看到小小學妹機器人貼的聯結, 開啟後看到文章為機率與數理統計大師 Professor David Spiegelhalter OBE FRS 所著，內容又是關於現在的工作, 忍不住的往下看。順手也就翻了一下。寫的同不同意就先不管了。
By David Spiegelhalter
Professor of Risk Understanding, University of Cambridge
題目: 'Choose the yum and risk the yuk?'
Do you waver as you reach for that bacon sarnie or glass of wine? Science tells us these things can be bad for us in excess.
But in this week's Scrubbing Up health column, risk expert David Spiegelhalter, says even those habits linked to risk can have benefits - and maybe people should be a little easier on themselves.
I own up. I am a serial risk taker. I live in a flood zone, cycle without a helmet, drink alcohol and on Sunday I had bacon for breakfast. I know that this is hardly Formula 1 racing, but reading the papers might suggest otherwise.
When the advice from cancer experts for avoiding bowel cancer is "try to avoid processed meats such as bacon, ham, salami, corned beef and some sausages", and women fearing breast cancer are told "there doesn't seem to be a threshold at which alcohol consumption is safe", then perhaps people like me are being grossly irresponsible.
Such stories bring a predictable response.
The threat from bacon sandwiches gave the opportunity for The Sun to produce the classic headline "Careless pork costs lives", while the Daily Telegraph was true to form and frothed on about the nanny-state denying us our bacon birthright.
But all these health warnings tend to have little influence on behaviour, just as scientific derision for homeopathy appears to have no effect on many people's enthusiasm.
So who is being unreasonable - the epidemiologists who give us health advice, or the public that duly ignores it?
Bacon sarnies
The curious fact is that both might be right.
The reasoning behind these health warnings seems to be this: if you do more of something pleasurable (which we shall give the generic name yum) there is a higher risk of something bad occurring (yuk), so therefore you should avoid yum.
But when presented with this argument you might ask two questions. First, maybe the pleasure of yum makes the risk worth taking, especially if yuk might occur a long time in the future? Second, maybe there are other benefits of yum than could cancel out the risks of the particular yuk that has been identified?
So suppose bacon sandwiches are your particular yum: research shows that 50g per day - that is a great greasy three-rasher sandwich - increases your risk of bowel cancer by 20%.
But this means that out of every 100 people who stuffed down that big bacon sandwich every day of their lives - just imagine them - the number of bowel cancers would rise from five to six.
And this possible harm is way in the future. Again The Sun put in their inimitable style: "I would rather have the occasional bacon sarnie than be 110 and dribbling into my All-Bran".
In addition, if a middle-aged woman gave up alcohol, it might reduce her risk of breast cancer, but could increase risk of some other cancers as well as heart disease.
So we need to look at the whole picture before trying to get people to change what they do, since everything has benefit and harms - just think of the joggers who get knocked down by cars - and people need to be able to find their own balance.
'Nudging'
These issues are tricky, and reflect a basic tension between individuals and society's points of view.
If everyone improved their lifestyle just a bit, then the benefits to the overall health of the nation would be large but each individual would not notice the difference. An inspired epidemiologist, Geoffrey Rose, called this the Prevention Paradox and we see it being played out again and again.
That is why it is understandable that attempts to create these shifts in behaviour by exhorting people to change tend to fail - and make them anxious and guilty.
It explains the current call for society-wide actions such as minimum alcohol pricing, and enthusiasm for 'nudging' people towards better behaviour.
When you find the muesli at the front of the breakfast counter, and the bacon sandwiches in an unmarked gloomy corner of the canteen, you know you're being nudged.
So as you reach for your yum, perhaps sometimes pause a moment and realise that you are taking a gamble on the yuk occurring, but that it may be a risk worth taking.
“選則好吃的而甘冒惡果?”
你拿培根三明治或一杯葡萄酒時會猶豫嗎? 科學家告訴我們這些東西食用過量時對我們是不好的. 但本週的Scrubbing Up health 專欄, 風險專家David Spiegelhalter說即使那些跟風險有關的習慣也可以有助益- 也許人們可以輕鬆一點來看待它們.
坦白的說，我是個慣於冒險者。我住在一個容易淹水的區域、騎單車不戴安全帽、喝酒，還有，星期天早餐我吃培根。我知道這絕不如一級方程式賽事，但是報紙可能有不同的建議。當癌症專家建議為避免腸癌應避吃加工持食品如培根、火腿、薩拉米香腸、鹹牛肉及一些香腸，擔心乳癌的婦女被告知酒精攝取並沒有一個安全標準量時，像我這樣的人是非常不負責任的。
這樣的故事會有些可預期的反應。
來自培根三明治的威脅給太陽報一個機會刊登像“不好的豬肉危及生命”這樣經典的頭條，同時每日電訊真的在推動一個奪取天賦吃培根權的保姆政府。然而這些健康警告對行為幾乎沒甚麼影響，一如科學的嘲諷無法影響人們對順勢醫療法的熱衷。
所以誰在那裡不理性-給我們健康建議的流行病學家或是忽略這些建議的老百姓？
培根三明治
奇怪的是兩者都可能是對的。健康警語的邏輯看來是這樣的：如果你從事越多令你感到歡愉的事(yum), 那就會有比較高的風險發生壞的後果(yuk) ，因此你應該拒絕yum。 面對這個的論述時你可能有兩個疑問：第一，也許yum的歡愉值得冒些險，特別如果yuk可能是許久後的未來才會發生；第二，也許yum有另外一個好處可以彌補這個特定yuk 的風險。
假設培根三明治是你特別的yum：研究顯示每天吃50公克美味油膩三片燻肉的三明治會增加腸癌風險20%。但是這意指每一百個每天吞進這個大培根三明治的人裡，想像，之中得腸癌的人從五個增加為六個。且這個可能是在很久後的未來才有的傷害。太陽報用他們獨特的風格寫道“我寧願偶爾吃吃培根三明治也不要口水滴進麥片般的活到110歲。”此外，一個中年婦女戒酒也許會降低得乳癌的風險，但是可能增加罹患其他癌症與心臟病的風險。
所以，在試圖說服人們改變時前我們需要做全盤檢視，因為每件事都有好有壞。想想，慢跑者可能被車子撞上，人們必須找到自己的一個平衡點。
善誘
這個議題很複雜，並反應著個人與社會關點之間的基本緊張。每個人改善他們生活型態一點點，雖然這個國家的整體國民健康會有很大的好處， 然而個人卻不會感受到這個差異。優秀流行病學家Geoffrey Rose 稱這為“預防悖論”， 我們一再的看到它上演。這就是為什麼以規勸的方式企圖變動行為模式常常失敗是可以理解的，並讓他們焦慮且感到罪惡。
這解釋著當前對社會的呼求廣泛的行動：比如最低酒價，以及熱切的“善誘”人們導向比較好的行為。當你發現喜瑞兒被放在早餐食品櫃頭而培根三明治被放在餐廳黑暗不明的角落時，你知道你正被善誘。
所以當你去享用你的歡愉時, 也許你可以暫停一下，想起你賭上了不好的結果，但是也許那是值得冒險的。
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