In 2017, the headline from The New York Times rocked the sports world: “111 N.F.L. Brains; All But One Had C.T.E.” For many, an examination by Boston University’s CTE Center became the last bit of evidence needed to show that playing football and developing the neurodegenerative disease were certainly linked.
Not so fast.
Merril Hoge and Dr. Peter Cummings, a former NFL player and a forensic neuropathologist, respectively, argue in an op-ed and in a new book titled Brainwashed: The Bad Science Behind CTE and the Plot to Destroy Football that the methodology in the study that the Times reported on was questionable at best. They say that drawing conclusions on football’s safety based on a flawed study is problematic.
Among the duo’s critiques of the 110-out-of-111-brains study are that it did not have a control group, it displayed selection bias by utilizing brains donated by families who showed symptoms of CTE, and that there was no attempt made to account for other possible factors for the condition of the donated brains.
“Good research design requires a control group against which findings can be compared,” they state in the op-ed. “In this case, the control group could have been brains from 100 athletes from sports other than football, brains from 100 men who had never played contact sports — any cohort that would have allowed the researchers to determine whether men of a certain age who hadn’t played in the NFL also showed signs of CTE. For some reason, this study didn’t have that.”
“If you only look at brains from people who seem to have neurological problems, don’t be surprised when you find signs of those problems,” they continue, explaining their second point. “A better approach would have been to randomly examine brains from some ex-players who exhibited mood, cognitive or behavioral issues as well as from some who didn’t. But this study didn’t do that.”
Finally, to explain their final point, they write “...nearly half the players had a history of substance abuse, suicidal thinking or a family history of psychiatric problems, but these were offered as possible results of CTE, not as possible independent causes of mood, cognitive or behavioral disorders.”
Despite their qualms with the study, Hoge and Cummings were quick to say that they aren’t denialists when it comes to CTE, nor about the potential dangers that repeated hits to the head could pose. They advocate for more research and data, and want to broaden CTE research beyond just the sport of football.
“Let’s do science they way science is supposed to be done, and then act on that information, rather than on fear,” they write.