Fulde Me Twice

How to tell if you believe in bullshit is one of many excellent articles and videos produced by Maddox, owner of The Best Page in the Universe. Maddox covers everything from inventions, people on the internet and their stupid crusades to movie reviews but one of the main features of his content are his virtuoso rants. Often these rants are dedicated to systematically debunking stupid things people say, do and believe. Whilst I was doing some general research into the statistics St Vincent’s uses to promote prohibition, Maddox’s rant about believing in bullshit came to mind. Specifically the part about scientific method and all the steps Dr Fulde et al seemed to have skipped when producing their initial report.

scientifc method
It would appear that when producing his paper “Presentations with alcohol related serious injury to a major Sydney trauma hospital after 2014 changes to liquor laws” Dr Fulde decided to start with Step 1 before jumping to Step 5 and finishing with Step 6

Earlier this year I analysed the data presented by Dr Gordian Fulde and published by the Medical Journal of Australia. What I have published speaks for itself and mounts a very strong case and the fact that people are now distancing themselves from the “25%” claim speaks volumes. Not being one to just let an issue go, I decided to further scrutinise the data on an hour by hour scale based on changes to the level of foot traffic observed within the precinct. I also decided to test out what many have claimed – that the decline in injury does not correlate with the decline in patronage, and if you weigh these numbers up side by side you are statistically more likely to be involved in an incident than before. Was there any truth to that suggestion? Suuuuurely not!

Before we get started let me offer full disclosure in case anybody wants to suggest confirmation bias due to some kind of agenda bizarrely related to my former employers dating life. Yes, I am obviously opposed to the lockout laws. But not because I want to be out partying all night or because I was impacted professionally. Quite the contrary. I’m way too old for that partying shit and I was too busy winning industry awards to be impacted professionally. One of the big motivators of my opposition was (and still is) the constant bullshit stemming from the pro-lockout side. We have a number of parties that have driven and lobbied the agenda for their own self gain or that of others, emotionally manipulating the public who lap up every word they say like a prairie dog. Ignorance breeds ignorance and I don’t think bad behaviour should be rewarded. When the very people who implemented them don’t believe in them it’s hard to understand why the hell does anyone else. It’s because of lies and bullshit that I’m so staunch in my opposition. If I was to perpetuate bullshit like they do, I would be just as bad. You can trust the Surely Not Ethics Department on this, which is more I can say for some.

apple orange
On the left we have an apple. On the right you’ll notice an orange. These two tasty treats are obviously nothing alike and it would be foolish to compare the two

The initial report claimed the laws were a great success. At first glance there was indeed a “significant reduction” seemingly thanks to the change of laws. However after being subjected to a small amount of scrutiny, these numbers did not look impressive at all. After running the magnifying glass over them further, they now look downright atrocious.

It is not logical to quote statistics that only take into account actual figures with no consideration to key variables. Obviously the number of presentations to St Vincent’s would be lower given the number of people visiting the area was lower (never mind presentations slightly increased and Fulde was using the entire catchment area when discussing a small section). Given the comparisons published by Dr Fulde were based on oranges versus apples, I decided to level the playing field by bringing devising a much fairer analysis.

I’ve also paid a bit more attention to the full range of statistics and created a report on those stats as well as the weekend data. The weekend data quoted ad nauseam was from what Dr Fulde likes to call “High Alcohol Time” or “HAT”. Or in English, 6pm Friday to 6am Sunday. I’m not sure why Dr Fulde deemed Sunday through to Thursday irrelevant to the topic. Anyone who visited the city or the cross in the years before the lockout laws would fondly remember Sunday nights where every bar and club was heaving. It was arguably bigger than Friday for some. Wednesday nights were just as popular, with a midweek blow out constantly on the cards for all who dared venture out “for a couple”. Thursday night the same – uni night. I’m not sure what going out on Thursday nights had to do with university, but my god I was calling myself in anyway. While I was not much of a Monday or Tuesday night reveller myself, thousands of travellers were as well as Sydney’s hospitality workforce who were out enjoying their “weekend”.

Sydney was open 24 hours a day, 7 days a week. As it, and any other vibrant, international city should be.

hugos
Hugos Kings Cross in the glory days. RIP

The methodology behind the adjusted comparison figures is fairly simple. I have taken the actual presentation figures from the year before the lockouts were implemented (provided by Dr Fulde) and applied the changes in patronage seen in the precinct (provided by City of Sydney and various media sources). This would allow us to see an accurate estimation of what the numbers would look like if the patronage of the area was the same pre-lockout as it was a year later.

Presentation data - hourly with adjusted comparison
Data taken from St Vincent’s alcohol related presentations compared with variations in foot traffic between the two sample periods. Sources as above. Please note “High Alcohol Time” (HAT) refers to 6pm Friday – 6am Sunday

As you can see from the table above, there is a vast difference when comparing the pro-rata figures based on variations to foot traffic. By the logic of lockout supporters, the changes in alcohol related trauma presentations and patronage should have been proportional. That could not be further from what we have observed. In some cases the stats reflect a further reduction, which is great. But in the majority of cases we have seen the opposite.

1am - 2am

For example, looking at figures  between 1am and 2am we saw 34 presentations the year before the laws were introduced and 18 the year after. An impressive reduction of 47.06%. However we also saw a 55% decrease in foot traffic. It’s fair to say had we experienced the same volume of visitors to the precinct the year before the presentations would be 55% lower as well. Based on this, the figure we should be comparing to is not 34. It’s 34 reduced by 55% which is 15 (it’s actually 15.3, but for this analysis I will be rounding up or down to get a whole number). Because we have levelled the playing field, the 2014-15 trauma figures do not act proportionally. The 2014-15 figures are still the 2014-15 figures, the 2013-14 figures have just been adjusted to reflect 2014-15 traffic.

The end result – a 20% increase in trauma presentations between 1am and 2am.

Looking at the same timeslot during HAT a 58.33% reduction become a 9.09% reduction. While this is still a reduction in incidents, which is great, it certainly can not be used to claim a win for the laws.

2am to 6am
2am – 6am – When lockouts are in full effect

The next few hours are quite shocking. It’s obvious to anyone who has been out late in the last two years that the streets are deserted after lockout kicks in. Between 2am and 6am foot traffic is down anywhere from 75 to 90 percent. Based on the figures above (copied from the first table) you can see that the much celebrated reductions ranging from 25% to 57.14% over the entire week are actually 200% to 233.33% increases when a fair comparison is made. It’s worse during HAT where decreases ranging from 17.65% to 30.77% were claimed, an accurate comparison shows increases between 250% and 350%.

6pm - 12am
6pm – 12am – this used to be a busy period with after work socialising and people celebrating the start of the weekend. According to City of Sydney research 15% of people out in the precinct we’re going out to socialise in 2015, compared with 46% in 2012 and 58% in 2012. By contrast, 57% were on their way home compared to 23% in 2012 and just 3% in 2010.

Leading up to midnight we had already increases from 9pm-10pm and 11pm – 12am. Unfortunately, we now see a statistical increase between 6pm – 8pm before a relieving drop from 8pm to 9pm. From 9pm to Midnight, the increase ranges between 16.67% and 200%.

12am - 1am
Midnight – 1am saw an increase in foot traffic. Possibly attributed to people heading towards what is potentially their last stop of the night. Pre-lockout days, people were happy and safe inside venues at this time of night

On the bright side, we do see a decrease using the methodology at one point throughout the night. Based on the initial comparison it appeared incidents had increased between midnight and 1am by 36.36% week long and 77.78% during HAT. The more realistic comparison shows the increase s are only 15.38% week long and 45.45% during HAT. Still not ideal, but not as bad as the increase observed by Dr Fulde. Which is good news.

As a side note, it was a tad confusing to hear some of Dr Fulde’s remarksin the months after the release of his report. The period just after midnight was the only period that was in stark contrast to the rest of the report, seeing quite the spike in presentations. This point was ignored in the report, so perhaps he simply forgot about it. I suppose that would explain why he totally contradicts his own findings, as below –

“The reduction was most marked in the period after midnight, which corresponds with the main thrust of the changed regulations,” Fulde said.

“In my concept of it, it made fewer people who were totally out of control drunk be on the footpath and that means there were less cranky, hot-and-bothered, people all tightly jammed up.

“The package (has) worked in Kings Cross and the city,” Fulde said.

Huffington Post – 2/11/2015

9am - 6pm
9am – 6pm – Success! During business hours the area is much safer!

On the bright side, the area appears to be much safer during business hours. For the most part patronage had not varied enough to impact the relatively small figures recorded for these hours, but when it did there were still reductions observed. Interestingly we did see an alarming spike between 1pm – 2pm. Queue rage and the takeaway store? Developer disagreements at long lunches? Who knows. It’s also interesting to speculate as to what’s caused a decrease during the day. Obviously none of this can be attributed to changes in legislation. I would offer NSW Police and the Kings Cross LAC  some of the credit, as there is always a healthy  and highly visible contingent of officers patrolling the area during daylight hours!

Overall, this more authentic representation of the data paints a grim picture. The reductions Dr Fulde claimed to have observed were 22.64% based on every day of the week and 24.29% during peak or HAT. According to this analysis, figures based on the whole week have in fact seen a 38.98% statistical increase. HAT figures come out even worse, with a 49.3% statistical increase. The suggestions that statistically you are now more likely to be assaulted/injured/etc than before are entirely accurate, and alarmingly so. It’s little surprise many have been abandoning this report and have moved on to a new, hip set of buzzwords and statistics.

“The reduction was most marked in the period after midnight, which corresponds with the main thrust of the changed regulations,” Fulde said.

“In my concept of it, it made fewer people who were totally out of control drunk be on the footpath and that means there were less cranky, hot-and-bothered, people all tightly jammed up.

“The package (has) worked in Kings Cross and the city,” Fulde said.

Huffington Post – 2/11/2015

 

faceplant
The so called “face plant” is a leading cause of facial injury in 2016. The carnage is indiscriminate, with many infants and the elderly falling victim in this alarming new trend. Community & family safety lobby group  “Wowsers & the Associated #Nannystate of Killara”  are currently researching ways to put an end to this epidemic and quell the rivers of blood flowing down your street. “Our priority is keeping your family safe”said WANK junior vice president Gertrude, 104. It’s believed suggestions will include a sundown curfew preventing responsible adults from leaving their own home when bad light makes walking outside unsafe – surelynotnews 15/4/2016

The latest well rehearsed rhetoric figures to come out of St Vincent’s relate to an apparent reduction in “facial fractures”. On SBS program The Feed’s lockout forum, Dr Tony Grabs who said

“since the lock-out laws our emergency department is a completely different place”. 

A review by the hospital’s plastic surgery unit found that the number of facial and mandible fractures in the two years before the lock-out laws were introduced totalled 145, compared to just 58 in the two years after the laws came into effect.*

“That is a dramatic reduction in facial trauma,” he said.

23/3/2016 – Dr Tony Grabs – The Feed SBS – Quoted in the Sydney Morning Herald

*Dr Grabs did not make those remarks, that’s Fairfax journo Kate Aubsusson throwing in her own $0.02 into the mix. Ms Aubusson and her own possible agenda aren’t really relevant .Nor are her chime ins helpful at all for the reader. But to be fair she’s doing her bit and toeing the company line. With the current climate of uncertainty over at Fairfax, one can’t blame her for that.

An unnamed St Vincent’s spokesperson also was quoted by Fairfax in an article on April 4th 2016.

Facial fractures are down from 145 in two years prior to lockout laws to 58 in the two years since. In the two years before lockouts, 82 per cent of facial injuries were alcohol related. The figure for the two years after lockouts, he said, was 64 per cent 

  • 4/4/2016 – St Vincent’s Spokesperson – Sydney Morning Herald

It’s not confirmed whether or not this spokesperson was David Faktor or somebody else who represents the hospital. For those who missed it, Mr Faktor was the spokesperson who had the audacity to publicly accuse The 7.30 Report of misleading the public for airing initial reports into the hospitals mishandling of cancer treatments. On April 5th 2016 NSW Health released their explosive interim report into the ongoing cancer treatment scandal, declaring that St Vincent’s were the ones who misled the public, as well as their own patients, and had in fact staged a cover up.

busted
NSW Health Interim Report – Ouch

As any logical person would have predicted, it seems like someone is trying to muddy the waters again here. They’re claiming facial fractures are down and also saying the percentage attributed to alcohol are down. But that’s it. No information on when, where or how they occurred. The only other publicly available data is from the two year study we were previously disucssing. The fancy new “facial fracture” numbers are from a four year study. Something does not seem right at face value, so without further ado, let’s have a quick look at the latest claims.

Reluctantly assuming (I don’t like having to make assumptions, I’d rather the exact data!) the two year periods are A) March 2012 – 2014 (before) and B) March 2014 – March 2016 (after) the claim is there were 145 facial fractures in period A and 58 in period B, a total reduction of 87.  Using their percentages to work out alcohol related facial injuries (82% and 64%), the numbers become A) 119 and B) 37, making the total reduction 82, an impressive figure. However this time they’re not just trumpeting the overall reduction, they’re promoting the claim that the percentages of facial fractures related to alcohol have dropped.

trumpet
Apt

As you can see it does appear to be quite a significant difference. But the time frame is far too broad to accurately draw a watertight conclusion using the scientific method. Don’t get me wrong, four years of data is better than two years every time. But the way they have presented it does not show a lot of faith in the more detailed picture. What we have here is two years of data lumped in the same basked. We have no idea what time of day these facial fractures occurred so can’t properly conclude they are relevant. We don’t even know whether they occurred one week, one month, 23 months before or after the laws were changed.

For example – Hypothetically, period A could have been 89 in the first year and 30 in the second. Meaning facial fracture injuries were already experiencing a significant downturn, which would be in line with violence statistics and trends. Period B could have been 7 in the first year and 30 in the second, meaning we’re seeing a dramatic surge in injuries of this nature. I’m only speculating here, but it’s easy to see why it’s important to have more accurate data, when drawing conclusions. If the statistics truly reflect the result that is being touted, why have they not been clearly presented? Surely they would stand up to closer scrutiny?

Using the methodology from the first set of stats, I’ve roughly applied the changes in patronage to the pre-lockout figures. Admittedly it isn’t as accurate as the previous analysis, but it’s the best that can be done with what’s available.

fractures
Source – St Vincent’s spokesman quoted in smh

I’m not going to dispute the hospitals claims of facial fractures somehow linked to alcohol are now occurring at a much lower rate. I’ll get to that in a moment. What I will point out here though is despite presenting their numbers in a way that suggests there are far less of these injuries than before, this isn’t really the case. Firstly, they claimed that in the two years preceding the lockout laws there were 119 facial fractures caused in some way by alcohol. In other words, 1.14 per week. Hardly the “carnage” described by Dr Fulde and his hysterical cohorts.

war zone
NOT Kings Cross & the surrounding areas of St Vincent’s – this is an actual war zone

Now to compare. As we’ve been told there were 37 alcohol related facial fractures in 2014-2016 comparing that with 119 in 2012-2014 tells us there were 82 less of these injuries over the next two years – a 68.91% reduction. 0.78, or almost one less per week. Impressive, and good to see. But would that be noticeable in the “war zone” that was St Vincent’s? Would that even be considered “a dramatic reduction in facial trauma”???

Using the methodology from our first study, a more realistic comparison comes from looking at pro rata figures taking into account the difference in patronage. Many have said this has dropped by around 82%. I am a little more generous to our dear medical professionals and after analysing foot traffic by the hour I am prepared to work with 57%. This would mean the 2012-2014 figure we should be using is 51. Comparing this to the 37 cases, a more accurate reduction observed is 27.45%. Which is nothing to be sneered at. Until you realise that figure represents 14 cases.

Over two years this works out to be 0.13 per week – or one every 7-8 weeks. One less facial fracture every couple of months.

Dr Fulde described his department before the lockout laws as a “war zone” and the decrease in severe head injuries since then as “spectacular and terrific”.

25/1/2016 – smh.com.au

I don’t think spectacular is the right word to use…

“I can assure you, if you come into emergency department at St Vincent’s, we all – we still see lots of assaults. Remember it only dropped it by 25 per cent.”  –Dr Gordian Fulde 

26/2/2016 – Lateline

Apparently neither did Dr Fulde. But it did seem at least he was finally veering away from the same old drivel in the Lateline discussion quoted above. But in fairness anything is better than the same old, tired lines like below….

“The Sydney lockout laws have been extremely successful from an emergency room perspective!” – Gordian Fulde. #KingsCrossER

— Channel 9 (@Channel9) September 10, 2015

What utter tripe.

As I mentioned earlier, the lack of information means the analysis is not as detailed as I would like. Despite that,  it still shows quite clearly how these morally superior human beings grossly exaggerate the impact the laws have had. Not just the fact that they may not have done as much good as suggested. But the fact that they may have even made the area more dangerous than it was before. In their defence though, Sydney was named safest city in the world so the only way was ever going to be down. Much like presentations were leading up to the campaign of hysteria, as per Barry O’Farrell below –

tbt
Unfortunately the OLGR links no longer lead anywhere but the “new and improved” website landing page. Picture collated on Twitter @SuurelyNot

Back to the claim made that less facial fractures are due to alcohol in the two years since the lockout laws. Whilst the good spokesman is obviously trying to imply that this means less people are being viciously assaulted and punched or kicked in the head, it also tells us another story. It’s great that less people are suffering terrible injuries caused by drunken assault or misadventure. But hang on a minute, if a smaller percentage of people suffering these injuries due to intoxication, how are the rest of them being caused? Rather than proving a win in the battle against “alcohol fuelled violence”, all this is telling me is people are now finding more ways to fuck up their face without even needing a sip of grog than ever before. Surely that’s not a good thing!

To give you one last insight into how farcical this whole thing is, I’ll pass on an anecdote about someone who attempted to gather some more meaningful data to study. Sources have contacted St Vincent’s and Dr Fulde and requested the raw data. They were denied. A source did some research and called Kings Cross Police asking “how they knew if violence was alcohol related”. They said they did not know and referred him to the media unit. The media unit did not know and said call the hospital. The hospital said “we don’t know”. When asked if they did blood tests the response was that’s only allowed by law if it’s a motor vehicle accident. Talk about running a tight ship.

nice hat
I have it on very good authority this 2007 “facial fracture” was simply caused by an idiot forgetting he was standing up and “face planting”. Alcohol related, most definitely allegedly. But caused by violence? Most definitely not. It’s just Charles Darwin doing his thing should and frankly, he wouldn’t approve his theory being hijacked. Either that or the idiot was drinking irresponsibly that night because of a bad influence mate and a never ending supply of vodka redbull

Nobody can confirm these stats and whether or not they are alcohol related. Even if they could, they are only analysing the victim. There is no way of telling if the perpetrator was drunk, on drugs, sober, etc. These stats have no validity and are meaningless at best, cooked and deliberately misconstrued to deceive at worst. Given everything else that’s going on down at the hospital, it really is time for NSW Health to lift the lid on the whole operation.

Despite best efforts, under the most basic scrutiny the numbers do not hold up or appear remotely impressive. They certainly do not justify the damage caused to the community. They do not prove a decrease in violence. They do not validate those who negligently approved the legislation. All they seem to prove is human beings are becoming more creative with how they do damage to themselves, and are perhaps becoming less coordinated as the years go by. Given the amount of people who have allowed themselves to be Fulde for a second time, that conclusion does not surprise me in the slightest.

 

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surelynot.live 14.4.2016
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