Scientists will tell you that CTE stands for Chronic Traumatic Encephalopathy. Former Steelers running back Merril Hoge might say it stands for Conclusions That Exaggerate.
Recently, Hoge and Boston University neuropathologist Peter Cummings released a book challenging the link between football and CTE — the brain disease found posthumously in a couple hundred former NFL players, including suicide victims Junior Seau and Dave Duerson.
In promoting "Brainwashed: The Bad Science Behind CTE and the Plot to Destroy Football," Hoge and Cummings penned an Op-Ed for Yahoo Sports that questioned CTE research and the media "hysteria" surrounding it.
They cited a Boston University study that examined the brains of 111 former NFL players and found CTE in 110 of them. They mentioned how the study had no control group, showed selection bias due to the fact that the donated brains came from family members who suspected CTE, and failed to point out factors such as smoking, obesity and steroid use — all of which have been linked to CTE symptoms.
The conclusion? There is still tons we don't know about the link between CTE and football, so parents shouldn't feel obligated to push their kids toward cross-country just yet.
Some find that hypothesis dismissive on the surface, but (perhaps predictably) the book earned copious praise from those involved in the NFL.
From Ben Roethlisberger to Trent Dilfer to Suzy Kolber to Chris Mortensen to Trey Wingo to Bruce Arians, all lauded the work as eye-opening, enlightening, or at the very least, interesting.
But could Hoge and Cummings have left off myriad reviewers who disliked the book and its premise? Could they, too, have engaged in selection bias?
This question is what prompted me to ask various Seahawks about the CTE phenomenon. I felt there was truth to Hoge and Cummings' suggestion that most people questioning the link between football and CTE were deemed "deniers," so what did players think?
"You can't just trust everything someone says, whether it's good, bad or indifferent, you have to do your own homework," linebacker Bobby Wagner said. "When you get new information like that, you can't just believe what you hear, you have to take it upon yourself to go and get your own perspective of the information."
Added offensive lineman Germain Ifedi: "I don't think there's ever going to be a conclusive conclusion. There's a lot of gray area. There are so many factors, but I think the conversation is right to be had."
Receiver Doug Baldwin was a bit more skeptical of Hoge and Cummings' premise.
"I'm not a neuroscientist, but common sense would tell me that if you hit your head a number of times, and you have concussions, there's going to be some lasting implications for that," Baldwin said, adding that he doesn't want his kids playing football when they're older. "This is a dangerous game. No matter how much fun you have, there are some residual implications."
Baldwin's is the outlook shared almost universally by the masses, so there's a part of me that welcomes dissenting views from the likes of Hoge and Cummings. Dr. Julian Bales, a neurosurgeon at NorthShore University HealthSystem in Chicago, does as well.
Bailes, who was OK with his sons playing football, thinks CTE is a complex subject and that "it's important to have discourse and a balance and get their (Hoge's and Cummings') perspective." He also noted that until we can diagnose CTE in people that are still alive, we'll never know its true prevalence.
But there is still a major problem with Hoge and Cummings' argument: While it's true that the Boston University study in which 110 out of 111 brains of former NFL players didn't have a control group, a Mayo Clinic study from two years earlier did. Its findings? Of the 198 brains studied from people who had no exposure to contact sports at any point in their lives, none showed signs of CTE.
"The fact remains that the only known cause (of CTE) has been exposure to hundreds of thousands of hits to the head," Bailes said. "If someone says to me 'Dr. Bailes, I don't want to get lung cancer,' I might not know all the causes, but I'd say stay away from cigarettes. The default is to try and stop the exposure."
That said, there is no denying that CTE has caused some unhealthy hysteria. Lili-Naz Hazrati, a pathologist at Toronto's Hospital for Sick Children who studies athletes' brains, told Yahoo Sports a story of an amateur athlete who suffered from depression and memory loss and killed himself because he thought he had CTE.
Turns out it was vasculitis, which was treatable. Hazrati also criticized the Boston University study for lumping brains with Stage 1 CTE with those with more advanced symptoms, and recently co-authored a study that said "despite the persuasive claims made by the media about CTE, research on the disease and the effects of (mild traumatic brain injury) in general remain in its infancy."
Hoge and Cummings aren't claiming that CTE doesn't exist. Like Hazrati, they just think further research is necessary before hard-line conclusions are drawn.
I can respect that. But given the information that's out there, I can also respect heavy cynicism toward Hoge and Cummings' hypothesis.
Scientists should proceed with great rigor until we fully understand the causes and effect of CTE. But until they do, parents and potential football players should proceed with caution.