"The Earth Path" by Starhawk

"Phantom Parks: The Struggle to Save Canada's National Parks" by Rick Searle

Interesting Links:
Utne Reader
David Suzuki Foundation
New Scientist
Discover Magazine
The Medical Post Online
Ad Busters!
New Internationalist
Mother Jones.com
Salon.com
NOVA On-line
The Book of Zines
Killing the Buddha
London Review of Books
American Council on Exercise
Runner's World
The Great Illusion


Recent reads:
"A Deepness in the Sky" by Vernor Vinge

"Celtic Folklore Cooking" by Joanne Asala

"Power Spellcraft for Life" by Arin Murphy-Hiscock

"Reinventing Medicine" by Larry Dossey

"Wicca: A Year and a Day" by Timothy Roderick

"The Science of the Craft" by William H Keith

"50 Years of Wicca" by Frederic Lamond

"The Magical Life" by Vivianne Crowley

"Which Witch is Which?" by Patricia Telesco

"Perdido Street Station" by China Mieville

"Cyberhenge: Modern Pagans on the Internet" by Douglas E. Cowan

"An Ye Harm None: Magical Morality and Modern Ethics" by Shelley Rabinovitch

"Crystal Ball" by Sibyll Fergusen, revised and expanded by Witch Bree

"Gaia Eros: Reconnecting to the Magic and Sprit of Nature" by Jesse Wolf Hardin

"A Century of Spells" by Draja Mickaharic

"Evolutionary Witchcraft" by T. Thorn Coyle

"Witching Culture: Folklore and Neo-Paganism in America" by Sabina Magliocco

"Kundalini for Beginners" by Ravindra Kumar

"Ka: Stories of the Mind and Gods of India" by Roberto Calasso

"Magical Tattwa Cards" by Dr. John Mumford

"WitchCraft Today (Expanded edition)" by Gerald B. Gardner

"Self-Initiation for the Solitary Witch" by Shanddaramon

"The Second Circle: Tools for the Advancing Pagan" by Vanecia Rauls

"Grimoire for the Apprentice Wizard" by Oberon Zell-Ravenheart

"Black Magick Woman: The Sinister Side of the Song of Solomon" by Janet Tyson

"Everyday Moon Magic" by Dorothy Morrisson

"Advanced Witchcraft" by Edain McCoy"

"Handfasting and Wedding Rituals" by Raven Kaldera and Tannin Schwartzstein

"Joing Hearts and Hands: Interfaith, Intercultural Wedding Celebrations" by Rev Susanna Stefanachi Macomb

"Handfasted and Heartjoined" by Lady Maeve Rhea

"Handfasting: A practical Guide" bu Mary Neasham

" Goddess in the Grass: Sperpentine Mythology and the great Goddess" by Linda Fourbister

"Theories of the Chakras: Bridges to Higher Conciousness" by Hiroshi Motoyama

"The Knife Thrower" by Steven Millhauser

"Schizophrenia: A Very Short Introduction" by Christopher Finn and Eve Johnstone

"Schizophrenia: The Facts" by Ming T. Tsuang and Stephen V. Faraone

"A Community of Witches" by Helen Berger and Colleagues

"American Gods" by Neil Gaiman"

"Scherzo" by Jim Williams"

"Goddess in the Grass: Serpentine Mythology and the Great Goddess" by Linda Fourbister

"The Forest of Souls" by Rachel Pollack

"Wiccan Roots" by Philip Heselton

"A User's Guide to the Brain" by John J Ratey, MD

"A Goddess Arrives" by Gerald Gardner

"A Community of Witches" by Helen Berger

"Nature Spirits" Selected lectures by Rudolf Steiner

"Fatal Majesty" by Reay Tannahill

"Myths to Live By" by Joseph Campbell

"The Secret Life of Germs" by Philip M Tierno Jr, PhD

"Adam, Eve, and the Serpent" by Elaine Pagels

"Whiteout: Melt" by Greg Rucka illustrated by Steve Lieber

"Whiteout" by Greg Rucka illustrated by Steve Lieber

"Queen and Country-Operation: Crystal Ball" by Greg Rucka illustrated by Leandro Fernandez

"Tunnel in the Sky" by Robert Heinlein

"The Sex Chronicles" by Zane

"The Black Man's Guide to Good Health" by Reed, Schulman and Shucker

"The Withdrawing Room" by Charlotte MacLoed

"Queen and Country-Operation: Morningstar" by Greg Rucka illustrated by Brian Hurtt

"The Best American Science and Nature Writing 2000" edited by David Quammen

"The Bourne Identity" by Robert Ludlum

"Gerald Gardner: Witch" by J.L. Bracelin

"Queen and Country-Operation: Broken Ground" by Greg Rucka illustrated by Steve Rolston

"The Ferryman Will Be There" by Rosemary Aubert

"Philosophy of Wicca" by Amber Laine Fisher

"Wilderness Tips" by Margaret Atwood

"Origins of Modern Witchcraft" by Anne Moura

Wednesday, March 09, 2005

Playing with Risk

Aspirin cuts the risk of stroke in women by 24%, reported recent media articles picked up from Reuters Newswire. Wow! That’s great news. Or is it? There is a trend in medical reporting in mainstream media to only report relative risk reduction, like the 24% percent reported in this article. Relative risk is exactly that, relative. In terms of medical treatments, it is the risk of developing a disease or condition if you are taking the preventative therapy being studied, compared to the risk if you were not take any therapy at all.

Let’s take a look at the data from this trial as an example. Over the course of the trial, 170 of the almost 20 000 women receiving aspirin in the trial had an ischemic stroke. That is slightly less than 1% (0.9%). For the placebo arm, 221 women had an ischemic stroke, slightly more than 1% (1.1%). What that translates into is that in a group of 1000 women, over a ten-year period aspirin may prevent two strokes. The numbers no longer sound so impressive.

Unlike many other articles in mainstream media, I was happy to see that the Reuters one balanced its report on the benefits of aspirin, with a sentence on side effects: Women taking aspirin were 40% more likely to develop stomach or intestinal bleeding that required transfusion. Yikes! Again, let’s look at the absolute numbers:

Out of the 19 934 women receiving aspirin, 910 experience gastrointestinal bleeding and 127 required transfusion. That translates into 4.6% and 0.6%, respectively. In the placebo arm, the numbers were 751 (3.8%) and 91 (0.5%), respectively. So, in a room full of the same 1000 women, aspirin can be expected to cause about 8 cases of stomach or intestinal bleeding over 10 years, one of which may require transfusion.

So where does that leave us in this case? In a room full of 1000 women, taking a baby aspirin a day over ten years would reduce the number of ischemic strokes by two or three and increase the cases of gastrointestinal bleeding requiring transfusion by one or general gastrointestinal bleeding by eight. In other words, take an aspirin a day for ten years your absolute risks of ischemic stroke is 2 in 1000, your risk of developing stomach or intestinal bleeding is 8 in 1000, and your risk of needing a blood transfusion is 1 in 1000.

A couple of important points did come out of this study. Women and men respond to medical treatments differently. While aspirin reduces the risk of both stroke and heart attack in men, in women it only reduces the risk of stroke and has no significant effect on heart attack. Given the increase likelihood of gastrointestinal complications, it brings into serious question the currently common practice of prescribing low dose aspirin for the prevention of heart attack in women.

Clinical trials, especially in the early stages of drug development and testing, often only study the drug in men. Women, it seems, have too many hormonal fluctuations that may screw-up the results or make the results harder to interpret. But in the end, women use most medications just as much as men when the drug finally makes it to market. This clinical trial highlights the fact that more of an effort must be made to understand drug effects in both genders prior to establishing widespread prescribing guidelines or habits.

Amanda 12:07 PM
E-mail your comments to: ramblingraven@cosmic-muse.com