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Re: [casi-analysis] Briefing note on UK Government's response tothe Lancet Iraq Mortality Survey

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Chris Lightfoot has some more excellent commentary on this at

Among other things, he points out another downing street statement:

     Asked to explain further the Government's previous concerns and doubts
about the methodology applied in the ``Lancet'' article about the number
of Iraqi deaths, the PMOS replied because it relied on the extrapolation
technique assumed, that Iraq was uniform in terms of intensity of
conflict. It wasn't. The article also assumed that bombing was general
throughout Iraq, which was not the case. The Iraqi Department of Health
had issued figures that showed over a 6 month period there were about
3,000 deaths, which was a long way short of the figures quoted in the
``Lancet''. The Iraqi DOH measured those figures by the number of people
who came into hospitals throughout Iraq, and it was very difficult to rely
on any such figures quoted in the ``Lancet'' with any certainty.

I haven't seen the original source on which this is based - perhaps
somebody should be pressing the govt. to release it so we can see what
they're basing it on. There is a newspaper report on it from late
september at And
yes, the PMOS is being misleading again.

I'm also very interested in another of Chris' points, and I think it is
one that CASI old-timers are well-placed to analyse. I'll copy it in

"``The pre-war infant mortality rate reported by this study is far below
that from other statistics; therefore we can't trust this study.''

This one's much more interesting. The Lancet study reported an infant
mortality rate of 29 per 1,000 live births (95% confidence interval 0 --
64), as compared to a UNICEF estimate of 107 per 1,000 live births. (For
comparison, the value for the UK in 2003 is 6 per 1,000 births.)

This suggests that the samples they took were not representative of this
segment of the population.

Two immediate comments: firstly, the UNICEF figure has no error estimate,
and so is difficult to compare to the new estimate; secondly, the old
Iraqi régime may have inflated infant mortality figures to support the
argument that sanctions were responsible for a large rise in infant
mortality. (I can't justify the latter argument -- it's just a hypothesis;
in any case, the Coalition Provisional Authority quoted a similar figure,
108 deaths / 1,000 births, in June this year.)

One other possibility: the researchers counted the numbers of births and
deaths among the interviewed samples over a fixed interval. This will only
give an accurate estimate of the infant mortality rate if the birth rate
doesn't vary substantially (a child who dies during the survey period may
have been born before it). However, to explain the discrepancy, a large
increase in the birth rate in the immediate pre-war period would be
required, and there's no reason to suppose that had happened.

This issue, unlike most of the others, is a bit troubling. But the bulk of
the deaths estimated by this study occurred among adults, not children, so
-- unless this is evidence for a wider problem -- this doesn't affect the
basic conclusion; in any case, the survey compared the households' pre-
and post-war circumstances using the same methodology, and it is the ratio
of pre- and post-war mortality rates from which the estimate for the total
numbers of deaths was derived."

Daniel O'Huiginn
07745 192426
24, Priory Road, Cambridge

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