{"id":1477,"date":"2020-07-22T11:18:21","date_gmt":"2020-07-22T10:18:21","guid":{"rendered":"https:\/\/blogs.bmj.com\/adc\/?p=1477"},"modified":"2020-07-22T11:18:21","modified_gmt":"2020-07-22T10:18:21","slug":"vote-counting","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/adc\/2020\/07\/22\/vote-counting\/","title":{"rendered":"Vote counting"},"content":{"rendered":"

If eleven people say one thing, and a twelfth disagrees, where do we go with the decision?<\/p>\n

Let us start with a simple question. What if it’s “Are the chips any good at the canteen?” Straightforward – the 11 probably outweigh the 1. But … what if the 11 all report hearsay … “Simone always eats them” … “They smell good” … and the one is a regular connoisseur of the fried potato? Or what if the one is a gastronome, whose ‘best chip’ was at a Michelin star establishment and sits, iconic in their taste memory?\u00a0 Your decision as to go with the democratic answer is balanced by the directness, applicability and closeness-to-your-taste of the reporters. It may also be balanced by the alternatives, and the degree of hunger you’re experiencing (or the closeness of the next preterm twin delivery).<\/p>\n

This is all true of evidence-based child health too. We’re using fancy terminology to say exactly the same thing as the chip question. We’re asking a necessary question. We know what we value as outcomes. We seek as much information as we can, and we weight the sources (or sauces). We consider the directness of the information to our population, the variance in the data provided, the strength of the answers and the likely truthfulness of them. And we balance all that against our resources. We make the best decision we can and know we’ll revisit it when things change.<\/p>\n

Sometimes democracy is the right way forward, and sometimes it’s right to throw it out.<\/p>\n