Levels of Evidence 

This moment of scientific inquiry was brought to you by Monty Python and the Holy Grail.

How do we know that what we consider facts are actually true? How did we as a culture determine what was fact in the first place anyway ? 

We all know that the basic view of reality has changed over time. We once believed the world was flat, but now we view it as a near sphere. We once believed the sun rotated around the earth and now we know otherwise. Such ideas were determined by the learned scholars and scientists of the day and, in their day, views were held as strongly as ours. Dissent from the prevailing view cost some, like Galileo, their lives. In those days, fact mixed with belief, and changing theories could be viewed as heresy.

Then came the Renaissance. Open inquiry was more acceptable. Our powers of observation and capability of measurement were improving. The stage was set for the Scientific Revolution. 

In this marvelous time, as the Renaissance gave way to The Enlightenment, the foundations modern science and medicine were established. The Scientific Method was born. The Scientific Method is simple. It requires that facts be determined iteratively (in cycles) as follows:  Observation prompts a hypothesis, which is then tested by experiment. The hypothesis is subsequently revised to fit the measured results. This process occurs repeatedly, with the goal of getting closer and closer to the best fact we can find, which we call a theory. 

Patients generally try to seek out the best sources of information. The problem is, it is sometimes difficult to discern what that is. Even if charlatans and hucksters are discounted, and one's attention is restricted to research studies and media reports of research, there can be confusion. 

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