After a fantastic lecture from Dr. Ellie Horthersall about maths, statistics and medicine in Dundee I felt inspired to write a blog post and look further into the statistics of the public health sector. Ellie trained as a doctor and now lectures at the University of Dundee as well as working in the pulic health sector dealing with statistics on a daily basis. Firstly she informed us of the statistics used for students who get onto the course which are very complicated and it is very rigorous. Each student has to complete a UCAS form and a UKCAT test which involves lots of problem solving and mathematics. Each of these tests are then merged together to calculate whether or not they can be accepted onto the course. Ellie explained how Dundee University is trying to change the norm of student doctors being middle class, white, very intelligent people and they are looking at getting students from different backgrounds onto the course whom show potential.
Statistics is all about maths but there is also a lot of common sense when understanding some of the maths within simple statistics. More complex statistics are very tricky to understand and takes experts in the field to decipher them. Ellie talked about many statistics which are used within the Public health sector. Statistics are gathered for example, for the average growth of a baby while in the mother’s womb so it can be compared to see if the baby is developing correctly or not. These statistics will help Doctors and Midwives check whether the baby is growing at the correct speed depending on the time of measurement and if there is a problem they will be able to do more tests which may determine why there is a change in development. This data is very useful and helps to identify different problems which the mother carrying the child may have which in turn will prompt the doctor to have more regular scans or checkups.
BMI is another statistical chart which is used by doctors to determine whether your height matches your weight in being of a healthy weight to being underweight or obese. This is a very general chart which may be invalid if you are a bodybuilder or long distance runner. Example of a BMI chart below:
Maths is crucially important for nurses, as well as doctors as a huge amount of their job, requires the use of maths and for example a SEWS (Scottish Early Warning Score) or NEWS (National Early Warning Score) Chart which is filled in when a patient is in a hospital several times throughout the day. These have several areas which I have researched through the Royal College of Physicians and these include; respiratory rate, oxygen saturation, temperature, systolic blood pressure, pulse rate, level of consciousness. Each of the 6 are scored each time the patient is checked depending on how unwell they are and a score is calculated. This will alarm the nurse if it is high or low which they will check again in case there was a mistake or phone the doctor for assistance. This is a very handy tool for doctors and nurses to use in a hospital ward for each patient. An example of a SEWS chart can be found here: http://journals.plos.org/plosone/article/figure/image?size=large&id=10.1371/journal.pone.0087073.g002
Other jobs which the medical profession require maths for are:
- Drug doses (per kg for children)
- Fluid prescribing
- Biomechanics
- Pharmacodynamics
- Biochemistry
- Interpreting research and probabilities
These are all really crucial parts of mathematics which if they get wrong it could cost the life of a patient which has happened before with over-prescription of drugs such as morphine. In the article below doctor gave patient six times the amount of a painkiller than he was supposed to. This resulted in the doctor having a 15month suspended jail sentence for her manslaughter. http://www.yorkshirepost.co.uk/news/doctor-bitterly-regrets-morphine-overdose-1-2300386
There are a huge amount of other statistics which are gathered by the government and public health to create life expectancy tables, an effect of vaccines, hospital mortality ratios, patterns in diseases to name but a few. These tables which are created show a general idea of each area but don’t actually look at the reasons why. There are many reasons why the life expectancy may be lower in one part of Scotland to the likes of London for example. Deprivation, money, poverty, access to good health care…. the list goes on. Each of these factors influences the life expectancy of an area. Other things such as boy racers getting killed in one year in freak accidents may also influence that year’s life expectancy figures. To calculate the life expectancy in a year all that is done is the ages of the people that have died in that year is added up and divided by the number of people that died. The table below also shows the difference in life expectancy between women and men which is between 5 and 10 years of difference.
An article on the BBC news looks at the life expectancy difference between women and men reducing: http://news.bbc.co.uk/1/hi/health/7699457.stm
Australian Government explains how life expectancy can be impacted:
“Life expectancy is affected by many factors such as: socioeconomic status, including employment, income, education and economic well-being; the quality of the health system and the ability of people to access it; health behaviours such as tobacco and excessive alcohol consumption, poor nutrition and lack of exercise; social factors; genetic factors; and environmental factors including overcrowded housing, lack of clean drinking water and adequate sanitation.”
These factors are also apparent in the UK and Scotland and do affect the life expectancy in different parts.
At the end of her presentation, Dr. Ellie explained the importance of teaching mathematics to children of a young age and the profound understanding of fundamental mathematics (PUFM) is essential in all medical professions and starting in the Primary school is essential to build up their knowledge. I also feel that mathematics is essential for everyday life and as Ma (2010) suggests each of her PUFM concepts of connectedness, basic ideas, longitudinal coherence and multiple perspectives are all so crucial when developing in further in life and learning. Teaching mathematics requires the in-depth knowledge of not just how to do the problems but also why and teachers with a PUFM are able to explain maths better to children and make it more enjoyable and encourage the children to understand mathematics to a higher level.
Overall a fantastic insight into the life of doctors and health care professionals use of statistics to do many things within their jobs.
References:
Australian Government (2012) Life Expectancy and Well-being. Available at: http://www.health.gov.au/internet/publications/publishing.nsf/Content/oatsih-hpf-2012-toc~tier1~life-exp-wellb~119 (Accessed: 11 Nov 2017)
BBC News (2008) Life expectancy gender gap closes. Available at: http://news.bbc.co.uk/1/hi/health/7699457.stm (Accessed: 11 November 2017)
Hothersall, E. (2017) Numeracy: Every contact counts (or something) [Lecture to MA2 Education Students] Discovering Mathematics. University of Dundee: 9 November.
Ma, Liping (2010) Knowing and Teaching elementary mathematics: teachers’ understanding of fundamental mathematics in China and the United States. New York: Routledge.
The Royal College of Physicians. (2015) National Early Warning Signs (NEWS). Standardising the assessment of acute-illness severity in the NHS. Available at: https://www.rcplondon.ac.uk/projects/outputs/national-early-warning-score-news Accessed: 10 November 2017