Burying the Evidence
Displaying successes while hiding failures can make an intervention appear more effective and less risky than it is. Taleb illustrates this selection problem with delayed harms from historical radiation treatments.
THE IDEA
BURYING THE EVIDENCE
Taleb argues that medicine can mislead when successes are displayed while failures disappear from view, sometimes because patients have died before the harm is recognized.
He gives a historical illustration of intervention bias. In the 1940s and 1950s, he reports, many children and teenagers received radiation for acne, thymus gland enlargement, tonsillitis, to remove birthmarks and treat ringworm of the scalp. In addition to the goiters and other late complications, approximately 7 percent of patients who received this radiation developed thyroid cancer two to four decades later. Taleb then speculates that low radiation doses might be protective and questions the motives behind sun-protection products. The passage provides no evidence establishing either claim. They do not follow from the evidence-selection argument or from the length of human exposure to sunlight.
When to use it
Evaluating the effectiveness of medical interventions by accounting for unpublished negative outcomes
Assessing historical events or technologies where failures are systematically underreported
Making personal health decisions by seeking balanced information on risks and benefits
Analyzing investment strategies that ignore losses while trumpeting gains
FROM THEORY TO EVERYDAY LIFE
In practice
Radiation treatment for childhood conditions
Taleb reports that children and teenagers received radiation for conditions such as acne and ringworm in the 1940s and 1950s, and that approximately 7% of those treated developed thyroid cancer decades later. His example concerns delayed harms that an initial record of treatment outcomes can miss.
A MOMENT TO REFLECT
Put it to work.
How might burying evidence affect your perception of medical treatments?
Can you identify a situation in your field where successes are displayed but failures are hidden?
What are the implications of intervention bias for policy making and personal decisions?
CONTINUE THE CONVERSATION
Source texts
- Antifragile (Nassim Nicholas Taleb)