Super important that doctors discuss the risks, even the rare ones, when severe, with patients before doing a procedure/jabbing them with something/putting them on a pharmaceutical
This is despite the fact that her PhD was extremely statistics-heavy, and she still does statistical analysis in her job, not every day, but more than once a week. Admittedly she's not a medical statistician, but I don't think that should matter.
For doctors an aggregate 1% chance is low, but the realization of the outcome in a single person is not a percentage, its binary bad side effects or not.
Admittedly, doctors could usually do better in communicating risks (e.g. see the famous example of 1/3 risk of impotence, which patients interpret either as 1 out of 3 people, 1 out of 3 times having sex, or 1/3 of the time of sex).
Anybody who has played much D&D knows that a 1% chance isn't as low as it sounds.
- 1% chance of living the rest of your life in mind numbing pain
- 50% chance of having to remove that pesky wisdom tooth
(numbers pulled out of thin air)
In the first case, I'd really really think about it hard and deep, and question myself if it's really that necessary; in the second, meh, worst case I lose a wisdom tooth.
Sounds like she is proceeding with the procedure despite this fear, which seems to indicate to me a fairly astute assessment of the risk.
However, I agree people are generally not very good at evaluating risk.
And it’s not like the outcomes are random so that <1% bad outcome with unknown causes could be 100% for a gene she has.
Her fear isn’t completely irrational as perhaps her stats knowledge is useful to not assume perfect estimation of those odds.
I always found it interesting how people assume numbers are spot on when they are frequently just estimates or averages of multiple experts guessing.
Having just read the tweet linked below (since I can't get past the paywall) this seems Health and Human Services ballpark.
We can argue about whether FDA should have more oversight but there are very real restrictions on what FDA is actually authorized to do by Congress.
That's all to say: FOIA into FDA is interesting but the IRB seems responsible here and there's a claim the researchers deviated from approved consent forms. Anyway it just seems that this might be complaining the FDA didn't do something that it cannot do.
With this study they cut it out, remove, and study it, without the study they burn it away.
If that's really the case, then this seems like a non story to me.
The current most wildly successful, heavily prescribed medicines today are statins. They help 1 in 104 people in terms of preventing heart attacks, 1 in 154 people in terms of preventing stroke. (Those are people without known heart disease, but they are the vast majority of people taking statins.) They harm 1 in 10 by causing muscle damage, 1 in 50 by causing diabetes. [1] That's the success story. (Sure, you can debate the details. Do they really cause diabetes? Unclear. Do they help anyone, ever, to not die sooner? Unclear.)
It seems like the main reason they're considered so successful is that they do indeed lower an intermediate metric, namely blood cholesterol level. I am sure that bloodletting was successful at removing blood, and if you have an infection, you could even say at removing bad blood.
And yes, I'm cherrypicking my definition of success. Modern medicine can indeed dramatically improve outcomes for a large set of problems (eg cancer). But doctors were successfully setting bones back in the bloodletting days, too.
[1] https://thennt.com/nnt/statins-for-heart-disease-prevention-...
Note this is exactly why we actually use the studies of people with prior cardiovascular disease that this meta excludes. Those people are sufficiently likely to actually have another heart attack within the time horizon of the study that you can get useful data!
The other option is to only conduct 60 year trials. It should be obvious why that isn't a viable option.
I'm going to disagree about the cohort. That only means that if you have prior heart disease, you should not be looking at an NNT derived from a population without prior heart disease. The site's conclusions are mostly irrelevant for you, and should not factor into a rational decision.
If you don't have prior heart disease and are weighing your options, then those data are relevant to you. The vast majority of people who are deciding whether to take statins are in this category.
People deciding whether to try to remove a bullet from their abdomen, and who have no reason to believe that they have ever been shot, should not be weighing the outcomes of test subjects who had been shot before participating in the trial. (It would really suck to be in the control group...)
I'm not saying you shouldn't take statins, with or without prior heart disease. An individual would have more to go on than the existence or absence of a prior heart disease diagnosis. Exact cholesterol readings, for example, might create more or less urgency.
But if I were in the situation of deciding for myself, I'd want better evidence for them than I have seen presented so far. I am suspicious of an industry for which this is a big success story.
Something went wrong, but don’t fret — let’s give it another shot.
Not the actual mountain mind you, there you'd probably be diagnosed with an acute case of Shahed drone instead.