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Comment by cpncrunch | Hacker News Reader

Because it was debunked back in 1997:

http://www.neurology.org/content/48/3/626.short

Just another case of HN users clicking on flashy things without stopping to examine the evidence. Some more examples:

- deep brain stimulation: hundreds of upvotes here on stories about this, but then when studies come out showing that it it no better than placebo that story gets 3 upvotes on HN.

- fecal transplants for C dificile: again hundreds of upvotes for stories touting this, but then when it is found to be no better than placebo the story gets no upvotes on HN.

These are just a few examples, but I see this all the time on HN. It makes me a little disappointed in the community and thinking that perhaps I should be hanging out somewhere else instead.

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Clearly the author didn't find the results from the paper you pointed to particularly compelling. It's listed as reference 136 and mentioned several times. The last of which, "In the absence of more precise knowledge of the extents of analgesic consumption and the durations of exposure, the reliability of these reports [45, 136, 137] is open to question." Is there a reason you find the Stewart paper to be more definitive than this author suggests?

That reference talks about "gross abuse". I'm not sure exactly what quantities they were talking about, but if you take too much of anything it will cause health problems.

Not a biologist by any stretch of the imagination, so I am asking purely out of ignorance - how does your study debunk the OP's? Yours is about NSAIDs (i.e. aspirin) decreasing the risk of Alzheimer's, OP's is about paracetamol (not an NSAID) increasing the likelihood of Alzheimers. Correct me if I'm misunderstanding something here...

I think perhaps you didn't read it carefully enough:

"In addition, we examined use of acetaminophen...No association was found between AD risk and use of acetaminophen"

GP's study includes PA (which is also known as acetaminophen) as well as NSAIDs, and finds no effect, so it is a contrary result. Calling it a preemptive debunking may be a bit excessive, but given that it is a more direct study of the relationship, it (from the abstract, at least) seems to be a reason for skepticism.

"Not a biologist by any stretch of the imagination"- a problem with the software engineers on Hackernews pontificating about other subjects.

This is quasi-ad hominem, and yet there's a kernel of truth to it, i.e. being a software engineer doesn't necessarily make you a critical thinker.

"I am asking purely out of ignorance ... Correct me if I'm misunderstanding something here"

How do you think 25cf should have handled this differently?

Just ask the question. The preamble and last sentence only detract from the main point: how does your study debunk the OP's? Yours is about NSAIDs (i.e. aspirin) decreasing the risk of Alzheimer's, OP's is about paracetamol (not an NSAID) increasing the likelihood of Alzheimers.

If you're misunderstanding something, don't worry, someone will set you straight.

It found aspirin most likely has a protective effect.

It found no strong evidence of any association for acetaminophen, but the 95% confidence interval on the result is pretty wide. So it doesn't entirely rule out the possibility of there being a relationship, and based on its results alone it's entirely plausible that a test with more statistical power could find that it doubles your risk of Alzheimer's disease. But it could also plausibly find that it has a mild protective effect.

Regardless of which is the case, this study still strongly challenges what's being suggested by TFA. Even a doubling of Alzheimer's risk resulting from a lifetime of acetaminophen use is nothing at all like its suggestion that Alzheimer's is a disease that was unheard of before the development of NSAIDs related to Tylenol.

> its suggestion that Alzheimer's is a disease that was unheard of before the development of NSAIDs related to Tylenol.

Minor point: Tylenol isn't an NSAID, nor is the prior drug to which the article links Alzheimer's.

There's a strong bias in all disciplines towards "positive" results, i.e. those that demonstrate an effect. They're more exciting, and in the short term they're usually more profitable. There isn't a lot of tolerance for thorough examination. I feel like science didn't use to be this way, or at least the romantic stories I was told about science didn't go like this.

Re: fecal transplants, do you mean the study with N=46 in which FMT scored a 91% cure rate, 28% higher than placebo? http://www.hcplive.com/conference-coverage/acg-2015/fmt-pass...

Citations needed.

That was one study. There have been a total of 2 placebo-controlled trials into fecal transplants for C.Diff AFAIK. One showed some benefit over placebo, and the other showed no difference. It looks like that link you posted has just cherry-picked the good result.

https://news.ycombinator.com/item?id=10679067

Post links. The one I posted was the most recent I found (October 2015), but most studies I saw (every one I checked, N > 5) reported distinct success for FMT in their abstracts.

[EDIT] You've posted a link now, and the article is behind a paywall. There may be a correlation between that and the fact that it didn't get any upvotes, but we'd need sizable trials to be sure. :)

I didn't realise it was a paywall. If you search for "Mixed Results for Fecal Transplant in First Randomized Trial" you'll get through the paywall.

I hate paywalls for this reason, but I didn't find any non-paywalled versions of the article -- they all just seem to cherry-pick the good result and completely ignore the other one.

People like to hope and don't like seeing their hopes destroyed. You see the same with the life-extension and cryogenics or uploaders.

The Neurology article is paywalled. From the abstract:

> No association was found between AD risk and use of acetaminophen (RR = 1.35; 95% CI: 0.79-2.30), and there was no trend of decreasing risk with increasing duration of use.

Depending on the methodology (no multiple regression?) and the possible association between NSAID and paracetamol intake, there may be a smoking gun, right there :-)

>- deep brain stimulation: hundreds of upvotes here on stories about this, but then when studies come out showing that it it no better than placebo that story gets 3 upvotes on HN.

I had no idea DBS is no better than placebo, do you have a source to back it up?

https://news.ycombinator.com/item?id=10447589

Thanks for the link. I assumed that you were commenting on DBS for Parkinsonism and was a bit surprised to find people say a proven therapy does not work.

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