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Martin Greenwald, M.D.'s avatar

Great post. I don't know the medical details of the case, but I agree that convicting someone based partly on statistics like this is seems really bad. Weird stuff happens in medicine all the time and usually it isn't intentional wrongdoing. Statistical anomalies can be used to alert us and guide further investigation, but we ultimately need to find a real and convincing cause.

Also, generally speaking—and again I don't know all the details of the case—using something someone wrote in the context of a therapy exercise as evidence against them is shockingly inappropriate. The fact that the counselor was employed by the hospital, thus creating even more conflicts of interest, is even crazier. I'm surprised that kind of thing would be admitted in court in the first place.

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Ivan Fyodorovich's avatar

Back when a ship lost power and crashed into a support pillar of the Francis Scott Key Bridge, people had takes to the effect of "what are the odds the ship would bullseye the pillar. This must have been the work of <whoever I hate>" Of course the problem with this argument is that if the ship had lost power and not crashed into anything, we never would have heard about it. Unless you have a sense of how common ship power outages are, you can't draw any such conclusions.

Even after accounting for the cherrypicking, there did seem to be a pretty high correspondence between Letby being on shift and bad stuff happening to premies. After reading the New Yorker article, that was the only point that made me wonder if she was still guilty. At the same time, you have to wonder if at some other hospital, some premies had crises and people began to suspect nurse Lisa Lotby, but then a couple premies crashed in other peoples' shifts and Lisa was no longer an object of suspicion. How often does stuff like that happen? Base rates for this thing are so hard to figure.

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