Ex­perts should say no when they don’t know:

The Irish Times - Tuesday - Health - - Front Page - Muiris Hous­ton

‘One of the most com­mon er­rors that ex­perts make is to as­sume that, be­cause they are smarter than most peo­ple about cer­tain things, they are smarter than ev­ery­one about ev­ery­thing.” So says Tom Ni­chols, pro­fes­sor of na­tional se­cu­rity af­fairs at the US Naval War Col­lege, in a re­cent ar­ti­cle in the on­line magazine Aeon. His lat­est book, The Death of Ex­per­tise: The Cam­paign Against Es­tab­lished Knowl­edge and Why It Mat­ters cov­ers ground well-re­moved from the shores of naval war­fare; his ar­gu­ments are es­pe­cially rel­e­vant to health­care.

Over the past few months I have be­come concerned at some of the “ab­so­lute cer­tainty” state­ments em­a­nat­ing from self-styled ex­perts in the field of health. The me­dia (this news­pa­per in­cluded) has rightly given voice to a va­ri­ety of opin­ions; how­ever, my sense is that some of these opin­ions have be­come so ab­so­lutist and dog­matic as to in­hibit healthy dia­logue.

In Ni­chols’s view, “over­con­fi­dence leads ex­perts not only to get out of their own lane and make pro­nounce­ments on mat­ters far afield of their ex­per­tise, but also to ‘over­claim’ wider ex­per­tise even within their own gen­eral area of com­pe­tence. Ex­perts and pro­fes­sion­als ... as­sume that their pre­vi­ous suc­cesses and achieve­ments are ev­i­dence of their su­pe­rior knowl­edge, and they push their bound­aries rather than say the three words that ev­ery ex­pert hates to say: ‘I don’t know.’ ”

A rea­son­able doubt

Emerg­ing as it has in tan­dem with a wide­spread phenomenon of false news, such supremacy of ex­per­tise feeds a wor­ry­ing trend: the ig­nor­ing of sci­en­tific ev­i­dence – as seen, for ex­am­ple, among those who are against vac­ci­na­tion – be­ing met with a thun­der­ous Redemp­torist-like re­sponse where the ex­pert re­fuses to ut­ter even the slight­est hint of rea­son­able doubt. Com­bined, the ef­fect is one of shock and awe – a pow­er­ful force of alien­ation for read­ers, view­ers and lis­ten­ers, es­pe­cially the fake news fol­low­ers.

“Of all the cat­e­gories of fake news, health news is the worst” ran a re­cent head­line in the At­lantic. Ac­cord­ing to Kelly McBride, vice-pres­i­dent of the Poyn­ter In­sti­tute, the current jour­nal­is­tic en­vi­ron­ment of quick story turnover cre­ates ad­di­tional prob­lems for sci­ence news, be­cause “the cy­cle of jour­nal­ism and the cy­cle of sci­ence are com­pletely in­com­pat­i­ble”.

McBride sus­pects that health news may be at a tip­ping point of bad in­for­ma­tion, where the au­di­ence dis­trusts the mar­ket­place of ideas, which, she says, “is re­ally dan­ger­ous when it comes to health­care”.

A Kim Jong-un style of ex­per­tise doesn’t ap­pre­ci­ate this dan­ger. Nor does it ac­knowl­edge the ephemeral na­ture of med­i­cal re­search. Most new med­i­cal stud­ies are wrong and can­not be repli­cated – not be­cause of fraud but be­cause of gen­uine hu­man er­ror. True ex­per­tise looks past the new­est sci­ence to where knowl­edge has ac­cu­mu­lated over time. It val­ues caveat over con­clu­sion.

Bad at pre­dic­tive

Ni­chols points to another prob­lem for ex­perts: pre­dic­tion. “It’s what the pub­lic wants, but ex­perts usu­ally aren’t very good at it. This is be­cause they’re not sup­posed to be good at it; the pur­pose of sci­ence is to ex­plain, not to pre­dict. And yet pre­dic­tions, like cross-ex­per­tise trans­gres­sions, are cat­nip to ex­perts.”

Over the last few months I have be­come concerned at some of the ‘ab­so­lute cer­tainty’ state­ments em­a­nat­ing from self-styled ex­perts in the field of health

Ex­perts can be broadly di­vided into two cat­e­gories: hedge­hogs (who know one big thing) and foxes (who know many things). Hedge­hogs tend to be overly fo­cused on gen­er­al­is­ing their spe­cific knowl­edge to sit­u­a­tions that are out­side of their com­pe­tence, while foxes are bet­ter able to in­te­grate more in­for­ma­tion and to change their minds when pre­sented with new or bet­ter data. Foxes self-crit­i­cal, point-coun­ter­point style of think­ing pre­vents them from build­ing up the sort of ex­ces­sive en­thu­si­asm for their pre­dic­tions that hedge­hogs dis­play for theirs.

“Pro­fes­sion­als must own their mis­takes, air them pub­licly and show the steps they are tak­ing to cor­rect them,” Ni­chols con­cludes.

And as some­one who has ex­pe­ri­enced the power of “I don’t know” both as a doc­tor and a jour­nal­ist, may I gen­tly sug­gest that “ex­pert” health opin­ion writ­ers and com­men­ta­tors adopt the hu­mil­ity in­her­ent in the phrase?

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