I am trusted by 86.5% of people.

I made-up this number.

I have no idea how many people or what per cent trust me – I don’t even know what ‘trusted’ means.

These are some of the hazards inherent in data and statistics.

Please do not take this the wrong way. I love numbers as much as anyone. They are a handy way to simplify the world. If nine out of ten dogs prefer Pedigree Chum, then, who am I to argue.

Brexit was the most recent at-scale demonstration of the failure of a population to interpret numbers and data. Fake information in the hands of bad people, particularly when they are on TV, the newspapers or radio is incredibly powerful. We, that is, the people, seem powerless to resist.

I always prefer a good story. I don’t know when our powerlessness to numbers began. In our evolution, we have been using systems to count-out bones and cowry shells for millennia, but against the timeline of storytelling, this is nothing. Perhaps it is the relative newness that explains our doe-like paralysis at the hands of a man with numbers.

Stories combined with numbers are like Kryptonite.

I attended a conference this week in Doncaster – it was the annual UK Dementia Congress (the same one that awarded my team Dementia Friendly Hospital of the Year back in 2013).

There were lots of numbers.

‘Look, see here, I did this and things improved by 36.4%’

‘98.4% of patients were happy with their care’

‘the p value is <0.0001’

‘Agent X reduced the amount of brain amyloid by 54%’

‘the Neuropsychological Inventory improved from 40 to 120 – that is great!’

All numbers, and all made-up by me just now.

I know that people don’t consciously invent numbers, that doing so is in breach of nursing, therapy, medical codes of conduct – if the GMC discover your shenanigans, you’ll be in trouble!

Academics spend hours examining numbers and data, indeed, this is one of their most important roles – to read between the lines and determine whether the numbers someone is proposing are real of fantasy.

Most data is not subject to such rigorous analysis. Most just pops out of peoples’ mouths and falls on eager to adopt ears.

Where do we go from here?

Well, the following are some principles that I recommend:

If anything is 99.9% effective, you have to ask, effective against what, how, when, where? Sure, Domestos, like Pedigree seems to have some fairly significant numbers attached to it, yet, life is not so black and white. After all, how many of us would (like my dog Maisie, when she’s very thirsty), drink out of the toilet bowl, safe in the knowledge that the .1% of remaining bugs won’t do you any harm?

Votes, where 99% of people support one candidate or another are always rigged. Humans are not like this – our genetic, gender, cultural and historical variation means that no matter the situation, there are always people with different opinions – so long as they are able to express them; if you risk getting murdered if you don’t vote for Comrade X, you will likely vote for Comrade X, or in a less sinister vein, if you don’t vote for Comrade X, we won’t necessarily kill you, but you’ll lose your job, or your family will suffer, and so on.

Numbers without narrative are also meaningless.

We used our Purple bag scheme and there was a 33 per cent drop in the numbers of patients experiencing pneumonia. Whatever. Without understanding the context, the inclusion and exclusion criteria, the numerators and denominators, this number doesn’t tell you anything.

It is not that people are intentionally trying to mislead (although that was the case with Johnson, Farage and co) – it is more that the levels of pressure and competition out there are so great that folk are rushed into producing results that they can’t necessarily assure.

The financial constraints in the NHS which are impossible, force people to behave in ways that they would not normally.

This takes us to a place of fear and coercion.

Two enemies of safety and harmony.

If I am too afraid to tell you that your system is a joke and is not working, you will believe your system is working and others will start to adopt the same mantra – use Rod’s system – it is incredibly effective at reducing pressure ulcers, complaints or, whatever.

This takes me to the origins of this blog – almondemotion – the amygdala as seat of fear and primitive responses to threat, when our logical, empathic mind is displaced by fight or flight.

I know that people reading this, particularly those who know me will think it strange that I am advocating for more rigorous measurement and use of statistical methodology – after all, I tend to be the intuitive, gut-feeling guy.

We need to wed our intuitions to rigour.

Don’t let one oppress the other. There is a time and a place for each.

Let your mind and imagination spiral into places not considered – propose and test new ideas, processes and procedures, go where no person has gone before! Then, check the numbers.

Alternatively, you can start with the numbers but, do not end there, see there is necessarily more. See that only by feeling safe in the knowledge that data and numbers can be questioned or challenged, examined, held-up to the light and tested for rigour can we gain confidence.

Check the checkers, have a laugh with the innovators.

leonard-nimoy-spock-picture

Please let me know what you think… Like, retweet, comment or share. Thanks.

 

 

 

 

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