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Geographical Analysis and Ethical Dilemmas in the Study of Childhood Leukemias in Great Britain

Julian Besag

Besag and Newell (1991) provide what might be viewed as a statistician's version of Stan Openshaw's Geographical Analysis Machine (GAM), with the specific aim of identifying spatially localized anomalies ("clusters") in a database comparing the addresses at the time of diagnosis of all registered cases of childhood leukemias in Great Britain between 1966 and 1983 with the nominal populations at risk in more than 100,000 census enumeration districts (ED's). The talk will discuss the simple statistical ideas introduced in the paper and describe the potentially alarming results obtained for the final five-year period 1979-83, which is centered on the census year 1981. The speaker will defend his decision not to publish the detailed findings, will question the motives of those who would not carry out any follow-up studies and will seek the views of the audience in the general context of the merits and dangers inherent in so-called "cluster busting" for rare diseases, whether in the UK, the USA or elsewhere.

Reference: J. Besag and J. Newell (1991), "The detection of clusters in rare diseases", Journal of the Royal Statistical Society, A 154, 143-155.