9:59:59.000,9:59:59.000 As a kid I've always loved information 9:59:59.000,9:59:59.000 that I could get from data 9:59:59.000,9:59:59.000 and the stories that could be told with numbers 9:59:59.000,9:59:59.000 I remember growing up I'd be frustrated on 9:59:59.000,9:59:59.000 how my own parents would lie to me 9:59:59.000,9:59:59.000 using numbers you know. 9:59:59.000,9:59:59.000 [?] "I've told you once I've told you a thousand times." 9:59:59.000,9:59:59.000 No dad, you've only told me 17 times and twice it wasn't my fault. 9:59:59.000,9:59:59.000 I think that's one of the reasons I got a PhD in statistics. 9:59:59.000,9:59:59.000 You know I always wanted to know, 9:59:59.000,9:59:59.000 what are people trying to hide with numbers? 9:59:59.000,9:59:59.000 As a statistician, I want people to show me the data 9:59:59.000,9:59:59.000 so I can decide for myself. 9:59:59.000,9:59:59.000 Donald and I were pregnant with our third child 9:59:59.000,9:59:59.000 and we were at about 41 and a half weeks, 9:59:59.000,9:59:59.000 what some of you may refer to as been overdue. 9:59:59.000,9:59:59.000 Statisticians we call that being within the 95% confidence interval. [Laughter] 9:59:59.000,9:59:59.000 And, at this point in the process 9:59:59.000,9:59:59.000 we had to come in every couple of days 9:59:59.000,9:59:59.000 to do a stress test on the baby, and this is just routine, 9:59:59.000,9:59:59.000 it tests whether the baby is feeling any type of undo stress. 9:59:59.000,9:59:59.000 And you are rarely, if ever, seen by your actual Doctor, 9:59:59.000,9:59:59.000 just whoever happens to be working at the hospital that day. 9:59:59.000,9:59:59.000 So we go in for a stress test and after 20 minutes 9:59:59.000,9:59:59.000 the Doctor comes out and he says, 9:59:59.000,9:59:59.000 "your baby is on distress, we need to induce you". 9:59:59.000,9:59:59.000 Now, as a statistician, what's my response? 9:59:59.000,9:59:59.000 Show me the data! 9:59:59.000,9:59:59.000 So he proceeds to tell us the baby's heart rate trace went from 18 minutes, 9:59:59.000,9:59:59.000 the baby's heart rate was on the normal zone 9:59:59.000,9:59:59.000 and for 2 minutes it was in what appeared to be 9:59:59.000,9:59:59.000 my heart rate zone and I said, 9:59:59.000,9:59:59.000 "well, is it possible that maybe this was my heart rate"? 9:59:59.000,9:59:59.000 You know, I was moving around a little bit... 9:59:59.000,9:59:59.000 it's hard to lay still on your back, 9:59:59.000,9:59:59.000 41 weeks pregnant for 20 minutes... 9:59:59.000,9:59:59.000 you know, maybe it was shifting around. 9:59:59.000,9:59:59.000 He said "well... we don't want to take any chances". 9:59:59.000,9:59:59.000 I said okay..."what if I was at 36 weeks with the same data, 9:59:59.000,9:59:59.000 would you decision be to induce"? 9:59:59.000,9:59:59.000 Well, no, no I would wait until you were at least 38 weeks 9:59:59.000,9:59:59.000 but you are almost 42, there is no reason to leave 9:59:59.000,9:59:59.000 that baby inside let's get you a room. 9:59:59.000,9:59:59.000 I said... well... 9:59:59.000,9:59:59.000 why don't we just do it again? 9:59:59.000,9:59:59.000 We can collect more data, I can try to be really still for 20 minutes, 9:59:59.000,9:59:59.000 we can sort of average the two and see .... you know, what that means ... (laughter) 9:59:59.000,9:59:59.000 and.. he goes, 9:59:59.000,9:59:59.000 "Ma'm,I just don't want you to have a miscarriage". 9:59:59.000,9:59:59.000 That makes 3 of us. 9:59:59.000,9:59:59.000 And he says, "your chances of having a miscarriage double 9:59:59.000,9:59:59.000 when you go past your due date, let's get you a room". 9:59:59.000,9:59:59.000 Wow. So now as a statistician, what's my response? 9:59:59.000,9:59:59.000 Show me the data! 9:59:59.000,9:59:59.000 Dude you're talking chances, 9:59:59.000,9:59:59.000 I do chances all day long, tell me all about chances. 9:59:59.000,9:59:59.000 Let's talk chances. (Laugher) 9:59:59.000,9:59:59.000 Let's talk chances. 9:59:59.000,9:59:59.000 So I say, ok, do I go from like a 30% chance to a 60% chance? 9:59:59.000,9:59:59.000 Like, where are we here with this miscarriage thing? 9:59:59.000,9:59:59.000 And he goes..."not quite but it doubles 9:59:59.000,9:59:59.000 and we really just want what's best for the baby". 9:59:59.000,9:59:59.000 Undaunted, I try a different angle. 9:59:59.000,9:59:59.000 I say ok out of 1000 full term pregnant woman, 9:59:59.000,9:59:59.000 how many of them are going to miscarry 9:59:59.000,9:59:59.000 just before their due date? 9:59:59.000,9:59:59.000 And then he looks at me, and looks at Donald then he goes, 9:59:59.000,9:59:59.000 "about 1 in a thousand". 9:59:59.000,9:59:59.000 I said Ok, Ok, and so of those thousand women, 9:59:59.000,9:59:59.000 how many are going to miscarry 9:59:59.000,9:59:59.000 just after their due date? ..."About two". 9:59:59.000,9:59:59.000 I said ok, so you are telling me that my chances 9:59:59.000,9:59:59.000 go from 0.1% chance 9:59:59.000,9:59:59.000 to a 0.2% chance. 9:59:59.000,9:59:59.000 Ok, so at this ppoint the data is not convincing us 9:59:59.000,9:59:59.000 that we need to be induced 9:59:59.000,9:59:59.000 and so then we need to have a conversation 9:59:59.000,9:59:59.000 about how inductions leads to a higher rate 9:59:59.000,9:59:59.000 of cesarean sections and if at all possible we'd like to avoid that. 9:59:59.000,9:59:59.000 And then I said, you know, 9:59:59.000,9:59:59.000 and I really don't think my due date is accurate. (Laughter) 9:59:59.000,9:59:59.000 And so this really stunned him 9:59:59.000,9:59:59.000 and he looks sort of puzzled 9:59:59.000,9:59:59.000 and I said, well you may not know this 9:59:59.000,9:59:59.000 but pregnancy due dates are calculated 9:59:59.000,9:59:59.000 assuming that you have a standard 28 cycle 9:59:59.000,9:59:59.000 and my cycle ranges, sometimes it's 27 9:59:59.000,9:59:59.000 sometimes is up to 38, 9:59:59.000,9:59:59.000 and I have been collecting the data to prove it. 9:59:59.000,9:59:59.000 And so we ended up leaving the hospital that day 9:59:59.000,9:59:59.000 without being induced, 9:59:59.000,9:59:59.000 we actually had to sign a waiver to walk out of the hospital. 9:59:59.000,9:59:59.000 And I'm not advocating that you not listen to your Doctors, 9:59:59.000,9:59:59.000 because even with our first child 9:59:59.000,9:59:59.000 we were induced at 38 weeks, cervical fluid was low, 9:59:59.000,9:59:59.000 I'm not anti-medical intervention. 9:59:59.000,9:59:59.000 But why we were confident to leave that day? 9:59:59.000,9:59:59.000 We had data that told a different story. 9:59:59.000,9:59:59.000 We had been collecting data for 6 years. 9:59:59.000,9:59:59.000 I had this temperature data, 9:59:59.000,9:59:59.000 and it told a different story. 9:59:59.000,9:59:59.000 In fact, we could probably pretty accurately estimate conception. 9:59:59.000,9:59:59.000 Yeah, that's a story you want to tell 9:59:59.000,9:59:59.000 at your kid's wedding reception... 9:59:59.000,9:59:59.000 I remember like it was yesterday ... (Laugher)... 9:59:59.000,9:59:59.000 my temperature was a sizzling 97.8 degrees 9:59:59.000,9:59:59.000 as I stared into your father's eyes, oh yeah, (Laughter) 9:59:59.000,9:59:59.000 22 more years we're telling that story. 9:59:59.000,9:59:59.000 But we were confident to leave because 9:59:59.000,9:59:59.000 we had been collecting data. 9:59:59.000,9:59:59.000 Now what does that data look like? 9:59:59.000,9:59:59.000 Here's a standard chart 9:59:59.000,9:59:59.000 of a woman's waking body temperature 9:59:59.000,9:59:59.000 during the course of a cycle. 9:59:59.000,9:59:59.000 So from the beginning of the menstrual cycle 9:59:59.000,9:59:59.000 until the beginning of the next. 9:59:59.000,9:59:59.000 You'll see that the temperature is not random. 9:59:59.000,9:59:59.000 Right, there clearly there is a low pattern 9:59:59.000,9:59:59.000 at the beginning of her cycle 9:59:59.000,9:59:59.000 and then you see this jump and then a higher 9:59:59.000,9:59:59.000 set of temperatures at the end of her cycle. 9:59:59.000,9:59:59.000 So what's happening here? 9:59:59.000,9:59:59.000 What is that data telling you? 9:59:59.000,9:59:59.000 Well ladies, at the beginning of our cycle, 9:59:59.000,9:59:59.000 the hormone estrogen is dominant and that estrogen 9:59:59.000,9:59:59.000 causes a suppression of your body temperature. 9:59:59.000,9:59:59.000 And at ovulation, your body releases an egg 9:59:59.000,9:59:59.000 and progesterone takes over, pro-gestation. 9:59:59.000,9:59:59.000 And so your body heats up in anticipation 9:59:59.000,9:59:59.000 of housing this new little fertilized egg. 9:59:59.000,9:59:59.000 So why this temperature jump? 9:59:59.000,9:59:59.000 Well, think about when a bird sits on her eggs... 9:59:59.000,9:59:59.000 why is she sitting on them? 9:59:59.000,9:59:59.000 She wants to keep them warm, 9:59:59.000,9:59:59.000 protect them and keep them warm. 9:59:59.000,9:59:59.000 Ladies, this is exactly what our bodies do every month, 9:59:59.000,9:59:59.000 they heat up in anticipation 9:59:59.000,9:59:59.000 of keeping a new little life form. 9:59:59.000,9:59:59.000 And if nothing happens, if you are not pregnant, 9:59:59.000,9:59:59.000 then estrogen takes back over and that cycle starts all over again. 9:59:59.000,9:59:59.000 But if you do get pregnant, sometime you 9:59:59.000,9:59:59.000 actually see another shift in your temperatures 9:59:59.000,9:59:59.000 and it stays elevated for those whole 9 months, 9:59:59.000,9:59:59.000 that's why you see those pregnant woman 9:59:59.000,9:59:59.000 just sweating and hot, 9:59:59.000,9:59:59.000 because their temperatures are high. 9:59:59.000,9:59:59.000 Here is a chart that we had about 3 or 4 years ago 9:59:59.000,9:59:59.000 we were really very excited about this chart, 9:59:59.000,9:59:59.000 you'll se the low temperature level 9:59:59.000,9:59:59.000 and then a shift and for about 5 days, 9:59:59.000,9:59:59.000 that's about the time it takes for the egg to travel 9:59:59.000,9:59:59.000 down the fallopian tube and implant, 9:59:59.000,9:59:59.000 and then you see those temperature charts go up a little bit. 9:59:59.000,9:59:59.000 And in fact, we had a second temperature shift 9:59:59.000,9:59:59.000 confirmed with a pregnancy test that were indeed pregnant 9:59:59.000,9:59:59.000 with our fist child, very exciting. 9:59:59.000,9:59:59.000 Until a couple of days later 9:59:59.000,9:59:59.000 I saw some spotting and then I noticed heavy blood flow, 9:59:59.000,9:59:59.000 and we had in fact had an early stage miscarriage. 9:59:59.000,9:59:59.000 Had I not been taking my temperature 9:59:59.000,9:59:59.000 I really just thought my period was late that month. 9:59:59.000,9:59:59.000 But we actually had data to show 9:59:59.000,9:59:59.000 that we had miscarried this baby, 9:59:59.000,9:59:59.000 and even though this data revealed a really 9:59:59.000,9:59:59.000 unfortunate event in our lives, 9:59:59.000,9:59:59.000 it was information that we can then take to our doctor. 9:59:59.000,9:59:59.000 So if there was a fertility issue or some problem 9:59:59.000,9:59:59.000 I had data to show, 9:59:59.000,9:59:59.000 we got pregnant, our temperature shifted, 9:59:59.000,9:59:59.000 we somehow lost this baby... 9:59:59.000,9:59:59.000 what is it that we can do to help prevent this problem? 9:59:59.000,9:59:59.000 And it's not just about temperatures 9:59:59.000,9:59:59.000 and it is not just about fertility, 9:59:59.000,9:59:59.000 we can use data about our bodies to tell us a lot of things. 9:59:59.000,9:59:59.000 For instance, did you know that taking your 9:59:59.000,9:59:59.000 temperature can tell you a lot 9:59:59.000,9:59:59.000 about the condition of your thyroid? 9:59:59.000,9:59:59.000 So your thyroid works a lot like the thermostat in your house. 9:59:59.000,9:59:59.000 There is an optimal temperature that you want in your house, 9:59:59.000,9:59:59.000 you set your thermostat, 9:59:59.000,9:59:59.000 when it gets too cold in the house your thermostat kicks in 9:59:59.000,9:59:59.000 and says, "hey we need to blow some heat around", 9:59:59.000,9:59:59.000 or if it gets too hot your thermostat 9:59:59.000,9:59:59.000 sort of registers turn the AC on, cool us off 9:59:59.000,9:59:59.000 that's exactly how your thyroid works in your body. 9:59:59.000,9:59:59.000 Your thyroid tries to keep an optimal temperature 9:59:59.000,9:59:59.000 for your body. 9:59:59.000,9:59:59.000 If it get too cold your thyroid says we need to heat up, 9:59:59.000,9:59:59.000 if it gets too hot, your thyroid cools you down. 9:59:59.000,9:59:59.000 But what happens when your thyroid is not functioning well? 9:59:59.000,9:59:59.000 But when it doesn't function then it shows up 9:59:59.000,9:59:59.000 in your body temperatures, 9:59:59.000,9:59:59.000 they tend to be lower than normal and very erratic. 9:59:59.000,9:59:59.000 So by collecting this data 9:59:59.000,9:59:59.000 you can find out information about your thyroid. 9:59:59.000,9:59:59.000 Now, what is it, if you had a thyroid problem and you went to the doctor, 9:59:59.000,9:59:59.000 your doctor would actually test the amount of 9:59:59.000,9:59:59.000 thyroid stimulating hormone in your blood. 9:59:59.000,9:59:59.000 But the problem with that test is 9:59:59.000,9:59:59.000 it doesn't tell you how active the hormone is in your body. 9:59:59.000,9:59:59.000 So you may have a lot of hormone present 9:59:59.000,9:59:59.000 but it might not be actively working to regulate 9:59:59.000,9:59:59.000 your body temperature. 9:59:59.000,9:59:59.000 So just by collecting your temperature every day 9:59:59.000,9:59:59.000 you get information about the condition of your thyroid. 9:59:59.000,9:59:59.000 So what if you don't want to take your temperature every day? 9:59:59.000,9:59:59.000 I advocate that you do 9:59:59.000,9:59:59.000 but there's tons of other things you can take. 9:59:59.000,9:59:59.000 You can take your blood pressure, you can take your weight... 9:59:59.000,9:59:59.000 yeah, who's excited about 9:59:59.000,9:59:59.000 taking your weight every day. (Laughter) 9:59:59.000,9:59:59.000 Early on in our marriage Donald had a stuffy nose 9:59:59.000,9:59:59.000 and he had been taking a slu of medications 9:59:59.000,9:59:59.000 to try to relieve his stuffy nose to no avail. 9:59:59.000,9:59:59.000 And so that night he comes and he wakes me up and he says 9:59:59.000,9:59:59.000 "honey, I can't breath out of my nose". 9:59:59.000,9:59:59.000 And I sort of roll over and I look, and I said, well can you breath out of your mouth? 9:59:59.000,9:59:59.000 And he goes, "yes, but I cant breath out of my nose"! 9:59:59.000,9:59:59.000 And so like any good wife, I rushed him 9:59:59.000,9:59:59.000 to the emergency room 9:59:59.000,9:59:59.000 at 2 o'clock in the morning. 9:59:59.000,9:59:59.000 And the whole time I'm driving and I'm thinking 9:59:59.000,9:59:59.000 you can't die on my now. (Laughter) 9:59:59.000,9:59:59.000 We just got married 9:59:59.000,9:59:59.000 people would think I killed you! 9:59:59.000,9:59:59.000 And so, we get to the ER and the nurse sees us 9:59:59.000,9:59:59.000 and he can't breath out of his nose and so 9:59:59.000,9:59:59.000 she brings us to the back and the doctor say, 9:59:59.000,9:59:59.000 what seems to be the problem and he goes, 9:59:59.000,9:59:59.000 " I can't breath out of my nose". 9:59:59.000,9:59:59.000 And he said, you can't breath out of your nose? "No"... 9:59:59.000,9:59:59.000 but he can breath out of his mouth...(laughter) 9:59:59.000,9:59:59.000 OK, he takes a step back and looks at both of us 9:59:59.000,9:59:59.000 and he says sir, I think I know the problem, 9:59:59.000,9:59:59.000 you're having a heart attack, 9:59:59.000,9:59:59.000 I'm going to order an EKG and a CAT scan 9:59:59.000,9:59:59.000 for you immediately. 9:59:59.000,9:59:59.000 And we are thinking, 9:59:59.000,9:59:59.000 no no no, it's not a heart attack he can breathe 9:59:59.000,9:59:59.000 just out of his mouth...no, no, no, 9:59:59.000,9:59:59.000 and so we go back and forth with this doctor 9:59:59.000,9:59:59.000 because we think it is the incorrect diagnosis 9:59:59.000,9:59:59.000 and he's like no really, it'll be fine, just calm down. 9:59:59.000,9:59:59.000 And I'm thinking, how do you calm down... I don't think he's having a heart attack. 9:59:59.000,9:59:59.000 Fortunately for us, this doctor was at the end of the shift. 9:59:59.000,9:59:59.000 This new doctor comes in he sees us clearly 9:59:59.000,9:59:59.000 distrust with a husband who can't breath 9:59:59.000,9:59:59.000 out of his nose. 9:59:59.000,9:59:59.000 He starts asking us questions. 9:59:59.000,9:59:59.000 He says well, do you two exercise? 9:59:59.000,9:59:59.000 We ride our bikes, we go to the gym... occasionally. (Laughter) 9:59:59.000,9:59:59.000 We move around. And he says, what were you doing 9:59:59.000,9:59:59.000 just before you came here? 9:59:59.000,9:59:59.000 I'm thinking, I was sleeping, honestly, 9:59:59.000,9:59:59.000 But OK, so Donald goes into the slu of medications 9:59:59.000,9:59:59.000 he was taking and he lists, 9:59:59.000,9:59:59.000 "I took this decongestant, and then I took this nasal spray"... 9:59:59.000,9:59:59.000 and then all of a sudden the light bulb goes off 9:59:59.000,9:59:59.000 and he says, "oh, you should never mix 9:59:59.000,9:59:59.000 this decongestant with this nasal spray 9:59:59.000,9:59:59.000 clogs you up every time. 9:59:59.000,9:59:59.000 Here, take this one instead", gives us a prescription 9:59:59.000,9:59:59.000 We're looking at each other and I looked at the doctor 9:59:59.000,9:59:59.000 and I said why is it that it seems you 9:59:59.000,9:59:59.000 were able to accurately diagnose his condition 9:59:59.000,9:59:59.000 but this previous doctor wanted to order 9:59:59.000,9:59:59.000 an EKG and a CAT scan? 9:59:59.000,9:59:59.000 And he looks at us and says, 9:59:59.000,9:59:59.000 when a 350 pound man walks in the ER 9:59:59.000,9:59:59.000 and says he can't breath, 9:59:59.000,9:59:59.000 you assume he's having a heart attack 9:59:59.000,9:59:59.000 and you ask questions later". 9:59:59.000,9:59:59.000 ER doctors are trained to make decisions quickly, 9:59:59.000,9:59:59.000 but not always accurately. 9:59:59.000,9:59:59.000 And so had we had some information 9:59:59.000,9:59:59.000 about our heart health to share with him 9:59:59.000,9:59:59.000 maybe we would have gotten a better diagnosis 9:59:59.000,9:59:59.000 the first time. 9:59:59.000,9:59:59.000 I want you to consider the following chart, 9:59:59.000,9:59:59.000 of systolic blood pressure measurements 9:59:59.000,9:59:59.000 from October 2010 to July 2012. 9:59:59.000,9:59:59.000 You'll see that these measurements start 9:59:59.000,9:59:59.000 in the prehypertension/Hypertension zone, 9:59:59.000,9:59:59.000 but over about the course of a year and a half 9:59:59.000,9:59:59.000 they move into the normal zone. 9:59:59.000,9:59:59.000 This is about the hear rate of a healthy 16 year old. 9:59:59.000,9:59:59.000 What story is this data telling you? 9:59:59.000,9:59:59.000 Obviously is the data from someone 9:59:59.000,9:59:59.000 who's made a drastic transformation 9:59:59.000,9:59:59.000 and fortunately for us, that person happens to be here today. 9:59:59.000,9:59:59.000 So that 350 pound guy that walked into the ER with me 9:59:59.000,9:59:59.000 is now an even sexier and healthier 9:59:59.000,9:59:59.000 225 pound guy, and that's his blood pressure trace. 9:59:59.000,9:59:59.000 Over the course of that year and a half 9:59:59.000,9:59:59.000 Donald's eating changed 9:59:59.000,9:59:59.000 and his exercise regimen changed and 9:59:59.000,9:59:59.000 his heart rate responded, 9:59:59.000,9:59:59.000 his blood pressure responded to that change 9:59:59.000,9:59:59.000 that he made in his body. 9:59:59.000,9:59:59.000 What's the take home message 9:59:59.000,9:59:59.000 that I want you to leave with today? 9:59:59.000,9:59:59.000 By taking ownership of your data just like we've done, 9:59:59.000,9:59:59.000 just by taking this daily measurements about yourself, 9:59:59.000,9:59:59.000 you become the expert of your body, 9:59:59.000,9:59:59.000 you become the authority. 9:59:59.000,9:59:59.000 It's not hard to do. 9:59:59.000,9:59:59.000 You don't have to have a PhD in statistics 9:59:59.000,9:59:59.000 to be an expert in yourself. 9:59:59.000,9:59:59.000 You don't have to have a medical degree 9:59:59.000,9:59:59.000 to be your body's expert. 9:59:59.000,9:59:59.000 Medical doctors, they're experts on the population, 9:59:59.000,9:59:59.000 but you are the expert on yourself. 9:59:59.000,9:59:59.000 And so when the two of you come together, 9:59:59.000,9:59:59.000 when two experts come together 9:59:59.000,9:59:59.000 the two of you are able to make a better decision 9:59:59.000,9:59:59.000 than just your doctor alone. 9:59:59.000,9:59:59.000 Now that you understand the power of information 9:59:59.000,9:59:59.000 that you can get through personal data collection, 9:59:59.000,9:59:59.000 I'd like you all to stand and raise your right hand. 9:59:59.000,9:59:59.000 Yes, get it up. 9:59:59.000,9:59:59.000 I challenge you to take ownership of your data 9:59:59.000,9:59:59.000 and today, I hereby confer upon you 9:59:59.000,9:59:59.000 a TEDx associate's degree in elementary statistics 9:59:59.000,9:59:59.000 with a concentration in time dependent data analysis 9:59:59.000,9:59:59.000 with all the rights and privileges adverteining there to 9:59:59.000,9:59:59.000 and the next time you are in your doctor's office. 9:59:59.000,9:59:59.000 As newly inducted statisticians, 9:59:59.000,9:59:59.000 what should always be your response? 9:59:59.000,9:59:59.000 Show me the data! I can't hear you... 9:59:59.000,9:59:59.000 Show me the data! One more time... 9:59:59.000,9:59:59.000 Show me the data! 9:59:59.000,9:59:59.000 Show me the data. 9:59:59.000,9:59:59.000 Thank you.