HEALTH MAT­TERS

Macclesfield Express - - MACCLESFIELD PEOPLE -

●» WITH Dr Paul Bowen, a GP with McIlvride Med­i­cal Prac­tice, Poyn­ton, and ex­ec­u­tive chair of NHS Eastern Cheshire Clin­i­cal Com­mis­sion­ing Group (CCG). UPON read­ing a re­cent ar­ti­cle about an­tide­pres­sant pre­scrib­ing in Mac­cles­field, I was re­minded of a favourite say­ing: “Sta­tis­tics are used much like a drunk uses a lamp­post – for sup­port, not il­lu­mi­na­tion.”

As such, sta­tis­tics can be used to por­tray what­ever ‘truth’ we wish, but they of­ten don’t tell the full story.

As a doc­tor, I’m nat­u­rally scep­ti­cal about such data with­out hav­ing an op­por­tu­nity to re­view the ev­i­dence, ap­ply con­text, and await in­tel­li­gent, ob­jec­tive in­ter­pre­ta­tion.

How­ever, many of my GP col­leagues will iden­tify with the com­mon sce­nario of a pa­tient grip­ping a news cut­ting on the latest health scare or won­der drug, want­ing to know more.

Data is dif­fer­ent from ev­i­dence.

Data might sug­gest peo­ple who are ad­mit­ted at the week­end are more likely to die in hos­pi­tal, but with­out a much deeper dive into the rea­sons why and types of peo­ple ad­mit­ted, and how and when they died, one can­not jump to the con­clu­sion that hos­pi­tals are dan­ger­ous at week­ends.

The same is true of an­tide­pres­sant fig­ures.

We shouldn’t rush to the in­ter­pre­ta­tion that the re­cently re­ported ‘high pre­scrib­ing’ fig­ures of these med­i­ca­tions for peo­ple in Mac­cles­field is a bad thing.

The data doesn’t say more peo­ple have de­pres­sion, or even that more peo­ple are pre­scribed an­tide­pres­sants, but sim­ply that there were more pre­scrip­tions is­sued.

The data doesn’t tell us if 100 peo­ple were is­sued with one drug each, or 20 peo­ple were treated and their dose or med­i­ca­tions were changed five times.

We use an­tide­pres­sants to treat pain, menopause, mi­graines and many other con­di­tions – and jump­ing to con­clu­sions can be dan­ger­ous and un­fair.

More im­por­tantly, what if the data does re­flect more peo­ple lo­cally are on an­tide­pres­sants for de­pres­sion – this could re­flect a greater will­ing­ness for peo­ple to seek help, or for GPs to pre­scribe what is proven safe treat­ment?

Too many peo­ple go through life un-di­ag­nosed, un­able to see their GP, afraid of the stigma.

The sta­tis­tics sug­gest this might not be the case lo­cally, but I would need to see more data to make a bal­anced judge­ment.

What re­ally mat­ters are out­comes. Do these peo­ple get bet­ter? Do they go back to work or col­lege? Do they en­joy life again and was their ex­pe­ri­ence of care pos­i­tive? This is the data I’d love to see.

To go be­yond the data, and get in­for­ma­tion based on in­tel­li­gence, it is im­por­tant for us all to be scep­ti­cal, and dig deeper.

There is a lot of clin­i­cally-sound health news avail­able at nhs.uk/ news, which I would thor­oughly rec­om­mend.

●» Dr Paul Bowen

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