ILLUSION

ILLUSION can be more dangerous than ignorance.

I will present today at the Guidelines International Network meeting on DynaMed Plus: Unique value for developing, updating and disseminating guidelines. Here are two quotes from my introduction:

If we don’t know whether treatments work or not, we can be honest in our decision-making, even it makes decision-making more complicated. If we overly simplify it by providing the ILLUSION of certainty (sounds easier) we can really get into serious trouble.

Postmenopausal hormone replacement therapy used to be standard of care for prevention of heart disease based on an ILLUSION of efficacy derived from observational studies. Many in the world were surprised when randomized trials found it ineffective compared to placebo and, considering the risks of breast cancer and other adverse effects, it suddenly became recommended against.

This ILLUSION problem in medicine can also steer us away from effective treatments.  Absence of statistical significance (often with data suggestive of efficacy but too small a sample size for statistical significance) has been frequently overinterpreted as factual representation of no effect.

The ILLUSION problem is not unique to medicine. Anywhere we consider decision-making the ILLUSION can lead us astray from the reality. Don’t let the state of being busy and active become an ILLUSION of being productive and meaningful.