Intended for healthcare professionals

Evidence That Really Matters

Scared to death?

BMJ 2002; 325 doi: https://doi.org/10.1136/bmj.325.7378.1442 (Published 21 December 2002) Cite this as: BMJ 2002;325:1442
  1. Gary Smith, Fletcher Jones professor (gsmith@pomona.edu)
  1. Department of Economics, Pomona College, Claremont, California 91711, USA

    Phillips et al report a “Hound of the Baskervilles effect” among Chinese-Americans andJapanese-Americans, who have abnormally high cardiac mortality on the fourth day of each month because they think the number 4 is unlucky.1 Is it plausible that the number 4 is regarded with the same terror that the fictional Charles Baskerville felt as he was pursued in the dark by a huge hound “with its flaming jaws and blazing eyes”? We encounter the number 4 every day. Could one more 4, the fourth day of a month, be fatal?

    Methods and results

    A natural test is to compare deaths on the third, fourth, and fifth days of each month. A longer horizon is flawed because a systematic cycle that causes deaths to peak near day 4 may show statistical significance that reflects a bulge near …

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