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Q J Med 2002; 95: 247-249
© 2002 Association of Physicians


Commentary

The nature of truth: Simpson's Paradox and the limits of statistical data

M. Heydtmann

From the Liver Research Laboratories, Queen Elizabeth Hospital, Birmingham, UK


    Introduction
 
‘Give me a fruitful error any time, full of seeds, bursting with its own corrections. You can keep your sterile truth for yourself.’ Vilfredo Pareto

We usually think in terms of true and false, and often believe that we know which is which. Nonetheless, sometimes information which appears to be true is in fact false. Although we try to base our medical knowledge on objective evidence—research and statistics—rather than our personal opinions, Simpson's Paradox reminds us of the limitations of statistical evidence. In this phenomenon, an apparent paradox arises because aggregated data can support a conclusion which is opposite from that suggested by the same data before aggregation.


    An example
 
One would generally conclude from the data in Table 1Go that treatment A is the treatment of choice for the condition studied (given that side-effects are equal). Suppose, however, that these patients consisted of two subgroups: those with a high serum level . . . [Full Text of this Article]


    Is Simpson's Paradox dependent on the absolute numbers, and does statistical significance protect from the effect?
 

    Does a properly designed trial prevent Simpson's Paradox?
 

    Is Simpson's Paradox common?
 

    Acknowledgments
 

    Notes
 

    References
 

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