“Supposing that truth is a woman, what then?” The Lie Detector, The Love Machine and the Logic of Fantasy

One of the consequences of the public outcry over the 1929 St Valentine’s Day massacre was the establishment of a Scientific Crime Detection Laboratory at Northwestern University. The photogenic “Lie Detector Man”, Leonarde Keeler, was the Laboratory’s poster boy and his instrument the jewel in the crown of forensic science. The press often depicted Keeler gazing at a female suspect attached to his “sweat box”; a galvanometer electrode in her hand, a sphygmomanometer cuff on her arm and a rubber pneumograph tube strapped across her breasts. Keeler’s fascination with the deceptive charms of the female body was one he shared with his fellow lie detector pioneers, all of whom met their wives – and in William Marston’s case his mistress too – through their engagement with the instrument. Marston employed his own “Love Meter”, as the press dubbed it, to prove that “brunettes react far more violently to amatory stimuli than blondes”. In this paper I draw on the psychoanalytic concepts of fantasy and pleasure to argue that the female body played a pivotal role in establishing the lie detector’s reputation as an infallible and benign mechanical technology of truth

COVID-19: Rapid antigen detection for SARS-CoV-2 by lateral flow assay: A national systematic evaluation of sensitivity and specificity for mass-testing

Background Lateral flow device (LFD) viral antigen immunoassays have been developed around the world as diagnostic tests for SARS-CoV-2 infection. They have been proposed to deliver an infrastructure-light, cost-economical solution giving results within half an hour. Methods LFDs were initially reviewed by a Department of Health and Social Care team, part of the UK government, from which 64 were selected for further evaluation from 1st August to 15th December 2020. Standardised laboratory evaluations, and for those that met the published criteria, field testing in the Falcon-C19 research study and UK pilots were performed (UK COVID-19 testing centres, hospital, schools, armed forces). Findings 4/64 LFDs so far have desirable performance characteristics (orient Gene, Deepblue, Abbott and Innova SARS-CoV-2 Antigen Rapid Qualitative Test). All these LFDs have a viral antigen detection of >90% at 100,000 RNA copies/ml. 8951 Innova LFD tests were performed with a kit failure rate of 5.6% (502/8951, 95% CI: 5.1–6.1), false positive rate of 0.32% (22/6954, 95% CI: 0.20–0.48). Viral antigen detection/sensitivity across the sampling cohort when performed by laboratory scientists was 78.8% (156/198, 95% CI 72.4–84.3). Interpretation Our results suggest LFDs have promising performance characteristics for mass population testing and can be used to identify infectious positive individuals. The Innova LFD shows good viral antigen detection/sensitivity with excellent specificity, although kit failure rates and the impact of training are potential issues. These results support the expanded evaluation of LFDs, and assessment of greater access to testing on COVID-19 transmission. Funding Department of Health and Social Care. University of Oxford. Public Health England Porton Down, Manchester University NHS Foundation Trust, National Institute of Health Research

Large streamlined trials in cardiovascular disease

In the search for new and better therapies, reliable evidence of efficacy and safety—usually provided from large-scale randomized trials—is essential to support licensing, inform guidelines, and change clinical practice. However, the size, duration, complexity, and costs of conducting contemporary clinical trials have risen steadily. This coupled with an apparently diminishing likelihood of a positive trial has raised concerns about return on investment to the point of restricting drug development in cardiovascular diseases (CVD).1 More efficient ways to conduct randomized trials need to be developed with engagement by the various stakeholders