In Praise of Observational Evidence
asteriskmag.com
In Praise of Observational Evidence
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Re: In Praise of Observational Evidence
#2Damn fine article, lovely conclusion, a real pleasure to read
Re: In Praise of Observational Evidence
#3Quite thought-provoking, and connecting it to a related field it seems the (relative) success of LLMs and the likes are indications that enough data can at least learn you something without always needing to interfere with the world first(?)
Re: In Praise of Observational Evidence
#4They reference RCT without first defining it.
Re: In Praise of Observational Evidence
#5> The increasing availability of large datasets should make this an especially good time to reconsider observational evidence in many fields.
This is not happening.
> I was surprised to find that they usually discard papers based on observational evidence wholesale.
He he...welcome to the real world!
Re: In Praise of Observational Evidence
#6In medicine, observational evidence is actually better and far more ethical than the RCT. (Which simply dooms the terminally ill to fake treatment.) You just need large datasets and an agile culture that's responsive to new input.
Don't forget that RCTs are very far from perfect and issues -- sometimes literally fatal issues -- have later turned up via observational evidence in large cohorts. Vioxx, for instance. Many others.
I believe, without the tiniest shred of doubt, that the only trials drugs need to go through are initial safety/toxicity trials (phases 0/1) and that everything else would be much better left to access+observation.
Re: In Praise of Observational Evidence
#7The reality that individuals and cultures create can be a dark and confining place. Empiricism is our only window to a universe full of possibility and light. Humanity is like a child, standing on our toes to peer through and wonder.
Re: In Praise of Observational Evidence
#8They reference RCT without first defining it.
https://en.wikipedia.org/wiki/Randomized_controlled_trial
I noticed that as well. My eyes feverishly scanning the previous paragraph for the definition.
Re: In Praise of Observational Evidence
#9Seth Roberts was arguing this ~20 years ago and would have loved the advent of LLMs...
Re: In Praise of Observational Evidence
#10In medicine, observational evidence is actually better and far more ethical than the RCT. (Which simply dooms the terminally ill to fake treatment.) You just need large datasets and an agile culture that's responsive to new input. Don't forget that RCTs are very far from perfect and issues -- sometimes literally fatal issues -- have later turned up via observational evidence in large cohorts. Vioxx, for instance. Man…
This feels off. In medicine, any evidence can also be blinded by confounding factors that are far easier to miss without adding specific controls. Really, in any field this will be the case.
Should we demand an RCT before we accept evidence? Of course not. At some point you do have to make a choice on things.
And it should be noted that most drugs do have early cutoff criteria if the evidence is strong enough that it is working. It isn't like people are wanting to withhold good treatments from the world. Adding controls and randomizing them, though, has proven to be highly effective at helping progress.