Statistical Thinking & Defensive Medicine

I've read two books by Ben Goldacre: Bad Science and Bad Pharma, How Drug Companies Mislead Doctors and Harm Patients.

Here is a good review of Bad Pharma by Dr. David Healy.

I think both books are must reads for anyone interested in science and health. Most of us have no idea how the human mind can trick itself into tricking people. It's really kind of magical. (wink) The tricks we play on ourselves can lead to devastating outcomes in the real world - I'm talking about death here.

People are all vulnerable to things like motivated reasoning and confirmation bias. Most of us never learned about good statistical thinking. Percentages are thrown around all the time in the media that only confuse an issue while making it seem like the efficacy of a drug, or procedure is clear cut. But what do the numbers, the simple numbers, really say?

Everyday we are bombarded with information about diet programs, exercise routines, high tech healthcare, and the next, next thing in medicine. Most of this information is from the P.R. and Marketing Departments of companies motivated by one primary driver - money. A lot can become confused when it's all about the bottom line.

There are certain sectors of society that would be better off, I believe, if the primary driver wasn't money, if we could at least include some other incentives. For example, sectors of society where it's a question of life and death. In medicine we should have a mix of incentives that are properly paid attention to.

This morning I read an article from the BBC, and I just had to share it with you.

Do Doctors Understand Test Results by, William Kremer

It's important for all of us to understand that doctors and health workers are only human and just because they're wearing the white coat doesn't mean that they aren't vulnerable to making the same mistakes we might make when looking at statistics. I'm guessing that most of you are just as baffled by statistics as I am. I have to expend some energy making an effort to really understand the stats.

If I'm careful, and make an effort to understand good information presented to me in a way that I can readily understand, I'm hoping that I'll be able to make the right choices about my healthcare.

We must also understand that healthcare organizations are just as motivated by the bottom line as your neighborhood pub. I had an allergy once that was quickly "cured" by an injection of steroids, only after a barrage of tests at a San Francisco hospital that ruled out a list of scary conditions including Lupus Disease. These tests cost me and my insurance company over $5,000. I would have loved it if they had given me the steroids first and let me go home.

"It's surprising that in the 21st Century, many still think of doctors as Gods and you don't ask God." says Gigerenzer.

"A physician is someone who can help you but also someone you need to challenge in order to get the best treatment."

Gerd Gigerenzer and Glynn Elwyn spoke to Health Check on the BBC World Service. Listen again to the programme on the BBC iPlayer or get the Health Check podcast.




Steven Cleghorn

Steven is an autodidact, skeptic, raconteur and film producer from America who has been traveling since he was a zygote. He's a producer at The Muse Films Ltd. in Hong Kong and a constantly improving (hopefully) Globe Hacker. He's seeks the company of interesting minds.