9 November 2022: Expert Group on Statistics - B

The second interquartile session of statistics expert group evidence returned to HCV infections of bleeding disorder patients. The number were influenced by developing medical interventions, for example, the survival rates of HIV co-infected people improved due to better treatments, whereas the original anti-viral treatments for HCV alone were not well tolerated and not very effective (the Interferon-based treatments). It was highlighted that HCV does not just affect the liver, but also the brain, the heart, and the kidneys, for example.

Counsel sought to drill-down on mortality rates, but there were difficulties with generalisations that go beyond liver-related factors. It was agreed that there will likely be a number of other “unknown” deaths arising from HCV but it has not been possible to record these.

At one point the word “guess” was replaced with “judgemental estimate” which created some polite light relief from the numerical numbness. This euphemistic reframing had been connected to an almost impenetrable section of presentation over number sets and their meaning. Penrose got a mention in relation to numbers of deaths “from AIDS” which suggested an overall higher risk within the Scottish population, possibly due to higher rates of needle use. That could reflect a higher HIV prevalence in the donor population, too. The Eileen Trust (set up for non-bleeding disorder HIV infectees) noted how it was difficult to always record the country of transfusion infection.

Counsel shifted to the shorter sections of the report covering vCJD and HBV. There were five confidently known cased of vCJD connected to blood infection routes (four transfusion-related, one from bleeding disorder product use). The triangulation method was used to strengthen the conclusions since there was not a test or procedure for determining vCJD infection other than post-mortem. More generally, the majority of vCJD infectees died within 5 years of being infected, but there was no post-mortem carried out on these earlier patients, so it was not possible to know if vCJD was the actual cause of death.

The question was posed about any on-going risk of vCJD to those who had been advised of possible exposure to an implicated batch of blood or blood product. The panel responded that it simply was not possible to say what the risk might be, if any.

On HBV, the major difficulty was the lack of data. Because there had been no financial support provision which would have required peoples’ information be gathered, it was not possible for the panel to draw any conclusions since these would be very unreliable. The data on HBV infection is just not there, even to allow modelling methods to be applied.

Comments

Post a Comment

Popular posts from this blog

26 July 2023: Sunak - A

And in walked the Prime Minister (PM), at exactly 2pm. One minute later the Chair enters. Sir Brian said a few words of thanks for the special circumstances related to access people had to endure due to the additional security arrangements. The PM gave the oath following his own religious affiliation. Counsel contextually reviewed how the witness had stated that his knowledge and involvement relied on other Ministers, however he had received more recent briefings in preparation for the appearance today. The first questions went straight to the communications from Penny Mordaunt when she was Paymaster General (PG). These highlighted in strong terms the need for action at the time and not to delay. Before answering, the witness wanted to say how he recognised this was, “An appalling scandal … people have suffered for decades” (and other fine words not backed up with action). In relation to the letters from the PG, he did not see them under the normal situation of a triage to filter the c...
Read more

25 July 2023: Dunn - B

Questions from core participants: Was there an investigation into the newspaper leaks? She was not aware of one, but that would have been taken forward by the Cabinet Office. (Fox and chicken coop comes to mind.) What are the main elements being used to come up with the leaked figures? She was not able to say but would get back to the Inquiry with that information. On psychological support, will the research be made publicly available, and when? She expected it would be and was expected in August. The research was understood to have been commissioned in 2022, but the need was highlighted in 2020. Why did it take so long to get to the point of commissioning the work? She said there was a process of “ongoing dialogue” after which it was decided that what was required was more ongoing dialogue. (That’s not exactly how it was phrased.) The Chair referenced himself as having, on several occasions, expressed the hope that he can recognise how everyone in the UK, including England, was benefi...
Read more

17 November 2022: Panel on finding the undiagnosed - A

Another panel of leading medics were assembled to address the issue of how to find people who are still undiagnosed. There was one from each of the four nations: Professor Graham Foster (England); Professor John Dillon (Scotland); Doctor Brendan Healey (Wales); and Dr Joanne McLean (Northern Ireland). As usual, for each witness there was a brief review of their respective roles and responsibilities. The situation in England started with a description of the HCV elimination initiative and its arrangement involving the pharmaceutical companies which was lauded by the English witness but seemed curious. For their cooperation, the pharma companies get anonymous, headline data on patients. There is a three phase elimination programme in England. Phase 1 is about oral therapies. Phase 2 is about risk groups. It involves an incentivised process to encourage the identification by re-engagement with patients who had had a positive test but had not been treated. It involved about 50,000 people. ...
Read more