Day 252 - 20 May 96 - Page 26


     
     1
     2   Q.   Yes, I thought it was ten but it may not matter?
     3        A.   Well, let us say it was ten.  That does not mean that
     4        the range is 155, going from 145 to 165.
     5
     6   Q.   I see.
     7        A.  The range, in fact, is much greater than that.  This
     8        measurement here is a standard deviation which is arrived
     9        at by a very complicated mathematical procedure, but it is
    10        not simply a range of values.  So that a standard
    11        deviation, if we looked at the figure I quoted earlier, 9.7
    12        plus or minus 7.5 you could have a range of values from 2
    13        to 18 which would give you a standard deviation of 7.5.
    14        So, a high standard deviation like this indicates a huge
    15        spread of values.  In other words, the 5 subjects were
    16        behaving in very different ways.
    17
    18   MR. JUSTICE BELL:   That is 20 I think, in that one?
    19        A.   Yes.  Yes, that was in the other study there.  We have
    20        moved on to the second one now.
    21
    22   MS. STEEL:  The table is of measurements made after both groups
    23        had been given a high fat meal?
    24        A.   Well, it is the same -- wait a minute, the table
    25        itself refers to what are called baseline measurements.
    26        The 20 subjects were all given the sensible diet and then
    27        measurements of blood lipids were made and these other ones
    28        that are in the table.  They were then, after that, given
    29        the high fat diet.  They do not tell us what interval
    30        elapsed between the two.  I have to assume that one study
    31        immediately followed the other but, I mean, one could have
    32        been conducted in the middle of summer and one in the
    33        middle of winter on the same 20 subjects.  It is probably
    34        unlikely, but we simply do not know what is in the paper.
    35
    36        So, the same 20 people were subjected to the two dietary
    37        treatments one after another and before they were given
    38        this dose of fat a blood sample was taken and these are the
    39        measurement that we see here.  So, these measurements are
    40        the response to having been on a healthy diet or a high fat
    41        diet for a month, and I am surprised that there are not
    42        greater differences, but the differences are very small and
    43        they are not statistically significant.
    44
    45   Q.   So you, from your reading, think that these measurements
    46        were taken before they were given the oral fat load?
    47        A.  Yes, that is what it says in the paper.  That these
    48        were the baseline values.  What happened after that is
    49        stated underneath there, and they only consider one of the
    50        variables which is the triglycerides factor.  As I said 
    51        before, changes in triglycerides were not thought to be 
    52        involved in the atherogenic process and that is why in the 
    53        COMA report they are not mentioned.
    54
    55   MR. JUSTICE BELL:   Can we just pause for a moment.  I would
    56        like to look at that again.
    57
    58   MS. STEEL:  I think the witness is wrong.
    59
    60   MR. JUSTICE BELL:   I have just looked at Dr Miller's letter

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