Hang on, Furious of Feltham, what about all those perfectly good doctors who get a bad name from the few bad apples who bandy around statistics?
(small rant follows, not to be taken the wrong way; I'm just trying to explain that it's frustrating when all "doctors" get lumped with the same brush)
I am in no way defending the deliberate misuse of emotive "statistics" that appears to have occurred in this case. However, I am constantly told that my professional duty lies in providing information to enable patients to make "an informed choice". I am very often asked for figures by my punters to help them decide what they want to do e.g. have an operation, try one particular treatment or another. I would find it really difficult to say "I can't give you the mortality rate for this operation unless I can first explain to you the full data that gave rise to this mortality rate, the number and premorbid condition of the patients involved in obtaining the figures, the confidence intervals of the actual result, and the applicability of this figure to your good self". Quite aside from the fact that many people would drift off before the end of the sentence, how can I be expected to convey such complicated concepts in ten minutes? Answer; I can't ; and neither can most doctors. The patient asking me doesn't want to understand detailed statistics; they want a rough chance in terms they can understand.
Here is a real example, based on what I'd tell a patient with an 8cm aortic aneurism who was otherwise fairly well, and asked advice on whether he should get it repaired or not: OK, There is a 9 in 10 chance that if your aneurism bursts, it will kill you. If we try to fix it by replacing the damaged artery with a graft, the operation has a 1 in 10 chance of killing you. However, this means that 9 in 10 people do get better after the operation. What you have to balance is whether you prefer to just wait and see what happens knowing that you could have up to 40 years of health before the aneurism bursts (but it mught be less than that, and no-one can predict how much less) , or you can take the 1 in ten risk of an operation, and if it does work then you won't have an aneurism to burst anymore. Have a think about it, talk to your wife, talk to a friend and come and see me again next week.
no subject
(small rant follows, not to be taken the wrong way; I'm just trying to explain that it's frustrating when all "doctors" get lumped with the same brush)
I am in no way defending the deliberate misuse of emotive "statistics" that appears to have occurred in this case. However, I am constantly told that my professional duty lies in providing information to enable patients to make "an informed choice". I am very often asked for figures by my punters to help them decide what they want to do e.g. have an operation, try one particular treatment or another. I would find it really difficult to say "I can't give you the mortality rate for this operation unless I can first explain to you the full data that gave rise to this mortality rate, the number and premorbid condition of the patients involved in obtaining the figures, the confidence intervals of the actual result, and the applicability of this figure to your good self". Quite aside from the fact that many people would drift off before the end of the sentence, how can I be expected to convey such complicated concepts in ten minutes?
Answer; I can't ; and neither can most doctors. The patient asking me doesn't want to understand detailed statistics; they want a rough chance in terms they can understand.
Here is a real example, based on what I'd tell a patient with an 8cm aortic aneurism who was otherwise fairly well, and asked advice on whether he should get it repaired or not:
OK, There is a 9 in 10 chance that if your aneurism bursts, it will kill you. If we try to fix it by replacing the damaged artery with a graft, the operation has a 1 in 10 chance of killing you. However, this means that 9 in 10 people do get better after the operation. What you have to balance is whether you prefer to just wait and see what happens knowing that you could have up to 40 years of health before the aneurism bursts (but it mught be less than that, and no-one can predict how much less) , or you can take the 1 in ten risk of an operation, and if it does work then you won't have an aneurism to burst anymore. Have a think about it, talk to your wife, talk to a friend and come and see me again next week.
Does that sound too complicated?