"The Temporal Stage Fallacy: A novel statistical fallacy in the medical literature"
In Medicine, Health Care and Philosophy
Publisher Springer Netherlands
ISSN 1386-7423 (Print) 1572-8633 (Online)
Subject Behavioral Science and Humanities, Social Sciences and Law
Issue Volume 9, Number 2 / July, 2006
Category: Scientific Contribution
DOI 10.1007/s11019-005-3349-2
Pages 243-247

by David Shier and J. Lee Tilson

(1) Department of Philosophy, Washington State University, P.O. Box 645130, Pullman, WA 99164-5130, USA (shier@wsu.edu)
(2) Sommers, Schwartz, Silver & Schwartz, 2000 Town Center, Suite 900, Southfield, MI, 48075 (lee.tilson@gmail.com)


Abstract: Celebrated for disproving the traditional view that lack of oxygen at birth (perinatal asphyxia) contributes significantly to cerebral palsy, a 1986 New England Journal of Medicine article by Karin Nelson and Jonas Ellenberg engineered a new consensus in the medical community: that lack of oxygen at birth rarely causes cerebral palsy. We demonstrate that the article's central argument relies on straightforwardly fallacious statistical reasoning, and we discuss significant implications -- e.g. how carefully fetuses are monitored during labor and delivery, expert testimony in malpractice cases, and public policy decisions.


Keywords: asphyxia neonatorum - asphyxia neonatorum/complications - birth injuries/complications - cerebral palsy - cerebral palsy/etiology - Daubert - Ellenberg - Jonas - expert testimony - fetal anoxia - fetal distress/complications - hypoxia-ischemia - brain/etiology - malpractice - movement disorders/etiology/physiopathology/prevention & control - National Collaborative Perinatal Project - National Institutes of Health (US) - Nelson - Karin - New England Journal of Medicine - obstetrics - perinatology

References:

American College of Obstetricians and Gynecologists: 2003a, Obstetrician-Gynecologists and Pediatricians Say Most Newborn Brain Injuries Do Not Occur During Childbirth. ACOG publication

American College of Obstetricians and Gynecologists: 2003b, Neonatal Encephalopathy and Cerebral Palsy: Defining the Pathogenesis and Pathophysiology. ACOG publication

Huber, P.: 1991, Galileo’s Revenge: Junk Science in the Courtroom. Basic Books

Nelson, K., Ellenberg, J. (1986) "‘Antecedents of Cerebral Palsy – Multivariate Analysis of Risk’" New England Journal of Medicine 315: 81-86

McCollough, M.: 2003, ‘A Dispute on Doctors’ Cerebral Palsy Role’, Philadelphia Enquirer, Feb. 10, 2003

U.S. Court of Appeals, 5th Circuit: 1999, Tanner v. Westbrook, 174 F3d 54