Earlier quoted context omitted.
Obviously you don't understand HN.. everyone here is a "very smart software engineer" and knows far better than a simpleton like you with your decades of medical training and experience.
The neurologist wants what's best for his patients today, which is to know whether a treatment is likely to work or not. Others may value the mechanism more for very legitimate reasons. For instance, if you underatand the mechanism it leads to further research that could utilize a related mechanism or perhaps see potential side effects that would otherwise be hard to identify. You really need both. "Is it true?" is a…
There is a huge amount of effort required to say why something works with certainty. Usually to get there requires many years of experience with a new surprising result. Which requires publishing lots of results before understanding the mechanism.
If you refuse to believe anything that isn't figured out from first principles is true... I mean... I have a condition and if someone told me a higher percentage of patients on a new drug did well than on the one I use, do I care if they can tell me exactly why? Not in the slightest. I will wait a year or two to see if side-effects crop up and ideally see the results confirmed, but I'm not going to not get a treatment likely to help just because they don't know how exactly how it works.
I think it's good practice to assume the results of a paper are accurate, even if you give no credence to the interpretation.