Harry Rutter, Miranda Wolpert and Trisha Greenhalgh are British professors in the areas of public health, mental health, and primary care health respectively. They have written a blog post titled, "Managing Uncertainty in the COVID-19 Era." The post appeared on the British Medical Journal website. They offer five rules for coping with high degrees of uncertainty and making sound decisions in that context. I think the rules are incredibly applicable in a wide array of settings, not simply in healthcare. Here are the five rules:
- Most data will be flawed or incomplete. Be honest and transparent about this.
- For some questions, certainty may never be reached. Consider carefully whether to wait for definitive evidence or act on the evidence you have.
- Make sense of complex situations by acknowledging the complexity, admitting ignorance, exploring paradoxes and reflecting collectively.
- Different people (and different stakeholder groups) interpret data differently. Deliberation among stakeholders may generate multifaceted solutions.
- Pragmatic interventions, carefully observed and compared in real-world settings, can generate useful data to complement the findings of controlled trials and other forms of evidence.