Posts Tagged ‘Health_statistics’

Two Scientists in Congress

November 25, 2016

At the time of writing “Head In The Cloud”  by William Poundstone there were only two scientists total in the United States Senate and House of Representatives.  That is of 535 representatives only 2 (0.3%) are scientists.  It seems only appropriate that a low-information electorate have a low intelligence congress.  HM says low intelligence as it is science that has produced advancement and modernity.   Absent science we would be living in filth and ignorance.  Included here are both the physical and social sciences.

It is more than scientific knowledge that is important.  The empirical basis of science together with evaluation methodologies and statistics are important.  We need these to have a rational basis for policies and for a means of evaluating the benefits and dangers of different policies.  When debates in Congress are based upon data, rigorous research can be done to assist in defining the ways to proceed.  Scientists do not always agree.  Nor are the initial results of investigations always correct.  But eventually there is convergence with resulting better ideas and policies.  This is the democracy of the future.  Will it ever be achieved?

The low-information electorate complements nicely argumentation based on beliefs.  People fail to realize that beliefs are double-edged stores where both edges are blunt. One blunt edge makes it difficult, if not impossible, to see the problems with one’s own beliefs.  The other blunt edge makes it difficult, if not impossible, to see alternative ideas and courses of action.

Some religious beliefs force religion into its historical role of retarding science and keeping humans ignorant.  Moreover, many of the people holding these religious beliefs are not satisfied with the religious freedom guaranteed in the Bill of Rights.  Rather, they feel compelled to enforce their beliefs on others by changing the laws of the land. What happened to, “Judge not that ye be not judged” (Matthew 7 1-3). These same people are appalled at the sharia practiced by some Muslems, yet fail to perceive that what they are doing in the United States is indeed sharia.  These same beliefs forbid the teaching of science and engaging in scientific and medical practices that can advance humankind and relieve a great deal of misery.

© Douglas Griffith and healthymemory.wordpress.com, 2016. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.

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Where to Find Good Health Statistics

February 7, 2010

Health statistics are important. They are needed to make informed decisions not only about health care for you and your loved ones, but also for he health care of the nation. Unfortunately, there are a number of problems regarding health statistics. There are all sorts of health statistics coming from all sources. One problem is that the different sources have different agendas. This potential bias should be obvious for drug companies, but there is also potential bias coming from health agencies, which one would presume to be neutral. Agencies can believe in certain policies and then present statistics to support these policies. Different statistics are appropriate for different purposes. The immediately preceding blog post, Health Statistics, discussed the difference between survival rates and death rates.

There is a very good book to help you understand health statistics. It is Know Your Chances: Understanding Health Statistics by Steve Woloshin, MD, MS, Lisa M. Schwarts, MD, MS, and H. Gilbert Welch, MD, MPH. They help you see the hype in medical news, ads, and public service announcements. The publisher is the University of California Press, www.ucpress.edu.

The following websites are recommended sources for good, reliable health statistics. All these sites are free. The first set of sites were created primarily for consumers.

The Center for Medical Consumers is an independent, nonprofit organization. It provides recent health news and a skeptical view on health claims.

medical consumers.org

Consumers Reports Best Buy Drugs is another independent, nonprofit organization. It uses the Drug Effectiveness Review Project to compare the benefits, side effects, and costs of different drugs for the same medical problem.

consumerreports.org/health/best-buy-drugs/index.htm

The Ottawa Health Research Institute for Patient Decision Aids is an academic affiliate of the University of Ottawa. They provide a comprehensive inventory of decision aids, ratings of the effectiveness of these aids, and provides information on how to get them.

decisionaid.ohri.ca

Although the following sources were created primarily for physicians and policy makers, consumers should not fear consulting them. These are all free.

The U.S. Federal Agency under Health and Human Services, Agency for Healthcare Research and Quality (AHRQ) has a website that summarizes all the available data about treatment for specific conditions (look for EPC Evidence Reports).

ahrq.gov/clinic/epcix.htm

The Drug Effectiveness Review Project (DERP) is a collaboration of public and private organizations developed by the Oregon Health and Science University. It provides comparative data on the benefit, side effects, and costs of different prescription drugs that treat the same problem. This is the course used by the aforementioned Consumer Reports Best Buy Drugs.

ohsu.edu/drugeffectiveness/reports/final.cfm

The National Institute for Health and Clinical Evidence (NICE) is an independent, nonprofit, British organization that advises the British National Health Service. They provides summaries of all the available data about treatments for specific conditions.

nice.org.uk/guidance/index.jsp?action=byTopic

The Physician Data Query (PDQ) is part of the National Cancer Institute. It provides summaries of all the available data about cancer prognosis and treatments.

cancer.gov/cancertopics/pdq

The U.S. Food and Drug Administration (FDA) Center for Drug Evaluation and Research reviews and approves new and generic drugs.

fda.gov/cder/index.html To look up individual drugs, go to accessdata.fda.gov/Scripts/cder/DrugsatFDA/

The U.S. Preventive Services Task Force (USPSTF) is an independent panel of experts sponsored by the AHRQ. They provide recommendations on a wide variety of clinical topics.

ahrq.gov/clinic/uspstfix.htm

 

Health Statistics

February 5, 2010

Health statistics are important. They are needed to make informed decisions not only about health care for you and your loved ones, but also for he health care of the nation. Unfortunately, there are a number of problems regarding health statistics. There are all sorts of health statistics coming from all sources. One problem is that the different sources have different agendas. This potential bias should be obvious for drug companies, but there is also potential bias coming from health agencies, which one would presume to be neutral. Agencies can believe in certain policies and then present statistics to support these policies.

There is a very good book to help you understand health statistics. It is Know Your Chances: Understanding Health Statistics by Steve Woloshin, MD, MS, Lisa M. Schwarts, MD, MS, and H. Gilbert Welch, MD, MPH. They help you see the hype in medical news, ads, and public service announcements. The publisher is the University of California Press, www.ucpress.edu.

They state that if there were a hall of fame for exaggeration, survival statistics would get a lifetime achievement award. These statistics are frequently used in cancer screening. Survival statistics can be reported for any span of years. The choice is arbitrary, but the five year survival rate is quite common. The five year survival rate is the ratio of the number of patients alive five years after diagnosis divided by the number of patients originally diagnosed with the cancer. This statistic has its uses. For example, if different treatments for cancer patients were being evaluated, this would be a good statistic to use to compare the relative effectiveness, or lack thereof, for the respective treatments.

However, it is not a good statistic to use as evidence to support cancer screening. Cancer screening is the policy of testing everyone of a specific demographic or age group. The correct statistic for evaluating the effectiveness of screening is the Annual Death Rate. The Annual Death Rate is the ratio of the number of people who die from the disease over a year divided by the number of people in the demographic age group of interest. If screening is effective, then it should be reflected in decreasing death rates.

A reasonable question is how could there be survival statistics indicating that screening is effective, but annual death rates indicating that screening is not effective. Few people seem to realize that there are costs to early testing. Early cancers or precursors of cancer can go away on their own. Some cancers are so slow in developing that you are likely to die from something else before you would die from the cancer.

For example, the 5-year Survival Rate for the deadly skin cancer melanoma improved from 49% in 1950 to 92% in the most recent data available. Death rates have gone up during this period from 1 death in 1,000 to almost 3 deaths in 1,000.

One of the bests examples here can be found in screening for prostate cancer. For decades the Prostate Specific Antigen Test (PSPA) was regarded as mandatory for all men in a certain age group. Only recently, was this position changed. Now the PSPA test is not generally recommended, even for high risk groups. It is to be given only after consultation with a physician. The reason for this change was the discovery that the test was not affecting the Annual Death Rates. Cancers were being caught and treated, which resulted in improved survival rates, but there was no corresponding decrease in the Annual Death Rates. Prostate cancer advances at a wide range of rates. Although some prostate cancers advance relatively quickly, others advance so slowly that a man if much more likely to die from something else before the prostate cancer can kill him.

One way of looking at the difference between the survival rate and the annual death rate is to regard it as an index of unnecessary treatments. Thousands of men had their prostate glands removed with some of them suffering the side effects of impotence and incontinence. These same men could have lived on without surgery and eventually died of something else.

© Douglas Griffith and healthymemory.wordpress.com, 2010. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.