1. Communicating Statistics What is the message? Philip Sedgwick St. George’s, University of London Burwalls: King’s College London. UK Annual Meeting for Teachers of Medical Statistics, July 1 st to 3 rd 2015.

2. Burwalls 1 st to 3 rd July 2015 Introduction Teaching statistics: Use of words? Impact on message? Expectations in application.  From research setting to….  ….Patients and public. Current teaching examples.

3. Burwalls 1 st to 3 rd July 2015 My Background Teaching medical statistics: Thirty years. MBBS, MRes. & MSc. students. MBBS: School Leavers and Graduate Entry.

4. Kaplan-Meier Survival Curves Aim: Evaluate effectiveness integrated care programme for patients with chronic low back pain. Design: Randomised controlled trial. Intervention (I): Combined patient-directed and workplace-directed intervention; one year follow-up. Control (C): Usual care. Participants: 134 adults (18-65), sick listed ≥ 12 wks due to low back pain. Outcome: Full sustained return to work. Survival times: Time until outcome. 4 (BMJ 2010;340:c1035) Burwalls 1 st to 3 rd July 2015

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6. Median duration:  Intervention: 88 days; Control: 208 days. One year estimates (approximate):  Intervention: 75%; Control: 65%. Log Rank Test: P=0.003 Hazard Ratio (HR) = 1.9; 95% Cl 1.2 to 2.8; P=0.004  Intervention: Significantly shorter times than control. Key Points: Teaching Burwalls 1 st to 3 rd July 2015

7. Patient experience?  Describe benefits treatment (median duration)?  May not benefit from intervention?  Enhanced recovery with control?  May not return to work. Nonetheless - Message is: Intervention: Significantly shorter times than control. Application Burwalls 1 st to 3 rd July 2015

8. Statistics: Culture of significance and superiority. Group experience: P-values & 95% CI. Conflict between “evidence” and pragmatism. What is the message?  Teacher to Student?  Student (Doctor) to Patient? Challenges Burwalls 1 st to 3 rd July 2015

9. Words Confuse? Statistical Significance  P < 0.05; 95% CI (Based on same theory). Significance: Everyday meaning = Importance. Statistics: Does not equate to importance.  Group experience: Relevance to population. Burwalls 1 st to 3 rd July 2015

10. The death of the P-value: What a chance!? Journal of Basic and Applied Social Psychology. Ban on hypothesis testing. Burwalls 1 st to 3 rd July 2015 Ban on significance versus ban on P-value.

12. What is Chance? Statistics: Synonymous with risk. Chance: Noun, adjective or verb. Culturally loaded society.  “Words matter and confuse”.  Teacher, student & patient. Banned. Odds, bias, error, confidence, qualitative expressions of risk, Burwalls 1 st to 3 rd July 2015 A Choice of Words

13. CASI Cork 11 th to 13 th May 2015 Concluding Thoughts Teaching  Curriculum: Modern needs;  Teaching is about relevance, not just facts;  People are not statistics. Culturally loaded society.  “Words matter and confuse”.  Use your words wisely!

14. CASI Cork 11 th to 13 th May 2015 © Swiss Statistical Society