Musings of a phenomenologist

Science, psychiatry and random musings

Why oh why oh why? (Do I read the BBC news health section)

Posted by soveda on October 3, 2008

I did it again, this was going to be a follow up post about the mental health act but instead here I am ranting about the BBC’s coverage of a health story.

The story in question is: Sick leave link to “early death”.

Why am I picking on this? (the inverted commas are in their title BTW)

Well, firstly because of the title, the use of inverted commas to highlight “early death” would seem to suggest that those words mean something else. As an example suggesting that someone went to have a “massage” is somewhat different to going for a massage. Or am I being picky?

The reporter has then done it again, second paragraph of the main story:

The “unexpected” finding could help pick out at risk groups, the University College London researchers reported in the British Medical Journal.

Does the writer not believe that the finding was unexpected? If they wanted to quote the study then they should have used more than one word. You can feel the “air quotes” as you read the sentence.

And breathe…

Now as to the study itself, I have now read it and it is interesting in what it says.

Here are the actual results from here:

Results After adjustment for age, sex, and employment grade, employees who had one or more medically certified spells of sickness absence (>7 days) in a three year period had a mortality 1.7 (95% CI 1.3 to 2.1) times greater than those with no medically certified spells. Inclusion of diagnoses improved the prediction of all cause mortality (P=0.03). The hazard ratio for mortality was 4.7 (2.6 to 8.5) for absences with circulatory disease diagnoses, 2.2 (1.4 to 3.3) for surgical operations, and 1.9 (1.2 to 3.1) for psychiatric diagnoses. Psychiatric absences were also predictive of cancer mortality (2.5 (1.3 to 4.7)). Associations of infectious, respiratory, and injury absences with overall mortality were less marked (hazard ratios from 1.5 to 1.7), and there was no association between musculoskeletal absences and mortality

Those confidence intervals get awfully close to 1.0 (no difference) at times but I’ll let you make your own decisions about that.

The study does state that it has been known from previous work that long term sick leave is associated with increased mortality but the unusual finding is that a relatively short period of sick leave has an effect. The different effect of different diagnoses is also interesting but although they report that Psychiatric diagnoses are linked to a higher risk of cancer death (2.5 times more) than cardiovascular mortality (1.2 times more) they state that this difference is not statistically significant.  I don’t know whether this was an error in the write-up but this then does not seem to support their conclusions or the BBC report.

Read the study, check the stats and make your own minds up, but please please please go back to the data rather than news sources.

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