Friday, 29 January 2016

Anything for the weekend?

Harry S. N. Greene, pathologist, cancer researcher, and Yale professor, when testifying in 1957 to a Congressional committee, disputing an interpretation of a statistical study,  famously said
It was noted long ago that the front row of burlesque houses was occupied predominantly by bald-headed men. In fact, such a row became known as the bald-headed row. It might be assumed from this on statistical evidence that the continued close observation of chorus girls in tights caused loss of hair from the top of the head. 
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I think of this wherever a politician mentions the 'Weekend Effect'  (painfully often of late).

Whereas people in ivory towers (no – considering the state of academic funding I should make that stucco-clad breezeblock towers) may talk about "The Post hoc ergo propter hoc fallacy", I think of bald men and naughty ladies.

BMJ study wisely says (my emphasis)
The weekend effect is real, concludes Helen Crump in her review of the evidence (doi:10.1136/bmj.h4473). Paul Aylin confirms this in his Editorial but explains that we are left with a range of possible explanations (doi: 10.1136/bmj.h4652). These need to be scrutinised before assumptions and suggestions harden into policy. 
Here are a few obvious yeah-buts that have occurred to me without the benefit of any training in statistical analysis (beyond O-level maths).
  • People don't practise many extreme sports during the working week; they save their death-defying stunts up for the weekend. Even practices as gentle as rambling (risking exposure, hypothermia...) can lead to weekend emergency hospital admissions.
  • People who start feeling dicky during the week don't go straight to hospital. Come 5 o'clock Friday though, and nobody's picking up the tab for their misfortune, they high-tail it to A&E (in the absence of a weekend GP service)
  • Elective surgery is done during the working week. Emergency surgery is done from Monday through to Sunday (sorry  can't bring myself to say "Twenty-f..."; see  just no can do) . As a result, the average surgery patient is automatically nearer death at the weekend.
  • etc etc ...
Last Wednesday, Inside Health went into this in much more (and more persuasive) detail. published a round-up of some research last year, but the list of 8 papers was compiled in October 2015, and the earliest 2 date from 2010. And only the most recent 2 date from 2015.

All of  which reminds me of the lady mentioned on Midweek (?) last Wednesday who always packed a hand grenade when flying, to reduce the possibility of anyone else having one. Or the driver who, on learning that most road-traffic accidents happen near junctions, automatically put his foot down whenever he saw one. As the title of an early BMJ article warned at the time of the first paroxysm of Jeremy Hunt's madness:

Seven day working: why the health secretary’s proposal is not as simple as it sounds

And as archy said, in archy and mehitabel (rough quote),

whenever a politician 
does get an idea 
he usually gets it wrong

Well, must go. Time for More or Less.


PS – A crossword clue:

Model worker? Hardly, arriving at THIS time. –  (8)

Update 2016.03.11.10:40 – Added PPS

Time's up: TEMPLATE (with apologies to people whose brand of English doesn't include the word temp.

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