Why we publish no numbers
The figures quoted in this category are its least reliable output. This article explains the policy that follows from that, because a reader is entitled to know why a reference is withholding something.
This document contains no satisfaction rates, no outcome percentages, no complication rates, no durations expressed as a definite number of months and no prices. Not because those things are uninteresting, but because in this category they are produced by methods that cannot support them, are repeated without attribution until they acquire the appearance of fact, and are the single most effective tool available for making an unsettled claim sound settled.
What we publish instead is a description of the evidence by its shape, a fixed vocabulary of qualitative verdicts that contains no numbers, and an explicit register of what is not known. That is less satisfying to read and more defensible to have written.
2.5.1Where the numbers in this sector come from
Trace almost any figure quoted about a cosmetic injectable back through the pages that repeat it and you will typically arrive at one of four origins.
- A small uncontrolled study, whose figure describes a handful of people assessed by people who knew they had been treated.
- A manufacturer's marketing material, where the underlying method is not stated and the study is not identified.
- A satisfaction survey conducted by the people who provided and were paid for the treatment.
- Nothing at all. A number that first appeared on a page without a source and was copied onwards.
Once a figure has been repeated a few dozen times it becomes a fact by circulation. Nobody is lying. Each page is accurately reporting what the previous page said, and the whole chain rests on something that was never established.
2.5.2Why a wrong number is worse than no number
Because numbers do something to a reader that prose does not. A precise figure signals that something has been measured, that a method existed, and that a result was obtained. It closes down a question that ought to remain open. A sentence saying that most people are pleased with the result invites you to wonder how that was established. A figure saying that a specific percentage of patients reported improvement does not, and that is the whole reason it is used.
In this category the effect is particularly damaging because the central claim is unresolved. A reader who has absorbed a set of confident figures is no longer in a position to weigh whether the question has been answered, because the figures have already answered it for them.
2.5.3Durations and prices, specifically
Two categories of number deserve individual mention because their absence from this document is most likely to frustrate a reader.
How long it lasts. We will not give you a figure in months. The evidence that would produce one does not exist, the figures in circulation are manufacturer suggestions and clinic convention rather than measurements, and the truthful answer is that the material clears within weeks and whether anything persists past that is the open question of the whole category. A number here would be an invention dressed as information.
What it costs. We publish no prices, because prices vary by practitioner, area, product, number of sessions and region, because quoting a range would immediately be treated as a benchmark, and because a price on a reference site becomes a marketing input for the clinics we deliberately do not link to. The article on cost in the deciding chapter explains how to think about it without a figure, which is a more useful thing to have.
2.5.4What we publish instead
Three things, and each is designed to carry information that a number would carry, without the false precision.
The evidence note. Every substantive claim in this document that could in principle be tested is set out in a bordered block that states the claim as it is usually made, says what kind of evidence would settle it, says what kind exists, and gives a verdict from a fixed published vocabulary. The vocabulary contains seven terms and none of them contains a number. Every verdict on the site is collected in a public register so that you can see the whole set at once and hold us to it.
The not known block. Open questions, listed explicitly, gathered into a second public register. A reference that publishes its own gaps can be checked against them.
Qualitative description of evidence. Small, short, uncontrolled, industry connected, unreplicated. Those words carry real information about what a literature can establish, and unlike a percentage they cannot be lifted out of context and repeated as a fact about the treatment.
| The question a reader arrives with | What a typical page says | What this document says |
|---|---|---|
| How long does it last | A specific number of months | The material clears within weeks; whether anything persists past that is unresolved, and this is the central open question |
| How well does it work | A percentage of patients who improved | A verdict from a fixed vocabulary, with what would settle the claim stated alongside it |
| Is it safe | A very low complication rate | The known complications, and the fact that no denominator exists from which any rate could be calculated |
| What does it cost | A price or a range | How to think about total course cost, what to ask, and why we will not benchmark the market |
| Is it better than the alternative | A comparison table with scores | A comparison of material properties, and a statement that no head to head evidence exists |
A framework written by this publication to organise a decision. It is not a measurement, it is not drawn from any study, and no figure in it should be quoted as a finding.
2.5.5What this policy costs us
It is worth saying plainly. Pages with figures perform better. A reader arriving with a question about how long the treatment lasts wants a number and will go and find one somewhere else. A page that answers the question with an explanation of why the number does not exist is a page that a proportion of readers will leave.
We accept that. A reference that optimises for giving people the answer they came for, whether or not the answer exists, is not a reference. The whole value of this document rests on the reader being able to trust that anything stated in it is stated because it can be supported, and that trust is worth more than the traffic.
2.5.6The exceptions, stated so they are not surprises
There are numbers in this document. They are of three kinds and all three are verifiable.
- Legal references. Section numbers, years of Acts, statutory instrument numbers. These are citations, not measurements, and every one of them links to the text on legislation.gov.uk.
- Our own rate card. The price of a listing and of a newsletter sponsor line, which we publish because it is our own commercial arrangement and concealing it would be worse.
- Counts of our own material. How many articles this document contains, how many evidence notes it carries. These are facts about the document itself.
If you find a number in this document that does not fall into one of those categories, or into a direct quotation from a named legal or regulatory source, it is an error and we would like to know about it.
Questions
Why will you not just tell me how long it lasts?
Because we would have to invent the figure. The injected material is cleared within weeks. Whether any effect persists beyond that is the central unresolved question of the category, and a number in months would conceal exactly the thing you most need to know.
Are you saying every figure I read is false?
No. Some are accurate reports of small studies. The difficulty is that a figure detached from its method looks the same whether it came from a careful trial or from nowhere at all, and in this category a great many came from nowhere at all.
Do you publish prices?
Only our own. We publish what we charge for a practitioner listing and for a newsletter sponsor line, because that is our commercial arrangement and concealing it would be worse than publishing it. We do not publish market prices for the treatment.
Is this not just avoiding the question?
It is refusing to answer a question that cannot currently be answered, which is a different thing, and it is stated openly rather than by omission. The article on cost and the article on what is not known both explain what can be said instead.
What if I find a number on this site?
Then it is a legal citation, our own rate card, a count of our own material, or an error. We would like to hear about the fourth kind, and the contact page exists for it.
- Cochrane Handbook for Systematic Reviews of Interventions
- EQUATOR Network, reporting guidelines for health research
- PubMed, US National Library of Medicine
- ASA rulings database
- The Consumer Protection from Unfair Trading Regulations 2008
Links to regulators, professional bodies, legislation and research indexes. They are cited because they are public and checkable, not as endorsement of this publication. No source listed here has any commercial relationship with us.
Revisions to this document
This reference is revised when the evidence changes. Subscribe and you will be told what was revised, what the verdict was before, and what it is now.
One email when this document is revised, with what changed and why. Any sponsor line is labelled as such and can never influence an evidence verdict. Rates are published on the newsletter page. We do not sell, share or rent the list. Unsubscribe from any email.