Statistics. So much around us revolves around statistics. The economy, the chances of having an earthquake, the safety of our flights, the likelihood of our children being accepted into their chosen university, our pension funds, and most importantly – our health.
Quite a few times we’ve heard from patients, “the chances of that treatment to succeed, according to my doctor, are not high” or “according to statistics, this chemotherapy would increase the likelihood of a successful outcome by 10%.” Frankly, it all makes a lot of sense because it is based on science and research. Until we ask ourselves the question – on which side of the statistics is our patient?
The problem with statistics can be demonstrated in the famous Pareto principle, also known as the 80/20 rule. The idea, first introduced by the Italian economist Vilfredo Pareto, is that 80% of effects come from 20% of the causes. Therefore, it is much more efficient and eventually effective to invest resources in the causes that solve 80% of the cases. This principle is widely used in many fields of life, one of which is health.
This is where it starts to become tricky. When a patient receives a statistical answer, we respect the science behind it – but we also know that if they happen to be within the 20% and not the 80%, they might be in trouble. Not because their physician is not right, but because the system is not built for optimal personalization but rather for the mainstream. This is how drugs are developed, how medical procedures are designed, and how experiments are conducted. Nevertheless, in front of us, there is not 80% or 20%, but rather 100% of a patient!
We are the first to acknowledge that statistics is an important tool. We use it all the time to support our findings. Without it, the health system would not work. But we also understand that the variability is huge and that the challenge is to understand which statistics are relevant for the specific single patient.
Today, more than ever, we can do so. First, because we have the data. Health data is probably the biggest growing sector of all. There is so much data out there that the question is actually where and how do we find it, and how do we properly analyze it. Second, we have many more ways to determine each patient’s unique characteristics by using objective parameters, such as past medical records, gene sequencing, biome analysis, and more. In a way, we can break the patient who’s in front of us into pieces so we can find the relevant data that best suits the ‘culmination of pieces’ that is the whole patient. Last but not least, is the personal desires of our patient. While science uses statistics as a mean of measuring effects, it might well be the case that a specific patient has a different desire than the mainstream. More than once, we’ve heard patients ask our team to look for alternative treatments, no chemotherapy, easier hormonal treatment or other information, even though it’s not part of the recommended medical guidelines. It’s like a patient is telling the doctor, “You mean your statistics are facts, but my facts are just statistics.”
While statistics is definitely a science, navigating through it on behalf of a specific patient is an art which begins by investing time in understanding the patient, rather than the numbers. This is what we try to do every day.
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