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Mar 2012

Thyroid-Associated Periorbitopathy: Of Mountains, Measurements, and Levels of Evidence

Author Affiliations

Author Affiliation: Moorfields Eye Hospital, London, England.

Arch Ophthalmol. 2012;130(3):378-379. doi:10.1001/archopthalmol.2011.1883

On being asked why he wanted to climb Mount Everest, the famous mountaineer George Mallory replied, “Because it's there!” Higher primates seem to have an innate curiosity about their surrounding world, mankind having honed this quest for knowledge into the discipline of scientific investigation. In many cases, the enquiring and scientific mind would appear to be climbing mountains just because they are there, leading to the investigation or publication of studies without obvious value. However, the logical acquisition of knowledge and comprehension is a stepwise process, whereby scientific observation moves the subject from absolute uncertainty (no knowledge or understanding), to accurate observation with a rudimentary understanding (as with Medieval astronomy or medical case reports), to modification of early and sometimes incorrect conjecture to sound hypothesis based on greater levels of evidence (as with Johannes Kepler's observations on planetary motion or medical case series), and finally to observational evidence or formal logic that shifts a hypothesis toward absolute certainty; whether the latter state is possible remains debatable.

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