Every day we are bombarded by television ads, public service announcements, and media reports warning of dire risks to our health and offering solutions to help us lower those risks. But many of these messages are incomplete, misleading, or exaggerated, leaving the average person misinformed and confused. Know Your Chances is a lively, accessible, and carefully researched book that can help consumers sort through this daily barrage by teaching them how to interpret the numbers behind the messages. In clear and simple steps, the authors--all of them staff physicians at the Veterans Administration Medical Center in White River Junction, Vermont--take the mystery out of medical statistics. By learning to understand the medical statistics and knowing what questions to ask, readers will be able to see through the hype and find out what--if any--credible information remains. The book's easy-to-understand charts will help ordinary people put their health concerns into perspective.This short, reader-friendly volume will foster communication between patients and doctors and provide the basic critical-thinking skills necessary for navigating today's confusing health landscape.
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From School Library Journal
"How to see through the hype in medical news, ads, and public service announcements" boasts the cover of this accessible and reader-friendly book by Dartmouth Medical School faculty and researchers Woloshin, Lisa M. Schwartz, M.D., and H. Gilbert Welch, M.D. (Should I Be Tested for Cancer?). Assaulted by incomplete, misleading, and overstated health messages by the media, health journals, and pharmaceutical companies, the general public is poorly prepared in how to read the information critically, how to assess credible evidence, and how to interpret statistics. The authors here set out to correct these shortcomings by explaining how to understand risk, judge the benefit of health interventions, and consider outcomes. The subject is complex, but the text is short and simple. Quick, useful quizzes complete coverage and verify that the reader has understood the material. "Learn More" boxes provide easy opportunities to investigate a subject in more detail. A "Quick Summary," glossary, and "Credible Sources of Health Statistics" section are helpful in presenting the basic skills necessary in navigating today's confusing health-media landscape. Recommended for all libraries.—James Swanton, Harlem Hosp. Lib., New York
Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved.
Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved.
Review
"Short and simple. . . . . Present(s) the basic skills necessary in navigating today's confusing health-media landscape. "--Library Journal
" Delightful and educational reading, simple enough for laypeople to understand yet academic
enough to meet the needs of . . . . students."--Choice
enough to meet the needs of . . . . students."--Choice
"Know Your Chances is an accessible and empowering text."--Journal of Biosocial Science
"A great reminder that . . . medical claims should always be evaluated by how they affect you and your current state of health."--Tampa Tribune
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Most Helpful Customer Reviews
26 of 27 people found the following review helpful
By Rick Evans
Format:Paperback
As the medical care industry consumes larger proportions of the U.S. GDP we are bombarded by a rising number of messages from pharmaceutical companies,medical device suppliers, hospitals, medical specialists and activists seeking attention for their medical services and causes. Adding to these advertisements are medical reporters trying to attract eyeballs to their print or electronic news media.
Often these messages are accompanied by numbers intended to cast an amplifying light onto the message or simply parroted by "health reporters" too lazy to interpret data into a less misleading or alarmist form.
Know Your Chances: Understanding Health Statistics is a fast read, only 113 pages, that takes the reader step by step through what it takes to put these numbers into perspective. Why, for example is it true that the risk for being struck with colon cancer is both 5 out of 10000 and 1 out of 19. The difference between the two is time frame which is often omitted from the message.
Naked percentages are another abuse of numbers often appearing in messages. Activists will often use large percentages of small populations to suggest a big change while a corporation might use a small percentage of a large population to play down danger. Both are misleading but common.
The authors define risk in the first chapter and show the reader how to put it into perspective in chapters 2 and 3. This foundation is important as it shows how the oft cited lifetime population or annual population risk is not the same as individual risk. Lifestyle, family and medical history greatly influence individual risk.
The benefits of "health intervention" are tackled in chapters 4 and 5. Aside from weighing the benefits of intervention against the risk of doing nothing side effects must be considered. Also the outcome of an intervention must be distinguished from a treatment's benefit. They're not the same.
Think reducing risk is always good? Think again. Reducing a minor risk with a treatment that has dangerous side effects is hardly desirable. Think about a sleeping pill that might gain you 30 minutes more sleep during an eight hour night but leave you feeling drowsy during your morning commute. Chapters 6 and 7 educate the reader about the downsides of risk reduction and how to balance benefit against side effects. The remaining chapters show help the reader recognize exaggerated claims and how to become a healthy skeptic.
Each chapter includes simple but illustrative quizzes that help the reader ensure they have grasped the concepts discussed.
This book will likely be read by few patients. Few know about the book and most simply follow their doctor's advice. However this book should be a must read for any health reporter. Policy makers and influencers hoping to improve the quality of health care would also benefit reading this book.Primary care doctors would also benefit with a gentle reminder of what the learned or should have learned in medical especially in an era of soaring health care costs and exaggerated claims by for profit health care suppliers.
Often these messages are accompanied by numbers intended to cast an amplifying light onto the message or simply parroted by "health reporters" too lazy to interpret data into a less misleading or alarmist form.
Know Your Chances: Understanding Health Statistics is a fast read, only 113 pages, that takes the reader step by step through what it takes to put these numbers into perspective. Why, for example is it true that the risk for being struck with colon cancer is both 5 out of 10000 and 1 out of 19. The difference between the two is time frame which is often omitted from the message.
Naked percentages are another abuse of numbers often appearing in messages. Activists will often use large percentages of small populations to suggest a big change while a corporation might use a small percentage of a large population to play down danger. Both are misleading but common.
The authors define risk in the first chapter and show the reader how to put it into perspective in chapters 2 and 3. This foundation is important as it shows how the oft cited lifetime population or annual population risk is not the same as individual risk. Lifestyle, family and medical history greatly influence individual risk.
The benefits of "health intervention" are tackled in chapters 4 and 5. Aside from weighing the benefits of intervention against the risk of doing nothing side effects must be considered. Also the outcome of an intervention must be distinguished from a treatment's benefit. They're not the same.
Think reducing risk is always good? Think again. Reducing a minor risk with a treatment that has dangerous side effects is hardly desirable. Think about a sleeping pill that might gain you 30 minutes more sleep during an eight hour night but leave you feeling drowsy during your morning commute. Chapters 6 and 7 educate the reader about the downsides of risk reduction and how to balance benefit against side effects. The remaining chapters show help the reader recognize exaggerated claims and how to become a healthy skeptic.
Each chapter includes simple but illustrative quizzes that help the reader ensure they have grasped the concepts discussed.
This book will likely be read by few patients. Few know about the book and most simply follow their doctor's advice. However this book should be a must read for any health reporter. Policy makers and influencers hoping to improve the quality of health care would also benefit reading this book.Primary care doctors would also benefit with a gentle reminder of what the learned or should have learned in medical especially in an era of soaring health care costs and exaggerated claims by for profit health care suppliers.
21 of 22 people found the following review helpful
By Vickie Venne
Format:Paperback
If I were in charge of store displays, I would require that this book would be prominently presented for sale next to every pharmacy in this country. And I would recommend that every person who takes any medicine read it. This book is a terrific, easy to read resource for anyone who wants to make truly informed decisions regarding the risks and benefits of their personal health situation. In this technologically sophisticated age, we want to believe that those highly marketed drugs improve our health - both when we are sick and when we are trying to prevent disease. As a genetic counselor who works with families who have an increased risk of developing cancers, I spend much of my clinical time helping them understand their risk of disease and management options to reduce that risk. Many procedures and drugs do help certain people, but this book will help you understand if the drug or procedure will make a significant difference - or if you (or your third party payor) will be spending lots of money for only a little benefit. In addition, as our country continues to deal with a health care system that desperately needs to be fixed, this primer will be important for everyone who participates in the policy conversations to gain a better understanding of the way in which hype about medical risks and benefits often confuses the discussion.
14 of 14 people found the following review helpful
Format:Paperback
Discussions of health care reform tend to focus on who pays for care. This book is a much-needed reminder to address an even more important question: Why are we struggling to pay for treatments and drugs that may not be accomplishing anything?
The authors walk us through a discussion of risk with detailed examples and illustrations. Sure, it's a little simple, but not everyone has studied statistics. I've had graduate-level stats courses and I found the discussions helpful and enlightening.
What's really scary is that we're exposed to hype in news reports, which often seem to come directly from press releases of the pharmaceutical companies. I wonder how many MDs read these statistics without understanding what's going on.
Even worse, we're getting propaganda from medical institutions. The authors show a misleading flyer from the prestigious M.D. Anderson Health Center in Houston.
My favorite part of the book is the discussion on survival rates. If you're diagnosed early you may not get an extra day of life. You just live with the knowledge longer.
I can't help wondering if the millions of dollars we're spending on drugs claiming to lower cholesterol and reduce hypertension might not be better spent on healthy food, exercise and stress reduction. As the authors point out, we need evidence that people with better "numbers" really live longer and experience less suffering. We also need evidence that these drugs really contribute to meaningful outcomes, not just lower numbers.
Just this morning the Wall Street Journal solemnly reported a drug that promised to lower "prostate cancer risk" by 23% among a large sample of high-risk men. Following the guidelines of this book, it was easy to spot flaws. The difference between the placebo group and the drug group was just 6.5%, not 23%. In other words, out of 1000 men, 65 seem to have been spared the diagnosis - not 230. Is that a big number? The authors advise, "It's up to you."
The authors warn us to look with skepticism at promised outcomes. For instance, "shrink the tumor" doesn't always mean "reduce risk death by cancer." "Increase bone density" doesn't mean "avoid hip-fracturing falls."
In this article, the outcome was "diagnosed with prostate cancer," not "death from prostate cancer." If many of the men were 70 or over, it's possible that they would end up dying *with* prostate cancer, as opposed to dying *from* prostate cancer.
The only point I'd add (and I may have missed it in the book) is that extremely large samples can lead to misleading results. When you have huge samples, you can get significant correlations by chance. A study of hundreds of thousands sounds impressive but you need to look more closely.
Everyone needs to read this book, especially consumers of the medical system, legislators and regulators.
The authors walk us through a discussion of risk with detailed examples and illustrations. Sure, it's a little simple, but not everyone has studied statistics. I've had graduate-level stats courses and I found the discussions helpful and enlightening.
What's really scary is that we're exposed to hype in news reports, which often seem to come directly from press releases of the pharmaceutical companies. I wonder how many MDs read these statistics without understanding what's going on.
Even worse, we're getting propaganda from medical institutions. The authors show a misleading flyer from the prestigious M.D. Anderson Health Center in Houston.
My favorite part of the book is the discussion on survival rates. If you're diagnosed early you may not get an extra day of life. You just live with the knowledge longer.
I can't help wondering if the millions of dollars we're spending on drugs claiming to lower cholesterol and reduce hypertension might not be better spent on healthy food, exercise and stress reduction. As the authors point out, we need evidence that people with better "numbers" really live longer and experience less suffering. We also need evidence that these drugs really contribute to meaningful outcomes, not just lower numbers.
Just this morning the Wall Street Journal solemnly reported a drug that promised to lower "prostate cancer risk" by 23% among a large sample of high-risk men. Following the guidelines of this book, it was easy to spot flaws. The difference between the placebo group and the drug group was just 6.5%, not 23%. In other words, out of 1000 men, 65 seem to have been spared the diagnosis - not 230. Is that a big number? The authors advise, "It's up to you."
The authors warn us to look with skepticism at promised outcomes. For instance, "shrink the tumor" doesn't always mean "reduce risk death by cancer." "Increase bone density" doesn't mean "avoid hip-fracturing falls."
In this article, the outcome was "diagnosed with prostate cancer," not "death from prostate cancer." If many of the men were 70 or over, it's possible that they would end up dying *with* prostate cancer, as opposed to dying *from* prostate cancer.
The only point I'd add (and I may have missed it in the book) is that extremely large samples can lead to misleading results. When you have huge samples, you can get significant correlations by chance. A study of hundreds of thousands sounds impressive but you need to look more closely.
Everyone needs to read this book, especially consumers of the medical system, legislators and regulators.
Most Recent Customer Reviews
5.0 out of 5 stars
Vital Information That's Easy to Understand
When you hear on the news that something will double your risk of getting some disease, do you ever wonder, "Double it from what to what?" It does make a difference. Read more
Published 3 months ago by jiffy
5.0 out of 5 stars
All Dr. Welch's books are must reads for everyone!!
All books by H. Gilbert Welch M.D. Should be read by everyone. I am a physician and I learned a great deal from these books. Also he has some YouTube videos. A warning...... Read more
Published 3 months ago by Trent A. Johnson
4.0 out of 5 stars
Depends on what you know going in...
I lecture to doctor colleagues on some of the topics in this book and they often need reminding of the concepts. Read more
Published 4 months ago by M. Rethman
5.0 out of 5 stars
Everyone should have this information.
When you consult with a doctor about anything, you should have this information at your fingertips.
I have a small medical library - it is the book friends borrow most often.
I have a small medical library - it is the book friends borrow most often.
Published 4 months ago by Tanna B. Kasperowicz
5.0 out of 5 stars
Explains How Survival Rates Improve While Death Rates Stay the Same
Screening can dramatically improve survival rates. The authors explain why that isn't necessarily good news. Read more
Published 7 months ago by Michael Caracappa
5.0 out of 5 stars
Excellent Summary, Easily Readable
It can be hard to make sense of health messages - the message writers may not know what they're doing, or, more likely, they are exaggerating. Read more
Published 22 months ago by Loyd E. Eskildson
5.0 out of 5 stars
Great Guide to Good Healthcare Decisions
This book does a terrific job of helping us translate the mountain of healthcare claims we see and hear each day... Read more
Published on May 10, 2011 by S. M. Russell
1.0 out of 5 stars
Health scare rather than health care
The American health care system has many, many problems. Suggesting
that health screening is one of them is absurd. Read more
that health screening is one of them is absurd. Read more
Published on January 31, 2011 by sporcutt
4.0 out of 5 stars
Know some of your chances
This is the rare non-fiction book where more chapters might be desired. How would one evaluate a hospital? a specific physician? Read more
Published on June 17, 2010 by James S. Kelley
3.0 out of 5 stars
An Elementary Approach
This book is okay as far as it goes, but it appears to have been written for high-school-age students or younger. Read more
Published on May 24, 2010 by Karen A
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