Hi again!
First, I have to whine that I constantly feel that I lack knowledge. And it's absolutely true. So if you know the answer to something I don't or disagree with something I say, don't hesitate to mention it (politely, if you can :)
It'd be great to learn more and fill the holes in my understanding.
Okay. That said...
I'll admit, at the time when I entered the School of Public Health as a first-year Masters student, I had no idea that I would be taking a total of 4 biostatistics classes within 3 semesters. All I had was a vague image that epidemiology was the process of taking data (numbers!) and translating that into information that the general public can understand.
In truth, epidemiologists seem to me to be enslaved by numbers. We have to read papers dating back to the 1980's about the correct way to interpret models and numbers. Well, it is important that we understand our data properly, and don't demand more answers out of them than they are equipped to offer. So in this sense, it's good to think a lot about the figures.
Until we get to the point where the concern is too much in the numbers themselves.
Here, I'll illustrate two examples that I find interesting. I know there are many more out there!
--Cutoff points.
Cutoff points for p values (if you don't know what I'm talking about, feel free to comment as such) are hilariously arbitrary, in my opinion.
Cutoff values in clinical use--such as BMI cutoffs for who is 'obese' versus 'morbidly obese' or Hemoglobin counts > 13.5 being 'eligible to donate whole blood'--seem to be more thoroughly thought out and disputed in most cases...?
--Goals.
This is something that came up in my Global Health class last week. Those periodical ___ (fill in with the name of a health initiative of choice) Conferences like to set goals for how much work they want to get done before their next meeting. The funny thing is, some of those organizations get too caught up in the numbers and suggest crazy things to achieve them.
I think one example (I apologize for not remembering the exact organization, notes are somewhere else right now...UN?) was about HIV/AIDS goals.
The idea was that the participating countries wanted to get their AIDS prevalence lowered to a certain number. Sound normal enough?
But considering that AIDS is a life-long condition that can't go away, its prevalence in a population will inevitably keep increasing as long as the incidence of new cases never hits zero.
So someone suggested that they stop providing antiretroviral therapy (a.k.a. let the cases die off), otherwise the goals won't be reached. Plus that would be better economics.
......ETHICS, anyone?
I'd like to believe that our job as health care providers is to help all people live, and let them enjoy good quality of life while they're at it, rather than strive blindly for numeric goals set by higher-level policy......but that's just me.
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