Talk:Harvard abortion study

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Rarely have a seen a more blatant example of junk science. You can't exclude people who die of breast cancer, from a study on breast cancer! --Ed Poor 13:06, 24 April 2007 (EDT)
I'm sorry but wait just one cotton-picking horn-swaggling carn-sarnint (civility filter on) minute here, it doesnt say that the people who were excluded from followup as a result from death had died of breast cancer. I have a hard time believing they'd just ignore those deaths if they did occur, where on earth did you get tie impression that they did? Further, where the entry reads that it excludes women who got cancer afterwards, its excluding women who did and who didnt have abortions who got cancer afterwards because in those circumstances they're outside of the control of the experiment. You're misreporting out of context factoids that otherwise would show how stirctly they adhered to the scientific method in a pathetic attempt to show how the study ignored the most relevant data it was examining, as though the entire scientific community wouldnt have jumped on their necks already. No wonder why the CPedia front page gloats that "Only on Conservapedia" will use of the scientific method be deemed a sin.--RexMundane 13:45, 24 April 2007 (EDT)
  1. It doesn't say that. It says Only on Conservapedia: this study debunked.
  2. Thanks for turning on your civility filter: I read you loud and clear.
--Ed Poor 13:58, 24 April 2007 (EDT)

It seems that footnote 6 to the article argues that there is not a link between cancer and abortion.--1048247 13:52, 24 April 2007 (EDT)1048247


How about a link to the actual study so we can draw our own conclusions instead of reading Andy's slanted opinions? Jrssr5 13:08, 24 April 2007 (EDT)

Here's the NY Times's spin on it: [1] --Ed Poor 13:11, 24 April 2007 (EDT)
And here's an older NY Times story: [2] --Ed Poor 13:13, 24 April 2007 (EDT)

Can I point out, that although I think I have a scientific background, that I have no idea what:

"Among parous women [the overwhelming majority of the study], the [hazard ratios] HRs were 1.58 (95% CI, 1.13-2.20) for PR- breast cancer and 0.80 (95% CI, 0.60-1.05) for PR+ breast cancer (P for heterogeneity = 0.002) among women with induced a.."

actually means in real terms for women. If this is meant to be an informative article, than it fails because it makes the mistake of in attempting to be scientifically accurate, it actually presents scientific gobbledegook. The HR is presumably a hazard ratio. Does that mean that the increased risk represents a 1.58%, or 58% increase, and an increase on what? If the chance of developing breast cancer is 50%, then is the increase to 51.8% (hardly a significant increase) or to 76% (a pretty devastating significant). On the other hand if the risk is 0.05%, then and increase to 1.63% would be pretty significant, whereas one to 0.076% would not really be significant at all.

Please consider your audience. --CatWatcher 13:37, 24 April 2007 (EDT)

That part should probably be rewritten. Basically it means that the women in the study who had children (parous) were 58% more likely to get progesterone negative breast cancer if they ever had an abortion, and the same women were somewhat less likely to get progesterone positive breast cancer. If I did the math right there were 442 breast cancer cases among women who ever had an abortion. 59 (13%) were progresterone negative and 92 (21%) were progesterone positive. Murray 13:57, 24 April 2007 (EDT)
And according to [3] the prevalence among US women of breast cancer in general is about 1 in 8. Though to extrapolate the risk for PR- from the study (ie, what % of women who had abortions will get it by these figures) we'd need to know the rate of PR- breast cancer. Murray 13:59, 24 April 2007 (EDT)
That makes more sense. However, the point still remains (and it's not just here, it's generally in reporting of medical research). Whenever anyone says there is an incresed risk of X, if X is very low probability, then the incresed risk is negligible. It only matters if the original risk is significant, and the increase is significant. --CatWatcher 14:03, 24 April 2007 (EDT)
Thanks, Murray, your comments are enlightening. Catwatcher, realize that I'm quoting from the study and it is the fault of the authors for downplaying that fact and not explaining it better. But as Murray shows, these are significant percentages, not the unimportant ones that you suggest might be the case.--Aschlafly 14:05, 24 April 2007 (EDT)
In this case, I'm not playing devils advocate or anything. I am genuinely confused by this article. When I read the article as it stands at the moment, I cannot actually understand what it is saying, and whether there is an increased or a decreased risk of cancer if a woman has had an abortion. Perhaps I should come back and readi it tomorrow when all the argy-bargy has finished!--CatWatcher 14:10, 24 April 2007 (EDT)
Here's a summary of the findings: breast cancer in general (including all types) was not more likely in women who reported ever having an abortion. Women who reported miscarriages (spontaneous abortions) were somewhat less likely to get breast cancer, though the effect was fairly small and did not quite meet the criterion for statistical significance. Still speaking of all types of breast cancer, the findings were the same regardless of whether the women ever gave birth, or whether an abortion occurred before or after they gave birth. The hormones estrogen and progesterone are implicated in some breast cancers, so they also looked at these specific cancer types. Reported abortion had no effect on the likelihood of getting estrogen receptor positive or estrogen receptor negative (ER+ or ER-) breast cancer. Progresterone receptor positive (PR+) breast cancer was not related to abortion in women who never had kids, and was a little less likely in women who had kids and reported an abortion compared with those with kids and no abortion (that effect also was not quite statistically significant). PR- negative cancer, though, was 58% more likely in women who reported having an abortion if they also had children at some point. About 80% of the women in the study had children. Murray 15:40, 24 April 2007 (EDT)
Great analysis, but I do quibble with your statement about women who did not have any children. The ranges are so wide on the 95% CI that no conclusions can be drawn about them. The numbers are statistically insignificant, another sign of how the 100,000+ women in this study were simply too young for studying breast cancer.--Aschlafly 15:59, 24 April 2007 (EDT)
Andy - It was statistically not significant, though barely - p = .06 - if I understand correctly what you were referring to. The criterion for statistical significance is arbitrary and doesn't always reflect whether something is meaningful. On the other hand, statistical significance is dependent on the sample size, and with such a huge sample any effect that doesn't reach significance is bound to be small and likely not meaningful. So I can't argue with your quibble. I already have a copy of the article but I appreciate the offer. Murray 16:06, 24 April 2007 (EDT)

Contents

Opinions in article

this age disparity is analogous to an attempt to draw conclusions about heart disease by studying teenagers.

This statement is not a fact, however, it leads readers to believe it is. So I changed the sentenced and attributed the sentence to the person that first stated the sentence to make it a fact.

The analogy is factual. Don't make your change a third time. It's inappropriate to insert someone's user id. into an entry anyway. The page history has that info.--Aschlafly 14:02, 24 April 2007 (EDT)

Would like to start by pointing out one clear error for starters. At the start of the study, the women where between ages of 29-46 [4] So, how can one get the avrage age of the womens in the study to be 42 now 14 years later when the yongest women in the study should be atleast 43? Timppeli 14:03, 24 April 2007 (EDT)

By the way, I have a copy of the paper and can email to a few open-minded readers here who want to analyze its or my claims further.--Aschlafly 14:12, 24 April 2007 (EDT)
I would be interested in reading the study to draw my own opinions ... my email link should work. no guarantees as to how quick i'll get to reading the study though. Jrssr5 14:15, 24 April 2007 (EDT)
As no one seams to have an answer to the question i raised, im going to remove the mention about the average age of 42. Timppeli 15:07, 24 April 2007 (EDT)
I see my edit got reverted, but could i have some explanation why please, as it sounds kinda weird to claim the average age of the women in the reasearch to be 42 when youngest is 43. Timppeli 15:22, 24 April 2007 (EDT)
I thought I had explained this here, but now I can't see it. So maybe what I wrote was not saved. Your point is a good one.
The study ended in 2003, when the youngest would have been 39. The average of 42 applied to those who had an abortion, which means they were on average 12 years old when Roe v. Wade legalized abortion nationwide. It makes sense that the younger side of the population was more likely to have had an abortion, so an average of 42 is plausible.
Regardless, that is the age given by the study says and I've offered to email it to folks who want to analyze it. One took me up on my offer here.--Aschlafly 15:26, 24 April 2007 (EDT)
Thanks for the clarification. Timppeli 15:38, 24 April 2007 (EDT)

They did a pretty poor job of reporting the age - presumably the 42 reported is at the end of the study, but if they clarified that anywhere I can't find it. Murray 15:42, 24 April 2007 (EDT)

That's part of the spin, of course. If they reported that of 42 up front, then many informed readers would immediately react, "that's too young for most women to have developed breast cancer!" FYI, I found the age 42 in table 1. Murray, let me know if you need a copy. Your comments are good and I appreciate what you have to say.--Aschlafly 15:56, 24 April 2007 (EDT)

For the sake of comparison, the Reuters report on this (I haven't seen the original article so am not sure if this is accurate) said: "Michels' team noted that the studies that had seemed to show abortion caused breast cancer also mostly looked at younger women who had not reached menopause."--Britinme 22:00, 26 April 2007 (EDT)


By the way Andy, thanks for your above comment. Much more data would probably be required for either of us to change our mind about the issue so that we agreed, but it's nice to discuss it calmly and rationally Murray 21:19, 24 April 2007 (EDT)

Full study text

Anyone wanting the study text, contact me. ColinRtalk 14:18, 24 April 2007 (EDT)

Hey, Colin could you please send me the full study text. --Staple 18:52, 24 April 2007 (EDT)


I fail to see why it would have been necessary to include African American or Hispanic women: their reproductive organs do not differ from that of white women. The only difference could thus come form lifestyle and environmental differences, but that was not what this study was about.

May I remind everyone here that an earlier study that seemed to show a correlation, was not ripped apart and scrutinized, in fact it was supported and cited from.

Middle Man

Ethnicity is a valid issue. Reproductive organs don't differ but genetics sometimes do. Given that breast cancer has a genetic component, it could be different for different ethnic groups (I have no idea whether it is). Murray 21:15, 24 April 2007 (EDT)

You would have a good point, if this was a study about inherited vulnerability to breast cancer. The existence of a special gene carried by African American or Hispanic women only, that would somehow increase vulnerability to breast cancer, only after an abortion, and not even in the case of a completed pregnancy, seems highly unlikely to me, although I do not have a Ph.D in genetics. In any case I do not believe this is sufficient to "debunk" this study.

Middle Man

I don't have a PhD in genetics either but that's not quite what I meant. It's possible that, for example, that the prevalence of genetic polymorphisms that are associated with breast cancer occur at different rates in different ethnic groups. At least some polymorphic genes are related to hormone function, and abortion alters hormone function relative to giving birth. So it's conceivable there could be a difference. Having said that, I wouldn't claim that this issue means the study is meaningless, and my reading of the research is that there is no link between abortion and breast cancer - my talk page has a list of studies that have found no link. Murray 11:04, 25 April 2007 (EDT)

The authors should have disclosed this weakness in their study. Breast cancer prevalence does have a strong ethnic component. Asians, for example, have breast cancer much less than whites. I bet a significant percentage (e.g., 5%) of the population in the Harvard study were Asian, but the authors concealed that.
Murray, I looked at your list on your talk page that purports to present studies deny an abortion-breast cancer link. How many of those "studies" have you read? Zero? Less than 10%? Don't you think you should disclose that to the reader???? One that I recognize I have read (Lancet), and it is neither a study nor a denial that abortion increases breast cancer.--Aschlafly 11:15, 25 April 2007 (EDT)
Hi Andy. I've read the methods and results sections of all of them at some point, if not the intros and discussions. I'm not sure what your issue with the Lancet article is. It is essentially a meta-analysis, which is a useful and novel contribution even if no new data were collected. For the sake of discussion I will post more details on each study when I have time - have already done some of that. Murray 12:03, 25 April 2007 (EDT)
Murray, you claim that all 24 articles are "Studies showing no abortion-breast cancer link." I have read 1 out 24, and your claim is completely false with respect to that article (Lancet). The Lancet article is not a study and it does not deny that abortion increases breast cancer risk. Your claim may also be false for your other 23 articles, which you cannot say you've read.
Are you taking an Oprah Winfrey approach here, as in "so what" if the book was false? It's a good book anyway? Or so what if the Wikipedia editor is a fake, his edits were likable any way? Your statement about the Lancet study on your talk page is false in at least two independent ways, and you can't vouch for the other articles either. Enough said. I know I'd immediately correct such a falsehood, but I leave that up to you.--Aschlafly 20:24, 25 April 2007 (EDT)
Andy, I have read the studies. I find it ironic that you falsely claim that I haven't, then dismiss them while proclaiming that you haven't either. If you'll bother to look at the list again, I've listed some details of the methods and the results of many of them, and I will add more as I have time. Perhaps you could clarify what exactly your issue is with the Lancet article. As I said above, it combined data from a number of previous studies and analyzed it. I will quote from it: "...neither the results from the individual studies nor their weighted average suggest any adverse effect on the subsequent risk of breast cancer for women with prospective records of having had one or more pregnancies that ended as an induced abortion, compared with women having no record of such a pregnancy. Furthermore, among the studies with prospective records of induced abortion, no significant variation in the results was found between those with objective and those with self reported information" p. 1010. If you want to claim that doesn't deny that abortion increases breast cancer go right ahead, but your logic is difficult to follow. I guess the collaborative attitude disappears when the data make you unhappy. You don't have to believe the data are accurate, but to deny them without bothering to look is ridiculous. Murray 21:56, 25 April 2007 (EDT)
Murray, you have a falsehood on your talk page about the Lancet article, and you're apparently sticking to it. I'm not going to spend all night arguing with you any more than I would spend all night arguing with Oprah Winfrey about her defense of the false book, or Wikipedia's defense of the fake editor. Your quote from Lancet does not deny that abortion increases breast cancer. It compares the effect of an abortion to a mythical lack of pregnancy. It does not deny that the pregnant woman increases her risk of breast cancer by having the abortion. If you don't grasp the distinction, then please read, and reread, and reread, until you do. Also, Lancet was not a study.
Earlier you said you "read the methods and results sections of all of them at some point, if not the intros and discussions." Now you say something quite different, that you "read the studies." Which is it? Regardless, if you read the Lancet article and still insist on calling it a "study" that denies that abortion increases breast cancer, then your persistence in this falsehood would be enough cause for concern.--Aschlafly 22:17, 25 April 2007 (EDT)

I guess that's the long version of saying that you're not going to bother to read or try to rebut the other studies, or indicate what your issue is with the Lancet article. Yes, I was careless with language in the last post. I read the methods and results of each. Obviously part of the issue here is that we have different definitions of risk. Here's the bottom line: a woman who has an abortion has the same risk of breast cancer as if she'd never been pregnant, or if she had a miscarriage, which is far more common than induced abortion. Pregnancy confers protection, but it does not follow that ending pregnancy increases a woman's risk, because her risk remains the same as it was before she got pregnant. It's pointless to discuss this further, but I would appreciate it if you would refrain from further implications that I'm lying. Others should read the studies themselves and draw their own conclusions. Murray 22:35, 25 April 2007 (EDT)

My opinion hasn't changed that the listing of the Lancet article on your talk page as an example of "Studies showing no abortion-breast cancer link" is false. Lancet is the only study in that list that I've read. Maybe some or all of the other articles listed are also unjustified. I see from your list that several of the other articles had very few subjects, and may thus be misleading in their claims.
But I'm not going to spend any more time repeating myself here. I'll refer this to the Conservapedia panel and they will make their own decision. Due to other pressing issues they may not get to this for a while.--Aschlafly 00:23, 26 April 2007 (EDT)
I didn't expect your opinion to change Andy, though it would be nice if you would just once explain your reasoning regarding the Lancet article. I have no idea what you're referring to about the panel or what decision there is to be made. I haven't tried to edit what I see as bias out of this article or any others that are relevant. Are you asking the panel to rule on whether to delete my talk page? That's fine, I'm sure they will read each of the studies and that they have the competence to understand them. Murray 13:56, 26 April 2007 (EDT)

Ok, I read the study and have a few comments about the study article ...

  1. "The research study excluded women who had abortions and then died from breast cancer!" This quote is misleading. The researchers censored women who had forms of carcinoma, which is cancer that can originate and spread elsewhere through the lymphnodes and is not breast specific. This makes sense because you wouldn't want to include cancer that originated in the lung in a breast cancer study.
  2. "The research study treated women who left the specific question about past induced abortions blank, perhaps due to embarrassment, as though they did not have an abortion" They addressed this and said they also tried ommitting those who missed questions and did not see a change in results.
  3. "The research report concealed how almost none of the subjects of the study were African American or Hispanic" while not covered specifically in the article, my assumption would be that with so many other variables included (age, body mass index, family history, birth control usage, etc) you would want to limit the study to a more similiar group of people. Keeping them of the same/similar race would keep potential conditions that vary by race out.
  4. "Over 25% of the respondents to the questionnaire exhibited confusion about the wording, where the unfamiliar term "spontaneous abortion" was used to mean "miscarriage"." I don't see the point here, how could there be a difference between inducing and miscarriage? In both cases the fetus is lost prematurely. Also, maybe I missed it, but I don't see where you got that 25% from.

And I also want to point out that of the 105,716 participants: 2916 got breast cancer, and only 535 of them reported having abortions. If abortions did contribute to the risk of breast cancer you would expect that number to be way higher. Jrssr5 14:05, 25 April 2007 (EDT)

I was wondering if I should keep waiting for a response to my take on the study ... Jrssr5 14:26, 1 May 2007 (EDT)
Point 1: No, the follow-up excluded women newly diagnosed with breast cancer.
Point 2: Omitting those who left that question blank is unhelpful. What needs to be disclosed, and wasn't, is what happens when those who left the question blank are counted as having had an abortion. Also, see my reply below to Britinme.
Point 3: The results are meaningless if the ethnic groups having the highest rates of abortion are omitted. At a minimum, this flaw should be disclosed to the reader and the public, rather than misleading them to think the conclusions apply to all Americans.
Point 4: There is a huge difference between a miscarriage and an abortion. A miscarriage is natural, and an abortion is not. No one would expect the health consequences to be the same, and they aren't.--Aschlafly 00:19, 2 May 2007 (EDT)
I don't have the time to comment on the other points, but as to point 4, many forms of abortions are biologically very similar to how miscarriages occur. I would a) be very interested in hearing in more detail why you think one would have fewer health consequences (other than the vague issue of being "natural") and b) would be curious if you can point to any evidence that the female body's post-miscarriage reactions are different in any substantial way than those following an abortion(especially in regard to hormone levels and other blood work that could plausibly alter breast cancer rates). JoshuaZ 00:33, 2 May 2007 (EDT)
They aren't similar at all. A miscarriage is something the body causes, anticipates, and heals. An abortion is an unnatural, violent interference with the course of nature, shocking the body in a way it does not expect or want. Almost nothing natural causes cancer, while many unnatural things do cause cancer.--Aschlafly 01:56, 2 May 2007 (EDT)
Um, not all (if any) miscarriages are anticipated by the body and I would be more than surprised to see evidence to the contrary. Moreover, plenty of natural things cause cancer. cough*light*cough (UV radiation is a known mutagen which can lead to cancer). ColinRtalk 02:22, 2 May 2007 (EDT)
Andy, you didn't read my points very clearly and just respouted what you said earlier. I'm not going to rehash them, but reread everything I wrote, then you can try to tell me I'm wrong. Point 4 is the only one you managed to address properly, even though JoshuaZ and ColinR make good points. Jrssr5 08:04, 2 May 2007 (EDT)

Age of Participants

The section on the participants being too young is just wrong. The study indicated that the subjects were ages 29 to 42 when they were enrolled in the study. Since this is longitudinal research (i.e. an over-time study) they have aged since then to 39 to 52. Given the sample size and the longitudinal component, it's unlikely that the sample itself is biased by age.

Do you also think we could make meaningful claims denying causation of heart disease based on studying teenagers? How about claims deny that cigarette smoking causes cancer based on 20-year-olds?--Aschlafly 14:41, 25 April 2007 (EDT)
Mr. Schlafly, you're sufficiently educated to understand the distinction here. The study is longitudinal, meaning that it enrolled participants and then studied them over a period of time- in this case ten years. So, it did not base its conclusions on a pool of 29-42 year olds but, rather, on a pool of participants who were in that range of ages when the study began but are between 39 and 52 now. While I would certainly like to see the longitudinal component continued for another 10 years or more, the data already available can be used to analyze the question at hand. If abortion does cause breast cancer then we would expect to see a statistically higher rate of cases of breast cancer emerge over those ten years among those who have had abortions than among those who have not. What we see is that women who have had abortions are no more likely to develop breast cancer than women who have never been pregnant and that a completed pregnancy reduces the likelihood of breast cancer. Thus, pregnancy is a protective factor but abortion is not carcinogenic. I don't expect you to recognize that distinction but, at the very least, be honest about the ages of the study's subjects. Your snide comments about studying cancer from smoking in 20 year olds misrepresent my point entirely. A crossectional study wouldn't convince me, but a study that enrolled subjects between the ages of 14 and 26 (median age 20) and then studied them for ten years until they were ages 24 to 36? Well, that's certainly a good start. If smoking does cause cancer, we would expect to see higher cancer rates among smokers over that ten year period, wouldn't we?
The above comment is unsigned but correct. The authors specifically deal with the fact that the study is both ongoing and longitudinal. That is to say, it is continuing into those age groups at which breast cancer rates normally increase. It was specifically designed that way to address weaknesses in earlier studies (dealt with in the references to this study). We will have to await further reports to see if there is any more apparent correlation between abortion and breast cancer as that happens, but if there was a real link you would expect to be seeing some kind of effect as some of the women who were enrolled at the beginning of the study were as old as 42 in 1989, so would now be reaching the age where breast cancer would be more likely regardless of reproductive history. At the moment, no such connection is evident on the basis of this study.--Britinme 11:12, 2 May 2007 (EDT)

Miscarriages

Why does the article claim that miscarriages would not increase cancer rates? I have trouble imagining any biological mechanism that would cause abortion to increase cancer rates that would not apply to miscarriages as well. Do we have any basis for this claim? JoshuaZ 13:33, 26 April 2007 (EDT)

I stated that above in my analysis and have yet to get a response. I thought Andy would be willing to engage in a discussion about my findings after reading the study, but I'm not going to hold my breath. Jrssr5 13:57, 26 April 2007 (EDT)

Problems with this article

I have just got hold of a copy of the study. This article says that 25% of the respondents showed 'confusion' over the term 'spontaneous abortion' and cites a page reference. I would like to know the exact text on which this term 'confusion' is based, as the article only cites a page reference which is not evident on my downloaded copy. The study says: "Of the 107 721 study participants who returned the 1993 questionnaire, 106 804 (99.1%) answered the question on spontaneous and induced abortion." That doesn't sound like confusion. Moreover, the cohort of women enrolled in this study were "116 671 female registered nurses 25 to 42 years of age", who would as a result of their nursing training definitely not have a problem distinguishing a spontaneous abortion from an induced abortion. There are other problems, but let's look at these first.--Britinme 23:43, 1 May 2007 (EDT)

I cannot cut and paste the passage on this computer, but in "Statistical Analysis" it shows that about 25% of respondents did not answer the question on induced abortion at all. Not yes, not no. But they did answer a question on "spontaneous abortion," with about 12% saying "yes" (which seems high). This is confusing. Most people call this "miscarriage", including nurses (few of whom would have any involvement with abortions). They would think of abortion when they see "spontaneous abortion." Confusion may well have been intended, as this mixes the data and will minimizes differences in outcome between those having had abortions and those who did not.
Whether you agree or not, you can't dispute that 25% failed to answer the most important question in the survey.--Aschlafly 00:11, 2 May 2007 (EDT)
It certainly needs looking at, and I will paste the appropriate paragraph for people more accustomed than me to statistical analysis to comment on. However, let's address the issue of language here. The term 'spontaneous abortion' is the correct medical term for a miscarriage, and the term that was used in the questionnaire. The people answering the questionnaire were all registered nurses - ie had all been fully trained and qualified in nursing. All nurses spend part of their training in obstetrics and gynaecology, and would be familiar with that expression from their medical training. The argument that this highly trained medically qualified group of women would not recognise the term 'spontaneous abortion' as meaning 'miscarriage', especially when paired with the phrase 'induced abortion' as an opposite, is ludicrous. I think even non-medically-qualified people such as yourself would know the difference between the word 'spontaneous' meaning 'happened on its own' and 'induced' meaning 'somebody made it happen' in this context. The article needs changing to remove this rather silly sentence. Incidentally, 12% is not at all 'high' in terms of spontaneous abortion - if anything, it seems to me rather on the low side. A rate of 15-20% is usually quoted. Here is one medical reference that seems to bear that out, when it compares the rate of spontaneous abortion in normal and diabetic women. [5]
The paragraph on statistical analysis reads as follows:
Our analyses included all women who answered the questions on abortion throughout follow-up between 1993 and 2003. In 1993, some women responded only to the question on induced abortion but omitted the spontaneous abortion question and vice versa. Of the 105 716 women included in this analysis, 28 392 did not answer the question on induced abortion but answered the question on spontaneous abortion; 13 652 of these women indicated that they had a spontaneous abortion. We assumed that the women who answered only half of the question did not answer the other question because of an oversight or because they felt that the question did not apply to them; we thus coded the missing response as "no induced abortion." Similarly, 22 768 women did not answer the question on spontaneous abortion in 1993; of these, 9167 answered that they had an induced abortion. We again coded the nonresponses as "no spontaneous abortion." Information on induced and spontaneous abortion was updated biennially; since a response option of "no" was not provided on subsequent questionnaires, a response of "no" was coded for either abortion if "yes" was not marked. We conducted sensitivity analyses of our approach. Results did not change when we excluded nonresponses to half of the 1993 question from the analyses or coded a missing response as "no" only if the other part of the question was answered with "yes."
--Britinme 10:40, 2 May 2007 (EDT)
The term "spontaneous abortion" is not recognized by the Merriam-Webster dictionary, and does not even appear in the definition for miscarriage. While I am open-minded about this, so far it appears to be an effort to confuse the important distinction between abortion and miscarriage, and thereby confuse the very different health effects. Apparently it did confuse 25% of the respondents to the questionnaire in this study.--Aschlafly 12:28, 2 May 2007 (EDT)
Try reading more than one dictionary. In fact try [6][7]

[8] [9] [10]. Even in M-W it defines miscarriage as the 'spontaneous expulsion of a human fetus before it is viable and especially between the 12th and 28th weeks of gestation', using the word 'spontaneous' correctly, and in its definition of 'abortion' includes the almost identical phrase 'spontaneous expulsion of a human fetus during the first 12 weeks of gestation'. The Oxford dictionary does the same thing. [11]. To maintain as you do that medically-trained women would be confused by this commonly-used expression is downright silly and undermines the whole credibility of your argument.--Britinme 15:32, 2 May 2007 (EDT)

If I may interject, the problem with studies like this is that they are used by partisans to justify their preconceived notions. It's like the New York Times claiming that women are more likely to be beaten by their husband than by anyone else; therefore, it's better for women to single than married. You have to dig into it to discover that they included the most violent category of live-in lover as a "husband" in the study, i.e., a man to whom the woman is not legally married (no marriage license).

So many other studies have similar problems. I first started learning about "statisticulation" like this by reading Darrell Huff's classic on junk math: How to Lie With Statistics. I got 760 on my math SAT, so I'm awfully hard to fool. --Ed Poor 12:35, 2 May 2007 (EDT)

As one with multiple family members in the health and medicine field, who all know the term "spontaneous abortion" to mean miscarriage, despite not being in a ob-gyn specialty, I would be incredibly alarmed if that large of a percentage of nurses was not familiar with a standard medical term. In fact, I would safely say that one could conduct a poll at a local hospital and find that most, if not all, nurses know what "spontaneous abortion" means. ColinRtalk 12:55, 2 May 2007 (EDT)
It's a well-known fact that the wording of questions has a significant impact on surveys, often more than the typical 4% margin of error which comes from small sample size. --Ed Poor 13:05, 2 May 2007 (EDT)
I just asked an M.D. and she said "miscarriage" is a far more common and familiar term than "spontaneous abortion." The latter term is plainly an effort to confuse the two very different events, and make an abortion seem to be the same as a miscarriage.--Aschlafly 13:09, 2 May 2007 (EDT)
It probably is more familiar to non-medically-trained people. However, the point is that all these women were registered nurses with medical training. You haven't dealt with that issue and it won't go away if you ignore it.--Britinme 12:34, 3 May 2007 (EDT)
Well, English isn't my native language, actually its 3th foreign language for me and i have no medical training. Still i would understand what was meant with "spontaneous abortion". I would be very worryed if native english speaker with medical training wouldn't. Timppeli 13:44, 2 May 2007 (EDT)

Aschlafly - you keep stating that the researchers 'concealed' the fact that only a minority of participants in the study were from other than non-Hispanic white background. This implies a deliberate concealment. As far as I can see in the report they were absolutely open about the fact that 92% of their participants were non-Hispanic whites, and in fact even drew attention to it by pointing out that this meant they were from a group that might be less likely for sociological reasons to seek an abortion. Since anybody who reads the report can see this, on what basis are you making the assertion that it was deliberately concealed?--Britinme 19:13, 3 May 2007 (EDT)

You tell me: what percentage of the participants were black? Hispanic? It's concealed. Even the 92% figure is buried very deep in the article, where few (and certainly not the press) are likely to notice.--Aschlafly 19:17, 3 May 2007 (EDT)

Please could we also settle the issue of potential misunderstanding of the words 'spontaneous abortion'? I think you are utterly mistaken in your view that it could be confusing, but if you insist on keeping that viewpoint in the article, it needs to be balanced by pointing out that the study participants were all registered nurses who would have encountered that phrase during their training.--Britinme 19:13, 3 May 2007 (EDT)

25% of the respondents were confused by the question. Enough said. "Spontaneous abortion" is not the customary term for a miscarriage inside or outside the medical profession. Nurses wouldn't use the contrived term any more than a lay person would.--Aschlafly 19:17, 3 May 2007 (EDT)
Um, yes they would. Every health care professional I know uses the term "spontaneous abortion" when talking to others in their profession, just as I'm sure there is plenty of law jargon you use with other lawyers, but not with clients or non-law people. And yes, it is the customary term in the medical profession, otherwise, I'm sure the study would have used another term. ColinRtalk 22:35, 3 May 2007 (EDT)
It is not true to say that 25% 'were confused' by the question. It is not at all the same thing as a 25% non-response. You also omit to say that the authors of the study attempted to deal with the not unreasonable objections you raise to this. They re-analyzed the data after excluding women who didn't respond to either of the questions and found the same results, and found the same if they coded only some of those missing answers as non-abortions. On the linguistic issue you are absolutely wrong. 'Spontaneous abortion' is an accurate medical term, not a contrived one. Further up the page I gave you six dictionary references that showed it to be so. I realize this is a topic on which you have very strong opinions, but to allow those to blind you to something as simple as the use of a medical term in a medical journal by medical researchers working with medically-trained subjects is something you cannot get around.--Britinme 23:27, 3 May 2007 (EDT)
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