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EXPERTS' EYE VIEW:
Andrew D Oxman, Iain Chalmers, Alessandro Liberati on behalf of the World Artifexology Group
A field guide to experts
BMJ 2004; 329: 1460-1463 [Full text]
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[Read Rapid Response] Experts - definition
Chris Oliver   (17 December 2004)
[Read Rapid Response] Who is an expert/specialist?
Rajendra N Srivastava   (17 December 2004)
[Read Rapid Response] Self recognition
Monica J. Murphy   (17 December 2004)
[Read Rapid Response] -- Expanding the scope --
Gary Fox   (18 December 2004)
[Read Rapid Response] Experts
Das Sabapathy, None   (18 December 2004)
[Read Rapid Response] Expertise's other half
Trisha Greenhalgh   (19 December 2004)
[Read Rapid Response] Me, I'm a Buzzard!
David M Hambidge   (20 December 2004)
[Read Rapid Response] The Power of Ignorance
Larry Culliford   (24 December 2004)
[Read Rapid Response] Bravo
Juan Pericas   (27 December 2004)
[Read Rapid Response] Forensic experts
Giusto Giusti   (29 December 2004)
[Read Rapid Response] Is Christmas over already?
B.Hoa Nguyen   (30 December 2004)
[Read Rapid Response] Good article in wrong journal
Sunil V Badve, Ashwinikumar Khandekar   (14 January 2005)

Experts - definition 17 December 2004
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Chris Oliver,
Adjunct Senior Lecturer
z170 Southern Cross University Lismore NSW Australia 2480

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Re: Experts - definition

Laugh!

Another definition I quote to my students when I tell them to beware of 'experts'

'EX' - former or has-been 'PERT' - drip under pressure

Unfortunately I cannot cite the author of this quote.

Competing interests: None declared

Who is an expert/specialist? 17 December 2004
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Rajendra N Srivastava,
Consultant Pediatric Nephrologist
Apollo Indraprastha Hospital, New Delhi 110044, India

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Re: Who is an expert/specialist?

There may be a fine difference between an expert and a specialist. The latter can be defined as one who knows more and more about less and less, until he knows practically everything about almost nothing.

Competing interests: None declared

Self recognition 17 December 2004
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Monica J. Murphy,
RN Outpatient Case Manager
Mental Health Centre Penetanguishene L9M 1G3

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Re: Self recognition

I'm forwarding this article to the research team at this hospital. I hope they find it as interesting and insightful as I do, although my fear is that they won't recognize themselves.

Competing interests: None declared

-- Expanding the scope -- 18 December 2004
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Gary Fox,
Physician
Gandy Health Center, 2200 Jefferson Ave, Toledo OHIO (USA) 43624

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Re: -- Expanding the scope --

Solely classifying experts misses the broader picture of the context in which experts are often found and quite possibly from which they evolved – meetings. I propose the broader category of artimenagology, with artifexology being but one subcategory. It is important to both expand the scope of this field and to encourage active involvement of other investigators; PubMed searches produce no retrievals for either artimenagology or artifexology. Here is a current lexicon for species found at meetings according to GAGME (Games At General Meetings Enterprise)(1):

Gorilla – Monster ego. May pound fist or shoe on the table, or may take the whole table and pound with it. Often leaders.

Elephant - Has a hundred years of experience with whatever is under discussion. Moved only by divine intervention. Often in leadership positions.

Boar - Never uses 5 words when 500 will do.

Donkey* - Characterized by on-off switch. Classic line "yes, butt* we can’t because . . ." Commonly in management. *(not “ass” in polite company, please)

Horse - Steady, sturdy, dependable, carries heavy loads, rarely expresses disagreement. May get spooked in unfamiliar environments. Excellent managers.

Zebra – Strange -- Really strange. Ideas so weird may have originated in another universe. An exception to evolution and double helix theories. Proof that common sense is uncommon.

Grizzly - Hibernates for extended periods. Presence alone may be intimidating. May resemble a teddy bear until eats someone alive.

Hog - Shows up when food shows up. Can detect an ice cube melting from 200 meters.

Kangaroo - Ideas jump around randomly. Once wound up, hard to stop.

Owl – Head turns 360 degrees. Never blinks. Indecisive -- always looking for more data.

Chimp - Class clown since grade school. Can keep the group in stitches for hours.

Parrot - Parrots.

Black Widow – Rarely noticed at meetings. Extremely dangerous. Will kill and eat their own spouses.

Mole - Nocturnal. Silent. Nights are spent digging up any foundation laid at the meeting, which is the evidence of their presence.

Opossum (the "O" is critical, the "O-sign") - shows up early to obtain seat of preference. Saves all sleep for meetings. If competition, can rank on the "O-scale."

Dolphins - social creatures. Volunteers. Peacemakers. Show up early and stay late to chat.

Bats - Devil's advocate. View the world upside down, in the dark, by radar.

Giraffe – Different. Sticks it's neck out. Innovator. Feet are visible, but head is hidden in clouds.

Hyena - Leaves the carnage to others, but is first in line to pick the spoils.

Koala - social conscience of group, environmentalist, strict vegetarian. Checks other people's tuna cans for "Dolphin-Free" label.

Chameleon - Expresses opposing opinions within the same sentence. Smiles while discussing nuclear winter. Resemblance to politicians is not coincidental.

Skunk - Has one issue. When anything scenting of that issue arises, states, "You know I make a stink when it comes to …."

Tortoise - Historian. Knows the metaphysical reason why the grass is green. Predicted The Flood. Knew Moses.

Lemming - "Wow. Great idea." (Not.)

Pigeon - Flies in from left field, dumps a load that splatters on everyone else. Often from "corporate."

Dodo - Relative of the turkey. Proves the Peter Principle. Can't fly and can't run fast enough. Believes there actually were "Good Ol' Days." Flunked the spell-checker exam at the M&M factory.

Unicorn - Unique appearance, insight, direction. Steady, steadfast, visionary; creates organizational mythology and culture. Capable of spearing bats, working like a horse, outrunning gorillas and elephants, squashing moles and black widows, speaking dolphin, laughing with chimps, romping with horses, donkeys, and zebras, muzzling boars, and corralling the talents of kangaroos, lemmings, and owls. Perfect leader. Mythological creature.

Space does not allow elaboration. Do note that sea life (octopus, squid, snail, shrimp, sting ray, shark, catfish ...), extinct creatures, and mythological beasts, as well as meeting fruits and vegetables, are part of the broader picture. Also note part of the complexity in this field of study is hybrids, like gorillephants, donboars, chimphins, and horhogs.

Note: Any resemblance to actual persons is the _object_ of this research.

Conflicts of interest: The author attends no less than 3 meetings per week.

References

(1) Personal conversation 12/17/04; original research rejected by editorial committees representing all major medical journals.

Competing interests: None declared

Experts 18 December 2004
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Das Sabapathy,
Retired
Unemployed,
None

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Re: Experts

There are experts who really know what is what. These guys really contribute, teach and do some real work wherever they are sent. They also establish good rapport with their local counterparts. There are also a few who do not know much about their supposed field of expertise. Experts mainly infest third world countries - being sent there by WHO, UNO, UNICEF,ILO & the like.Their tenure of expertise is predetermined by agreements between the thirld world governments and the organizations who send them. They mostly copy the output of their local counterparts, alter a word here or a sentence there and submit these to their organizations. The workers of the third world have to tolerate / bear this burden - they cannot complain! - a few who bow down and pay homage - may sometimes have a fair chance ofbecoming 'experts' themselves!

Competing interests: None declared

Expertise's other half 19 December 2004
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Trisha Greenhalgh,
Professor of Primary Health Care
University College London

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Re: Expertise's other half

Thanks, BMJ, for an article on experts written by three men who quote 12 more men, and illustrate their piece using 8 male stereotypes.

Female experts are, perhaps, a different species entirely, distinguished not by their ties but by their footwear. Here are some suggestions, to which others will surely add:

The expert in stilettos, whose mission is to sex up her subject: http://www.fortunecity.com/emachines/e11/86/duncan1.html

The expert in bare feet, who seeks to demystify her subject by linking it to natural rhythms and bodily functions: http://www.salon.com/people/bc/1999/06/22/greer/

The expert in court shoes (and matching handbag), who does things her way and expects the rest of us to follow suit: http://www.margaretthatcher.org/RECORD/Iron%20Ladies.htm

The expert in football boots, who plays men at their own game before eating them for breakfast: http://www.zipworld.com.au/~rocket/unofficial/winnie.htm

And the expert in small, sensible shoes, who can snuggle up to the big boy driving the boat and whisper the answer in his ear: http://en.wikipedia.org/wiki/Condoleezza_Rice

Competing interests: None declared

Me, I'm a Buzzard! 20 December 2004
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David M Hambidge,
Self -employed
Home based office

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Re: Me, I'm a Buzzard!

As a self-proclaimed Expert Witness in Adult Mental Health, I have thoroughly enjoyed this article and the replies. May I extend the original classification to include my prefered species, Buteo buteo, The Buzzard. I scrounge an existence off the wreckage of other people's lives, both patients and so called colleagues who may describe my involvement as "that bald headed B*S*ARD, again."

According to the RSPB, buzzards are particularly vulnerable to poison baits, in the form of case instructions with a hidden agenda that only comes clear when I'm in court.

Also, buzzards spend most time perched, getting indigestion from illegible poor quality documents supplied, but can spend hours effortlessly soaring the countryside, looking for a kill, or stuck in the traffic. And for the benefit of Trish, the females are identical.

Seasonal Whatsits to all

Competing interests: I work as one , in the area of Adult Mental Health

The Power of Ignorance 24 December 2004
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Larry Culliford,
Consultant Psychiatrist
Brighton CMHC, 79 Buckingham Road, BN1 3RJ

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Re: The Power of Ignorance

I enjoyed reading this, although wondered if I didn't detect a smidgeon (rhymes with pigeon, of course: see the paper, p1462) of false modesty from the authors. If you are the first to describe something - artifexology in this case - you probably know more about it than anyone else (especially if you have invented it). Doesn't this make you, de facto, not just experts but THE experts in the field? A 'quasi-expert' or 'pseudo-non-expert' is just as much an expert as any other, albeit an ostrich perhaps, a bird, you notice, that is well-versed in denial, unable to fly, and not really looking like a bird.

A description of an expert that appeals to me as actually useful (in some circumstances anyway) goes: "Someone who has a good grasp of the extent of human ignorance on a given subject". An excellent example of such an expert would be Professor Sir Martin Rees, the Astronomer Royal (a peacock of a title, if ever there was one), whose latest TV programme is even called, "What We Still Don't Know" (Channel Four). I approve of this kind of expert, and predict a growing popularity for them in the future.

The one thing a person can achieve a sense of absolute incontrovertibility over is their own personal ignorance in the face of a specific, discrete question. There are times when you can say, "I don't know", with 100% certainty. I find that wonderfully relaxing. You don't have to pretend any more. You can remain ignorant of the evidence, and just continue to live in the faith that(to paraphrase the mediaeval mystic from Norwich, Mother Julian), "All manner of things will be well". This attitude affords a person boundless hope in the face of life's myriad (and sometimes unpleasant)uncertainties. Of course, as a psychiatrist, I can attest confidently to this, because I don't really know all that much, and yet I am obliged to be an expert on hope.

Happy New Year everyone!

Competing interests: None declared

Bravo 27 December 2004
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Juan Pericas,
Primary Care Pediatrics
Spain

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Re: Bravo

Bravo again. As an "expert" i some subjects (preventive services and vaccines) i recognise myself in some of your definitions of "expert". I've learned a lot in this article.

Competing interests: "Expert"

Forensic experts 29 December 2004
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Giusto Giusti,
professor of legal medicine
Rome 00133

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Re: Forensic experts

I read with an intellectual pleasure, but also with a sorrowful smile and a bitter taste in my mouth, the article on the Guide to experts. I am an expert, too, of that particular sub-type called forensic expert. I could recognize some characteristics of Colleagues (and of myself, of course) in the classification that was proposed. Unfortunately, the specific topic was not afforded by the Authors, so only small particles can be attributed to forensic experts. Moreover, some animals are not described, for instance the pig or the bitch or the fox. To choose the right expert in a criminal or civil case can be a problem, in many countries. Often, the verdict depends on the opinion of the forensic expert. Any effort to improve the qualification of experts should be appreciated, and this article can help.

If the Authors would like to extend their research to forensic experts, I am at their disposal for "helpful suggestions and advice".

Competing interests: I am an "expert".

Is Christmas over already? 30 December 2004
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B.Hoa Nguyen,
family doctor
93291

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Re: Is Christmas over already?

Something about being kind to your fellows as you would like to be treated also? I have the good luck of working with very nice and good experts. More often than not. Thank you for a very entertaining piece. I always looked forward to reading BMJ extra-curricular writing.

Competing interests: None declared

Good article in wrong journal 14 January 2005
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Sunil V Badve,
Clinical Associate
PD Hinduja National Hospital & Medical Research Center, Mahim, Mumbai 400016 India,
Ashwinikumar Khandekar

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Re: Good article in wrong journal

The expert article by 'the expert' is certainly good. I think the name of this expert medical journal should be changed to 'British Non- medical Journal' as most of the articles are for light reading. Only a few articles are genuinely 'medical'.

Competing interests: None declared