Key concepts for making informed choices

Aronson, Jeffrey K.; Barends, Eric; Boruch, Robert; Brennan, Marnie; Chalmers, Iain; Chislett, Joe; Cunliffe-Jones, Peter; Dahlgren, Astrid; Gaarder, Marie; Haines, Andy; Heneghan, Carl; Matthews, Robert; Maynard, Brandy; Oxman, Andrew D.; Oxman, Matt; Pullin, Andrew; Randall, Nicola; Roddam, Hazel; Schoonees, Anel; Sharples, Jonathan; Stewart, Ruth; Stott, Janet; Tallis, Raymond; Thomas, Nerys; Vale, Luke

Abstract

An alliance of researchers lays out a framework for taking decisions based on thinking critically about claims and comparisons. Everyone makes claims about what works. Politicians claim that stop and search will reduce violent crime; friends claim that vaccines cause autism; advertisers claim that natural food is healthy. One group of scientists claims that "deworming" programmes (giving deworming pills to all school children in affected areas) improve school performance and health, calling deworming one of the most potent anti-poverty interventions of our time. Another that deworming does not improve either school performance or health. Unfortunately, people often fail to think critically about the trustworthiness of claims, including policy makers weighing claims made by scientists. Schools do not do enough to prepare young people to think critically 1. So many people struggle to assess the trustworthiness of evidence. As a consequence, they may not make informed choices. To address this deficit, we present here a general tool: Key Concepts for Making Informed Choices (Table 1, with examples in Box 2). We hope scientists and professionals in all fields will use, evolve and evaluate it. The tool was adapted, drawing on the expertise of two dozen researchers, from a framework developed for healthcare 2 (Box 1). Ideally, the Key Concepts for Making Informed Choices should be embedded in education for citizens of all ages. This should be done using learning resources and teaching strategies that have been evaluated and shown to be effective. Trustworthy evidence People are flooded with information. Simply giving them more is unlikely to be helpful unless its value is understood. A recent survey in the UK showed that only about a third of the public trust evidence from medical research; about two-thirds trust the experiences of friends and family 3. Not all evidence is created equal. Yet people often don't appreciate which claims are more trustworthy than others; what sort of comparisons are needed to evaluate different proposals fairly; or what other information needs to be considered to inform good choices. For example, many people don't grasp that things can be associated without one necessarily causing the other. The media sometimes perpetuates this problem by using language suggesting that cause-and-effect has been established when it has not 4 , using statements such as "coffee can kill you", or "drinking one glass of beer a day can make you live longer". Worse, exaggerated causal claims often pepper university and journal press releases 5. Studies that make fair comparisons are vital, yet people often don't know how to assess the validity of research. Systematic reviews that synthesise well-designed studies relevant to clearly-defined questions are more trustworthy than haphazard observations; they are less susceptible to biases (systematic distortions) and the play of chance (random errors). Yet results from single studies are often reported in isolation, as facts. Hence the familiar flip-flopping headlines such as "chocolate is good for you", followed the next week by "chocolate is bad for you".

Citation

Aronson, J. K., Barends, E., Boruch, R., Brennan, M., Chalmers, I., Chislett, J., Cunliffe-Jones, P., Dahlgren, A., Gaarder, M., Haines, A., Heneghan, C., Matthews, R., Maynard, B., Oxman, A. D., Oxman, M., Pullin, A., Randall, N., Roddam, H., Schoonees, A., Sharples, J., …Vale, L. (2019). Key concepts for making informed choices. Nature, 572(7769), 303-306. https://doi.org/10.1038/d41586-019-02407-9

• Journal Article Type: Article
• Acceptance Date: Aug 12, 2019
• Online Publication Date: Aug 12, 2019
• Publication Date: Aug 15, 2019
• Deposit Date: Oct 31, 2019
• Publicly Available Date: Oct 31, 2019
• Journal: Nature
• Print ISSN: 0028-0836
• Electronic ISSN: 1476-4687
• Publisher: Nature Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 572
• Issue: 7769
• Pages: 303-306
• DOI: https://doi.org/10.1038/d41586-019-02407-9
• Keywords: Multidisciplinary
• Public URL: https://nottingham-repository.worktribe.com/output/2999501
• Publisher URL: https://www.nature.com/articles/d41586-019-02407-9
• Contract Date: Oct 31, 2019