A LEADING statistician said doctors must do more than “dump information” on patients in the wake of a landmark legal ruling brought by a Lanarkshire mother whose son was brain damaged during birth.

Professor Sir David Spiegelhalter said medics had to distinguish between patients who would be satisfied with a basic summary of the potential benefits and risks, and those who would want a more complex picture including uncertainties around the evidence.

He said: “We have to adapt to the audience because people vary enormously in what they want to hear and what they can deal with.

“There’s no one size fits all – there’s no single audience for information.”

Sir David added that more also needs to be done to educate the public on understanding data based on numbers so that they can “grapple with overblown claims” in relation to health, such as new drugs, treatments or screening programmes.

It comes as a four-day conference in Glasgow by the Royal Statistical Society (RSS), starting today, which will examine issues such as how to break down statistics to help inform, rather than bombard, patients about their options.

There is now increased pressure on doctors to make sure patients are “aware of any material risks involved in a proposed treatment”, compared to the previous legal test that asked whether a doctor’s conduct “would be supported by a responsible body of medical opinion”.

It follows a watershed Supreme Court ruling in 2015 which saw Nadine Montgomery, from Cumbernauld, awarded £5.25 million after a 16-year legal battle.

The court upheld Mrs Montgomery’s contention that had she been given proper advice it might have led her to deliver more safely by elective caesarean.

She was small but her obstetrician did not tell her that this increased the risk of her son becoming stuck, particularly as she was diabetic and diabetic mothers are known to give birth to larger than average infants.

In the event, her son Sam did become stuck and suffered oxygen deprivation to his brain which resulted in severe disabilities, including cerebral palsy and nerve damage.

Sir David, a Cambridge academic and president of RSS who has played a leading role in a number of health-related public inquiries, including the case of serial killer GP Harold Shipman, said the ruling put a greater onus on medics to explain the case for and against certain treatments.

He said: “It can’t be like when you download software and there’s the agreement that you tick where it’s just page after page of stuff that nobody reads.

“That is not giving information. It can’t be about just dumping stuff on people. It’s got to be accessible.

“People vary enormously in what they want to hear and what they can deal with. There’s no one size fits all – there’s no single audience for information.

“Some people are perfectly entitled to say ‘that’s fine, just tell me what to do?’.

The problem is, after Montgomery, doctors have to be a bit careful because after that ruling you really have to relax the paternalistic view.

“You can’t just do what the profession thinks is reasonable, you have to take into account patients’ own personal circumstances, desires and values.”

He added that educating the public on how to understand statistics was increasingly important in that context.

“Whether to take a statin or not, what kind of therapy to have after a diagnosis of cancer – those kind of issues are obviously incredibly important at a personal level. So many claims are based on statistics.

“As statisticians, we are not trying to say one side or the other; we are saying let’s try to understand the evidence and provide people with the tools to critique it.

“Then we can improve people’s ability to grapple with the overblown claims, the inaccuracies, and I think that is an essential social skill for the 21st century.”

HeraldScotland: REJECTED OFFER: Health Secretary Jeremy Hunt has rejected the BMA's offer to call off the strike, if he lifts the threat to impose the contract on junior doctors.

ANALYSIS by Helen McArdle: ‘Lies, damned lies and statistics’ fails to reveal the whole story

AS Mark Twain said, there are three kinds of lies: “lies, damned lies, and statistics”.

That is an unfair indictment of statistics, however. The real problem is not with statistics but with those who manipulate them to suit a particular agenda, leaving their audience misled or bamboozled rather than informed.

A recent example is the spat between UK Health Secretary Jeremy Hunt and Nobel prize-winning physicist Professor Stephen Hawking over the so-called “weekend effect”, which has underpinned the push for “a seven-day NHS” in England.

Mr Hunt says understaffing of hospitals at weekends is responsible for 11,000 deaths a year, citing, among others, a 2015 BMJ study which analysed 14.8 million admissions in 2013-14 and concluded the relative risk of death within 30 days of admission was 10 per cent higher than average for patients admitted on a Saturday and 15 per cent higher for a Sunday admission.

The “relative risk” takes into account the fact that a higher proportion of Saturday and Sunday admissions are emergency cases, and that there is also a greater prevalence of patients who have a higher predicted mortality risk than those admitted on weekdays. Once Fridays and Mondays were included, the study said this “more generalised ‘weekend effect’” amounted to “around 11,000 extra deaths annually”.

However, the authors also stress that it would be “rash and misleading” to assume that these deaths were necessarily preventable.

Mr Hawking said Mr Hunt was “cherry-picking evidence”, stressing that four of the eight studies cited by Mr Hunt were not peer-reviewed and he had ignored 13 papers which contradicted his statements.

Patients, and taxpayers, are left bewildered.

Statistics are at the root of some of the most bitter health controversies. Breast screening is a prime example. Routine mammograms to detect tumours in women aged 50 to 70 seems, intuitively, a good idea, but is it cost effective?

There is a raft of evidence which argues it exposes huge numbers of healthy women to potentially harmful radiation and leads other to undergo surgery for “cancers” which would never have become life threatening – so-called “false positives”. One Swiss study estimated breast screening was saving one life per1,000 women screened.

But perhaps statistics could also save lives. In 2005, Professor Sir David Spiegelhalter said murderous GP Harold Shipman may have been caught earlier if the same statistical modelling technique invented in 1943 for quality control in munitions factory production lines had been applied to his killing spree.

The formula would have gone beyond identifying a higher fatality rate – something not unusual for a GP such as Shipman who had many patients in care homes and hospices – to spot additional patterns, such as an odd number of patients dying in his presence.

The Shipman Inquiry concluded there were 215 confirmed and 45 probable victims. That is a lot of potentially avoidable deaths.