Last year, the New York Times reported that the brain bank associated with Boston University researchers found “evidence” of chronic traumatic encephalopathy (CTE) in 76 of 79 former NFL players examined. This week, the Old Gray Lady reported the group finding CTE in 110 of 111 players examined.
The math doesn’t add up. Neither does the science.
What does add up, to a figure outnumbering the actual cases of CTE documented in football players, is the number of articles the New York Times has published on the brain malady. What other disease boasts more articles on it in the newspaper of record than documented cases of the actual disease?
It’s not just the fuzzy math that gives the disease to at least two players previously cleared as CTE sufferers that makes the Boston group’s claims suspect, but the weird science that calls a series of anecdotes collected over more than a decade a “study.”
Families, alerted to neurological issues through sudden mental illness, Alzheimer’s-like symptoms, or suicide, donate brains they suspect damaged to validate or invalidate their suspicions, sometimes as a precursor to a lawsuit. In contrast, more than 99 percent of NFL players go to the grave without scientists examining their brains. This results in something called a “selection bias,” a phrase rarely used in the press by members of the Boston group but often used by them in peer-reviewed publications. To her credit, Dr. Ann McKee, the focus of the New York Times article, spoke that very phrase in the newspaper. But the disclaimer didn’t even convince the writer from projecting the group’s findings onto the entire pool of NFL players, so the prospect of readers approaching the information with caution seems unlikely.
A selection bias makes it impossible to project the findings from this small group of players onto all players. No randomization exists. The sample group virtually guarantees results showing neurological issues. “The most common primary cause of death was neurodegenerative,” the Boston group admits in the Journal of the American Medical Association of the brains they examined over the years. Drawing broad conclusions from such a skewed pool would be something akin to polling the readers of Breitbart on their opinions on Donald Trump and then proclaiming the results as representative of U.S. public opinion.
The New York Times would rightly mock such methodology. Why do they embrace similar methods employed by the Boston group?
Unfortunately, no study exists that attempts to show the rate of CTE in football players or in the general public. Here’s what the best minds in sports medicine concluded at the Fourth International Conference on Concussion in Sport in Zurich:
[C]hronic traumatic encephalopathy (CTE) represents a distinct tauopathy with an unknown incidence in athletic populations. It was further agreed that a cause and effect relationship has not as yet been demonstrated between CTE and concussions or exposure to contact sports. At present, the interpretation of causation in the modern CTE case studies should proceed cautiously. It was also recognised that it is important to address the fears of parents/athletes from media pressure related to the possibility of CTE.
They know neither what causes CTE nor its prevalence among athletes. People who claim they know don’t do science. They do speculation.
Beyond obvious problems with making sweeping claims based on the findings in a pool tainted by selection bias, CTE researchers trouble scientists outside their field by offering different definitions of what constitutes a positive diagnosis. This results in the competing groups studying CTE finding wildly varying rates of CTE in the postmortems they perform on football players. Other scientists do not replicate Dr. McKee’s findings. That’s a major problem when you want to call your work science.
Saying McKee found CTE in all but one football corpse she examined may say something about football. It may say something about McKee.
Real science might involve comparing a group of football players against a sort of control group, as a recent study published by the American Medical Association’s Neurology journal just did. “Cognitive and depression outcomes later in life were found to be similar for high school football players and their nonplaying counterparts from mid-1950s in Wisconsin,” the article, which looked at almost 4,000 high school players from Wisconsin, reports. “The risks of playing football today might be different than in the 1950s, but for current athletes, this study provides information on the risk of playing sports today that have a similar risk of head trauma as high school football played in the 1950s.”
But the good news here and in a very similar 2012 Mayo Clinic study touting very similar results does not mesh with the narrative. So, we instead get bombarded with the bad news, such as Kansas City Chiefs linebacker Jovan Belcher murdering his wife and then himself. When news hit of the ghoulish exhumation of the brain of the linebacker—the victim of a self-inflicted gunshot to the head—to examine it for a wrongful death suit against the Chiefs, I asked respected neurologist Christopher Randolph whether such a belated postmortem on an obliterated brain could yield signs of CTE. “If the brain is sent to Boston,” he answered, “CTE will be identified regardless of what shape it is in.”
Such is the reputation of the Boston University group touted in a Tuesday New York Times headline as finding CTE in 110 of 111 NFL brains examined. BU scientists, to their credit, did not rob the earth of Belcher’s brain for the purpose of furthering wrongful death litigation against the Chiefs. Another group also interested in brains and lawsuits, not necessarily in that order, did.
But other people looking to turn feigned misfortune into fortune found the diagnosis they wanted from the Boston group’s doctors. For instance, convicted fraudster Joanna Leigh initially hoodwinked Boston Marathon charities into giving her tens of thousands of dollars by touting a medical evaluation from the most famous doctor associated with the Boston group, Robert Cantu, a coauthor with McKee on the Journal of the American Medical Association article timed for publication Tuesday alongside the Times piece.
“The majority of this patient’s severe cognitive, somatic, mood and sleep symptoms that have completely disrupted her life are due to her post-concussion syndrome,” Cantu wrote of Leigh. “As a result of these symptoms Dr. Leigh is currently and for the foreseeable future disabled from the kind of complex consulting work she has done before the bomb blast injury was sustained.”
But Boston police recovered video showing Leigh nowhere near the blasts. Cantu judged her disabled as a result of injuries she never sustained. He got that terribly wrong. What else does Cantu and his colleague, Ann McKee, get wrong? Whatever it is, you won’t read about it in the New York Times.
Daniel J. Flynn is the author of The War on Football: Saving America’s Game (Regnery, 2013).