Thread by @VincentRK

If you have smoldering multiple myeloma, a type of blood disorder, you could see 4 experts and come away with 4 different options:

1) No treatment
2) Mild treatment with 1 drug
3) Cancer like treatment with 3 drugs
4) Aggressive treatment including bone marrow transplant

Of course truth is that one of the treatment options is right. But how is a patient to decide which option will provide the best quality and quantity of life? Which expert to trust?

For each patient there is one right answer and the truth is not necessarily in the middle.

The point is that complex medical problems, whether it is smoldering myeloma, or cancer, or COVID have a lot of variables that need to be considered to make the right call.

Some experts make the right call because they have the ability assess all variables. Some do so by luck.

But it may be harder to come to the right decision by consensus of experts or group think. Which is why a lot of expert consensus recommendations ends up being the lowest common denominator: the one that everyone can live with. Wishy washy.

A consensus decision could well be wrong. And if so then it has more serious repercussions because now everyone is following the wrong advise. At least when each one followed their own favorite expert at least some people by average would end up doing the right thing.

If there is a meeting of the minds it's more helpful to have perspectives from experts in various fields rather than 5 experts with similar skill sets.

I don't have answers. In my field, I go back and forth from one single expert opinion to consensus depending on the question.

But it's something I have seen over and over in this pandemic. We have examples of individual people being right on something when the collective wisdom of a consensus group of experts was wrong. So it's worth considering.