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The Rise and Fall of Evidence Based Medicine (1998) [pdf]

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Re: The Rise and Fall of Evidence Based Medicine (1998) [pdf]

#41

Post by spondylosaurus »

SkyPuncher wrote: post #35
spondylosaurus wrote: post #28

Earlier quoted context omitted.

As a rule of thumb, I find it's usually safe to dismiss criticism of HIPAA from anyone who misspells it as HIPPA. Not knowing that it's an acronym for Health Insurance Portability and Accountability Act (emphasis on portability there, as you pointed out!) tends to be a sign that you don't know what the hell HIPAA is or is for. "HIPPA," on the other hand, is an ever-convenient boogeyman you can invoke in all kinds of…

Being pedantic. Calling people out on HIPAA/HIPPA is like the warn out slight-of-hand trick you pull at a party and everyone pretends to laugh. I've never seen anyone who actually understands HIPAA get caught up on this. It's a common typo/misspelling.

You'd think it's a common typo, but I have literally only ever seen it spelled as "HIPPA" by people trying to use HIPAA as a punching bag for whatever happens to be their current pet issue. And those people almost always misspell it.

The number of anti-vaxxers citing "HIPPA" as the reason why the local concert hall was trampling on their civil rights by asking to see proof of vaccination was... extremely high.

Re: The Rise and Fall of Evidence Based Medicine (1998) [pdf]

#42

Post by LorenPechtel »

mjburgess wrote: post #18
Retric wrote: post #11

Earlier quoted context omitted.

Yes and no, Statistics have an inherent weakness when you don’t have consistent buckets to place everything into. If individual specialists classify cases differently they really can see statistically valid numbers from relatively few cases where double blind studies using different classification criteria see improvements below the noise floor.

Also, largely, there is no scientific evidence for the vast majority of problems. The only evidential basis for causal analysis are experiments where (1) you intervene to bring about the cause deterministically; and (2) where you control all confounding causes. Those conditions are impossible to meet for the vast majority of interactions in complex systems, such as people & medicine. If you run associative statistics…

Brings to mind an interesting tidbit I ran into--long ago your sign probably did correlate with meaningful things in life. Not that the stars mattered, but the seasons did. Early life nutrition would vary. Even today you'll find a correlation between signs and ADHD diagnoses--because of the school year. There is almost a year of difference between the oldest students entering school and the youngest--and those youngest are appreciably more likely to get an ADHD diagnosis.

Re: The Rise and Fall of Evidence Based Medicine (1998) [pdf]

#43

Post by technothrasher »

smegsicle wrote: post #16
msla wrote: post #13

Earlier quoted context omitted.

> they can just make it "evidence based homeopathic medicine" and so on and so on Only if the homeopaths lie about the evidence.

curious how combative some people seem to get about homeopathics when placebo has been shown to have consistent positive effect, without side effects, for almost every illness

If placebos don’t have side effects, why do the control groups in placebo-based trials always report side effects?

And given that “homeopathic” to most casually informed people is the same as “naturopathic”, what those people are taking are not necessarily harmless placebos.

As for your “almost every illness,” that’s just meaningless hyperbole.

Re: The Rise and Fall of Evidence Based Medicine (1998) [pdf]

#44

Post by LorenPechtel »

rgbgraph wrote: post #30

There was a great book about Evidence Based Medicine, from a woman out of Oxford, I read a long while ago. Can't for the life of me remember the name, but Oxford does have a center for "Evidence Based Medicine," and the whole idea has been slowly coming back into fashion. Instead, all I can recommend is a collection of essays -- loosely -- related to the subject: Where's the Evidence? , Silverman --- On another note,…

I do agree things should be studied but you have to be careful with it. Studies are big and expensive and things can be missed. Remember the big flap over hormone replacement therapy being shown harmful? Oops--all it really showed is what we knew all along, estrogen is risky for fat women.

Re: The Rise and Fall of Evidence Based Medicine (1998) [pdf]

#45

Post by ethanbond »

jvanderbot wrote: post #33
ethanbond wrote: post #22

Earlier quoted context omitted.

What exactly is HIPAA’s role here? With or without HIPAA, medical institutions don’t want to share their data, especially not the ones with good data because they do their own research.

not op: but possibly ... The free exchange of information would make publicly funded data-driven discoveries more feasible. (?)

HIPAA is not the impediment, incentives are.

Re: The Rise and Fall of Evidence Based Medicine (1998) [pdf]

#46

Post by dang »

metalliqaz wrote: post #21
neverrroot wrote: post #19

[flagged]

[flagged]

Regardless of what the GP said, you broke the site guidelines here, which ask you to edit out swipes (like "What are you talking about"). Your comment would be just fine without that bit.

We've to ask you this kind of thing more than once before. If you wouldn't mind reviewing https://news.ycombinator.com/newsguidelines.html and taking the intended spirit of the site more to heart, we'd be grateful.

Re: The Rise and Fall of Evidence Based Medicine (1998) [pdf]

#47

Post by [deleted] »

kspacewalk2 wrote: post #37
pella wrote: post #26

(2020) Will COVID-19 be evidence-based medicine’s nemesis? https://journals.plos.org/plosmedicine/article?id=10.1371/jo... "It is surely time to turn to a more fit-for-purpose scientific paradigm. Complex adaptive systems theory proposes that precise quantification of particular cause-effect relationships is both impossible (because such relationships are not constant and cannot be meaningfully isolated) and unnecess…

Sounds extremely susceptible to quackery and hand-waving appeals to authority.

[deleted]

Re: The Rise and Fall of Evidence Based Medicine (1998) [pdf]

#48

Post by importantbrian »

rgbgraph wrote: post #30

There was a great book about Evidence Based Medicine, from a woman out of Oxford, I read a long while ago. Can't for the life of me remember the name, but Oxford does have a center for "Evidence Based Medicine," and the whole idea has been slowly coming back into fashion. Instead, all I can recommend is a collection of essays -- loosely -- related to the subject: Where's the Evidence? , Silverman --- On another note,…

What makes you conclude that statins are "bunkum"? I don't know anything about anti-depressants or surgical implants, but I have gone down the rabbit hole on statins and at least as far as I can tell they do what they are generally claimed to do, are safe, and so if you are at high risk for hear disease you should probably be taking them.

Re: The Rise and Fall of Evidence Based Medicine (1998) [pdf]

#50

Post by [deleted] »

bedobi wrote: post #8
cactusplant7374 wrote: post #3

I thought all medicine is evidence based as long as it’s not homeopathic or chiropractic?

homeopathic medicine, chiropractic medicine, folk medicine, traditional medicine, osteopathic medicine, crystal healing medicine... you can make an infinite list of nonsense and if you want to disambiguate and say "evidence based medicine" to refer to actual medicine, they can just make it "evidence based homeopathic medicine" and so on and so on can't beat these people

[deleted]
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