Lies, damned lies ...

Widely reported in the press was a study by a team at Oxford University's Department of Public Health that revealed a significant improvement in heart attack mortality over the past 10 years. This was a huge study, using HES data, but although the headline numbers tell a clear story, the reasons behind them are less evident. The study shows both a reduction in heart attacks and a rise in survival from attacks; the fall in heart attacks may well be attributable to improvements in lifestyle, detection and management, but as usual further study is needed. Another day, another set of data: the fourth annual national heart failure audit reports relatively poor outcomes, with high mortality rates, particularly amongst patients not admitted to cardiology wards. In-hospital mortality rates for patients admitted to cardiology wards were less than half those for patients admitted to other wards (8% for cardiology ward patients, 15% for general wards and 17% for other wards). Less than half of all patients with acute heart failure were admitted to cardiology wards. Finally, for the cynics, a paper in BMC Public Health considers the question of how to measure and analyse this kind of data, taking US decline in coronary heart disease as a case study.