{"id":1002,"date":"2014-11-21T20:54:24","date_gmt":"2014-11-21T19:54:24","guid":{"rendered":"https:\/\/blogs.bmj.com\/adc\/?p=1002"},"modified":"2014-11-14T17:21:22","modified_gmt":"2014-11-14T16:21:22","slug":"statsminiblog-will-rogers-phenomenon","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/adc\/2014\/11\/21\/statsminiblog-will-rogers-phenomenon\/","title":{"rendered":"StatsMiniBlog: Will Rogers Phenomenon"},"content":{"rendered":"<p><a href=\"https:\/\/blogs.bmj.com\/adc\/files\/2014\/02\/20140205-091454.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-full wp-image-859\" src=\"https:\/\/blogs.bmj.com\/adc\/files\/2014\/02\/20140205-091454.jpg\" alt=\"20140205-091454.jpg\" width=\"180\" height=\"76\" \/><\/a>The American humorist, Will Rogers, was reported to have said (of the migration of folk from Oklahoma to California):<\/p>\n<blockquote><p><i>When the <a title=\"Okie\" href=\"http:\/\/en.wikipedia.org\/wiki\/Okie\">Okies<\/a> left <a title=\"Oklahoma\" href=\"http:\/\/en.wikipedia.org\/wiki\/Oklahoma\">Oklahoma<\/a> and moved to <a title=\"California\" href=\"http:\/\/en.wikipedia.org\/wiki\/California\">California<\/a>, they raised the average intelligence level in both states<\/i><\/p><\/blockquote>\n<p>While this is a deeply unkind comment reinforcing geographical stereotypes, it does a neat job of capturing an epidemological paradox. If you re-define group definitions, you can make both groups averages improve (survival, or IQ) without changing one jot the overall truth. Such a phenomenon must be guarded against when re-defining risk groups, for example on the basis of new diagnostic technologies, and seeing &#8216;group based&#8217; benefits.<\/p>\n<p>To take it pictorially:<!--more--><\/p>\n<p>If we have two risk groups, and individuals with good (80%), moderate (50%) and poor survival (10%), we can split them like this:<\/p>\n<p><a href=\"https:\/\/blogs.bmj.com\/adc\/files\/2014\/11\/Slide1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-medium wp-image-1003\" src=\"https:\/\/blogs.bmj.com\/adc\/files\/2014\/11\/Slide1-300x225.jpg\" alt=\"Slide1\" width=\"300\" height=\"225\" srcset=\"https:\/\/blogs.bmj.com\/adc\/files\/2014\/11\/Slide1-300x225.jpg 300w, https:\/\/blogs.bmj.com\/adc\/files\/2014\/11\/Slide1.jpg 960w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p>The overall survival rate is 50%; the low risk group ~70% and high risk group ~20%.<\/p>\n<p>If, by better diagnostic technology, we split the orange patients out and plop them in the high risk group this happens:<\/p>\n<p><a href=\"https:\/\/blogs.bmj.com\/adc\/files\/2014\/11\/Slide2.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-medium wp-image-1004\" src=\"https:\/\/blogs.bmj.com\/adc\/files\/2014\/11\/Slide2-300x225.jpg\" alt=\"Slide2\" width=\"300\" height=\"225\" srcset=\"https:\/\/blogs.bmj.com\/adc\/files\/2014\/11\/Slide2-300x225.jpg 300w, https:\/\/blogs.bmj.com\/adc\/files\/2014\/11\/Slide2.jpg 960w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p>The low risk group improves, now ~80% and high risk group also improves, now 30%. Despite our increasing surival rates in both low and high risk groups, the\u00a0overall survival rate is unchanged at 50%.<\/p>\n<p>We&#8217;ve done nothing.<\/p>\n<p>The Will Rogers phenomenon is subtle, but real. Beware when reading comparisons across time and between different groups. Is some thing really going on?<\/p>\n<p>&#8211; Archi<\/p>\n<p>&nbsp;<!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>The American humorist, Will Rogers, was reported to have said (of the migration of folk from Oklahoma to California): When the Okies left Oklahoma and moved to California, they raised the average intelligence level in both states While this is a deeply unkind comment reinforcing geographical stereotypes, it does a neat job of capturing an [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/adc\/2014\/11\/21\/statsminiblog-will-rogers-phenomenon\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":7,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2676],"tags":[],"class_list":["post-1002","post","type-post","status-publish","format-standard","hentry","category-stats"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - 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