In 1897, Povl Heiberg published an impressive paper in the Danish Medical Journal entitled Studies on the statistical method of investigation as aid for therapeutic studies. What was Heiberg’s background, and how did he come to grasp something most physicians and other people still have difficulty in grasping today?
Povl Heiberg was born in Sorø, Denmark, in 1868 and died in Denmark in 1963. He was the son of a priest – Gabriel Thomas Schatt Rørdam Heiberg (b.1832). Povl’s mother – Johanne Kristiane Müller (b. 1837) – ran the home – a priest’s farm including a dairy. Povl Heiberg received a good deal of his school education at Sorø Academy, a Danish boarding school, and became a mathematical student there in 1886.
Heiberg studied medicine at Copenhagen University from 1886 to 1893. After holding a number of clinical positions in hospitals and general practice between 1893 and 1906, he became a district medical officer (‘kredslæge’) in 1906, and held this position until he retired in 1938.
Heiberg published his thesis in 1909 (entitled Contributions to the history of scarlatina in Denmark during the 19th century), more than 60 peer reviewed articles (several of which were published in English or German), a number of books, and many reports on health statistics. He played an active part in public debate at meetings and in newspapers, and edited Ugeskrift for Læger (the Danish Medical Journal) for four years.
Heiberg’s research focussed on mortality and morbidity statistics, and nutritional, social, and housing aspects in relation to health and disease. He was strongly convinced of the detrimental effects of alcohol and war.
Heiberg had a keen interest in the historical development of evidence-based clinical practice. That coupled with a thorough understanding of the risks of systematic and random errors in research, combined with his mathematical understanding, placed him well in advance of most of his contemporaries.
It seems very likely that Heiberg himself was aware of the importance of his 1897 article. In an article in Ugeskrift for Læger published in 1940 entitled Reflections on numeric studies, he stressed the importance of mathematical thinking and the avoidance of systematic and random errors in evaluating therapies (Heiberg 1940). He also referred repeatedly to the mathematical education he had received at home, in school, and later as a student in his autobiography, as well as republishing a shortened version of his 1897 article (Heiberg 1958).
Apparently, Heiberg never conducted controlled clinical trials or randomised clinical trials himself.
Heiberg P (1897). Studier over den statistiske undersøgelsesmetode som hjælpemiddel ved terapeutiske undersøgelser. [Studies on the statistical study design as an aid in therapeutic trials]. Bibliotek for Læger 1897;89:1-40. Translated into English by Sarah Louise Klingenberg, Mette Hansen, Dimitrinka Nikolova, and Christian Gluud. The James Lind Library.
Heiberg P (1940). Causerier over talmæssige undersøgelser. [Reflections on numeric studies]. Ugeskrift for Læger 102:540-550.
Heiberg P (1958). Spredte erindringer. Fra en gammel læges liv. [Random memories. From an old physician’s life]. København: Arne Frost-Hansens Forlag, 1-157.