'Nothing matters very much, and few things matter at all' - Arthur Balfour, Conservative Prime Minister 1902-05

Doctors haven't been good at explaining to patients some of the principles that underpin medical practice. A lot of the misunderstandings which occur relate to risk and probability, and that in turn is something that our schools have failed to teach their pupils. A good explanation of some of the issues is given at this site.

I could go on about why I think it's important to increase the public understanding of science, and medical science in particular, but this chap does it much better than I ever could.

And I spent quite a bit of time trying to do something about it myself - see The Book.

popular science/medicine

The following links will take you to a number of online articles I contributed to Cambridge University's Naked Scientists site. Some are basic explanations of how medical imaging works, but others deal with the issue of risk and risk/benefit analysis:

radiation risks

The public are becoming increasingly aware of the risks of the ionising radiation used in medicine. When used responsibly, the potential benefits of x-rays and scanning will outweigh any small risk. I co-authored this leaflet which hopefully helps to put the risks into perspective.

The issue of radiation hazards is covered in a bit more detail in this excerpt from some teaching material I use in Leeds, and on the publications page of this site, I refer to this national guidance on the protection from unnecessary radiation of female patients who might be pregnant.

More recently, I gave this public lecture at the Royal Society of Medicine entitled 'Stop worrying - radiation is good for you'. I also worked with a small independent film company to produce a 'taster' film on the subject of radiation risks and maintaining a sense of proportion. We hoped to use it to obtain a grant to produce a longer film, but unfortunately, that didn't come to anything. Anyway, here it is, for what it's worth.

and talking of risk.............

...............and they way we react to it, there is still a lot of concern about the risks to our children of vaccination, and particularly the measles/mumps/rubella vaccine (MMR). This was stirred up a few years ago by a paper in The Lancet (since retracted) which was used by one of its authors (Andrew Wakefield) to suggest that the development of autism could be related to vaccination. No matter that there was no evidence for this, that the claims have since been refuted and that vaccination had virtually eradicated these infectious diseases; some parents are still reluctant to protect their children. I mention this in one of the Naked Scientist pieces referenced above, but there's a much more eloquent plea for common sense here, written (some years ago, before measles had been almost eradicated) by Roald Dahl, whose young daughter died of the disease.  Dahl's article will hopefully make today's parents think twice before putting their children at risk from infections that they have come to consider as little more than a nuisance (and not just their children - as vaccination rates fall, we lose 'herd immunity' and the children of more responsible parents are also put at increased risk of infection before they have been fully vaccinated).

The result of all this  unnecessary scare-mongering? - we're returning to the situation Dahl described, and in the UK, children are beginning to die of measles again. And despite the good common sense spoken by those who know about autism, the single-interest anti-vaccination lobby persists in spreading alarm and misinformation.

how do clinical tests (including imaging) work?

Patients have a touching faith in the ability of 'tests' to diagnose their disease, and of course we rely heavily on clinical testing in medical practice.  All the same, there is a lot of misunderstanding around how we use tests, and how we assess the results.  This article looks at the theory of testing in a non-mathematically threatening way, and also examines at the issue of how we use tests to screen asymptomatic members of the public for sub-clinical disease. This is a hot topic, and there is a lot of misunderstanding (not least on the part of media and politicians) about the potential for screening, and the performance of established screening programmes (see also the Times article on the journalism page).