The American Heritage Dictionary (3rd ed.) offers the following definitions of the word: “1. The condition of being mendacious; untruthfulness. 2. A lie; a falsehood.” In his editorial response1–
to my article,2
Dr. Grannis stated that “Reich goes on to postulate that not only are 33% of LCs [lung cancers] ‘pseudodisease’(ie, nonlethal if untreated), but that another 33% are ‘nonaggressive’ in their behavior. This is at variance with the data from thousands of clinical series examining this disease.” And, “He postulates that death occurs when FEV1 falls to 1 L” [italics added]. In the section dealing with the long-term sequelae of lobectomy,,2
I prefaced the notional figures supplied in this model, whose purpose was to account for the seeming paradox of higher survival and increased mortality in the screened cohorts vs controls, with “Consider the following hypothetical scenario.” In this hypothetical scenario involving two 3,000-sized cohorts, I assumed that LC developed in 10%, divided equally into aggressive, indolent, or overdiagnosed phenotypes, all in the first year, all in the left upper lobe, and that all were treated with lobectomy. I wrote, “Assume further that… excess deaths from respiratory failure, pneumonia, or coronary disease occur when the mean FEV1 falls to 1 L… ” To postulate is “to assume or assert the truth, reality, or necessity of, especially as a basis for an argument” (American Heritage Dictionary, 3rd ed.). In my correspondence with Dr. Grannis, in response to his initial comments in the capacity of an outside reviewer, I pointed out that this was a hypothetical scenario and not, as he stated, a postulated phenotypical (and actuarial) distribution. I no more believe, postulate, or promote the idea that LCs are equally divided into these phenotypes than I believe that all LCs occur within the first year of screening, all within the left upper lobe, or that all individuals die when their FEV1 falls to 1 L. The reader should judge whether his choice of the term postulate was intended to discredit the article by willfully and with foreknowledge distorting what I wrote and, if so, whether this constitutes untruthfulness.