There was a question yesterday about Evidence Based Medicine vs Science Based Medicine. The SBM criticism of EBM is the over-reliance on Randomized Controlled Trials that meet p=0.05, without looking at the prior probability that a treatment would help. For example, EMB would say that if you have an RCT that shows that a lucky rabbit's foot works, then you have reasonable evidence to put that into practice. The issue…
The strength of significance testing is that it purposely doesn't try to tell you how likely something is to be true, only how likely the data you got was the result of chance assuming the treatment is no better than placebo. You're still taking the prior probability into account when trying to figure out the truth, you're just not putting a number on it.
My concern with bayesian approaches is that, like with frequentist approaches, the truth is still fundamentally unknowable, only now you're encouraged to put a number on that and pretend that it's science. While bayesian approaches totally make sense in trying to determine a patient's likelihood of having some disease when there is already data available for the prevalence in a population and the sensitivity and specificity of the tests, using bayesian logic to weight clinical trials strikes me as being highly dubious.
It would be one thing if SBM actually developed a framework to give a weight to each methodological feature of a trial, but so far I haven't seen much work to build a functioning system. Though if you're really honest about all the ways that you can have positive results without something actually being true, it seems like almost no amount of research will ever have a significant effect on the prior.