It was an October surprise courtesy of the Lancet
medical journal. A report, rushed to the public via online publication
five days before the 2004 election, claimed the American-led
coalition had directly or indirectly killed about 100,000 Iraqi
civilians since the invasion — most from airstrikes. The media,
with no great love for Bush and already turning against the war,
went wild.
The Lancet was so delighted with the reaction (if not
the “wrong” election outcome) that in 2006 it updated its figure to a stunning 655,000 deaths.
Further, this time it said violence directly caused all deaths.
This paper, by amazing coincidence, appeared just before the
mid-term election.
There were critics, including yours truly. But now there’s even more ammunition in
the form of a statistical analysis by David Kane presented at the Joint
Statistical Meetings in Salt Lake City. Naturally Kane’s
assessment is under vicious attack not by proponents of good
epidemiology but rather opponents of the war, primarily a troll at the
website Deltoid, Tim Lambert.
(Normally a “troll” is someone who gets his jollies through
specious attacks on others blogs. In Lambert’s case, he began his
own blog to give him wider range and even alters individuals’
Wikipedia entries.)
To come up with its 2004 figure, lead author Les Roberts of the Johns Hopkins Bloomberg
School of Public Health in Baltimore and fellow researchers
sent Iraqis to interview 998 families in 33 neighborhoods across
the country. They asked how many people in each household had died
and of what, then extrapolated to Iraq as a whole. Thence the
100,000 figure, which they insisted was “conservative.”
BUT CONSIDER JUST THIS: Because the sample size was so small, the
range for deaths was wider than Rosie O’Donnell’s rump: 8,000 to
194,000. So the Lancet researchers merely split the
difference. They said the tiny sample size was necessary because
the interviewers were in constant danger — assuredly from being
caught in the crosshairs of an F-15 Strike Eagle.
Further, the researchers used death certificates but didn’t feel
bound by them — interviews were fine. “In the Iraqi culture it was
unlikely for respondents to fabricate deaths,” they wrote. Sorry
guys, but I’ve reported from Iraq three times and I’ve written that interviewing Iraqis is essentially
worthless because “they just tell you what they think will prove
advantageous to them.”
Aside from the timing of the papers’ release, and bearing in
mind that motivation alone is not grounds for conviction, consider
that Roberts admitted to the Associated Press in 2004, “I was
opposed to the war and I still think that the war was a bad idea,”
adding, “As an American, I am really, really sorry to be reporting
this.” Yeah. Right. Sure.
Lancet editor Richard Horton, for his part, accused the Coalition of engaging in “Democratic
imperialism” adding “the evidence we publish today must change heads
as well as pierce hearts.”
Thank goodness the tradition of disinterestedness in medical
journals continues.
WANT MORE EVIDENCE the researchers knew their paper wasn’t worthy
of lining bird cages? The 100,000 figure is allegedly the excess
over pre-war Iraqi mortality, which they claimed was 5.0 per 1,000
people annually. That was a fabrication absolute vital to the
overall calculation. According to the CIA World Factbook, the
pre-invasion (2002) rate was over 20 percent
higher at 6.07 per 1,000. Remember, the study was allegedly looking
for excess mortality; therefore the lower the authors set pre-war
mortality the higher the excess post-invasion mortality looks.
Consider, too, that 100,000 deaths during the survey period
meant an average of over 180 a day, of which the Lancet
attributed a majority to airstrikes. Have you heard anyone claim
our airstries killed over 90 civilians on any one day during the
entire course of the war?
Anti-war and anti-American groups even said the Lancet
figure was ridiculous. The website iraqbodycount.org estimated at the time about
14,000-16,000 deaths since the war began, a figure that even now
ranges from about 68,000 to 74,500. The Evil One himself, bin
Laden, in his pre-election video, made reference to the Iraq war
and stated “over 15,000 of our people have been killed.”
Lancet supporters like Lambert ignored all of this, for
obvious reasons. But they’ve, well, raised Kane over the Kane
paper.
THE FOURTEEN-PAGE PAPER by Kane, a fellow at Harvard University’s
Institute for
Quantitative Social Science, is so complex that unless you have
a strong background in statistics it may cause your head to
explode. But it contains one conclusion that, aside from all of the
above information, renders the Lancet study worthless.
The Lancet in 2004 stated, “More than a third of
reported [post-invasion] deaths and two thirds of violent deaths
happened in the Fallujah cluster. This extreme statistical outlier
has created a very broad confidence estimate around the mortality
measure and is cause for concern about the precision of the overall
finding.” An “outlier” is a figure that is so numerically distant
from the rest of the data that it’s often treated as an error and
hence rejected for use in the final assessment.
But Kane decided to include it for a very good reason. If
two-thirds of the death data come from Fallujah, how can it
possibly be considered an outlier? Politically inconvenient, maybe,
but not an outlier. Upon including the Fallujah data, Kane
concluded that as incredibly wide as the confidence interval was as given, it now became so wide
“that the lower bound is negative.” This means the figures the
Lancet came up with are not of statistical significance and therefore, in statistician
lingo, “don’t count for squat.”
Kane does grant that some unknown figure in the full dataset
just might alter his conclusion. But keep in mind that Kane took
the Lancet data at face value; therefore he didn’t factor
in the fabricated too-low mortality rate. Nothing in that dataset
is going to alter his conclusion. In any event, the Lancet
authors refuse to release their figures. Now folks, this isn’t like
KFC protecting its secret recipe of 11 herbs and spices. Releasing the
data would make everything transparent and settle this once and for
all, which is exactly why the Lancet and the authors keep
it under armed guard on a remote desert island.
Lambert, in his blog, after three years of blasting
critics of the Lancet study, conceded, “I would suggest
that [Kane] has proven that this confidence interval is wrong,”
indeed, “obviously so.” Then he went back to bashing those same
critics (self included) while letting his acolytes do the heavy
lifting in his comments section.
Kane patiently provided over 50 responses to those comments. For
the most part, the critics pretend to be dispassionate defenders of
proper statistical analysis. But occasionally a comment appears
that really speaks for them such as, “David, thanks for your answer. In
other words, mass carnage and slaughter. A vast crime against
humanity, for which the occupiers are obliged to pay reparations.”
Or: “David, you’re just window-dressing a
problem … . There are clearly two types of town [sic] in Iraq
— those being blown to shit by Americans, and those being only
slightly blown to shit by Americans.”
Kane was also repeatedly lambasted for allowing conservative
blogger Michelle Malkin to post his paper,
notwithstanding that he did the same for leftist blogger Tim
Lambert.
Finally, Kane realized that responding to anybody who reads and
comments on Deltoid is spitting into the wind. It’s enough that
he’s done a great service in further exposing the truth about
civilian casualties in Iraq and exposing a once-great medical
journal that has abandoned accuracy for advocacy.
Michael Fumento, a health, science, and military
writer, has been embedded three times in Iraq and once in
Afghanistan.
