Evidence Based Practice and Self-Deception

Evidence Based Practice and Self-Deception

All people, both you and I are susceptible to deception and self-deception.

Some people say ‘the treatment worked’ but they don’t realize that their personal experience is no basis for proof that the treatment indeed is or was effective.

All they can claim is that they have noticed an improvement after the treatment. This may indicate a real effect, but it may also be an inaccurate observation or a post hoc ergo propter hoc fallacy reasoning, incorrectly assuming that succession in time necessarily indicates a causal link.

Some say: ‘People who defend a scientific and evidence-based osteopathy do not seem to have confidence in what they see happening to their own eyes.’

The whole process of seeing is in itself largely an interpretation of the brain. We have two blind spots in our field of vision, and we are not even aware of them. I saw with my own eyes how a magician sawed a woman in two, but it was an illusion, a false perception. I saw how a patient got better after treatment, but my interpretation that the treatment was the cause of this improvement can be a mistake, based on a wrong attribution.

Why do we often have the impression that some treatments work: some possibilities:

  • The affection just followed its normal course and lots of affections heal spontaneously.
  • Many diseases and syndromes have a cyclic pattern whereby there are better and worse periods.
  • We are all subject to suggestions.
  • Maybe there was also another treatment, maybe medication?
  • The original diagnosis could have been wrong.
  • Temporary mood improvement is often mistaken for healing.
  • Correlation and causality are often misinterpreted.
  • It is not because an effect in time follows a certain action, that that action is necessarily also the cause of the effect. When the rooster crows and the sun rises, we usually realize that it is not the crows that make the sun rise.

There are so many ways to be wrong.

Fortunately, there is also a way in which we can ultimately get it right: scientific research. There is nothing mysterious or complex about the scientific method. In essence, it is just a handy toolbox full of sensible ways to test things.

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