Good hospital/Bad hospital

Several years ago, back when I was working in the Emergency Department, I had a rather fascinating encounter with a patient’s wife.  It was late in the evening on a Friday….a generally bad time to come in to the ER….and she had brought her husband in with a large cut on his arm.  He needed stitches for sure, but the place was hopping that night, and so she, her husband, and her two small children had been stuck in the waiting room for several hours.  After some time, she had come in asking me when someone was going to come get him.  At that point, I think they still had 4 or 5 people ahead of them, and I let her know.  

She (fairly understandably) flipped out.  
As I tried to calm her down, she started to lecture me about how long they had been waiting….and then proceeded to let me know that this wait had come after she had driven her husband over an hour and a half to get there.  “You are SUPPOSED to be the best hospital in the country” she raged.  “How can you be if you make patients wait so long????”.
Now I had the “why am I waiting so long” conversation with literally thousands of patients in my time in the ER, but something really struck me about this poor woman’s frustration.  She had brought her husband to a hospital that was supposed to be the best (this particular hospital bounces around the top 5 in the country pretty routinely), but not for what he needed done that night.  What he needed was a simple set of stitches, the likes of which nearly any doctor in the country could have done.  When I took a look at her address, I realized she had driven by at least five different hospitals with ERs to get to ours.  Most likely any one of them would have gotten her faster service with the same quality of care.  In fact, within the next few years, three of them would devise marketing strategies around publicizing that fact.  The problem is, this woman had confused “the best” with “good at everything”.  
When it comes to hospitals, that’s just not true.
Given my professional experience, I was unsurprised  to see Time reporting that not one of the 17 best hospitals (according to US News and World Report) made the consumer reports list of safest hospitals.  
There’s a couple reasons for this, some good and some bad:
  1. Best hospitals tend to be large teaching hospitals.  Large teaching hospitals have a lot of residents. Residents can be a little dicey.
  2. Best hospitals tend to see huge numbers of patients.  This can complicate things.
  3. Best hospitals tend to see cases other hospitals can’t help.  Almost all of your top hospitals will have higher mortality rates than smaller community hospitals.  Why?  Because unless you’re literally DOA, the first thing a small hospital will do with a really sick patient is to ship them off to a hospital with a good intensive care unit.  The top hospitals almost never transfer their patients.
  4. Best hospitals are ranked in large part on how they treat the toughest cases.  The more unique your condition, or the worse your risk factors, the more selective you need to be.  The more routine your complaint, the more a top hospital can actually work against you….you’re going to be one of many, and nothing makes you stand out.
  5. Large medical centers, specifically in urban settings, give away a lot of free care to a lot of high risk populations.  These patients are unlikely to do well in any setting, and can skew the data tremendously.  Location counts.
There’s constant strife over how to accurately rank hospitals, because professionals skew hospital rankings in the direction of valuing medical uniqueness.  Patients on the other hand, tend to value things like “comfort of chairs in the waiting room” nearly as high as they do “physician competence”.  Patient’s also claim to want things that they don’t really….for example nearly everyone says they value physician competence over bedside manner, yet patient’s routinely rate physicians with good bedside manner higher than those with good technical skill.  Patient’s receiving appropriate care also file plenty of complaints if it wasn’t the care they expected.  No hospital ranking is going to hit every part of the hospital equally regardless of who ranks it, and every department can have a bad day.   
I don’t have a lot of answers to these issues, but it’s important to keep them in mind when you hear ideas for improvement.  While the Time article got a bit too political for my taste, it is true that patients can only make informed decisions if the information they have is what they think it is.

19 women don’t like sports

Normally this is the sort of thing Joseph’s blog specializes in, but I couldn’t let this one slide.

I’ve spent all of last week and this week listening to construction workers traipsing around my basement, working diligently to finish it so we can finally have the sports room my husband’s impressive memorabilia collection deserves.  Thus, it distressed me a bit to see the headline that married women only watch sports for the sake of their husbands.  Is my interest in the sports room one big lie? Has my Red Sox fandom all been a fraud?  Should I toss out all my vintage basketball cards from the 80s?  And football…..okay, I actually didn’t like it all that much until I got married.  I’ll give you that one.  Two out of three ain’t bad.

Anyway, I pretty amused when Jezebel and other’s quickly pointed out that the sample size for this study was 19.     19 women, all from around the University of Tennessee.  In case you’re curious, The Bleacher Report ranked Knoxville the 44th best sports town in the USA.  Maybe my perception is skewed because Boston’s #2, but I’m not sure that’s an overly representative sample from an overly representative town.

Get some good Southie girls together and ask them what they think, I bet you’ll get a wicked different picture.

Fair Market Rent and Another Dubious Infographic

I’ve seen this infographic a few places now, and it has been causing me some furrowed brow time:

Supposedly, this is a graphic showing how many hours you would have to work per week at a minimum wage job in order to afford a two bedroom apartment in each of the given states.  This version appears to be a year or so out of date, but here’s the original report.
I had all sorts of questions about this when I saw it, so of course I went digging.  
To clarify the parameters, affordable is defined to mean 30% of income, and this chart assumes only one income earner per apartment.  Availability of low income housing or other programs is not taken in to account, which is probably where I find this chart most misleading.  Massachusetts has a fairly extensive Section 8 housing program, and from my understanding New York and California do as well.  I couldn’t find a ranking for the state distribution of aid levels, but I’d wager the less affordable the state, the more they give out in assistance.
As for the fair market value rents….I couldn’t find where they got their figure from.  Rents in Massachusetts vary wildly between the 3 largest city areas.  Boston rents run high….mostly because students rent most of the apartments near the colleges.  Springfield and Worcester however are much cheaper.  The MA website for Section 8 housing cites the difference between Boston and Worcester as almost $450 a month.  It appears the number used above is an average of several areas.  
If you dig further in the report however, it becomes even more interesting.  Apparently New England is the only section of the country that doesn’t report whole counties when reporting fair market rates for renters, New England only reports rates for metro areas and surrounding communities.  Is the northeast really that much pricier than the rest of the country, or does their reporting just make them look that way?
While I ultimately appreciate the issue at hand with this chart, I think it would be nice to see a more comprehensive chart including states efforts to address the high housing cost.  On the chart above, NH appears slightly more affordable, but if you google “section 8 housing nh” you will find a lot of people telling you to save yourself the trouble and move to Massachusetts.  Bigger cities tend to mean higher rents AND more social programs.  Throwing them all in to one big average is not the best way of representing information in a usable fashion.

Humor, Gender, and YouTube Research

While peer reviewed research is the gold standard for results, sometimes more informal research can be pretty darn interesting.  I got sent an interesting informal study this week that I thought was quite fascinating despite (or perhaps because?) it lacked typical rigor.

This study was based on humor and gender.  Now, as a matter of course most gender research annoys me.  Gender is the biggest subgroup you can have (3.5 billion of each, give or take) and any conclusions you draw must be taken with the knowledge that much of the data will vary wildly.  This is fine if your goal is something like, oh advertising that will appeal to a larger number of women or men in specific.  However, if your goal is to address something to a specific man or woman (like say therapy) gender generalizations can only give hints of paths to follow, and will rarely tell the story for one person.  One of the bigger challenges couples therapists face is actually convincing clients that it doesn’t matter what most men do, it matters what your spouse does, and vice versa.

Quick example: Back in the day when it used to be a novel idea that a woman would be Secretary of State, I remember having someone tell me that women would be bad at international diplomacy because your average woman was more emotional than your average man.  I had never thought about it before, but I remember retorting that I sincerely hoped that we never had an average woman in a position that high, as I was sure we had probably had never had an average man.  On average, nobody should be Secretary of State.

I thought about some of this when the AVI forwarded me this Steve Sailer post about men being funnier than women.  Humor is another tricky subject to study, and you put it together with gender and you can get bogged down for forever in questions and caveats.  Humor is in large part a cultural construct (watch the British, German, and French versions of The Office and you’ll see what I mean), and even within humor there are always questions about who is “truly” funny.  Commercially successful comedians?  Indie comics?  Their TV shows and movies or their stand-up days?  Or are we just talking about cocktail party chatter and our friends?  Also, the kind of humor you like has a lot to do with who you think is funny…puns?  Situational comedy, pranks, physical comedy, LOL cats?  My personal favorite comedy brand is the Comedy Central Roasts and South Park.  However you answer these questions though, I think it’s important to note that your average person is not terribly funny to anyone outside their own circle.


Quick example:  This is only funny for those who both appreciate farming humor and know who LMFAO is.  Since I listen to the radio and grew up on a farm, it made me laugh pretty hard:




That being said, I thought the research Kyria Abrahams did was truly enlightening.  She went through and found 10 unknown but rising comedians, and wrote down all the topics they made jokes about.  Then she postulated that the list of mens topics was more varied and more interesting to a broader audience than the women’s list.  Take a look and see if you agree:

Female Comics

Apartment is annoying
Bathroom attendants
Being a female comedian (x2)
Cosmo Magazine
Dating is awkward (x2)
Diamonds
Did poorly in school
Doesn’t want kids because she’s “selfish”
Gay marriage
Gynecologists/pap smears
Hangovers
Hates New York
Her body (x2)
Her mom (x2)
Her vagina
How guys hit on her
It’s hard being a woman, putting on makeup, and wearing heels and stuff
Jizz
Just got engaged
Just went through a breakup
Masturbation
Roommate is annoying
Sex and condoms
She’s flat-chested
She’s fat
She’s too pretty to do standup (x2)
What she’s wearing
What/who she looks like (x2)
Yoga
Male comics:
Alaska
Being thanked on an elevator
Clichés people use
Free AIDS clinics
God won’t help you bowl/God doesn’t exist
Having sex with animals
His name
Holding the phone between your ear and shoulder
How to treat AIDS
If the Jews killed Jesus
Jail shows
Mayan 2012 prediction
People asking him where he’s from
Pickle juice
The “ethnic needs” section of the supermarket
The age of sliced bread
The Cyclone at Coney Island
The Roman Empire
The storylines behind rollercoasters
Vegan soul food
What/who he looks like (x2)
White chocolate is racist

So yes….the men’s topics are more unexpected, fresher, and more likely to be funny than the women’s.  Now whether that’s because women are getting pigeonholed or what, I can’t say, but I had to appreciate this addition to the conversation.  While I have seen plenty of discussion regarding men and women and who is funnier, I had never seen someone actually try to tease out what comedians were talking about when we assessed their humor.  It’s an important variable, and her data suggests a big discrepancy.  If women changed this would it close the gap?  Who knows, but it’s an interesting thought.  To act like the gender/humor question only has one moving variable (the listener’s sexism) is to reduce two extremely complex topics down to nothing.  Mentioning other variables is not sexist (as Kyria was accused of in her comments section) it’s just good research.

The moral of the story?  Keep average people off my TV, when I want comedy, I want exceptional.

Friday Fun Links 7-6-12

Between the heat and being 8 months pregnant, running to catch the bus is pretty much more than I can handle these days.  Still, it’s nice to know my age doesn’t preclude me from competing in the Olympics.  

Apparently I’m on the wrong end of the bell shaped curve if I want to win a medal though….

If sports aren’t your thing, how about a summer romance?  What, you’re trapped in the friend zone?  Here’s the stats on whether you should try to get out or not.

No summer vacation?  Stuck at work?  Use data?  Here’s Juice Analytics new chart chooser (2.0) to help figure out how best to present your data.  Haven’t tried it yet, but it looks awesome.

I’ve written before about retractions and their impact on public trust…but this was pretty stunning.  Yoshitaka Fujii, a Japanese anesthesiologist, has been found to have faked data in 172 published studies, dating back to 1993.  That’s a record.

My bff from college is from West Virginia, and always told me that coal is a big deal there.  Turns out she wasn’t exaggerating….apparently it matters more than political party in how people vote.

James over at I don’t know but…. had a good post about the inaccuracies in the reporting about the Higgs boson.  Went more in depth than I could have, for sure.

That’s it for now, have a good weekend!

More physics…Einstein and teaching

With all the Higgs Boson excitement, I have had  physics on the brain lately.  Thus when Instapundit linked to this article from NPR, regarding how Einstein would not have been qualified to teach high school physics, I was intrigued.

The article is a rant against (some) licensing standards.  Licensing standards are really just performance metrics, which does make them an interesting study in data and outcomes.  Teaching is a particularly tricky profession to measure outcomes in, as every attempt to standardize (SATs, MCAS, etc) is typically met with objections about what real learning is.

I was fascinated by the Einstein question though.  While I certainly like Einstein, I was wondering if I’d really have wanted him as a physics teacher.  When I took psych stats in grad school, I averaged 107% in the class (there was lots of extra credit), but I was probably the worst resource there.  I can’t explain basic stats worth anything to people, because it comes naturally.  That’s why I like critiquing news stories….it’s much easier to explain what’s wrong with something when you have an example in front of you.  Explaining a t-test from scratch though?  I’ll leave that to the professionals.

Aside from that, the study the NPR post points to is pretty interesting.  It compares licensed, unlicensed and alternatively credentialed teachers from NYC.  Interestingly, the most significant factor in teacher effectiveness tended to be years of experience (in the first few years) instead of credentialing.  All the differences however, were evaluated based on standardized testing scores, which may or may not be something you agree with as a metric.  Still, a fairly interesting and comprehensive look at the issue, if your interested in education metrics.

Update:  The purpose of education and outcome metrics are going to become increasingly important if this catches on (and I hope it does).

Higgs Boson…comic edition

It has nothing to do with statistics, but the Higgs Boson story has been the most exciting news I’ve heard in a while.  Physics was always my favorite of the sciences, and it’s nice to see hard science reporting make major headlines.

Thanks to my science/math geek cred, I’ve gotten asked by a few people to break down what the big deal is, so I’ve been looking for a good, simple, comprehensive resource to point people to.  PhD comics apparently was all over this back in April, and I’m posting it here because I like it.  Yay for science!

4th of July, Census Bureau style

Here’s hoping everyone had a relaxing 4th of July!

Today I learned that the White House sponsors two official Independence Day parties at the White House. One of them is for service men and women and their families, the other is for a broader group of friends of the White House.  I bring this up because apparently my younger brother finagled a ticket to the second one. Kind of makes my day feel a little lame, but hey, at least the house is coming along, and I’m the most relaxed I have been in a while.

I was looking for some good stats about the White House, but then I found this which I thought was equally interesting.  It’s no West Lawn Party….but we here at Bad Data Bad do what we can with what we have.

Without further ado, here’s some (year old) fun facts, courtesy of our Census Bureau:

The Fourth of July 2011


On this day in 1776, the Declaration of Independence was approved by the Continental Congress, setting the 13 colonies on the road to freedom as a sovereign nation. As always, this most American of holidays will be marked by parades, fireworks and backyard barbecues across the country.

2.5 million

In July 1776, the estimated number of people living in the newly independent nation.
Source: Historical Statistics of the United States: Colonial Times to 1970
<http://www.census.gov/prod/www/abs/statab.html>

311.7 million

The nation’s estimated population on this July Fourth.
Source: Population clock <http://www.census.gov/main/www/popclock.html>

Flags

$3.2 million

In 2010, the dollar value of U.S. imports of American flags. The vast majority of this amount ($2.8 million) was for U.S. flags made in China.
Source: Foreign Trade Statistics <http://www.census.gov/foreign-trade/www/>
<http://www.usatradeonline.gov>

$486,026

Dollar value of U.S. flags exported in 2010. Mexico was the leading customer, purchasing $256,407 worth.
Source: Foreign Trade Statistics <http://www.census.gov/foreign-trade/www/>
<http://www.usatradeonline.gov>

$302.7 million

Annual dollar value of shipments of fabricated flags, banners and similar emblems by the nation’s manufacturers, according to the latest published economic census data.
Source: 2007 Economic Census, Series EC0731SP1, Products and Services Code 3149998231
<http://www.census.gov/econ/census07/>

Fireworks

$190.7 million

The value of fireworks imported from China in 2010, representing the bulk of all U.S. fireworks imported ($197.3 million). U.S. exports of fireworks, by comparison, came to just $37.0 million in 2010, with Japan purchasing more than any other country ($6.3 million).
Source: Foreign Trade Statistics <http://www.census.gov/foreign-trade/www>
<http://www.usatradeonline.gov>

$231.8 million

The value of U.S. manufacturers’ shipments of fireworks and pyrotechnics (including flares, igniters, etc.) in 2007.
Source: 2007 Economic Census, Series EC0731SP1, Products and Services Code 325998J108
<http://www.census.gov/econ/census07/>

Patriotic-Sounding Place Names

Thirty-one places have “liberty” in their names. The most populous one as of April 1, 2010, is Liberty, Mo. (29,149) Iowa, with four, has more of these places than any other state: Libertyville, New Liberty, North Liberty and West Liberty.
Thirty-five places have “eagle” in their names. The most populous one is Eagle Pass, Texas (26,248).
Eleven places have “independence” in their names. The most populous one is Independence, Mo. (116,830).
Nine places have “freedom” in their names. The most populous one is New Freedom, Pa. (4,464).
One place with “patriot” in the name. Patriot, Ind. (209).
Five places have “America” in their names. The most populous is American Fork, Utah (26,263).
Source: American FactFinder <www.census.gov>

Early Presidential Last Names

138

Ranking of the frequency of the surname of our first president, George Washington, among all last names tabulated in the 2000 Census. Other early presidential names that appear on the list, along with their ranking, were Adams (39), Jefferson (594), Madison (1,209) and Monroe (567).
Source: Census 2000 Genealogy <http://www.census.gov/genealogy/www/freqnames2k.html>

The British are Coming!

$98.3 billion

Dollar value of trade last year between the United States and the United Kingdom, making the British, our adversary in 1776, our sixth-leading trading partner today.
Source: Foreign Trade Statistics <http://www.census.gov/foreign-trade/statistics/highlights/top/top1012yr.html#total>
<http://www.usatradeonline.gov>

Fourth of July Cookouts

More than 1 in 4

The chance that the hot dogs and pork sausages consumed on the Fourth of July originated in Iowa. The Hawkeye State was home to 19.0 million hogs and pigs on March 1, 2011. This estimate represents more than one-fourth of the nation’s estimated total. North Carolina (8.6 million) and Minnesota (7.6 million) were also homes to large numbers of pigs.
Source: USDA National Agricultural Statistics Service
<http://usda.mannlib.cornell.edu/usda/current/HogsPigs/HogsPigs-03-25-2011.pdf>

6.8 billion pounds

Total production of cattle and calves in Texas in 2010. Chances are good that the beef hot dogs, steaks and burgers on your backyard grill came from the Lone Star State, which accounted for about one-sixth of the nation’s total production. And if the beef did not come from Texas, it very well may have come from Nebraska (4.6 billion pounds) or Kansas (4.1 billion pounds).
Source: USDA National Agricultural Statistics Service
<http://usda.mannlib.cornell.edu/usda/current/MeatAnimPr/MeatAnimPr-04-28-2011.pdf>

6

Number of states in which the value of broiler chicken production was $1 billion or greater between December 2009 and November 2010. There is a good chance that one of these states — Georgia, Arkansas, North Carolina, Alabama, Mississippi or Texas — is the source of your barbecued chicken.
Source: USDA National Agricultural Statistics Service
<http://usda.mannlib.cornell.edu/usda/current/PoulProdVa/PoulProdVa-04-28-2011.pdf>

Over 1 in 3

The odds that your side dish of baked beans originated from North Dakota, which produced 36 percent of the nation’s dry, edible beans in 2010. Another popular Fourth of July side dish is corn on the cob. Florida, California, Georgia, Washington and New York together accounted for 68 percent of the fresh market sweet corn produced nationally in 2010.
Source: USDA National Agricultural Statistics Service
<http://usda.mannlib.cornell.edu/usda/current/CropProdSu/CropProdSu-01-12-2011_new_format.pdf> and
<http://usda.mannlib.cornell.edu/usda/current/VegeSumm/VegeSumm-01-27-2011.pdf>

Please Pass the Potato

Potato salad and potato chips are popular food items at Fourth of July barbecues. Approximately half of the nation’s spuds were produced in Idaho or Washington state in 2010.
Source: USDA National Agricultural Statistics Service
<http://usda.mannlib.cornell.edu/usda/current/CropProdSu/CropProdSu-01-12-2011_new_format.pdf>

More than three-fourths

Amount of the nation’s head lettuce production in 2010 that came from California. This lettuce may end up in your salad or on your burger.
Source: USDA National Agricultural Statistics Service
<http://usda.mannlib.cornell.edu/usda/current/VegeSumm/VegeSumm-01-27-2011.pdf>

7 in 10

The chances that the fresh tomatoes in your salad came from Florida or California, which combined accounted for 71 percent of U.S. fresh market tomato production last year.
Source: USDA National Agricultural Statistics Service
<http://usda.mannlib.cornell.edu/usda/current/VegeSumm/VegeSumm-01-27-2011.pdf>

Florida

The state that led the nation in watermelon production last year (750 million pounds). Other leading producers of this popular fruit included California, Georgia and Texas, each had an estimate of more than 600 million pounds.
Source: USDA National Agricultural Statistics Service
<http://usda.mannlib.cornell.edu/usda/current/VegeSumm/VegeSumm-01-27-2011_new_format.pdf>

81 million

Number of Americans who said they have taken part in a barbecue during the previous year. It’s probably safe to assume a lot of these events took place on Independence Day.
Source: Mediamark Research & Intelligence, as cited in the Statistical Abstract of the United States: 2011
<http://www.census.gov/compendia/statab/>, Table 1239

Useful knowledge for a day in the sun

A midweek day off during a heat wave?  Time to go outside!

While I hate most infographics, I can’t hate David McCandless.  Here’s all you need to know about the sunshine vitamin:
Happy 4th of July!