U3A Talk

This is a talk on life as well as on common medical controversies.
People are generally well meaning.
Treat others as we would like ourselves to be treated is a motto that most if us work by.
So where does it go wrong?”
Well I guess we all like to be treated in different ways.

I like to think on the alternatives in life, in the choices we make, why we make them and the consequences both obvious and hidden.

Coeliac disease
Screening tests.
The big ones here are Prostate Cancer, Breast Cancer and Bowel Cancer. Why screen at all?

A silly question which carries a sting in the tale.

To detect cancer, and other diseases early enough to be able to do something about them.
Disease exist in our community that develop over time and cause serious health problems.
Tests exist to detect these diseases.
Simple enough.
It has nothing to do with preventing such diseases.
Having a screening test does absolutely nothing to prevent a disease occurring or even worse being present when you do the procedure and being missed.

Who has screening tests. People at risk.

Family History . Population History. Occupational History , Exposure History.

A screening test has to be useful, It has to  have a high sensitivity and high specificity. This means that it is able to detect problems early enough [sensitivity], and accurately enough [specificity].

It has to diagnose conditions that are dangerous, reasonably common and hopefully treatable without causing problems of it’s own worse that what one is trying to treat, in other words it has to be safe.

Screening can by done by endoscopy, faecal and urine sampling, Blood tests and Radiological procedures such as X-Ray, CT , Bone scan and MRI to mention a few.

Pitfalls of testing.

Cost , the equipment is all there  but some are very expensive. New tests in particular. Cheapest but still not cheap are the Urine testing for sugar protein and blood

Time, Some tests like 24 hour ECG’s and bone scans can take days to do

Patients often have limited time themselves to do the test in.



Loss of results

Wrong results

Statistical use of the results.

Endoscopy, looking inside the body through a tube, is a good way of detecting cancers. Lung, throat, Stomach, bladder  and bowel cancer can be detected this way.

Who here volunteers to have a colonoscopy every 6 months? or a bronchoscopy.


Would you have all of them every 5 years? What would be a good age to start.

Not many , Reasons  discomfort, embarrassment, time , risk

Having a procedure often involves having an anaesthetic, The risk of dying from an anaesthetic increases with age and other medical conditions but can occur in healthy young people as well. Somewhere between 1 in 5,00 to 1 in 10,000. As well as the risk of the procedure itself. Perforation of the bowel and  bladder, rupture of the oesophagus, damage to the vocal cords, aspiration and pneumonia, Urethral stricture with a urethroscopy .

wrong diagnosis, no diagnosis, missed diagnosis and lost specimen.

Import of the result and use of statistics. This is one that I have great difficulty in understanding.

Say that a mammogram will diagnose a breast cancer with 95% accuracy.

You have a patient who comes to you with a positive result from a screening procedure.

What should you tell her. As the patient if you are told it has a 95% accuracy what does this mean.

Murky waters lie ahead. The false positive paradox is a statistical result where false positive tests are more probable than true positive tests, occurring when the overall population has a low incidence of a condition and the incidence rate is lower than the false positive rate. When the incidence, the proportion of those who have a given condition, is lower than the test’s false positive rate, even tests that have a very low chance of giving a false positive in an individual case will give more false than true positives overall.[2] So, in a society with very few infected people—fewer proportionately than the test gives false positives—there will actually be more who test positive for a disease incorrectly and don’t have it than those who test positive accurately and do. The paradox has surprised many

Low-incidence population

of people
Infected Uninfected Total
(true positive)
(false positive)
(false negative)
(true negative)
Total 20 980 1000

Now consider the same test applied to population B, in which only 2% is infected. The expected outcome of 1000 tests on population B would be:Infected and test indicates disease (true positive)1000 × 2/100 = 20 people would receive a true positiveUninfected and test indicates disease (false positive)1000 × 100 – 2/100 × 0.05 = 49 people would receive a false positiveThe remaining 931 tests are correctly negative.

In population B, only 20 of the 69 total people with a positive test result are actually infected. So, the probability of actually being infected after one is told that one is infected is only 29% (20/20 + 49) for a test that otherwise appears to be “95% accurate”.

A tester with experience of group A might find it a paradox that in group B, a result that had usually correctly indicated infection is now usually a false positive. The confusion of the posterior probability of infection with the prior probability of receiving a false positive is a natural error after receiving a life-threatening test result.

As breast cancer in the general female population is a relatively low incidence disease the outcome of a false pasotive is quote high.

Herein another risk, traumatising people with false positives and equivocal results, one does not like to rule out cancer conclusively if some doubt is present leads to up to 15% of women who have a screening mammogram having to undergo further procedures , usually invasive biopsies  with pain discomfort, bruising and rarely infection.

Not to mention the 5% who have a false negative, also not as common as it sounds.

Finally  Cancers are incredibly small, incredibly fast growing and have usually been present for 6-18 months before getting big enough to be detected. So one may have a bowel or breast cancer present at the time of screening, have it missed due to its size and present with a large cancer 6 months later.

Finally removal of the cancer does not guarantee that the cancer has been successfully treated. Cancers can spread [metastasize] before removal. Melanoma is an example.

In the other hand BCC usually grows locally only but very aggressively, Some poor souls it does metastasize. SCC  has a slightly higher spread rate than BCC which is why it needs removal and follow up.


Prostate Cancer is an enigma which is treated in an ageist and sexist manner by most people and the medical profession. It has none of the media appeal of breast cancer,  the young mother cut down in her prime with dependent children and husband.

Instead an older man has a blood test at the insistence of his wife and gets told his PSA is up.  Still the hope of a wrong diagnosis. Multiple other causes. He may have an infected prostate, very high reading 20+ , treatable with antibiotics. He may have BPH [benign prostatic hyperplasia] an example of the word benign not really meaning what you think it does. At least it is not cancer and after 15 hours of agony not being able to pass urine a catheter is inserted by a first year resident, hopefully in the right place with no perforation and one is on the way to a TURP  or onion peeling from the inside with the risk of loss of sexual function, not that it matters for an old guy anyway.

Next he has a trans rectal biopsy with 12 needles taking samples then he is told the bad news.

Bad news? We are doing nothing for you. Most men with prostate cancer are so old they die with it not because of it. Prostate cancers can be very slow growing [Which type have I got? We don’t know] Your life span is to short  to worry about it. The treatments cause loss of sexual function, baldness and you will go blind.

Only joking.

The facts are that prostate cancer is treatable, One can have surgery, radiotherapy or a combination.

Prostate cancer does spread rather early so  prevent developing cancer or to
Males generally get cancer later than females

I would like to present an over view of the screening dilemma.

I will reference my talk to certain illnesses and conditions that are common in the community and a few that are not. Along the way I will mention several misconceptions with these conditions. I welcome relevent questions but will deal with most in the breaks or afterwards.

Medicine is concerned with the health of individuals first and  then with health of populations. It consists of both diagnosis and treatment of medical conditions. Originally these were of the body but those of the psyche then followed. As new treatments and medications were developed medicine became an enlarging field with more expectations of keeping people healthy.

Means of diagnosis improved. At first these were only applied to people with illnesses, but then the ability to look for problems ahead of time became apparent and screening was born.

Screening is a form of diagnosis that came late to medicine. Tests on urine for protein and blood were possible. Blood tests began being used at the start of the 19th century and X-Rays were developed.

Progress was slow so much that the routine testing strips we know use routinely with 10 tests on were still a 2 strip novelty 40 years ago ..

CXRays for TB detection were among the first general screening projects undertaken.

This dreaded disease, still present today, was reduced a hundred fold with detection treatment and isolation. Screening was abolished in the 1970’s in Australia. for 3 reasons which are still valid today. Cost, Radiation exposure [side effects] and near elimination of the condition. One funny twist of fate due to litigation and over investigation a large percentage of the population still have CXR’s for other reasons which equate to a de facto screening program.

The modern health problems are those of living longer, diabetes cancer and heart disease [stroke]. These conditions all increase with age and all reduce life expectancy greatly. They have an enormous impact at any time but more so when the sufferers are young.

Ao to screening.

The ideal screening test is something non invasive, very reliable easy to do and producing a treatment outcome beneficial to the patient.

Bowel Cancer.

A sample of poo, well 2 or 3 actually a day apart preferably after avoiding meat in the diet an








I did say “Only 37 of 58 sources list raw data”.
“37 of 58 represents the fraction of data sets”,
yes that is exactly what I said.

” not the fraction of raw data,”
I did not make that claim.

“You have denied for years that there are more than 5000 stations in the world ”

I have denied the number of active stations in the world.
There is a difference. Take
“International Surface Temperature Initiative (ISTI), . This release in its recommended form consists of over 30 000 individual station records, some of which extend over the past 300 years.”
this gives 30 thousand stations which are mostly inactive or extinct.
Station locations existing within the last 300 years with at least 1 month of data are used in GHCN-M version 3 (a).
Station locations during the periods 1871–1900 (b), 1931–1960 (c), 1961–1990 (d), and 1991–2013 (e) are also shown.

Or take
(GHCN-M) dataset in 1992, more than 6000 stations. A second version of GHCN-M, containing 7280 stations in 1997 in 2011, a third version of GHCN-M.
which says makes Routine updates for about 2000 stations are made on a daily basis.

NASA’s GISS dataset 6000 stations.
A bit of tight squeeze as  Since version 2, GHCN-M has been a major component in the GISS data set. A bit hard to fit 7280 stations into 6000 but as only 2000 are active I guess you can ignore the rest.

the United Kingdom produced a first release of its CRUTEM product in the late 1980s. Today, a global dataset of over 6000 stations is still maintained in its fourth iteration. Since it also includes GHCN I guess it might have only 2000 active stations as well.

mathematically 2000active stations in the world seems to confirm  my position that “You have denied for years that there are more than 5000 stations in the world ”
Today, GHCN-D provides daily maximum and minimum temperature for nearly 30 000 stations. Although more stations exist on the daily scale
Given the historical nature of data creation, sharing, and rescue, there are many cases where a single station exists in multiple data sources.
the duplicate records do not necessarily have identical temperature values for the same station even though they are based upon the same fundamental measurements.
There are 194,367 station records used
Although the preference is to have data as raw as possible, there are times where such data do not exist, or have not been provided to the databank. Therefore pre-processed data are accepted
GHCN-D was selected to be the highest priority, or target dataset, and the monthly dataset derived from it is the starting point for the merge process. GHCN-D is regularly reconstructed, usually every weekend, from its 25-plus data sources to ensure it is generally in sync with its growing list of constituent sources
the U.S.-based Cooperative Observer Program (COOP) Summary of the Day data set. These sources provide data for more than 2500 stations worldwide, and they remain the primary sources for updates to version 3.
[25] CLIMAT bulletins transmitted via the Global Telecommunication System (GTS) provide data each month for approximately 1400 GHCN-M stations in more than 125 countries and territories.
Locations of the approximately 2300 GHCN-M stations for which data are routinely available.


Jackson Thurlow (def) was 379K, now 267k. He screwed his ACL (right knee) in nab 2016 – looks a starter but awkwardly priced with a dubious ceiling. CONSIDER

Jaimie Elliott (fwd) was 413k (season high 451k in 2015),now 291k. Missed the entire 2016 season with a back injury. Will play if fit. CONSIDER (YES for me!)

Patrick Ryder (fwd/ruck) was 447k (season high 543k), now 418k. Suspended for 2016 – Number one ruck for the power. Solid option at his price. YES

Harley Bennell (mid/fwd) was 548,600, now 387k. Calf injury ruled him out for the season. If his calfs hold up he’s a bargain. Proceed with caution. YES.

Jarryd Roughhead (fwd) was 520k, now 367k. Out with cancer (blimey!) and beat it to death. Onya Roughie. Locked in cause it’s a great story, but he’s also a bloody decent player. YES

Sam Reid (fwd) was 390k, now 275k. Calf and Achilles issues, missed 2016. Mid price madness, decent player, not SC relevant. Averaged 72 in his last full season. PASS

Aaron Sandilands (ruck) was 433k (season high 581K), now 308k. Got flattened by Nic Nat, puncturing a lung. Only played 5 times in 2016. Massive discount for this aging behemoth. Will divide the community. THE CHOICE IS YOURS! YES for me.

Jarrod Witts (ruck) was 393k, now 217k. Never really made an impact at the pies, traded to GC. Uncertain TOG in 2017, whispers around he will get the R1 spot. Can’t lock him in on a whisper though. WATCHLIST.

Nat Fyfe (mid) was 624k (670k high), now 573k. Basically broke his leg and only played 5 in 2016. Super elite on the cheap? Yep. YES

Dyson Heppell (mid) was 499k (season high 571k), now 513k. Suspended for the year. Definitely should consider at this price. YES for me.

Jobe Watson (mid) was 439k (season high 576k), now 453k. Suspended for the year. Question marks a plenty over Jobe, I’m backing him to have impact, but maybe not for SuperCoach. PASS

Michael Hurley (def) was 485k, now 464k. Another banned Bomber. Rebound king last time around the traps, potential to peak over 550k. I’m in. CONSIDER

Michael Bellchambers (ruck) was 294k (season high 333k), now 305k. *altogether now – “another banned bomber”. Strange price on this lad, could get R1 at windy hill (or whatever they call it now) but beware – he wanted to quit football and I heard a whisper he’s carrying an injury. PASS

Dayne Beams (mid) was 612k, now 432k. Only played 2 in 2016, out with basically a completely shattered body. BUT super elite output available for 432k. Get in my team! YES.

Mark Murphy (mid) was 421k (season high 556k), now 432k. Played 10 in 2016 then screwed his ankle. Looks worth the punt to me. YES

Kristian Jaksch (fwd/def) was 281K, now 206k. Played 1 in 2016. Ex-giant who plays a lot in the magoos. Wait to see if named. WATCHLIST

JOM (mid) 525k (2015 starting price), now 318k. Has no knees. Last sighted on the titanic. Proceed with caution. Hawks debut in rd3-4 is the word on the street. Watchlist

David Swallow (mid) was 554k (2015 Starting price), now 280k. He’s missed eons, lord knows why. Too cheap to pass up for a bloke with his ceiling. YES

Josh Thomas (mid/fwd) was 385k, now 193k. Ate a cow and got suspended for 2 years. Rookie priced DPP should be watched closely. WATCHLIST

Lachlan Keefe (def) was 330k, now 165k. Helped Josh Thomas eat that cow. Rookie priced key position back. Won’t set the world on fire, unless by accident. But there’s still money to made here. YES.

Matt Sharenberg (def) was 271k, now 164k. Knee and ankles have stopped this kid. Missed all of 2016. Huge talent, locked in for me if fit. YES.

Curtly Hampton (def) was 264K, now 160k. Missed last year and only played 5 in the season previous. Rookie bench option – if he can get fit, and stay fit and break into the Crows line up. Just a few conditions then! WATCHLIST.

David Myers (mid) Was 460k, now 133k. Stuffed his shoulder in 2015 then suspended for the season of 2016. Massive discount. Most likely on everyone’s bench. YES

Angus Monfries (mid) was 342K, now 325k. Suspended for the season. Nope. PASS

Billy Longer (ruck) was 368K, now 260k. Behind Hickey in the pecking order. Nope. PASS

James Stewart (fwd) was 280K, now 169k. Couldn’t crack into the GWS forward line, played 1 in 2016. Like many, if named, will attract attention. WATCHLIST

Hugh Goddard (def) was 308k, now 186K. Played once in 2016 and ruptured his achilles. Good kid by all reports. Might be worth a look if he can crack into the Seaford backline.WATCHLIST

Jake Carlisle (def/fwd) was 381k, now 337k. *Say the line* yet another banned bomber. Unseen in the saints colours, big doubts over his SuperCoach relevance, despite DPP. But he is 25 and at a new club. WATCHLIST

Michael “Dr.” Hibberb (def) was 419k (season high 491k), now 402k. Last banned bomber I promise! Same write up as Carlisle, but slightly older and averaged 82 in his last season. WATCHLIST

Matt White (mid/fwd) was 328K, now 198k. Tore his pectoral in round 1. OUCH. Out for the season. Very much on my radar as a bench option. CONSIDER

Riley Knight (mid) was 290K, now 201k. Played once in 2016. Persistent ankle problems. Barron reckons he’s a big chance for senior footy in 2017. Smokey for RD1. WATCHLIST

Tom Downie (ruck/fwd) was 326K, now 217k. Played once in 2016, behind Mummy and Lobb for Ruck duties. PASS

Micheal Talia (def) was 390k, now 213k. Common theme here…. Played once in 2016. Injured himself, then club suspended for possession of illicit drugs. If he’s off the horse but in with horse he’s a chance. WATCHLIST.

Nathan Vardy (ruck) was 293k, now 265k. Played once for cats in 2016 then traded to WCE. No Nic Nat opens the door, but Lycett and Giles are also in line. I smell rotation. PASS

Cam McCarthy (fwd) was 288k, now 200k. Homesickness – out for the season. Looks primed to take the full forward spot at freo, although he has the potential to go hot and cold. Still good for the coin. YES

Tim Broomhead (fwd) was 329K, now 185k. Played 2 uninspiring games in 2016. Seems VFL bound. PASS

Will Hoskin Elliott (fwd) was 220k, now 200k. Traded by GWS to the pies, you’d have to think he’s a big first team chance. WATCHLIST

Cam Ellis Yolmen (mid/fwd) was 401k, now 304k. Appeared twice late in the crows campaign, if Thompson moves out of the mid CEY could be one to move in. Good average when not sub affected (82) but at a super awkward price. WATCHLIST.

“Tony Banton

“Tony Banton wrote this relevant to the discussion here but at JC.
As I’ve tried to explain (along with a few others) to angech. Given that the two sets of instruments are measuring the same thing, then the trend is the same, yes?”
Two wrong comments in one sentence pushing hard to make up a fiction.

First the two sets of instruments are both measuring temperature [not anomalies]. They are however not measuring the same thing.
One is measuring sea water temperature collected by ships,from different levels and heated and cooled by various other inputs on the way.
The other is measuring temperatures in sea water at a set level with hopefully the same sort of thermometer without ship and human interference.
-Second “then the trend is the same, yes?” No.
One is said to be measuring 0.12 C average lower than the other.
That does not tell you the trend of the two types at all
That would be an average of each trend over the same time period for the same number of ships and buoys. It says nothing about the actual trend of each type over that time period.
One could be double the trend of the other but one could still say the average trend is 0.12 lower.
The trends are said to be similar. You need to specify the time intervals for comparison and it is obvious that two such disparate systems should rarely be in synchronicity as to trends.
There is no common period where one can truly compare trends. Buoys go from 0 to 7/8 of measuring system type used over 20 years. There are no true trends to compare.
That is not to say the mathematicians like Zeke cannot do a serial breakdown of the ship and Buoy temperatures over the time period of common use but varying number.
I do not see it?
Could he put it up?
Would be grateful to see the true trends and their correspondence

angech says:

Anomalies vs. Temperature
“tell what would be a trend you’d consider true.”
There would be a trend for the Buoys, It would start off awkward with only 1 Buoy and as more are added one would have to merge [sigh] the data sets and this would give a buoy only trend.
One would already have a full ship only set of data which again would have to merge the ships as they begin to decrease in number.
Zeke has both of these.
Then to compare trends in general you could have the ship only trend and the buoy only trend.
Obviously due to the much longer ship data length, CO2 warming increase and natural variability these two trends will not match.
Next you could take the period where ship and buoy data are both available and truly compare their anomaly trends on the same baseline.
This also allows you to compare the difference in real temperature between buoys and ships.
This is the average temp over the time period of each data set and Zeke quotes 0.12 but does not give the period this must be quoted for.
It really should be for 30 years but it might be extrapolated out over 20 years of data I guess.
When I say “must be quoted for” I mean you cannot pick a point out in time at the start of the change and say buoy temps immediately dropped 0.12 C below the ships. It had to be worked out over time.
Here is the nub of the problem,
What I would hope to see is quite variable data with an overall match in trend*.
I would expect reasonably marked differences in the data from the two different ways of measuring and the various improvement/changes in ship measuring.
If we found an exact match I would hope everyone knows that is basically impossible.. If we found a highly correlated match we should be extremely suspicious mathematically. If we found quite variable data with an overall match in trend this would be very reassuring that the science is being done correctly.
The trends may be quite different because they are over a fixed time period but the difference in temps is simply the average difference over this time.
Again, like the pause [where one can always find a pause] but in reverse one can always find a matching trend in overlapping trends if they overlap twice while passing and you use those two points.

angech says:

“why you find it obvious that the two systems can’t have similar trends.”
Not what I said.
I did not say they could not have similar trends*, in fact I would expect similar trends. I said you cannot extrapolate, as Tony did,saying ” Given that the two sets of instruments are measuring the same thing, then the trend is the same, yes?”
They are not measuring the same thing, they are measuring different things, hence the trends can not be the same.
“why you find it obvious that the two systems can’t have exactly the same trend.”
Statistics , Taleb and common sense.

 Victor Venema (@VariabilityBlog) says:
“it is your political movement that assumes the global temperature record is so amazingly accurate that minimal adjustments of 0.05°C or less are a political scandal and that the temperature data is so accurate that it is not possible that what you call a “hiatus” is a measurement/estimation artifact.”
Not me, not political.Skeptical, contrarian.

“minimal adjustments of 0.05°C or less are a political scandal”.
Let us both be clear here on the use of the word minimal.
Putting a figure in units giving a reading of much less than one and then claiming it is “minimal” is a political clever gambit.
Remember  “Our climate has accumulated 2,455,968,886 Hiroshima atomic bombs of heat since 1998″ raising the ocean temperature less than 0.1 degree.?”
0.05C is not a minimal adjustment, 0.05C per decade is not a minimalist adjustment.
We are blogging on an article by Zeke on the importance of such a critical adjustment.

“assumes the temperature data is so accurate that it is not possible that what you call a “hiatus” is a measurement/estimation artifact.”
Please, I have always maintained that our time intervals are too short to leap to conclusions.
By your logic what you call a recent rise in global temperatures is possibly a measurement/estimation artifact
angech says:

paulski0 says: February 21, 2017 at 4:06 pm
“There is one true globe. It is the whole globe (and nothing but the globe).”
We are limited in our knowledge of said globe and we choose to represent it by what we have available at the time. A poor example would be that 600 years ago most global representations did oit have Australia in. Hadcrut is and was a representation of the known globe

You assert that HadCRUT4 is then taken to be a normal distribution effectively centered on the result of infilling with hemispherical average in empty cells.This is interesting.

In which case you and Steven and ATTP would be right. But in this case all three of you would have already pointed this out. So it cannot be right.

My understanding is that HADCRUT is not a full hemispheric data set. It is infilled to a certain latitude only and parts of the Arctic and Antarctic are not uncovered cells but excluded cells.
There are uncovered cells in part of the Arctic and Antarctic and Africa in their latitude range due to poor observational areas which are “infilled”.
Could you clarify this?

Steven Mosher says: One simple way I’ve explained it people willing to understand is this. If you want to claim that hadcrut is unbiased, then you are asserting that the true values in the blank regions have rates of warming that are precisely equal to the average of all the covered regions. . In other words you’re asserting something highly unlikely.
Except HADCRUT say that they infill by using the global average, hence it is very likely. Why is this so hard to understand.

Copyright Crystal Ball Department.

angech says:

Joshua says: “What say you? Ready to up your game?”
No need . The cards have been dealt and the outcomes will become evident in the next 6 months.
Republicans re ask for more details and e- mails next 2 weeks.
NOAA refuses, Boss stood down, Inquiry ordered. 2 months
Or NOAA reluctantly follows orders, 2 months.
Either nothing to find 25%,
little to find 25%,
or a mess 50%.
At the same time Trump has to take a gamble, repudiate Paris Accord on his own or ask congress to vote on it. Latter course is the gamble as Democrats oppose and there may be enough warmist republicans to block Trump.
Best maneuver to cancel it but say the American people should decide through Congress anyway. Puts the pressure back on Democrats and warmist Republicans instead of him.
This is the way he should go.
Whichever way this issue will be dragged into it if any malfeasance can be found. Likelihood of an investigation 97%.
Copyright Crystal Ball Department.