How we report outcomes, and what the numbers can show

The rules we hold ourselves to

A statistic on our site sits beside its source, on the same page, and if we cannot point to the source the number does not go on the page. Outcomes are claimed only where we can show the measurement, and we do not publish results from other people’s programmes as if they were ours [1].

We publish no testimonial a patient did not say to us, and no percentage improvement that we have not measured ourselves. If something on the site is wrong, we fix it, and where the error was material we leave a note on the page saying what changed and when [1].

The standards behind those rules

Doctors in the UK work to the General Medical Council’s Good medical practice. It requires any information a doctor communicates to be accurate and never false or misleading, which means checking it, leaving nothing relevant out, never minimising risks of harm and never presenting opinion as established fact, and it applies these duties to advertising a service [2].

The advertising code says the same of health claims. Objective claims must be backed by evidence, where relevant consisting of trials conducted on people [3]. A registered provider must also run systems to assess, monitor and improve the quality and safety of its services [4].

Your own outcomes, measured over time

The outcome that matters most to you is your own. When you start a programme with us, targets are set with your physician and re-measured on schedule, and your results become a plan that says what matters, what to change and when each marker will be measured again [5].

Every result arrives into one record and is read together, so you and your doctor can see what moved and by how much over time [5]. A change in one marker is a reason to talk, since a single reading can vary for reasons that have nothing to do with your health.

What a sound outcome report includes

A sound outcome figure tells you who was counted. Trial reports use a flow diagram to show how many people were enrolled, allocated, followed up and analysed [6], and an outcome report from a clinic needs the same honesty about everyone who began, including those who stopped.

It also says how the outcome was measured. Patient reported outcome measures, questionnaires that record how people feel and function in their own words, can help patients and clinicians make better decisions and allow fair comparison between providers [7]. For day case and inpatient care in private hospitals, the Private Healthcare Information Network publishes information on safety, quality and costs [8].

The limits every outcome number has

Small numbers swing by chance. Spiegelhalter showed that plotting each provider’s result against the number of cases behind it, with limits drawn for the variation chance alone would produce, avoids ranking providers into misleading league tables [9].

Who chooses a service shapes its results too. People who seek preventive care are often well and motivated, so their outcomes may look good whatever the clinic does, and a fair figure needs a comparison or an adjustment for that. A clinic that tells you these limits beside its numbers is easier to trust than one that does not.

Timing matters as well, because a marker measured soon after a change in diet or medicine may move again, and outcomes such as illness avoided take years to show, so a sound report says how long people were followed. A first reading that is unusually high or low also tends to settle towards the average on its own, which is why a comparison group matters.

Questions to ask of any clinic’s results

These questions help you judge an outcome figure from any provider, including us.

• Who was counted, and were the people who stopped included?
• How was the outcome measured, and by whom?
• Over what time was it measured?
• How many people does the figure rest on?
• Compared with what, and was the comparison adjusted for who chose the service?
• Is the source of the figure on the same page?

How The Wellness can help

Membership gives you a doctor who knows you, priority access and continuity all year, so your results are measured, compared and explained by the same team over time. If you see a doctor only now and then, a GP appointment is £150. If anything on our site looks wrong to you, write to team@thewellnesslondon.com with the page and the line [1].