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SPH Podcast on Health Studies Helps You Lose Weight (Not Really) Free Associations scrutinizes health claims, and has fun doing it

The SPH professors hosting the Free Associations podcast: Donald Thea (from left), Matthew Fox, and Chris Gill. Photo by Nick Gooler, School of Public Health

It drives people nuts.

One study says coffee will extend your life. The next one says it will kill you.

Or it’s red wine. Or bacon. Or whatever.

“Last week they said this, this week they’re saying that, and as a consumer that’s really hard to wade through and figure out what is real and what is not,” says Donald Thea, a School of Public Health professor of global health, one of three voices on the new Free Associations podcast, which looks at the validity of the research behind the most recent health claims.

The podcast, a fast, funny and well-informed conversation among health experts, launches tomorrow. It’s produced by the Population Health Exchange (PHX), SPH’s new resource hub and continuing education initiative focused on public health. The podcast hopes to help listeners sort through competing claims and look beyond those DRAMATIC HEADLINES! to the actual medical research behind them. The first two episodes will be available for download Tuesday, and new episodes will be released every other week thereafter.

Listen to a sample of their conversation about an infamous claim that the measles/mumps/rubella vaccine causes autism:

“The three of us are deeply cynical iconoclasts,” says Thea, who cohosts with Matthew Fox (SPH’02,’07), an SPH professor of epidemiology and global health, and Christopher Gill, an SPH associate professor of global health. “We very much like to question authority.”

But they do it with science. They take apart and examine the scientific method behind publication studies, looking for biases and errors. They also compare what the results actually say to what can be reported via sound bites on the evening news.

“What we are doing is pulling back the curtain on how you make the sausage and showing that maybe the conclusions that are being sold as true aren’t, because they got it wrong,” says Thea, who is also director of BU’s Center for Global Health and Development.

What the media find interesting tends to quick fixes and studies that in the long run may not be borne out, they say. Among the subjects in the first six episodes are a report that moderate wine drinking is good for your health, and one on the relationship between chocolate consumption and atrial fibrillation. Each 45-minute episode includes shorter segments explaining study methods and terminology (e.g., selection bias or how peer review works) and offbeat health-related news. Regardless of the topic, fans of National Public Radio shows like Car Talk or Wait, Wait…Don’t Tell Me will feel right at home with their sardonic banter.

All three hosts attend what are called journal club gatherings at SPH, where staff and students get together informally to hash over notable articles in recent medical journals. Who suggested turning those conversations into a podcast? “It was Matt’s idea,” the others say in unison, as Fox nods in mock contrition. A fan of the NPR podcast Pop Culture Happy Hour, Fox pitched the idea to Leslie Tellalian, SPH director of lifelong learning and prime mover behind PHX.

She said yes. The three speak to a very broad audience, from public health students and professionals to the general public, Tellalian says, and she hopes they’ll attract listeners to PHX’s other offerings. “I think they’re really good people to open doors for us,” she says. “Understanding what they do and how they do it helps people understand what public health is and the role it plays and the importance of it.”

In addition to being friends, the podcast hosts have each taken a turn teaching the course Skills in Critical Analysis and Evidence-Based Writing for Public Health Professionals. They’ve taught students how to analyze a journal article, find its strengths and weaknesses, and come up with conclusions about its value.

“The students love it when we tear down these icons of authority, like the New England Journal of Medicine or The Lancet, and say, ‘That article’s a piece of crap,’” Thea says.

“We all do this research too, so we’re pretty familiar with the ways that we’ve gotten it wrong,” says Fox. “We just thought it would be fun to get together and do something that was topical and use those critical thinking skills.”

Such critiques are not just intellectual exercises. There were localized outbreaks of measles after the MMR-causes-autism study, and more recently, the Zika virus outbreak led to several irresponsible theories likely to cause more harm than good, according to Thea.

“There is this belief that anything that is published is true,” says Gill. “That is not the case.”

Free Associations seems especially timely in the age of fake news, phony internet experts, and a president who claims that global warming is a Chinese hoax. The hosts say it’s frightening the way basic science is being called into question, often for political reasons.

“What’s going on at the EPA has been another thing that’s motivated some of this,” Fox says. “Seeing the way they are going off a complete lack of science in making these policy decisions just made me more interested in what the science actually says.” The three profs are not trying to sow doubt in the scientific process by debunking some reports, he says, but are saying that challenging the results is part of the process.

“The real issue is that the scientific process is a lot messier and less definitive than is popularly believed,” says Gill. “It’s much more incremental, it lurches back and forth before taking paradigm shifts and exposing new truths.”

PHX Free Associations Podcast Launch and Listen Party, featuring the live recording of an episode, is Tuesday, September 12, from 5:30 to 7:30 p.m., in the Hiebert Lounge, 72 E. Concord St., on the Medical Campus. It is open to all, and there will be refreshments and prizes. RSVP here.

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A Door Opens For Public Health Studies

A Door Opens for Public Health Studies SPH partnership gives researchers unprecedented data access

Dan Berlowitz

Researchers at the Boston University School of Public Health (SPH) have unprecedented access to medical claims and clinical data, under a partnership forged with Optum Labs, a Cambridge, Massachusetts–based research center.

Optum Labs reached agreements to collaborate with seven health care organizations including SPH—the only school of public health on a list that includes Pfizer, Tufts Medical Center, and the American Medical Group Association.

Partners have access to millions of medical claims and clinical records of insured patients, for research that could range from medication studies to health policy and outcomes analyses.

The de-identified records include information about tests, treatments and costs of care, as well as patients’ race, income level and geographical location.

“As a school of public health, we hope to bring to this partnership a whole new set of questions that large data sets are able to address—not just about the effectiveness of medication, as many studies may look at, but everything from understanding environmental health exposures, to basic epidemiology, to health policy questions,” says Dr. Dan Berlowitz, a professor of health policy and management at SPH who is leading the collaboration.

“These data represent a broad swath of the population—not just the elderly, as Medicare does, or veterans who are seen in the VA, but children and people of diverse ages and backgrounds,” he says. “This broadens the opportunities for our faculty and students throughout the institution to explore issues using detailed data representing millions of people.”

Traditionally, access to claims data has been relatively limited, with many studies relying on smaller databases, or on records of patients covered by Medicare and Medicaid, federally funded insurance programs. The partnership with Optum Labs will allow researchers to access a much larger pool of de-identified clinical and claims data, in collaboration with researchers and experts from other health care institutions.

“Data is sort of the life blood of what we do in research,” says Dr. Mark Prashker, SPH associate dean of institutional development and strategic planning and an associate professor of health policy and management. “This gives us big data in health care—it allows us to ask questions we couldn’t ordinarily ask…I think it has the potential to revolutionize how we think about solving health care–delivery questions.”

Researchers who want access to the data are asked to submit proposals to a SPH review committee, which will work with Optum Labs and other research partners to ensure collaboration.

Among the possible areas of research are cost-effectiveness studies related to health care delivery, and comparing the success of various clinical interventions, Berlowitz and Prashker say.

Dr. Paul Bleicher, chief executive officer of Optum Labs, said the partnerships will help Optum Labs “accelerate the pace of our innovation, paving the way for exciting new research initiatives that can be directly translated to improvements in patient care.”

Optum Labs—founded by health care company Optum and the Mayo Clinic in 2013—already has more than 20 major research initiatives underway, ranging from studies that compare the effectiveness of various medical devices, to research into how treatment patterns vary across geographic areas. Optum Labs encourages dissemination of research findings through publication in scientific journals and presentations at professional meetings. Several projects are slated for publication in mid-2014.

Optum is an arm of UnitedHealth Group, one of the country’s largest health care companies.

Dr. John Noseworthy, president and CEO of Mayo Clinic, said the research collaborative is “excited to welcome the fresh insights and perspectives that new partners will bring.” In addition to having access to large sources of clinical and claims information, he said, “all partners will now benefit from the unique viewpoints that others bring, as we work to transform health care in the US.” and improve access and treatment.

Other new partners include: Lehigh Valley Health Network, of Allentown, Pennsylvania; Rensselaer Polytechnic Institute, of Troy, New York; and the University of Minnesota School of Nursing.

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Icatcher Helps You Manage Your Podcasts On Ios

The iTunes directory is a great way to browse, discover, and download podcasts. But, as of now, there is no way to subscribe to the podcast’s feed directly from your iDevice. However, as always, there is an app for that.

iCatcher! by Joeisanerd, is a magnificent solution for downloading, streaming, subscribing to, and managing podcasts on iOS. If there is a specific feature that you are looking for in a podcast app, there is a good chance that it is already in iCatcher…

Key features

iCatcher displays an intuitive user interface for subscribing to podcasts. Users have the ability to search for a podcast (using an API in coordination with the iTunes directory). Finding podcasts by searching for the name, author, or keyword is relatively easy. However, unlike the iTunes directory, there isn’t a way to browse the official iTunes directory for podcasts, which makes discovering podcasts inside iCatcher limited.

iCatcher provides the ability to browse the web in search of a podcast’s RSS feed. Users can use this web browser to browse third-party directories, but not the official iTunes directory. Users also have the ability to manually enter a podcast feed, with authorization (username and password) support.

iCatcher gives you the ability to intuitively manage both a large or small number of podcasts. After the initial setup of adding all podcast feeds of choice, the use of iCatcher is a breeze. With a tap of a button, the user can refresh all subscribed podcast feeds and download new releases.

After all feeds finish refreshing, the podcasts begin downloading. iCatcher currently does not have support for simultaneous downloading, a feature ideal for users with capable network speeds.

iCatcher has the ability to classify subscribed podcast feeds in intuitive playlists. The user can create a playlist by selecting individual podcasts, or create a playlist by using keywords, such as “iPad” or “Apple news.”

After subscribing to a podcast feed, the user has the ability to view all episodes that exist in said feed. Users can stream or download old episodes, view show notes, refresh the individual feed (without refreshing all others), and edit settings for that individual podcast.

Other features

Unlike some other podcast applications, iCatcher has the ability to play a podcast at 4 different speeds. Users can choose to play their podcast at 1x, 1.25x, 1.5x, and 2x speeds. Currently .5x and 1.75x speeds are not supported.

iCatcher is a universal application that runs beautifully on the iPad, iPhone, and iPod touch. The application rarely crashes, and the developer updates the application on a regular basis. You get your money’s worth when buying iCatcher.

iCatcher supports AirPlay, so users can play podcasts at various speeds through their Apple TV and any other AirPlay supporting device.

iCatcher gives the user the ability to export their podcasts in a .OPML format. You can download a backup of my podcast feeds from here. I think you might enjoy some of them.

Summary

iCatcher is a top-quality universal podcast-consuming application for iOS that can be purchased in the App Store for $1.99. I use this application on my iPhone every day. In fact, it would be safe to say that it is the most used application on my iPhone.

The developer is good at responding to support and can be found on Twitter. You can also visit the developer’s website here.

If you like this application, consider supporting the developer by leaving a review in the App Store. I learn something new about iCatcher every day — it’s extremely feature-packed.

What do you think about this app? What application do you use to handle your podcasts?

Fake Seo Case Studies On Facebook

There is an increasing trend of publishing SEO case studies on Facebook to show how a tool or service can help increase search rankings and traffic.

At least one Facebook Group admin is taking action to challenge and remove them because they are designed with an agenda at best and are outright fakes at worst.

SEO Case Studies Tell Only One Story

A common problem with SEO case studies published on Facebook is that they are expressly designed to tell you a story of success in defeating Google’s algorithm.

If there is one constant in search marketing it may be the understanding that there is no sure thing or guarantees in SEO.

No SEO tool or person can guarantee specific results that are based on a third party.

Yet some SEO case studies published in Facebook groups are designed to create the impression that the tool can outwit Google.

Flaws in SEO Case Studies Published on Facebook

I don’t mean to say that all SEO case studies have issues.

One of the most consistent flaws I see in many case studies is that they are based on local geographic based keyword terms.

Except for highly competitive areas like injury attorneys, local search keyword phrases are relatively non-competitive, especially in small towns.

It’s easier to rank a page for the name of a small town and keywords than it is to rank for more competitive phrases in larger metro areas like Los Angeles or New York City.

One literally does not need a tool or that many backlinks to rank well for the name of a small town and local-search related keywords.

This lack of competition is why so many case studies are based on local geographic based keywords, particularly with city names that relate to smaller towns.

Rather than pick on an actual SEO case study (which I don’t want to do) I will use an SEO competition as an illustration of the ease of ranking local search keyword phrases.

The competition a while back was to see who could rank and hold on for the search phrase, Rhinoplasty Plano Texas.

The winner of that competition was a website constructed almost entirely of Lorem Ipsum Roman Latin words.

Only the heading tags were written in English.

The winners of that competition demonstrate a weakness in Google’s algorithm within low volume search queries that are tied to a low population geographic area.

That weakness tied to a local search queries in a low population area can be exploited to create an SEO case study that appears to show positive results in terms of how many search queries a site begins to rank for.

There are two kinds of successes that are variously claimed in SEO case studies published on Facebook:

Amount of keywords a site is ranking for

Increase in traffic

How Did a Latin Language Site Rank for English Keywords?

There were a lot of things going on to power that ranking.

But the chief reason is the low search volume for that search phrase.

Google is very much about showing users what they want to see.

But Google tends to do less well determining what users want when users are not searching with a particular set of keywords, like Rhinoplasty Plano Texas.

There was close to zero search query volume and trivial competition.

The fact that a webpage composed almost entirely of Latin could rank for the phrase Rhinoplasty Plano Texas is as much a reflection of the low competition for that phrase as it is an exposure of a weakness in Google’s algorithm that allows a non-English website to rank number one for a low competition keyword phrase.

Next time someone shoves a case study in your face, check to see if it’s based on local search keywords, most times it is.

Choosing a trivial search phrase is one way to help tilt an SEO case study so that it produces seemingly positive results.

100% Fake Case Studies

Another way hustlers generate business is by using fake case studies.

These unethical people don’t even bother to rank a site in an easy niche.

They just copy a Google Analytics graph from someone else’s case study and claim it as evidence that their link building service produces results.

They publish screenshots of web traffic analytics graphs with marks indicating the date links were added after which the analytics report shows the search traffic growing exponentially.

They usually don’t show you the keywords so you can check if the site is ranking, they rarely show the site or the actual amount of traffic.

There are a lot of specifics missing.

But more importantly, some of those web analytics screenshots are fake.

This is a big problem on Facebook Groups because the most unscrupulous and ambitious will show up to deceive people.

Fake SEO Case Studies on Facebook

I asked Steven Kang (@SEOSignalsLab), the administrator of the private SEO Signals Lab Facebook group about these fake case studies.

This is what the Steven Kang said:

Engaging screenshot posts in large SEO groups mean more people in their funnel for link building vendors and tool makers.

Translated, there is a huge commercial-driven motive standing behind each forgery. Some are calling this justifiable marketing and I completely disagree.

To discourage dishonest posts, I am requiring each poster to allow on-demand inspection and provide proof of the screenshot data to trusted moderators.”

There was a guy in that Facebook group earlier this year who was posting screenshots of his client work and Steven kicked him out of the group and deleted every post he had ever made in that group.”

Generating Traffic is Trivial

It’s easy to create a case study using a brand new domain to create the illusion that several hundred visitors per month are a direct result of their efforts.

Creating a website and taking it from zero to several hundred visitors per month is also relatively easy to do.

It’ll look great on an analytics graph yet it’s not always particularly meaningful.

Case Studies Disappear When Challenged

I don’t mean to say that all SEO case studies published on Facebook are fake.

But the problem of fake SEO case studies published on Facebook has become so problematic that Facebook Administrators like Kang require that anyone posting a case study allow inspection of things like Google Analytics data.

That requirement has dramatically cut down on the number of people sharing case studies in that Facebook Group.

When confronted with an SEO case study, be skeptical.

It’s OK to ask to demand to see specifics like keyword phrases and domain names in order to judge the truthfulness of their claims.

As Kang noted, SEO case studies are done for lead generation, these people want your money.

It’s not unreasonable to demand more information about the case study before handing over your money.

Review: Brookstone’s Perfect Drink 3 Helps You Craft Cocktails With Whatever’s On Hand

Craft cocktails are in the midst of a renaissance, buoyed by rediscovered classic recipes, higher-quality ingredients, and increasingly talented bartenders. Pre-made mixes and artificially-flavored spirits are declining in popularity, as freshly-assembled natural flavors are ascending. But once you’ve had a truly great cocktail at a restaurant or bar, making one by yourself at home may seem challenging. The latest version of Perfect Drink ($40), Brookstone’s (and developer Pure Imagination’s) “app-controlled smart bartending” solution for iOS users, is here to help.

Perfect Drink has been through a few hardware and software revisions, but the latest-generation accessory and just-released version 3.0 app elevate it to greatness. The core of the product is a precise digital scale — recently upgraded from the original hardware — that works in tandem with your iPad or iPhone to eliminate the need for measuring cups. You call up a recipe in the Perfect Drink app and just add liquids until the scale and app tell you to stop, dynamically adjusting the recipe if you overpour. A just-released update enables the app to store a list of all the spirits, fruit, and mixers you have on hand, helping you quickly choose from recipes you’re capable of making…

Key Details:

Set includes a highly precise digital scale, cocktail shaker, basic iPad stand, washable dish, and pouring spouts

Uses a 3.5mm cable to connect to any iOS device

Free app stores the ingredients you have, shows recipes you can make with what’s on hand

Scale is powered by 3 AAA cells

The Perfect Drink set comes with five key parts: a digital scale with enough precision to measure down to the hundredth of an ounce, a washable clear plastic plate, a stainless steel cocktail shaker, a basic plastic stand to hold your iPad, and a set of two optional pouring spouts for your bottles (not shown). To set everything up, you’ll need to install three self-supplied AAA batteries in a screw-protected battery compartment on the scale’s bottom, place the clear plate on top of the scale, and connect the scale to your iOS device.

Rather than using Bluetooth, Perfect Drink includes a 3.5mm cable to connect to the headphone port of your iPad or iPhone — a quaint design decision that helps the scale conserve power. The app listens for signals sent through its headphone port and registers the weight of whatever’s on the scale, deciding whether what’s on there is too light, too heavy, or just right for the recipe. You press “on” or “off” buttons to turn the scale on or off, and a “zero” button to make the scale ignore the weight of the clear anti-spill plate and the cocktail shaker or glass you’re using to assemble ingredients. A “units” button can switch between milliliters (measured to ones), grams (ones), pounds/ounces (tenths) or just ounces (hundredths) if you want to use the scale without the app; the original Perfect Drink scale didn’t have quite as much precision.

But the key to Perfect Drink’s appeal is that the app is there so you needn’t worry about the numbers at all. Regardless of whether your recipe calls for ingredients to be assembled in a shaker or a glass, you’re presented with a “virtual glass” that starts at the bottom, visually filling up each ingredient’s progress indicator as you pour the specified liquid, then moving on to the next step.

When you come to an ingredient surrounded by dashed lines, an on-screen warning pops up: “this item is small, be careful measuring.” This isn’t an issue for 0.5- to 2-ounce pours, but for quarter-ounce pours, attaching one of the included spouts to a bottle will slow the pour down and give you greater precision. If you pour too much, the app will automatically adjust the rest of the recipe so you can get the right proportions. Resting the bottle against the edge of the glass or shaker can change the measured weight, so you need to pour from a slight distance to avoid inaccurate measurements.

It’s also worth noting that Brookstone sells a version of Perfect Drink called Perfect Bake ($55), a highly similar scale-and-app combo that includes plastic bowls and an oven thermometer rather than a cocktail shaker and pouring spouts. Although the scales are virtually identical to one another and both apps are free to download from the App Store, the Perfect Drink scale can’t be used with the Perfect Bake app (or vice-versa): the Perfect Bake app refuses to show ingredient quantities unless it’s connected to a Perfect Bake scale. That’s basically the developer’s way of saying that the software’s not really free, so pay for an additional scale if you want the complete solution to work.

The question of whether Perfect Drink will be a good fit for your home bar really comes down to two questions. First, are you a beginner to the world of cocktails with an interest in learning more? Second, are you actually a perfectionist?

If your answer to the first question is yes, Perfect Drink is highly likely to be worth the investment for you. Between the great recipe database and the simplicity of making drinks by following the app’s pouring guidelines, you’ll quickly be making delicious cocktails at home with no prior expertise. The drinks I’ve made with Perfect Drink have ranged from fun and fruity to serious and strong. However, “perfection” is another story: the system works well and offers great convenience, but as you get more serious about cocktails, you may begin to appreciate the value of an inexpensive but precise measuring cup to achieve more consistent (if slower) results.

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Sph Professor Examines Nation’s Healthcare Woes

SPH Professor Examines Nation’s Healthcare Woes

Page Turners SPH Professor Examines Nation’s Health Woes Book excerpt: in Me vs. Us, Michael Stein outlines how the country’s focus on individual medicine endangers major public health issues

In his new book, Me vs. Us: A Health Divided, Michael Stein examines this question: why do we care so much about health care, yet so little about public health? Stein, a Boston University School of Public Health professor of health law, policy, and management and department chair, and a primary care physician, shows how over history, public health has repeatedly been overshadowed by individual medicine, which has led to less public health funding, fewer resources for issues like obesity and climate change, and misguided priorities. This excerpt from Me vs. Us (Oxford University Press, 2023) is published with the author’s permission.

Filmmakers understand the distinction between individuals and groups. When they shoot a character in a coma or re­ceiving a bone marrow transplant, they know the viewer is thinking: she could be me. When they sweep across the debris of a village where an earthquake has killed thousands, they know the viewer, thinking on a different scale, may be moved and disturbed, but without any route for self-identification, will be less riveted. For filmmakers, our collective reality is most comprehensible through individual life stories rather than large groups.

Similarly, our interest in health care, the medical care of individuals, supersedes our interest in public health, the well-being of collections of people. Medical care concerns itself with identifiable persons, whereas public health takes up statistical or anonymized lives, many lives seen through an extreme wide shot. Let me offer two scenarios that demonstrate these two divergent perspectives.

Scenario 1: You are the doctor seeing James, a 25-year-old man who rides a motorcycle and who has come to your medical office for a routine annual physical. At the end of his visit, you must make the choice between discussing organ dona­tion or not bringing up the subject at all. Which would you do with James?

When imagining yourself as the doctor in this scenario, I believe that you would choose not to discuss donation. You would avoid this troubling issue because to bring it up is to move the conversa­tion perhaps outside James’ personal concern—he merely wanted the rash on his hand checked and a flu vaccine—and to turn what might have been a perfectly smooth and upbeat medical visit into an awkward occasion that includes an imagined and fatal accident.

Scenario 2: Now approach the same question of organ donation imagining yourself as a regular, non–health care–employed cit­izen who lives in James’ hometown. Young men who ride motorcycles are sometimes seen in medical offices for routine annual physicals. At such visits, the choice must be made between discussing organ donation or not bringing up the subject at all. What do you think doctors should do in these situations?

I believe that you would recommend that doctors, as a group, should discuss donation with these young men.

The first scenario introduces a medical question: How do I care for this patient? The second introduces a public health ques­tion: What should we want for our town? Medical doctors deal with one motorcyclist at a time, whereas public health-ers con­sider aggregates of young motorcycle drivers. If you gave dis­crepant answers (I wouldn’t discuss donation in scenario 1, but every medical provider should discuss donation in scenario 2), it suggests that looking at a problem from different perspectives can change your judgment. The way you would treat the unique patient in front of you differs from the way you view a group of comparable patients. The physician is trained to be the perfect agent for each and every motorcycle rider. The public health practitioner, trying to come up with a policy, is trained to imagine herself as the pro­tector of society, and considers a single patient as simply part of a collection of motorcycle riders. Discrepant answers suggest there is a conflict between these two perspectives.

We might admit that the public health perspective has a gen­erous (though poignant) prospect—his donated organs could imaginably save the lives of others in his hometown if James has a fatal accident—but still, most of us would not insist that doctors and motorcycle-owning patients have this difficult conversation. We might agree with the group perspective and the public health interest in creating the largest possible base of transplantable organs, but we understand it is difficult to oblige doctors to follow in practice. And so, we would be hesitant to create and enforce a policy penalizing doctors if they did not discuss organ donation with motorcycle riders. Based on my informal surveys, persons who give discrepant answers to my two scenarios feel far more strongly about their “no” to the question in scenario 1 than about their “yes” to the question in scenario 2. We prefer and defer to the medical perspective; we naturally assume it.

Our fears about health have always been cleaved: Each of us worries about him- or herself (the Me perspective of medical health) and we worry about others (the Us perspective of public health). And yet, what is best for the individual may not be feasible for the group, and vice versa. Medical care and public health thus represent distinct dispositions and attitudes, competing views of health.

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