An October 2006 article by IBC argues that the Lancet estimate is suspect "because of a very different conclusion reached by another random household survey, the Iraq Living Conditions Survey 2004 (ILCS), using a comparable method but a considerably better-distributed and much larger sample." IBC also enumerates several "shocking implications" which would be true if the Lancet report were accurate, e.g. "Half a million death certificates were received by families which were never officially recorded as having been issued" and claims that these "extreme and improbable implications" and "utter failure of local or external agencies to notice and respond to a decimation of the adult male population in key urban areas" are some of several reasons why they doubt the study's estimates.