By Robert B. Young, MD
The New England Journal of Medicine doesn't like "research parasites". That's the term used in its January 21,2016 editorial Data Sharing to disparage people who, among other sins, may "use the data" to try to disprove what the original investigators had posited [my emphasis]. This is an amazing statement by what should be a preeminent reporter of medical science, but for too long has allied itself with the anti-gun movement.
The advance of science requires transparency. Once published, a study's design and data have to be shared so that others can confirm or correct them. Critiquing them is how conclusions gain credence.
NEJM clearly states its motivation, less a self-serving excuse about honoring patient subjects: "What could be better than having high-quality information carefully reexamined for the possibility that new nuggets of useful data are lying there, previously unseen? The potential for leveraging existing results for even more benefit pays...tribute to the patients who put themselves at risk to generate the data. The moral imperative [is] to honor their collective sacrifice" [my emphasis].
The moral imperative is to do the science right. Carefully reexamining information by others is how it is validated. This is about leveraging grants and protocols to generate more publications and career advancement.
Withholding data is part of the gaming that goes on all too frequently in academic research that also includes avoiding reporting negative findings and (rarely) even making up results in order to look good. Funding depends on appearing productive. Reputation and rank come from success competing with other researchers for recognition.
This is why we need "research parasites", professionals who can analyze and report on what academic studies really mean, which is often less than the media or even their authors claim. It's a huge problem among the "public health" research community, who have never seen an anti-gun claim they couldn't underwrite or a pro-rights position they wouldn't undercut-all while ignoring overwhelmingly safe routine firearm use and hundreds of thousands of defensive uses that prevent harm each year. Conflicting findings are instantly discredited since they do not come from the tight-knit community of self-validating anti-gun authorities. This is even more problematic as it comes from the social sciences that depend on assessing behaviors, not the "hard" science disciplines in which objective experimentation is the gold standard.
This more or less began with Arthur Kellerman and Frederick Rivara, who published "Gun Ownership as a Risk Factor for Homicide in the Home" in NEJM in 1993. From it came the notorious claim that having a firearm in a home increases the risk of being murdered by a gun by 2.7. Of course, they picked 3 violent, crime-ridden urban neighborhoods to study, didn't even determine whether the firearms were owned by household members or others, and never considered that owning firearms for protection is very different from having them in order to assault. And, as far as we know, they've never released their raw data for review.
This pattern has continued ever since. (For an introduction, see "Junk Science as Propaganda".) More recently we have read about " ... the dominant public health issue of today: "Gun Safety", by the Chair of Family Medicine at the Cleveland Clinic in S. News,January 28, [2016] who apparently thinks so because there are "approximately the same number of [firearms] deaths a year as motor vehicle accidents." [sic] But there were less than 600 accidental gun deaths last year. Shouldn't a more "dominant public health issue" for my profession be the hundreds of thousands of deaths caused every year in the U.S. by health care provider mistakes? It's so much easier to beat up on millions of safe, responsible gun owners.
....a meta-analysis ( or summation of many studies) about "The Accessibility of Firearms and Risk for Suicide and Homicide Victimization Among Household Members" in the January 2014 Annals of Internal Medicine. They discover that most suicides and homicides occur at home, the presence of firearms is notably associated with adolescent suicide, "firearms stored loaded or unlocked are more likely to be used than those that are unloaded or locked", and women are more likely than men to be victims of homicide at home. None of this is surprising. But they ignore fundamental risk factors of mental illness and criminality, and the good in firearms used to prevent victimization. Guns in a home do not draw people to kill as moths to a flame.
. . . "The relationship between gun ownership and stranger and nonstranger firearm homicide rates in the United States, 1981-2010" from the October 2014 American Journal of Public Health. They found a correlation between gun ownership and homicides by acquaintances, not strangers. It seemed that homicide rates change by about 1.3% with each 1 % change in gun ownership rates. Of course, there are more households with more guns than get acknowledged, so these rate relationships aren't reliable. Their cause (gun ownership) can be effect (homicides): "people may be more likely to acquire firearms when they observe higher rates of homicide". As always, no attention is given to how gun ownership may prevent more homicides than do occur.
. . . that acquaintance "femicide" associated with gun ownership is somehow unique. This work is from the author of the AJPH article above, an example of how academics "leverage existing results" to pad their bibliographies. "Firearm Ownership and the Murder of Women in the United States: Evidence That the State-Level Firearm Ownership Rate Is Associated with the Nonstranger Femicide Rate" finds that firearm murders of women increase 10.2% with a 10% increase in gun ownership (whatever the significance of that 0.2% is, given underestimates of gun ownership). This appeared in Violence and Gender, a journal less than 2 years old mostly studying males harming females. Its scholarly reputation is not clear. Articles lie behind a $55 per copy paywall, which makes them unlikely to be questioned but hasn't diminished their media value.
... about defense against terrorists. A January 27, [2016] piece in the Bloomberg funded The Trace by two prominent anti-gun apologists points out that the odds of being hurt by an acquaintance with a gun is far greater than by a terrorist. This just a lead-in to their thesis is that having firearms is more dangerous than protective, period. Of course, their belief in defensive gun uses is limited to shootings found in police reports or the media. That is nonsense. The federal Institute of Medicine and the National Research Council estimate that there are from 500,000 to 3 million defensive gun uses annually. The great majority are not reported, don't involve shooting, and prevent many deaths, injuries, and crimes.
... , finally, a new survey published in AJPH claiming that most Americans would "consider" buying a "smart gun" that is "childproof'. Well, who wouldn't? The problem is that the survey was slanted toward eliciting agreement on superficialities in younger respondents. The NSSF's 2013 survey included a broader selection of the population, impartially explained the technology involved, and didn't pretend anything is "childproof'.
And anti-gun academics keep complaining that there is not enough research (read: "government funding for their projects"). There are plenty of studies, too many even for DRGO to keep up with, but patterns emerge with familiarity:
Basic bias: Many of these academics have been open about their fear and loathing of firearms. They treat guns as independent risk factors, and then choose hypotheses and analytic approaches that reinforce that. Yet some individual is responsible for every shot fired. Firearms are tools, the means to someone's end ( even if, rarely, literally), but they are not the agents responsible for the actions.
Selection bias and cherry-picked data: Anytime a study is done, choices are made about what data will be sought, from what sources and over what time periods, and then how it should be interpreted. A smart academician (and they're very smart) can skew their oiltcoines··rrom start to finish. The scrupulous ones don't.
Arbitrary analogies: Comparing deaths from gunshot to entirely different phenomena (vehicle accident deaths, for example). Lessons can be drawn from flawed premises that have no relationship to the ways that guns work and can harm (say, that we must have "smart guns", because autos have built-in safety devices).
Blame mongering: There is no interest in explaining the overall declining risks of negligence (accidents), criminal intent (violence), and mental illness (suicide). Anti-gun academics focus on blaming everyone when the wrong people wrongly use them at the wrong times. That doesn't justify restrictions on scores of millions of American families with hundreds of millions of firearms that they use consistently safely.
Diversionary tactics: Setting up straw men, such as proclaiming the news that being shot by someone you know is more likely than being attacked by a terrorist. This raises anxiety that can be resolved with the reassurance that we can "do something", beginning with accepting the intended conclusions. The real world work of discriminating guns owned legally or illegally, investigating who has them and why, identifying which was the injurious ones and who used them for what reasons can be avoided.
False attributions: Depicting correlation as causation, always. The more honest authors admit this problem, but most present gunshot deaths and injuries as consequences intrinsic to the existence of guns, rather than as aberrations from normal gun use and users.
Ad hominem attacks: When anti-gun exponents can't compete on the merits they disparage their pro-rights opponents, especially with a progressive liberal vs. regressive conservative flavor. See almost any mention of "the gun lobby''.
If you read this "research", look for those signs. There is no shortage of "gun research"-just a shortage of serious scholars willing to examine firearms and their use without antipathy.
We'll get somewhere when academics care to examine how to support thoughtful, responsible gun ownership instead of assailing the historic American tradition of widespread gun possession. That will be when they call for outreach, education, treatment, and stiff consequences as the answers to "gun violence", not restrictions without evidence of efficacy. It will be when the right to keep and bear arms is accepted as strongly as the right to free speech and religion.
If you don't choose to wade into this academic morass, we understand. We "research parasites" will continue doing it for the common good.
· Robert B. Young, MD is a psychiatrist practicing in Pittsford, NY, an associate clinical professor at the University of Rochester School of Medicine, and a Distinguished Fellow of the American Psychiatric Association.
