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Reckoning with Risk: Learning to Live with Uncertainty Paperback – 24 Apr 2003
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"This is an important book, full of relevant examples and worrying case histories. By the end of it, the reader has been presented with a powerful set of tools for understanding statistics...anyone who wants to take responsibly for their own medical choices should read it" - New Scientist
About the Author
Gerd Gigerenzer is Director of the Centre for Adaptive Behaviour and Cognition (ABC) at the Max Planck Institute for Human Development in Berlin and a former Professor of Psychology at the University of Chicago.
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Top customer reviews
The book does a very good job of explaining Franklin's Law (nothing is certain except death and taxes), illustrating it with important problems like HIV tests and DNA testing. The idea that even DNA tests are not infallible will come as news to some! It also discusses cost-benefit issues in diagnostic tests and the way to explain risk in a way that is not misleading, specifically emphasising the value of ARR and NNT over RR reduction.
All in all, the book seems to me an essential contribution to public education, especially for doctors and lawyers.
Most highly recommended.
In fact, the treatment of the topic is repetitive. Each chapter tends to prove the same thing, without offering any new insights. Although a few revelations about the number of incidences of some diseases (including HIV and breast cancer) are interesting, there is a risk that some readers could use these to justify taking (or not taking) treatment without really understanding the issues involved - precisely what the author is striving to avoid.
The most interesting chapter of all is the one on games, which offers potentially hours of endless fun for the reader, who can use the techniques described therein to win money off colleagues!
The book has as its central theme the confusion caused, intentionally or otherwise when information is presented poorly. It presents a truly startling picture of the resulting innumeracy not just within the general public but also amongst trained professionals.
Though the lessons are generic, a significant portion of the book deals with examples drawn from the world of medicine. These are used to illustrate the very simple root causes by which information is presented in ways that obscure meaning and make reasoned judgement difficult if not impossible.
These medical examples are far from obscure and deal with issues that will be of concern to many of us, such as data on HIV AIDS, Breast Cancer Screening, Prostate Cancer and use of the contraceptive pill for example.
The thrust of the book is not that information does not exist to assist judgement of risks in these areas, but that the way it is presented and communicated serves to perpetuate innumeracy amongst patient and clinician alike. This innumeracy can have dramatic consequences with inappropriate treatments being selected and patients being caused undue worry, distress or physical harm. An example is cited of a surgeon who performed breast removal operations on 90 patients who showed no sign of disease, simply based on his interpretation of the risk they faced of contracting it in the future.
The examples are not limited solely to medicine and the legal profession comes in for its share of scrutiny including DNA fingerprinting and an insightful look at how innumeracy may have contributed to the outcome of the O.J. Simpson case.
The lessons for the broader business community are clear.
The book is divided in to three sections that don't just provide examples of the problem of effectively communicating data but clear simple guidance on how it can be avoided.
By dealing with topic areas that many of us will recognise the book is able to clearly illuminate the problems of innumeracy and graphically illustrate the impact this can have with lessons for our personal and business lives. It may also provide particularly valuable insights for those who face the specific health problems it uses as examples and help create understanding of the real risks faced for example by a positive breast cancer screening result.
The book also has some absurd but real examples of innumeracy lunacy, for example the Mexican government which increased road volume by simply repainting a four lane highway with six lanes - a 50% increase. The high volume of accidents this caused led to the road being reduced back to 4 lanes - a 33% reduction and the later claim that road volume had actually been increased by 17%! It also has a section of fun examples of innumeracy to help drive the point home and a chapter on teaching clear thinking.
It's an entertaining an illuminating read that should improve your ability to ask the right questions to get to the bottom of what data is really telling us.
What if you have a positive mammogram, or test positive for HIV? Do you know how likely it is that you have actually got breast cancer, or that you are indeed HIV positive? Most of us don't have the foggiest, yet this is the sort of information we all need desperately.
There is a simplification at the heart of the book - not all statistical information can be summarised effectively using natural frequencies - and the author is not a mathematician and gives no sign that he understands that this is a simplification. But often enough natural frequencies will do the trick, and you will find no better explanation of how to think than this book.
What can I say? Everyone should read it. That means you!
Although it does help you to understand everyday statistics of this nature better, it only appears to make about 3 points throughout the entire book. Most of the chapters just recycle the same ideas using various, mainly medical, examples. A punchy 20 page book would have been just as informative, less repetitive and thus more interesting and effective.
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