A recent article reminded of the importance of evidence and what the author calls "The Evidence Revolution." This is a book review and may drive demand for Helen Pearson's Beyond Belief: How Evidence Shows What Really Works. This is an indictment of the anecdotal, the emotional, and the perils of groupthink that have driven so much in policy and "conventional wisdom."
The perils that she unveils are beyond inconvenience or even injustice. There are examples of acute harm driven by the unsupported and unsupportable consensus of the expert community. The first example is Dr. Spock, and no, not the Star Trek (DesiLu, 1967) master of overcoming emotion in the pursuit of logic and reason.
This Dr. Spock was an American pediatrician who "authored The Common Sense Book of Baby and Child Care in 1946." According to Connecticut History, he became "the world’s most famous pediatrician," and according to The Evidence Revolution, he "revised his book in 1958 to say parents should place their infants face down to sleep to avoid choking."
The only problem with this proactive advice from the "most famous pediatrician" is that children died. The Evidence Revolution says that "Sudden Infant Death Syndrome (SIDS) increased" following his public endorsement. As time passed, "evidence accumulated that face-down sleeping correlated with a much higher risk of SIDS."
Evidence and dead children accumulated. Thirty-two years later, "a 1990 study showed that SIDS infants were nearly nine times more likely to have been sleeping face-down." A late-century "public health campaign" pushed to avoid face-down sleeping. The frequency of "SIDS deaths dropped nearly 70 percent." Science debunked eminent opinion.
Experts may be qualified by their education, experience, or training. Anyone can be an expert in something, and there are a multitude of evidence codes and published opinions that both provide guidance and standards.
But expert opinions may be more difficult. Particularly when someone brings fame and acclaim with their expertise. It may be difficult to believe that someone who has become larger than life may not have the best or most conclusive opinion. How can we vet and differentiate opinion, choose between experts?
The Evidence Revolution explains that these kinds of outcomes are what drove the reasonably recent "rise of evidence-based medicine." With randomized trials, carefully designed studies, and careful consideration of contrary study results, science is capable of both individual and societal progress and improvement.
Nonetheless, there is evidence that too often science fails us. There are shortcomings, and the efforts of a few may be responsible for our safety. Reading that, I was pulled back to Roman poet Juvenal and his inquiry "Quis custodiet ipsos custodes?" ("Who watches the watchmen?"). So, in parallel, who studies the studiers?
The Evidence Revolution describes non-profits that strive to "conduct systematic, standardized reviews of the data from research on various health questions." With this focus, the intent "is to provide clear, objective overviews of all the relevant evidence."
There is some skepticism as to who pays for research. What happens when a funded study fails to support the sponsor's hypothesis? Who watches this? Are negative outcomes buried? Despite the verification and review efforts, The Evidence Revolution says a scant majority of Western healthcare, even today, "is in line with evidence-based clinical guidelines."
The author proceeds to cite other examples of regulatory or other systemic adoption of hypotheses without empirical proof. There is a discussion of examples of such missteps in economic policy, education, and general management. These are each troubling, demonstrating inordinate reliance on the reputation and volume of some advocate while ignoring the empirical evidence, or at least questioning the absence of it.
The article on The Evidence Revolution begins with "the official motto of ... the Royal Society of London: 'Nullius in verba' ('Take nobody's word for it')." Perhaps we can learn much from Dr. Spock (the pediatrician) and the other examples of groupthink, authority bias, and more that can distract from the real credibility foundations:
The trier of fact (judge or jury) is often faced with competing expert conclusions. What supports the conclusions? What are the signs or symptoms? What empirical evidence exists to support or refute a conclusion? What objective indicia exist, and how does it fit with the hypothesis or conclusion?
But, most importantly, how effective is the expert's explanation of the constellation of evidence, the process they used for examination and evaluation, and the logical path to their opinion? In the end, the finder of fact will not be an expert. They will nonetheless have to be effective at evaluating and comprehending the expert's process, analysis, and opinion(s).
The finder of fact and the advocates for the parties would do well to think critically and adopt the Royal Society advice, "Take nobody's word for it."
