The misuse of statistics is now so endemic in medicine that it has become impossible to distinguish truth from falsehood – to know whether the supposed causes of illnesses really are as they seem, or whether a new drug is as safe and effective as claimed. While this is potentially very serious for reasons it is scarcely necessary to elaborate on, it is also invariably the case when medical statistics have wider political ramifications.
Thus Professor Nick Black, in a recent review of the data on which Health Secretary Jeremy Hunt based his contentious assertion that inadequate hospital staffing at weekends was responsible for 6000 ‘avoidable’ deaths a year, notes it does not include ‘any indication of the severity or acuity of the patients’ diagnoses’. This is a serious omission for it is essential to know before drawing any inference about the reason for those ‘avoidable’ deaths - whether those admitted at the weekend are older or more ill than those during the week. And a separate study concluded that they tend to be, and when this is taken into account ‘that difference in mortality no longer exists’. There was, in short, arguably no justification for those gimmicky plans for a ‘7-day NHS’ or that futile acrimonious spat with the junior doctors.
Similar considerations apply to the extraordinary assertion that the decline in life expectancy and rise in the mortality rates in the elderly are due to ‘cuts’ in Social Services, as reported last week.
This is based on a highly dubious correlation demonstrating that ‘every 1 per cent decline in social care spending is associated with a significant rise in old age mortality’. There is no conceivable way this could represent a cause-effect relationship – and thus cannot possibly be true.
Those with longer memories may recall a similar misuse of statistics for political ends – Sir Douglas Black’s report on Heath Inequalities in the early years of the Thatcher Government with its claim that 70,000 people were dying every year in Britain due to (relative) ‘poverty’ - that could only be prevented by a full blooded socialist programme of wealth redistribution.
There is no doubting that the progressive increase in life expectancy of this age group over the past few decades has recently gone into reverse but, as I have noted in this column before, with so many now taking a cocktail of ten or more drugs, this is much more likely to be due to the adverse effects of over-medication.
Tips for dry eyes
The proposal that wearing glasses with plain lenses might mitigate the itching irritation of ‘dry eye’ by protecting the cornea from the effects of pollution has prompted two further useful tips. For one woman mentioning her symptoms to a friend prompted the suggestion that she takes Bioglan Super Fish Oil capsules that ‘thankfully made a remarkable difference – reducing the need for copious quantities of daily eye drops’. Then, similarly friendly advice for another reader alerted him to the possibility that his eye discomfort might be being exacerbated by the draught from the ventilation vents in his car drying out his cornea ‘and I found this to be the case’.
A wintry complaint
This week’s medical query comes courtesy of Mr ER of Lancashire who every December for the past 15 years has developed ‘tension’ in the region of his diaphragm – ‘sometimes I can pinpoint the exact moment’. Within a couple of days his waist measurement has gone from 32 to 39 inches - though with no wind, flatulence or constipation to account for it. “This massive bloating and sense of concrete in my stomach causes severe shortness of breath, hyperventilation, fatigue and total sleep disruption”, he writes. Relief comes in early spring when he feels, by comparison, he is ‘walking on air’. “I have no food allergies, except pulses, and I am not depressive. Can anyone help?”