Change search
ReferencesLink to record
Permanent link

Direct link
The democratic fallacy in matters of clinical opinion: implications for analysing cause-of-death data
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.ORCID iD: 0000-0001-5474-4361
2011 (English)In: Emerging Themes in Epidemiology, ISSN 1742-7622, Vol. 8, no 1Article in journal (Refereed) Published
Abstract [en]

Arriving at a consensus between multiple clinical opinions concerning a particular case is a complex issue - and may give rise to manifestations of the democratic fallacy, whereby a majority opinion is misconstrued to represent some kind of "truth" and minority opinions are somehow "wrong". Procedures for handling multiple clinical opinions in epidemiological research are not well established, and care is needed to avoid logical errors. How to handle physicians' opinions on cause of death is one important domain of concern in this respect. Whether multiple opinions are a legal requirement, for example ahead of cremating a body, or used for supposedly greater rigour, for example in verbal autopsy interpretation, it is important to have a clear understanding of what unanimity or disagreement in findings might imply, and of how to aggregate case data accordingly.In many settings where multiple physicians have interpreted verbal autopsy material, an over-riding goal of arriving at a single cause of death per case has been applied. In many instances this desire to constrain findings to a single cause per case has led to methodologically awkward devices such as "TB/AIDS" as a single cause. This has also usually meant that no sense of disagreements or uncertainties at the case level is taken forward into aggregated data analyses, and in many cases an "indeterminate" cause may be recorded which actually reflects a lack of agreement rather than a lack of data on possible cause(s).In preparing verbal autopsy material for epidemiological analyses and public health interpretations, the possibility of multiple causes of death per case, and some sense of any disagreement or uncertainty encountered in interpretation at the case level, need to be captured and incorporated into overall findings, if evidence is not to be lost along the way. Similar considerations may apply in other epidemiological domains.

Place, publisher, year, edition, pages
BioMed Central, 2011. Vol. 8, no 1
National Category
Public Health, Global Health, Social Medicine and Epidemiology
URN: urn:nbn:se:umu:diva-39824DOI: 10.1186/1742-7622-8-1PubMedID: 21223568OAI: diva2:396587
Available from: 2011-02-10 Created: 2011-02-10 Last updated: 2015-04-29Bibliographically approved

Open Access in DiVA

The democratic fallacy in matters of clinical opinion: implications for analysing cause-of-death data(180 kB)37 downloads
File information
File name FULLTEXT02.pdfFile size 180 kBChecksum SHA-512
Type fulltextMimetype application/pdf

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Byass, Peter
By organisation
Epidemiology and Global Health
In the same journal
Emerging Themes in Epidemiology
Public Health, Global Health, Social Medicine and Epidemiology

Search outside of DiVA

GoogleGoogle Scholar
Total: 37 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 73 hits
ReferencesLink to record
Permanent link

Direct link