We’re Not In Kansas Anymore

Earlier today, the results of a telephone survey dealing with Autism were made known to the media and, subsequently, the general public. 

A telephone survey is nowhere as reliable as a research study however in the hands of the media, this telephone survey has become the Holy Grail many anti-vaccine and epidemic theorists have long sought.  The problem with this is that the results of the telephone survey will only serve to undo most of the current ongoing research on Autism Spectrum Disorders.

A control procedure is an essential part of research because it allows researchers to eliminate and isolate biological variation, researcher bias and environmental variation that can skew data.  Yes, the control procedure provides an important baseline from which to begin the study.

A researcher must only measure one variable at a time while using the control procedure as the reliable baseline data so that the results can be accurately recorded, measured and interpreted.

There are two types of control procedure, positive and negative, both providing researchers with ways of increasing the statistical validity of their data.

If the control procedure fails, there is something wrong with the design. For this reason, scientists prefer to use positive control procedures in order to reduce the chances of false negatives.

When a researcher establishes a strong control procedure, it becomes the most important part of any scientific design. Failure to provide sufficient evidence of strong control procedure has been known to invalidate a studies.  For this reason, it’s vital to ensure that studies are as accurate as possible during the data collection cycle otherwise everything that follows afterwards becomes tainted and invalid.

Telephone surveys, however, are not meant to provide accurate information.  They are meant to elicit the answer the telemarketers expect.  This is why the questions asked are skewed and double barreled.

Telemarketers and telephone surveyers don’t have a principal investigator as chief researcher; telemarketers and telephone surveyers have an employer in charge of delivering the results the contractor wants delivered.

The margin for error is huge and even with errors, the survey can stand as is replete with errors.

Measurement Error is a bias that occurs when surveys do not survey what they intended to measure. It results from flaws in question wording, question order, question response options and more.  (mention the two questions here)

Coverage Error is associated with the inability to contact portions of the population. Telephone surveys usually exclude people who do not have landline phones in their household, the homeless, people who are not home at the time of attempted contact regardless of the reason and more. What’s more, it also excludes cell phone users since the Random Digit Dialing samples have been set up to exclude cell phone exchanges in keeping with government policies.

Non-response Error results from not being able to interview people who would be eligible to take the survey. Non-response bias is the difference in responses of those people who complete the survey versus those who refuse to complete the survey regardless of their reasons for refusing to do so.
 
The findings from the telephone survey are based on the results of a national telephone survey of more than 78,000 parents of children ages 3 to 17. The survey dealt with many health issues and included two questions on autism.

Parents were asked whether they’d ever been told by a doctor or other health care provider that their child had autism, Asperger’s syndrome, pervasive developmental disorder or other autism spectrum disorder.

If the parent said yes, they were asked if their child currently has autism or an autism spectrum disorder. “Yes” to both questions was counted as a child with an autism disorder.

So what exactly is a health care provider?  Most people assume this means a doctor or a specialist.  They are mistaken.  A health care provider is, by definition, an individual who provides health services to health care consumers.

This means that if a physician, nurse, dentist, mental health worker, birth control counselor, STD manager or even an early childhood educator provides health services to an individual or family, that person is considered to be a health care professional.  That’s what the McGraw-Hill Concise Dictionary of Modern Medicine states and upon checking a little further, it’s the definition used by various Colleges of Physicians and Surgeons in North America.

The telephone survey was seriously flawed from the beginning.  The design was very bad. 

Now the Health Resources and Services Administration (HRSA) is the group who announced the findings of the survey to the media.  HRSA, in case one is unaware, is an Agency of the U.S. Department of Health and Human Services.  It is the principal Federal Agency charged with increasing access to health care for those who are medically underserved.

HRSA’s programmatic portfolio includes a range of programs or initiatives designed to increase access to care, improve quality, and safeguard the health and well-being of the Nation’s most vulnerable populations.

Isn’t just a little too coincidental that HRSA’s findings should be released to the media on the same day that US President Barack Obama returned to the front lines of the health reform debate after investing weeks on foreign and economic crises?

And isn’t it just a little strange that Obama should start focusing on health care while standing amidst a sea of white coat-wearing doctors from all 50 U.S. states?

What’s really going on here?

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