Day 022 - 12 Sep 94 - Page 34

     1        say:  "There is this difference, let us go forward from
     2        there".
     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.
    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.
    22   Q.   It is not just because they record them more efficiently?
    23        A.  No, almost certainly that is true.
    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.
    34   Q.   Or why those extremes make a difference or may make a
    35        difference?
    36        A.  It depends-----
    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. 
    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.
    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.

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