Hacker News Reader

Comment by spchampion2 | Hacker News Reader

Judging from the comments I've seen, nobody believes this because RFK has completely shot his credibility, and I don't blame them either.

But it turns out there may actually be some emerging evidence to support this. This recent Harvard meta-analysis [1] from just last month looked at 46 different studies and suggested that there may actually be something happening here although it's not conclusive. Correlation but not yet causation.

Nobody should be making policy on this yet, but it's the kind of thing that I would allocate some research dollars to if I hadn't just fired all of the competent researchers.

1 - https://hsph.harvard.edu/news/using-acetaminophen-during-pre...

View on HN

> Further, a potential causal relationship is consistent with temporal trends—as acetaminophen has become the recommended pain reliever for pregnant mothers, the rates of ADHD and ASD have increased > 20-fold over the past decades

I do not have at all the right background to evaluate this research so treat this opinion for what it's worth, but it seems incautious for the authors to close with this note near the end. People like RFK are looking for an explanation for that 20-fold increase. But the hazard ratios in the studies with positive results seem to be along the lines of 1.05-1.20. They do also note changes in diagnosis criteria before this sentence, but it still seems like if they're going to mention a 20-fold increase, they should be even more explicit that any association with increased Tylenol use could only ever explain a very small part of that.

Ya, an increased risk of 5-20% on an already very low risk.

That means mothers who don't take Tylenol have baseline 3% chance their child will be diagnosed with autism. And mothers who took Tylenol (at the levels of the study) may have a 3.15% to 3.6% chance (assuming causation, which has not been proven).

It seems unlikely we "cracked the code" here.

The best justification for the high increase we're seeing in the data is still just that the data itself has changed in how it's measured and tallied and so on.

I read the study and TBH it's more or less expected that a correlation would exist between increased NDD diagnoses and prescriptions common to pregnant women in regions with increased NDD diagnoses.

Being afforded better care during pregnancy should correlate with better attention (and diagnosis of conditions) to offspring.

If one were cynical one might say this was a good call by Andrea Baccarelli, the Dean of the Faculty, to commission a meta study looking for correlations between common treatments and NDD diagnoses in the current climate of funding going toward whomever can put forward a thread to follow in pursuit of autism.

I forget, is that the same RFK Jr who dumps dead bear carcasses in parks?

EDIT: Indeed it is! The US government is scooby-doo villains? https://www.npr.org/2024/08/05/nx-s1-5063939/rfk-jr-central-...

The irony is that if Tylenol use in pregnancy actually does increase the risk of autism, RFK's destruction of trust in the government's scientific process will probably just push that sort result back. He's a charlatan and totally unscientific regardless.

Luckily for those of us who care, there are private and foreign government organizations who still take healthcare and science seriously. Unfortunately the only sane solution seems to be to ignore the US authorities on this for the time being.

Right, I think this falls under the "broken clock correct twice a day" saying. RFK Jr says a lot of crazy things, but he probably does occasionally say something that makes sense, through no skill of his own.

I mean, he rails against processed food and color/dye additives, some of it being stuff that other countries with reputable FDA-analogues have banned. There could be something to that, even though I can confidently assume his opinions don't come from any sort of scientific rigor.

Some blue states are even (quietly?) jumping on the "MAHA" bandwagon on some issues. Not to categorically say "blue states right, red states wrong", but if your polarized political opponents are putting some of your ideas into practice, maybe not all your ideas are bad, regardless of how unscientifically you may have come by them.

You're forgetting that for half the country that trust was destroyed years ago, and RFK actually being aware of and wanting to investigate evidence like this is restoring it.

That half of the country is not having their trust in science restored. They're forcing their superstitions onto everyone else and calling that science.

Their trust was destroyed by Dr. Oz and Facebook posts.

Mine was destroyed after they caused a walkout at the CDC.

We are not the same

That is a retrospective meta study, which leads to lots of speculation, but little actual proof of causation.

>> The researchers noted that while steps should be taken to limit acetaminophen use, the drug is important for treating maternal fever and pain, which can also harm children.

also:

>> Baccarelli noted in the “competing interests” section of the paper that he has served as an expert witness for a plaintiff in a case involving potential links between acetominophen use during pregnancy and neurodevelopmental disorders.

Huh, but digging in a little more does show some stronger studies... hmmmm...

https://pmc.ncbi.nlm.nih.gov/articles/PMC6822099/

> Nobody should be making policy on this yet, but it's the kind of thing that I would allocate some research dollars to if I hadn't just fired all of the competent researchers.

Yes but that is the whole RFK brand. He and his supporters always try to have their cake and eat it too. Claim something, things go wrong and blame others for misconstruing RFK's comments.

The way this is going - RFK is going to make claims based on this paper and when people get harmed, he and his supporters will claim that people who followed RFK's assertion didn't hear him correctly. He clearly said the policy was based on this paper and people should have done more research and read this paper. See this paper says there is correlation and not causation. So, you cannot blame RFK for this mishap.

> Nobody should be making policy on this yet

Maybe we should. We're talking about pregnant women and autism, along with taking a different painkiller. And if the theory is wrong, it'll only take a few years to find out, presumably.

For people who don't have children: most medical advice regarding pregnant women and infants is overwhelmingly cautious and errs on the side of, "if we don't have enough studies confirming it's 100% safe, it's better to stick to the less questionably safe way." I'm not sure why this would be any different.

> I'm not sure why this would be any different.

The issue here is you need to make a trade. It's not like cutting out alcohol. Now you have to decide, what alternative painkiller will replace it.

There was an initial reason why Tylenol became the standard one, because others were assessed to be riskier in other ways.

I agree with you, people should weight all the known risks from all legitimate studies and data, and base policies around that, and this is no exception.

People are worried though that this won't be the case, and that bias is present from the start in this case, and we might end up making the wrong policy call.

> Judging from the comments I've seen, nobody believes this because RFK has completely shot his credibility, and I don't blame them either.

All you’re stating is that you’ve found an echo chamber - which is true of Hacker News (and Reddit, and BlueSky). It’s also true of TruthSocial. I guess my annoyance is that this is Hacker news not DNC news - and as such, I’d hope for more than one (or even two!) perspectives.

I don’t think RFK has shot his credibility - even if he did withdraw from the DNC on October 9, 2023, less than two years ago. His perspective seems stable 20 years on after he wrote “Deadly Immunity” in 2005.

If you think he lost credibility, it wasn’t recent.

How can anyone find him credible after he pitched a "gold standard" health report (MAHA) that had hallucinated references, misrepresented research and "oaicite" markers that indicated it was AI generated?

I don't find that to be a controversial statement.

[1] https://www.science.org/content/article/trump-officials-down...

FYI, "DNC" or "RNC" doesn't refer to the party in general, it's the national party committee (also overloaded to refer to the convention). RFK Jr has certainly never been a member of the DNC.

Reply on news.ycombinator.com