This morning I sit pondering the limitations of randomized controlled trials for practice decisions and how, ironically the limitations for practice are precisely due to their strengths. It will take a few posts to make this point and unpack its implications. The thoughts have been in there and have peaked out on the blog on occasion but never systematically reasoned and explained (at least I do not believe so). I was inspired to address RCTs head on by the recent set of posts on adjustment sets and their proven usefulness with induction and their potential usefulness for practice when applied to deduction and abduction.
That set of posts will take more time to brew.
For now I sit and ponder while thoroughly enjoying freshly brewed coffee at home on a beautiful spring morning (my criteria for beautiful spring has changed a bit after this winter). The coffee is sublime. I had my previous coffee maker for many years and was not that great at cleaning it with one of those cleansing solutions (meaning it had been years). Slowly over time the brew from that coffee changed from coffee to some sort of acidic brown muck that I, due to the slow transition of being from wonderful coffee to horrendous muck, never noticed. Funny how the basic reliability of sensory perception can be alluded by sub threshold changes incrementally over time. My wife noticed how bad it was. A restaurant only coffee drinker for years she tried it one morning recently and was, well, disgusted by it. That prompted me to purchase cleaning solution, which prompted me to clean it, which led to its demise (I guess it had been so long that the grime and build up were keeping it working).
Yesterday afternoon I picked up a new brewer and this morning I enjoy a fresh brew. Sometimes things change slowly and we do not perceive them until something abrupt happens and we start fresh.
I leave it to the reader to make all the analogies to life that are possible from the coffee maker story.