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NP Platformed: A huge breakthrough in dementia prevention or a glitch in the matrix?

The Vancouver Sun sent this email to their subscribers on June 1, 2023.

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Plus: Losing faith in Johnston View this email in your browser NP PLATFORMED Welcome to NP Platformed, a daily newsletter from NP Comment. Was this newsletter forwarded to you? Sign up here to have National Post deliver it to your inbox. QUOTE OF THE DAY "You could fill a newspaper’s obituary page with all the institutions Justin Trudeau’s Liberals have marred, stomped over like defiant toddlers in the throes of a tantrum and ultimately dealt crippling blows it will take years to recover from." — Sabrina Maddeaux Alternate text Arlen Redekop/The Province EITHER A SOFTWARE BUG OR A VERY BIG DEAL This week, a big scientific splash was made by a small group of biostatisticians — only four of them! — centred at Stanford University. The quartet may have made a major discovery about infectious disease by looking at big medical data from, of all places, Wales. Like the rest of the United Kingdom, Wales and its autonomous National Health Service keeps a comprehensive linked database of pretty much every interaction that any resident has with physicians, druggists and hospitals … or, well, morticians. The SAIL databank (“Secure Anonymized Information Linkage”) knows when a Welshman gets rheumatoid arthritis or a Crestor prescription, and eventually knows when he dies and what he died of.  I mention all this at the outset of the column to remind Canadians of the shameful state of data collection and data liberation here. Maybe we are too libertarian to tolerate something like SAIL, or its equivalents kept by other European countries and large American insurers. But we’re certainly missing out on world-changing discoveries, and not just in medicine, because of our constipated approach to statistical measurement.  Digression over; back to the actual news. There’s a sort of constant hum among medical researchers about whether there is still a lot of undetected or unsuspected infection wreaking havoc with us and shortening our lives in ways currently attributed to other causes. Occasionally a hypothesis of this kind erupts into the medical mainstream: a good example is provided by multiple sclerosis, which in just the last few years has been shown to be connected closely with the Epstein-Barr virus.  In recent times there have been some accidental big-data findings hinting that infectious disease may be a surprisingly big cause of senile dementia. (Antiviral drugs, taken for whatever reason anytime in life, seem to reduce the risk of it.) The Stanford stat boffins discovered a fascinating way of checking one possibility by exploiting a natural experiment. NHS Wales started rolling out vaccines against herpes zoster in 2013; zoster is the virus that causes chickenpox in children and shingles in older adults, so doctors everywhere are increasingly keen on prophylactic shingles vaccination, because shingles is wretched and occasionally disabling. You may have had your ear bent about this by your own doc.  At the time, trial data suggested there wasn’t much point in giving the zoster vaccine to adults over 80, partly because the protective effect takes years to fully develop. So the Welsh NHS imposed a cutoff according to birthdate. Only those born on or after Sept. 2, 1933, were eligible to be jabbed for zoster. Hence the natural experiment. Is there a noticeable difference in dementia risk between the people born slightly before the cutoff date and those born slightly after?  The answer in the study is “Holy heck, yes.” Only 0.01 per cent of the Welsh people born before the cutoff date ever got a zoster vaccine; among those born after, the rate is 47.2 per cent. As you would expect, the risk of shingles diagnosis is quite a lot lower in the “after” group, about one-third lower. As vaccines go, that’s a decent performance.  But there is also a sharp discontinuity between the “before” and “after” groups when it comes to developing dementia over a seven-year follow-up period. Merely being eligible for the vaccine led to an estimated 8.5 per cent reduction in dementia risk, and since only half of those eligible got the jab, the vaccine itself may cut dementia risk by more like 20 per cent.  Mechanistically, nobody has any idea why or how herpes zoster would predispose someone to dementia. And studies with “regression continuity” designs sometimes have sly weaknesses: few experienced readers would accept that 20 per cent estimate as gospel. On the other hand, the authors worked really hard to rule out confounding explanations for their finding. (They ruled out, for example, a “Sept. 2”-specific effect in other birth years not related to any vaccine rollout.) They redid the math using several different proxies for dementia, and checked out diagnostic subtypes including Alzheimer’s; the discontinuity was there in all cases.  There’s no obvious alternative way of accounting for the drop off in dementia risk. Remember, the idea of a link already had some circumstantial statistical support; and even if the protective effect of zoster vaccine is 10 per cent or five per cent rather than 20, there are still hundreds of other viruses that may be contributing to an easily preventable dementia burden without us knowing it yet. This finding could just be one of those random kinks in the fabric of reality, but it could also be the pistol that starts a race to unfathomable changes in the quality of later human life. — Colby Cosh THE LATEST IN NP COMMENT David Johnston determined to destroy faith in democracy Sabrina Maddeaux: A parliamentary crisis is brewing thanks to the former governor general The undermining of Canadians’ trust will continue as long as David Johnston remains John Ivison: Poll shows few have faith in David Johnston's report on foreign interference, or Trudeau to fix the problem Erin O'Toole — the man China wanted to take down Terry Glavin: CSIS should brief Conservative candidates who lost, as they 'are in all likelihood still being targeted' Danielle Smith gears up for her next big fight — with Ottawa Rex Murphy: Notley was Smith's local opponent in the election. Trudeau is Alberta's overarching foe In Canada, courts mandate socialism to fulfil charter rights the-vancouver-sun Pardy: The Supreme Court has allowed the philosophy of John Rawls to determine meaning of 'fundamental justice' We could use a little more controversy over Quebec's ridiculous 1995 sovereignty referendum Chris Selley: There is no good reason for testimony and documents about misspending on the No side to remain secret — certainly not forever We should learn to see history as Europeans do, warts and all William Watson: After all, Robespierre has a subway station named after him If you didn’t like Ottawa’s first carbon tax, you won't like the second one either Carson Binda: Buried in the Clean Fuel Regulations Believing in a world without Canadian oil and gas is magical thinking Gina Pappano: To divest from the oil and gas sector is to hurt Canada and everyday Canadians FROM ELSEWHERE It’s only been a few days, if that, since we linked to GMU’s Can-Am economist, Alex Tabarrok. But today, at his Marginal Revolution blog, Tabarrok did the damn-near-impossible by making a new and original observation about George Orwell. ---------------------------------------------------------------------------------------------------------------------------------- Advertisement $ 2038200 QL R LIV T ASIN Was this newsletter forwarded to you? Sign up here to get it delivered to your inbox. We'd like your feedback. Write to us at [email protected] or hit reply to send us a note. ---------------------------------------------------------------------------------------------------------------------------------- Advertisement $ 2038200 QL R LIV T ASIN © 2023 Postmedia Network Inc. All rights reserved. Unauthorized distribution, transmission or republication strictly prohibited. 365 Bloor St East, Toronto, ON, M4W 3L4 You received this email because you are subscribed to NP Platformed, registered as [email protected] • • • Contact us © 2023 Postmedia Network Inc. All rights reserved.
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