Seek Rigorous Evidence

Both scurvy and infant crib death offer insights about the value of evidence.

  • In 1747, British naval surgeon James Lind conducted an important experiment. He wanted to find a treatment for scurvy. Scurvy begins with gum disease, progresses to open wounds, internal bleeding and ultimately death. A variety of cures were proposed. Lind selected a dozen sailors from three dozen who suffered with scurvy. To six pairs he provided different treatment. Some were given cider, some oranges and lemons. Since we now know that scurvy is caused by lack of vitamin C, those who ate oranges and lemons recovered. Lind’s trial designed, collected and reviewed evidence.
  • Standard advice, years ago, was to place an infant to sleep in a crib on its stomach. In Baby & Child Care, the famous pediatrician Benjamin Spock advised against putting a baby to sleep on its back. It took almost twenty years to review evidence which conclusively identified the dangers of front-sleeping. Some estimate 60,000 infants died between 1970-88 because of this delay.

Useful Experiments

Good intentions and bad advice can certainly yield disastrous results. The imperative of life and death impact suggests we ought to get faster and far better at experiments that provide rigorous evidence for decisions. The choice about front or back-sleeping infants was never designed or intentional. Parent behavior and death incidents were studied for patterns. But, Lind’s action research did provide different antidotes to sick men.

 Ethical Design

It is strange that arbitrary decisions seem to have little ethical review while designed experiments face severe scrutiny. Yet, it is possible to establish a trial without denying others.

 It is simply a matter of locating an appropriate contrast or control. In early reading skill development research our clients did not deny service to any preschool students –  they simply identified children similar to those who participated in a special, enriched intervention program. This provided the experimental design which ensured claims could be made about the distinct contribution of the enriched intervention.

 Knowing is Not Doing

Despite Lind’s work centuries ago, scurvy is, regrettably, a disease that still affects malnourished people today. Knowing is not the same as doing. Spreading awareness of evidence or  transferring knowledge is an important process that requires time and resources. They are part of the reason that it took a long time for school districts and parents to adopt Kindergarten or for the public adoption of seat belts. Decades after the evidence is in, social marketing is actively promotes awareness about placing infants on their backs to sleep safely.

 Experiments  or “Wander-Squander”

Complex problems we barely understand preclude  making change. Discovery of what works requires experiments. A mindset that actively designs and executes trials is a critical step toward adaptation – a precursor to learning. What experiments are relevant to your work? Are you consistently seeking evidence for your own advice and actions?

Tim Harford, Adapt author, writes: “The alternative to controlled experiments are uncontrolled experiments.” We think this is an accurate description.  At our office we reference the thoughtless, uncoordinated  busyness of many activities as “wander-squander.”  Unfortunately, uncontrolled experiments dominate many work days for most people. And, there’s little or nothing that they teach us. Controlled experiments help us learn what works, what doesn’t and why.

Lisa Wyatt, Ed. D. is a strategy architect and partner in Phillip Wyatt Knowlton, Inc. PWK is a performance management resource for systems and social change with clients worldwide. She is also n author and W.K. Kellogg Leadership Fellow. See :

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