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The Post-Factual World: Reconciling It With Evidence-Based Practice

One of the great challenges we face in attempting to live in an evidence-based world and practice in an evidence-based manner is that we now effectively live in a post-fact world. Currently, we see this illuminated in politics, where presidential candidates seem to feel free to simply make up information; fact checking comes too late and counter-information or even non-information is passed off as simply true because it was said. The candidate can then count on his or her followers to pick up the false information and amplify it, so that the public at large is left feeling that it is possibly true, or perhaps left not caring since everyone seems to simply disagree on what is “real.”

Lest we think this is true solely in politics, this problems pervades science as well. One can easily find information and counter-information on any controversial topic and for many that are not. Consider climate change, effects of high-school sex education on pregnancy rates, whether smoking causes cancer, the highly controversial issue of vaccination, and so on. How can we begin to make sense of all this data?

For one, we first must admit to our own cognitive biases. We tend to look for information that supports what we already believe, and we tend to attack information that runs counter to what we believe. This is a well-understood phenomenon. This is the so-called “echo chamber” effect. We see this quite frequently in politics. Just go to your local bookstore and look at all the political books. You will those that support a hard-right point of view, and those that support the hard left. The likely purchases of those books are the people who already hold strong convictions on the right or left. Those books reinforce beliefs rather than challenge them. Even within our own profession, consider how we might respond to a significant positive paper about chiropractic, compared to a significant negative one. One will be touted and used for PR purposes, while the other will likely undergo both reasoned and emotional attack. In reality, our first column for this blog was about how not to react when negative information came out.

The truth is, you can find information on the web to support any point of view or perspective you have. Some of the information is simply not good. In the end, the best we can hope for is that we recognize our own biases, seek to limit them, and gain enough critical appraisal skills so help separate the wheat from the chaff. This requires effort on your part, but I think that the point here is that this will ultimately help your patient, since so often when we seek information it is in the effort to find effective treatment for our patients.

 

 

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