Sunday, September 20, 2015

The numbers fail to get better

This week saw the release of a report from the ongoing joint study by researchers from the Department of Veterans Affairs and Boston University, bringing up to date the results of its analyses of brains of former football players.  As of this report, of 91 former NFL players examined by this group, 87 were found to have chronic traumatic encephalopathy (CTE), the disease at the center of football's ongoing struggle with concussions and subconcussive trauma and their impact on players in (usually) their post-football lives.When expanded to include former football players at any level (high school, college, or semipro) 131 of 165 showed the telltale evidence of CTE.

(For comparison, here's the ESPN.com report on the study, which adds some interesting reactions, including a tweet from a former player and a comment from a real Maroon.)

For this occasion, simply some observations:

1) The difference between NFL and non-NFL players is striking. Doing the math suggests that 44 of 74 non-NFL former players showed CTE. That's almost 60%, which is not nothing, but falls well short of the 96% of former NFL players.

There are many possible reasons for this disparity, of course. It's always possible that the lessened exposure to those repeated head blows makes that much difference, but that's not an assumption that can safely be made from current evidence. More use of artificial turf fields in the NFL, greater size and speed of NFL players, longer seasons; these are just a few of the possibilities, and answers are going to take time, something current sufferers do not have.

2) At this state of research and understanding of football-related brain trauma, the study sample available to researchers is inevitably skewed. Despite how it may sound, we're not to the point of harvesting the brains of ex-football players. Brains are donated to this brain bank. Sometimes an ex-player can make arrangements for his brain to be donated after his (presumably, hopefully) natural death; in most cases, though, the brain is donated by the player's family after his (violent and self-inflicted, too frequently) death. In the vast, vast majority of these cases, the brains are donated precisely because of either the nature of the player's death or because of symptoms of brain trauma reported during the player's lifetime, or frequently both.

It may turn out that the non-NFL sample will be more enlightening, simply because of the greater parity of CTE and non-CTE results. It's probably not that easy to persuade former NFL players who experience no particular trauma in their retirement to donate their brains for study after their deaths, but it would probably help.

3) While this is the largest repository in this particular field, it is not the only one. It is probably the most well-funded, with a chunk of that money coming from the NFL itself. The principal researcher on the BU team, Ann McKee, is an acknowledged Cheesehead who was featured in the book League of Denial: The NFL, Concussions, and the Battle For Truth, the book (and accompanying PBS Frontline film) that has probably done the most to expose this condition, and the NFL's Big Tobacco-like stonewalling, to the larger public. When you follow that link, you might get a book blurb that starts with the remarkable claim by the NFL, ten years ago, that:

 “PROFESSIONAL FOOTBALL PLAYERS DO NOT SUSTAIN FREQUENT REPETITIVE BLOWS TO THE BRAIN ON A REGULAR BASIS.”

I guess we have to acknowledge that there has been progress.

4) At any rate such numbers (particularly among former NFL players) don't help the NFL in its ongoing litigation. It's worth relaunching the weekly reminder that even the NFL has acknowledged in a legally binding manner that one in three NFL players are likely to "develop long-term cognitive problems" and to do so at "notably younger ages" than the general population. We'll be generous and suggest that of the twenty-two players you saw on the field at any given time in the game you watched today, there's a decent likelihood that seven of them will end up with some kind of long-term debilitating condition as a result of their NFL careers. I invite you to keep that in mind tomorrow night.

And if you're looking at the numbers and thinking that eighty-seven dead former players doesn't really sound like that many, I invite you to answer this question:

What number of deaths is ethically acceptable?

Dr. Ann McKee, director of the lab running the study, presenting on her research.
Image credit: merrimack.edu

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