Moneyball. It’s a gift that keeps on giving for me as a guy wrapped up in patient recruitment data. As an ex-patriot Brit, I must admit that it took me about 10 years to start to appreciate baseball, and it has taken another 10 to figure out just some of the intricacies. A seemingly simple game, it is filled with deeply meaningful and detailed subtexts, and perhaps it is not without irony then that the game lends itself so well to so many “sports-as-life” American metaphors.
Possibly because of this, baseball has even woven itself into the fabric of the English language in such a way that even the Brits (a non-baseball playing/viewing nation) will still use (or at least understand) uniquely baseball terms such as “play hardball”, “touch-base”, “home-run”, “throw a curveball”, “in the ball park”, and “strike-out”.
As a Red Sox fan, I obviously followed the team’s progression with great interest through the off-season games. This is a time during which emotion easily replaces logic, and nowhere is this more apparent than in the media. What stands out to me is the way that a normally astute media starts to display a more emotional reaction to player performance.
Take a player like Matt Carpenter (St. Louis Cardinals second baseman) for example. He is probably the best leadoff hitter in Major League Baseball right now. In the 2013 season he led the Major Leagues in hits (199), doubles (55), and runs (126) through September 20, 2013 while batting .318. This data is generated from 157 games played with 626 at-bats.
During the 2013 post-season however, Carpenter has only recorded 12 hits, 2 doubles, 8 runs, with a batting average of .200. This performance dip has had his detractors in the media howling at his post-season ineffectiveness – even to the point where there have been suggestions that he be dropped in the batting order. But the mainstream media ignores the fact that this data is generated from 15 games played and only 60 at-bats. Of course, this is far too small an n to cast out the best leadoff hitter in baseball.
I know, I know – there is something to this that is tied up in what sells to the public, (people are more attentive to emotion than logic during October) but it seems somehow disingenuous to me that just because a sport has statistical credibility, the media can use that credibility to make a case that simply should not exist.
From the patient recruitment perspective, we also see the same thing happening again and again. Emotion versus logic.
Clinical R&D is set up to ascertain the safety and efficacy of a target molecule through a series of trials that require sequentially larger and larger numbers of patients in order to make statistically verifiable claims. The reliance on a sufficiently large n and the double blind is intrinsic to the process so that observational data (emotion) does not bias the numeric assessment (logic).
In one of our latest campaigns, BBK generated more than 2,600 pre-qualified referrals to a study, sending them to over 130 sites in a 12-week period via our patient recruitment management system, TrialCentralNet (TCN). Over 87 percent of these referrals were viewed in TCN by a staff member at these sites.
From a meta-analysis of the screening rate, BBK was able to determine that screening rates had increased by almost 50 percent at sites who were receiving referrals, whereas – in the same time span – screening rates had smoothed or decreased by up to 30 percent at sites who were not receiving referrals. Not too shabby – something to celebrate even. Sounds a bit like the 2013 season that Matt Carpenter just had.
And yet, after receiving eight referrals, and only viewing three of them, a single site can make enough noise about the quality of referrals to rattle a few cages and potentially drop the media work within that market area. To react to this kind of feedback in this way would be akin to dropping Carpenter in the World Series.
Site needs and emotions count of course, and these are tricky waters to navigate to be sure. (Before you howl in protest – I understand that there are more complex relationships at work) In baseball, emotions run high in October and addle the brains of otherwise rational people. But in patient recruitment for clinical trials, October is no excuse for ignoring the very logic that drives our industry.
To read Moneyball – Part One, click here.