Know Your Chances: Understanding Health Statistics. Stephen Woloshin, Lisa Schwartz, and Gilbert Welch

Woloshin, Stephen; Schwartz, Lisa and Welch, Gilbert. Know Your Chances: Understanding Health Statistics. University of California Press, Berkeley. 2008. NF; 07/12

This feeling of ambivalence is getting familiar. I feel about this book as I did about Hadler’s Rethinking Aging,and Bad Science by Goldacre. Am I just jealous of successful health-reform authors? Of course I am. Still, while I applaud the content, the ideas, and the attitude I wish it had been done with a little more aplomb and a better effort to hide the authors’ high opinion of their special knowledge.

I can’t fault the basic idea, coinciding as it does with my own attitude to the popular conception of health science. Spin is, increasingly, the content not only of media and advertising conversation about scientific “fact”, but also of the allegedly aboveboard publications of science academia. This involves a hideous cynicism based on concepts imported from elsewhere (business mostly, I think) that are frankly immoral in a context that should have a protected altruistic focus: Buyer Beware (a.k.a. There’s a Sucker Born Every Minute), All’s Fair in Love and War (a.k.a. Screw the Bastards Because God Knows They Screw Us), and We’re the Experts (a.k.a. What the Ignorant Lumpen Don’t Know Won’t Hurt Them).

But I am afraid the people who need to read this book (just about everybody) won’t persevere for much the same reason we didn’t do well in high school mathematics. It’s boring. (I should be careful including myself in that group. My poor performance was a combination of DNA and bone laziness.) The dear well-meaning authors needed a straightforward professional journalist with a sense of humor to get rid of the patronizing Grade 8 schoolteacher know-it-all diction:

The answer to the first question is c. According to the table, 26 percent of those who took Lunesta complained of an unpleasant taste in the mouth, compared to only 6 percent of those taking placebo. Remember that 6 percent reflects the background level of unpleasant taste. So the amount of unpleasant taste caused by Lunesta is the difference between 26 percent and 6 percent, that is 20 percent. (Chosen at random by opening the book at any page…)

So in the end I love them for their determination to shoot straight with science and numbers, for their motivation to clean up public perception, and for their perseverance in getting published. But I didn’t read the whole book. No way am I ploughing all the way through something that makes me feel like I’m back in what used to be referred to as junior high school, enduring the ennui of being 14 years old, forced to listen all day to better-informed people telling me the difference between my ass and a hole in the ground. 9.1/3.0

About John Sloan

John Sloan is a senior academic physician in the Department of Family Practice at the University of British Columbia, and has spent most of his 40 years' practice caring for the frail elderly in Vancouver. He is the author of "A Bitter Pill: How the Medical System is Failing the Elderly", published in 2009 by Greystone Books. His innovative primary care practice for the frail elderly has been adopted by Vancouver Coastal Health and is expanding. Dr. Sloan lectures throughout North America on care of the elderly.
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