Confirmation bias

[KennyA]

Some excellent posts and a couple of highly illustrative examples made on this thread. Many thanks to all for taking the time to respond.

On the point above about Wikipedia it should be noted that anyone can make changes to a Wikipedia page. When a change is proposed you have to do a bit of digital battle with avid Wikipedia keepers and must prove your edits with references if your edits are contested. If no page exists for Dr. Unwin then, if anyone is inclined to learn about the process, a page may be created. Wikipedia is no more biased than the people who are willing to invest their time in adding to it and maintaining it.

That is no longer the case, and hasn't been for many years. I have in the past been prevented from making factual changes to Wikipedia pages.

Wikipaedia still claims anyone can post there, but this is true only up to a point. Wikipedia now insists you comply with their rules and ethos - this includes:

All Wikipedia articles and other encyclopedic content must be written from a neutral point of view, representing significant views fairly, proportionately and without bias.

Wikipedia of course gets to say what's neutral, what's significant, what's proportionate, and what is bias.

 

[ianf0ster]

I used to be naive about the impartiality of things like Medical Studies, Public Service Broadcastsers, Medical Charities and Wikipedia.

But then over 80% of all medical research supports the views of those funding it. Thinking about this I'm amazed that it isn't 100% since they all need funding and if the results don't match what the funder desires, then not publishing is always a tempting option. - I understand that happening. there - even researchers need to earn a living.
What really makes me angry (strangely, because the truth usually/often eventually comes out) are the ones where the headlines are the exact opposite of the data! And the ones where the data is organised (without taking all confounders into consideration) so as to support a theory where an alternative organisation of data would not support the theory. I really hate those, because they are just trying use their intelligence and superior technical knowledge to 'con' the uninformed (both Doctors and public).

 

[Lupf]

Some excellent posts and a couple of highly illustrative examples made on this thread. Many thanks to all for taking the time to respond.

On the point above about Wikipedia it should be noted that anyone can make changes to a Wikipedia page. When a change is proposed you have to do a bit of digital battle with avid Wikipedia keepers and must prove your edits with references if your edits are contested. If no page exists for Dr. Unwin then, if anyone is inclined to learn about the process, a page may be created. Wikipedia is no more biased than the people who are willing to invest their time in adding to it and maintaining it

That is no longer the case, and hasn't been for many years. I have in the past been prevented from making factual changes to Wikipedia pages.

Wikipaedia still claims anyone can post there, but this is true only up to a point. Wikipedia now insists you comply with their rules and ethos - this includes:

All Wikipedia articles and other encyclopedic content must be written from a neutral point of view, representing significant views fairly, proportionately and without bias.

Wikipedia of course gets to say what's neutral, what's significant, what's proportionate, and what is bias.

I confirm what @KennyA is saying. In my field I've noted that Wikipedia put a stop to a controversy when people started editing a page, and it has removed all reference to public disputes. The page is now totally anodine. So I wasn't surprised not to find pages on some of the more vocal LCHF proponents.

From a wikipedia point of view this is understandable as they do not want to be seen to give conspiracy theorists a platform. Unfortunately this can affect actual scientific disputes.

 

[HairySmurf]

Wikipaedia still claims anyone can post there, but this is true only up to a point. Wikipedia now insists you comply with their rules and ethos - this includes:

All Wikipedia articles and other encyclopedic content must be written from a neutral point of view, representing significant views fairly, proportionately and without bias.

Wikipedia of course gets to say what's neutral, what's significant, what's proportionate, and what is bias.

Sounds like a pretty good ethos to me. Written in language that does not sway the reader toward any particular competing viewpoint, includes references to all competing viewpoints, and does not favour one viewpoint over another via the quantity or quality of swaying statements or references. The people who decide that are almost entirely volunteers interested in specific topics. There are over 6.7 million pages on Wikipedia written in English. Wikipedia staff only tend get involved with a small minority of pages written about highly controversial matters. Sure, if you want to edit the page about Donald Trump for example you'll run into the paid Wikipedia edit police, but absolutely nothing would stop you writing a balanced page about Dr. Unwin for example.

 

[KennyA]

Sounds like a pretty good ethos to me. Written in language that does not sway the reader toward any particular competing viewpoint, includes references to all competing viewpoints, and does not favour one viewpoint over another via the quantity or quality of swaying statements or references. The people who decide that are almost entirely volunteers interested in specific topics. There are over 6.7 million pages on Wikipedia written in English. Wikipedia staff only tend get involved with a small minority of pages written about highly controversial matters. Sure, if you want to edit the page about Donald Trump for example you'll run into the paid Wikipedia edit police, but absolutely nothing would stop you writing a balanced page about Dr. Unwin for example.

I think this totally misses the point. You will not find a page about David Unwin on Wikipedia. Can you think why?

This is what Wikipedia says about this forum:

The forum was cited as being popular in highlighting the adoption of a low carbohydrate diet as a way of achieving weight loss and improving HbA1c in patients with Type 2 Diabetes, despite the approach being 'generally frowned upon in the UK'.[12]

Now, this reference actually takes you to David Unwin's 2014 paper here:

https://wchh.onlinelibrary.wiley.com/doi/10.1002/pdi.1835

But the selective and partial quote lifted from the paper makes it look like the reference endorses an anti-low carb opinion. This has presumably been through Wikipedia's editing process, and therefore I have to assume the implication is intentional. Here is the full quote:

Studies have shown good results for a low carbohydrate/higher fat diet in people with type 2 diabetes and in those with central obesity.2,3,7 However, the approach is generally frowned upon in the UK, despite the fact that many patients are trying it of their own accord.

And here is the abstract from the paper:

Patients with diabetes have long been exhorted to give up sugar, encouraged instead to take in fuel as complex carbohydrate such as the starch found in bread, rice or pasta (especially if ‘wholemeal’). However, bread has a higher glycaemic index than table sugar itself. There are no essential nutrients in starchy foods and people with diabetes struggle to deal with the glycaemic load they bring. The authors question why carbohydrate need form a major part of the diet at all. The central goal of achieving substantial weight loss has tended to be overlooked. The current pilot study explores the results of a low carbohydrate diet for a case series of 19 type 2 diabetes and pre-diabetes patients over an eight-month period in a suburban general practice.

A low carbohydrate diet was observed to bring about major benefits. Blood glucose control improved (HbA1c 51±14 to 40±4mmol/mol; p<0.001). By the end of the study period only two patients remained with an abnormal HbA1c (>42mmol/mol); even these two had seen an average drop of 23.9mmol/mol. Weight fell from 100.2±16.4 to 91.0±17.1kg (p<0.0001), and waist circumference decreased from 120.2±9.6 to 105.6±11.5cm (p<0.0001). Simultaneously, blood pressure improved (systolic 148±17 to 133±15mmHg, p<0.005; and diastolic 91±8 to 83±11mmHg, p<0.05). Serum gamma-glutamyltransferase decreased from 75.2±54.7 to 40.6±29.2 U/L (p<0.005). Total serum cholesterol decreased from 5.5±1.0 to 4.7±1.2mmol/L (p<0.01).

This approach is easy to implement in general practice, and brings rapid weight loss and improvement in HbA1c. Copyright © 2014 John Wiley & Sons. Practical Diabetes 2014; 31(2): 76–79

 

[HairySmurf]

I think this totally misses the point. You will not find a page about David Unwin on Wikipedia. Can you think why?

Yes, I can think why. I will not find a page about Dr. Unwin on Wikipedia because nobody has taken the time to create one.

Here's a step by step guide:

How to Create a Wikipedia Page for Someone: A Step-by-Step Guide

Wikipedia is one of the most popular and widely used online encyclopedias, containing a vast amount of information on various topics. Creating a Wikipedia page for someone can be a great way to establish their online presence, highlight their achievements, and provide accurate information to the pub

www.linkedin.com

Here's an article in The Guardian that establishes 'significant coverage', 'impact' and 'demonstrated level of notability' - the thresholds a person must pass in order to warrant their own Wikipedia page. If there's one article I would assume there are others:

British doctor pioneers low-carb diet as cure for obesity and type 2 diabetes

A lifestyle approach developed by Dr David Unwin shows benefits that could have significant health implications

www.theguardian.com

The rest is the process is something you, or anyone, anywhere, can figure out themselves, if they can be bothered.

As to your point about the selective quote - is the 'generally frowned upon' bit not fact? Seems okay to me, whatever the source. In fact, it might be pretty clever of someone to link to a pro-low carb paper like that. 'Low carb is generally frowned upon, and you can check if this is fact or not by reading this paper here'. Who do you think wrote the Wikipedia page for this website Kenny? Who do you imagine took the time to do that?

 

[zand]

Low carb isn't frowned upon by my GP surgery anymore. I was given a great leaflet about it at my last diabetic review.

 

[lovinglife]

Low carb isn't frowned upon by my GP surgery anymore. I was given a great leaflet about it at my last diabetic review.

Mine neither, in fact they actively encourage it

 

[Kernow Debra]

Mine too! First thing GP told me was “you can reverse this”.
Gave me a leaflet about Dr Michael Mosely’s low carb diet.

 

[HairySmurf]

Good points - it seems like that Wikipedia page could do with an update. Any volunteers?

 

[AndBreathe]

Low carb isn't frowned upon by my GP surgery anymore. I was given a great leaflet about it at my last diabetic review.

Was the leaflet something they had composed themselves, or had bought in?

 

[AndBreathe]

Good points - it seems like that Wikipedia page could do with an update. Any volunteers?

You seem keen yourself?

 

[zand]

Was the leaflet something they had composed themselves, or had bought in?

It was a print-out comprising 4 pages. One with colour pictures of what to eat and what not to eat. I gave the original to my daughter-in -law, unfortunately I can't find my photocopy now. I don't remember any mention of any organisation though.

 

[Kernow Debra]

Was the leaflet something they had composed themselves, or had bought in?

Mine was a self composed letter for all newly diagnosed.
From the head GP, some useful links to DVLA and info on meds for driving.
A quick explanation of reversal and a link to the
Fast 800 diet, Dr Mosley
Also a link to The Mediterranean Diet if I remember correctly.

Didn’t fancy the crash type 800 diet, as I wanted long term solution.
And the Mediterranean was a no no as my partner is violently allergic to fish!

But the GP’s letter had sowed the seeds of reversal and hallelujah I found this forum and low carb was adopted.
87 to 38 after 3 months(with meds)
38 to 40 after 3 months with no meds
40 to 37 after another 3 months no meds.

Also have to say my DN has been very supportive and happy to let me do my thing.
Only thing she raised her eyebrows at was me not cutting my fat off my bacon!

Let’s hope all GP practises sow the seeds.

 

[AndBreathe]

It was a print-out comprising 4 pages. One with colour pictures of what to eat and what not to eat. I gave the original to my daughter-in -law, unfortunately I can't find my photocopy now. I don't remember any mention of any organisation though.

Thanks. No worries.

 

[AndBreathe]

Mine was a self composed letter for all newly diagnosed.
From the head GP, some useful links to DVLA and info on meds for driving.
A quick explanation of reversal and a link to the
Fast 800 diet, Dr Mosley
Also a link to The Mediterranean Diet if I remember correctly.

Didn’t fancy the crash type 800 diet, as I wanted long term solution.
And the Mediterranean was a no no as my partner is violently allergic to fish!

But the GP’s letter had sowed the seeds of reversal and hallelujah I found this forum and low carb was adopted.
87 to 38 after 3 months(with meds)
38 to 40 after 3 months with no meds
40 to 37 after another 3 months no meds.

Also have to say my DN has been very supportive and happy to let me do my thing.
Only thing she raised her eyebrows at was me not cutting my fat off my bacon!

Let’s hope all GP practises sow the seeds.

Mediterranean is a style, but fish isn’t mandatory. My OH has significant issues with fish too, although much more so with crustaceans

Anyway, the main thing is, you found a way.

 

[HairySmurf]

You seem keen yourself?

Nope, I'm biased

 

[AndBreathe]

Nope, I'm biased

Nobody noticed