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Chemical pathology
Viewpoint
The casino of life
  1. P J Twomey1,
  2. T M Reynolds2,
  3. A S Wierzbicki3
  1. 1Department of Clinical Biochemistry, Royal Infirmary Edinburgh, Room S6114, Level 2, 51 Little France Crescent, Edinburgh EH16 4SA, UK
  2. 2Clinical Chemistry Department, Queen’s Hospital, Belvedere Road, Burton upon Trent, Staffordshire, DE13 0RB, UK
  3. 3Department of Chemical Pathology, Guy’s and St Thomas’s Hospital, 5th Floor, North Wing, Lambeth Palace Road, London SE1 7EH, UK
  1. Correspondence to:
 Dr P J Twomey
 Department of Clinical Biochemistry, Royal Infirmary Edinburgh, Room S6114 Level 2, 51 Little France Crescent, Edinburgh EH16 4SA, UK; taptwomeyaol.com

https://doi.org/10.1136/jcp.2003.013433

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    Markets, mathematics, and medicine: should chemical pathology look to the stockmarket?

    Medicine is continuously changing—screening tools, diagnostic assays, and new medications and treatment modalities are rapidly being developed. However, in this age of super fast computers, one question that is not often asked is whether healthcare professionals are making the most of the currently available patient data? Chronic conditions such as diabetes mellitus, hypertension, and dyslipidaemia are increasing in prevalence at an alarming rate. At the same time, treatment guidelines are evolving and the audit of treatment targets is now being instituted as an objective means of measuring quality. However, there is relatively little research into the examination of the effects of such targets for individual patients as opposed to patient populations. We have previously shown that the effect of individual risk factor variation on screening for coronary heart disease can be considerable.1 So, how can we rationally overcome this variability in the monitoring of chronic clinical conditions? As ever, analogous problems exist in other fields of human endeavour.

    “One question that is not often asked is whether healthcare professionals are making the most of the currently available patient data?”

    Given the importance attached to finance in human motivation, enormous effort has been devoted to the analysis of stock and bond price variation. Financial and stock markets show that shares, like individuals, exhibit great variability as a result of real, transitory, artefactual, and criminal causes. Statistical tools called “risk measures” have been developed to identify these components and overcome the problem of distinguishing real from alternative causes.

    Measures commonly used by stock market “chartists” include the following:

    1. The moving average2 shows the average share price over a user defined period of time using multiple measurements. The more volatile the share the better this risk measure is, because patterns …

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