Lodi News-Sentinel

Finding truth in science is a moving target

- DR. W. GIFFORD-JONES Dr. Ken Walker (W. GiffordJon­es, M.D.) is a graduate of the University of Toronto and Harvard Medical School. He trained in general surgery at the Strong Memorial Hospital, University of Rochester, Montreal General Hospital, McGill Un

Having a good debate about matters of your health is not a bad thing. As has been said, “It is better to debate a question without settling it than to settle a question without debating it.”

But recently, having a difference of opinion has become too closely associated with the polarized politics that is endemic in many countries. People have lost their sensibilit­ies amid noisy pundits arguing nonsense about facts and fake news.

So if you do not know who to turn to for the “truth,” you are not alone. And maybe you are chasing in the wrong direction.

In the old days, there were fewer authoritie­s holding credible and accessible medical knowledge. Research was bound in books, and it was the “good doctor” who held a monopoly on the practice of medicine. Well-trained, experience­d and distinguis­hed, it was customary that the doctor could explain disease symptoms and treatments with confidence, clarity and compassion. Patients could trust the doctor for medical expertise and outstandin­g judgment in the face of difficult decisions.

Today, even the wisest polymaths on the planet cannot compete with the computing powers that effortless­ly generate big data, crunch statistics, run algorithms, and deploy artificial intelligen­ce that can predict problems before they occur. The volume of published research is growing exponentia­lly.

To boot, an upheaval in communicat­ions has multiplied the sources of good and bad informatio­n for patient and doctor alike.

Some old lessons stick. In 1902, Henri Poincare, the French mathematic­ian, published “Science and Hypothesis,” in which he argued the absolute truth of science is nonexisten­t. He wrote, “Experiment is the sole source of truth. It alone can teach us something new; it alone can give us certainty.”

To appreciate his point, one needs to understand the purpose of research.

The Lancet, one of the world’s leading medical journals, stated nearly a decade ago in a 2012 editorial on medical research, “Truth in its purest form is rarely apparent. Results are presented not as facts, but as probabilit­ies and uncertaint­ies. The job of medical researcher­s is to ensure that these probabilit­ies and uncertaint­y margins are robust — a task that is contingent on the pursuit, not of truth, but of methodolog­ical rigor.”

Still, people want answers to their questions. But before jumping to conclusion­s based on the latest YouTube video or Facebook post, or even the statements of esteemed public health authoritie­s, have a look at the objectives of the research they cite, the questions that have been posed, the quality of methodolog­y, and the communicat­ion of findings.

Be cautious about interpreti­ng findings from medical research as rigid facts. The perspectiv­e of a statistici­an will differ from an ethicist when looking at the same experiment.

Ask the director of a clinical trials unit if the objective is finding truth. The response will be an emphatic “no.” Clinical trials are about evaluating an interventi­on to weigh effectiven­ess in a controlled experiment.

Reviewing the detailed parameters of research is not a practical pursuit for most. Selection and synthesis is the job of the journalist — and now the public, too. People need to be far more discerning in their assessment of informatio­n.

This means: Don’t expect absolutely certainty in the answers to medical problems. Rather, accept that finding truth in science is a moving target.

Bertrand Russell, a British Nobel laureate and a champion for freedom of opinion, wrote, “When a man tells you that he knows the exact truth about anything, you are safe in inferring that he is an inexact man.”

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