On Critical Thinking: Carly Taylor's False Facts About Birth Control.

we live in an era when critical thinking
has come to be a sort of surrogate virtue it's the presumed solution to so many of our problems and whenever we encounter a problem we attribute it to the shortcomings of the education system and the lack of critical thinking don't tell me it's just me guys I hear this all the time from the government from high-level mainstream media and from low-level youtubers columnist bloggers personalities like myself who just struggled to make their voices hear heard in the cacophony of the Internet in contrast to the concept of Education I'd here just like to talk for a minute about encouragement the video that's coming is heavily laden with scientific facts and many of you will not watch the whole video you'll fast-forward or just skip the second half of it entirely I know this mm-hmm and it's also in part a criticism of the particular personality who's been representing or misrepresenting these facts within the vegan digital demi-monde Carly Taylor so Carly Taylor is mostly known as the girlfriend of James ASPI and to my knowledge she is 23 years old she has formal education in biomedical sciences she has formal education in chemistry in psychology and that would certainly include the reading of medical literature this kind and the interpretation of statistics whether you think of those as social science statistics course statistics as used in medical research when looking at basically the numbers for how effective drugs are and the outcomes of trials however Carly is currently in a romance with a man who teaches meditation someone who preaches Vipassana and a very spiritual soft hippie approach to veganism and it's obvious that she's not being encouraged to think about scientific problems scientifically she's not being encouraged to think about medical problems medically now this second video on the subject is partly a response to the fact that Melissa was shocked when she learned that currently had this kind of education I pointed it out to her and she suddenly regretted that in her first video she was so flattering or polite towards Carly she asked me repeatedly before she uploaded her first video if I thought she wasn't being too mean or too harsh towards Carly and her criticism there and then when she found out she had this educational background she said oh I I should have been much much harsher on this woman now why is that what are the assumptions here and what's the the kind of you know that what's the picture frame that prefigures how we perceive these personalities and the information we receive from them in recent videos of complaint at length about celebrity culture devouring politics we also have a problem of celebrity culture devouring the biomedical sciences people were learning about science and health from celebrities and in a sense only learning things they want to learn only hearing voices they want to hear and whether they examine it or not they may be hearing these voices because they have a pretty face because they're connected to some celebrity they're following because they agree with them or appeal to them in in any number of really irrational and perhaps aesthetic and perhaps rather shallow ways so this turnaround of my girlfriend's part was partly because of this discovery of really who Carly is and it's partly also that I read two of the peer-reviewed studies that my girlfriend read she read many more she did quite a lot of research this series of videos and when I was reading them things left out at me things seemed salient and important to me that didn't leap out when my girlfriend get in the first reading I said no no this is really important this is what you've got a point this this needs attention drawn to it and again this is a contrast between education and encouragement Melissa and Carly are about the same age and I know they both have a BA from University and there are two kind of parallel lives here being lived I'm here with Melissa and I'm really encouraging her to think you know in a more exacting and precise and demanding way to go over these peer-reviewed studies and share their no no no are you sure you caught this like do you see it's saying something here in passing essentially here briefly but it's really important so just to give you a couple of examples about nine minutes into this video I can give a time stamp the number ten comes up ten pregnancies at least ten pregnancies that were included in the analysis of the report so you know minimum of ten and I said no no no this is mentioned briefly but this is really important it's important for a number of reasons one of them being that that's the kind of tangible number ordinary people can relate to you're not talking about an abstract problem of methodology procedure or philosophy or something and how this is structured we're saying no no no look there were at least ten and pregnancies that were omitted in calculating the rate of pregnancy that results using this form of birth control and there was another one that popped out at me which was actually reading a separate peer-reviewed article that's not discussed in this video I was going through it and it briefly gave you what the actual definition of perfect use was because the I would imperfect use and then mixed methods and in each report that needs to be pinned down exactly what's meant by those terms and this particular report I was reading perfect use involved a median of twelve days of abstinence per cycle that means you're reviewing this as a form of quote unquote birth control in which women are not having any vaginal intercourse for the perfect.you statistic not having any vaginal intercourse for 12 out of 25 days the number of days in the cycle is very right you also look at average and median for that too they could have a 30-day cycle they could have a 22 day cycle it varies from woman a woman can vary from month to month and the number 12 is not the maximum you can women who are having no sex at all for 15 days or three days these are these are really glaring problems that are buried in the methodology people not people who enter camp these are not skills I learned in my formal education at all if I had to rate the value of education at the University of Toronto on a scale of one to ten I would give it a zero if I had to rate the quality of education at University of Victoria on a scale of one to ten trust me it's a zero don't even get me started and I know that people are entirely capable of going through the motions of a BA whether it's in the sciences philosophy or almost any other field and learning nothing or learning remarkably close to nothing despite the fact that even they get straight A's or even they get reasonably good grades without really deeply picking up the course content or without learning lessons in a way that they can apply them to their own lives the way I develop this habit of mind that I am now sharing with my girlfriend I'm encouraging her to think critically as loath as I am to use that golden that golden buzzword critical thinking you know it comes out of caring and I know caring doesn't sound sophisticated it doesn't sound as appealing as critical thinking but the habit of what people call critical thought for me absolutely there's no other way to put it rises out of caring I was in a situation when I was living in Laos Laos as a third world country in Southeast Asia it's just north of Cambodia I was there and at that time I was trying to get into the humanitarian sector I wasn't yet in and I was busy doing ten of the things and I read this report humanitarian report on a sex scandal that involved statutory rape teenagers getting pregnant and humanitarian workers having sex lives that were not really commenced herbal with what donors thought of as humanitarian work okay and this was in remote villages of northern Laos where people were still starving not in the big city where the quality of life was much higher with a life expectancy was a decade longer and so on but out on the the the edges of the ragged edges of Lao civilisation where quality of life was still very low and where certainly it was possible for people doing humanitarian work to reduce the local native people to a situation of prostitution dependency or what-have-you if they didn't abide by a pretty strict moral code there was this report put out but the agency guilty of these various transgressions and I got to see how sitting in a room thirty other people who just wanted to believe the [ __ ] who wanted to believe the hype interpreted the statistics come first and that the facts presented this report a hundred percent wrong and I was the guy who read this and got it right and just like these examples I mentioned just like stopping on wait wait wait what does that sentence mean stop really think about why did the author put this in here and why is it phrased this way because sometimes people are writing under constraints I mean I can remember in that report which was supposed to be counting the number of accidental pregnancies see the link to this research document this video suppose we counted the number of accidental pregnancies that arose between humanitarian workers and barefoot teenagers in these poverty-stricken villages I've been in those villages by the way people were literally barefoot they're not joking anyway um intermission of this you just get one sentence that said in addition to the cases listed in the table several others were omitted for the following reason and you'd have to take that sentence and say no no this report was supposed to count the number of pregnancies and instead there's an unspecified number that were omitted and it's plural it's at least two it's at least two or three we don't know it could be ten and they've been omitted for these reasons you know statements like that nobody taught me how to do this nobody not my university not my parents I mean nothing in my upbringing taught me how to do this but whether I was reading ancient Buddhist philosophy or completely modern secular political science I've got to say what other people call critical thinking I call caring and this is why in a sense encouragement is even more important than education hey hey there's something wrong here there's something wrong with your work you should care and that's really what I'm trying to share with Melissa and obviously living parallel lives and the other side of the world you've got James ASPI teaching he passes the meditation of people living his reckless brainless hippie lifestyle in the shadow of his you know seven-year drug habit and all these other things that have reduced his cognitive capacity to the level of a shaven ape and you know he's obviously encouraging her to play the ukulele and act like a bimbo and sell this kind of hippy pseudoscience soft medicine in a context like this we're talking about endorsing a dubious form of birth control not approved by the FDA as a form of birth control that's in the video next few minutes that's to follow there's a real question of what kind of thinking is being encouraged now the moral of this story I think is worth telling and setting up this video partly because veganism itself so much comes out of an ethos of care of saying to people why don't you care I care these are the facts but the facts alone are inert and meaningless I need you to care I need you to look in the mirror in question why don't you care about what's on your plate what's on your fork and what the knock-on ecological effects are right but I mean all over the world I mean whatever whether it's the consequences of u.s. foreign policy of dropping bombs on a foreign country or if the consequences of flushing your toilet where does your sewage go what are the impacts of that there's nothing in neat within us about caring about the consequences of our action or caring enough to read a report to read a document and to really stop to check if you understand what you're saying to check if the author understands they're saying to really just care about the content again even at that first step of reading let alone the next step of coming here on the Internet and then sharing those recommendations with others it will never give you a green day unless it's 99.4% sure that you are not fertile that day so that's actually even more safe than the birth control pill in terms of preventing pregnancy and that 99.4% statistic is backed by two clinical trials that are in peer-reviewed medical journals as well as 30 years of research so I really did my research before trying out the Daisy and this is such a reputable company the scope of my last video on this topic was very broad so I'm making a follow-up video now to never win on just the Daisy specifically I didn't emphasize enough in my prior video that there was an important research article published which in the harshest terms possible calls the Daisy study fraudulent and appeals for it to be redacted Carly you should know better than to promote a product from a company who has promoted itself on fraudulent efficacy rates you say that you have a Bachelors of Science in biochemistry you say that you did the research you didn't research well enough you weren't critical enough Carly I feel like with the Bachelors of Science in biochemistry you could be doing more for the movement than recording videos of yourself hugging puppies or singing over the rainbow come on Carly this is about sex this is about pregnancy it's not about puppies or rainbows you need to take responsibility just because you're cute doesn't mean that you can support a product and endorse a product publicly that could lead to unintended pregnancies I think you should take down your videos gushing about the Daisy they've been dishonest in their marketing claims and they've used statistics that are based on bad science to push their products I hope that by the end of this video you can see that there are legit researchers who have gone into this themselves I hope that by the end of this video you can realize that the Daisy is a scam I hope that you can realize that the Daisy is basically just an overpriced thermometer don't trust this product don't buy this product this is a tweet from Chelsea B Paulus PhD she says it wasn't a clinical trial it was a poorly worded retrospective mailed survey with a low response rate and beyond the poor data the analysis was done incorrectly a responsible company would stop promoting misleading information and thereby would stop putting people at risk of unintended pregnancy this screenshot is from the daisies website in their terms and conditions I'm just going to read a couple parts but this is the general disclaimer for the Daisy device they say Daisy is a fertility monitor and not fda-approved as a contraceptive method or device we do not accept liability for claims made by the manufacturer or other material resources I did include a link to this study in the description box below but I thought I would go through it and read out some of the most important parts so the study is titled published analysis of contraceptive effectiveness of dayz and dayz view app is fatally flawed and it was published by Chelsea B Paulus the background of the study reads in March 2018 dr. Martin C Koch and colleagues published an analysis purporting to measure the effectiveness of the Daisy device and Daisy view the prevention of unintended pregnancy unfortunately the analysis was flawed in multiple ways which render the estimates unreliable unreliable estimates of contraceptive effectiveness can endanger public health the main body reads this commentary details multiple concerns pertaining to the collection and analysis of data in Koch and associates 2018 a key concern pertains to the inappropriate exclusion of all women with fewer than 13 cycles of views from the Perl index calculations which has no basis and standard effectiveness calculations I included parts from a webinar that Chelsea Paulus and a gynecologist have recorded so that's later in this video and in that they discuss why a research study such as this can't actually use the statistics to calculate a pearl index it's because it's a retrospective study that any pearl index calculation any perfect use calculation really can't be made from this type of research okay so I continue multiple additional methodological concerns as well as prior attempts to directly convey concerns to the manufacturer regarding marketing materials based on prior inaccurate analyses are also discussed in the conclusion she says the Koch and associates 2018 publication produced unreliable estimates of contraceptive effectiveness for the Daisy device and Daisy view app which are likely substantially higher than the actual contraceptive effectiveness of the device and app those estimates are being used in marketing materials which may inappropriately inflate consumer confidence and leave consumers more vulnerable than expected to the risk of unintended pregnancy prior attempts to directly convey concerns to the manufacturer of this device were unsuccessful in preventing publication of subsequent inaccurate analyses to protect public health concerns with this analysis should be documented in the published literature the Koch and associates 2018 analysis should be retracted and marketing materials on contraceptive effectiveness should be subjected to appropriate oversight so as I said in the harshest terms possible in a formal research article they condemned Daisy and say that their study was fraudulent and could lead to unintended pregnancy and that it's a public health concern so in the background section of this article I think this is rather important so this commentary argues that this paper merits retraction given the demonstrated potential for these estimates to be used in marketing materials leading to public confusion about the actual contraceptive effectiveness of the Daisy device and a CPU app the manufacturer of Daisy has cited this study the 20 2018 study in contraceptive effectiveness claims in marketing materials and in figure 1 you can see that they have used this on their Facebook page for the Daisy fertility monitor they say that now with the release of our new clinical trial we have shown that Daisy when used in combination with the Daisy view app is even more effective 99.4% so in the main text the author says that the coke and associates 2018 effectiveness estimate are fatally flawed and unreliable for multiple reasons first their purl index calculations are void of meaning since the author's inappropriately excluded from the Perl index calculations all women with fewer than 13 cycles of use ignoring cycle and pregnancy information from the majority of study participants this approach has no basis in standard effectiveness estimation approaches and would severely underestimate unintended pregnancy rates by inappropriately excluding women who may be at greatest risk of unintended pregnancy there was a table in the study from 2018 which suggested that at least 10 pregnancies occurred to women with fewer than 13 cycles but these pregnancies were not included in the Perl index calculations so the calculations were flawed because they didn't include these pretty critical pregnancies in addition the investigators did not prospectively collect information regarding perfect or imperfect use of the method for each cycle instead they asked about overall perfect or imperfect use with a retrospective survey this precludes their ability to correctly calculate perfect use unintended pregnancy rates in either the Perl index or life table calculations they are not comparable to correctly estimated perfect use pregnancy rates for other contraceptive methods in other studies so the author says that even if the inappropriate exclusion of pregnancies were corrected the underlying data remain unreliable given the weak approach to pregnancy ascertain meant if the criteria for examining the temperature / device use data were premise upon the woman's self reporting and unwanted pregnancy on the survey an unknown number of pregnancies may have been excluded given that unwanted pregnancies including those ending in abortion may be underreported furthermore the survey question asked women to report unwanted pregnancies occurring during Daisy use the term unwanted is not synonymous with unintended and it is unclear how women may have interpreted this question but standard contraceptive effectiveness estimates include all unintended pregnancies including mistimed and unwanted pregnancies under s attainment of unintended pregnancies could lead to inflated estimates of contraceptive effectiveness several other aspects of the questionnaire also raised concern for example a survey question presumably attended to ascertain if at baseline Daisy was being used to avoid or attempt pregnancy offered the following response options a to avoid a pregnancy B for family planning or C both however response options a and B and therefore also C are poorly distinguished and likely to be perceived synonymously by some respondents meaning that even this already limited measure of baseline pregnancy intentions is unreliable while some issues in data collection and analysis are not unique to the study they nonetheless raise additional concern about the accuracy of the estimates for example no inclusion exclusion criteria were described to ensure that the analytic population was at meaningful risk of pregnancy also the majority of survey respondents reported concurrent use of contraceptive methods in addition to Daisy the potential confounding effect of use of other methods on the effectiveness estimates is not addressed in the analysis so when Daisy claims that just using daisy alone is 99.4% effective they are in effect using fraudulent science because when they did this study they also had women who were participating who used other contraceptive methods in addition to just the Daisy so they really can't make that claim that the Daisy by itself is ninety five ninety nine point four percent effective for these reasons this analysis produced estimates which cannot be understood as reflective of the true and still unknown contraceptive effectiveness of the Daisy device and Daisy View app our forthcoming systematic review of studies assessing the effectiveness of various fertility awareness based methods carefully considers the quality of prospective studies on effectiveness of various fa BMS studies of extremely poor quality such as those in the caulk and associates 2018 study must not be understood as providing reliable evidence on contraceptive effectiveness the manufacturer of the Daisy device valley electronics has made inaccurate marketing statements in the past based on previously published analyses which purported to assess contraceptive effectiveness of their products but which also contained fatal flaws so you can see that this is the Daisy USA Twitter page and this is the kind of marketing that they use they say that the Daisy is just as effective as the Paragard the non-hormonal copper IUD in their marketing Daisy used the ninety nine point three percent effectiveness rate here and this is from a study that also is fatally flawed in the study she says for example in addition to multiple concerns pertaining to the methods of pregnancy as retainment in Freundel 1998 which was collected via mailed retrospective questionnaire the calculation which generated a zero point seven perfect use pearl index used an incorrect denominator which included all cycles rather than only cycles of perfect use which would inflate perfect use effectiveness rates on the Daisy fertility monitor Facebook page somebody asks how can we make Daisy more effective by tracking other fertility signs parenthesis cervical fluid and cervical position on our own and Daisy fertility monitor responds to this person saying Daisy is currently ninety nine point four percent effective used alone this ninety nine point four percent effectiveness rating is based off of this 2018 study which is fatally flawed okay finally the conclusions the scientific and reproductive health communities have a responsibility to protect public health by ensuring that inaccurately conducted analyses of contraceptive effectiveness do not put unsuspecting consumers at a greater than expected risk of experiencing an unintended pregnancy women and couples interested in using any form of contraception including an F ABM such as Daisy deserve robust effectiveness data on which to base their contraceptive decisions unfortunately the 2018 study from [ __ ] and associates their estimates are fatally flawed and inaccurate and are likely to be substantially higher than the actual contraceptive effectiveness of the device and app by using marketing language based on inaccurate analyses belly electronics falsely increases consumer confidence and the effectiveness of the Daisy device and the Daisy View app which could endanger the well-being of their customers to protect public health scientific integrity and potential customers these concerns should be documented in the published literature the Koch and associates 2018 analysis should be retracted and marketing materials on contraceptive effectiveness should be subjected to appropriate oversight this issue isn't discussed in Chelsea policies paper but I thought I would mention this issue so in the general disclaimer on Daisy's website they say that conclusions regarding the contraceptive reliability of monitoring basal body temperature are based upon independent studies but if you look at the bottom of the 2018 study in the section that says competing interests it says we have read and understood BMJ policy on declaration of interests and declare the following interests this study was funded by the Valle electronics AG Zurich Switzerland NV dr is an internal scientist and employee of the company and vdr analyzed the stored data so this is pretty damning and a pretty important conflict of interest to be noting about this study so I'm gonna end this video with edited clips from a webinar from Chelsea B Palace and dr. Rachel Arita their presentation was called effectiveness of fertility awareness based methods for pregnancy prevention and in this they discuss their scientific study in which they really comprehensively went through all the research available and they talk about the actual effectiveness rates of all the available fertility awareness based methods on the market or that you can use in your everyday life it is notable that in their research they didn't include any studies about the Daisy or any studies from valley electronics dr. Chelsea Poulos is a reproductive health epidemiologist and senior research scientist at the gue mocker Institute she has extensive experience in research on contraception and has conducted multiple studies pertaining to contraceptive effectiveness safety and susceptibility for a range of contraceptive methods dr. Poulos recently completed an analysis assessing how use of multiple contraceptive methods such as how use of FA BMS in conjunction with barrier methods during the Fertile window impacts the estimation of FA B prevalence in the United States along with dr. Victoria Jennings of the Institute for Reproductive Health dr. Poulos wrote the chapter on fertility awareness based methods in the upcoming edition of contraceptive technology she's also organized a panel pilot presentation on FA BMS at the 2017 North American forum on family planning and has presented on FA BMS to global audiences she is a member of the scientific subcommittee for the association of fertility awareness professionals and serves as a guest lecturer on scientific literacy to students of fertility awareness education programs dr. Rachel Aroo TIA is board-certified in obstetrics and gynecology as well as preventive medicine she grew up in New England completed her MD at Harvard Medical School and moved to North Carolina for her residency in obstetrics and gynecology at Duke University she has been an assistant professor at the University of North Carolina Chapel Hill and does her clinical work at reply' ob/gyn and fertility which has a practice focused on promoting access to fertility awareness based methods her research is focused on using women's health visits has an opportunity to prevent chronic disease and on the use and effectiveness of FA BMS for avoiding pregnancies she is also a certified instructor of the sense of plan fertility awareness based method substantial confusion exists on the effectiveness of FA BMS for preventing pregnancy so we wanted to devote a full webinar to this specific topic let's move on to discussing what kinds of studies can be used to estimate contraceptive effectiveness two different study designs can estimate contraceptive effectiveness one advantage of prospective studies is that investigators can collect detailed information on contraceptive use and how it changes over time and on information and information on outcomes like pregnancies so prospective studies can sometimes even perform repeated pregnancy tests on women and this is a more reliable way of ascertaining if an unintended pregnancy has occurred more reliable than asking women to self-report their preg these also prospective studies are the only design that enable calculation of perfect youth effectiveness estimates however a major disadvantage is that estimates from retrospective surveys depends on accurate recall and reporting of detailed contraceptive and pregnancy history by participants and we know that under reporting of important events like unintended pregnancies or abortion is common also if a method is not just commonly used in the general population it may be difficult to have enough information to generate stable effectiveness estimates for that method and finally researchers cannot estimate perfect use effectiveness from retrospective surveys these this type of study design can only provide typical use estimates to summarize the best available data from prospective studies on FA BM effectiveness for pregnancy prevention we conducted a systematic review to our knowledge this is the most comprehensive review that has been conducted on the topic our manuscript is currently impressed and should be available in August of 2018 we reviewed over 8,000 titles and abstracts over 400 full-text articles and ultimately included 74 articles which represented 53 unique cohorts we did not identify any studies that we consider to be high quality we decided at the beginning of our analysis that we would not present the effectiveness estimates from low quality studies we had significant concern that these estimates were not accurate given serious problems with the way the data was collected and or analyzed looking at the middle column you can see that there were 21 moderate quality studies and these will be the focus of estimates that I present in the following slide two examples of basal body temperature based methods are bio self and natural cycles we identified one low quality and one moderate quality study of bio self the moderate quality study generated a typical youth pregnancy probability of a nine per 100 women years and no correctly calculated perfect use estimates there is one moderate quality study of natural cycles and the most conservative estimate from this study which we determined to be the most reliable estimate generated a typical youth pregnancy rate as 9.8 per 100 women years correctly calculated perfect use probabilities were not available at the time of the literature search so a publication with a perfect youth estimate was subsequently published in addition there were four other basal body temperature based method studies of a variety of different methods and the effectiveness estimates will not be described for these methods because they were all low quality studies no Studies on the Daisy or any other devices from belly electronics were included in their comprehensive study this means that there are no high quality moderate quality or low quality studies done on the Daisy the sensor plan and marquette monitor based studies demonstrate the lowest probabilities of unintended pregnancies and may potentially be the most effective fertility awareness based methods however this is based on a small number of moderate quality studies in specific populations and so more evidence would be needed to state this confidently a very few studies accurately calculated perfect youth effectiveness estimates however the lowest perfect use estimates were again four cents a plan and the market monitor both having less than one percent pregnancy rates for probabilities among perfect youth cycles there's a suggestion that some FA BMS may have promising perfect use pregnancy rates however fabs in general are highly dependent on the consistency and correctness of youth more data would be required to confirm these estimates so users of FA BM should be informed about the known effectiveness estimates or the lack of effectiveness estimates for the specific FA BM they are using and they should be advised not to extrapolate from effectiveness estimates from difference may be a method in other words you cannot infer that the Daisy is just as effective as sense it plan you cannot infer that Daisy has the same effectiveness as natural cycles so this table includes an overall estimate of typical use for FA BM a 15% this estimate primarily reflects people who report using the rhythm method since the majority of women in the United States who report using an FA BM report using specific rhythm since this 15% estimate is based on a retrospective survey as we noted before calculating perfect use is not possible so that's why there's no perfect use in that column estimates from the prospective studies are in purple and these should be considered best-case scenarios and may not be generalizable to all populations in our systematic review we did not identify any high-quality prospective studies on any method on any si BM method again estimates from prospective studies should be considered best case scenarios and may not be generalizable to a broader population overall while some data are available on the effectiveness of individual FA BM s understanding the true effectiveness of each unique FA BM would require data from high quality studies [Music] [Applause] [Music]