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Originally Posted by Perhaps Shimmy
Yeah, so basically,
-The whole paper is about a protein called tau. This protein is found in the brains in all people. In people with certain neurodegenerative diseases like Alzheimer's and CTE, tau starts sticking to itself and forms huge aggregates. Whether these aggregates cause brain cells to die, or they're just a symptom of disease is not 100% established. It's at least partially the former tho.
-In this paper, they are trying to establish a method for identifying these aggregates in living patients, which is difficult to do. They use a method called [F-18]FDDNP-PET, which combines PET(positron emission tomography, which is like MRI and is already widely used) and FDDNP, which is some sort of dye that attaches to tau. When they do PET after administering FDDNP to patients, they can allegedly see where the FDDNP is, and therefore where tau is.
-They took a former NFL player and used FDDNP-PET on them. ~4 years later, the person died. They then took the guys brain and looked at where tau really was, to see if it matched with the FDDNP-PET scans.
Sounds like a pretty good study so far
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The ethical problems are:
-The researchers have a patent on FDDNP, so it's in their best interest to push it as a diagnostic tool. They stand to make both research funding and private profits through the patent.
the same ethical problem is present in literally every drug and medical device that is patented.
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-They gave the report to CNN's Sanjay Gupta before the paper was published. Gupta is a known shill, and was almost certainly paid by the researchers to push this paper onto CNN.
This is an extremely serious claim and I really doubt this is the case. There isn't really an ethical concern with trying to publicize results by contacting science journalists, sending them advance manuscripts, etc. Of course if they pay those journalists there's a problem. But you're just making stuff up here.
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The problems with the paper are:
-It's a case study, so only a N of 1.
This is only a problem if the authors try to present it as if it was not a preliminary result. As far as I can see they have not.
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-The correlation between the FDDNP-PET and postmortem tau was rs = 0.592, P = .0202. That's ok, but certainly not "highly correlated" as they say. also, it just squeaks by the significant threshold of p=.05. It's very likely that FDDNP stains other things besides tau, so it's not a great diagnostic tool.
Maybe it is, maybe it isn't. They'd have to establish diagnostic guidelines and do double blind studies on the implementation of those guidelines on football players/non football players. The correlation isn't really the important part, the important part is how often to the diagnostic guidelines that they set up lead to false positives and negatives in the double blind study. Obviously this would be a colossal undertaking as the study would have to have (I'm guessing) tens of thousands of football/non football volunteers to get enough data (which necessarily involves them dying) to see how reliable the diagnostic guidelines are.
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-We don't know how much of the tau was formed in the 52 months between the scan and when the player died.
-all the CTE diagnostic methods are done via the researchers themselves, or through anecdotal evidence through the person's family members.
-The person allegedly had CTE symptoms at the time of the scan, 4+years before he died. So it was already too late to perform interventions and administer medications and therapies to this person. How good is a diagnostic test if it's already too late to do anything about the diagnosis?
That's the jist of it, but there are other problems with the paper. If the data is reliable, it's a step in the right direction because it's a way to diagnose patients for future studies.
These are all bizarre nits to pick that are only valid if the researchers aren't presenting this as a preliminary first step. Which it seems like they are?