Transformative change requires statistical evidence

Editor – With the ubiquitous use of smart phone technology I welcome the introduction of technology that potentially improves access to the NHS for our patients. The paper by Bartlett et al provides an engaging description of the use of a smartphone-based platform aiming to improve ‘did not attend’ (DNA) rates.¹

Complex systems vary over time so it is important that sufficient information is provided for the reader to be able to determine whether the DNA rates described in the paper simply changed over time or were improved. The application of a validated statistical framework such as Statistical Process Control (SPC) would allow differentiation between non-significant change and statistically significant improvement.^2,3 In addition, by analysis of the temporal relationship between the intervention and improvement, correlation or causation can be determined.

It is important, as clinicians, that we apply the same statistical rigour to determine the benefit of innovative system technologies as we would to the use of a new medication or surgical technique.

Conflicts of interest

TD is on the editorial board of Future Healthcare Journal.