The performativity of numbers in illness management: The case of Swedish Rheumatology

Mediações - Revista de Ciências Sociais, 2021

The Covid-19 pandemic outbreak engendered an intense circulation of tables, graphics, statistics and rankings that seek to narrate the infection`s behavior and deaths. Such "data" became the object of disputes and negotiations, highlighting the centrality and political effects of numerical narratives. For a long time, researchers have been approaching processes of measuring populations and social phenomena as instruments of power and, more recently, they have advanced in the discussion on the political effects of reducing complex social processes to numbers. In this introduction, we outline issues that populate contemporary debates on quantification processes in the fields of social sciences and science and technology studies (STS). More specifically, we address the role of numbers in government and State narratives and we introduce debates on the role of classifications, on scalar effects, and on the use of numbers on technologies of government.

2017

This paper explores how accountability metrics are enacted in unfolding healthcare practices. We examine the socio-technical infrastructures that underpin and enable quantification of care, and how users of quantified data not only react to quantitative practices and underlying infrastructures, but also actively give shape to them through practices of gamification. In the paper, we elucidate three ways of gamification: adjusting to quantification infrastructures, ignoring quantification infrastructures, and playing with quantification infrastructures. Such games, we show, are played within the context of, and give shape to emerging infrastructures of measuring healthcare. This opens up to a diversity of ontological practices in relation to quantification infrastructures, as well as to unfolding identities of the professional quantified self.

Surgical Neurology, 2001

Author's Note Clinical research is undergoing a gradual transformation. The medical community increasingly demands better standards of scientific evidence. Clinical research, particularly in the surgical specialties, has historically been based on personal case reports and series.

Research Methods in Medicine & Health Sciences, 2020

The UK Brexit debate and the current Covid pandemic have been fertile grounds for people seeking poor use of statistics, and demonstrate a need to reiterate some basic principles of data presentation. Communicating basic numbers to convey the correct message is a vital skill for a public health professional but even basic numbers can be difficult to understand, and are susceptible to misuse. The first issue is how to understand ‘orphan’ numbers; numbers quoted without comparison or context. This leads on to the problems of understand numbers as proportions and how to make comparisons using proportions. Percentages, and in particular percentage changes, are also a major source of misunderstanding and the baseline percentage should always be given. The use of relative risk can also convey the wrong message and should always be accompanied by a measure of absolute risk. Similarly, numbers needed to treat should also refer to baseline risks. Communicating numbers is often more effective...

2013 46th Hawaii International Conference on System Sciences, 2013

This paper follows the documents (texts, numbers) of a statistics system called IPLOS. IPLOS is intended to coordinate, control, standardize and stabilize municipal care services in Norway and generate statistical knowledge about the clients. We follow the production of IPLOS numbers, their movements through the interlocking organizations, and how IPLOS is understood, used, and interacts with service delivery. We find that rather than IPLOS numbers stabilizing the organization, the organization destabilizes the numbers.

Social Science & Medicine, 1996

The ambiguities of risk which stem from its translation from epidemiological findings into clinical knowledge and practice and thus to lay experiences of health and illness is a clear dilemma. How are risks expressed statistically, or otherwise mathematically, to be interpreted and communicated within the discourse of medico-science, and how within the discourse of an individual's everyday life? An important tool in all risk discourses and in preventive practices such as health information is testing and test results. Test results--presented in mathematical terms as points on a scale, or as a number--are in fact fundamental to preventive practice. But what do we know about how people involved in these tests understand them and how the results are used in the construction of ideas about risk and normalcy? This article attempts to answer part of that question by drawing on an empirical study of the use of numbers as metaphors in talks between a nurse and her potential patients in a directed health survey.

Healthcare Management Forum, 2010

In the words of one hospital manager, "hospital data is currently indigestible and alien to the average user." Drawing upon the experience of an academic hospital that, contrary to established practice, published real numbers alongside rates and ratios during a Clostridium difficile outbreak, the authors examined the pitfalls of publishing only abstract performance measures and the advantages of releasing real numbers to the public. This article identifies lessons for hospital board governance, media relations, employee communications, and citizen and patient engagement that are applicable across the healthcare industry in many countries. If healthcare is to be a caring industry, then care should be taken in the public reporting of data and information.

Medicine Anthropology Theory

All Danish adults have access to their electronic medical records on the e-health platform Sundhed.dk, which is intended as a means to empower patients. But what happens when patients see their paraclinical test results presented as numbers which are flagged as either ‘normal’ or ‘abnormal’? Based on fieldwork in general practices and consultations, and on observations of individuals living with chronic illnesses, we investigated how patients and physicians interpret and interact with such numerical values, creating, as we argue through the words of Gregory Bateson, ‘epistemological errors’. We show how health record transparency blurs the patient’s senses and understanding and makes it harder for them to interpret their state of health and to trust the clinical judgement of health professionals. We argue that the immediate access to test results triggers a runaway process in which numerical values (be they normal or abnormal in comparison with a standard point of reference) transfo...

2009

Abstract Numeracy���that is, how facile people are with mathematical concepts and their applications���is gaining importance in medical decision making and risk communication. This article proposes six critical functions of health numeracy. These functions are integrated into a theoretical framework on health numeracy that has implications for risk communication and medical decision-making processes.

Sociology of Health & Illness, 2013

In this article we describe how patients assign meanings to medical test results and use these meanings to justify their actions. Evidence is presented from lay interpretations of medical tests for monitoring hepatitis C viral infection (HCV) to show how numeracy becomes embodied in the absence of physical symptoms. Illness narratives from 307 individuals infected with HCV were collected from the internet and analysed qualitatively. As part of standard medical care, chronically infected HCV patients are required to have periodic blood tests for laboratory testing. The lab results are presented numerically and compared with established physiological standards. HCV patients' knowledge and interpretations of test results have important consequences for their health behaviour and their medical decisions. In their stories, the patients described their decisions to begin, delay or stop treatment and developed strategies to alter their diet, exercise and use alternative therapies according to changes in their test result. The perceived meanings of test results are powerful signifiers that are capable of altering the course of HCV patients' illness, lives and stories. An interpretive model of health numeracy has the advantage of promoting understanding between patients and healthcare providers over a model that views innumeracy as a skill deficit.