form discussion (not an Oxford style debate) between proponents of opposite views, so they can really hammer home what they each agree on and what they each disagree on. So for big topics, if there are two commentators citing opposite conclusions from "the studies", what I would really love to see is to have the disagreement discussed and hashed out in a constructive way. I'm not sure if that's possible!!
Hi there! I often find almost any big topic overwhelming to understand because there are so many claims over what research shows and I find myself in an endless loop of clicking on a study reported in an article or cited in a show and then discovering very quickly that that study didn't seem to show what is being claimed. So, thank you for your show! I'm really enjoying it.
Anyway, I have a few questions I have been pondering:
1. What do we actually know about the risk and impact of the hormonal combined contraceptive pill? There is so much out there about the risks of everything from blood clots to changes in female sexual desire, to estrogen killing all the frogs. What do the studies actually show on this question?
2. Carrying on with the theme of the impact of hormones: there was a question below on what we actually know about puberty blockers which I also have been thinking about. That would be a great one to cover too. Also, more broadly, what does the research actually show about the impact of the watchful waiting method Vs the immediate validation methods of treatment, and how strong is the evidence for things like rapid onset dysphoria or social contagions amongst some groups?
3. Do we have any good studies or data on reproductive technology, e.g IVF, surrogacy, etc? What do we know about the risks, benefits, harms, etc?
4. In conversations on marriage and divorce, people almost inevitably bring up statistics that everyone sort of knows but that I found hard to track down in any meaningful sense, like almost half of marriages end in divorce, and women are much more likely to initiate a divorce than men, that family courts are discriminatory towards fathers in favour of mothers, etc. People then draw conclusions from this that I can't see any justification for, for example, even if it is true that women initiate divorce more, does that tell us that they gave up on the marriage first, or just that they file more of the paperwork? If family courts favour mothers in more cases, is that because they're favouring women, or favouring whoever was the primary carer? In other words: What do we actually know about marriage, divorce, and - just to be spicy- adultery, rates of infidelity?
5. Linked to the above, there are lots of commentators now who emphasise the risks to children who grow up with unmarried versus married parents, and divorced parents versus those who are together, a lot of commentary on fatherless homes in particular, and a lot of commentary on the risks of growing up with a stepparent in the home (especially stepfathers). Again, it strikes me as difficult to tell whether some of the outcomes are due to the marital state of the parents themselves, or whether it is just that those parents who are able to stay married and create a stable home environment are also the sort of people who can parent a child towards better outcomes, or whether there is a genetic link there. What can we actually conclude from the research?
I appreciate those are all more sociological questions than the topics you usually cover, which are more amenable to bring studied in lab settings. But I focused on those ones because I already agree with pretty much every topic you've said you should do an episode on! Yes to them all!
Recently someone shared year over year standardized test scores for my kids' school. My gut tells me this is a terrible way to look at data, given theyre two different cohorts and one group could have started well behind another group, scored lower on the test, but actually achieved more learning during the year. Is this silly of me? Regardless of the small sample size problem, comparing cohorts from year to year on standardized tests to evaluate the school is going to be full of problems, right?
Also, it's all the rage these days to claim social media is harming children, but is this any different than the "video games are harming children" argument? (Or dance halls, or pinball, etc.) I've seen this argument with citations of studies showing an increase in mental health treatment for youth, but that's terrible analysis to then link it to social media, right?
You’ve already answered my first question - whether the podcast will focus solely on medical questions - with the latest episode.
In terms of topics, I’d definitely be interested in:
Meditation/mindfulness - I vaguely remember reading that a small percentage of people have negative side effects, but a sufficiently high number that if it were a drug you probably wouldn’t prescribe it
Intermittent fasting
Functional disorders - my prior (prejudice?) here is that they exist but are vastly over-diagnosed and the therapies offered have a very poor evidence base, particularly with regard to long-term efficacy.
Perhaps after you’ve done something less contentious, like youth gender medicine, a look at whether cycle helmets actually reduce risk.
Again, a nice non-contentious topic: do diversity trainings work?
Here's another episode suggestion: Placebo effect. I recently came across this (someone posted it somewhere) https://www.nejm.org/doi/full/10.1056/nejm200105243442106. It compares studies that have placebo groups and no treatment groups and finds very little evidence of a placebo effect. I was listening to a podcast the other day and a host said confidently, "We know the placebo effect is real." I've even heard people suggest prescribing placebos to trigger the effect in lieu of actual treatment. This study is also over 20 years old. What is the current status of the placebo effect?
One thing I haven’t heard discussed but is an important topic for me as a clinical psychologist is what to make of all the evidence-based psychotherapies in light of the replication crisis in psychology. Please cover this!
What's the optimal office temperature? Or more realistically, what is the optimal range of office temperatures. In other words as temperature drops, or rises, is there an inflection point in productivity, meaning we should design air-con systems to stay within a certain range and stop pandering to wimps, usually women and gayers ime who can't adjust their clothing by one layer. Or are we better insisting on a tight temperature range for the AC so no-one has to adjust their apparel and the energy and climate costs of that ('cos climate costs aren't in prices though they should be) can go swivel.
It would be helpful if you made brief asides (with editing?) to define terms of art from statistics or methodology. I know this is will be mildly repetitive but many common concepts aren't well defined (or understood) in the sciences. I think they're often critical to define to build to your larger points (eg Stu looks like a hedgehog, p < 0.00001).
What are your thoughts on technologies such as GeneSight (genetic testing for predicting best responses to psychotropic medications) and AlphaStim (cranial electro therapy stimulating)? Do any of these novel technologies for the treat of mental health symptoms look promising to you?
I would love to hear what the studies show about EMDR therapy. When I was in graduate school in Clinical Psychology two decades ago, the consensus was that eye movement part of EMDR was all window dressing and it was the trauma exposure aspect that healed patients. However, I see now that both the WHO sand American Psychological Association list EMDR as an evidence based therapy.
Another interesting topic for the show to explore would be the idea of "trauma". It seems like more and more problems are being labeled as trauma, and the source of that alleged trauma is often very unclear or unfalsifiable. For example, there is this very popular physician called Gabor Mate who attributes all kinds of health problems to hidden childhood trauma. This just seems like the "repressed memory" panic of the 1990's to me. The problem is that people like him get lots of uncritical media attention, and virtually nobody requests data and evidence for his claims. It would be nice to see you both dissect the evidence behind such claims.
Ask us anything!
Hello everyone! Thanks so much for all these questions. We'll leave it a couple more days before we start replying properly, but we'll try to answer all of them. And we'll discuss between us which ones we want to address in a future episode! Keep them coming. Thanks again!
This may be too spicy for your show, but I’d love to see a conversation with Jesse Singal about his reporting on puberty blocker studies and research degrees of freedom (e.g., https://jessesingal.substack.com/p/on-scientific-transparency-researcher).
I also really enjoyed Stuart’s short book on intelligence, and a conversation about IQ (myths and facts) would be really cool
Related to something I saw Stuart post on twitter. What do studies show regarding the behavior/safety of different breeds of dogs? I've heard lots of people say that Pit Bulls are not dangerous or aggressive unless they are raised to be, but they don't seem impartial.
I think you guys are off to a strong start. Engaging content and your episodes are generally of Goldilocks length.
I would encourage you to have guests on occasion. It is good to spice things up, you two are good at asking questions (your day jobs), and then you don't have to be the total experts on every topic.
Please consider doing a round two on nicotine and vaping and invite Prof Ann McNeill of KCL's Nicotine Research Group. She has led the teams preparing the PHE/OHID evidence reviews and is highly regarded in the field. Measured, respectful, and just knows everything about these topics, including having contributed to a lot of the primary research.
Keep up the good work and thank you!
Joe
Disclosures: My employer, PinneyAssociates, Inc., provides consulting services on tobacco harm minimization for JUUL Labs, Inc., on an exclusive basis. I also own an interest in a novel nicotine gum that has not been developed nor commercialized.
PS to answer another part of your question: yes, it would be wonderful to have guests on, particularly those who cite or carried out the relevant research, so they can also comment on drawbacks. One thing that I honestly would *love* to see is a forum for a long form discussion (not an Oxford style debate) between proponents of opposite views, so they can really hammer home what they each agree on and what they each disagree on. So for big topics, if there are two commentators citing opposite conclusions from "the studies", what I would really love to see is to have the disagreement discussed and hashed out in a constructive way. I'm not sure if that's possible!!
Hi there! I often find almost any big topic overwhelming to understand because there are so many claims over what research shows and I find myself in an endless loop of clicking on a study reported in an article or cited in a show and then discovering very quickly that that study didn't seem to show what is being claimed. So, thank you for your show! I'm really enjoying it.
Anyway, I have a few questions I have been pondering:
1. What do we actually know about the risk and impact of the hormonal combined contraceptive pill? There is so much out there about the risks of everything from blood clots to changes in female sexual desire, to estrogen killing all the frogs. What do the studies actually show on this question?
2. Carrying on with the theme of the impact of hormones: there was a question below on what we actually know about puberty blockers which I also have been thinking about. That would be a great one to cover too. Also, more broadly, what does the research actually show about the impact of the watchful waiting method Vs the immediate validation methods of treatment, and how strong is the evidence for things like rapid onset dysphoria or social contagions amongst some groups?
3. Do we have any good studies or data on reproductive technology, e.g IVF, surrogacy, etc? What do we know about the risks, benefits, harms, etc?
4. In conversations on marriage and divorce, people almost inevitably bring up statistics that everyone sort of knows but that I found hard to track down in any meaningful sense, like almost half of marriages end in divorce, and women are much more likely to initiate a divorce than men, that family courts are discriminatory towards fathers in favour of mothers, etc. People then draw conclusions from this that I can't see any justification for, for example, even if it is true that women initiate divorce more, does that tell us that they gave up on the marriage first, or just that they file more of the paperwork? If family courts favour mothers in more cases, is that because they're favouring women, or favouring whoever was the primary carer? In other words: What do we actually know about marriage, divorce, and - just to be spicy- adultery, rates of infidelity?
5. Linked to the above, there are lots of commentators now who emphasise the risks to children who grow up with unmarried versus married parents, and divorced parents versus those who are together, a lot of commentary on fatherless homes in particular, and a lot of commentary on the risks of growing up with a stepparent in the home (especially stepfathers). Again, it strikes me as difficult to tell whether some of the outcomes are due to the marital state of the parents themselves, or whether it is just that those parents who are able to stay married and create a stable home environment are also the sort of people who can parent a child towards better outcomes, or whether there is a genetic link there. What can we actually conclude from the research?
I appreciate those are all more sociological questions than the topics you usually cover, which are more amenable to bring studied in lab settings. But I focused on those ones because I already agree with pretty much every topic you've said you should do an episode on! Yes to them all!
Recently someone shared year over year standardized test scores for my kids' school. My gut tells me this is a terrible way to look at data, given theyre two different cohorts and one group could have started well behind another group, scored lower on the test, but actually achieved more learning during the year. Is this silly of me? Regardless of the small sample size problem, comparing cohorts from year to year on standardized tests to evaluate the school is going to be full of problems, right?
Also, it's all the rage these days to claim social media is harming children, but is this any different than the "video games are harming children" argument? (Or dance halls, or pinball, etc.) I've seen this argument with citations of studies showing an increase in mental health treatment for youth, but that's terrible analysis to then link it to social media, right?
You’ve already answered my first question - whether the podcast will focus solely on medical questions - with the latest episode.
In terms of topics, I’d definitely be interested in:
Meditation/mindfulness - I vaguely remember reading that a small percentage of people have negative side effects, but a sufficiently high number that if it were a drug you probably wouldn’t prescribe it
Intermittent fasting
Functional disorders - my prior (prejudice?) here is that they exist but are vastly over-diagnosed and the therapies offered have a very poor evidence base, particularly with regard to long-term efficacy.
Perhaps after you’ve done something less contentious, like youth gender medicine, a look at whether cycle helmets actually reduce risk.
Again, a nice non-contentious topic: do diversity trainings work?
Here's another episode suggestion: Placebo effect. I recently came across this (someone posted it somewhere) https://www.nejm.org/doi/full/10.1056/nejm200105243442106. It compares studies that have placebo groups and no treatment groups and finds very little evidence of a placebo effect. I was listening to a podcast the other day and a host said confidently, "We know the placebo effect is real." I've even heard people suggest prescribing placebos to trigger the effect in lieu of actual treatment. This study is also over 20 years old. What is the current status of the placebo effect?
One thing I haven’t heard discussed but is an important topic for me as a clinical psychologist is what to make of all the evidence-based psychotherapies in light of the replication crisis in psychology. Please cover this!
What's the optimal office temperature? Or more realistically, what is the optimal range of office temperatures. In other words as temperature drops, or rises, is there an inflection point in productivity, meaning we should design air-con systems to stay within a certain range and stop pandering to wimps, usually women and gayers ime who can't adjust their clothing by one layer. Or are we better insisting on a tight temperature range for the AC so no-one has to adjust their apparel and the energy and climate costs of that ('cos climate costs aren't in prices though they should be) can go swivel.
It would be helpful if you made brief asides (with editing?) to define terms of art from statistics or methodology. I know this is will be mildly repetitive but many common concepts aren't well defined (or understood) in the sciences. I think they're often critical to define to build to your larger points (eg Stu looks like a hedgehog, p < 0.00001).
What are your thoughts on technologies such as GeneSight (genetic testing for predicting best responses to psychotropic medications) and AlphaStim (cranial electro therapy stimulating)? Do any of these novel technologies for the treat of mental health symptoms look promising to you?
I would love to hear what the studies show about EMDR therapy. When I was in graduate school in Clinical Psychology two decades ago, the consensus was that eye movement part of EMDR was all window dressing and it was the trauma exposure aspect that healed patients. However, I see now that both the WHO sand American Psychological Association list EMDR as an evidence based therapy.
Another interesting topic for the show to explore would be the idea of "trauma". It seems like more and more problems are being labeled as trauma, and the source of that alleged trauma is often very unclear or unfalsifiable. For example, there is this very popular physician called Gabor Mate who attributes all kinds of health problems to hidden childhood trauma. This just seems like the "repressed memory" panic of the 1990's to me. The problem is that people like him get lots of uncritical media attention, and virtually nobody requests data and evidence for his claims. It would be nice to see you both dissect the evidence behind such claims.
Hello! Have you considered doing an episode on attention spans and if they have shortened due to social media and similar?
It's something often assumed to be true but what does the actual research say?