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Know Your Chances: Understanding Health Statistics [Paperback]

Steven Woloshin , Lisa M. Schwartz , H. Gilbert Welch
5.0 out of 5 stars  See all reviews (2 customer reviews)
Price: CDN$ 29.43 & FREE Shipping. Details
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Book Description

Nov. 30 2008 0520252225 978-0520252226 1
Every day we are bombarded by television ads, public service announcements, and media reports warning of dire risks to our health and offering solutions to help us lower those risks. But many of these messages are incomplete, misleading, or exaggerated, leaving the average person misinformed and confused. Know Your Chances is a lively, accessible, and carefully researched book that can help consumers sort through this daily barrage by teaching them how to interpret the numbers behind the messages. In clear and simple steps, the authors—all of them staff physicians at the Veterans Administration Medical Center in White River Junction, Vermont—take the mystery out of medical statistics. By learning to understand the medical statistics and knowing what questions to ask, readers will be able to see through the hype and find out what—if any—credible information remains. The book's easy-to-understand charts will help ordinary people put their health concerns into perspective.This short, reader-friendly volume will foster communication between patients and doctors and provide the basic critical-thinking skills necessary for navigating today's confusing health landscape.

Frequently Bought Together

Know Your Chances: Understanding Health Statistics + Seeking Sickness: Medical Screening and the Misguided Hunt for Disease + Overdiagnosed: Making People Sick in the Pursuit of Health
Price For All Three: CDN$ 55.38


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Review

“Short and simple. . . . . Present(s) the basic skills necessary in navigating today’s confusing health-media landscape. “
(Library Journal 2008-08-26)

“ Delightful and educational reading, simple enough for laypeople to understand yet academic enough to meet the needs of . . . . students.”
(L. Synovitz Choice 2009-07-01)

“Know Your Chances is an accessible and empowering text.”
(Journal Of Biosocial Science 2011-02-07)

“A great reminder that . . . medical claims should always be evaluated by how they affect you and your current state of health.”
(Tampa Tribune 2008-12-20)

“A great reminder that . . . medical claims should always be evaluated by how they affect you and your current state of health.”
(Highlands Today 2008-12-20)

“Read this book first and then think again.”
(Time Magazine 2009-03-26)

From the Inside Flap

"This is the book for anyone (and that's most of us) who has ever felt whipsawed by the incessant and often contradictory media reports of health threats and medical fixes. The authors—well-known experts in risk analysis—take readers by the hand and show them in easy-to-follow steps how to evaluate health stories and decide for themselves what really matters and what is merely hype. A valuable and unique contribution."—Marcia Angell, MD, former editor of The New England Journal of Medicine

"We have a deluge of medical information coming from caregivers, drug companies, and the media. Some of this is accurate and important, some misleading and irrelevant. This concise and clearly written primer gives us a strategy to navigate through these data and arrive at an intelligent understanding of what we need for our health and what we can forgo."—Jerome Groopman, MD, author of How Doctors Think

"Valuable to any patient or prospective patient, from junior high schoolers to senior citizens."—Joel Best, author of Stat-Spotting: A Field Guide to Identifying Dubious Data

"Many people have an interest in making you unnecessarily afraid about diseases you're not likely to get or cause you to have unrealistic expectations about the benefits of treatment. This book gives you the skills to make your own judgments about these claims. It provides a roadmap for deciphering the kinds of statistics that keep us from making truly informed decisions."—Maryann Napoli, Associate Director of Center for Medical Consumers

"The authors have done a remarkable job of dispelling the clouds that often separate people from the medical information that they need. Know Your Chances reflects the authors' confidence that, with a little help, people can make sound decisions about their own health."—Baruch Fischhoff, author of Acceptable Risk

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Most helpful customer reviews
2 of 2 people found the following review helpful
5.0 out of 5 stars Enlightening, Refreshing and Very Important Feb. 24 2009
By G. Poirier TOP 50 REVIEWER
Format:Paperback
This book is absolutely superb! The authors do an excellent job in bringing the often complicated field of medical statistics to a level that any interested layperson can easily understand. In addition to going through many examples that illustrate how important it is to ask the right questions when confronted with often sketchy statements about survival rates, death rates, drug performances, etc., they show how useful information may be sought and interpreted. This information may then be used by the interested individuals to make decisions about what to do in their own specific cases. The book includes a glossary, risk charts for women and men (with information on how to read them) and many other useful features. The writing style is clear, friendly, engaging and authoritative while remaining jargon-free. Because of this, the book is accessible to a very broad readership. In addition, this book can be considered as another important contribution to the fight against innumeracy. It can be enjoyed and used by anyone.
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Format:Paperback
This is a excellent book on the topic, directed to folks who have no training in Medicine or Medical Statics. The authors present information on what to look for in medical stat's and medical advertising. I was a phrama rep for 25+ years and this is the most unbiased straight forward presentation of this topic I have yet to see. If a drug company presentd their products to Doctors, using the information that is discussed,or doctors demaned to see the same information of the Rep and Drug Company, there would be a lot of the NEW DRUGS, lab tests and or Medical Procedures not being so quickly prescribed or ordered, as they would not pass the test that would show they are even a good as what is currently being used. Take a copy of this with you when you next visit you MD and he wants to order drugs/tests or procedures.
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Amazon.com: 4.5 out of 5 stars  21 reviews
26 of 27 people found the following review helpful
5.0 out of 5 stars Nice tutorial Jan. 18 2009
By Rick Evans - Published on Amazon.com
Format:Paperback
As the medical care industry consumes larger proportions of the U.S. GDP we are bombarded by a rising number of messages from pharmaceutical companies,medical device suppliers, hospitals, medical specialists and activists seeking attention for their medical services and causes. Adding to these advertisements are medical reporters trying to attract eyeballs to their print or electronic news media.

Often these messages are accompanied by numbers intended to cast an amplifying light onto the message or simply parroted by "health reporters" too lazy to interpret data into a less misleading or alarmist form.

Know Your Chances: Understanding Health Statistics is a fast read, only 113 pages, that takes the reader step by step through what it takes to put these numbers into perspective. Why, for example is it true that the risk for being struck with colon cancer is both 5 out of 10000 and 1 out of 19. The difference between the two is time frame which is often omitted from the message.

Naked percentages are another abuse of numbers often appearing in messages. Activists will often use large percentages of small populations to suggest a big change while a corporation might use a small percentage of a large population to play down danger. Both are misleading but common.

The authors define risk in the first chapter and show the reader how to put it into perspective in chapters 2 and 3. This foundation is important as it shows how the oft cited lifetime population or annual population risk is not the same as individual risk. Lifestyle, family and medical history greatly influence individual risk.

The benefits of "health intervention" are tackled in chapters 4 and 5. Aside from weighing the benefits of intervention against the risk of doing nothing side effects must be considered. Also the outcome of an intervention must be distinguished from a treatment's benefit. They're not the same.

Think reducing risk is always good? Think again. Reducing a minor risk with a treatment that has dangerous side effects is hardly desirable. Think about a sleeping pill that might gain you 30 minutes more sleep during an eight hour night but leave you feeling drowsy during your morning commute. Chapters 6 and 7 educate the reader about the downsides of risk reduction and how to balance benefit against side effects. The remaining chapters show help the reader recognize exaggerated claims and how to become a healthy skeptic.

Each chapter includes simple but illustrative quizzes that help the reader ensure they have grasped the concepts discussed.

This book will likely be read by few patients. Few know about the book and most simply follow their doctor's advice. However this book should be a must read for any health reporter. Policy makers and influencers hoping to improve the quality of health care would also benefit reading this book.Primary care doctors would also benefit with a gentle reminder of what the learned or should have learned in medical especially in an era of soaring health care costs and exaggerated claims by for profit health care suppliers.
21 of 22 people found the following review helpful
5.0 out of 5 stars if you take medicine, you should read this book Feb. 2 2009
By Vickie Venne - Published on Amazon.com
Format:Paperback
If I were in charge of store displays, I would require that this book would be prominently presented for sale next to every pharmacy in this country. And I would recommend that every person who takes any medicine read it. This book is a terrific, easy to read resource for anyone who wants to make truly informed decisions regarding the risks and benefits of their personal health situation. In this technologically sophisticated age, we want to believe that those highly marketed drugs improve our health - both when we are sick and when we are trying to prevent disease. As a genetic counselor who works with families who have an increased risk of developing cancers, I spend much of my clinical time helping them understand their risk of disease and management options to reduce that risk. Many procedures and drugs do help certain people, but this book will help you understand if the drug or procedure will make a significant difference - or if you (or your third party payor) will be spending lots of money for only a little benefit. In addition, as our country continues to deal with a health care system that desperately needs to be fixed, this primer will be important for everyone who participates in the policy conversations to gain a better understanding of the way in which hype about medical risks and benefits often confuses the discussion.
14 of 14 people found the following review helpful
5.0 out of 5 stars Should be required reading for everyone April 28 2009
By Dr. Cathy Goodwin - Published on Amazon.com
Format:Paperback
Discussions of health care reform tend to focus on who pays for care. This book is a much-needed reminder to address an even more important question: Why are we struggling to pay for treatments and drugs that may not be accomplishing anything?

The authors walk us through a discussion of risk with detailed examples and illustrations. Sure, it's a little simple, but not everyone has studied statistics. I've had graduate-level stats courses and I found the discussions helpful and enlightening.

What's really scary is that we're exposed to hype in news reports, which often seem to come directly from press releases of the pharmaceutical companies. I wonder how many MDs read these statistics without understanding what's going on.

Even worse, we're getting propaganda from medical institutions. The authors show a misleading flyer from the prestigious M.D. Anderson Health Center in Houston.

My favorite part of the book is the discussion on survival rates. If you're diagnosed early you may not get an extra day of life. You just live with the knowledge longer.

I can't help wondering if the millions of dollars we're spending on drugs claiming to lower cholesterol and reduce hypertension might not be better spent on healthy food, exercise and stress reduction. As the authors point out, we need evidence that people with better "numbers" really live longer and experience less suffering. We also need evidence that these drugs really contribute to meaningful outcomes, not just lower numbers.

Just this morning the Wall Street Journal solemnly reported a drug that promised to lower "prostate cancer risk" by 23% among a large sample of high-risk men. Following the guidelines of this book, it was easy to spot flaws. The difference between the placebo group and the drug group was just 6.5%, not 23%. In other words, out of 1000 men, 65 seem to have been spared the diagnosis - not 230. Is that a big number? The authors advise, "It's up to you."

The authors warn us to look with skepticism at promised outcomes. For instance, "shrink the tumor" doesn't always mean "reduce risk death by cancer." "Increase bone density" doesn't mean "avoid hip-fracturing falls."

In this article, the outcome was "diagnosed with prostate cancer," not "death from prostate cancer." If many of the men were 70 or over, it's possible that they would end up dying *with* prostate cancer, as opposed to dying *from* prostate cancer.

The only point I'd add (and I may have missed it in the book) is that extremely large samples can lead to misleading results. When you have huge samples, you can get significant correlations by chance. A study of hundreds of thousands sounds impressive but you need to look more closely.

Everyone needs to read this book, especially consumers of the medical system, legislators and regulators.
13 of 14 people found the following review helpful
5.0 out of 5 stars Enlightening, Refreshing and Very Important Feb. 24 2009
By G. Poirier - Published on Amazon.com
Format:Paperback
This book is absolutely superb! The authors do an excellent job in bringing the often complicated field of medical statistics to a level that any interested layperson can easily understand. In addition to going through many examples that illustrate how important it is to ask the right questions when confronted with often sketchy statements about survival rates, death rates, drug performances, etc., they show how useful information may be sought and interpreted. This information may then be used by the interested individuals to make decisions about what to do in their own specific cases. The book includes a glossary, risk charts for women and men (with information on how to read them) and many other useful features. The writing style is clear, friendly, engaging and authoritative while remaining jargon-free. Because of this, the book is accessible to a very broad readership. In addition, this book can be considered as another important contribution to the fight against innumeracy. It can be enjoyed and used by anyone.
7 of 7 people found the following review helpful
5.0 out of 5 stars A road map for deciphering medical information - we all need this book! Jan. 31 2009
By Elizabeth Canner - Published on Amazon.com
Format:Paperback
When we are barraged with drug ads that promise miracle cures to our everyday life problems, when there's a good chance our doctor is on the payroll of a drug company,
and when patient advocacy organizations are often funded by the pharmaceutical industry, it's hard to know what medical information to trust. "Know Your Chances" is a clearly-written and easy-to-understand guide that helps the reader to figure out fact from fiction in medical information.

The authors are well-known doctors from Dartmouth Medical School who have spent many years analyzing and teaching about risk analysis in medicine. They bring their teaching ability to this book - presenting engaging examples and easy to learn tools for deciphering medical statistics.

This is a book everyone should read to ensure that they are getting the best health information possible.
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