Sublingual immunotherapy, meta-analysis, and knowledge in the age of information

Abstract

‘‘All men by nature desire knowledge,’’ wrote Aristotle (384322 BC). All human beings wish to understand the world around them, and to that end, some construct theories of various kinds to help make sense of it. Plato (428-348 BC), Aristotle’s mentor in the grand pursuit of humanist inquiry, provided a figurative account of prisoners chained deep inside a cave. Their vision blocked, they see only the wall of the cave and some shadows of objects outside. One prisoner breaks free and escapes from the cave. In the light of the sun, he sees the real world for the first time. He returns with a message for his fellow prisoners: they had been seeing nothing but shadows; the real world lies beyond the cave. Plato distinguished between 2 levels of awareness: opinion and knowledge. Observation of the visible world represents opinion only. For Plato, knowledge stands for something certain and infallible, greatly exceeding mere sensory experience. In current phrasing the product of observation might be described as ‘‘data’’ or ‘‘information,’’ terms that are similar but not interchangeable. Data are unrelated facts. When a significant relation exists among data points, then data become information. Information is always about something, such as the size of a measurement, the occurrence of an event, or a blueprint. Any pattern that has an effect on the arrangement or transformation of other patterns is information. It does not need to be true or accurate. A signal that creates misunderstanding is still information. As a rule, as the amount of information increases, the message becomes more accurate. There is no single widely accepted definition of knowledge, and there are many competing propositions. Philosophical debates generally start with Plato’s formulation of knowledge as ‘‘justified true belief.’’ Knowledge arises from information. ‘‘Transformation’’ is essential to that process. In the context of health care, transformation allows primary research or observation data to become usable for clinical decision making. Sources of knowledge include research findings and also experience, authority, trial and error, and theoretical principles. Professional culture in the field of medicine identifies knowledge with particular persons,