• Eva Wisenbeck

Sadistic Statistics – Medical Metrics

LifeHakx – Sadistic Statistics

By Eva Wisenbeck 01/04/2021


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Tongue twistingly tantalising sadistic statistics!


“Statistics is the discipline that concerns the collection, organization, analysis, interpretation, and presentation of data.” - Wikipedia



Medical Metrics!


What are some of the key numbers we all should know, and we should all ask for before starting or having any medical treatment?

To get the best outcome for you, and your loved ones, the key metrics to understand are:

- Absolute Risk Reduction (ARR)

- Relative Risk Reduction (RRR)


Let’s get straight in to an example explaining how Absolute shows risk against the whole picture and Relative shows the comparison between two groups.

Example:

  • 200 people are enrolled in a trial

  • 100 people (50%) get the actual medication

  • 100 people (50%) are given an inert placebo

  • 3 people in the treatment group get sick

  • 4 people in the placebo group get sick


This can either be shown as:


Relative Risk Reduction (RRR)

  • 4-3 = 1 person avoided sickness thanks to taking the medication

  • 1/4 = 0.25 = 25%

  • So the RRR is 25% that is you are 25% better off taking the medication.

Or


Absolute Risk Reduction (ARR)

  • 3/100 = 0.03 = 3% got sick whilst taking the medication

  • 4/100 = 0.04 = 4% got sick who didn’t take the medication

  • So the ARR is 4%-3% = 1% so you are 1% better off taking the medication.


So is it 25% or 1%?

Both are right! But you need to know if the number is the Relative or Absolute number to be able to evaluate it for your situation.

Of course it’s also no good if the trial was done with say exclusively 20 year old males and you are a 70 year old woman, so we also need some more information about the trial or research itself.


Then there is Number Needed To Treat (NNT), as in how many people needs to have the treatment to avoid one “Event” (such as death, heart attack, pregnancy...) occurring. This too is a crude number as it doesn’t take into account how many people suffer side effects, nonetheless, it all helps build up a picture. There is a Number Needed to Harm (NNH) although for me the Absolut Risk Reduction and Number Needed to Treat is a very good start for when you have a chat about what is right for you and your loved ones.

No pill or potion is inherently all good or all bad, there is always a sliding scale of benefit and risk of harm depending on your personal situation such as underlying health, age, sex, genetics etc.

This is even true with seemingly “innocent” treatments like aspirin, birth control pills, statins, PPIs, flu vaccines and on and on and on.


I know, it’s complex, it is however very important and the only way you can truly give fully informed consent for any medical intervention.


It’s a chat to have with your doctor as they can help evaluate your full picture against the medical metrics and help you come to a decision of what is best for you - in other words, what are the benefits and what are the risks of harm and what are the alternatives. And yes this should also always include a chat about options and other ways to reduce your risk such as through lifestyle, nutrition etc!!


Free Prior Informed Consent


Informed consent: The process by which a patient learns about and understands the purpose, benefits, and potential risks of a medical or surgical intervention, and then agrees to receive the treatment or declines the treatment.

Consent is a fundamental legal and ethical principle. All patients have the right to be involved in decisions about their treatment and care and to make informed decisions. The exchange of information between doctor and patient is essential to good decision making. Serious harm can result if patients are not listened to, or if they are not given the information they need - and time and support to understand it - so they can make informed decisions about their care.

Doctors must be satisfied that they have a patient’s consent before providing treatment or care. The law surrounding Informed Consent might vary from country to country so please ask questions and find out what it means for you specifically.


Here is an example of Informed Consent steps:

  1. All patients have the right to be involved in decisions about their treatment and care and be supported to make informed decisions if they are able.

  2. Decision making is an ongoing process focused on meaningful dialogue, the exchange of relevant information specific to the individual patient.

  3. All patients have the right to be listened to, and to be given the information they need to make a decision and the time and support they need to understand it.

  4. Doctors must try to find out what matters to patients so they can share relevant information about the benefits and harms of proposed options and reasonable alternatives, including the option to take no action.

  5. Doctors must start from the presumption that all adult patients have capacity to make decisions about their treatment and care. A patient can only be judged to lack capacity to make a specific decision at a specific time, and only after assessment in line with legal requirements.

  6. The choice of treatment or care for patients who lack capacity must be of overall benefit to them, and decisions should be made in consultation with those who are close to them or advocating for them.

  7. Patients whose right to consent is affected by law should be supported to be involved in the decision-making process, and to exercise choice if possible.



The 7 Nolan Principles of Public Life


In the UK the Government has committed to adhere to the Nolan Principles as follows:

“The Seven Principles of Public Life apply to anyone who works as a public office-holder. This includes all those who are elected or appointed to public office, nationally and locally, and all people appointed to work in the Civil Service, local government, the police, courts and probation services, non-departmental public bodies (NDPBs), and in the health, education, social and care services. All public office-holders are both servants of the public and stewards of public resources. The principles also apply to all those in other sectors delivering public services.”


The 7 principles are:

  1. Selflessness - Holders of public office should act solely in terms of the public interest.

  2. Integrity - Holders of public office must avoid placing themselves under any obligation to people or organisations that might try inappropriately to influence them in their work. They should not act or take decisions in order to gain financial or other material benefits for themselves, their family, or their friends. They must declare and resolve any interests and relationships.

  3. Objectivity - Holders of public office must act and take decisions impartially, fairly and on merit, using the best evidence and without discrimination or bias.

  4. Accountability - Holders of public office are accountable to the public for their decisions and actions and must submit themselves to the scrutiny necessary to ensure this.

  5. Openness - Holders of public office should act and take decisions in an open and transparent manner. Information should not be withheld from the public unless there are clear and lawful reasons for so doing.

  6. Honesty - Holders of public office should be truthful.

  7. Leadership - Holders of public office should exhibit these principles in their own behaviour. They should actively promote and robustly support the principles and be willing to challenge poor behaviour wherever it occurs.

Do you feel these principles are upheld by the doctors and public life professionals you interact with? And those making decision that impact on your life?

What can you do to encourage an open and full discussion about your, and your loved ones, health and possible medical treatments?



“How Big Food and Big Pharma are killing millions of people”


Dr. Aseem Malhotra, a UK NHS cardiologist, author, activist and more, invited top leaders in European Medicine to expose “How Big Food and Big Pharma are killing millions of people” in an incredible panel debate in the European Parliament. He argued the case for lifestyle medicine and explained why lawmakers need to change EU health policy.


Prescribed medications are estimated to be the third biggest killer, after heart disease and cancer. Bad Pharma sees millions taking drugs they don’t need – destroying their lives! For years public health advice across Europe has got it dangerously wrong” - Dr. Malhotra

The panel set out to show how the food and beverage industry and pharmaceutical companies have had a pervasive influence over policy that coerces doctors into prescribing unnecessary and potentially harmful treatments rather than providing patients with basic lifestyle solutions.

In the UK, more than half of all adults take at least one prescription medication with 50% of those over 70 on at least three. It is estimated that prescribed medication is the third most common cause of death after heart disease and cancer. The panel argued that evidence-based medicine has been hijacked by major conflicts of interest at the highest levels, and revealed unscrupulous lobbying practices that drive up profits at the expense of public health.


Dr. Malhotra said - “With global health systems forecast to collapse in the next few years, two things are driving ever-increasing demand: The escalating burden of chronic disease, caused by entirely preventable lifestyle illnesses, and over-treatment, seeing millions taking drugs and undergoing surgeries that will provide zero benefit and as a result costing national economies billions.”

The unified panel set out to show and expose collusion between politicians, respected medical institutions, ‘charities’ and medical journals for financial gain, resulting in an epidemic of misinformation with devastating consequences for health worldwide.






If you are curious and would like more information about Medical Metrics here are some great resources.


NHS “Consent to treatment” https://www.nhs.uk/conditions/consent-to-treatment/

FDA “Informed Consent” https://www.fda.gov/regulatory-information/search-fda-guidance-documents/informed-consent

NCBI ”Informed consent for clinical treatment” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3307558/

General Medical Council “Decision making and consent” https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/decision-making-and-consent/about-this-guidance

GOV.UK “The Seven Principles of Public Life” https://www.gov.uk/government/publications/the-7-principles-of-public-life/the-7-principles-of-public-life--2

Bill Gates “6 Books I Recommended for TED” https://www.gatesnotes.com/About-Bill-Gates/6-Books-I-Recommended-for-TED-2015?WT.mc_id=03_21_2015_TED_tw&WT.tsrc=Twitter

Dr Aseem Malhotra - Profit over Population Health - at the European Parliament https://youtu.be/jcnd3usdNxo

Dr Aseem Malhotra - You Can Not Drug People Into Being Healthy https://youtu.be/_iEUiJHkDns

Dr Aseem Malhotra - Eat Real Food, Protect The NHS & Save Lives https://youtu.be/dzwuNsopJxs




Meet The Team

Eva Wisenbeck

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Eva Wisenbeck is a Co-Presenter of LifeHakx & a Wellness Coach

Mary Collins

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Mary Collins is the Creator and Presenter of LifeHakx Media.