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← Show Me the Data: Becoming an Expert on Yourself: Talithia Williams at TEDxClaremontColleges

Dr. Talithia Williams' talk explores how each of us can begin to collect data about ourselves that can provide insight into our personal health.

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Showing Revision 8 created 08/12/2014 by Ivana Korom.

  1. As a kid I always loved information
  2. that I could get from data
  3. and the stories that could be told
    with numbers.
  4. I remember, growing up,
    I'd be frustrated
  5. at how my own parents
    would lie to me using numbers.
  6. "Talithia, if I've told you once
    I've told you a thousand times."
  7. No dad, you've only told me 17 times
  8. and twice it wasn't my fault.
    (Laughter)
  9. I think that is one of the reasons
    I got a Ph.D. in statistics.
  10. I always wanted to know,
  11. what are people trying to hide
    with numbers?
  12. As a statistician,
  13. I want people to show me the data
  14. so I can decide for myself.
  15. Donald and I were pregnant
    with our third child
  16. and we were at about 41 and a half weeks,
  17. what some of you may refer to
    as being overdue.
  18. Statisticians, we call that
  19. being within the 95 percent
    confidence interval.
  20. (Laughter)
  21. And at this point in the process
  22. we had to come in every couple of days
  23. to do a stress test on the baby,
  24. and this is just routine,
  25. it tests whether or not the baby
    is feeling any type of undue stress.
  26. And you are rarely, if ever,
    seen by your actual doctor,
  27. just whoever happens to be
    working at the hospital that day.
  28. So we go in for a stress test
    and after 20 minutes
  29. the doctor comes out and he says,
  30. "Your baby is under stress,
    we need to induce you."
  31. Now, as a statistician,
    what's my response?
  32. Show me the data!
  33. So then he proceeds to tell us
  34. the baby's heart rate trace
    went from 18 minutes,
  35. the baby's heart rate was
    in the normal zone
  36. and for two minutes
    it was in what appeared to be
  37. my heart rate zone and I said,
  38. "Is it possible that maybe
    this was my heart rate?
  39. I was moving around a little bit,
  40. it's hard to lay still on your back,
  41. 41 weeks pregnant for 20 minutes.
  42. Maybe it was shifting around."
  43. He said, "Well, we don't want
    to take any chances."
  44. I said okay.
  45. I said, "What if I was at 36 weeks
  46. with this same data?
  47. Would your decision be to induce?"
  48. "Well, no, I would wait
    until you were at least
  49. 38 weeks, but you are almost 42,
  50. there is no reason
    to leave that baby inside,
  51. let's get you a room."
  52. I said,
    "Well, why don't we just do it again?
  53. We can collect more data.
  54. I can try to be really still
    for 20 minutes.
  55. We can average the two and see
  56. what that means.
    (Laughter)
  57. And he goes,
  58. "Ma'am, I just don't want you
    to have a miscarriage."
  59. That makes three of us.
  60. And then he says,
  61. "Your chances of having
    a miscarriage double
  62. when you go past your due date.
    Let's get you a room."
  63. Wow. So now as a statistician,
    what's my response?
  64. Show me the data!
  65. Dude, you're talking chances,
  66. I do chances all day long,
    tell me all about chances.
  67. Let's talk chances.
    (Laughter)
  68. Let's talk chances.
  69. So I say, "Okay, great.
  70. Do I go from a 30-percent
    chance to a 60-percent chance?
  71. Where are we here
    with this miscarriage thing?
  72. And he goes, "Not quite, but it doubles,
  73. and we really just want
    what's best for the baby."
  74. Undaunted, I try a different angle.
  75. I said, "Okay, out of 1,000
    full-term pregnant women,
  76. how many of them are going to miscarry
  77. just before their due date?
  78. And then he looks at me
    and looks at Donald,
  79. and he goes, about one in 1,000.
  80. I said, "Okay, so of those 1,000 women,
  81. how many are going to miscarry
    just after their due date?"
  82. "About two."
    (Laughter)
  83. I said, "Okay, so you are telling me
    that my chances
  84. go from a 0.1-percent chance
  85. to a 0.2-percent chance."
  86. Okay, so at this point
    the data is not convincing us
  87. that we need to be induced,
  88. and so then we proceed
    to have a conversation
  89. about how inductions lead to a higher rate
  90. of Cesarean sections, and if at all
    possible we'd like to avoid that.
  91. And then I said,
  92. "And I really don't think
    my due date is accurate."
  93. (Laughter)
  94. And so this really stunned him
  95. and he looked sort of puzzled
  96. and I said, "You may not know this,
  97. but pregnancy due dates are calculated
  98. assuming that you have
    a standard 28-day cycle,
  99. and my cycle ranges —
  100. sometimes it's 27,
    sometimes it's up to 38 —
  101. and I have been collecting
    the data to prove it.
  102. (Laughter)
  103. And so we ended up leaving the hospital
    that day without being induced.
  104. We actually had to sign a waiver
    to walk out of the hospital.
  105. And I'm not advocating
    that you not listen to your doctors,
  106. because even with our first child,
  107. we were induced at 38 weeks;
    cervical fluid was low.
  108. I'm not anti-medical intervention.
  109. But why were confident to leave that day?
  110. Well, we had data
    that told a different story.
  111. We had been collecting data for six years.
  112. I had this temperature data,
  113. and it told a different story.
  114. In fact, we could probably pretty
    accurately estimate conception.
  115. Yeah, that's a story you want to tell
  116. at your kid's wedding reception.
    (Laughter)
  117. I remember like it was yesterday.
  118. My temperature was a sizzling 97.8 degrees
  119. as I stared into your father's eyes.
    (Laughter)
  120. Oh, yeah. Twenty-two more years,
    we're telling that story.
  121. But we were confident to leave
    because we had been collecting data.
  122. Now, what does that data look like?
  123. Here's a standard chart
  124. of a woman's waking body temperature
  125. during the course of a cycle.
  126. So from the beginning
    of the menstrual cycle
  127. till the beginning of the next.
  128. You'll see that the temperature
    is not random.
  129. Clearly there is a low pattern
  130. at the beginning of her cycle
  131. and then you see this jump
    and then a higher set of temperatures
  132. at the end of her cycle.
  133. So what's happening here?
  134. What is that data telling you?
  135. Well, ladies,
    at the beginning of our cycle,
  136. the hormone estrogen
    is dominant and that estrogen
  137. causes a suppression
    of your body temperature.
  138. And at ovulation,
    your body releases an egg
  139. and progesterone takes over,
    pro-gestation.
  140. And so your body heats up in anticipation
  141. of housing this new little fertilized egg.
  142. So why this temperature jump?
  143. Well, think about
    when a bird sits on her eggs.
  144. Why is she sitting on them?
  145. She wants to keep them warm,
  146. protect them and keep them warm.
  147. Ladies, this is exactly
    what our bodies do every month,
  148. they heat up in anticipation
  149. of keeping a new little life warm.
  150. And if nothing happens,
    if you are not pregnant,
  151. then estrogen takes back over
    and that cycle starts all over again.
  152. But if you do get pregnant, sometimes you
  153. actually see another shift
    in your temperatures
  154. and it stays elevated
    for those whole nine months.
  155. That's why you see those pregnant women
    just sweating and hot,
  156. because their temperatures are high.
  157. Here's a chart that we had
    about three or four years ago.
  158. We were really very excited
    about this chart.
  159. You'll see the low temperature level
  160. and then a shift and for about five days,
  161. that's about the time
    it takes for the egg to travel
  162. down the fallopian tube and implant,
  163. and then you see those temperatures
    start to go up a little bit.
  164. And in fact, we had
    a second temperature shift,
  165. confirmed with a pregnancy test
    that were indeed pregnant
  166. with our first child, very exciting.
  167. Until a couple of days later
  168. I saw some spotting
    and then I noticed heavy blood flow,
  169. and we had in fact
    had an early stage miscarriage.
  170. Had I not been taking my temperature
  171. I really would have just thought
    my period was late that month,
  172. but we actually had data to show
  173. that we had miscarried this baby,
  174. and even though this data
    revealed a really
  175. unfortunate event in our lives,
  176. it was information
    that we could then take to our doctor.
  177. So if there was a fertility issue
    or some problem,
  178. I had data to show:
  179. Look, we got pregnant,
    our temperature shifted,
  180. we somehow lost this baby.
  181. What is it that we can do
    to help prevent this problem?
  182. And it's not just about temperatures
  183. and it's not just about fertility;
  184. we can use data about our bodies
    to tell us a lot of things.
  185. For instance, did you know that taking
    your temperature can tell you a lot
  186. about the condition of your thyroid?
  187. So, your thyroid works a lot like
    the thermostat in your house.
  188. There is an optimal temperature
    that you want in your house;
  189. you set your thermostat.
  190. When it gets too cold in the house,
    your thermostat kicks in
  191. and says, "Hey, we need
    to blow some heat around."
  192. Or if it gets too hot,
    your thermostat registers,
  193. "Turn the A.C. on. Cool us off."
  194. That's exactly how your thyroid works
    in your body.
  195. Your thyroid tries to keep
    an optimal temperature
  196. for your body.
  197. If it gets too cold, your thyroid
    says, "Hey, we need to heat up."
  198. If it gets too hot,
    your thyroid cools you down.
  199. But what happens when your
    thyroid is not functioning well?
  200. When it doesn't function, then it shows up
  201. in your body temperatures,
  202. they tend to be lower than normal
    or very erratic.
  203. And so by collecting this data
  204. you can find out information
    about your thyroid.
  205. Now, what is it, if you had a thyroid
    problem and you went to the doctor,
  206. your doctor would actually test
  207. the amount of thyroid stimulating hormone
    in your blood.
  208. Fine. But the problem with that test is
  209. it doesn't tell you how active
    the hormone is in your body.
  210. So you might have
    a lot of hormone present,
  211. but it might not be
    actively working to regulate
  212. your body temperature.
  213. So just by collecting
    your temperature every day,
  214. you get information
    about the condition of your thyroid.
  215. So, what if you don't want to take
    your temperature every day?
  216. I advocate that you do,
  217. but there are tons
    of other things you could take.
  218. You could take your blood pressure,
    you could take your weight —
  219. yeah, who's excited about
  220. taking their weight every day?
    (Laughter)
  221. Early on in our marriage,
    Donald had a stuffy nose
  222. and he had been taking
    a slew of medications
  223. to try to relieve his stuffy nose,
    to no avail.
  224. And so, that night he comes
    and he wakes me up and he says,
  225. "Honey, I can't breath out of my nose."
  226. And I roll over and I look, and I said,
    "Well, can you breath out of your mouth?"
  227. (Laughter)
  228. And he goes,
    "Yes, but I can't breath out of my nose!"
  229. And so like any good wife, I rush him
  230. to the emergency room
  231. at 2 o'clock in the morning.
  232. And the whole time
    I'm driving and I'm thinking,
  233. you can't die on me now.
  234. We just got married,
  235. people will think I killed you!
    (Laughter)
  236. And so, we get to the emergency room,
    and the nurse sees us,
  237. and he can't breath out of his nose,
  238. and so she brings us to the back
    and the doctor says,
  239. "What seems to be the problem?"
  240. and he goes,
    "I can't breath out of my nose."
  241. And he said,
    "You can't breath out of your nose?
  242. No, but he can breath
    out of his mouth. (Laughter)
  243. He takes a step back
    and he looks at both of us
  244. and he says,
    "Sir, I think I know the problem.
  245. You're having a heart attack.
  246. I'm going to order an EKG and a CAT scan
  247. for you immediately."
  248. And we are thinking, no, no, no.
    It's not a heart attack.
  249. He can breathe, just out of his mouth.
  250. No, no, no, no, no.
  251. And so we go back and forth
    with this doctor
  252. because we think
    this is the incorrect diagnosis,
  253. and he's like, "No really, it'll be fine,
    just calm down."
  254. And I'm thinking, how do you calm down?
  255. But I don't think
    he's having a heart attack.
  256. And so fortunately for us, this doctor
    was at the end of the shift.
  257. So this new doctor comes in,
    he sees us clearly distraught,
  258. with a husband who can't breath
  259. out of his nose.
    (Laughter)
  260. And he starts asking us questions.
  261. He says, "Well, do you two exercise?"
  262. We ride our bikes,
    we go to the gym occasionally.
  263. (Laughter)
  264. We move around.
  265. And he says, "What were you doing
    just before you came here?"
  266. I'm thinking, I was sleeping, honestly.
  267. But okay,
    what was Donald doing just before?
  268. So Donald goes into this slew
    of medications he was taking.
  269. He lists, "I took this decongestant
    and then I took this nasal spray,"
  270. and then all of a sudden
    a lightbulb goes off and he says,
  271. "Oh! You should never mix this
    decongestant with this nasal spray.
  272. Clogs you up every time.
    Here, take this one instead."
  273. He gives us a prescription.
  274. We're looking at each other,
    and I looked at the doctor,
  275. and I said,
    "Why is it that it seems like you
  276. were able to accurately diagnose
    his condition,
  277. but this previous doctor wanted to order
  278. an EKG and a CAT scan?"
  279. And he looks at us and says,
  280. "Well, when a 350-pound man walks in the
    emergency room and says he can't breath,
  281. you assume he's having a heart attack
  282. and you ask questions later."
  283. Now, emergency room doctors
    are trained to make decisions quickly,
  284. but not always accurately.
  285. And so had we had some information
  286. about our heart health to share with him,
  287. maybe we would have gotten a better
    diagnosis the first time.
  288. I want you to consider
    the following chart,
  289. of systolic blood pressure measurements
  290. from October 2010 to July 2012.
  291. You'll see that these measurements start
  292. in the prehypertension/hypertension zone,
  293. but over about the course
    of a year and a half
  294. they move into the normal zone.
  295. This is about the heart rate
    of a healthy 16-year-old.
  296. What story is this data telling you?
  297. Obviously it's the data from someone
  298. who's made a drastic transformation,
  299. and fortunately for us,
    that person happens to be here today.
  300. So that 350-pound guy that walked
    into the emergency room with me
  301. is now an even sexier and healthier
  302. 225-pound guy,
    and that's his blood pressure trace.
  303. So over the course of that year and a half
  304. Donald's eating changed
  305. and our exercise regimen changed,
  306. and his heart rate responded,
  307. his blood pressure responded
    to that change
  308. that he made in his body.
  309. So what's the take-home message
  310. that I want you to leave with today?
  311. By taking ownership of your data
    just like we've done,
  312. just by taking this daily measurements
    about yourself,
  313. you become the expert on your body.
  314. You become the authority.
  315. It's not hard to do.
  316. You don't have to have
    a Ph.D. in statistics
  317. to be an expert in yourself.
  318. You don't have to have a medical degree
  319. to be your body's expert.
  320. Medical doctors,
    they're experts on the population,
  321. but you are the expert on yourself.
  322. And so when two of you come together,
  323. when two experts come together,
  324. the two of you are able
    to make a better decision
  325. than just your doctor alone.
  326. Now that you understand
    the power of information
  327. that you can get through
    personal data collection,
  328. I'd like you all to stand
    and raise your right hand.
  329. (Laughter)
  330. Yes, get it up.
  331. I challenge you to take ownership
    of your data.
  332. And today, I hereby confer upon you
  333. a TEDx associate's degree
    in elementary statistics
  334. with a concentration
    in time-dependent data analysis
  335. with all the rights and privileges
    appertaining thereto.
  336. And so the next time
    you are in your doctor's office,
  337. as newly inducted statisticians,
  338. what should always be your response?
  339. Audience: Show me the data!
    Talithia Williams: I can't hear you!
  340. Audience: Show me the data!
  341. TW: One more time!
  342. Audience: Show me the data!
  343. TW: Show me the data.
  344. Thank you.
  345. (Applause)