Date: Thu, 31 Oct 1996 01:17:49 -0500 (EST)
From: [E--rS--r] at [aol.com]
To: Multiple recipients of list <[n--b--n] at [mainstream.net]>
Subject: Limiting the Scope of CDC-NCIPC - the Evidence

October 30, 1996
Phil Fontanarosa MD
Editor JAMA
7 pages by facsimile only

Limiting the Scope of CDC-NCIPC - the Evidence

By pretending that only the National Rifle Association was involved, Trunkey1
has seriously misinformed readers about the sequence of events that has
caused Congress to limit the scope of the Centers for Disease Control -
National Center for Injury Prevention and Control (CDC-NCIPC).  It is
testimony before Congress by scholars and physicians organizations,2
including our own, that eliminated NCIPC's ability to use tax money for
political purposes.  We and the others testifying (not even one of whom was
from the NRA) provided irrefutable evidence that: (1) the CDC's goal of
reducing the private ownership of firearms preceded CDC's published research
by 7 years,3 (2) area research reviews4,5,6 show that a majority of
peer-reviewed research invalidates the CDC's methodology and contradicts
CDC's interpretation of their and others' research on guns,  including the
research cited in the Eastern Association of Surgery of Trauma report7 so
favored by Trunkey, (3) CDC has illegally used tax-money for unabashed
political purposes, including funding gun prohibition newsletters and a rally
with Handgun Control Inc.'s Sarah Brady2 and (4) the published opinions of
CDC and NCIPC Directors and researchers brandishing their personal hatred of
firearms8 and their announced9 (but later recanted10) goal of "systematically
build[ing] a case that owning firearms causes deathx We're doing the most we
can do, given the political realities" makes them distinctly ill suited to
their pose11 as objective scientists.  The CDC-commissioned "independent"
study of the "quality of research on firearm injury prevention"12 did not
include even one critic of the CDC and, in a 23 page report, pretended to
vindicate a decade of CDC-sponsored research on the subject without even
discussing one of the peer-reviewed and published criticisms of CDC's
methodology and interpretation.  Withstanding CDC and CDC admirers' media
blitz of "spin control," Congressional criticism and the overwhelming vote to
reduce NCIPC funding and scope indicates that CDC's Directors and researchers
were utterly unconvincing in their testimony or reports to Congress regarding
their competence and objectivity in their research on guns and gun violence.
 That the CDC Director has retroactively attempted to pull funding of one of
the political projects we exposed to Congress13 is additional evidence of the
accuracy of our testimony.  Every significant gun violence researcher
sponsored by the CDC is either individually or institutionally a member or
faculty of one or more avowed gun prohibitionist organizations such as Cease
Fire or Handgun Epidemic Lowering Program.

In a short report we cannot possibly detail all the CDC's transgressions,
however "Guns and Public Health: Epidemic of Violence or Pandemic of
Propaganda?",6 a peer-reviewed article of over 83 pages and 368 footnotes by
two Harvard medical school professors, a Columbia medical school professor, a
biostatistician, and a criminologist and published in the Tennessee Law
Review, meticulously documented massive deviations from accepted scientific
practice in the medical literature on guns and gun violence.  These included;
endemic fact errors -- even apparently deliberate falsifications of
statistics and fabrication of reference sources; citations of reference
sources for "facts" opposite to what the references actually said;
conclusions based on "data" which the authors subsequently refused to divulge
to scholars who desired to check them (particularly inappropriate behavior
since these studies were funded with public tax money); assertions of "fact"
buttressed by citations not to studies but to editorials, or publications by
anti-firearms lobbying groups (whose partisan affiliation is not revealed);
and wholesale failure to mention or deal with contrary studies or data.  In
summary the authors concluded that CDC-funded studies on guns promote "an
emotional anti-firearms agenda" and "are so biased and contain so many errors
of fact, logic and procedure that we cannot regard them as having a
legitimate claim to be treated as scholarly or scientific studies."

Continuing to ignore such extensive peer reviewed criticism of CDC's research
methodology and interpretation,4,5,6 continuing to ignore the net benefit of
firearms in America,14,15 and disguising politics in the robes of science
will leave medicine's orthodox prohibitionists talking to themselves, ignored
and unfunded by Congress and the people.

Typically, articles in the medical literature on guns begin with an emotional
recitation of contrived rank-orderings and statistics claiming an "epidemic"
of gun violence when the data actually show a stable to declining trend of
violence for all demographic groups except teens and young adults involved
with the predatory drug trade.5,6,15  Then, typically, researchers whose
membership in prohibitionist organizations is a matter of public record have
misapplied epidemiologic methodology to criminological and sociological
problems and accepted their marginal results as proof of the desirability of
draconian gun restrictions.  They often accept unrepresentative sources of
data16,17 and then attempt to defend their conclusions18,19 - ignoring the
most basic tenet of research, that scientific truth cannot be teased from
unrepresentative samples using misapplied methodology (a principle colorfully
memorialized by the acronym "GIGO": garbage in = garbage out).  They ignore
the enormous body of research that invalidates the medical literature's
orthodoxy and exposes transgressions of all the scientific canons, including
the exposure of outright scientific fraud.5,6,15  Unlike the editors and
CDC-sponsored researchers who have vilified the physicians and others who
dare to doubt their politically correct views in ad hominem attacks20,21,22
that do not examine or even acknowledge any of the inconvenient, but
pertinent, evidence we cite, Congress examined the evidence offered by the
prohibitionists and found it wanting.  Congress examined the evidence offered
by us and other scholars - missing from Trunkey's "report" -  and found it
persuasive.  The vote to reduce NCIPC funding and scope only reflects
Congressional rejection of CDC's unethical and illegal use of tax money to
cloak politics in the robes of science.  

In 1974, realizing that each Presidential administration seemed to be
sequentially appointing its own director of that institution, the Dean of
American epidemiologists and former Chief Epidemiologist at the CDC,
Alexander Langmuir, said in a February 9, 1977 Atlanta Constitution interview
that "this is politicization of the CDC, and every important man is going to
leave as fast as he can find a new job."   His concerns about politicization
were confirmed by such statements as those by Dr. David Satcher, the new
director of the CDC appointed by the Clinton administration.  The Atlanta
Constitution reported on 8/21/93 that the CDC's new director "says the
agency's ....mission will be an essential ingredient of president Clinton's
health care reform program."  The Clinton administration places stringent gun
control at the centerpiece of its legislative and campaign agenda and it can
be fairly observed that the CDC, under direction of prohibitionist
ideologues, has advanced a results-oriented research agenda.  Science as a
handmaiden of politics is science not at all.

Front page exposure of CDC's exaggeration of AIDS risk for heterosexuals to
obtain increased federal funding,23 CDC Director Satcher's involvement with
the Clintons' socialized medicine proposals, as well as CDC's politicization
of gun violence research only underscore our greatest concern - that
recognition of the politicization of the CDC will terminally undermine the
credibility of the CDC even in it's traditional role in the study of epidemic
disease.  If we ever have to confront a nightmarish epidemic of Ebola
Hemorrhagic Fever, will the CDC have any remaining credibility?

Sincerely,

Edgar A. Suter MD
National Chair
Doctors for Integrity in Policy Research Inc.
5201 Norris Canyon Road, Suite 220
San Ramon, CA 94583 USA

1 Trunkey D. "Trauma Systems at Risk." JAMA. September 25, 1996; 276(12):
944-945.

2 Waters WC IV, Faria MA, Wheeler TW, and Kates DB. testimony before the
Subcommittee on Labor, Health and Human Services, Education and Related
Agencies, House Committee on Appropriations. March 6, 1996. Hearing Volume,
Part 7: 935-970.

3 Fingerhut LA and Kleinman JC "Firearm Mortality Among Children and Youth".
Advance Data #178. Washington DC: NCHS Nov. 3, 1989.

4 Kleck G. Point Blank: Guns and Violence in America.  New York: Aldine de
Gruyter. 1991.

5 Suter E. "Guns in the Medical Literature - A Failure of Peer Review."
Journal of the Medical Association of Georgia. March 1994; 83: 133-48.

6 Kates DB, Schaffer HE, Lattimer JK, Murray GB, and Cassem EW. "Guns and
Public Health: Epidemic of Violence or Pandemic of Propaganda." Tennessee Law
Review. Spring 1995; 62(3):513-596.

7 Violence Prevention Task Force of the Eastern Association of Surgery of
Trauma. "Violence in America: A Public Health Crisis - the Role of Firearms."
J Trauma. 1995;38:163-168.

8 Rosenberg M, Director CDC-NCIPC. avowing his desire to create a public
perception of firearms as "dirty, deadly -- and banned." in William
Raspberry, "Sick People With Guns." Washington Post. Oct. 19, 1994, p. A23.

9 O'Carroll PW, Acting Section Head of Division of Injury Control, CDC.
quoted in Goldsmith MF. "Epidemiologists Aim at New Target: Health Risk of
Handgun Proliferation." JAMA. 1989; 261: 675-676.

10 O'Carroll PW, Acting Section Head of Division of Injury Control, CDC.
Correspondence: CDC's Approach to Firearms Injuries." JAMA. 1989;262:348-349.

11 Satcher D. Director, CDC. "Gunning for Research." Washington Post.
November 5, 1995. page c2.

12 Tarlov AR, Cook PJ, Kelsey J., and Moore M. "Firearm Injury Prevention:
Report of the Special Panel to Evaluate the Quality of Research on Firearm
Injury Prevention that has been Supported by the National Center for Injury
Prevention and Control, Centers for Disease Control and Prevention." Atlanta
GA: CDC. November 1995.

13 Satcher D. Director, CDC. letter to Rep. Sam Johnson. February 28, 1996.

14 Kleck G and Gertz M. "Armed Resistance to Crime: The Prevalence and Nature
of Self-Defense with a Gun." J Criminal Law & Criminology.
1995;86(1):150-187.

15 Suter EA, Waters WC IV, Murray GB, et al. "Violence in America - Effective
Solutions." Journal of the Medical Association of Georgia. June 1995; 84:
253-263.

16 Weil DS, Knox RC.  "Effects of Limiting Handgun Purchases on Interstate
Transfer of Firearms." JAMA 1996;275:1759-1761.

17 Kellermann AL, Rivara FP, Rushforth NB et al. "Gun ownership as a risk
factor for homicide in the home." N Engl J Med. 1993; 329(15): 1084-91.

18 Weil D.  Firearm Design and Firearm Violence." JAMA 1996;276:1036.

19 Kellermann AL. "Correspondence: Guns in the Home." NEJM. 1994; 330:368.

20 Kassirer JP describing peer-reviewed publications critical of
CDC-sponsored research as "howls of protest. from the National Rifle
Association and its surrogatesx" in "A Partisan Assault on Science: the
Threat to the CDC." NEJM. 1995;333793-794.

21 Kellermann AL stating "Edgar Suter is philosophically closer to the
militia movement than he is to the scientific community.". in McDonald RR.
"Are Guns a Health Menace?" Atlanta Journal-Constitution. August 27, 1995.
pages Q1-Q2.

22  Kellermann AL stating "Had you bothered to ask any of a number of experts
to review Kates' manuscript prior to publication, you would have learned that
his views are closer to the militia movement than the mainstream scientific
and legal communityx.You have embarrassed the University of Tennessee." in
letter to Mahoney LA, Editor in Chief, Tennessee Law Review, responding to
her offer of publication of a rebuttal to the Kates et al. "Pandemic of
Propaganda" article [reference 6 above]. December 22, 1995.

23 Bennett A and Sharpe A. "Health Hazard: AIDS Fight is Skewed by Federal
Campaign Exaggerating Risks." Wall Street Journal.  May 1, 1996. pages A-1 &
A-6.