• David Wright

Women 32% more likely to die after operation by male surgeon – but should we be worried?

The Guardian recently headlined an article with the quite shocking conclusion that women are almost a third more likely to die during surgery when it is performed by a man.


Death! Scandal! Re-tweet! Outrage!


Although the clinical trial was well designed and did come to that conclusion, the reality is not that scary. As the excellent “More or Less” podcast discussed, the main reason behind this lies between the very important distinction between relative and absolute risk – something the Guardian failed to mention.

 
Are you feeling lucky?

If I told you that I had a secret method that could double your chance of becoming a millionaire then I’m sure you would be very interested to hear all about it. But if it turned out it would just increase your chance from 1 in 45 million to 2 in 45 million (and involves buying a second lottery ticket) then you’d rightfully feel a bit pissed off!

 

This rather extreme example highlights the difference between a relative change (doubling your chance of success) and an absolute change (rather than having to buy a ticket every day for 123,000 years you’d only need to do it for 61,500 years - which is no realistic improvement for us mortals). It just goes to show that a large relative change may still be quite meaningless without context.


So, what is the context of the 32% increased relative mortality in the original article? The study showed that the absolute risk of a women dying in surgery when performed by a female surgeon was 5 deaths per 1,000 which increased to 6.6 deaths per 1,000 when performed by a male. Clearly something that should be looked into, but it is a very small increased risk. In fact, the More or Less podcast suggests that the difference may not be due to the surgeon at all as more complicated surgeries are often given to those with more experience which tend to be men (an issue for another time).


Understanding and reporting these differences correctly is an essential part of accurate scientific communication. Although the media isn’t held to these high standards, the pharmaceutical industry is by Clause 6.1 in the ABPI:



So next time you hear a wild claim in the news, or you write about a clinical finding, ask yourself if the difference is really meaningful or if you’re just being sold an extra lottery ticket.



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