[HN Gopher] Experts warn Letby inquiry of misreading stats to ex...
       ___________________________________________________________________
        
       Experts warn Letby inquiry of misreading stats to explain
       'suspicious' deaths
        
       Author : YeGoblynQueenne
       Score  : 78 points
       Date   : 2023-10-08 10:22 UTC (12 hours ago)
        
 (HTM) web link (www.thejusticegap.com)
 (TXT) w3m dump (www.thejusticegap.com)
        
       | JackeJR wrote:
       | The expert statistical analysis alluded to is simply the
       | framework for causal inference. Had Letby not been on duty for a
       | similar group of patients, would the number of patients who had
       | died been the same?
       | 
       | If the answer is no, then a follow on question regarding whether
       | or not factors associated with Letby could have resulted in the
       | deaths rather than Letby herself. This could be a fellow worker
       | who always worked in tandem with her etc.
       | 
       | Finding the appropriate set of data and applying statistical
       | techniques for this is not trivial hence the expert mention.
        
       | oxfordmale wrote:
       | In two cases, the victim died by insulin overdose, Letby herself
       | admitted that the only possible explanation was foul play. That
       | means there is a killer on the ward. The police interviewed the
       | other nurse on the shift, and she was cleared. Even if Letby gets
       | acquitted from the other cases, her sentencing likely will not
       | change.
       | 
       | One challenge for the defence was that there are few studies on
       | injecting air in small babies for obvious reasons. Air embolisms
       | are very painful, and such a study wouldn't pass ethics approval,
       | let alone parental consent.
        
         | YeGoblynQueenne wrote:
         | Those babies didn't die. Those were not murder accusations but
         | attempted murder.
         | 
         | To clarify. Lucy Letby was accused of deliberately
         | administering a high dose of insulin to two babies, in an
         | attempt to murder them.
         | 
         | Those two babies were "Child F", and "Child L" for both of
         | which she was charged , and convicted of attempted murder.
         | 
         | My source for this information is this article in "Nursing
         | Times":
         | 
         | https://www.nursingtimes.net/news/children/breaking-lucy-let...
        
           | oxfordmale wrote:
           | Thanks for correcting this mistake.
           | 
           | My point is that the judge awarded her a life sentence on
           | each of the cases:
           | 
           | "on each of the seven offences of murder, and the seven
           | offences of attempted murder, I sentence you to imprisonment
           | for life."
           | 
           | Even if the other cases turn out to be unsafe, she would
           | still be imprisoned for life.
        
       | rwmj wrote:
       | While the statisticians are right to be cautious about clusters
       | of deaths => serial killer, we also have to remember that a 9
       | month trial presented lots of evidence to a jury, they
       | deliberated for over a week, and returned seven guilty verdicts.
       | Unless you were also sitting at that trial or have read every
       | line of court transcript, it would be very unwise to start
       | claiming there's a miscarriage of justice.
        
         | contravariant wrote:
         | I suppose, but it wouldn't be the first time a judge or jury
         | was swayed by dubious statistics.
         | 
         | At least that is exactly what happened to Lucia de B [1] (which
         | they mention in the article), which at first glance looks
         | eerily similar.
         | 
         | [1]: https://en.m.wikipedia.org/wiki/Lucia_de_Berk
        
           | DanBC wrote:
           | The difference is that statistics were used in de Berk's
           | prosecution, but were not used in Letby's prosecution.
        
             | contravariant wrote:
             | Just implicitly assuming that something couldn't have been
             | chance is just trying to do statistics on pure intuition,
             | which is notoriously difficult.
             | 
             | Though unlike the Lucia de B case it doesn't seem likely
             | these deaths could all have been natural. The evidence
             | pointing towards Letby seems mostly probalistic in nature
             | though, which should be treated carefully.
        
             | YeGoblynQueenne wrote:
             | Woa, careful. That's not true. The staff duty roster was
             | used by the prosecution to argue that Lucy Letby "the
             | common denominator" in all the suspicious deaths:
             | 
             |  _Chief among these was the duty roster spreadsheet showing
             | staff shifts, through which the Crown Prosecution Service
             | (CPS) was "able to show the jury that Letby was the one
             | common denominator in the series of deaths and sudden
             | collapses on the neonatal unit"._
             | 
             | https://theweek.com/law/lucy-letby-and-the-importance-of-
             | und...
             | 
             | That is totally statistical information - even though it's,
             | shall we say, lay statistics and not what you'd expect to
             | see from a statistician.
        
           | Freak_NL wrote:
           | Please; write 'Lucia de Berk', not 'Lucia de B'. She was
           | exonerated in full, and has since indicated quite clearly
           | that she wishes to be known under her full name, not the
           | initialized suspect name.
        
             | contravariant wrote:
             | Oh, seems I got that exactly the wrong way around. I was a
             | bit on the fence about it, and figured not using her real
             | name was the safest option.
             | 
             | However if Lucia de Berk herself wishes people to use her
             | full name then that is a very noble decision. The edit
             | window has passed unfortunately, but I will use her full
             | name in future.
        
         | iudqnolq wrote:
         | edit: wrong, can't delete
        
           | [deleted]
        
         | quietbritishjim wrote:
         | Those arguments included that the suspicious deaths all lined
         | up perfectly with Lucy Letby's shifts, that she was often
         | caught interacting with those babies when she had been
         | instructed not to, and that when she was taken off the ward the
         | deaths instantly stopped. That is a level of causality checking
         | far stronger than most Bayesian analyses.
        
           | automatic6131 wrote:
           | And she took home documents from several of those patients,
           | which she'd have no ordinary reason to have fished out of the
           | trash.
        
             | frou_dh wrote:
             | And the little old thing that she wrote "I killed them on
             | purpose" on a post-it-note at her house.
        
               | kitd wrote:
               | Those notes had little effect in her conviction
               | apparently, according to a criminal psychiatrist on BBC
               | radio. It is behaviour typical of someone suffering
               | depression, for which she was having treatment at the
               | time.
        
               | YeGoblynQueenne wrote:
               | It's important to keep in mind that the post-it note [1]
               | with the "confession" was not _meant_ as a confession,
               | for example it wasn 't a signed confession and it wasn't
               | accepted by Lucy Letby as a confession. The prosecution
               | pointed out to the note as a confession.
               | 
               | I have no idea how much that affected the jury but it's
               | just as important to remember that false confessions are
               | a thing, and a common thing at that [2], and they have
               | led to many false convictions. The wikipedia article I
               | cite has a _very_ long list from many places in the
               | world.
               | 
               | At the end of the day, innocent people can confess and
               | guilty people can maintain their innocence. A confession
               | is no more reason to accept guilt than protestations of
               | innocence are reason to assume innocence.
               | 
               | Again, I don't know how much the jury were influenced by
               | the note, but, anecdotally, the press has certainly held
               | it up as some sort of evidence, and I've seen people on
               | the internet take it as such, also. See for example a
               | parent comment.
               | 
               | _____________
               | 
               | [1] For example, here:
               | 
               | https://www.liverpoolecho.co.uk/news/liverpool-news/lucy-
               | let...
               | 
               | [2] https://en.wikipedia.org/wiki/False_confession
        
               | atlantic wrote:
               | Yes, typically, when people are depressed, they write
               | things like "I ate my neighbours for breakfast" or "I
               | massacred everyone in the mall". I get that too. My desk
               | is covered with those notes.
        
               | adammarples wrote:
               | Writing "I killed them on purpose" is not typical
               | behaviour of depressed people.
        
               | Intralexical wrote:
               | Most depressed people don't have strings of deaths
               | following them wherever they go.
               | 
               | It is not unexpected of depressed people to blame
               | themselves for bad things that happen around them, I
               | think. ...For multiple reasons, (1.) because you really
               | do hate yourself that much, and might view those tragic
               | events as also personal failures, and (2.) because for
               | the suicidally depressed, it can be a way to manufacture
               | a reason to believe why you _deserve_ to be hated or
               | physically injured.
               | 
               | IIRC the insulin levels or something were rather
               | suspicious, but in general I sorta can't and shouldn't
               | comment on the validity of rest of the case as a
               | bystander. But when I read about that note in particular,
               | my read on it was that somebody who actually did kill
               | them versus somebody who just feels really bad about the
               | situation and wants to vent in their own private space
               | would write down the exact same thing in the exact same
               | way with equivalent plausibility. She was a nurse, and
               | babies died in her care; it is entirely plausible that,
               | especially if she was already depressed, she would view
               | that as being her fault and find some way to internalize
               | the tragedy even if she didn't actually do anything to
               | cause it.
               | 
               | And, IIRC, Letby did basically say that that was what she
               | meant by the note-- So, in sum, an innocent person who
               | had been blaming themselves and a murderer trying to lie
               | their way out of justice IMO would have written down the
               | exact same thing with equal plausibility, and then tried
               | to explain it the exact same way, which means that IMO
               | that datapoint is basically useless for determining her
               | guilt.
               | 
               | There was other evidence presented too, of course. I'm
               | glad to hear that the conviction didn't rest on just that
               | note, because given the situation, we don't actually know
               | in isolation why she wrote that or what she meant by it--
               | Most murderers try to avoid leaving confessions lying
               | around to be used as evidence too.
        
               | kitd wrote:
               | I'm going by the testimony of a psychiatrist who had been
               | following the trial. Depression can apparently push
               | people into a mental world where everything is at rock
               | bottom and what gets written is just an expression of
               | that.
        
               | ad404b8a372f2b9 wrote:
               | Ah jinx!
        
             | ad404b8a372f2b9 wrote:
             | And she had post-it notes at home where she had written "I
             | killed them on purpose."...
        
             | littlestymaar wrote:
             | Like with the unauthorized interaction with the babies[1],
             | this is only relevant to the case if (1) it's not a common
             | behavior among nurses in her unit and (2) she did that
             | specifically to the victims, and not with many of her
             | patients.
             | 
             | [1] https://news.ycombinator.com/item?id=37810382
        
           | ssl232 wrote:
           | I went down the rabbit hole on this a couple of months ago.
           | Some of the details are a bit hazy in my memory now as it was
           | about 2 months ago, but in the interest of playing devil's
           | advocate...
           | 
           | > the suspicious deaths all lined up perfectly with Lucy
           | Letby's shifts
           | 
           | Once a nurse has been around the ward for long enough to have
           | seen several deaths, you can produce a table showing a set of
           | baby deaths correlating to any nurse's shifts [1]. The ward
           | was for seriously ill newborn babies, so baby deaths were
           | unfortunately common, and each nurse would regularly be on
           | shifts where one would die.
           | 
           | As you say, these deaths were considered "suspicious", but
           | some (e.g. [2]) claim otherwise, saying key tests that would
           | rule the accused method of murder in or out were not done at
           | the time of death.
           | 
           | > she was often caught interacting with those babies when she
           | had been instructed not to
           | 
           | (Again, playing devil's advocate) the job selects for nurses
           | who (apart from Letby, it seems) deeply care for young
           | babies. Not a smoking gun.
           | 
           | > when she was taken off the ward the deaths instantly
           | stopped
           | 
           | This has been contested. As far I can tell the hospital's
           | death rate statistics disagree with the Office for National
           | Statistics. The latter's data appears to show the deaths
           | peaked after Letby was taken off the ward [3] (note, I
           | haven't checked the underlying source mentioned in the
           | tweet).
           | 
           | Replies to some comments below yours:
           | 
           | > And she took home documents from several of those patients,
           | which she'd have no ordinary reason to have fished out of the
           | trash.
           | 
           | Apparently this is quite common for nurses working on this
           | and other intensive care wards. Nurses just off duty are
           | often phoned by the nurses who took over the shift, asking
           | for details on particular babies' treatment or behaviours
           | that day. Having files on the babies to hand would let Letby
           | give exact details without having to remember or misremember
           | them.
           | 
           | > And the little old thing that she wrote "I killed them on
           | purpose" on a post-it-note at her house.
           | 
           | This looks bad, yes, but again not a smoking gun. I think I
           | read this happened after she was already taken off the ward
           | or had somehow found out she was under investigation for
           | causing baby deaths. I could believe a note like that could
           | be written by someone on the verge of a breakdown or under
           | extreme stress. The "I killed them" bit I could believe
           | someone could write if they regret not having spotted
           | something earlier that someone more experienced might have,
           | especially if they have imposter syndrome.
           | 
           | As the blog makes clear, it's not really about whether Letby
           | is innocent or guilty, it's about whether she got a fair
           | trial. It seems many statistics were misused in her case,
           | circumstantial evidence was used as smoking guns, and some
           | evidence was not fully addressed [4]; basically enough to
           | question the verdict.
           | 
           | [1]
           | https://twitter.com/profnfenton/status/1692837686166368660
           | 
           | [2] https://gill1109.com/2023/05/24/the-lucy-letby-case/
           | 
           | [3]
           | https://twitter.com/LawHealthTech/status/1692917506078376019
           | 
           | [4] Apparently during the trial it was mentioned that sewage
           | pipes crossed the ceiling and backflow sometimes came into
           | the sinks. Definitely not a good mix to have in a ward with
           | very ill babies. Hopefully infection spread from bad plumbing
           | was fully ruled out as causes of death during the trial. Some
           | critics don't seem to think it was.
        
             | weinzierl wrote:
             | I'd like to add another point that struck me as odd when
             | going down the same rabbit hole:
             | 
             | The C-peptide level in Child F's discharge letter have been
             | called _" the golden thread"_ of the case by the leading
             | Detective Sergeant of the investigation Paul Hughes.
             | 
             | The deputy senior investigating officer DCI Nicola Evans
             | called it a _" real milestone"_ in the investigation.
             | 
             | The Guardian called it _" a smoking gun in this medically
             | complex case"_.
             | 
             | Dr Stephen Breary, the hospital's neonatal unit head
             | consultant, said about its discovery: _" If there was a
             | iota of doubt, it was removed then."_
             | 
             | I think it is fair to say that if this letter would not
             | have been found, after already a year of rather fruitless
             | investigation, there would quite likely not have been a
             | case.
             | 
             | Yet, the very same Dr Breary, who was also under pressure
             | because of the apparent rise of deaths in his department,
             | came up with this document more than two and a half years
             | after the child was released and just a couple of days
             | before Letby was about to return to his department against
             | his will.
             | 
             | I'm not saying Dr Breary is under suspicion or Letby is
             | innocent, but think the discharge letter should have seen
             | more scrutiny.
             | 
             | My point is that I don't think there is anything in this
             | case that really holds water if you seriously probe it and
             | if you pile up flawed arguments - no matter how many - it
             | will not bring you any closer to the truth. If I can wagger
             | a prediction, and I already said this when Letby was
             | convicted: I see a successful appeal and this verdict be
             | shredded. Not because I think Letby is innocent, but
             | because a working legal system should not put anyone behind
             | bars for life with such a weak case.
        
               | notahacker wrote:
               | Apart from the general ridiculousness of insinuating that
               | of all records someone might adulterate or invent, he
               | would pick a digital copy of a _discharge letter sent to
               | an third party whose other baby had died_ , your
               | timelines are all wrong. Breary got the police involved
               | in April 2017. Nobody thinks it's a coincidence that it
               | was a few days before Letby was due to return to the
               | ward; stopping her from returning to the ward was his
               | stated reason for going to the police.
               | 
               | The "smoking gun" turned up inconveniently _late_ , in
               | February of the following year, when he'd been asked to
               | go through the records of the kids who survived.
        
               | weinzierl wrote:
               | _" Apart from the general ridiculousness of insinuating
               | that of all records someone might adulterate or invent,
               | he would pick a digital copy of a discharge letter sent
               | to an third party whose other baby had died, [..]"_
               | 
               | That's what you say. I neither said nor insinuated any of
               | that.
               | 
               | The case is supported by two main pillars. One is the
               | idea that the stats support suspicions clusters of
               | deaths. I expected that to be challenged back in August
               | and we see it happen now.
               | 
               | The second pillar is the _" smoking gun"_ of Child F's
               | raised peptide levels. In my opinion this pillar is far
               | from being strong enough to support this case alone. If
               | we don't see any additional props appear, I expect it to
               | crumble in the appeal.
               | 
               |  _" your timelines are all wrong."_
               | 
               | - August 2015: Child F blood sample [2]
               | 
               | - February 2017: Police investigation launched
               | 
               |  _" On the night before Valentine's Day in February 2018,
               | nearly a year after police launched their investigation"_
               | [1]
               | 
               | - July 2016: Letby removed from frontline care [1]
               | 
               | - February 2018: Smoking gun found [1]
               | 
               | - May 2017: Letby scheduled to return [1]
               | 
               | [1] https://www.theguardian.com/uk-
               | news/2023/aug/19/trust-me-im-...
               | 
               | [2] https://www.theguardian.com/uk-news/ng-
               | interactive/2023/aug/...
        
               | notahacker wrote:
               | Thank you for posting the timeline
               | 
               | So unless you're going to insist on a special calendar in
               | which February 2018 occured two days before March 2017,
               | you're basically confirming that I was correct to point
               | out that your original statement that "Dr Breary, who was
               | also under pressure because of the apparent rise of
               | deaths in his department, came up with this document more
               | than two and a half years after the child was released
               | and just a couple of days before Letby was about to
               | return to his department against his will." got the
               | timeline all wrong.
        
               | weinzierl wrote:
               | Oh, this is so embarrassing and I only see it now.
               | 
               | What I initially misread was _" Letby had been just six
               | days from returning to work on the neonatal unit at this
               | point."_ from [1]. This sentence refers to the 27 April
               | 2017 two paragraphs before and not to the smoking gun
               | discovery in the following paragraph. When I compiled the
               | timeline I totally focussed on the months. 27 April plus
               | six days would be May. But 2017, not 2018.
               | 
               | I stand corrected and thank you for pointing it out.
        
               | gus_massa wrote:
               | Why was Child F in the hospital? Is it posible to be a
               | false positive?
               | 
               | From
               | https://www.google.com/search?q=c-peptide+false+positive
               | 
               | https://labs.selfdecode.com/blog/c-peptide/
               | 
               | > _However, while healthy kidneys are efficient at
               | breaking down C-peptide, in people with impaired kidney
               | function and kidney disease, blood C-peptide levels will
               | falsely increase and urine levels will falsely decrease._
        
             | LorenPechtel wrote:
             | Considering point #4: I am aware of a case locally where a
             | nurse was accused of murdering a baby. Digging deeper we
             | find: The nurses had been complaining of the low quality
             | supplies that were being provided. Specifically mentioned
             | were IV lines that were prone to breakage. The baby died
             | from a failure of an IV line at just the wrong spot.
             | 
             | The hospital's expert witness supposedly said the line had
             | been cut. Dig deeper: No, the witness was asked if the
             | damage to the line was consistent with being cut. Yes, it
             | was, but that doesn't mean it wasn't also consistent with
             | simply breaking.
             | 
             | In the end it's pretty clear the hospital tried to throw
             | the nurse under the bus to cover up the fact that it was
             | their shoddy supplies that killed the baby. No idea on what
             | sort of settlement the parents got, no details on what the
             | nurse got but it was substantial.
        
               | FireBeyond wrote:
               | I worked for an ambulance company that has had one of our
               | local hospitals try to throw us or our employees under
               | the bus on at least two occasions in five years:
               | 
               | 1) understand that there are two types of ambulance
               | (generally) - basic life support and advanced life
               | support - the latter carries invasive care options, and
               | narcotics, the former does not. They called us for an
               | interfaculty transport approximately 200 miles. Patient
               | was given pain meds before transport. Late in transport,
               | EMTs on a BLS ambulance (no narcotics physically on board
               | the ambulance) noted the patient was in profound
               | respiratory depression and treated that - arriving at the
               | hospital, it was discovered that the patient had been
               | given vastly too much narcotics. Originating hospital
               | _insisted_ that it _must_ have been given in transport.
               | Kept insisting all the way to a DOH hearing. The EMT and
               | the ambulance company were cleared and the hospital and
               | nurse faced repercussions for documentation,
               | administration, cover-up issues, but they still had to
               | have their day in  "court" to get to that point.
               | 
               | 2) A deputy cracked his neck, and unbeknownst to him,
               | partially severed a blood vessel. He contacted EMS
               | complaining of nausea and vomiting. Among other things, a
               | stroke test was done (negative) and he was taken to the
               | hospital. CTs were done, and the physician at the
               | hospital was insistent that all was clear, and was about
               | to discharge him with vertigo, while other deputies
               | insisted something was seriously wrong, and getting worse
               | with him. Another provider sent scans to a major trauma
               | center who noted that he had indeed had a stroke. He was
               | also now failing a stroke test. He was transferred and
               | treated but irreversible damage had occurred needing 24/7
               | nursing care, and lawsuits were launched. He died a month
               | or so later. The hospital tried to throw EMTs under the
               | bus, saying that they failed to diagnose or tell the
               | hospital that the patient was having a stroke. Even
               | though at the hospital another initial stroke test was
               | performed by a physician with a negative result. The
               | hospital then said there were subtle signs that in
               | hindsight the EMTs "should have recognized" (but
               | apparently a physician should not have been expected
               | to...). That case is still ongoing, but the ambulance
               | company managed to extricate itself after settling for
               | policy limits (which was farcical in itself).
        
             | qingcharles wrote:
             | Criminal trials are very tough. I've spent thousands of
             | hours in criminal courts. One thing I would say first is
             | that most lawyers are generally not experts in anything
             | outside of law, so things like medicine and statistics are
             | tough for them. That's why they bring in their own experts.
             | 
             | Before trial the experts will go through all the discovery
             | and try to come up with theories that refute the
             | prosecutions idea. You essentially have infinite time to go
             | through the discovery. But, you do not know in advance what
             | the witnesses and opposing experts are going to testify to
             | on the stand.
             | 
             | During trial things move very, very quickly and you don't
             | have any time to really take into account everything the
             | witnesses are saying, and if there are things that say
             | needed some time to run a statistical analysis to see if
             | they were true, well you'd be screwed because you don't
             | have that time. So, essentially witnesses can say things
             | that seem really bad to a lay jurist, but if you had time
             | to run the math they would easily be explained as common
             | and not statistically significant.
             | 
             | In a complex trial like this I think it would be fairly
             | easy for it to go the wrong way.
             | 
             | The justice system is definitely designed to produce
             | convictions. Acquittals are a rare bird.
        
           | littlestymaar wrote:
           | > that she was often caught interacting with those babies
           | when she had been instructed not to
           | 
           | This is only a piece of evidence if:
           | 
           | - it's not a common behavior among nurses in her unit.
           | 
           | - she did that specifically to the victims.
           | 
           | Otherwise it could be that this rule isn't applied in
           | practice, or that she is just the kind of people who don't
           | really listen to instructions if they think they should not,
           | which albeit a questionable attitude in an hospital isn't the
           | same thing as "she killed them".
        
           | [deleted]
        
           | mrangle wrote:
           | Your second attempted point is nonsense in a working hospital
           | setting in general, or in a courtroom as far as evidence is
           | concerned. Your bookend points are the definition of
           | particularly weak circumstantial evidence. Also known as
           | statistical illusion.
           | 
           | She should be in prison if guilty of these horrific crimes.
           | However, sending an innocent person to prison for them is
           | substantially worse than no one going to prison for them.
        
             | tbalsam wrote:
             | Every "innocent until proven guilty" still has a p value.
        
           | taneq wrote:
           | I've watched enough cop procedurals to know that this means
           | it was the ward manager. It's too neat, obviously a set up.
           | /s
        
         | YeGoblynQueenne wrote:
         | According to the judge of the trial, most of the evidence was
         | circumstantial [1]. I don't know which part of the evidence the
         | judge considered circumstantial, and which not.
         | 
         | The police have said that the duty roster spreadsheet shown to
         | the jurors was an important piece of evidence used to convince
         | the jurors [2].
         | 
         | The spreadsheet in question has been circulated in the media
         | (I'm assuming, by the police) and it can be found in various
         | places [3].
         | 
         | Looking at that spreadsheet there is something that immediately
         | jumps out to me and that makes me think that at least that
         | piece of "statistical" evidence was downright dodgy.
         | 
         | I am curious to know if anyone else on HN sees the same thing.
         | Here's a direct link to the image on the Mail website:
         | 
         | https://i.dailymail.co.uk/1s/2023/08/18/22/74487747-12286051...
         | 
         | To be clear: I'm not trying to trap anyone, I'm just really
         | curious to see what everyone else thinks _about this particular
         | piece of evidence_.
         | 
         | ____________
         | 
         | [1] https://www.bbc.co.uk/news/uk-england-merseyside-66823777
         | 
         |  _Summing up at the end of her trial, judge Mr Justice Goss
         | told the jury it was a case in which the prosecution
         | "substantially, but not wholly" relied on circumstantial
         | evidence._
         | 
         | [2] https://theweek.com/law/lucy-letby-and-the-importance-of-
         | und...
         | 
         |  _Chief among these was the duty roster spreadsheet showing
         | staff shifts, through which the Crown Prosecution Service (CPS)
         | was "able to show the jury that Letby was the one common
         | denominator in the series of deaths and sudden collapses on the
         | neonatal unit"._
         | 
         | [3] https://www.dailymail.co.uk/news/article-12286051/Lucy-
         | Letby...
         | 
         | See first image on top, titled: "Staff chart that shows Letby
         | was present at every chilling incident".
        
         | Marazan wrote:
         | Yeah, this is not a case of someone being convicted based on
         | dodgy statistical data. Indeed she was found not guilty on a
         | large number of other deaths.
         | 
         | There was corroborating evidence which lead to her conviction.
        
           | notahacker wrote:
           | Not to mention the fact the background was the complete
           | opposite of a statistical witch hunt. The overlap between
           | Letby and abnormal baby collapses and deaths and her strange
           | behaviour around them had been noted by several colleagues,
           | but hospital management stuck doggedly to the null hypothesis
           | that it was just bad luck and resisted attempts to
           | investigate even after moving her to other duties (at which
           | point the unexpected baby collapses stopped)
        
         | rgrieselhuber wrote:
         | Also "experts warn" is argumentum ad verecundiam.
        
           | munch117 wrote:
           | What's the latin name for "argument by using fancy latin
           | names for things that could just as easily have been said in
           | English"?
        
           | lolinder wrote:
           | No, the headline is just documenting what the experts are
           | saying, it can't contain a fallacy because it doesn't contain
           | an argument. It's the experts themselves who are making the
           | argument, and they're not simply saying "trust us, we're
           | statisticians".
        
         | avianlyric wrote:
         | The other half of the equation is bias in the investigation.
         | Often a poor understanding of statistics is used to start
         | investigations, unfortunately those investigations are started
         | with the premise that a particular person "is probably guilty".
         | Turns out that when medical investigations are performed
         | looking for wrongdoing, they're much more likely to find
         | wrongdoing that if the investigation was performed simply to
         | understand if correct policy and procedure are followed. As a
         | consequence it's very normal for deaths previously ruled
         | "normal" to suddenly become "suspicious".
         | 
         | When people have studied these types of investigations, and has
         | the evidence re-evaluated by unbiased investigators, the
         | results are usually that nothing untoward occurred, or that
         | deaths are better explained by systemic failures rather than
         | the actions of specific individuals.
         | 
         | There's a good reason why we don't let police go on fishing
         | expeditions. Medical investigations, frequently initiated by
         | untrained administrators, and performed by individuals within a
         | hospital with no formal training in performing unbiased
         | investigations, nor given enough to perform proper
         | investigations, simply don't hold up to the standards we would
         | expect from a criminal investigation.
         | 
         | None of this is to say that the Letby verdict is unsafe, but it
         | wouldn't be the first time a medical investigation with lots of
         | evidence resulted in an awful miscarriage of justice.
        
         | crote wrote:
         | To a large extent they didn't _have_ to involve statistics.
         | There was plenty of better evidence in the Letby case.
         | 
         | However, the public perception around the time of the trial was
         | substantially different. Especially early on, the media focused
         | strongly on the fact that it "could not possibly be a
         | coincidence". Reading the trial coverage I got a very strong
         | feeling of deja vu, seeing the coverage pretty much mirroring
         | the Lucia de Berk case.
         | 
         | Considering the mountain of other evidence in the Letby case, I
         | highly doubt it was a miscarriage of justice. But I definitely
         | agree with the Statistical Society that just because something
         | _looks_ like a duck, it doesn 't _have_ to be a duck.
        
           | mrangle wrote:
           | Better evidence is irrelevant to her jury trial if false
           | evidence was included in the form of misrepresented stats.
           | Because that's how trial by jury works. She would get a
           | retrial, at minimum, if a judiciary body were to be convinced
           | that the prosecution introduced false evidence.
        
         | mrangle wrote:
         | No one forgets. 'We have to remember the jury" isn't a
         | persuasive argument. Juries are no match for statistical
         | misrepresentation. Even beyond stats, juries get it wrong
         | constantly. Courts don't have staff math experts, including the
         | judge. Were expert witness mathemeticians trial participants at
         | any point? It may be premature to claim that there was a
         | miscarriage of justice, but it may be similarly unwise to imply
         | that there likely wasn't.
        
         | wolverine876 wrote:
         | Did the statisticians question Letby's verdict? They are
         | talking about inquiries into other clusters of deaths.
        
       | rossant wrote:
       | Not directly related to this case, but the book Math on trial by
       | Leila Schneps and Coralie Colmez covers several examples of
       | misapplied statistics in court:
       | https://en.m.wikipedia.org/wiki/Math_on_Trial
        
       | mberning wrote:
       | I think this is a great example of a justice system working as
       | intended. The statistical evidence alone likely would not have
       | convicted her, but it could have exonerated or cast doubt on her
       | being the perpetrator. It did not, for reasons which were obvious
       | to the jury.
        
       | mellosouls wrote:
       | There seems to be some (understandable) confusion in some of the
       | comments about what the article here is reporting which isn't
       | helped by a lack of clarity in it or the underlying Guardian
       | piece, possibly in each case intended to push their own agendas.
       | 
       | There appears to be an interpretation here by some of a
       | potentially unsafe verdict due to misreading of statistics in her
       | conviction - which has certainly happened in the past in other
       | cases including those mentioned.
       | 
       | The expert input here though is intended as advice for the
       | inquiry into _what went wrong at the places Letby worked_ to
       | lessen the risk of it happening again.
       | 
       | That necessarily includes qualified and responsible analyses of
       | statistics, which will also have the benefit of increasing
       | protection and support of staff as well as improving safety
       | generally.
        
       | fiftyacorn wrote:
       | One thing the Letby trial left me wondering was how do doctors
       | and nurses working in areas with higher levels of mortality
       | protect themselves from this sort of accusation? And whether this
       | would put doctors off doing riskier procedures?
        
         | jdietrich wrote:
         | The suspicious deaths in this case were systematically ignored
         | by hospital management. Doctors who raised concerns about Letby
         | were disciplined for doing so. The hospital is now under police
         | investigation on suspicion of corporate manslaughter, because
         | it is highly likely that deaths could have been prevented if
         | they had investigated rather than silenced those concerns.
         | 
         | https://www.bbc.co.uk/news/uk-66120934
         | 
         | https://www.bbc.co.uk/news/uk-england-merseyside-67006930
        
       | Xenoamorphous wrote:
       | Kathleen Folbig case might me related to what it's being
       | discussed. She had four children die shortly after being born and
       | she was sent to jail.
        
       | zee2345 wrote:
       | [flagged]
        
       | piker wrote:
       | Anybody who closely followed this case who could identify for the
       | readers here any direct evidence of these crimes, or should we
       | read this article to imply Lucy herself might be innocent?
        
         | randomcarbloke wrote:
         | She kept notes, apparently there was an abundance of evidence
         | in her home, doctors had raised concerns.
         | 
         | This isn't a case of relying solely on data, rather the data
         | bear out what everything else suggests.
        
           | pbhjpbhj wrote:
           | IIRC, doctors/administrators dismissed statistical evidence
           | as "it couldn't be lovely Lucy". Whether it was possible to
           | make statistical inferences probably speaks more to whether
           | the family's have a case against the hospitals/health
           | authorities for neglect, eg neglecting to follow up on
           | suspicions.
        
         | crote wrote:
         | I recommend reading the Wikipedia page, the "2023 Trial"
         | section has a pretty good overview.
        
         | krisoft wrote:
         | There were various postmortem findings described as anomalous.
         | 
         | Child F had a bloodwork which indicated that someone gave them
         | a large amount of insulin.
         | 
         | Child D's post mortem X-ray is said to show air injected into
         | their blood vessels.
         | 
         | Child L also had insulin in their blood.
         | 
         | I'm not an expert so I can't say for certain how strong these
         | evidence are. Also my understanding that while these are
         | evidence that a crime happened, they do not tie Lucy directly
         | to the crime. The evidence for that is circumstatial, mainly
         | that she was the only one on duty for all the collapses said to
         | be suspicious.
        
           | YeGoblynQueenne wrote:
           | >> Child F had a bloodwork which indicated that someone gave
           | them a large amount of insulin.
           | 
           | >> Child L also had insulin in their blood.
           | 
           | Those were not post-mortems because these two children didn't
           | die. Lucy Letby was accused of attempting to murder them, by
           | injecting them with insulin.
           | 
           | See here, towards the end of the article, a summary of
           | accusations and convictions:
           | 
           | https://www.nursingtimes.net/news/children/breaking-lucy-
           | let...
        
         | anewhnaccount2 wrote:
         | The evidence suggests that many of the deaths had symptoms
         | consistent with being injected with air. We would need to have
         | a model of P(symptoms_i|not injected with air) to try and get
         | to the possibility of there having been a miscarriage of
         | justice.
        
         | DanBC wrote:
         | > or should we read this article to imply Lucy herself might be
         | innocent?
         | 
         | No, the point being made is that a murderer was able to evade
         | detection because her employing organisation did not understand
         | the data they had, because they did not understand statistics.
        
           | d1sxeyes wrote:
           | I don't think that's the point either. I think the point is
           | "be very careful jumping to conclusions, and just because you
           | may find patterns similar to those in this case elsewhere,
           | that does not mean that we are necessarily dealing with
           | another serial killer".
        
       | orra wrote:
       | Quite right. I remember Ben Goldacre's book _Bad Science_
       | documenting a few examples. I hope these are the same examples
       | raised in the letter, because otherwise a lot of miscarriage of
       | justice has happened in the UK.
       | 
       | What I remember from the book is entirely innocent people jailed
       | because the wrong statistical question was asked. IIRC along the
       | lines of two deaths, and the question asked was what is the
       | chance of this happening? As opposed to, assuming the first
       | death, what is the chance of the second? As opposed to, assuming
       | two deaths, what is the chance of bad luck versus malice.
       | 
       | (I am not commenting on the Letby case per se. AIUI there is an
       | appeal pending and UK law can be rather strict. Simply, we should
       | not respond to possible horrible events by convicting other
       | people who are innocent of statistical flukes, or misrepresented
       | statistics.)
        
         | InCityDreams wrote:
         | >otherwise a lot of miscarriage of justice has happened in the
         | UK.
         | 
         | Depends on 'a lot', but I rather suspect there will be/ will
         | have been fewer, now cops have to use cameras, but yes - a lot
         | of miscarriages of justice has happened in the UK. And every
         | other country.
        
         | DanBC wrote:
         | Just for clarity: statistics were not used in the Letby
         | prosecution.
         | 
         | The problem with Letby is that a serial killer was able to hide
         | because finding a rare event (a member of staff murdering
         | multiple babies) is hard to do in the noise (the mish mash of
         | data available).
         | 
         | Currently the English NHS is moving away from SIRI (Serious
         | Incident Requiring Investigation) to PSIRF (Patient Safety
         | Incident Response Framework) which focuses a lot more on "no
         | blame" and "open culture", so it's important that NHS Trusts
         | get the stats right to be able to detect and understand these
         | very rare events.
        
           | YeGoblynQueenne wrote:
           | >> Just for clarity: statistics were not used in the Letby
           | prosecution.
           | 
           | I was going to say that this is the second time I see someone
           | in this thread claim this, but I noticed the other comment is
           | also from your account:
           | 
           | https://news.ycombinator.com/item?id=37814660
           | 
           | As I say in that other comment, statistics _were_ used in
           | Lucy Letby 's trial, in the form of the staff duty roster
           | spreadsheet that the prosecution showed to the jurors to
           | convince them that Lucy Letby was a "common denominator" in
           | all the suspicious incidents.
        
       | hmottestad wrote:
       | I like to remember that the odds of winning the lottery are
       | easily in the 1 in 50 million, yet people still seem to win it.
       | 
       | It's statistically improbably to get 7 sons, but I'm certain that
       | throughout history that's happened at least once.
        
         | sgt101 wrote:
         | it's only statistically improbable to get 7 sons (in a row) if
         | you have all couples that create 7 children have a 50/50 chance
         | of son/daughter. If you have a reason why a couple will only
         | produce sons (genetics) then it becomes much less surprising.
        
       | brvsft wrote:
       | > There are obvious parallels with the Lethby case. Statements in
       | de Berk's diary about 'a very great secret' and a 'compulsion' on
       | a day that a patient had died were given a sinister
       | interpretation.
       | 
       | They didn't include any examples of the parallel. This goes over
       | some of the notes:
       | 
       | https://www.theguardian.com/uk-news/2022/oct/13/lucy-letby-p...
       | 
       | > On another, she wrote "I am a horrible evil person" and on
       | another in capital letters: "I AM EVIL I DID THIS," the jury was
       | told.
       | 
       | > She also wrote on the note: "There are no words", "I can't
       | breathe", "kill myself", "I haven't done anything wrong", "how
       | can I get through it?" and "I am an awful person". She had also
       | written "No Hope" and "Panic Fear" and then circled in capital
       | letters "HATE".
       | 
       | Personally, I don't think any of this is strong evidence, since
       | she contradicts herself a bit. But the notes more directly
       | address the murders because she wrote them in response to the
       | accusations. It isn't as vague as a diary entry mentioning a
       | secret.
       | 
       | And as far as I know, they had more evidence in the form of
       | testimony from experts suggesting the babies were killed by
       | injecting them with air, but I'm sure there are reasons to be
       | skeptical of that.
       | 
       | Mainly, I don't know how strongly any statistical "evidence" was
       | presented in court, how much the jury depended on it in their
       | guilty verdict, and how the UK court system works, so I don't
       | have a strong opinion. But I also don't believe a not-guilty
       | person would think to write anything like what she wrote in those
       | notes.
       | 
       | One last thing I'm curious about and have never heard definitive
       | information on is whether babies stopped dying when they took
       | Letby out of the NICU or whatever they call it. I suppose that
       | might still be accounted for in this statistical coincidence
       | element the RSS and other statisticians are discussing.
        
         | specialist wrote:
         | [deletia, cuz I misread the article.]
        
           | kitd wrote:
           | No it wasn't. See my sibling comment in this thread. At
           | worst, it alerted authorities to there potentially being foul
           | play. Her actual conviction was based on other factors.
        
             | specialist wrote:
             | Thanks for clarification. That's very reassuring.
        
           | [deleted]
        
         | kitd wrote:
         | On the afternoon of the conviction, there was an expert
         | criminal psychiatrist on BBC radio who had been following the
         | trial closely. Apparently those notes, though they made all the
         | headlines, played little part in her conviction, and are
         | typical for someone suffering stress &| depression.
         | 
         | The thing that did for her apparently were messages she had
         | sent some of the parents, the times of which contradicted her
         | testimony she had given the police and put her clearly in the
         | frame when she had given them an alibi.
         | 
         | So I'm not sure the clusters of "unlikely" cases played much
         | role either, other than alerting authorities to there
         | _potentially_ being foul play.
        
           | crote wrote:
           | That's a very good reason to warn the public about it, is it
           | not?
           | 
           | People generally do not read court transcripts, they read
           | media headlines. It's basically a guarantee that some people
           | are already convinced their statistically unlucky coworkers
           | are _also_ serial killers. It can easily lead to witch hunts.
        
             | kitd wrote:
             | You're right, but I think the article is about the RSS
             | warning the official inquiry rather than the public. One
             | would expect them to have a higher threshold of quality of
             | evidence than the typical tabloids or Twitter feeds.
        
           | [deleted]
        
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