W.O.W.’s 11/08/13 and 11/13/13-Survivorship Bias and Selection Bias

On Friday 11/08/13 I did the following WOW supervised by all 3 trainers at UE (Joy!).

MedX Compound Row with SS retrofits (starting with entire stack, then 360, 240 then 140-part of my demo to Ed)

Nautilus Pullover with SS retrofits

SuperSlow Systems Pulldown

SuperSlow Systems Neck Extension

Lumbar Extension via Romanian Deadlift

Then today (111/13/13) I went to Fike and did “shoulders”.

Dumbell Front Raise

Dumbell Bent Fly

Dumbell Lateral Raise

Barbell Overhead Press

Dumbbell Shrug

I have really enjoyed reading over the last WOW’s comments.  People of opposing viewpoints have challenged each other in meaningful ways and the discussions have been enlightening for me.  There have also been several examples of logical fallacies/cognitive errors.  I am not going to name names, since we all do it.  I am especially guilty of many logical fallacies (the sunk costs fallacy and cognitive dissonance have cost me more time in my life than I care to admit).

One of the logical fallacies that keeps appearing in the threads is one that is rampant in the fields of fitness and success.  The fallacy in question is that of Survivorship Bias.  Survivorship bias is the marketing that underpins P90X, Crossfit, as well as magazines such as Fortune, Success, Forbes and biographies of successful businessmen and athletes.  A very popular fitness fad that I have lost clients to (who later came back) are Fitness Boot Camps. These camps fashion themselves after boot camps or Navy Seals physical training camps.  These programs actually accrue some impressive results that are then heavily advertised.  The assumption is that the training was clearly responsible for the results.  What the Navy understands that the lay public does not, is that BUDS Hell week is not done to produce a given degree of conditioning; it is done to weed out.  Those that cannot recover and perform, or who become injured, ring the bell and go home.  Those who can recover, adapt, or even thrive make the cut.  But the boot camp did not make them that way, it was just a way to separate the wheat from the chaff.  The same can be said for programs such as Gym Jones, Crossfit, Insanity or P90X, which is why such programs are so popular amongst Everest-summiting mountain climbers, ex-special forces soldiers or SWAT team members. The fact that they succeed in something so tough only seems to reinforce their sense of superiority and group identity.  This luster of superiority is also what attracts those who ultimately don’t survive.  They too hope that they can forge elite fitness in the crucible of a boot camp that they pay to attend.  These are the folks that are hospitalized with rhabdomyolysis, tear their rotator cuff, herniate a disc or simply get tired of tearing their skin off on a plyo box.  Those that survive are those with the physical attributes that we would all like to have, and they become great spokespersons for the movement.

In medicine survivorship bias drives the use of one of the most marketed therapies in the history of medicine:  the administration of Tissue Plasminogen Activator in ischemic strokes.  The trial that launched this therapy was the NINDS trial.  In the trial those given TPA for their strokes ended up showing better neurological outcomes at 3 months than those who received only aspirin and supportive care.  The thing that was not acknowledged in the conclusions of this study were that results could only be measured in survivors.  If you looked at all patients (including those that died), you found that those who were sicker and got TPA were much more likely to die of fatal brain hemorrhages.  Thus, in the TPA group the sicker patients died leaving on the less sick to be measured for function at three months whereas those in the control group had to include the more severe strokes along with the less severe ones which made their function at 3 months look worse.  Now we see every hospital vying to be a “Stroke Center” and advertising with billboards that say “Time is Brain”.  The survivorship bias that launched TPA for stroke was further reinforced by Confirmation Bias.  Many times a patient presenting with major stroke symptoms will have spontaneous resolution or migration of a clot, or collateral circulation will find an alternate pathway to the area of the brain being deprived of its blood supply.  It is not uncommon to see a patient who is completely paralyzed and aphasic return completely to normal in a matter of minutes to hours (in which case it is called a Transient Ischemic Attack or TIA).  Many a neurologist has recounted stories of pushing TPA and then seeing a miraculous return to normal causing them and the patient’s family to credit the miracle drug.  I cannot tell you how many times I have seen a patient return to normal just seconds before the order to give TPA was carried out.  Just a few seconds made the difference between a diagnosis of TIA versus the actions of a miracle drug.

When I was researching the topic of survivorship bias I came across a website devoted to the subject of cognitive errors (www.youarenotsosmart.com).  In its very lengthy article on survivorship bias it told the story of a group of mathematicians who worked for the DoD during WWII who were asked to evaluate how to decrease the losses of B-17 bombers.  On a given bombing mission up to 50% of the planes would not return.  Crew members called themselves “already ghosts”.  Commanders of the Army Air Force had surveyed the damage of returning bombers and found that most of the bullet holes were in the wings, around the gun turret, and along the center underbelly.  Army Air Force officials had suggested that extra armor be installed at these locations.  Since weight was a critical issue, armor had to be used where it counted.  The DoD mathematicians intervened however and pointed out that these locations are exactly where you did not want to place the extra armor because you were analyzing the planes that survived.  These bullet holes represented where a plane could be shot and expect to survive.  Fortunately, the mathematicians prevailed and bomber crew mortality dropped significantly throughout the rest of the war.

In a similar vein, it is all too easy to observe Ken Hutchins (or other such personal training center) train clients over the years and note how few impressive physiques have been produced.  However, one must consider what kind of client has been serviced.  How might survivorship bias and selection bias skew our point of view.  A personal training center that offers a protocol with an emphasis on safety, in a clinical and private environment is very likely to draw from the very population that did not survive (or would never attend) a boot camp or hard-core bodybuilding gym, or crossfit “box”.  Further if the proprietor was famous for his involvement in The Osteoporosis Study, what kind of client do you think might show up at the door and how selection bias may have more to do with perceived physique outcomes than any protocol or approach itself.  Perhaps this is why a studio in Ohio, using exactly the same protocol, but is owned by a bodybuilder has a whole stable of successful bodybuilders and fitness competitors to point to.

For anyone new to BBS coming to read this blog, a 400+ comment thread may seem overwhelming and may suggest that BBS principles may be in question.  What must be realized is that exercise investigation is actually quite primitive, and those that have access to funding and resources do not understand the issues as well as some of the commenters on this blog.  What we are therefore stuck with is trying to make sense of our observations through the fog of cognitive bias that is part and parcel of the human brain.  Like any field, this one is filled with history.  Some of that history is good and grand.  Some of that history includes people that may have been (or felt that they were) betrayed or somehow thrown under the bus.  Once those lost opportunity costs are factor in, these cognitive biases can be put on steroids.  However, open discussions that get heated and run 400 posts are how refinement and discovery get made, and as long as everyone remains respectful, perhaps we can shore up the plane where it counts.  Like the Beastie Boys say about New York: “On the number 10 bus we fight and fuss, you know we’re thorough in the buroughs because that’s a must.”

A video called the Texas Sharpshooter illustrates Jeffrey’s points on bias


478 thoughts on “W.O.W.’s 11/08/13 and 11/13/13-Survivorship Bias and Selection Bias”

  1. I agree 100% with you Marcph. This article explains why that generation will avoid HIT and train more like you!

    The Worst Generation

    By Brian Moore

    “Gen Y workers get a bad rap in the workplace, with many a geezer complaining that their work ethic is less developed than their sense of entitlement. But is that really fair?

    Yes, according to new research that’s yielded actual data to back up that notion.

    In a series of studies using surveys that measure psychological entitlement and narcissism, University of New Hampshire management professor Paul Harvey found that Gen Y respondents scored 25 percent higher than respondents ages 40 to 60 and a whopping 50 percent higher than those over 61.

    In addition, Gen Y’s were twice as likely to rank in the top 20 percent in their level of entitlement — the “highly entitled range” — as someone between 40 and 60, and four times more likely than a golden-ager.

    Harvey’s conclusion? As a group, he says, Gen Yers are characterized by a “very inflated sense of self” that leads to “unrealistic expectations” and, ultimately, “chronic disappointment.”

    And if you think the Gen Yers in your workplace are oversensitive as well as entitled, Harvey’s findings back that up, too. Today’s 20-somethings have an “automatic, knee-jerk reaction to criticism,” he says, and tend to dismiss it.

    “Even if they fail miserably at a job, they still think they’re great at it.”

    Of course, to be fair, there’s another stereotype about Gen Yers. They may be high-maintenance, but they’re committed and idealistic, and determined to do work they believe in. A fair estimation?

    No, according to another study, which will be published in the Journal of Management in September. Co-author Stacy Campbell, an assistant professor of management at Kennesaw State University, says the study revealed that when it comes to work, the two things Gen Yers care most about are a) high salaries, and b) lots of leisure time off the job.

    “They want everything,” says Campbell. “They want the time off. They want the big bucks.”

    To reach their conclusions, Campbell and co-author Jean Twenge — a professor of psychology at San Diego State and author of “Generation Me,” a book examinning discontent among members of Gen Y — worked over the data from an ongoing survey of high school students conducted annually since 1975 by the University of Michigan. Among their findings was that while both Gen Y and Gen X want sizable salaries, Gen X workers show greater awareness that a hefty paycheck comes with a hefty workload.

    “The findings really support the idea that they’re entitled,” says Campbell.

    All this leads to a question: Where exactly does this tsunami of privilege come from? As Harvey puts it: “We’re wondering, how do they end up like this?”

    The answer, he thinks, can be found in a reworking of the children’s song “Frere Jacques” that he once heard elementary-school students sing. Instead of braying the original French chorus, the kids instead sang, “I am special/I am special.”
    Entitlement “gets ingrained in the formative years,” says Harvey. “It stems from the self-esteem movement, telling kids, ‘You’re great, you’re special,’” he says.

    Echoing the findings in Twenge’s “Generation Me,” Harvey says the “ultimate irony” of jamming unwarranted notions of self-worth into youngsters like corn down a goose’s throat is that it has the unintended effect of higher rates of depression in Gen Y.

    “You see high levels of disappointment,” he notes, adding that unwarranted self-esteem acts as a shield until the ugly truth intrudes.

    Recognizing that is easier than fixing it, he says, noting that excising entitlement from the minds of Gen Yers can be a daunting task. It was thought that giving entitled Gen Yers small bits of feedback a la their beloved Twitter might do the trick, but one study found that approach actually made the problem slightly worse, says Harvey.

    The quandary is one that both Gen Yers and their employers will eventually have to confront as Gen Y increases its presence in the workplace, says Campbell, adding that each will have to meet the other halfway.

    If not, there’s calamity brewing.

    “There’s a chance we’re going to have a group of disappointed and disgruntled employees,” she says. “Surely there could be a crisis if no one budges — where Gen Y says, ‘I want everything,’ and the company says, ‘You’re not getting anything.’”

  2. WOW

    TBDL I do this twice monthly

    Remedial shoulder work


    J C Curl challenge ; It’s now 12 weeks since I started this NTF micro-loading experiment, today up another 1lb… 11lbs in total, and at last some measurable growth, measured before today’s wow,………1/8″ Don’t laugh this is actual solid growth. For some one who has been training for a long time I am pleased. Diet / b/weight has remained pretty much constant, Paleoish (apart from a couple pints of draught Guinness most Saturday’s) Probably “only ” about 60 – 70 gms protein per day (I’m 210 lbs, All my experience strongly suggests to me that if the body wants to grow it will find what it needs from almost any reasonable diet…..I have seen some pretty impressive physiques built in parts of the world where we would say the diet was inadequate, and even taking into account genetics and selection bias I still believe this.

    Thanks again to Marc and his promotion of R/B’s… If you get your creative head on there are really useful strategies apparent with them. I am travelling for 8 weeks soon (unfortunately this interrupts the curl challenge) and will be taking a couple with me together with my home made suspension trainer….So no shortage of training opportunities

  3. Marc Pharmacist,
    Maybe generation y will be computer nerds who drink coffee and energy drinks all day and consider that fitness.Lol

  4. Patrick says:

    November 29, 2013 at 10:20 pm

    I agree 100% with you Marcph. This article explains why that generation will avoid HIT and train more like you!

    The Worst Generation

    By Brian Moore


    I am not very interested in anyone’s negative viewpoint of a group of people. I’m more interested in how to market fitness to this group. Would you have and creative ideas of your own to enable such a marketing effort?

    Further, to eliminate any confusion about my training, I’ll take a little time to clarify. Intensity, load, and force most likely trump everything in anaerobic weightlifting. I practice the highest intensity possible, from the very beginning of exercise, with as much load possible, and with as much force as safely possible. Dynamic loads with resistance bands, negative-only loads, standard reps, and isometrics are all done with intensity in mind. I consider other methods where load, force, or speed are sacrificed for whatever reason(s) to fall short of the definition of intensity. On the other hand, high effort training is not something I’m interested in, as I believe this high effort training is similar to the efforts wasted while doing aerobics.

  5. Generational stereotypes are a fun topic, but perhaps not all that valuable.

    It is interesting that the rise in the popularity of things like Crossfit, P90X, Zumba, and Insanity coincide with the arrival of Gen Y. I’m tempted to conclude they like high effort training in a social setting.

    Perhaps, like previous generations who loved aerobics, these younger folks need to beat up their joints a bit before appreciating the benefits of more sedate and boring training methods that emphasize strength and intensity. As always, youth is wasted on the young.

    Craig in OH

  6. Mike L says:

    November 30, 2013 at 9:45 am

    Marc Pharmacist,
    Maybe generation y will be computer nerds who drink coffee and energy drinks all day and consider that fitness.Lol

    For sure, coffee, computers, and energy drinks will be part of the fitness equation for gen…Y’ers. I don’t believe this group would ever be interested in long volume workouts. I think short, brief intense workouts that bring results will be what Y’ers want. They will not want to hassled at the gym with bb…types. Computer cards, 24-hour access, instruction done via internet videos, blogs for advice…..as all looks very rosy for Y’ers in the exercise crystal ball.

  7. Brian F says:

    November 30, 2013 at 9:06 am

    Thanks again to Marc and his promotion of R/B’s… If you get your creative head on there are really useful strategies apparent with them. I am travelling for 8 weeks soon (unfortunately this interrupts the curl challenge) and will be taking a couple with me together with my home made suspension trainer….So no shortage of training opportunities

    You’re welcome.

    Lots to recommend resistance bands

  8. @Marc

    If self-preservation (health and fitness) have to be “marketed”, there is a MAJOR problem. I’m more interested in allowing natural selection to do its work…this ‘entitled’ group will eventually get it together…or they won’t. The ones I’m raising will be just fine either way.

  9. Joe

    I always enjoy hearing from you. I find your words at times very pleasant. Further, I can see the logic in your words.

    Still, there is lots of money to be made marketing fitness, wellness, strength to Y’ers.

    Question is: How? What is best? Ideas?

  10. Craig says:

    November 30, 2013 at 10:47 am

    It is interesting that the rise in the popularity of things like Crossfit, P90X, Zumba, and Insanity coincide with the arrival of Gen Y.

    Is there truly a connection? Or….Just coincidence?

  11. Marc says:

    “Is there truly a connection? Or….Just coincidence?”

    Correlation/Association doesn’t prove a causation (as we all should know). But it does seem that these programs have been successfully marketed to some young people, a subset of Gen Y.

    Of course, opinions on Gen Y vary widely:

    www dot examiner.com/article/gen-y-likes-their-sports-and-fitness-social-too

    “Millennials are strongly gravitating towards group fitness and exercise. While participation in team sports only marginally increased, overall participation rates in several group fitness activities grew by double digits since 2009. Gen Y was the driving force behind the nearly 30 percent increase in group cycling participation, nearly 28 percent increase in cardio tennis participation and nearly 20 percent increase in high-impact aerobics. Additionally, Millennials are filling up yoga classes.”

    elitedaily dot com/sports/the-death-of-sports-how-competitions-like-crossfit-are-weakening-america/

    “The straying of Generation-Y and Millennials from defensive and zero-sum games presents a weakness that bleeds into other aspects of modern society. Generation-Y and Millennials are presented with so many options that they are unable to make a decision. ”

    hollyonhealth dot com/2012/01/22/generation-y-the-fulcrum-for-a-shift-in-the-fitness-paradigm/

    “Although there is still a disconnect between healthy behaviors and longevity, if there were ever a generation that would change America’s health and fitness paradigm, Generation Y would be the one to bet on. We are smart, confident, casual, chill, and value life and family over work and money. Combine this personality with an evolving scientific conscience that promotes healthy living and you get a group of people that enjoy running with the latest GPS-tracking smartphone, who rarely eat fast food and pride themselves in knowing the difference between saturated and unsaturated fats.”

    Craig in OH

  12. Get real physical education back into schools. This is how I would train Gen Y.

    “LaSierra High PE Program”

  13. Despite all our advances in modern structures, medicine, transport & knowledge about health the human race lifespan seems to have arrested and Is actually in decline, this will get worse, every species eventually weakens and dies off, sadly unless there is massive cultural & belief system intervention the slippery slope will get steeper, tribes like the Massai Warriors with their healthy strong lean bodies, good teeth, healthy eyes and robust personalities may well outlive us all unless a major nature catastrophe strikes them. The irony is, it may all start again, in Africa, the very place it all began.

    People are demanding more and more rights and freedoms, this is a nice fantasy but the problem is, you need firm social control (not Communism or dictatorship) but just strong governments with laws that are actually enforced to retain social order, tribes even animal tribes have strong punishment reward cultures within the community, look at what freedom and revolution has done in Egypt, Libya, Iraq & Syria, it starts at home too, parents too soft scared to discipline for fear of their children not loving them or being reported by authorities for a little boot up the ass because little johnny was naughty.I believe people that are persistent about proper strength exercise, nutrition and managing their health also have the power and discipline to do great things and contribute to society rather than feed off it like parasites weakening the fabric of strengthening the human genome.

    Sorry to add the off topic rant boys.

    I will post a workout tomorrow.

  14. Craig in OH

    That last paragraph post 14 is one of a few positives I hope continues, I think GenY get a hard time, but who raised them, who nurtured them?

    I know some really positive intelligent GenY’s and I am impressed with their attitudes and intelligence and ability to debate.


  15. @Pete

    I do not think your understanding of “rights and freedoms” is very developed.

    Young people should not have to continually fight for liberty. This is just evidence that there are fundamental problems present in the philosophy driving the political system.

    No amount — including infinity — of additional laws are are going to fix this, ever.

    Young people born into the world should be free by default to pursue their happiness in a self-consistent manner (one that does not forcefully interfere with anyone else).

    This ought to be, and I believe one day will be, the norm in social systems for young people growing up in the world.

    Anything less is ridiculous and a sign of how primitive many people still are (or more accurately, how primitive the philosophies are that they are accepting).

  16. Anthony

    I do not think your understanding of “rights and freedoms” is very developed.

    This start to your conversation lets me know you are not even beginning to develop social skills, take a moment to read that as if it was sent.

    You foolish boy

  17. WOW 11/30;

    11 days rest then

    Seated row
    Chest press
    OH Press
    Leg press

    All with minimal rest

    Really felt it on the leg press

  18. @Anthony

    I’m curious why you believe liberty should be the default state one is born into?

    This has never been the case…and never will be the case. Offspring are born into subjection by default. Another’s choice conceived them and another’s choices feed, shelter and protect them until they are able to do this for themselves.

    Beyond the subjection of a guardian, children are subject to whatever situation the parents decided to bring them into (political, social, economical).

    Liberty has never been guaranteed. A person (or group) has it to the degree it has been fought for (and won). The preservation of freedom is a continual fight (whether we realize it or not, whether we engage in it or not).

    To speak of “shoulds” regarding social norms sniffs of ethnocentrism. Your ideas and ideals are great, but to believe they are somehow superior (i.e. the default way it should be) is very socially normal of you.

    It’s not that I don’t agree with your desire for a fantasy world…it’s just that I live in the “desert of the real.”

  19. Liberty to the extremes equals chaos, disorder eventually violence.

    Children see boundaries as love, the opposite is lawlessness, there are countless movies out there written by great minds foreshadowing the consequences of all this desire for this so called total freedom, history shows what has happened in brutal perversion of human nature when law and order is relinquished, we all have rights to expression, creativity and contributing our ideas and positive constructs to society but they can’t just run rampant being sabotaged by Facebook & twitter, 21 convention would not exist if its founder did not impose controls, the world would be a disgusting place to live if everybody were allowed to just have every right they think they are entitled too.

    I reject Anthony’s hypothesis outright but I also without reserve respect Anthony’s contribution to the conversation and in no way personalize at him my view, person and behavior are separate and the meaning of everybody’s behaviors and communication has a positive intent.

    It is important to learn that the language that starts the conversation, will set the tone for the remainder of the interaction, I am sure us more mature and well lived guys hope the younger ones are open minded enough to learn.


  20. Joe A says:
    November 30, 2013 at 3:02 pm

    “Liberty has never been guaranteed. A person (or group) has it to the degree it has been fought for (and won). The preservation of freedom is a continual fight (whether we realize it or not, whether we engage in it or not).”

    Latest Department of Defense study finds that 75% of Gen Y is unfit for military service. Frightening.

  21. You can blame “gen Y” for what ever you want. But you have to consider how well did their parents repair them for life. Its not an excuse for any ones actions just something to think about.

    Values help. My Father grew up on a farm,and was in the Air Force. He taught me a work ethic that I still carry with me today. How to respect people too. He was tough and humble at the same time. In turn I try to pass it to my son.

    That work ethic helped me to go balls to the wall with my training. But more important succeed in life.

  22. @Dave S

    I believe parenting (or the lack there of) can and should be blamed…this doesn’t absolve anyone of personal responsibility once they are old enough to think and act on their own…but parents can’t expect others to instill values into their children for them with favorable results.

    This is why school PE will never be the answer (as was suggested)…if you want your kids to know something and act accordingly, YOU better teach them and show them. It is no one else’s job to ensure they are educated, to ensure they can think and problem solve, to ensure they are willing to work for the privilege of success, etc.

    Gen Y didn’t f*ck itself up…we’ll have to wait and see if Gen Y is content to remain that way or if it eventually ‘gets it’.

Leave a Reply

Your email address will not be published. Required fields are marked *