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No. 520 · Sunday 9 November 2026 · Vancouver

The Seawall Letter

Free, every Sunday. Leave whenever you like.

This week's issue

The headline said "linked to". Here is what that phrase means

A study of sixty thousand adults was reported this week under a headline with three confident words in it. I read the paper, and then I read the headline again.

No. 520 · Nov 9, 2026 · 9 min read

Printed letter draft with red pen marks under a desk lamp

The study followed people for eleven years and set two things side by side. It did not change what anyone did, and it could not say why one group differed from the other. The paper says so in its own second paragraph.

This week I go through the paper section by section, show where the headline stretched it, and say what a careful reader can take from it and what they cannot.

Plus: your letters about press releases, a short note on finding the original paper, and the one chart I still cannot make sense of.

Read: The headline said "linked to". Here is what that phrase means

The long read

Ten years of this letter: what I got wrong

I went back through five hundred issues and marked the ones I would write differently. Here are the best of the worst.

No. 517 · Oct 19, 2026 · 14 min read

From the shop

The letter stays free. These keep it going.

The archive

Every issue since No. 1, newest first

  1. 514

    What "peer reviewed" does and does not tell you

    One check among several, and what it leaves out.

  2. 513

    Reading a chart: the axis that starts at fifty

    Two bars, one trick, and how to spot it in the first five seconds.

  3. 512

    Why small studies make big headlines

    Fewer people, bigger swings, and louder news.

  4. 511

    A fortnight of headlines, checked one by one

    Eleven stories, the paper behind each, and what I could and could not find.

  5. 510

    What a confidence interval is saying

    A range, a guess and an honest way of showing both.

  6. 509

    Five words in health news worth slowing down for

    Linked, associated, may, up to and boosts.

  1. 508

    Why trials sometimes stop early, in plain words

    Who decides, why, and what the early numbers can and cannot show.

  2. 507

    The year in health news, in one long breath

    Every big story, one paragraph each, and how it held up.

  3. 506

    The best letters you've sent me, and my replies

    Ten years of corrections, arguments and one very kind note from a retired librarian.

  4. 505

    Who pays for a study, and where to find out

    The line at the end of the paper that most readers skip.

  5. 504

    A summer of preprints, read

    Papers not yet checked by anyone, and how to read them anyway.

  6. 503

    A night at a journal club in Vancouver

    Twelve people, one paper and an argument about page four.

Close portrait of Stanley in a brown tweed jacket

Stanley Leung

Forty years of family medicine, and I still read the small print

I'm Stanley, a family physician in Vancouver. I trained here, worked in a practice on the east side for thirty-four years, and still see people two days a week.

The Seawall Letter began in 2016 as a note to a few colleagues who kept asking what I made of the week's health news. It is still free, still written on Saturday night after my walk along the seawall, and it explains what a story says and what it does not. It is not medical advice and does not replace seeing your own doctor.

Empty hospital corridor at dawn with a trolley

Next issue: Sunday 16 November

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