Short rant on definitions:
I keep getting invitations from researchers who seek to "develop a standardised definition" of X. Such pursuits are usually futile and counterproductive. We need a standardised kilogram but not a standardised way of talking about how the world is.
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The American Pragmatist Charles Sanders Peirce (thanks for the intro, @MisakCheryl) said “Nothing new can ever be learned by analysing definitions”. Rather, we need to understand how a concept is used and what it contributes to our understanding.
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In the context of Covid-19 (to take one complex phenomenon which people seek to rationalise), we need to look at the problem in multiple different ways from different angles.
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We won't enrich our understanding by demanding consistent definitions or ways of expressing what are essentially qualitative phenomena. We need deliberation and mutual enlightenment, not technocratic standardisation.
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I've just been invited to contribute to the development of a standardised definition of "sustainability", for example. I refused. The term is used by different people in different ways because that's how language works. Plus, meanings *evolve* as our lives and language evolve.
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Well-meaning efforts to produce "standard definitions" are also about scientific power. Invite people whose views you value (and, often, share) to contribute to the definition. Bingo, you control how a word gets to be used "correctly" and "incorrectly".
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This drive to control our scientific language should not be mistaken for "rigour". It is misguided and potentially sinister. Let's talk about stuff, look at how words and concepts are used in real world settings, and strive for understanding, not control. 7/ end of rant
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Thread on our new state of the science review on #LongCovid. Commissioned by @TheLancet, peer-reviewed, coauthored with @sivanmanoj, @calirunnerdoc and Janko Nikolich. Link for free access is here (after 50 days that won’t work, then you’ll have to register and use this one:
1/kwnsfk27.r.eu-west-1.awstrack.me/L0/https:%2F%2… thelancet.com/journals/lance…
In writing this article, we wanted to get the basic science of Long COVID into dialogue with the clinical management of this condition and the patient lived experience. @calirunnerdoc brought lived experience to our author team. 2/
@calirunnerdoc Most but not all definitions of Long COVID put the cut-off at around 12 weeks (that is, if you’re still symptomatic 12 weeks after your initial COVID-19 infection, you’ve got Long COVID). 3/
It’s out! Our new state-of-the-science review of MASKS/RESPIRATORS in reducing transmission of respiratory infections. 13 authors (for our disciplines, see posts 3-4). 38000 words. 413 references. One conclusion: these devices work. For detail, read on. 1/ journals.asm.org/doi/10.1128/cm…
The commissioned review, which was independently peer-reviewed, had 3 objectives: 1. Summarize the evidence on masks/masking. 2. Examine why this evidence is so widely misunderstood, misinterpreted, or dismissed. 3. Outline an agenda for future research. 2/
Author team was chosen for breadth of expertise, including: public health, epidemiology, infectious diseases, biosecurity, fluid dynamics, materials science, mathematical modeling, data science, clinical trials, sociology, anthropology, psychology, and occupational hygiene. 3/
BREAKING
The senior officers of the Royal College of Physicians commissioned a survey of MRCPs’ views on physician associates (PAs). They have today released the actual findings, but the back story is shocking. I’ll link to the raw data at the end of this 🧵.
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We now know that senior officers presented a flawed and distorted version of the findings at the Extraordinary General Meeting on 13th March 2024. Here’s my thread on that presentation (from before I’d seen the actual results). 2/
Of note is that after an outcry, the senior officer who presented the slides at the EGM resigned. He can tell his own story there. I am hearing he did not make the slides but was told he had to present them.
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At yesterday’s #RCPEGM, a senior officer presented the results of a survey of MRCPs on their views about Physician Associates (PAs). They unwittingly supplied some good teaching material about how NOT to go about doing a questionnaire survey and how NOT to report the results.
Here’s the first slide after the title slide. What do you notice? They jump straight into “methodology”. Students, don’t do this! Start with a RESEARCH QUESTION!! You must be clear what EXACTLY you want to find out, and from whom. Ideally, state some HYPOTHESES.
Here's the six questions that were sent out to MRCPs. Notice how the choice of words narrows the issue being explored. No Qs are asked about primary care (where PAs are seeing undifferentiated patients), yet RCP seeks to certify PAs for working in primary care.
Around one in 4 consultations in general practice occurs remotely (usually by telephone but sometimes as video or asynchronous e-consultation). Appointment booking and triage usually occur remotely too.
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Since the pandemic began, UK policy (especially English policy) has swung from ‘remote by default’ to ‘everyone has a right to a face to face consultation’. GP land is busy, has major workforce issues (esp not enough doctors) and is creaking under the strain of task-shifting.
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Our paper on safety in remote GP consultations is getting a lot of coverage. Shout out to @oohGPwales who was lead author and analysed the 95 tragic safety incidents. 1/ 🧵
But NOTE: this paper is MAINLY about how remote care in GP land is remarkably SAFE. We followed 12 GP practices for 2y, looking for (among other things) evidence of patient harm from remote consultations. We found NONE.
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Staff in these 12 GP practices took a lot of measures to make sure that safety incidents didn’t happen. They often told patients “sorry you can’t have a phone consultation for that problem, you need to come and be examined”.
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