In this essay Dr. Rind counsels us on when to moderate our skepticism and recognize that our understanding of an illness or therapy might need to change
Our pediatrician said she always waits 6 months to see how a new drug or vaccine works before she recommends it. This gives time to see actual results rather than just test results. I think this is a good way of being skeptical but willing to try new treatments.
I really appreciated this article, thank you. I think we often get really accustomed to tagging flaws in any trial we read, especially when teaching, and it becomes as second-nature as reeling off familiar crossword answers: "apse", "rara avis", "immortal time bias", etc. It's good to be reminded that scouring a study for soft spots is not the same as invalidating it.
A very good dose of serious advice from David Rind. However, I do think that we should object firmly to the first sentence of the second paragraph: Note his chosen verbiage, ". . . .flaws that lead to the wrong answer". In biostatistical matters we actually never "uncover the right answer" and this startling point was made in a leading textbook some years ago by (I seem to recall) David Sackett (?) --- viz. in all applications of modern epidemiology sleuthing, including uses of even the most scrupulous RCTs, investigators will *always* get approximations of the Truth underlying some matter at hand. I think that epidemiologists sense reality through layers of fog, sometimes with greater difficulty than at other times, but never with 100.00 percent clarity despite strong applications of the most intense and au courant computational Kung Fu. In sum, I wish simply that Dr. Rind had said, ". . .focus on flaws that will lead the unwary to form misleading conclusions".
Our pediatrician said she always waits 6 months to see how a new drug or vaccine works before she recommends it. This gives time to see actual results rather than just test results. I think this is a good way of being skeptical but willing to try new treatments.
It's good to know that people are willing to talk about skepticism. This is something we haven't had enough of in the last several years.
I really appreciated this article, thank you. I think we often get really accustomed to tagging flaws in any trial we read, especially when teaching, and it becomes as second-nature as reeling off familiar crossword answers: "apse", "rara avis", "immortal time bias", etc. It's good to be reminded that scouring a study for soft spots is not the same as invalidating it.
Having the self awareness to recognize one’s own biases is something every consumer of EBM should strive for.
This sentence really hit me: "We all have some degree of intellectual conflicts of interest – we all like to be right". I can certainly relate.
Probably one of the best ways to balance our own conflicts of interest is to ask others who disagree to engage with us.
A very good dose of serious advice from David Rind. However, I do think that we should object firmly to the first sentence of the second paragraph: Note his chosen verbiage, ". . . .flaws that lead to the wrong answer". In biostatistical matters we actually never "uncover the right answer" and this startling point was made in a leading textbook some years ago by (I seem to recall) David Sackett (?) --- viz. in all applications of modern epidemiology sleuthing, including uses of even the most scrupulous RCTs, investigators will *always* get approximations of the Truth underlying some matter at hand. I think that epidemiologists sense reality through layers of fog, sometimes with greater difficulty than at other times, but never with 100.00 percent clarity despite strong applications of the most intense and au courant computational Kung Fu. In sum, I wish simply that Dr. Rind had said, ". . .focus on flaws that will lead the unwary to form misleading conclusions".
Appreciate the space to broadly reflect on my own biases. Thank you.