
110 N.F.L. Brains - dpflan
https://www.nytimes.com/interactive/2017/07/25/sports/football/nfl-cte.html
======
ggreer
Playing football is almost certainly bad for your brain, but this article does
a terrible job of making that case. The doctor in charge of the study says as
much:

> The set of players posthumously tested by Dr. McKee is far from a random
> sample of N.F.L. retirees. “There’s a tremendous selection bias,” she has
> cautioned, noting that many families have donated brains specifically
> because the former player showed symptoms of C.T.E.

This is equivalent to finding NFL players who showed signs of cancer, and then
testing them for cancer. Of _course_ you're going to get a rate close to 100%.
The article takes 10 paragraphs before pointing out that the rate of CTE among
former NFL players is much lower.

This sort of sloppy journalism is counterproductive. It makes it much easier
for football fans to discredit and ignore the problem. At best, it causes
people to endorse good policies for bad reasons.

~~~
saulrh
9% chance, the best possible case given the current data, of a horrible, slow,
lingering death 20 years later is still _unacceptable_. What's the rate for
getting mesothelioma after working with asbestos?

~~~
Goladus
Unacceptable to whom? Is the US a free country or not?

~~~
saulrh
Well, we already ban:

* Selling cigarettes to children

* Building buildings that burn to the ground with everyone trapped inside

* Murder

So... I guess that America _isn 't_ a free country? If everyone was a
perfectly informed perfectly rational expectation maximizer we wouldn't have
any of these problems. But since none of those things are true, there're all
sorts of predatory and greedy-counterproductive practices that are, yes,
_unacceptable_ , things that we have to ban for our civilization to continue
to improve. I submit that american football, in its current form, is likely
one of them. Too much glamour, too much money, too much tradition, too _good
at messing with people 's heads_, both in the way it sucks everyone into it
(high school football!) and with the brain damage thing.

~~~
Goladus
We don't ban selling cigarettes to adults, and tobacco use has plummeted since
1965. Building codes affect the general public. There is a clear and direct
link between owner negligence and public harm. Building codes also help to
reduce fraud and sheer incompetence among builders. It is easy to describe
situations where fraud and criminal negligence leads to death and property
damage to other people (not just yourself).

Meanwhile there are plenty of dangerous occupations, truck drivers, for
example, that are not deemed unacceptable and banned by authoritarian morality
police.

> If everyone was a perfectly informed perfectly rational expectation
> maximizer we wouldn't have any of these problems

This standard is hardly necessary. All that is necessary is to have sufficient
information to take _responsibility_ for decisions you make and their
consequences. That is known as agency. Of course it's different if your
decisions affect others. I could certainly see holding certain people or
organizations (like the NFL) responsible if there has been some kind of cover-
up about the long-term effects of concussions. But that's far different from a
crude authoritarian ban.

> I submit that american football, in its current form, is likely one of them.
> Too much glamour, too much money, too much tradition, too good at messing
> with people's heads, both in the way it sucks everyone into it (high school
> football!) and with the brain damage thing.

In other words, you don't like football and you don't like the tradition, so
you see no problem banning it. For you there's no downside, only upside.

No, banning is not necessary, at least not some kind of national ban issued
from on high. It starts with education. Parents stop letting their children
play Pop Warner. High schoolers in most of the country decide not to take the
risks of playing football. HS football programs decline. College recruiting
pools dry up, leading to a decline in the quality and popularity of College
football. From there, it's anyone's guess how the NFL will survive.

Sure, it won't happen overnight. But I can assure you that the consequences of
trying to issue an overnight ban of the most popular sport in the US would not
be pretty.

------
mikeh1010
I want to push back on the "every sport is dangerous" argument I'm seeing in
here.

There's a difference between "you might die right in the middle of this very
fun activity" and "you might die slowly and horribly years from now when
you're retired and in the midst of raising a family."

I ski pretty aggressively, and of course I might die doing that. But every day
I go home and know, "well it wasn't today! Today was just great clean fun." If
I had a nagging thought of "but today might give me a mental disorder in 20
years" then I'd be much less inclined to participate in the sport.

~~~
endorphone
But you have absolutely no idea if aggressive skiing is giving you CTE because
no one has ever looked to investigate it.

In football, as in boxing, the original investigation began because head
trauma is obvious, but as the study broadened some of the worst cases of CTE
were actually offensive linesmen. These are generally not the players who dish
or receive hard hits, and many had never had a suspected concussion in their
career. That led to the dominant theory that it isn't concussions -- the big
hits -- that are the main cause of CTE, but instead many small traumas (in
that case the o-line engaging with the d-line) that add up to CTE.

There is every reason to suspect that many other sports yield these sorts of
recurring sub trauma, and aggressive skiing seems a probable candidate [edit -
note that it does not require that you hit your head, have an accident, etc.
If enough of a high-G event is transmitted to the brain, that can be a
subconcussion]. It just isn't terribly common to do an intensive brain study
of people after death to find these correlations.

~~~
nicpottier
I don't know about GP, but I'm an aggressive skier and very, very rarely hit
my head. I have maybe a dozen falls a season, wear a helmet and am not
colliding with anything. This is a silly comparison.

~~~
endorphone
A sub-concussion doesn't require that you hit your head. It simply requires a
g-force event -- like skiing quickly over rough terrain -- that shakes the
brain around, building up the scar tissue that we know as CTE. Offensive
linesmen engage with the opponent via their body/arms, seldom hitting with
their head, but that rapid g-force of the body stopping is enough.

Again, someone studied football players because the impact is obvious. As it
reaches out, players in even relatively low-g sports like soccer are being
found with CTE.

~~~
switchbak
Having played the game for years, I can assure you the impact being generated
on the line is very real. These folks do interact with their body/arms, but
head on head contact is a very real part of the game, and that is the part
that really affects the brain.

And the part of soccer that seems to cause concern is heading the ball, not
the running around part.

Comparing helmet to helmet impacts to skiing over rough terrain feels like a
real stretch here.

~~~
endorphone
_And the part of soccer that seems to cause concern is heading the ball_

But we don't _know_ what the concern is in soccer. Heading is immediately
looked at because it's an impact, but the actual cause may be something
altogether different.

I mentioned the g forces measured in skiing elsewhere. They are absolutely in
the range of subconcussion.

------
artursapek
I think people take for granted now how good the Times is at these
interactive, zine-like layouts for their feature articles. I just want to say
another job well done on this one. Each one of these I see is a work of art
that clearly took a lot of time across the team.

~~~
ovrdrv3
You can tell there are many devs and designers on their team that take pride
in their work! Have you seen those articles that say, "guess what the rate is
for X over the years", and you fill out the graph with your mouse, and once
you are done you can see what the actual data looks like? It's refreshing

~~~
wcarron
IIRC, they are some the main contributors to D3.js

~~~
waterfowl
bostock worked there, so that would make sense.

------
beebmam
My dad played both college and professional football. He had early signs of
dementia 15 years ago, but it became really bad about 10 years ago. After a
long struggle, he died just earlier this year.

It's hard to deal with

~~~
thomyorkie
How old was he when the early signs began?

------
aezell
(N of 1 anecdote warning)

I started playing football at 6 years old. Tackle football came about two
years later. In my junior year of high school, my back problems and knee
problems were so bad, I had to quit. It was the best day of my life. In recent
years, I've become an ultrarunner and am generally very healthy.

I'm 41 now and about 5 years ago, I passed out after cutting my hand (vagal
response to the sight of my blood) and suffered a 10 minute long seizure after
passing out. So, I spent the next few days doing EEGs and MRIs on my noggin.

There was nothing definite but the neurologist noticed some lesions on my
brain in various places. First thing he asks me, "Did you play football as a
child?" I said yes, and he said, "You should have an MRI at least every 5
years to see if these things get any bigger."

Recently, my memory has gotten worse. I've found myself rocking or nodding my
head for no discernible reason. Control over my lower legs is variable. As a
runner, I'm fairly in tune with my body. I can tell that things are not going
as they should.

Who knows if I'll get CTE (or some other neurological problem) and if I do, if
it's related to the 10 years of football I played. What I do know is that this
experience is not one I'd want my children to have when it's most decidedly
not necessary.

All that to say that there might be a LOT of people like me in the US who
never even got close to college football or the NFL that could potentially
suffer this same fate.

~~~
LeifCarrotson
Has helmet technology improved in the last 25 years? It will be a few years
before my son could play tackle football (and I would probably try to gently
steer him towards real football), but the helmets I see at sporting goods
stores today look pretty much indiscernible from that which I wore for one
fall season in the early 2000s.

~~~
kendallpark
Helmet technology has improved but not at the rate that humans have improved
weightlifting/training. You've got bigger people running faster into
collisions (and as we all know, momentum = mass * velocity).

------
danso
There's always been the possibility of selection bias in finding CTE in
football players' brains. Many of the brains are studied at the request of the
family of the deceased player, presumably because they had noticed symptoms of
mental degeneration. And there are cases where the player themselves requested
the scans in their will. Junior Seau didn't leave behind a suicide note, but
he did kill himself in a way that left his brain physically intact.

The NYT piece notes that even if _none_ of the other ~1,300 NFL players (who
have since died since this research began) have brains affected by CTE, "the
minimum C.T.E. prevalence would be close to 9 percent, vastly higher than in
the general population.".

~~~
rory096
Isn't that still selection bias? Presumably CTE sufferers have a higher risk
of dying — their healthy peers may still be alive and thus not included in
that 1,300.

~~~
FanaHOVA
The NFL isn't a 10 years old league, there's plenty of players who passed
away. If anything there would be more examples since equipment was worse
before and there were less rules that protected players, especially top/crown
helmet leading tackles which started getting penalized with 15yd only in 2013.

~~~
hervature
I think the prevalence of concussions in football compared to rugby is proof
that "better equipment" doesn't prevent concussions. It has the paradoxical
effect of causing them. Better shoulder pads allow for people to launch their
bodies without fear of separating their shoulders. Conversely, helmets are not
designed to protect the brain, only to prevent skull fractures. Thus, I don't
think your argument holds water.

~~~
FanaHOVA
You are right about the equipment (even though obviously only concussion vs
concussion + skull fracture is a step forward!), but the difference between
football and rugby goes way beyond the equipment. In the former there's no
lateral passing, which means that the ball carrier will always be a target for
the whole defense. In rugby you can pass the ball, which makes the defense
spread wider and doesn't allow them to overcommit to a single player/tackle.

~~~
treehau5
Precisely. In rugby, it is much more stressed and emphasized to make _secure_
tackles.

In football, at any given point and time there is one person with virtually a
huge bullseye on them and it is sometimes a valid tactic to lay down a more
punishing hit (cause a fumble, make a statement, scare your opponent to make a
mistake or drop the ball next time, etc) at the expensive of not making a
"secure, form tackle"

Ironically, if I am remembering correctly, the Seahawks and coach Pete Carroll
teach more of a "rugby" style tackle, and that's why they consistently have
one of the best tackling defenses.

~~~
kendallpark
I've played both sports, can verify this is 100% correct. Couple other notes.

Football is a game of inches. There is huge incentive to slam someone as hard
as you can to stop their forward progress and ultimately deny the first down.
There's incentive for the ball carrier fight for the inches and "fall forward"
(which makes your head more vulnerable). In rugby you don't care about
fighting for the inches and hell, your teammates will shove you down once
they're set up to ruck over you. Fighting for inches in rugby is a quick way
to start a maul _and nobody wants a maul_.

Furthermore, football is played with greater momentum (mass * velocity). Those
breaks between plays equates to six seconds of full blown sprinting followed
by forty seconds of rest. In rugby you're running about constantly so you
simply don't have the energy most of the time for those massive hits. As for
the mass side of the equation, football players are on average bigger than
ruggers.

People think rugby is so hardcore for playing without pads (and it still is)
but the hardest hits I ever took were in football (and I played defense, for
goodness sakes). This is the consensus between everyone I've met that's played
both. You can play multiple rugby games in a weekend (happens all the time at
fests) but more than one football game a week is unsustainable.

------
alistproducer2
Historians will look back at American Football as our analog to the Roman's
gladiatorial games. A lot of people don't realize that during the Imperial era
of Rome fights to the death had become uncommon.[0] The games were watched in
an arena and primarily sold hard-hitting violence between members of the lower
castes of society and sometimes people got killed or horribly maimed....sound
familiar? I stopped watching American football last year once I could no
longer consciously watch men destroy themselves for money and the amusement of
a country that largely despises/fears them in any other setting.

0:
[https://en.wikipedia.org/wiki/Gladiator#Victory_and_defeat](https://en.wikipedia.org/wiki/Gladiator#Victory_and_defeat)

~~~
dsfyu404ed
There's a big difference between cheering on people killing each other and a
popular sport remaining popular after the long term consequences became known.

~~~
alistproducer2
I don't feel like you read my comment before posting.....

------
pcl
I don't really know what a normal brain looks like. A sidebar (middlebar?)
about halfway through the article describes what we're looking at:

 _The trauma of repetitive blows to the head triggers degeneration in brain
tissue, including the buildup of an abnormal protein called tau. Thin slices
of tissue are dyed and the tau shows up as these darker areas._

~~~
waynecochran
Yes. The site needs to show a normal brain. I don't have anything to compare
to. Really bad omission.

------
jessriedel
So the punter had CTE too? And all the quarterbacks? Obviously these players
can get concussions, but don't we expect them to have a much lower rate of
repeated, sub-concussive impacts that are supposed to result in CTE?

(They don't say so, but 110 of 111 were diagnosed, and if the only brain
tested without it was the punter I can't imagine them not emphasizing that. I
don't think this conflicts with the family's request to not identify the
player.)

Presumably there is some sort of way to quantify the extent of disease besides
yes/no. I'd really like to see the the extent vs. player position. Is there a
write up for this, or was it a direct to NY Times deal?

Look, football is a violent sport, and it's certainly plausible that this
induces a chronic, difficult-to-detect but serious disease over years of
playing, and that the organization making billions from it would fight against
that conclusion. But it's hard to square the smugness and outrage in this
thread with the observation that NFL players have a lower rate of all-cause
mortality than the general population.

[http://www.nytimes.com/2012/05/09/sports/football/nfl-
player...](http://www.nytimes.com/2012/05/09/sports/football/nfl-players-live-
longer-than-men-in-general-population-study-says.html)

Obviously that's consistent with the NFL having a significant net-negative
impact on the health of athletes, who are a special sub-population that is
likely to be of above-average health. (Although note that the average body
weight of their pool is also very high, which would almost assuredly still be
true even if they hadn't played, and that increases baseline death rates from
things like heart disease.) And that impact could be so negative as to
outweigh the benefits of playing, possibly necessitating rule changes,
compensation, etc. But there is no ghastly epidemic of NFL players dying by
the droves.

I don't think there's been a neurological performance test of retired players,
but one will probably be done and I'm willing to bet that NFL players again do
better than the general population (which, again, does not mean that playing
in the NFL doesn't make you dumber). Anyone want to bet against me?

~~~
jessriedel
Ahh, found the actual paper:

[http://jamanetwork.com/journals/jama/fullarticle/2645104](http://jamanetwork.com/journals/jama/fullarticle/2645104)

Incredibly, they list the number of each position type who have mild and
severe CTE (their only degree of gradation) but apparently don't list the
total number of players at each position, and hence I can't tell how many
brains didn't have CTE by position. Nonetheless, we can confirm that both the
punter and placekicker were diagnosed with mild CTE (a placekicker!) and the
severe:mild ratio was _higher_ among quarterbacks than lineman (11:2 for QBs
vs. 29:8 and 27:8 for offensive and defensive linemen respectively).

------
dnautics
Is no one curious about the one brain that didn't get CTE? there could be some
insight into how to prevent Alzheimer's for example, since oxidative
inflammatory responses are invoked in both conditions as a possible mechanism.

------
jonbarker
I'm more interested in what happens to the brain with youth soccer. Bigger
problem than a couple hundred pro athletes.

~~~
bhouston
I agree. Heading soccer balls is proven to at least temporarily reduce IQ.
I've never let my kids play that sport.

[https://www.washingtonpost.com/news/to-your-
health/wp/2016/1...](https://www.washingtonpost.com/news/to-your-
health/wp/2016/10/25/heading-a-soccer-ball-causes-instant-brain-changes-study-
finds/)

[http://www.cnn.com/2017/02/01/health/soccer-headers-
concussi...](http://www.cnn.com/2017/02/01/health/soccer-headers-concussion-
study/index.html)

~~~
nugget
So what are the safer competitive team sports for kids to participate in?

~~~
logfromblammo
Ironically, thanks to the potentially lethal weaponry used as equipment,
archery and target shooting.

Swimming is also relatively safe. Distance running might result in repetitive
stress injury, but it won't kill you.

Slow-pitch softball eliminates most of the risks from baseball. Hit by pitch
and RSI from pitching are the dangers there.

Cycling removes some of the RSI risk from distance running, but replaces it
with higher-speed impacts, usually into hard surfaces.

Edit: It depends on your definition of "team sport", really. If you define it
such that you can't meaningfully separate out any individual performances,
you're cutting out all relay-type competitions from the start. If you say
archery is not a team sport, then neither is a swimming relay race. Where do
you draw the line? What's the minimum number of participants that have to work
together to qualify as a team?

~~~
ouid
not really team sports though.

------
socrates1998
The bodies were all donated with the vast majority of them having symptoms of
CTE while they were alive.

Essentially, it's not even close to a representative sample of former NFL
players.

It would be the same as people who had knee problems, then were found to have
arthritis in their knees after an autopsy.

I would be very careful to say that all (or almost all) NFL players will have
CTE when they finish football.

I have seen more research on people's brains where they categorize them in two
types, ones that recover from brain trauma and others that don't. For me, that
seems more likely.

If you are an NFL player with the type of brain that recovers well, you
probably will be fine later in life. If you have a brain that just doesn't
seem to do well with that, then you could develop CTE. That would be my guess.

------
drtillberg
The JAMA data tables [1] also covered military service, with a high incidence
of CTE there (5 mild, 45 severe). Both of the kicker/punters in the study also
had mild CTE (did they kick with their heads?). Really leads to wonder about
the prevalence in the general population, for sport and laborers at large, in
addition to football players. The average years of play was 15.1, which is a
_really_ long time to play the sport.

The authors are playing to a theme here, rather than objectively reporting
results.

[1]
[http://jamanetwork.com/journals/jama/fullarticle/2645104](http://jamanetwork.com/journals/jama/fullarticle/2645104)

------
autokad
i wish they would outlaw head slapping, from teammates. when i played hs
football, after every play, players would slap teammates on the head (usually
the back) to show support - i hated it.

i also think players are too big today, more weight at higher velocities only
makes things worse for the head. the only reasonable thing I can think of is a
'salary cap' based on player weight as well.

------
pavement
Chronic Traumatic Encephalopathy in American football has been getting lots of
media attention over the past few years, and the counterpoints to whether or
not this is a serious issue will rely mostly on emphasizing the survivorship
bias of those who enjoyed a high quality of life despite possibly (or
assuredly) suffering such injuries, but in many ways almost all athletic
sports represent feats of corporeal risk to the player, and I don't think the
face of the game, or its popularity will change very much.

In many sports, people face death itself, and pay the ultimate price for
competing. CTE, while made plain by studies such as this, might only change
youth and amateur level competition. Professional leagues will probably
continue apace, even amid full disclosure of well-known hazards.

This particular hazard wasn't previously well understod, but now it is, so,
like boxing, it's still an improvement to the sport, to have players enter
competition properly informed of the risks they are undertaking, so that they
understand the choice they are making when they decide to play this game.

tl;dr The point of any given sport is usually to step into harms way, on some
level, in a controlled arena and to test your abilities against other people
in a contest of skill and endurance. That's how this works.

~~~
jordache
>might only change youth and amateur level competition. Professional leagues
will probably continue apace, even amid full disclosure of well-known hazards.

You don't see a direction link between the grassroots levels to the pro level?
If you kill the interest, or participation at the grassroots level, there will
never be a compelling pro league to source from.

Good riddance to a lame game of consisting of mostly low skilled athletes

~~~
CoffeeDregs
Football is only 5th on this list of dangerous sports:
[https://www.thetoptens.com/most-dangerous-
sports/](https://www.thetoptens.com/most-dangerous-sports/) The real issue is
that football trauma has effects over longer time periods and the long term
effects are discounted in the near term.

>Good riddance to a lame game of consisting of mostly low skilled athletes

Having played up to college, it's tremendous fun and has roles for a range
skillsets. While not necessarily very intelligent, everyone is very skilled.

~~~
paulcole
Is there any data behind that clickbait link?

~~~
duskwuff
User votes. Beyond that? No.

------
thomyorkie
As someone who played 3 years of football in middle school and 3 years in high
school and sustained 2 concussions along with tons of sub-concussive hits, I
just hope that by there will be a cure for CTE sometime in the next few
decades. Crossing my fingers for Johnson's Kernel or Musk's neural lace to
succeed.

------
m3kw9
Head gets hit repeatedly. That's the most complex and delecate organ in your
body. I don't know live appendages that can take hits repeatedly without any
long term side effects. Money talks in the NFL, so as long as that gets passed
around, they are not taming it down unless the govt steps in

------
hamburglar1
the 110/111 stat is incredibly misleading. The article even says that "many
families have donated brains specifically because the former player showed
symptoms of C.T.E.". Its unfortunate that the NYTimes sentimentalizes like
this. I think it's pretty clear that football causes C.T.E but the title and
lead 110/111 statistic is dangerously disingenuous.

------
aezell
If we really want to determine how dangerous or unhealthy football is, we
should consider the full picture.

As part of this thought exercise, let's take as a given that CTE doesn't exist
and brain injuries are unimportant.

After that, let's look at the prevalence of diabetes, heart disease, and other
long-term degenerative diseases in the NFL player population.

Then, let's look at the shortened earning potential of the NFL player. Yes,
for a year, maybe more, they are highly paid but lifetime earnings might not
be what you'd expect. How do the stresses of many men who leave the NFL with
no skills and often an abandoned college degree affect them and their
families?

Next, let's consider the lifestyle the NFL envisions for its fans. Spending at
least a full day each week sitting and eating unhealthy food while consuming
alcohol. Spend the rest of the week gambling on the outcomes of the games (or
individual players). Much of the time, this fandom is done as a family leading
to impacts on children in the home. There's a societal health impact here.

The list goes on if we follow this thinking. So, if we go back and remove our
given, we end up with a spectacle that unduly endangers its participants,
encourages unhealthy behavior in its fans, and indoctrinates our youth to be
accepting of all the above. Meanwhile, a very few wealthy families get even
wealthier on the backs of all that.

~~~
2bitencryption
I agree with your early points, but I don't think we need to take the typical
Hacker News stance of "everything is killing everybody and people need to
start behaving more like me and less like themselves."

> Next, let's consider the lifestyle the NFL envisions for its fans. Spending
> at least a full day each week sitting and eating unhealthy food while
> consuming alcohol. Spend the rest of the week gambling on the outcomes of
> the games (or individual players). Much of the time, this fandom is done as
> a family leading to impacts on children in the home. There's a societal
> health impact here.

Won't somebody please think of the children! They might grow up to watch
FOOTBALL!!

~~~
aezell
That wasn't my stance. My stance was one of examining the full societal cost
of any activity. Football is certainly not alone in the impacts it has on
families. It's just the one we are talking about in this forum.

But, if one is seriously trying to determine sociological trends, these are
the kinds of questions one must examine. It might be a similar line of
thought, with different details, for the increased use of digital devices in
our society.

Lastly, you're being facetious but their watching football might well be part
of the problem. Without participants or an audience, the NFL ceases to exist
thereby removing the negatives AND positives that its existence might create.

------
andrewsyc
As much as I love boxing and other sports, they are terrible for one's brain.
The worst thing one can do is cause any damage to your brain as that
dramatically effects quality of life.

------
hyperion2010
This study was made possible because of autopsies. If autopsies were standard
practice in the US this would have been discovered years, if not decades ago.

~~~
djohnston
Even if autopsies were standard practice for all Americans you wouldn't see
docs running tau-staining tests on every cadaver they received.

------
Ethereum
Do we have any idea what the baseline incidence of CTE, using the same
criteria used in this study, might be in the general population?

~~~
jessriedel
Apparently not. The criteria for what counts as evidence of CTE is still being
fleshed out, at least as of 3 years ago.

> The neuropathology of CTE is increasingly well defined. In 2013, McKee and
> colleagues published the largest case report to date of individuals with
> neuropathologically confirmed CTE, presenting proposed criteria for four
> stages of CTE pathology based on the severity of the findings [9••]. Formal
> validation of the reliability of these criteria and the staging system are
> currently being performed by a team of nine neuropathologists, funded by a
> National Institutes of Health (NIH)

[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4255271/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4255271/)

------
ZooAgent
Well that's a big surprise. But the NFL is a gigantic cult, people are not
going to boycott it just to improve the well being of the gods players.

------
et2o
The prevalence of CTE in the NFL brains is irrelevant until we can compare it
to the prevalence in the general population. And the issue is it's being more
closely examined in the NFL brains currently. General population prevalence
estimates are likely underestimated.

~~~
chasing
From the article:

"So even if every one of the other 1,200 players would have tested negative —
which even the heartiest skeptics would agree could not possibly be the case —
the minimum C.T.E. prevalence would be close to 9 percent, vastly higher than
in the general population."

Where are you getting your information that estimates of CTE in the general
population are low?

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et2o
CTE is a post-mortem phenotype. Dementia related to degenerative brain disease
is common but not often measured (autopsies aren't done very often for senile
patients with an obvious cause of death, especially for autopsies that
disfigure the skull).

The idea that <9% of the general population at death have degenerative brain
disease is highly implausible. Especially since we know AD has a prevalence
which is multiples of 9%. Of course, I am not claiming CTE is not a problem in
contact sports; merely that this headline is ridiculous. It's more important
to estimate an odds ratio and confidence interval for the point estimate. My
back of the envelope estimate for the OR would be ~3 (still concerning and
large!).

There are related common problems in my field of biomedical research. I am a
published author in Alzheimer disease, although it is no longer my primary
focus. :)

~~~
richardwhiuk
"The idea that <9% of the general population at death have degenerative brain
disease is highly implausible. " If you consider dementia explicitly, than the
epidemiology suggests a potential rate as high as 20-40% - which is much
higher than the lowest possible CTE rate.

(In fact, it's possible that all CTEs diagnosed in this report would be
classified as purely dementia in the general population).

~~~
et2o
Yes exactly.

I also think the general population prevalence estimates for dementia are too
low, for reasons not worth going into here.

