Friday, 26 August 2016

Sad night

I've just heard the very sad news that Richard Nixon has passed away this morning. I can't say I knew Richard very well, but I thought he really was a lovely guy and I am very saddened.

I knew of him (among other things) through his work on covariate adjustment in health economic evaluations, which I think was part of his PhD at the MRC Cambridge. I then got in contact with him more closely when I was thinking of organising the short course based on BMHE, since he and Chris were already doing something like that. I suggested we did the course together and he was very enthusiastic about it. In fact, when he was asked to teach a short course at the University of Alberta, he said the three of us should have a go, which we did. Then we taught the course at Bayes 2014UCL and at a one-day workshop organised by the RSS. He fell ill just before the last edition of the course.

Tonight I have a very vivid memory of the time we were in Edmonton having dinner after the first night of the course when I told that for some reason Italians usually get really crossed about chicken in pizza and that he used to tease me with that every time we've met since, saying that he would love a pizza with chicken. And how we used to introduce ourselves to the audience $-$ and how sometimes people were to young to get the references. I'll miss you, Richard.

Wednesday, 17 August 2016

National lottery

Yesterday, many British newspapers have covered the news of the new Dementia Atlas, released by the Department of Health.

As far as I can see, the atlas uses data from a variety of sources (including the Quality Outcomes Framework, QOF, scheme, which collects information from general practices around the country, providing incentives to the doctors to record data on key indicators).

So far so good $-$ nothing wrong with that. In fact, cool representation with maps highlighting geographical variation across England and providing rates for several summary statistics, eg prevalence of dementia, level of diagnosis, etc. As usual, though, the media couldn't resist jumping on the news and making a meal of it, mostly by presenting it with grand headlines, which in many cases missed the point, or bluntly mis-represented reality, I think.

For example, beloved Daily Mail and The Telegraph yell about "Post-code lottery in care". Now, it may well be that the data reveal massive inequality in the access to care and diagnosis across the country, which is a very good thing to expose in order to tackle it and then remove it or at least limit it $-$ that's in the spirit of the NHS. But, although I think the website should have made a much better job at explaining the numbers reported, it appears that the information presented in the maps is about the raw rates! It's not quite clear then whether the background characteristics of each area (defined in terms of Clinical Commissioning Group, CCG) do play a role in explaining away some of the differences in the actual rates for each of the measures reported in the table. 

So may well be that we're playing Peter Griffin's lottery with people's health. Or there may be much more than that. But some media just don't care about which is which...