PrintOur columnist explores why many “experts” base their conclusions on a singular experience—and shouldn’t.
I met someone at a party the other day, and he asked me about a problem that his horse had. Before I could respond, the partygoer standing next to me (drink in hand) jumped in and told the person what the diagnosis was, what he needed to do and what the horse’s problem was going to be in recovery.
The slightly inebriated “expert” then looked to me for affirmation. Now that the complicated things had been explained, I evidently could fill in the details.
My response was that perhaps his friend was right, but the problem in the explanation was obvious. He waited to hear what the problem was while the “expert” left to find more wine.
Now that I had a clear field, I explained: “You’re N=1.”
I got puzzled looks all around. N is the number of patients in your experiment. So my friend who asked the question and the local “expert” most likely have one horse in their knowledge base on this particular problem. Most veterinarians who practice sport horse medicine will have hundreds, if not thousands, of N in their data or knowledge base. So whom do you want to believe?
Oddly enough, the answer is complicated by human nature.
You want to believe your experiences, or those of your close associates.
A famous historian pointed out that we’re simply the sum of our previous experiences, so if it hasn’t happened to us it doesn’t exist in our worldview. This is the argument for a liberal (not leftist, just widespread) education. It teaches us that many things have happened outside of our experiences, and it teaches us a rational way to evaluate that information.
The other complicating factor is that horse sports are filled with rugged individualists who consider riding and caring for horses an art form. Some are loath to apply science to the individual truths that they can only find on the back of a horse.
I agree that many elements of riding and understanding the horse’s mind are, and will always be, an art form. Science can contribute to these artistic aspects of horsemanship, but modern equine medicine is definitively a science.
So horse sports, like many fields of human endeavor, have their fair share of self-taught “experts” who are happy to share their N=1 of wisdom but don’t really understand many of the details.
Just The Evidence
Veterinary medicine also has its fair share of rugged individualists. We have to struggle to remain objective in what’s very much a relationship-based industry. One way that this is done is called evidence-based medicine. This simply says, “when you make a statement or a treatment reg-ime, try to base it on science instead of what you think the answer is.”
For example, the other day a referring veterinarian asked how many cases of a new regenerative therapy procedure we’d done. My impression was that we’d done several hundred. I queried our database for the facts and found, surprisingly, that we’d done slightly more than 100.
Impressions and single-case stories will quickly lead you down the primrose path, and while they sound great, they should be avoided. If you’re actually practicing evidenced-based medicine you’ll not only stay current on the veterinary articles in your area of interest, but will also research a question when it’s asked of you.
