Doctors have to have a minimum understanding of basic statistics and if they don’t they put patients and professional integrity at risk. That surely is a lesson from the report of the Mid-Staffs inquiry and now the enforced closure of a children’s heart unit at Leeds.
Doctors will complain their training curriculum is already crowded – they don’t just have to conquer medicine but acquire personal, business and (if they are to play a part in the brave new world created by the Health and Social Care Act 2012) learn to be managers too. But without stats, how can they know whether a therapy or an intervention (or the performance of surgical colleagues) is effective and safe?
Not that medical statistics are easy, either in terms of data collection or interpretation. In an essay in the London Review of Books, Paul Taylor of University College London shows how hard it is to get reliable data on performance, despite the claims made by commercial data companies. The latter do important work, for example Dr Foster on hospital standardized mortality ratios but their business is selling information and they don’t necessarily have a first-line interest in how it’s interpreted.
As for patients, relatives and those who run the NHS, they too need to acquire more statistical and data literacy, especially around comparing performance. Government ministers, and patients, sometimes think you can boil performance down as if clinics were football clubs, ranked according to their points score. Jeremy Hunt recently asked a compliant thinktank, the Nuffield Trust, to envision his version of the Premiership.
It’s much more difficult than that. But the way forward has to be more patients, their relatives, their nurses and doctors, and health managers understanding a little more about data and distributions. Stats can be a matter of life and death.