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主题:【原创】戳穿所谓猛料---送给中间派的您 -- 虽远必诛

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家园 【原创】戳穿所谓猛料---送给中间派的您

现在是邪风日上,大有横行之势。看看这个

我来下一点猛料吧:西医罢工,死亡率下降

还派生出一个神奇的:

推论:目前中国每月死亡100万人。假如全中国的西医罢工3个月,原来3个月死亡300万人,降低到死亡150万人。也就是说,中国的西医大罢工3个月,能让150万人避免死亡,相当于一个城市的人口免于死亡。

怎么说好呢?幼稚可笑到了极点,还出来四处显眼。

实际上都不用驳斥的这个幼稚可笑的胡言乱语,在他给出的链接第四个,写得清清楚楚。外链出处

应当是没有看到,或者,看到了,但是看不懂。

贴出来给大家看看,仔细讲解一下,让不是非常清楚洋文的同学们也知道是什么。

问题:

Dear Cecil:

Hi, Cecil. I have come across a number of seemingly credible reports suggesting that every time doctors go on strike the overall death rate goes down, in some cases quite precipitously. Can you ascertain if this in fact is the case or if some other factors are at work here?

— Jacob

有明确的证据证明医生罢工死亡率下降,能够确认一下,或者解释一下是否其他因素起作用。

回答:

really so surprising that mortality statistics sometimes show a drop during a doctors' strike. What's staggering is that a reasonable person could see such stats and for even an instant think: Holy crap, those doctors are killing us. Sure, there'll always be a few alternative-medicine fringe dwellers who genuinely see the medical establishment as some sinister cabal presiding over a high-density feedlot of human misery. But the way this "fact" about doctors' strikes gets passed around suggests that a lot more people are a little more nuts than you'd want to imagine.

这些是有的,一定有人得出医生不是治病而是杀人的结论。其中这个词用得好 nuts,用金山词霸查查什么意思。

如果说医生杀人是nuts,得出可以救150万命的就一定是idiot了。

No one's suggesting that changes in the availability of doctors wouldn't affect what happens to their patients in the short term - a study from last May, for instance, found that in both Australia and the U.S. birth rates decreased from 1 to 4 percent on days when OB/GYNs held their annual conferences. But looking over the data on doctors' strikes, it's hard to see where the MDs are saving many lives by staying out of the OR:

医务工作者的行为短期内就会影响到这个社会的健康,比如说医生,助产士开会,出生率就会下降。

第一个事实:

One example often cited is that of a monthlong strike by Los Angeles County physicians in 1976, during which the mortality rate for patients was seen to drop by 18 percent. But a 1979 study in the American Journal of Public Health showed that the overall area death rate remained unchanged, as enough personnel remained on duty to handle the real emergencies. Any seeming benefit to patients' health likely resulted from about 11,000 fewer operations (presumably elective) being performed that month than was typical, meaning that an estimated 50 to 150 patients who could have been expected to die didn't.

1976年洛杉矶医生罢工,有报道死亡率下降18%,但是在1979年发表的关于当年的死亡率调查结果,发现没有变化。

主要的问题是少了11000个择期手术fewer operations,预期减少50-150个死亡案例。

这里要详细说明一下什么是择期手术,什么是急诊手术emergency operation.

急诊手术,比如说车祸,比如说工伤,还有象老赵的蛛网膜下腔出血。等不得。不做会死人。

择期手术则不同,都是慢性病,可以等,比如说关节置换,心脏的搭桥,乳腺癌切除等。早一天,晚一天区别不大。

医生罢工,我参与过奥克兰的。不是等同于公车司机罢工,您不做公车,改走路,骑自行车就可以了。

医生罢工是只有不重要的科室才可以罢工,急诊室,手术室,产房,以及配套的化验,放射线,想都不要想。

这些都是直接救命的。

相反择期手术不同,是手术就有风险,麻醉意外,术后的感染,肺栓赛等。

短期的取消择期手术,就把这些死亡率,取消了。但是患者该死的还是要死的,也就出现的当年的死亡率没有明显变化的结果。比如说乳癌,不做手术,当时不会死,以后还会死。但是当时做了,5年生存率增加了,在五年内活得人会比死的多。虽然在做手术的短期内,有人会有意外死亡。

这些人的寿命是降低了,但是整体是提高的,不然为什么做手术。

也就是说,把短期的结果,认为是永远的结果。非常幼稚可笑。

看问题要长期看。

另外,为什么不看到急诊手术的价值。可以做一个实验,把不相信手术的人,在急诊都不做手术,看看有多少会死。

当然已经有例子了,当然不签字手术,一尸二命的惨痛教训并不是很远。

2,

A four-month Israeli doctors' strike in 1983 was found to have some definable effects on public health - the percentage of cesarean sections increased somewhat, and one study suggested hypertension patients might have received worse treatment - but no observed impact on mortality. Nonetheless, the popular wisdom saw the work stoppage as a disaster: a detailed study of public perceptions afterward found that nearly one in four urgent-care patients (or their relatives) felt the strike had resulted in major health problems.

在以色列的研究发现,医生罢工明显影响医疗工作,剖腹产增加,高血压患者得不到良好资料,4个重症患者出现明显健康问题。

3,

A 1984 doctors' strike in Varkaus, Finland, mainly meant fewer visits for colds and stomachaches; no significant harmful effects to the public were seen, researchers found, and the uptick in visits after the doctors returned to work suggested that patients were glad to have them back.

1984年芬兰罢工没有明显影响公共健康,但是研究表明患者还是欢迎医生回来工作。

4,

Another key example used to support the proposition that fewer doctors means fewer deaths comes from a June 2000 article in the British Medical Journal written during another Israeli strike; the author reported that in the three months after doctors walked out death rates fell significantly in affected cities. However, her data was by no means the result of a scientific study but consisted mostly of anecdotal reports from funeral home directors, who claimed they'd seen "the same thing in 1983." What is known is that, as in the LA strike, many thousands of elective surgeries were postponed but emergency rooms and chronic care departments remained open.

这个在2000年六月在BMJ英国医学杂志上的关于另外一个以色列罢工的例子,别广泛宣传。但是结论为死亡率大大下降,并不是从系统研究得出的,而是从殡仪馆老板得出的。他还声称同1983年一样。

取样太偏颇了,而且还是择期手术的问题。急诊,重症照样要开的。

5

In 2003 a SARS outbreak closed four hospitals in Toronto, and all non-emergency services were suspended. Among other things, this led to the canceling of a quarter to a half of joint-replacement surgeries, 40 percent of cardiac surgeries, and as much as 93 percent of some outpatient procedures. The result? The greater Toronto area did see a slight dip in mortality rate relative to the prior two years, but so did the rest of Ontario, and the decrease wasn't statistically significant anyway.

2003年SARS的时候,多伦多4家医院关闭所有的急诊服务,四分之一到一半的关节置换被取消了,40%心脏手术,93%的门诊服务也被取消。

结果是大多伦多地区死亡率轻微下降,但是其它地区比如说没有取消的渥太华也是一样下降,没有统计学意义。是随机产生的结果。

总结部分:

So despite media suggestions to the contrary, doctors' going on strike doesn't seem to have much effect on the death rate one way or the other, and any reduction seen is probably the result of postponed or canceled nonemergency surgeries. And that figures: any surgery is risky, and some common procedures (like coronary bypass or aneurysm repair) have a death rate you just can't ignore. But leaving the tummy tucks out of it, most elective surgeries boast a pretty serious payoff, either in quality-of-life improvement right now or in medical trouble avoided down the line. If 600 people die each year as a result of hip-replacement surgery, does that mean the 200,000-plus patients that pulled through were fools to go under the knife? You're welcome to calculate the odds however you like, and in certain cases it may well make sense to question the value of surgery. As a general proposition, though, if my health is on the line, I'm glad to hear that the doctor is in.

医生罢工导致死亡率下降是因为取消择期手术。择期手术有风险,但是明显提高患者生活质量。

20万例髋关节置换会出现600例死亡,但是这20万患者的整体生活质量是明显提高的。

作者提出,他是愿意选择手术的。

看问题不能仅仅看一个方面。比如说开车会导致车祸死亡。但是有多少人开车?有多少人愿意放弃开车,去在长安街上骑毛驴?

同时看到,急诊手术救了多少生命,剖腹产挽救了多少母婴。

如果说放弃完全西医在中国三个月,死得人只能更多。

如果真的可以挽救150万,国家的医疗管理机构脑子都有病,看不出来?

那个幼稚的小白,为什么不写信为卫生部,用它的证据,结论去劝说大老爷放弃西医?估计被扔到垃圾桶的可能性大。明显精神不正常的表现。

另外,你有兴趣可以看看他写得其它内容,很好玩链接出处

简单看几个:

我正在修炼中 (阅:12 ↑0 ↓0

可惜我杂务缠身,心静不下来,还没有出现内景现象,现在只感觉眼前微微有些亮光(我只在纯黑暗环境中静坐)。但我的同班同学已经有出现此现象的。我对此已经没有怀疑。

但实际上此事必须亲证。否则哪天我到了这个境界,对别人而言恐怕还是不能作为证据。

药医不死病,佛渡有缘人 (阅:9 ↑0 ↓0

有时候还真得各安天命。

我坚持这个观点:治不好乙肝的医生其实在如何治疗乙肝上是没有发言权的,无论他有多显赫的学历和头衔。

嘿嘿,那些练气功的大师也不给他看看,是不是走火入魔了。

通宝推:所以我才飞好远,南加菜帮主,

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