David Spiegelhalter Quotes

That change in life expectancy is not that gripping in itself. So what we've done in the book, it does seem a rather a strange thing to say... "Over an adult lifetime, about... 50-60 years... take a year off your life." It's like losing roughly 1/50 of your life. It's actually because of... these daily habits... like losing a week every year of your life, the same as losing 1/2 hour off a day. So we could say... that... 2 hours watching television... it's as if it's taking 1/2 hour... off your life. ...You're aging an extra 1/2 hour sitting on your backside watching television ...

Psychologists got hold of this lovely idea of why we're trying to do it. I don't care what people do, so I'm not trying to change what they do, particularly. ...It would be nice if they could remember it... get the gist of something... learn something, but I don't even care too much about that. Psychologists have got this great scheme of what, perhaps, we're really trying to do, which is trying to breed some immunity to misleading anecdote, which is... the fact that we're so influenced by idiotic stories we hear on the web, or from our friends and neighbors.

So it's a different sort of risk. These are chronic risks. ...[T]hings that... if you carry on with them, are likely to shorten your life. So how can we express these... [T]hese are the ones that newspapers tend to get terribly wrong.

s are disastrous. ...Relative risks are deeply misleading. They're a manipulative form of communication. To ever say, "Oh, this doubles your risk, or increases your risk 50%," absolute No-no! They are hopeless. In some situations they can be very valuable... but in general, medical things what... should be always given... s... with and without something... Like my s... I was getting... 15%, 10 year risk: 15 out 100 people like me might expect to have a heart attack or stroke. So I... roughly halved it... only in terms of relative risk... from 15% to 7-8%. ...Being told it halved it does sound good, but if wasn't a very big number in the first place, halving it is of no interest... especially if the thing's going to give me some side-effects... if it did, it would be completely pointless... [Y]ou cannot know... whether you should do something... [Y]ou cannot trade off the benefits... [and] the harms from a medical treatment without knowing the absolute risk. You cannot do it in any rational way whatsoever. ...A lot of the communication now is using absolute risk, which is a huge improvement.

Gompertz's observation said that between the ages of 25 and 80, your risk of dying increases by about 9% per year. ...[T]hat means that every eight years your risk of dying doubles, essentially. ...[I]t's going to get you in the end. Mathematics proves it. You can't go on forever, because it's this exponential increase in the risk. Amazing, really powerful. That's why you peg out in the end. It's going to get you.

I do math and statistics. That's what I do, so I come at the whole business of turning numbers into stories. ...How can we turn numbers into stories?

[S]easonal flu—average year—kills 6,000 people in this country. Mainly old... vulnerable... frail...[etc.] So we are hit by this, year after year... epidemics... we've got to put this into perspective... [T]o an extent it is a trade-off between massive disruption... [I]f you say everyone has to stay in their home for 4 weeks... that's not just economic loss. It has a massive... health... [detriment] in terms of... mentality and fitness. Norsemen of harm will be done... so it's not just a matter of... "Minimize the number of deaths."

The worst... medical care would be just say, "Oh well, it's completely up to you. I'm not going to give you any advice." Well... you're the guy who knows... [the] supposed... expert. ...I want your advice. ...[T]his is an invaluable process which I hope all medical students have been taught. How to engage... It's not . ...Paternalism is ...immediately saying, "...I think you should do this," without really allowing that person a full autonomy to choose.

[W]e tend to think... of something that's going to happen... soon, or is well understood as risk, but if we're talking about what will happen in the world in ten years time. Who's going to start putting chances on this. You'd be... deluded... There's much... deeper uncertainty or... radical uncertainty...

There'a a nice thing about 1/2 hour because an adult life expectancy is 55 to 60 years... is actually a million 1/2 hours. A million 1/2 hours is 57 years. So you have got, not all of you... some of you have got a million 1/2 hours to fritter away.

Probability was only invented a few hundred years ago. It's not a natural way to think at all. It's extremely difficult and complex. Anything that can help people do it, is of benefit.

We need to think slow instead of fast, and resist drawing causal links between events where none may exist.

[I]n medicine... ... not manipulation or coercion, is when... as a doctor or... authority, you genuinely believe that this action is in the person's best interests, but they don't... want to do it. ...How do you make that an ethical persuasion? It's based on... two things, first... respecting the autonomy of the individuals, that they can refuse... no matter what, respect their ability to choose... the other thing is your authenticity, your integrity, that... you are doing this on behalf of that individual, for their best interest; not... to keep your clinic numbers up or to stop this person being a nuisance...[etc.]

This is called a hazard curve. ...This is the chance of dying before your next birthday, on average. ...[I]t's... on a , so 10%... (1 in 10) 83 year olds will not see 84... 1 in 100 people like me [age 59] will not see their next birthday. 1 in 1,000 thirty-two year olds, and 1 in 10,000 7 year olds... and there is a... lump, sadly jumping up at 17, as you can imagine... boys... a risk-taking lump, but if you ignore that lump... it's a... straight line between... 7 and 90.

Communication is not a one-way process. It's not just telling people things. ...[T]he first rule of communication is to shut-up and... just listen... and good doctors will do that. ...Good doctors will listen and explore the person's values and concerns, and... explore to what extent... that person want[s] to be guided... to be told what to do... and that's... appropriate to want... guidance from a trusted source. ...And ...make sure ...before ...that stage, you have ...genuinely laid out the options in a way that gives it balance. You haven't tried to manipulate them... into a particular direction. ...Very difficult ...but ...a worthy objective, and... having done that, it's perfectly reasonable to... then, give advice.