4 ms·

This is one of the more asinine articles I've read lately. It draws a false distinction between "saving lives" and "N-year survival rates", and then lambasts do

This is one of the more asinine articles I've read lately. It draws a false distinction between "saving lives" and "N-year survival rates", and then lambasts doctors for not understanding this fanciful distinction. It's a false distinction because we all eventually die. If we look at 100-year survival rates for test B, everyone's dead, so the survival rate is 0. So there is no such thing as "saving lives". There _only are_ N-year survival rates. Generally speaking, it takes a lot more than random musings of a random journalist to up-end an incredibly wide-spread metric of effectiveness of diagnostics and treatments...

matthewowen 14y ago
Tim Harford is hardly a 'random journalist'; he's a well respected economic journalist, and a fellow at Nuffield College, Oxford (which is notable within the university for its focus on social sciences). Besides which, it doesn't draw a false distinction between the two, at all - you've misread the article if you think that it does. The point it makes is that if a new screen improves five year survival rates it is very possible that it has not actually extended anyone's life, and that this is problematic because many doctors are unable to realise this (or to appreciate how significant the claims of other treatments are). In fact, your claim that there's no such thing as "saving lives" is a true case of asininity. Of course we die eventually - but some treatments can extend life, and that's why we use them. Moreover, this is actually a very important topic in the UK at the moment (note that this article was published in the Financial Times), because current NHS reforms are putting much more commissioning power in the hands of consortiums of GPs ('family doctors' in the US parlance) - so the ability of doctors to evaluate the claims of efficacy made for different treatments and screens is very important (and by the evidence of the research he cites, somewhat lacking). It's hardly lambasting - it is now important that GPs can understand these subtleties, whether they're happy about being in this situation or not.
comicjk 14y ago
> It's a false distinction because we all eventually die... There _only are_ N-year survival rates. The metric he's discussing is death rate from the disease in question. So although we all eventually die, we don't all die from, for example, pancreatic cancer. Thus, "does it reduce the death rate by pancreatic cancer" is a notably better metric than "does it reduce the total incidence of death over the next five years." As to whether a random journalist can come up with a better metric of success than the medical profession, look at your own response to the proposal. You misunderstood, you got angry, you questioned the credentials of the source. If the medical profession in general has that attitude to outside criticism, then yes, it seems likely that they would not be using the optimum statistical measures.
Pwnguinz 14y ago
If you don't like this particular article, Peter Norvig goes over the same topic (problem?) much more rigorously: http://norvig.com/experiment-design.html http://norvig.com/experiment-design.html
l00p 14y ago
^ This.

matthewowen 14y ago

Tim Harford is hardly a 'random journalist'; he's a well respected economic journalist, and a fellow at Nuffield College, Oxford (which is notable within the university for its focus on social sciences). Besides which, it doesn't draw a false distinction between the two, at all - you've misread the article if you think that it does. The point it makes is that if a new screen improves five year survival rates it is very possible that it has not actually extended anyone's life, and that this is problematic because many doctors are unable to realise this (or to appreciate how significant the claims of other treatments are). In fact, your claim that there's no such thing as "saving lives" is a true case of asininity. Of course we die eventually - but some treatments can extend life, and that's why we use them. Moreover, this is actually a very important topic in the UK at the moment (note that this article was published in the Financial Times), because current NHS reforms are putting much more commissioning power in the hands of consortiums of GPs ('family doctors' in the US parlance) - so the ability of doctors to evaluate the claims of efficacy made for different treatments and screens is very important (and by the evidence of the research he cites, somewhat lacking). It's hardly lambasting - it is now important that GPs can understand these subtleties, whether they're happy about being in this situation or not.

comicjk 14y ago

> It's a false distinction because we all eventually die... There _only are_ N-year survival rates. The metric he's discussing is death rate from the disease in question. So although we all eventually die, we don't all die from, for example, pancreatic cancer. Thus, "does it reduce the death rate by pancreatic cancer" is a notably better metric than "does it reduce the total incidence of death over the next five years." As to whether a random journalist can come up with a better metric of success than the medical profession, look at your own response to the proposal. You misunderstood, you got angry, you questioned the credentials of the source. If the medical profession in general has that attitude to outside criticism, then yes, it seems likely that they would not be using the optimum statistical measures.

Pwnguinz 14y ago

If you don't like this particular article, Peter Norvig goes over the same topic (problem?) much more rigorously: http://norvig.com/experiment-design.html http://norvig.com/experiment-design.html

l00p 14y ago

^ This.