Evidence

When I was in medical school, we spent a lot of time learning about evidence. The only way we could make good decisions was to base them off of good evidence. And so, we learned about what constituted evidence, how to critically appraise evidence, how to consider the risks and benefits, what are the ways to understand different methodologies and practices, and how to understand hidden biases.

So when I first saw the Covid studies coming out in the early Spring, I was really shocked, because we were setting global health policies on extremely shoddy evidence. Half the time, we were basing direct patient care that day on what new preprint* had just come out. None of us really knew if HCQ had done anything whatsoever. We were reacting, based on bangs and flashes, like an animal scared by lightning.

And colleagues assailed and harangued me for doubting the wondrous effects of HCQ, based on the anecdotes they had heard. And when we were scolded as a profession for hoarding and stockpiling HCQ for personal use, several colleagues got defensive and belligerent, clearly caught with their hands in the cookie jar.

I've been surprised by how people act during this pandemic. I have seen a lot of questionable things done, and the reality of the situation is that when you don't know what to do next, then sometimes people will do anything, because anything is something, and something is better than nothing. There's a reason why I have that quote, "ut aliquid fieri videatur". Sometimes in medicine, we do things not because it's right, but so that we look like we did something.



*A preprint is a submission to a journal for publication, not yet peer reviewed.

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