Cosma Shalizi on Twitter: “Of the Evaluation of Expertise (“I am not so good for that as an old roofer”) https://t.co/FXSnTJ4iF5″ / Twitter (and me on ‘medication adherence’)

This brilliant blog post using a conversational form to query prediction, expertise, practical action, and our expectations and ‘rationality’ around it was retweeted by David Chapman: http://bactra.org/weblog/1174.html

via Cosma Shalizi on Twitter: “Of the Evaluation of Expertise (“I am not so good for that as an old roofer”) https://t.co/FXSnTJ4iF5″ / Twitter

That led to me sharing one of my favourite little canters about ‘medication adherence’, cut-and-paste here as much for my own convenience as anything else:

‘Medication adherence’ is brilliant for this. I’ve seen (but can never find) a paper which puts the number of people who – fill the prescription and – take the medicine – in the recommended way – to the recommended course to be in the teen%s.

and this is with *every aspect of the symbolism of General Practitioners reflecting courtly ritual of time spent visiting the Monarch*! (Ooh – and you have to factor in the %age doctors got the right medication and wrote it down correctly, and legibly)

and the literature seems… thin… and vague… There’s a suspiciously round figure of 50% reported a lot ncbi.nlm.nih.gov/pmc/articles/P and there seem to be few really predictive factors ncbi.nlm.nih.gov/pmc/articles/P

“40-60% of patients could not correctly report what their physicians expected of them 10-80 minutes after they were provided with the information.” “over 60% of patients interviewed immediately after visiting their doctors misunderstood the directions”

This literature review suggests lack of good knowledge medscape.com/viewarticle/51 This pertains *even in RCTs* uspharmacist.com/article/medica

and what tickles me even more is that data collection in adherence monitoring is vague, varied, and unreliable frontiersin.org/articles/10.33 …so if you want nebulosity in medicine, it’s here in layers – it might *look like* we know what we don’t know… but we’re not sure!