SIMPLE

“Genius is the ability to reduce the complicated to the SIMPLE” – C.W. Ceram

Determining what evidence and guidance is trustworthy is complicated by

• the many factors to consider – methodologic factors that introduce risk of bias, conflicts of interests, statistical factors considering chance effects and variability in measurement, absence of “repeating the same experiment” in medicine, publication bias, variations in language interpretation, variations in judgments/values/preferences, challenges in gauging similarity of studies when interpreting consistency/inconsistency of findings, indirectness of populations studied or measures used compared to the realities for which we wish to conclude
• the relative effect of each of these factors -- Can I trust this? is not a yes/no question – it is a degree of how confident or certain or trustworthy the results are
• the lack of true quantitative methods to convey the degree of trust

Yet we have made this relatively SIMPLE for clinicians and policy-makers to understand. While traveling I had conversations with physicians from multiple countries where English is not their first language and they find the DynaMed level of evidence ratings (and explicit basis statements to explain them) a critical reason to use DynaMed rather than textbooks or other systems where they can’t tell what they can trust, how well they can trust it, and why. I hear the word SIMPLE a lot lately as feedback conveying high praise for providing a high value.

“If you can’t explain it to a six year old, you don’t understand it yourself” – Albert Einstein

DynaMed is relatively SIMPLE but not quite SIMPLE enough for your 6-year-old relative to use it.

But anywhere we are STORYTELLING, anywhere we are trying to express our views, anywhere we are trying to convey a concept – the more SIMPLE we can make our explanation the better our story will be. Whenever I draft a message, a paper, or a presentation the next immediate step to improve it is to make it more SIMPLE, to make it more concise, to make it less complex. And when doing that I often achieve a better understanding of the concepts as well.

We do, however, need to avoid OVERSIMPLIFICATION. It is better to be appropriately confused than inappropriately certain.