250,000 Jehovah's Witnesses have died refusing blood

by nicolaou 739 Replies latest watchtower medical

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  Band on the Run

  All right. Are we going to hire a superstar in Statistics to judge competing claims here? So far the arguments back and forth are not settling much.

  I must add that I never heard of a JW dying from a blood transfusion. Several were disfellowshipped for accepting blood. I recall the names being read aloud at the meeting and the collective moans of disaster. Strange, I always believed I would accept blood. The brother in my aunt's congregation was a very long time Witness of many decades. He sat in the back for about a year. Presto, Witness again. I wonder if newly converted Witnesses refuse blood more often. When you are in for decades, a lot of new light happens. It is more difficult to believe the big A. is going to happen in the next moment.

  If God created life, there should be more respect for it. We have survival instincts. Again, though, a decision by a competent adult. Would we make the same decision? Probably never but it is not our decision to make. What I find odious is the overreaching with the blood cards. Teenagers focus my energies more.
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  LisaRose

  Yes, I found the statement about building a calculator to be.....interesting. I take it to mean he did an excel spreadsheet? So what, so did I. But that means nothing if you are using the study to prove something it doesn't. couldn't get access to the study without paying $35, but I did read the abstract. It was designed to show cost benefit ratio, not determine mortality rates. It did prove that transfusions are cost effective, but I don't see how that proves a mortality rate.

  I did see a critique of the study called "Apple and Oranges", I am trying to get access to that as well.
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  Finkelstein

  Simon says ... A true model would take all these changing factors at different periods combined with the population of JWs at each time into account.

  Thats getting a little closer to the Truth.
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  Marvin Shilmer

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  “I looked at CDC numbers for severe anemia, for the US, there were 4,501 deaths in 2010, for a population of 281 million, that seems much lower than your New Zealand anemia rates.”

  LisaRose,

  I’d like to see the precise source for those figures to see how “severe anemia” is defined by the source. Can you share a link?

  The 2 values you offer express an annual mortality of 0.0016018% of the population for “severe mortality.

  Based values expressed in the Beliaev study, and after prorating based on assigning mortality values to 57% of the population of the 2 regions his data came from, I get an annual mortality of 0.0000086% of the population. This does no adjust upward for the increased rate of mortality among JWs in New Zealand but because JWs are such a small minority an adjusted value would not add much.

  This would make mortality related to “severe anemia” much higher in the United States than in New Zealand by a factor of nearly 200x. This is why I’d like to see the source you cite.

  Marvin Shilmer
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  Marvin Shilmer

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  “One question is, how were these patients selected.”

  LisaRose,

  A set of inclusion criteria was constructed and all patients who refused blood transfusion were identified for inclusion in the study. The JWs who met the criteria but were in palliative care were excluded. For years 1998-2007 there were 10,786 hospital admissions of 3,529 JW patients admitted to 4 hospitals. After reviewing these records it was found that 103 patients met the criterion.

  The same criterion was applied to all patients who accepted blood transfusion over the same period admitted to the same 4 hospitals. Patients in this group were selected based on a random drawing at a 1-to-1 ratio with the model group (above) from the same diagnose related sub-category as the model group. This resulted in a randomly selected group that was very well matched across a spectrum of variances to narrow the distinction down to one thing: accept blood or refuse blood.

  “Was it all severe anemia cases in those four hospitals, or were there cases of severe anemia in those hospitals that were not selected for some reason?”

  All cases of severe anemia were evaluated for inclusion. The only instances of exclusion were patients whose presentation met inclusion criterion but were in palliative care.

  “Were patients from other areas moved to these hospitals because of the study, or for some other reason?”

  We must assume patients are transferred to hospitals better equipped for critical conditions. For this reason my review ignored any possibility of mortality at a hospital without trauma service because all of the hospitals in this study had facilities and staff to offer trauma services. Because my values are achieved against a hard number of mortalities then, if anything, this method has the effect of understating the actual mortality of JWs in New Zealand with severe anemia refusing blood.

  “What has changed due to the increased use of blood substitutes and fractions since the study ended?”

  The change you mention occurred in year 2000. Most of the years included in the Beliaev study fall after the change. Hence retrospectively any values achieved would be conservative by comparison.

  “What is the death rate in New Zealand for severe anemia overall? That would be a great sanity check to see if we are in the ballpark.”

  Based values expressed in the Beliaev study, and after prorating based on assigning mortality values to 57% of the population of the 2 regions his data came from, I get an annual mortality of 0.0000086% of the population. This does no adjust upward for the increased rate of mortality among JWs in New Zealand but because JWs are such a small minority an adjusted value would not add much.

  “Why do four hospitals out of eighty treat 57% of the population?”

  The 57% figure does not represent 4 out of 80 hospitals.

  The 57% figure represents the population of New Zealand serviced by the 4 hospitals whose patient data was included in Beliaev’s study.

  Marvin Shilmer
• 

  slimboyfat

  LisaRose did you notice earlier in the thread where Marvin insisted the statistics were especially reliable because "New Zealand is an island"? What was that all about?
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  Marvin Shilmer

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  “And this study doesn't address deaths to to accidents where the patient might have lived l if they had accepted blood. I would think the cause of death would be listed as accidental injury, even though the blood issue was a contributing factor. That would, in effect, hide other cases of deaths because of the blood policy.”

  LisaRose,

  The Beliaev study was not conducted based on “cause of death” on a death certificate. Inclusion was based on patients who presented at or below a certain hemoglobin concentration regardless of why they were experiencing this hemoglobin concentration.

  “Marvin seems to think that because he is making conservative estimates in certain areas, he is justified making assumptions in other areas, and I just don't get that. Potentially under estimating in one area does not make it OK to make huge assumptions in other areas, it just makes you wrong.”

  What assumptions do you think I’ve made that are likely to statistically drive upward the figure of JWs who died due to refusing blood over the years 1961-2011? Please specify.

  Marvin Shilmer
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  Marvin Shilmer

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  “I take it to mean he did an excel spreadsheet? So what, so did I. But that means nothing if you are using the study to prove something it doesn't.”

  LisaRose,

  Yes. The calculator I constructed for this extrapolation is built in Excel.

  The study by Beliaev was conducted for a purpose other than how I’ve used the finding. But that does not make my finding weak. Whether my finding is weak depends on how I used data presented by Beliaev.

  Beliaev conducted his study to examine cost efficacy between treating severely anemic patients with and/or without red cell transfusion.

  I used hard findings published in the Beliaev study against the 10-year population of JWs in the same area to identify the ratio of annual deaths-per-JWs statistically the result of refusing blood. The annual ratio ended up being 3848-to-1. That is to say, based on hard numbers of mortality in the Beliaev study, over the 10-year period of 1998-2007, each year there was 1 death for every 3848 JW publishers. This rate of mortality is not the overall mortality of JWs suffering severe anemia. It is the rate of mortality of JWs suffering anemia over and above the rest of the same population.

  Because my presentation is based on actual (statistical) deaths over and above the rest of the population due to refusing blood, and because this mortality is well-documented in the Beliaev study then the statistical annual ratio of 3848-to-1 is beyond dispute.

  After establishing the above we have to ask this question: On average is the rest of the world’s population more or less likely to suffer severe anemia (for all causes)?

  I don’t see how or why the rest of the world would, on average, be less likely than New Zealanders to suffer severe anemia (for all causes). I looked hard to find this, and could not. The closest I came to finding such a cause is the Maori ethnicity factor. But the Beliaev study made a statistical adjustment for this.

  I do see how and why the rest of the world would, on average, be more likely than New Zealanders to suffer severe anemia (for all causes).

  So how did I treat this? I assigned the best case scenario to the rest of the world’s population by assuming it not more likely than New Zealanders to suffer severe anemia (for all causes).

  This leaves hard numbers that just about anyone can crunch to obtain a statistical number of deaths per annual number of JWs at any time during the period of 1961 to 2011.

  Hence the only bad inputs possible are of hard numbers. What hard numbers have I wrongly used as inputs?

  Marvin Shilmer
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  Marvin Shilmer

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  “LisaRose did you notice earlier in the thread where Marvin insisted the statistics were especially reliable because "New Zealand is an island"? What was that all about?”

  The fact that New Zealand happens to be an island is only one thing that helps statistically capture the population its healthcare system cares for. This is a factor to consider when attempting to use numbers of deaths to achieve a per capita ratio.

  The fact is that New Zealand is a sovereign nation and the Beliaev study presents a data set representing a very large percentage of the nation’s overall population. This is something that’s rare (nearly unique) in data presentations of mortality among Jehovah’s Witnesses refusing blood. It’s useful for constructing an excellent picture of deaths per capita among New Zealander JWs refusing blood over the period of 1998-2007. The annual rate is 1 JW for every 3848 JWs during the period of 1998-2007.

  Marvin Shilmer
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  Simon

  A set of inclusion criteria was constructed and all patients who refused blood transfusion were identified for inclusion in the study.

  And that is why your application of the results to ALL JWs is giving you an unbelievable answer.

  You are only looking at results from a small subset of the JW population.

  Yes. The calculator I constructed for this extrapolation is built in Excel.

  That means nothing. Are you claiming it's a model? Most likely from what I've seen so far all it really does is automate the calculation.

  Why even do that? I mean, if you have the numbers and the numbers are so hard then you wouldn't be re-calculating anything, ever ...

  Unless you want to play around and do "what ifs" until you get the answer you want. A round 50,000. Nice.

  The study by Beliaev was conducted for a purpose other than how I’ve used the finding. But that does not make my finding weak. Whether my finding is weak depends on how I used data presented by Beliaev.

  So it's weak then.

  Hey, maybe if you repeat the "I used hard numbers" mantra a few more times and click your heels together, you'll get back to Oz!

  The fact that New Zealand happens to be an island is only one thing that helps statistically capture the population its healthcare system cares for. This is a factor to consider when attempting to use numbers of deaths to achieve a per capita ratio.

  The fact is that New Zealand is a sovereign nation

  So you think they have a big wall or something? They don't have planes? That other countries allow hoardes of blood-refusing-near-death JWs to flood across their borders each day? Pretty much all nations run themselves so I'm not sure what that 'sovereign' part has to do with the price of milk.

  You stopped making sense many pages back Marvin, now this is just sheer entertainment.

  C'mon, say something else !!