I like Phil's methodology. I sent an e-mail to the Journal, questioning the data, and I sent a cc to the Listserv. Perhaps it did not get through, so I'll try to attach it here. Anyhow, I received a short "thank you" for the Journal, indicating that they would be responding "soon." We'll see. October 15, 1998 To the editor: I am writing to request clarification of statistical data presented in The New England Journal of Medicine 1998;339:1105-1111, an article entitled "Brain Surgery Helps Severe Parkinson's." The reason this is an important issue to those of us with Parkinson's is that data like these, promulgated by such a respected journal, has a way of becoming accepted by those dealing with it. In our case it can be used to sway political decisions regarding government research funding. The article states: "About 7 million people around the world have Parkinson's disease, which usually strikes after age 60, causing progressive tremor, muscle rigidity and other movement problems." First, what is the source for a PD population of 7 million "around the world?" If, as is frequently stated, up to 1.5 million have PD in this country, with a population of only 290 million people, how can there be only 7 million with the disease in a world of about 6 billion people? About 4.5% of the world's poulation has 21.4% of the world's Parkinson's population? Second, what is the source for the conclusion that Parkinson's "...usually strikes after age 60." All these years, based primarily on personal observation, I had thought that the oft-repeated average of 57 AT DIAGNOSIS was far too old. Now we are told that the disease STRIKES "after age 60." Clearly, I and most everyone I know with the disease must have been preemies. I was diagnosed at 57, but I now know that the disease had "struck" - atrophy of right bicep, cold hand, stiff and sore fingers - at least seven years previous. We look forward to receiving your reply. Sincerely, Bob Dolezal Parkinson's Advocate At 9:42 AM 10/16/98, Phil Tompkins wrote: >robert l dolezal, who has sharp eyes, wrote: > >> ... but where did these guys come up with a PD population of 7 >> million "around the world?" .... for starters, if up to 1.5 million >> of us have it in the U. S. of A., with a mere 290 million people, >> how can there be only 7 million with the disease in a world of >> about 6 billion people? > >Well, it's an improvement over the World Health Organization's >3.6-3.7 million total, based on a world prevalence percent of .07 >that they came up with! - see > >www.who.int/msa/mnh/ems/rates/parkinso.htm > >This got me going, so I looked up some of the many population >numbers that the US Census Bureau provides on-line, and found this: > >The US has 4.6 percent of the world's population (265 million out >of a world estimate of 5.77 billion in 1996). But in the prime >PD age bracket of 45 years old & up the US has 6.6 percent (83 >million out of an esimated world total of 1263 million), and 7.8 >percent of people 65 and up. > >Using the 45 and up age bracket and assuming (and I have no right to >such an assumption) a uniform world prevalence rate and 1 million >PWPs in the US, that would give about 15 million PWPs worldwide >(plus or minus some big error amount) as a very rough ballpark >figure, which should perhaps be reduced a bit owing to a somewhat >shorter life expectancy in the non-industrialized world. > >Phil Tompkins >Hoboken NJ >age 60/dx 1990