I am not so sure this completely discounts the statistical relevance of when Letby joined, more infants died. When she was reassigned from the day shift the the night shift, she brought along the same pattern of deterioration for the infants. I am not convinced that there being "no medical evidence" discounts these facts, but still, I wonder if it is possible that Letby is single most unlucky nurse in history and truly freak accidents happened on her watch by chance. Its hard to say.
> I am not so sure this completely discounts the statistical relevance of when Letby joined, more infants died.
There were mortality rate spikes happening at hospitals across the country. The common factor was defunding and understaffing.
> she brought along the same pattern of deterioration for the infants.
The investigators discarded cases but included a child that deteriorated seconds after Letby clocked in to the hospital before she even walked to her department. Everything I have read about the case screams fitting the data to match a predetermined outcome. This is how other nurses were jailed for mass murders that simply did not happen.
The case is really bizarre. The prosecution invented a new form of murder that every publicly interviewed expert claims is physically impossible, based on a paper about a single medical case from decades ago, of which the only surviving author supports Letby's defense (but was not allowed to testify).
The "statistical" evidence, as presented, is worthless. It does not analyze the data in any quantitative way. It collects some unusual facts, waves a wand, and with a theatrical whisper says "guilty". Neither is an accepted method of statistical analysis.
To put some meat on this claim, here's some things that should have been included:
- consider whether LL was given sicker children to look after
- more generally, consider other statistical factors that could have contributed: number and experience of doctors on shift, of patients, etc.
- consider whether night and day shifts had the same mortality
- consider how many "suspicious" deaths occured when other nurses were on duty
- consider wider nationwide factors affecting child mortality. E.g. is it broadly on the rise, maybe due to general deteriorating health of the population.
- once some kind of assigning of deaths was done, how much of an outlier was LL's "count"
- ...and finally comparing to some kind of base rate of how often nurses kill their patients. If you conclude there was a 1:1000 probability of these events occuring by chance, but a base rate of nurses killing patients is 1:10000, then it's still 10:1 more likely LL is innocent.
As far as I can tell none of the above was done properly. Some things were vaguely looked at, but in an anecdotal "analysis", not something containing actual mathematics.
Of course it's possible that you do this analysis and conclude LL is guilty - I don't know that. But the analysis, as summarized, is to a proper statistical evidence what a child's drawing is to a CCTV screenshot.
One additional thing of note is that it was the police and their expert witness that decided which deaths were “suspicious” vs “non suspicious”.
Without the categorisation of deaths being suspicious/non suspicious, Letby was on shift for 40% of the deaths (approximately what you would expect, she worked 35% of the week).
It was the police with the expert witness that then selected which deaths were suspicious, and they did this non-blind (ie the expert looked at the case notes, could see if Letby was on shift, and then made an evaluation on if it was suspicious or not).
After this categorisation, Letby was present at 100% of the suspicious deaths (and none of the non-suspicious deaths)
Sounds like the unit she worked in wasn't totally competent. I'd give general advice to anyone (who cares) to be careful working with a group of incompetents or in a drowning situation, it's hard to avoid catching shit.
I've recently read a story about a missing woman who was found years later apparently wood-chipped all over her backyard. The husband has never been arrested. How are we judging someone guilty in the nurses case when there is just a statistical uptick.
The background is the > decade of underfunding of public services. Whatever the details of this case, there's a very high noise floor. The conspiracy theorist in me does think that this case was a convenient lightning-rod for public opinion and a convenient distraction.
> The background is the > decade of underfunding of public services.
I would disagree. Similar countries with similar spending on health in terms of proportion of GDP or PPP spend per capita seem to have much better health systems. The UK has a fairly typical spend compared to France, Germany, the Scandinavian countries and so on on both measures - on each measure it spends less than some and more than others: httpshttps://en.wikipedia.org/wiki/List_of_countries_by_total_hea...
It spends a lot less than the US which is the one developed country I know of with a clearly worse service.
> Neither of these cases inspire confidence in the General Medical Council or the Crown Prosecution Service.
I do not have a great deal of confidence in either of those in any case. The CPS has did prosecute some of the Post Office Scandal cases (even though most were private prosecutions), it failed to prosecute Mohammed Al-Fayed and many others, it has a very poor record on domestic abuse (failing to prosecute emotional abuse after it became a crime, or where victims were male).
Spending is one thing, but the UK just trains too few doctors [1], a consequence of Conservative policies and mismanagement. The Conservative efforts to centralize the NHS in London has also resulted in a system that doesn't scale and doesn't distribute resources efficiently.
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