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Opinion Acute Perspective

David Oliver: Relearning to value experts and their knowledge

BMJ 2022; 378 doi: https://doi.org/10.1136/bmj.o1853 (Published 27 July 2022) Cite this as: BMJ 2022;378:o1853

Rapid Response:

COVID-19 Pandemic, Disregard for Expert ‘COVID-19 Pandemic Control Advisories’ and Uncomplimentary Outcomes: The Imperative to Rekindle the Relevance of ‘Multiparameter-based Medicine (MBM)’

Dear Editor

The ‘Global COVID-19 Pandemic Control Measures’ have reportedly been riddled with several ‘Challenges’ which have compromised the capacity for the world to be assured of success in the ‘Fight against the Pandemic’. An aspect of the ‘COVID-19 Pandemic Control Difficulties’ is the ‘Gross Disregard’ for ‘Professional Expertise’/ ‘Expert Professionals’. It is suggested the ‘Expert Professionals’ and ‘Apolitical Experts’ have been consistently undermined all through the span of the ‘COVID-19 Pandemic’[1]. Against the ‘Experts-informed COVID-19 Pandemic Control Advisories’, including the ‘Non-Pharmaceutical Intervention (NPIs)’ involving ‘Lockdowns-Shutdowns’, ‘No Travels (Local and International)’, ‘Reduced Economic Activities’ amongst several others, there were active resistance and non-compliance as ‘Wealth’ was prioritized over ‘Health’, ‘Livelihood’ over ‘Life’ and ‘Making a Living’ over ‘Living’. The ‘Expert Professionals’ were reportedly accused of ‘Lying’ in proffering their ‘Expert Opinions’[1]. The ‘Disregard for Expert Professionals’ was reportedly manifestly disposed during the ‘UK Brexit Referendum’ when a Prominent Politician stated ‘I think the people of this Country have had enough of Experts with Organizations and Acronyms saying that they know what is best and getting it certainly wrong’[2]. Subsequent unfolding events vindicated the ‘Expert Professionals’.

At the outset of the ‘COVID-19 Pandemic’, several ‘Public Health Control Measures’, particularly the ‘Non-Pharmaceutical Interventions (NPIs), were informed by ‘Expert Opinions’ but were reportedly resisted with the resultant untoward ‘Outcomes’ including among others: Unsuccessful Testing, Tracing and Tracking Programme, Confusing and Contradictory Public Health COVID-19 Pandemic Control Advisory, Increased COVID-19 Deaths and Critical Care Facilities not available to other Cases requiring Acute Care[1]. The ‘Expert Opinions’ were subsequently proved to be correct from the information emanating from the National Audit Office[3].

The ‘Social Media’ and ‘Mainstream Media’ reportedly became the ‘Source of Determinant COVID-19 Pandemic Control Information’, and possibly contributors to ‘COVID-19 Infodemic’, as they reportedly disseminated ‘Pandemic Information’ from ‘Selective and Superficial Reading’ compared with ‘Experts-influenced COVID-19 Pandemic Control Advisories’ backed by ‘Years of Training’, ‘Research Undertakings’ and ‘Practice Experience’[1]. There was intense ‘Mistrust of Experts’/ ‘Disregard of Expert Professionals’ with significant ‘Erosion of Professional Expert Respect’[4]. Again, subsequent emerging ‘COVID-19 Pandemic Information’ from the Office of National Statistics and the National Institute for Health and Care Excellence vindicated the ‘Expert Professionals’ but were regarded as biased, exaggerated or conspiratorial[1]. Incidentally, within the Medical Profession and Clinical Practice, ‘Professional Specialty and Sub-specialty Expertise’ is recognized and undergirds ‘Patient Referrals’ as appropriate and indicated.

The ‘Disregard of Expert Professionals/ Expert Opinions’, in the context of the ‘COVID-19 Pandemic Control’, is another perspective to the tendency to treat ‘Professionalism’ and ‘Expertise’ with disdain! This is reminiscent of the ‘Beginnings’ of the ‘Evidence-based Medicine/ Practice Movement’ with ‘Total Disregard for Expert Opinion’[5-9]. The ‘Evidence-based Medicine Movement’ was subsequently regarded as ‘Work in Progress’ and with time, ‘Clinical Expertise’/ ‘Professional Expertise’/ ‘Expert Opinion’ became progressively infused into ‘Emerging Evidence-based Practice Models’[10,11] with the ultimate contextualization, conceptualization, Technicalization and innovative disposition to adopt a ‘New Imaginative Model’: The ‘Multiparameter-based Medicine (MBM)’[12].

This brief ‘Communication’ is a ‘Modest Contribution’ to the ‘Expert Opinion Conversation’ and to support the imperative to Project, Promote and Support ‘Expert Opinion’/ ‘Professional Expertise’/ ‘Clinical Expertise’ where critically desired and deserving.

REFERENCES
1. Oliver D. Relearning to value expert knowledge. BMJ 2022; 378:o1853
2. Britain has had enough of experts, says Gove. Financial Times 2016 Jun 3. https://www.ft.com/content/3be49734-29cb-11e6-83e4-abc22d5d108c
3. National Audit Office. The government’s preparedness for the COVID-19 pandemic: lessons for government on risk management. 19 Nov 2021. https://www.nao.org.uk/report/the-governments-preparedness-for-the-covid...
4. Oliver D. David Oliver: Covid-19 and the Dunning-Kruger effect. BMJ2022;378:o1701
5. Sackett DL, Straus SE, Richardson WS et al. Evidence-based Medicine: how to practice and teach Evidence-based Medicine. 2. Edinburgh: Churchill. Livingstone 1992
6. GRADE Working Group. Grading quality of evidence and strength of recommendations. BMJ 2004; 328 (7454):1490
7. Sackett DL, Rosenberg WM, Gray JA, Haynes RB, Richardson WS. Evidence-based Medicine: What it is and what it isn’t. BMJ 1996; 312:71-72
8. Sackett DL. Evidence-based Medicine. Seminars Perinatol 1997; 21 (1):3-5
9. Haynes BR, Devereaux PJ, Guyatt GH. Clinical expertise in the era of evidence-based medicine and patient choice. BMJ 2002; 7:36-38
10. Forsyth S. What is opinion and what is evidence? BMJ 2019; 366:l5395 of 13th September 2019
11. Djulbegovic B, Guyatt GH. Progress in evidence-based medicine: a quarter century on. Lancet 2017; 390 (10092). Doi: 10.1016/S0140-6736(16)31592-6
12. Eregie CO. Beyond Evidence-based Medicine (EBM) as ‘Work In Progress’: An Innovative Proposal for ‘Multiparameter-based Medicine (MBM)’. https://www.bmj.com/content/366/bmj.l5395/rr of 4th October 2019

Professor Charles Osayande Eregie,
MBBS, FWACP, FMCPaed, FRCPCH (UK), Cert. ORT (Oxford), MSc (Religious Education),
Professor of Child Health and Neonatology, University of Benin, Benin City, Nigeria.
Consultant Paediatrician and Neonatologist, University of Benin Teaching Hospital, Benin City, Nigeria.
UNICEF-Trained BFHI Master Trainer,
ICDC-Trained in Code Implementation,
*Technical Expert/ Consultant on the FMOH-UNICEF-NAFDAC Code Implementation Project in Nigeria,
*No Competing Interests.

Competing interests: No competing interests

11 August 2022
CHARLES OSAYANDE EREGIE
MEDICAL DOCTOR
Professor of Child Health and Neonatology, University of Benin, Benin City, Nigeria and Consultant Paediatrician and Neonatologist, University of Benin Teaching Hospital, Benin City, Nigeria
Institute of Child Health, University of Benin, PMB 1154, Benin City, Nigeria.