Devil’s advocate: Let the facts speak for themselves

Due to the thought leadership of Yoda and Obi-Wan, 390,000 people declared their Jedi beliefs in the 2001 census. But many areas of literature are dominated by ‘thought leadership’, rather than what we might consider research evidence.

In 2005, influential guidelines on the management of occupational asthma were published. Many of the recommendations were firmly based on research evidence others were not. For example, the experts recommended annual health surveillance even in the total absence of any evidence of the most appropriate time interval. These guidelines have had little challenge, but have now been cited in more than 70 journal articles.

Another influential report has been the review Is work good for your health and wellbeing? This was, of course, not published in a medical journal with any associated critique. The entirety of the report seems to have been accepted by occupational health practitioners as work and health dogma.

The report concludes: “there is a strong theoretical case, supported by a great deal of background evidence, that work and paid employment are generally beneficial for physical and mental health and wellbeing”. The authors rightly refer to the strong case being theoretical. There is no data to back the authors’ own evidence statements of a benefit to physical health: two of the three ‘supporting’ reports are opinion, and the other relates solely to mental health.

It’s not that we should begin to proclaim that work isn’t generally good for your physical health after all. Rather, it’s about time we started to critique systematic reviews of evidence and fillet out what the evidence says from what the reviewers say. We should be especially careful when reports are funded by agencies with a specific interest, especially if they have any editorial role, and when they are not published in the mainstream health journals where they are naturally exposed to mechanisms that enable expert commentary.

There is compelling evidence that Jedi beliefs are widely held in England and Wales. The Office for National Statistics suspects that this is most common among people in their late teens and twenties, and “may well have encouraged people to complete their [census] forms”. The high prevalence of Jedi-ism is evidence-based. The possible high prevalence in specific age groups and contribution to census participation are expert opinion.

If Jedis truly are in their late teens and twenties, it should be easy to show that this religion is enjoying better health than others declared in the 2001 census. But before we rush in and extol the theoretical health benefits of Jedi-ism, we might want to heed Yoda’s advice: “Grave danger you are in. Impatient you are.”

In the era of evidence-based occupational health, there is a very real danger of mixing up the interpretation of evidence with the actual evidence. Let us not confuse expert opinion with evidence. The currency of evidence should be measured by its exposure to informed debate and challenges, not the stature of its authors.

Comments are closed.