Quackery, Evidence, Science

Joseph Reagle

Our question(s)

A caveat

Writing for the opponent

explaining another person’s point of view as clearly and fairly as you can, even if you strongly disagree… (Wikipedia 2018) (Wikipedia 2006)

[the ideological Turing test:] state opposing views as clearly and persuasively as their proponents” (Caplan 2021)

“[steelmanning:] addressing the best form of the other person’s argument, even if it’s not the one they presented” (Messinger 2012)

Discussion

A question, insight, or connection?

Quackery-baesd medicine

What is quackery?

predatory unmerited medical practices

Reactions to Salerno?

  • Mia: Salerno doesn’t appreciate social determinants of health (SDOH)

ex. Quack hunt

Teams document an item that satisfies the most criteria for spotting a quack. (Barrett 2018)

  • reveal only the benefits of their remedy.
  • claim to treat the “root cause” of your health problems.
  • promise quick, dramatic, miraculous results.
  • use disclaimers couched in pseudo-medical jargon.
  • use anecdotes and testimonials to support their claims.
  • display credentials not recognized by responsible scientists or educators.
  • diagnose their favorite diseases in virtually everyone who consults.
  • claim they are being persecuted by orthodox medicine and that their work is being suppressed because It’s controversial.
  • …

Evidence-based medicine (EBM)

The rise of evidence-based medicine

What is evidence-based medicine?

Extraordinary claims require extraordinary evidence. [Sagan 1993, “Broca’s brain”, p. 69]

  1. plausible mechanism, plus
  2. evidence of efficacy in light of:
    1. patients’ placebo
    2. researchers’ bias, degrees of freedom, etc.
    3. alternatives’ relative safety, efficacy, and cost

What is placebo?

eg, Novella on acupuncture

Science-based medicine (SBM)

Weaknesses of evidence-based medicine?

Publication bias

Advancement in science is predicated on making novel claims.

Yet, we need to publish non-novel findings to overcome publication bias, for example.

Plausibility & prior probability

Too many implausible, one-off, gee-whiz, studies.

EBM is a vital and positive influence on the practice of medicine, but it has its limitations [including] … the focus on clinical trial results to the exclusion of scientific plausibility. (Contributors 2020)

eg, homeopathy

Novella on science-based medicine

Unnecessary studies

parachutes

As with many interventions intended to prevent ill health, the effectiveness of parachutes has not been subjected to rigorous evaluation by using randomised controlled trials. (SmithPell 2003)

Conclusion

Our question(s)

Did we address everything in today’s GDoc?

Wrap up

5-minute essay (or bullets)

You have a friend who is fond of experimenting with dangerous self-help remedies; what would you recommend?

Review

What did you recommend to your friend experimenting with dangerous self-help remedies?