Information Allergy
Frank E Harrell Jr
Department of Biostatistics
Vanderbilt University
Information allergy is defined as (1) refusing to obtain key information needed to make a
sound decision, or (2) ignoring important available information. The latter problem is
epidemic in biomedical and epidemiologic research and in clinical practice. Examples
include
- ignoring some of the information in confounding variables that would
explain away the effect of characteristics such as dietary habits
- ignoring probabilities and “gray zones” in genomics and proteomics
research, making arbitrary classifications of patients in such a way that
leads to poor validation of gene and protein patterns
- failure to grasp probabilitistic diagnosis and patient-specific costs of
incorrect decisions, thus making arbitrary diagnoses and placing the
analyst in the role of the bedside decision maker
- classifying patient risk factors and biomarkers into arbitrary “high/low”
groups, ignoring the full spectrum of values
- touting the prognostic value of a new biomarker, ignoring basic clinical
information that may be even more predictive
- using weak and somewhat arbitrary clinical staging systems resulting from
a fear of continuous measurements
- ignoring patient spectrum in estimating the benefit of a treatment
Examples of such problems will be discussed, concluding with an examination of
how information–phobic cardiac arrhythmia research contributed to the deaths of
thousands of patients.