Eyes Wide Open: How to Make Smart Decisions in a Confusing World

I’m saying this not only as someone who has had to deal with experts a lot in my private life, but also – and I’m aware of the irony here – as an ‘expert’ myself. A professor, someone who advises prime ministers, heads of big companies and international organisations like the World Bank.

But I am an expert who thinks not only that others must be more challenging of us, but also that as a group we need to change. We need to be more open to people challenging our points of view, more accepting of uncertainty and the limits of what we can know. And we need to be more willing to admit to our own limitations.

For while there are of course many exceptions – wonderful, civilisation-enhancing exceptions – experts can be both flawed and biased.

I mean, they’re human, after all.

Follow the Money

Expert error is not only down to unconscious thinking errors like those I described in the previous chapter, however.

Up to a third of scientists admit ‘changing the design, methodology or results of a study in response to the pressures from a funding source’.19 (#litres_trial_promo) Eighty-one per cent of biomedical research trainees said that they would be willing to select, omit or fabricate data to, among other things, ‘win a grant’.20 (#litres_trial_promo) A recent study looking into the accuracy of scientific papers in leading medical journals – highly prestigious publications such as the Journal of Clinical Oncology, the American Journal of Cardiology and the New England Journal of Medicine – revealed that over 40 per cent of the best-designed, peer-reviewed scientific papers that have been published there have misrepresented the actual findings of research, largely due to funding pressures.21 (#litres_trial_promo) And ‘Numerous studies have shown that industry-sponsored clinical trials are often biased in favour of the sponsor, sometimes in ways that can only be detected with access to the original data and study protocol.’22 (#litres_trial_promo)

Bear this in mind as you happily eat your dark chocolate bar, in the ‘knowledge’ that dark chocolate is good for you. It turns out that the research that underpins this claim was predominantly funded by the confectionery company Mars.23 (#litres_trial_promo) And that in fact flavanols – the chemicals in dark chocolate thought to be good for the heart – are often removed during manufacturing, due to their bitter taste. (And that’s presuming that there’s much chocolate in the bar in the first place: many of them have a thin coating of chocolate, and are mostly sugar and fat.)

Also, think twice when you take a swig of your sports drink during exercise. It turns out that the scientific ‘facts’ that prompted you – you’ve got to keep drinking to stay hydrated; your brain doesn’t know when you’re thirsty; it reduces the risk of water intoxication – may be less impartial than you had reckoned with. A study in the British Medical Journal, conducted to coincide with the London Olympics, found that all of these claims are based on highly selective research funded by, wait for it – the makers of drinks like Gatorade, Powerade and Lucozade.24 (#litres_trial_promo)

So, if you’re planning to turn to an expert for important ‘objective’ advice, find out in advance whose payroll they are on, and what conflicts of interest this may present.

That was something the US Federal Drugs Administration did not do when it convened a panel of experts to determine whether a group of painkillers – COX-2 inhibitors, commonly known as ‘coxibs’ – should be removed from the market. These drugs were among the most heavily marketed in pharmaceutical history: their manufacturers spent billions of dollars on advertising, touting them as miracle drugs, ‘super-aspirins’ that relieved pain without the risk of stomach ulcers. Soon they ranked among the most prescribed drugs in the US. However, mounting evidence linked them with cardiovascular problems: the most controversial of them, Vioxx, had been aggressively promoted in ad campaigns featuring Olympic gold medallists Bruce Jenner and Dorothy Hamill, only for an FDA whistleblower to later estimate that it may have caused up to 140,000 heart attacks.25 (#litres_trial_promo)

At first glance, the FDA’s decision to convene a panel of experts to help it decide what to do made sense. The experts comprised professors, scientists, statisticians and patient representatives. They sounded like a very sensible group of people to take advice from. Following three days of public hearings, the panel reported back. Although they recognised that these painkillers did increase the risk of heart attacks, the panellists felt that the benefits outweighed the risks. Voting on each drug in turn, they recommended that all three drugs in that class – Celebrex, Vioxx and Bextra – be permitted to stay on the market. (Vioxx had actually been withdrawn by then, so in its case ‘returned to the market’ would be more accurate.)

A week later, it was revealed that of the thirty-two panel members, ten had financial ties to the manufacturers.26 (#litres_trial_promo) These individuals had voted 9–1 in favour of keeping Vioxx and Bextra on the market. If their votes had been excluded, only Celebrex would have passed muster.

When experts are on the payroll of the very companies that they are asked to evaluate (a pretty common practice – a survey of two hundred such expert panels revealed that a third of those on them had a financial interest in the drugs they evaluated), there’s a good chance that they will not be impartial.

We see these potential conflicts of interest in the world of finance, too.

Take those credit rating agencies, agencies like Standard & Poor’s, Moody’s and Fitch. We saw during the financial crisis the huge impact their ratings have on how companies are perceived by investors and lenders. But did you know that they are often paid by the very institutions that they review?27 (#litres_trial_promo)