[Stoves] How are DALYs and GBD numbers created?

Sat May 20 00:59:51 CDT 2017

Frank:

Sorry. We do not know what all causes each and every death. That's why we
have doctors' certificates, though not for all. And even when there are
doctors' certificates listing a cause, it is debatable and debated. The
IHME super-humans do in fact assign a single cause to every death record
they have, NO MATTER what the listed cause of death was.

Besides, a death is a death, with medical definition. A "premature death"
is an emotional term or IHME fiat. It used to be that a death at an age
lower than the national life expectancy at birth was called "premature
death". As infant and maternal mortality declined, the mean and the median
of deaths in sufficiently homogeneous large cohorts came close, implying
that "premature death" and "postmature death" numbered about the same.

Then too, is a national population a homogeneous cohort? And how does one
go about getting life tables and computing life expectancy at birth, at age
5 and so on to age 95? (The US now has 70,000 people over the age 100. All
will die a premature death. Or a post-mature one.)

Beginning 2012 or so, the pompous priesthood of public piety - I mean, of
public health - declared that every death before the age 86 was a premature
death.

Was every premature death caused by x, y, or z? What does one need to know
in order to assign such causes?

Don't even think of medicine. Medicine is about treating a disease. Health
and medicine are not the same thing.

I won't presume to talk about HIV or knife wounds to vital organs, but no,
we don't know what causes premature deaths. There are correlations of this
kind of that.

Killing by assumptions is euphemistically called attributability to risk
factors.

I am still waiting to understand what my post-mature mortality will be
attributed to. Surely not absence of dirty air. Have inhaled enough dirty
air from WHO.

Fixing a problem requires determining what the problem is. Except in
extreme cases - such as being caught in fires - PM2.5 exposures are not
known to actually kill anybody. I invite Kirk Smith and WHO to produce a
list of 7,000 people whose PM2.5 exposures have been measured over a
sufficiently long period to have caused identified diseases with no other
risk factor but such exposures.

But WHO and IHME cannot identify a problem other than that they can't
persuade enough skeptics that transition to LPG and electricity will
eliminate 4 million premature deaths.

That's why money is the best medicine. Throw money around, buy some media
time and conferences, and use hundreds of millions of dollars to put out
mind-numbing, prematurely-killing research in the hands of gullible media
and public.

Why? So you get more money for more research.

ditto.

This is an old debate. Back in 2001 July-September (ending on 9/11), there
was online debate under the Shell Foundation Household Energy and Health
initiative. One participant on this list wanted money for stove design.
Several others wanted money for epidemiological research.

Not one premature death has been averted.

No surprise. There is not an iota of quantitative evidence that the 20th
Century modern energy revolution - minus fires in wars - averted premature
deaths.

Research on premature mortality has one sole purpose - to cook the dead.

Nikhil

------------------------------------------------------------------------
Nikhil Desai
(India +91) 909 995 2080
*Skype: nikhildesai888*

On Sat, May 20, 2017 at 2:10 AM, Frank Shields <franke at cruzio.com> wrote:

> We all know what causes premature death: 1) contaminated water, 2) dirty
> air and 3) spoiled food.
>
> If we have 10M dollars to spend we go into a village and test the water,
> air and food. If they test ok we then spend the money and do a study to
> determine the unknown cause.
>
> If any one of the three is determined to be suspect we spend the 10M to
> find a solution to fix that problem. We don’t need to do another study to
> determine the cause of the problem. That would only waste the money and
> nothing gets accomplished. The only benefit is the ones awarded the money
> to do the research that puts out a report stating something we already know.
>
>
> Regards
>
> Frank
>
> On May 19, 2017, at 1:24 PM, Crispin Pemberton-Pigott <
> crispinpigott at outlook.com> wrote:
>
> Dear Nikhil
>
> I felt that with that advice in hand (yours) people reading this list
> should familiarize themselves with the root documents to understand how
> model-based this is, and where the limitations lie.
>
> One limitation is trying to take a population statistic and project onto
> an individual a specific ‘countable’ better outcome. If such a projection
> is not true for one person, it is also not true for a thousand people
> counted individually.  If we can understand that, we have a chance of
> seeing between other lines.
>
> Independent investigation of truth. It is a founding principle.
>
> Regards
> Crispin
>
>
>
> Crispin:
>
> I repeat - DALYs and risk factors for household fuel use in developing
> countries are cooked.
>
> Do not bother looking for emissions, concentrations, exposures, or for
> that matter even deaths and disability statistics with any physical
> counterparts -- THESE people, THIS area, THESE fuels and stoves, THIS
> moment.
>
> Let me spell out simply - they are all lies.
>
> Official lies. In officious publications.
>
> Nikhil
>
> ------------------------------------------------------------------------
> Nikhil Desai
> (India +91) 909 995 2080 <+91%2090999%2052080>
> Skype: nikhildesai888
>
> On Sat, May 20, 2017 at 12:29 AM, Crispin Pemberton-Pigott <
> crispinpigott at outlook.com<mailto:crispinpigott at outlook.com
> <crispinpigott at outlook.com>>> wrote:
> Dear Friends
>
> If you have wondered how the GBD and DALY numbers are generated, have a
> look at these two documents linked below.
>
> Note the clear distinction maintained between exposure and emissions. When
> it comes to cooking stoves there is a big difference. If the emissions go
> outside and do not result in exposure, the indoor exposure problem is
> solved. If emissions go outside and elevate an ambient level to a higher
> one, exposures increase a bit for everyone.
>
> We have the interesting case of upland Kyrgyzstan where dung and wood are
> primarily burned for cooking and heating. If the current situation is
> heavily polluted indoor air (leaky stoves etc) and pristine outdoor air, is
> it enough to put 100% of the emissions outside (seal the stoves)? Is it
> enough to reduce emissions by ½ and put all the it outside where it is
> diluted into insignificance? When is ‘enough’ an adequate response?
>
> How about in a crowded valley where it is 500 µg/m3 indoors and 100 µg/m3
> outside? The indoor pollution goes outside anyway, sooner or later, so
> putting it up a chimney would make nearly no difference to anything. Not
> even 100.01.
>
> My point is that reducing emissions is great, but that putting it in the
> right place is a Good Start, while working on absolute reductions.
> Thoughts, anyone?
>
> Regards
> Crispin
>
> Models of death and disability:
>
> http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)30505-6/
> fulltext
>
> Ambient PM2·5 was the fifth-ranking mortality risk factor in 2015.
> Exposure to PM2·5 caused 4·2 million (95% uncertainty interval [UI] 3·7
> million to 4·8 million) deaths and 103·1 million (90·8 million 115·1
> million) disability-adjusted life-years (DALYs) in 2015, representing 7·6%
> of total global deaths and 4·2% of global DALYs, 59% of these in east and
> south Asia. Deaths attributable to ambient PM2·5 increased from 3·5 million
> (95% UI 3·0 million to 4·0 million) in 1990 to 4·2 million (3·7 million to
> 4·8 million) in 2015. Exposure to ozone caused an additional 254 000 (95%
> UI 97 000–422 000) deaths and a loss of 4·1 million (1·6 million to 6·8
> million) DALYs from chronic obstructive pulmonary disease in 2015.
>
> And
>
> http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)31012-1/
> fulltext
>
> We estimated all-cause mortality by age, sex, geography, and year using an
> improved analytical approach originally developed for GBD 2013 and GBD
> 2010. Improvements included refinements to the estimation of child and
> adult mortality and corresponding uncertainty, parameter selection for
> under-5 mortality synthesis by spatiotemporal Gaussian process regression,
> and sibling history data processing. We also expanded the database of vital
> registration, survey, and census data to 14 294 geography–year datapoints.
> For GBD 2015, eight causes, including Ebola virus disease, were added to
> the previous GBD cause list for mortality. We used six modelling approaches
> to assess cause-specific mortality, with the Cause of Death Ensemble Model
> (CODEm) generating estimates for most causes…
>
>
>
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>
>
>
> Thanks
>
> Frank
> Frank Shields
> Gabilan Laboratory
> Keith Day Company, Inc.
> 1091 Madison Lane
> Salinas, CA  93907
> (831) 246-0417 cell
> (831) 771-0126 office
> fShields at keithdaycompany.com
>
>
>
> franke at cruzio.com
>
>
>
>
>
>
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