Day 022 - 12 Sep 94 - Page 34
1 say: "There is this difference, let us go forward from
2 there".
3
4 MR. MORRIS: Presumably, when people do a population study they
5 do take into account the recording of disease, they must
6 do, to produce a reasonable result that is going to be
7 taken seriously, yes?
8 A. Yes, I mean, they try to but, you know, there
9 obviously are deficits and deficiencies which it is
10 impossible to overcome completely in some of these
11 studies. If you have ever been to countries like certain
12 parts of Malaysia or Indonesia, the vast majority of the
13 population live in rural communities where the information
14 is not necessarily available.
15
16 Q. But you would say that it is established beyond any
17 reasonable doubt that so-called developed western
18 countries do have a much greater incidence of degenerative
19 diseases?
20 A. That is true.
21
22 Q. It is not just because they record them more efficiently?
23 A. No, almost certainly that is true.
24
25 Q. Is another advantage of population studies over the other
26 type of studies that often there are extremes between two
27 countries, for example, whereas within a particular
28 country often it is hard to get such extremes of, say,
29 diet or cultural background or whatever?
30 A. But these are the sort of pointers I was suggesting,
31 that one would then feel the need to investigate why there
32 should be such extremes.
33
34 Q. Or why those extremes make a difference or may make a
35 difference?
36 A. It depends-----
37
38 Q. What I am trying to say is I am trying to get you to -- if
39 you were a person who felt that population studies were
40 the most accurate way of identifying possible dietary
41 causes of ill-health, then what would you be saying? What
42 were the advantages of those studies over, say, cohort
43 studies?
44 A. I honestly do not think anybody would say that
45 population studies are the most accurate because of the
46 deficiencies, but they can be very, very useful in
47 pointing you in the direction to then subsequently carry
48 out research into various factors which have been found in
49 those individual countries, the sort of extremes you have
50 mentioned.
51
52 MR. JUSTICE BELL: Mr. Morris is asking you between population
53 studies your groups of people -- I forget the phrase he
54 used -- who have already -----
55 A. The case controlled studies.
56
57 Q. The case controlled studies and the cohort prospective
58 studies, can you put forward an argument for population
59 studies being more useful or helpful ---
60 A. No, I cannot.