This statistician is fighting the shoddy statistics that put nurses in prison for serial murder. LongReads
Cognitive biases can easily lead an investigation astray and have drastic effects on how suspicious a cluster of deaths seems. In this imaginary example drawn from real-world errors, a doctor reports that many deaths seem to occur while Nurse X is on duty. The hospital launches an investigation, reexamining deaths at Nurse X’s ward over the past 2 years. A simple statistical test* compares the rate of suspicious deaths when Nurse X is on duty with the rate when she is off.
Gill worries this is what led to the 2006 conviction of Geen, who was given 17 life sentences, with a minimum term of 30 years. Prosecutors argued there was a high rate of unexplained respiratory arrests—which are typically rarer than cardiorespiratory arrests—on Geen’s shifts, although they did not try to quantify the probability that this “unusual pattern” occurred by chance.
The similarities go beyond statistics to the way Letby has been vilified. Social media commentary will “make your stomach turn,” Gill says. “People are saying we should bring back hanging, shoot the bitch.” The media have portrayed her as an “evil creature,” says Neil Mackenzie, a lawyer based in Edinburgh, Scotland, who specializes in medical negligence cases and co-authored the RSS report. “I think there’s possibly misogyny in there,” Mackenzie says. “The press loves bad women.
In 2000, for example, a British physician named Harold Shipman was convicted of murdering 15 patients over a period of 3 years after an investigation yielded evidence that he had given overdoses of diamorphine—heroin, used in the United Kingdom for severe pain—and falsified the medical records of numerous patients, suggesting they had been sicker than they were to make their deaths appear less suspicious.
But implementing this kind of routine monitoring would be very complicated, says Bruce Guthrie, professor of general practice at the University of Edinburgh. The kind of data Spiegelhalter and his colleagues used is not routinely collected—it was pieced together as part of the Shipman investigation. And Shipman worked alone, which few family doctors do; many patients are likely to see multiple doctors.
De Berk later received a written apology from the Dutch minister of justice and an undisclosed financial compensation for the 6.5 years she spent in prison. Gill stays in contact with her; she likes his posts on Facebook sometimes. She told Gill she did not want to be interviewed for this story. “She’s managed to put it all far away, and she needs to keep it that way,” he says.
that unexplained medical tragedy would strike the same family four times. Like some other infanticide cases, it parallels the murder convictions of doctors and nurses based on suspicious clusters of patient deaths. As those cases show, seemingly common-sense statistical assumptions can mislead—with horrifying consequences.
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