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In the Eye of the Beholder

Janet E. Hux, MSc, MD, SM, FRCPC; C. David Naylor, MD, DPhil, FRCPC
Arch Intern Med. 1995;155(21):2277-2280. doi:10.1001/archinte.1995.00430210025004.
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Over the last 25 years the randomized clinical trial and the science of clinical epidemiology have begun to reshape the way medicine is practiced and taught, replacing anecdote and tradition with concrete quantitative data. During the same period, cognitive psychologists have demonstrated that the interpretation of quantitative data may be substantially influenced by the manner in which the data are presented.1,2 Early work by McNeil et al3 suggested that physicians' interpretations of treatment outcomes are not immune to such cognitive biases. That the results of properly conducted trials of medical interventions should have an impact on the application of those interventions in clinical practice is indeed encouraging. But, that the magnitude and even the direction of that impact should depend on the numeric presentation of the results is cause for concern. A number of recent studies4-12 have convincingly demonstrated that both physicians and patients are susceptible to


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