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You flip a coin. Fifty percent risk. That's quite a lot.
這和擲硬幣的幾率一樣。 50％的風險，不是一般的高。
If he instead would go to Hamburg,
如果他換而選擇去漢堡，
and to a clinic called the Martini-Klinik,
去一個叫Martini的醫(yī)院，
the risk would be only one in 20.
風險幾率則減少到5%。
Either you a flip a coin,
一邊是像擲硬幣一樣的50%的風險，
or you have a one in 20 risk.
另一邊是僅有的5%。
That's a huge difference, a seven-fold difference.
這是個巨大的差別，有7倍之多。
When we look at many hospitals for many different diseases,
我們調查過很多醫(yī)院，和很多不同的疾病，
we see these huge differences.
我們都發(fā)現(xiàn)了這樣巨大的差別。
But you and I don't know. We don't have the data.
但是你我不一定都知道，因為我們沒有數(shù)據(jù)。
And often, the data actually doesn't exist.
而通常，這些數(shù)據(jù)根本不存在。
Nobody knows.
沒人知道。
So going the hospital is a lottery.
于是，去醫(yī)院看病變成了買樂透。
Now, it doesn't have to be that way. There is hope.
但是，其實不一定得這樣。我們還是有希望的。
In the late '70s, there were a group of Swedish orthopedic surgeons who met at their annual meeting,
在70年代后期，有這么一群瑞士外科整形醫(yī)生，在年會上，
and they were discussing the different procedures they used to operate hip surgery.
他們討論到目前眾多的用于髖關節(jié)手術的方法。
To the left of this slide, you see a variety of metal pieces, artificial hips that you would use for somebody who needs a new hip.
在幻燈片的左邊，是各種各樣的金屬配件和髖關節(jié)假體，用于治療需要髖關節(jié)置換手術的病人。
They all realized they had their individual way of operating.
他們意識到他們每個人的方法都不同。
They all argued that, My technique is the best,
而且他們都認為我的方法最好。
but none of them actually knew, and they admitted that.
但其實，沒人知道哪個辦法最好，他們也承認這一點。
So they said, We probably need to measure quality so we know and can learn from what's best.
所以他們說，我們可能需要做質量評估來得知哪個是最好的方法，并學習它。
So they in fact spent two years debating,
事實上，他們花了兩年時間來辯論,
So what is quality in hip surgery?
該如何評價髖關節(jié)手術的質量。
Oh, we should measure this. No, we should measure that.
有的說應該評價這個指標，有的說那個。
And they finally agreed.
最終他們達成了共識。
And once they had agreed, they started measuring,
之后，他們便開始（給手術結果）做評估，
and started sharing the data.
也開始共享數(shù)據(jù)。
Very quickly, they found that if you put cement in the bone of the patient before you put the metal shaft in,
很快，他們發(fā)現(xiàn)如果在把金屬軸插入大腿骨之前先打入粘合劑，
it actually lasted a lot longer,
這能使手術結果保持更長時間，
and most patients would never have to be re-operated on in their lifetime.
而且絕大多數(shù)病人終身不用再做手術。
