Great post. Like you, I am disappointed that researchers of the caliber of Kate Baicker and David Cutler do not respond to the mounting debate about their paper. They should defend or disown their work rather than hope that the debate goes away.

In my mind, their paper is a product typical of high-end academic research. Two brilliant professors spot a gap in the evidence on a hot policy topic and decide to go after it. But the actual work gets done by a graduate student in his cubicle without windows or guidance, and then hastily published.

Then the problem arises that the paper becomes hugely influential and people start having a closer look. For our paper on the PepsiCo program, we reviewed in detail the seven publications that Baicker and colleagues called “high quality evidence”. We found that five of those analyzed programs that operated over 20 years ago and most of them had severe methodologic flaws. (John P. Caloyeras, Hangsheng Liu, Ellen Exum, Megan Broderick and Soeren Mattke. Managing Manifest Diseases, But Not Health Risks, Saved PepsiCo Money Over Seven Years. Health Affairs, 33, no.1 (2014):124-131)

Unfortunately, many defenders of the industry continue to take the Baicker paper at face value, while closely scrutinizing or ignoring more nuanced and scientifically sound findings.

So I herewith support your motion!

http://tinyurl.com/q3nzbf6

This posting is not that situation. in this case, it’s just a question of a very talented and accomplished researcher perhaps assuming that wellness vendors did understand basic arithmetic, and not realizing that most of wellness is so ridiculously bogus that you can’t assume that peer-reviewing things in wellness promotional journals means anything, as she could have safely assumed in a legitimate corner of health services research. So doing a meta-analysis of bogus papers just gives a very bogus number.

Still, I don’t know why she didn’t cut-and-run a long time ago, like I did, when I realized my own advocacy of this activity was sorely misguided.

This posting was more so that all Professor Baicker’s comments are in one place. That way when the wellness ignorati cite her (again), and we have already drawn their attention to this posting, which we have, we can point out that they know they are misrepresenting the situation. To date, we have only been able to speculate that they are misrepresenting the situation, since all of her recantations were in different venues.

Wow, wellness is not physics, and there are people who will enthusiastically over-promote the value of its grab-bag of concepts & tactics – who, without Al & Vic’s help, would have guessed? :eyeroll:

If you want to take on big-time smoke/mirrors purveyors, guys, at leastr train your sites on bigger targets – I hear Tony Robbins has dipped a toe into the wellness/health care pool…

In fact, you can follow my exploits in this wellness debacle here:

http://khannaonhealthblog.com/the-belly-of-the-beast/

Is anybody listening? I’d say so. My wife and I are embroiled in her employer’s wellness program for simple reason that not participating was too onerous financially. This large employer, with a wellness program run by a major league (well, as major league as a wellness vendor can get, anyway) vendor who is a litigant in at least one major case we know of, is a poke-prod-pry-punish program that would make Kate Baicker proud. Because, apparently, nothing makes her contrite.

In defense of my own political affiliations, I am not a Republican. In fact, I find the major leadership of the Republican Party as repugnant, stupid, and ineffective as most of their peers across the isle. I am an Independent conservative with a libertarian bent.

That clarified, Bob’s point about government approval being a marketplace propellant is right on. Nothing can advance the pointless like an endorsement from the clueless but powerful.

By the way, one other comment was tweeted but not posted. We were attacked for this “personal attack.” The irony is that the person who attacked us didn’t do it publicly, perhaps having learned the fate of attackers from ShapeUp (Dr. Kumar, how’d that work out for ya? http://theysaidwhat.net/2014/07/23/shapeup001/ )

However, unlike ShapeUp’s personality-driven self-indulgent rant, this other guy raised a good point that we would be happy to address: why the personal attack? First, it isn’t a personal attack–we have great respect for her primary-sourced work and called her the #1 researcher. I would love to be attacked like that. Second, all we are asking is for her to answer the question: does she support her own 3.27-to-1 or not? One could argue that the fate of the industry depends on this answer: the wellness ignorati have cited her 307 times (and that’s just in journals — try googling “Wellness” and “3.27”) so I think it’s a fair question. The ignorati have no other legitimate academic source–they sink or swim on 3.27-to-1.

Finally, I did write to her directly twice in the last few months and got no response, before going public. Likewise, before we posted columns showing that the Koop Committee completely lacks the ability or willingness to identify phony outcomes when they give out awards to their sponsors, we wrote to some Committee members ahead of time to point out their incompetence and ask them to address the mistakes before going public. Even Rachel Carson didn’t go public until her protestations got totally ignored by the chemical industry.

I think that is part of what Baicker means when she says “all the evidence is in.” Right now wellness programs probably do suck on average, but will they always suck? Does they ALL suck or are their positive deviants we can learn from?

That said, I get it that wellness backers aren’t promising results some day, they are grossly overselling the benefits of their product which is their job. Similarly researchers are grossly overselling their findings and that is their job. But does anyone actually listen to these people?