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Biobank Bias?


The big research news on BBC this morning is about the Biobank project- which looks at hundreds of thousands of 40-65 year olds to find out the relative significance of lifestyle and genes in causing ill-health.
I was invited to take part, and would have willingly done so, but my appointment was in the middle of the working day so, as I work for myself and time is money, I phoned to try to get a time I could afford to attend.
I was told politely but firmly that this would not be possible, that the times were computer generated and (you guessed it) they couldn’t over-ride the system. I also learned that the appointments would take 2-3 hours.
This is a serious chunk out of a working day and one most people could ill-afford. So, who do you think is likely to attend these appointments? Senior managers, directors, entrepreneurs, shopkeepers…the self-employed? I think not…
I would venture to suggest that the majority of those attending will be the very people you least want to know about. Those who are ‘safe’ – employed in public sector, local government jobs (the venue for this study was close to the major council offices here) or very stable routine occupations in town.
The very people that I would want to study as a research specialist would be those who have chaotic lives, in the inner city or peripheral housing estates or, indeed, adventurous builders and outdoor workers or financial risk-takers and achievers: the self-employed, the business owners and entrepreneurs.
When you study healthy lifestyles, risk behaviours are key. How we relate to risk drives some of us towards safe jobs and some to struggle to set-up businesses. It is also linked to sensation-seeking which drives some to drink or travel more than others and others of us to race cars or motorbikes. These are lifestyle choices and they are linked to the occupations we choose.
Equally, those struggling in deprivation or with chaotic lives at the margins of society should be drawn into the net of this study as well, if its findings are to make sense.
Surely the sampling strategy for such a major study should have been better designed to recruit more than bureaucrats and office fodder?

From → Health, Research

  1. thejourneywithnoend permalink

    Good point. That is basic Public Health Research 101 technique….
    Sounds like room for a lot bias ideas….

    • Hmm… Well, I thought so. How does this sort of research strategy get funded? I mean, this is big scale stuff. Sounds like an enthusiastic minister, a prof’s pet project, a shedload of money and not a great deal of thought. Pushed through in a hurry, maybe? Timed to coincide with the elections, too, perhaps? (Cynical? Moi?)

  2. Sally permalink

    Political stuff aside – you have valid points there – I disagree about the selection of population you say will attend. I think that it is the senior managers, directors and entrepeneurs who have more control over their time and so it is they who are more likely to attend. The people you call ‘safe’ – those in public sector, local government and office jobs have no control over time they can have off work to attend such interviews (though like managers etc they could take holiday time). The only section you have right is the unemployed – no they will no doubt be busy job hunting during working hours. And as regards who should be included, then I would have thought that as a researcher you would be interested in a cross-section of all groups, and not just those on the margins. Only then would you have a true representation of society.

    • Hi Sally,
      I am sorry if this came across as disrespectful of any population segment or social group, but we now know a lot more about the chaotic lives of those at the margins and of those who are in stable, routine occupations than we do of health choices of affluent risk-takers in society. If Biobank is to examine the interplay of genes and lifestyle, I think that the latter group is an important and interesting group to examine and – like any other – should not be left out.

  3. You make an excellent point!

    Which should lead to that we read the usual “scientific” study results with far more scrutiny and skepticism.

    Alexa Fleckenstein M.D., physician, author.

    • I think we use the terms ‘scientific’ and ‘expert’ far, far too much. Like brand labels, though, if they are abused they will lose all value. (Liked the pic of nettles on your site, by the way. As children, we used to have them at my gran’s as a side dish at lunch!!)

      • Did you like them as a boy?

        Big secret: How good stinging nettle taste! I have now tried them with potatoes, parsnip and celeriac, respectively – and they were delicious each time. Of course, leaves only, pureed, with olive oil, pepper and salt.

        Haven’t tried them with garlic yet.

        In European Natural Medicine, stinging nettle is considered the best herb overall, for its tonic effects on the immune system.

        Alexa Fleckenstein M.D., physician, author.

      • I think we were told they were good for you because they ‘cleansed the blood’… whatever that means!

  4. Sally permalink

    Disrespectful? Depends what you mean by saying that the majority of people attending such interviews are “those you least want to know about”. But what is the Biobank project about? Is it about finding out about the population as a whole or is it just about discovering more about ‘interesting groups’? I am quite certain that marginal groups will uncover intersting information – for everyone. But I am also quite certain that if it is about taking a snapshot of life then it needs to include a sample of the entire population. I also disagree with you about who will be more likely to attend. Maybe the grass is always greener from the other side, but as I see it those in charge whether entrepeneurs or managers, are the ones who have more flexibility and more say about whether they can attend. Of course, for everyone (not just those who are self-employed, timing of interviews is likely to be a matter for debate. Those who represent that group you find least interesting are more likely to be unable to take time out and make it up later. Their involvement might well mean taking holiday leave – if they have that degree of flexibility in their job (and not all do). It should not be an argument about including only those whom we wish to know least about, but about flexibility of interviews – for all.

  5. Same lore I heard as a child!

    I looked it up in Dr. Duke ‘s phyto database -

    Urtica dioica contains tons of interesting compounds – many are known to be protective of cancer, some protect the liver, some move your bowels faster and increase urine flow. They guard against diabetes and high blood fats. Also contain vitamins and an anti-depressant (serotonin).

    To put it in plain English: It probably means you pee and poop out the wastes from a long winter. And then you feel happy!

    Alexa Fleckenstein M.D., physician, author.

  6. Sally permalink

    Just thought I’d let you know that Biobank project claims it is easy to change appointment times …

    “If you want more information or to change your appointment time, that’s simple too – just call our Participant Resource Centre..”

    • Sadly, it is not as simple as they make out.
      I am not the only one to have had problems trying to re-arrange these appointments. Among the responses to my blog has been a corroboration of my experiences with three requests for alternative times turned down.
      Also, If you don’t work in town, or near to the research centre , there is also the cost of driving and parking (£5+ these days, just for the latter) or a bus fare (£3+) for a saver return. Hardly something to win over the benefit claimant, let alone me.

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