Thread by @medrants

1/ #UncleBob asks you to consider the implications of the famous Nietzsche quote, “There are no facts, only interpretations” These tweets inspired by following @VPrasadMDMPH
We all interpret data differently weighing the risks & benefits.

2/ How else can one explain competing guidelines? Committees look at the same data and make different recommendations. This is the potential flaw in "evidence based medicine".
Confirmation bias influences all these decisions.

3/ The critical care community developed a very aggressive guideline for early treatment of possible sepsis. The ID community left the joint committee and wrote a strong editorial about the risk of over use of antibiotics secondary to this guideline.

4/ Our beliefs in school opening during the time of COVID19 are strongly influenced by confirmation bias. The press talks constantly about the devastation of COVID, but much less about the consequences of our actions to limit the spread of COVID.

5/ Most debates in medicine involve interpretation and values. Until we start making these values and their resultant risks and benefits explicit, our debates have little probability of resolution.

6/ I suspect that all who read this can give important examples of such debates. Explore the unintended consequences (economists call these negative externalities) of our decisions. Rarely do politicians. Perhaps we can be more transparent in our decision making.