"At one time we had truth and lies. Now we have truth, lies, and statements that may not be true but we consider too benign to call false." Ralph Keys
Of course, it doesn’t stop there! Then we get commentary and
analysis via bloggers. Here’s an example
of a nice balanced piece by Neil O’ Connell who was a member of the guideline
committee. KarenMiddleton added her view on how the
guideline marks an important moment for the physiotherapy profession,
emphasising the ‘opportunity to evolve and look again at practice and
re-evaluate what is best for patients.’ … the guideline gives clear wording (italics for emphasis) on
that, and naturally is disappointing for some, yet welcome to others.
Naturally,
as is the way of the World, we get the bloggers, sceptics and Twitterati who
also helpfully summarise the guideline, and it is here where things begin to get
a little messy. What is clear, to us all in the ‘modern World’ is that there is
little time to read long documents, and it is human nature to look for short
cuts (so far so good). So in many fields such as medicine, pharmacy and
physiotherapy we have the rise of the ‘infographic’ …
Now, don't get me wrong here, infographics are brilliant, because they are short snappy and summarise long papers in one interesting and attractive figure. I you’ve never seen the work of Yann Le Meur … then you should. The artistry, accuracy and attention to detail, is both impressive and incredibly useful to visual learners.
Now, don't get me wrong here, infographics are brilliant, because they are short snappy and summarise long papers in one interesting and attractive figure. I you’ve never seen the work of Yann Le Meur … then you should. The artistry, accuracy and attention to detail, is both impressive and incredibly useful to visual learners.
HOWEVER
not all infographics … how shall I say … meet this exacting standard.
It
became apparently obvious to me, that writing an infographic allows the writer
to interpret something like a guideline, pretty much any way they want (just as
Bloggers and internet commentators do), Herein, lies the rub …
IF the infographic writer, for one reason or another, chooses to alter the emphasis or wording, miss bit out, or get bits wrong … then the reader or recipient can be easily mislead.
So, you end up with a snap-shot that can misrepresent the original document. Which of course, means that ANYONE can create their own version of the evidence base via the medium of the infographic.
IF the infographic writer, for one reason or another, chooses to alter the emphasis or wording, miss bit out, or get bits wrong … then the reader or recipient can be easily mislead.
So, you end up with a snap-shot that can misrepresent the original document. Which of course, means that ANYONE can create their own version of the evidence base via the medium of the infographic.
HERE
the fun begins!
Below
I’ve written a short infographic (well ... some text and a picture) to help anyone create their own evidence base.
If you follow the simple instructions, you can make any, paper review,
guideline or article say exactly what YOU LIKE … it is a miracle!
Try it
yourself, adjust your favourite intervention, be it CBT, exercise, massage into
a slightly bigger font or place on the positive side of the table/graph/pie
chart in a slightly bolder colour etc. alter a word here and there (for
emphasis/de-emphasis) and before you know it, you’ve changed the message of the
original. You can even miss stuff out if you like, say radio frequency
denervation or manual therapy (it is entirely your choice), if that’s is
something you don’t particularly subscribe to.
Indeed
... if someone from the AACP had thought of it they could have re-inserted acupuncture
into the LBP guidelines and lots of folk would never have noticed (cos’ they
don’t have time to read the source document). That would of course, be
disingenuous, but hey ... politicians do it daily, and we wouldn’t have had Iraq,
Brexit or Donald Trump without a little (or more) distortion of the truth.
Where
does this leave us? And why did I even bother to put pen to paper?
Well it requires us to have a realisation that we are in the
‘post-truth era’ as detailed so well by Ralph Keyes in his book The Post-Truth Era:Dishonesty and Deception in Contemporary Life. Keyes states:
‘At one time we had truth and
lies. Now we have truth, lies, and statements that may not be true but we
consider too benign to call false. Euphemisms abound. We’re “economical with
the truth,” we “sweeten it,” or tell “the truth improved.” The term deceive gives way to spin. At worst we admit to
“misspeaking,” or “exercising poor judgment.” Nor do we want to accuse
others of lying. We say they’re in denial. A liar is “ethically
challenged,” someone for whom “the truth is temporarily unavailable.”’ Ralph
Keyes
Furthermore
he states …
‘We can only understand the
motives of such dissemblers by examining the sea in which they swim. Trends
ranging from the postmodern disdain for “truth” to therapeutic non-judgment
encourage deception. There is much incentive and little penalty for improving
the “narrative” of one’s life. The increasing influence of therapists, entertainers, politicians, academics, and lawyers, with
their flexible code of ethics, contribute to the post-truth era. So do ethical
relativism, Boomer narcissism, the decline of community, and rise of the
Internet.’
So
there you have it folks … we have to adjust our radars, improve our awareness,
be on our guard, even occasionally take the time to read a source document.
Because, sometimes those nice folks who wrote that blog may just have written it to fit their own biases, or particular agendas, and in the same way, the handy
visual snapshot of reality ... the infographic ... has sadly fallen foul of exactly the same
concept.
The dissemblers are amongst us, and I truly don't know why they behave that way.
(Source: http://www.skepticalaboutskeptics.org/)
Now ... just a brief word on sceptics ... AND pseudo sceptics
The medical World has its fair share of sceptics or skeptics (as they are known in the USA), Ben Goldacre of Bad Science, is perhaps one of the most well known examples, Edzard Ernst is another. These brave souls, speak out on any issues from, basic bad science, global warming, Government policy, Prince Charles and his promotion of homeopathy, through to the risks of spinal manipulation etc.
Good sceptics adopt an open minded approach and use science, debate, exposure (of bad practice) and apply critical examination and inquiry to all sides (including their own).
Here's an example; Ernst has been a long time critic of alternative medicine (AM), and frequently adverse events (e.g. death after SMT) and general poor scientific practice relating to all sorts of disciplines within AM. These range from the more unconventional stuff like 'energy healing', and 'spiritual healing', through to say 'slapping therapy', and perhaps the more conventional, such as acupuncture. As such, he is commonly aggresively vilified and challenged by proponents of such therapies. His response is kindly, gentlemanly debate (often in the face of virtual abuse), use of science, critique, statistics etc. BUT when evidence comes along to challenge his World view on a topic, he has the good grace and conduct, to modify his view according to the developing and changing evidence base, or at the very least, air that evidence.
Of interest to some physiotherapists (either historically or practically), MASSAGE had been a target of his for a number of years, until a new paper caught his eye and he wrote this and then later, this. Ernst is an example of how a GOOD honest sceptic is able to adapt their paradigm to new evidence and update their hypotheses to fit the data. In physiotherapy, SOME of our emerging breed of bloggers, podcasters and self-proclaimed sceptics are able to do that, and do it very well. SOME appear to default to the habits of pseudo-sceptics.
Pseudo-sceptics ... tend to:
Sceptic or denier?
'A sceptic will question claims, then embrace the evidence.
A denier will question claims, then reject (or bury) the evidence....'
and for a brilliant commentary on pseudo-skepticism by Marcello Truzzi go here.
So be on your guard people … it's a tough environment out there, and distinguishing truth from fiction in a post-truth World ain't easy ... false news, pervades every aspect of the internet, even those sources, you thought you could trust, AND relies entirely on a passive (non-thinking) click of a button. Those who use it to their advantage know that, and you should too ... if you don't already!
After all, that is what brought us Donald Trump. Good luck folks.
I’ll leave you with the wise words of Ralph Keyes who vocalises this much better than I ever could …
The dissemblers are amongst us, and I truly don't know why they behave that way.
Now ... just a brief word on sceptics ... AND pseudo sceptics
The medical World has its fair share of sceptics or skeptics (as they are known in the USA), Ben Goldacre of Bad Science, is perhaps one of the most well known examples, Edzard Ernst is another. These brave souls, speak out on any issues from, basic bad science, global warming, Government policy, Prince Charles and his promotion of homeopathy, through to the risks of spinal manipulation etc.
Good sceptics adopt an open minded approach and use science, debate, exposure (of bad practice) and apply critical examination and inquiry to all sides (including their own).
Here's an example; Ernst has been a long time critic of alternative medicine (AM), and frequently adverse events (e.g. death after SMT) and general poor scientific practice relating to all sorts of disciplines within AM. These range from the more unconventional stuff like 'energy healing', and 'spiritual healing', through to say 'slapping therapy', and perhaps the more conventional, such as acupuncture. As such, he is commonly aggresively vilified and challenged by proponents of such therapies. His response is kindly, gentlemanly debate (often in the face of virtual abuse), use of science, critique, statistics etc. BUT when evidence comes along to challenge his World view on a topic, he has the good grace and conduct, to modify his view according to the developing and changing evidence base, or at the very least, air that evidence.
Of interest to some physiotherapists (either historically or practically), MASSAGE had been a target of his for a number of years, until a new paper caught his eye and he wrote this and then later, this. Ernst is an example of how a GOOD honest sceptic is able to adapt their paradigm to new evidence and update their hypotheses to fit the data. In physiotherapy, SOME of our emerging breed of bloggers, podcasters and self-proclaimed sceptics are able to do that, and do it very well. SOME appear to default to the habits of pseudo-sceptics.
Pseudo-sceptics ... tend to:
- Persistantly judge as false, and debunk anything that contradicts their paradigm.
- Are partially interested in truth, evidence and facts, but MORE interested in defending their own views/stance.
- May fail to update their paradigm to incorporate new evidence, and deny or bury data which doesn't fit their view.
Sceptic or denier?
'A sceptic will question claims, then embrace the evidence.
A denier will question claims, then reject (or bury) the evidence....'
and for a brilliant commentary on pseudo-skepticism by Marcello Truzzi go here.
So be on your guard people … it's a tough environment out there, and distinguishing truth from fiction in a post-truth World ain't easy ... false news, pervades every aspect of the internet, even those sources, you thought you could trust, AND relies entirely on a passive (non-thinking) click of a button. Those who use it to their advantage know that, and you should too ... if you don't already!
After all, that is what brought us Donald Trump. Good luck folks.
I’ll leave you with the wise words of Ralph Keyes who vocalises this much better than I ever could …
‘Post-truthfulness builds a
fragile social edifice based on wariness. It erodes the foundation of trust
that underlies any healthy civilization. When enough of us peddle fantasy as
fact, society loses its grounding in reality. Society would crumble altogether
if we assumed others were as likely to dissemble as tell the truth. We are
perilously close to that point.’ Ralph Keyes
Be
careful out there folks … words matter, and semantics are important AND that is the TRUTH
HT to Woody Guthrie for being an inspiration - "It's afolk singers critical thinkers job to comfort disturbed people and to disturb comfortable people" ... see what I did?
HT to Woody Guthrie for being an inspiration - "It's a
Author: Alan J Taylor is a writer and critic who thinks about stuff and works as a Physiotherapist, University Assistant Professor
and Medico-Legal expert witness ... The views contained in this blog
are his own and are not linked to any organisation or institution. Like Bukowski, he 'writes to stay sane'.
