Making sense of those numbers

By Marcus Wilson 28/04/2010 1

A couple of weeks ago I had a cholesterol test.  (That involves taking a blood sample, and I was relieved that this time I didn’t faint.)  I collected my results from the doctor’s surgery earlier this week. The nurse handed me a piece of paper, with lots of numbers on, and provided me the reassuring comment "yeah, those look fine."

Anything more specific?  No.  What exactly does X mmol/L of triglyceride actually mean? I assume it means I had X millimoles of triglyceride compounds per litre of sampled blood, but what is normal for someone my age? What is considered acceptable? Does this mean there are issues with my diet? So it was left for me to sift through hundreds of trashy ask-the-doctor websites till I found some reasonable stuff on what cholesterol tests tested for, how variable the results were, and what that actually meant in terms of health, diet choices, etc.  And, yes, after suitable education, I came to the same conclusion as the nurse: "yeah, those look fine."

Without some kind of informed comment, scientific data can be pretty meaningless to the average guy on the street (Just as my cholesterol numbers were initially meaningless to me.) Whose job is it to provide that comment? Last night, we had a great Cafe Scientifique discussion with Aimee Whitcroft (Science Media Centre – sciblogs followers will know her I’m sure), about how science journalism works in New Zealand. Often journalists (particularly in NZ where there are not enough of them to specialise deeply) would love to be able to put that informed comment into their writing, but are prevented from doing so by lack of understanding themselves. That is where they have to talk to scientists who know the area. And scientists should be prepared to make such comments.  Not every member of the public has the skill, the patience, or the scientific discernment to trawl through the literature and find these things out for themselves.  Remember, data doesn’t equal information.



One Response to “Making sense of those numbers”

  • And the sad part is, for most people, there is no effective way for them to gain even the knowledge you found on the trashy websites, let alone read and understand the science around whether cholesterol is actually a big problem or not, whether statins are an effective treatment (or a dangerous one), and what risks and alternative therapies there are. There is little readily accessible and trustworthy pop-sci level information available to the average punter – you wouldn’t see this explained in the average newspaper, for instance. In fact, most of the real research regarding these issues is behind paywalls. So when their doc says “take these pills” their only option is to say yes and comply, or no, and take all the risks themselves. And people wonder why alt med options are so popular!

    I have several concerns with this situation:
    1. There are strong incentives for big pharma to exploit this trust relationship (while looking like the good guys),
    2. I suspect that there is a great deal of potentially unnecessary cost in the medical system (extracted from both public and private purses). I informally surveyed a doze or so of my middle-aged friends recently; almost all of them were taking long term meds like statins or beta blockers. This is a new phenomenon – go back 50 years and there would be no analogue. Are we sure this is about improving health outcomes?
    3. GPs have an incentive to just prescribe the pills rather than lifestyle changes (and this incentive accrues to the patient, too) as it’s quicker (my GP charges extra for consultations longer than about 5 minutes). I don’ know if they get financial incentives but assume not.

    This system is not good for our physical or economic health, or for our general level of scientific knowledge.

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