Tag Archives: statistics

Numbers and Statistics still Bedevil Medicine

Go figure: In era of Big Data, numbers and statistics still bedevil medicine | Patrick Malone & Associates P.C. | DC Injury Lawyers – JDSupraSep 2019 

Big data and numbers may seem to drive the world these days, but human factors can play a dizzying role when it comes to statistics and medical treatments.

For those fascinated by numeracy in health care, writer Hannah Fry, in a readable New Yorker essay, details how medicine and patients alike have been bedeviled by attempts to quantify life-and-death decision making.

Fry shows how errors in evaluating statistics could confuse authorities investigating if Harold Shipman, a British doctor who cared for the elderly, was merely unlucky or a stone-cold killer.   Continue reading

90% Medicare Patients Have Little Risk of Opioid Overdose

Study Finds 90% of Medicare Patients Have Little Risk of Opioid Overdose — Pain News Network – by Pat Anson, PNN Editor – Mar 2019

Current methods used to identify Medicare patients at high risk of overdosing on prescription opioids target many people who are not really at high risk, according to a team of researchers who found that over 90% of patients have little to no risk of overdosing.

Almost all “current methods” of data collecting and research that are in any way related to opioids have been influenced by the PROPaganda that insists prescription opioids are the direct precursors of opioid addiction, overdose, and death.

But decreasing opioid prescriptions and increasing drug overdoses will make PROP’s demonization of prescribed opioids increasingly distant from the truth as the reality of poly-drug overdoses unfolds right in front of us.  Continue reading

NON-opioid Overdose Death Rates Rising

Nonopioid Overdose Death Rates Rose Almost As Fast As Those Involving Opioids, 1999-2016. – PubMed – NCBI – Jul 2019

I’m sure we’ll be hearing more and more about overdose deaths from illicit fentanyl and multi-drug combinations. In one narrow aspect, the DEA has succeeded: prescription opioids are extremely difficult to get hold of these days, even if you have a medically legitimate need.

So whoever needs the effective relief opioids provide from intractable (incurable, lifelong) pain, has to procure them on the black market, where they often end up with counterfeit versions.

The number of Americans dying from drug overdoses has risen rapidly, but the contribution of nonopioid drugs to this growth is not well understood.    Continue reading

Critical Appraisal of Clinical Research

Critical Appraisal of Clinical Research – Free full-text /PMC5483707/J Clin Diagn Res. May 2017

This article is a primer on how to read research studies: what to look for and what to question.

Evidence-based practice is the integration of individual clinical expertise with the best available external clinical evidence from systematic research and patient’s values and expectations into the decision making process for patient care.

It is a fundamental skill to be able to identify and appraise the best available evidence in order to integrate it with your own clinical experience and patients values.      Continue reading

Real Overdose Data from NIDA

Here is a whole page of some excellent charts from the National Institute of Drug Abuse (NIDA). – July 2019

NIDA has the most accurate, up to date, and pertinent information, since it’s the federal agency whose mission it is to deal with drug abuse, not the CDC or FDA.

Below is the chart showing that it’s illicit Fentanyl that’s increasingly involved. Note that in the numbers for prescriptions, the opioids are almost always not prescribed to the person overdosing.

Spurious Correlations

Spurious Correlations – by Tyler Vigen

Hi, I’m Tyler Vigen!  Spurious Correlations was a project I put together as a fun way to look at correlations and to think about data.

Empirical research is interesting, and I love to wonder about how variables work together.

The charts on this site aren’t meant to imply causation nor are they meant to create a distrust for research or even correlative data. Rather, I hope this project fosters interest in statistics and numerical research.

Above chart is just one example of bizarre correlations of unrelated data. (Click on chart to see full site with more of these.)

Pain Program Dropouts: Risk Factors Identified

Pain Program Dropouts: Risk Factors Identified – Medscape.com – Fran Lowry – March 13, 2019

Cleveland Clinic’s low back pain program, called Back on TREK, is a 10- to 12-week program that includes psychological and physical therapy sessions.

“Typically, the patient requirement is about 3 to 4 hours a week in two to three sessions in both group and individual sessions. We try to make it easy for patients,” said Mijatovic.

Despite the team’s best efforts, the dropout rate for the 12-week program was 58% of about 200 participants.  

Many patients with EDS have been abused by the Cleveland Clinic, which tends to discount invisible chronic pain, so I’m not at all surprised that more than half drop out. Continue reading

Contesting The Tyranny Of Metrics And Managerialism

We Are Not A Dashboard: Contesting The Tyranny Of Metrics, Measurement, And Managerialism – by David Shaywitz – Dec 2018

The dashboard is the potent symbol of our age. It offers the elegant visualization of data, and is intended to capture and represent the performance of a system, revealing at a glance current status, and pointing out potential emerging concerns.

Dashboards are the physical manifestation of the ideology of big data, the idea that if you can measure it you can manage it.

I am increasingly concerned, however, that the ideology of big data has taken on a life of it’s own, assuming a sense of both inevitability and self-justification.   Continue reading

Assumptions: Often Wrong, Never in Doubt

Often Wrong, Never in Doubt – Six Ways Assumptions Mislead Us – By Chuck Dinerstein — December 19, 2018

Facts are far harder to obtain than assumptions; they may require long periods of observations or expensive, sensitive measurement devices.

Assumptions can be made more easily, in the comfort of the office, frequently papering over or shaping missing data.

One of the unintended results of this approach is that given a limited set of facts, the strength of our conclusions is based upon our certainty in the strength of our assumptions.

Assumptions are just not as sexy as conclusions and are frequently overlooked in our haste to know or do – it is a variation of often wrong, never in doubt.   Continue reading

CMS’ opioid overutilization criteria

Performance of CMS’ opioid overutilization criteria for classifying OUD or overdose – Feb 2019

Researchers investigated whether the criteria underpinning CMS’ opioid Overutilization Monitoring System could effectively pinpoint Medicare subscribers with opioid use disorder (OUD) or at high risk for overdose.

The program, launched in 2013, asks that plan sponsors take action—such as utilization review, case management, and dose-dependent safety alerts or reimbursement denials—when they do identify high-risk beneficiaries. 

Here CMS is finally looking at outcomes of their policy. Meanwhile, the CDC, which even included a requirement to evaluate outcomes in its own guideline, has refused to do so.

I’m almost certain they fear that any outcome measurements will show how ineffective their guideline has been at stemming overdoses and how perversely effective it has been in harming pain patients. Continue reading