Bravo! Encore!

The Special Article on heuristic reasoning in the March 2011 issue is very interesting and thought-provoking with excellent use of limited space (Hicks EP, Kluemper GT. Heuristic reasoning and cognitive biases: are they hindrances to judgments and decision making in orthodontics? Am J Orthod Dentofacial Orthop 2011;139:297-304). The vastness of the problem embedded in their synopsis of heuristic and analytic systems of understanding is inherently present in our daily professional life, and applies tremendous practical influence to clinical diagnosis, treatment planning, and research in orthodontics. The potential complications inferred in this tortuous process are unnerving. For example, the practitioner’s treatment approach is deeply affected by such basic economic and philosophical approaches as fatalism, idealism, egoism, and altruism, to mention only a few.

My initial response to their final paragraph was immediate and adamant, especially considering the complications of subjectivity and bias as they relate to mathematical statistics. We should refuse to publish ANY paper in our journals, when the authors of that paper measure the data from the subjective clinical research project. In this age of digital records, any university teacher from lecturer or adjunct professor up to professor emeritus has access to residents or faculty associates who can independently gather the necessary data to be assessed, thereby eliminating the most basic of errors. Measurements should be done by machines or “blind” human operators. We do not intentionally wish to deceive or misdirect other practitioners; however, we must not let our emotional fervor or haste to publish allow us to unintentionally deceive our colleagues.

Congratulations on giving your readers another reason to read beyond the abstracts.