CERTAINTY
James suggested CERTAINTY for today’s word.
Beware of a false sense of CERTAINTY - “It ain’t what you don’t know that gets you into trouble. It’s what you know for sure that just ain’t so.” (Mark Twain)
More than 100 leaders and experts in the development of guidelines and systematic reviews met recently and grappled with the semantics of quality of evidence, confidence in the results, and CERTAINTY. Although many considered these concepts interchangeable I believe they are co-dependent but not the same.
To be clear I think CERTAINTY is confidence. Moderate certainty is moderate confidence. Certainty and confidence are interchangeable and represent our degree of belief that something is true.
QUALITY of evidence is a representation of how well the methods and findings support the conclusions derived from the evidence. We are getting better every year about making quality assessment more objective, more clear, more transparent, more reproducible.
In most cases high-quality evidence leads to a high degree of certainty, and low-quality evidence leads to a low degree of certainty. But there are times when we consider evidence that is not clearly specified in forms of rating “quality” (even when applying CRITICAL thinking). In these situations we can have a mismatch between the QUALITY of what we assess and the CERTAINTY of what we conclude.
For DynaMed we approach this when making recommendations by clearly labeling the different concepts of QUALITY of evidence for conclusions about expected effects (expressed as levels of evidence for evidence conclusions) and CERTAINTY of the likelihood that desirable consequences outweigh undesirable consequences (expressed as strength of recommendations).
But QUALITY is usually the primary determinant of CERTAINTY. As I look at the QUALITY of our work, our team, our processes, and our systems (high, but improvement still needed to get from great to exceptional) I have a high CERTAINTY that we will succeed (but improvements will continue to increase our likelihood of success).
To IMAGINE something else – Brian shared a link to the photo of the peace sign with 2,000 people, but not the record breaking 5,000, at
https://www.cbsnews.com/pictures/yoko-ono-human-peace-sign-john-lennon-birthday/2/