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Thursday, November 13, 2003
By Steven
Milloy
A new "study" claims a rise in heart
attacks treated at a Brooklyn hospital can be traced to the
Sept. 11 attacks.
But it's hard to decide which had less
thought go into it — this inadequate research or the American
Heart Association's decision to promote it.
The study's researchers compared the number
of patients admitted to the hospital for possible heart attack
or serious heart rhythm disturbance from July 13 to Sept. 10,
2001 (pre-9/11) with the number of patients admitted from
Sept. 11 to Nov. 10, 2001 (post-9/11). A similar comparison
was done for the same time period during the preceding year of
2000.
A 35 percent increase in heart attacks and
a 40 percent increase in arrhythmia were reported from
pre-9/11 to post-9/11. For the year 2000, the reported
increases in heart attack and arrhythmia were only 6 percent
and 7.5 percent, respectively, for the same time periods.
Combined with the indisputable facts that
the Sep. 11 attacks caused increased stress among many and
stress increases the risk of heart attacks and arrhythmia, the
claim that the Sep. 11 attacks increased the number of heart
attacks has some intuitive appeal.
It's too bad that the purported analysis
falls way short of confirming intuition.
First, the data presented are from only one
hospital. But there are about 65 hospitals in New York City
— and many other emergency medical facilities — that
weren't included in the study. The researchers didn't explain
why they thought the data from the Brooklyn hospital were
sufficient to make their case.
The study included a total of 113 heart
attack cases for 2001 and 103 for 2000. But this is only a
small fraction of the total number of heart attacks that
occurred in New York City during those years.
There were 4,775 fatal heart attacks in New
York City during 2001, according to the City's compilation of
vital statistics, meaning there could have been up to tens of
thousands more non-fatal heart attacks. The heart attack cases
included in this study constitute a very small and likely
non-representative proportion of the number of heart attacks
in New York City.
Ironically, New York City vital statistics
indicate that more fatal heart attacks occurred citywide in
2000 (4,815) than in 2001 (4,775). It's not clear that the
heart attack experience at the lone Brooklyn hospital reflects
the citywide experience.
It would also be important to compare the
2001 heart attack experience with more than just year 2000
data. After all, how do we know that 2000, rather than 2001
isn't the real anomaly?
Despite the small number of heart attacks
involved in this study, no effort was made to see whether any
of the heart attacks might have been related to stress caused
by the Sep. 11 attacks. The researchers apparently expect us
to assume that because there were more heart attacks in the
post-9/11 period, the increase can only be due to the Sep. 11
attacks.
Certainly, some of the media fell for that
line. Reuters' headline, for example, was "Study: Sept. 11
Attacks Cause Rise in Heart Attack."
About two weeks before the study was
released, I contacted University of Texas Medical School
researcher Dr. Jianwei Fang for a copy of the full study.
Rather than providing a copy, he referred me to the media
relations department of the American Heart Association, at
whose conference the results were released this week.
The Heart Association responded by sending
me a copy of Dr. Fang's abstract, essentially a
quick-and-dirty overview of the study results. When I
reiterated my request for a copy of the complete study, the
Heart Associated responded, "there is no full study at this
point."
Persisting in my futile request — I still
can't get over the fact that researchers announce study
results that can't be validated, verified or even minimally
reviewed before being trumpeted to the media — I asked the
Heart Association how I was supposed to evaluate the claims
without the study.
The Heart Association responded that I was
"free to ask other researchers to comment on the abstract to
gauge its validity." But how can anyone gauge the validity of
a study based on just a sketchy abstract?
The American Heart Association assured me
that because the abstract was accepted for presentation "means
it offers some degree of credibility."
I beg to differ.
Steven Milloy is the publisher of JunkScience.com, an adjunct scholar at the Cato
Institute and the author of Junk Science Judo: Self-defense Against Health
Scares and Scams (Cato Institute, 2001).
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