by nicolaou 739 Replies latest watchtower medical
Those stats don't add up,
You can't do it based on number of JW's in medical crisis now and work backward as there is a population of nearly 8 million JW's whereas pre 70's 60's 50's there were no where near those numbers.
The best way...probably... to do it would be to look at stats for blood use against total population then use that stat to estimate probability for jw's as a percentage of totaL population. Then work backwards for the decades adjusting for JW's in population.
Dr. Belivea et al ......
or as some peolpe call him Dr. Crazy asaLoon
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“Those stats don't add up…”
Which stats, and why don’t those stats add up?
“You can't do it based on number of JW's in medical crisis now and work backward as there is a population of nearly 8 million JW's whereas pre 70's 60's 50's there were no where near those numbers.”
Once you have an incident ratio you can apply it to any sample size matching the same criterion.
Marvin Shilmer
Once you have an incident ratio you can apply it to any sample size matching the same criterion.
Not on a statistical model of JWS and their variable situations concerning their no blood ban, for this situation the criteria
has too much wide variance. If you were to discern the number of people with anemia over the greater population you might have something
plausibly accurate.
Marvin:
If you have not read it, then how would you possibly know whether the study contains insufficient information?
Marvin: I have not read it, but several things occurred to me in reading your blog about it. You seem to have made a lot of assumptions based on this fairly small study.
You seem to assume that all hospitals in New Zealand have severe anemia cases in equal ratios as the four hospitals used for the study. All hospitals are not the same, those in the study might have been selected because they had acute trauma centers, who would be expected to get more accident cases, thus more cases of severe anemia. They were public hospitals, maybe they got a higher percentage of poorer patients, who might be expected to have more severe medical issues due to lack of education, or access. They might also get less cases, who knows? Have you read the study and do you know why those hospitals were chosen?
You are then assuming that all populations in the earth have the same ratio of severe anemia cases, which I think needs to be proven. That is a pretty huge jump. You seem to be assuming that all Jehovah's Witness populations have access to hospitals, medical care and blood transfusions, equal to the four hospitals in the study. Populations in wealthier countries get far more blood transfusion, so I doubt JWs in poor African countries even have the opportunity to get one in the first case.
You are assuming that all Jehovah's Witnesses in all parts of the earth refuse blood transfusions in the same ratio as the four hospitals in the study. Anecdotal evidence is that some JWs get the transfusion and don't tell the elders. Jehovah's Witnesses in other countries may have a different culture, in some ways, where they don't emphasize the blood issue as much. I noticed different attitudes even within my state (California) about the blood issue.
Mainly I just think it is impossible to take one study, where only 19 JW patients died, and extrapolate that to 50K worldwide. That is just too small group to make it meaningful. A small anomaly in the way one or two patients were selected could throw off your numbers by thousands and thousands.
That is not to say that you don't have a great idea, I think we do need to get this out in the open, I just think there needs to be more proof before we start throwing numbers around. The study, on its own, is pretty powerful stuff.
here is a question for you Marvin :
Did the NZ study separate for ethnicity particularly as the study was regional. Maori babies may have higher rates of anaemia according to a 2004 study which I could not link in for some reason.
okay now I can
https://www.ncbi.nlm.nih.gov/m/pubmed/15282623/?i=5&from=/8801154/related
@marvin
“Your blog premise is the JW death rate in New Zealand from anemia is 0.26/1000.”
besty,
That premise is found nowhere on my blog. To repeat something I expressed earlier in this discussion, my extrapolations are not based on a mortality rate but, rather, the actual number of deaths attributable to blood refusal .
marvins blog:
" That is, the extrapolated annual rate of mortality for Witnesses who suffer death from severe anemia as a result of Watchtower’s blood doctrine is .026%."
OK - so clarify the 0.026% figure for me - based on your blog statement above can we agree the following:
* It is a per cent figure, so by definition it means 'out of 100' - 0.026 per 100 or 0.26 per 1000 would be the normal mathematical expression equivalent to 0.026%.
* It is an annual rate of mortality
* It relates to Jehovahs Witnesses who die from severe anemia as a result of the Watch Tower blood doctrine (*Watchtower is a magazine)
I must be missing something when I conclude that you believe 0.26/1000 is the JW anemia mortality rate. Can marvin or anybody else help me out with what I am missing?
I'd like to see this NZ report by Dr Believa et al is it available on jwsurvey.
besty I think you are correct. Marvin needs to address your issue and mine. Perhaps they both go together - if the study included lots of Maori jw babies who were affected by low ferritin and went on to develop anaemia then mortality through refusing blood would be higher than the overall population of NZ. We at least need to clear up this issue.
This is a short of the said study conducted by Dr. Andrei Belyaev (AKA Beliaev):
BACKGROUND: Management of anaemic Jehovah's Witness (JW) patients, who refuse blood transfusion on religious grounds, is challenging. In the published literature, there are few cohort studies that consider causes of mortality in isolation and are lacking in their predictive power. This does not allow clinicians to monitor treatment progress of severely anaemic JW patients and adjust their risk of mortality. The study aims to develop an anaemia-related mortality risk prediction instrument. METHODS: This retrospective cohort study evaluated anaemia-related mortality risk factors of JW patients. JW patients were identified from the records of four major public hospitals in the Auckland and Midlands regions of New Zealand (North Shore, Auckland City, Middlemore and Waikato hospitals) for the period 1998 to 2007 inclusive. The inclusion criteria were age ≥15 years and severe anaemia (haemoglobin concentration ≤80 g/L). Palliative care cancer patients were excluded. RESULTS: Anaemia-related risk factors of mortality for JW patients were identified, weighted and used to construct a mortality risk predictive score (the Hamilton Anaemia Mortality Risk Score (Hamilton AMRS)). This permitted stratification of JW patients into mortality risk groups according to their Hamilton AMRS. It is shown that patients with Hamilton AMRS of 0 to 2 had 4% mortality, patients with Hamilton AMRS of 3 to 4 had 29% mortality, patients with Hamilton AMRS of 5 had 40% mortality and patients with Hamilton AMRS of ≥6 had 67% mortality. CONCLUSION: The Hamilton AMRS allows treatment monitoring of anaemic JW patients and adjustment of their risk of mortality.
This can be found at:
Now, can someone enlighten me how can someone extrapolate from these figures to arrive at an overal estimation of 50.000 or 250.000 deaths among JW's in direct consequence of blood transfusion refusal, world-wide, since 1945 (or 1954) ?
Eden
thats the wrong study edenone - the correct one is abstracted as follows:
http://onlinelibrary.wiley.com/doi/10.1111/j.1423-0410.2011.01573.x/abstract
Keywords:
Background It is well known that blood transfusion is life-saving, but also that it carries a serious risk of transmitting viral infections. Introduction of new methods of testing for transmissible diseases, blood banking and dispatch regulations has considerably increased the cost of blood products. However, the clinical benefits and cost-effectiveness of allogeneic red-blood-cell (ARBC) transfusion remain assumed yet undetermined. We assessed the clinical benefits and cost-effectiveness of ARBC transfusion in severe anaemia.
Methods This was a multicenter observational study comparing Jehovah’s Witness (JW) patients with matched ARBC-transfused patients. Inclusion criteria were age ≥15 years and severe anaemia (haemoglobin ≤ 80 g/l). Two JW patients with palliative care cancer and five JW patients with haemoglobin (Hb) concentration between 70·1 and 80 g/l, mild symptoms of anaemia and Auckland Anaemia Mortality Risk Score of 0–3 were excluded.
Results The entry criteria were met by 103 JW patients and the same number of patients treated with ARBC transfusion. ARBC transfusion reduced mortality by 94%, shock by 88%, gastrointestinal bleeding by 81%, infective complications by 81%, cardiac arrhythmia by 96%, angina by 86%, ischaemic myocardial injury by 81%, acute/acute on chronic renal failure by 66%, neurologic complications by 92%, delirium by 76%, depression by 91% and syncopal episodes by 95%. The incremental cost-effectiveness ratio of ARBC transfusion was 2011 US$22 515 for death prevented.
Conclusion ARBC transfusion in anaemic patients is clinically beneficial and cost-effective
