All please read! Once and For All: "Scientific Evidence"

[buffdoc]

This is addressed to all members of the board. I've read and been involved with, and even been flamed, on this board and others, regarding what treatments, drugs, supplements, etc are "proven" to work, and whose statements or preferences can be backed up by "hard, scientific evidence". You've all heard it, ad nauseum. Sometimes it comes out of noble motives, and concern; all too often it is an attempt to goad other members, or to appear more knowledgeable than one really is.
Sometimes it appears to come from other "docs", certain "lawyers" who shall remain nameless, or just bored, immature troublemakers, it would seem. It's a high and mighty technique that appears to position the poster above the mundane level of other's "preferences" and "unproven claims".
Well, here's my 2 cents worth. As a medical scientist (ie, physician), I can tell you only about my field. But within that field, only about 15% (that's right: 15%) of all medical treatments, drug therapies, surgical procedures, etc, that are commonly used on a daily basis, HAVE BEEN SUBJECTED TO RIGOROUS, SCIENTIFICALLY CONTROLLED TESTING. THAT MEANS 85% HAVE NOT! Excuse my emphasis, but it's rather irksome when I see non-scientists trying to use junk science to make their personal cases and promote their own agendas.
"Can this be true?", you ask. September 1978, Office of Technology Assessment, special report to the Congress of the United States. Check it out. Also, know that not much has changed in the years since '78.
This is not as bad as it seems. We used coronary angioplasty for about 15 years before there was ANY good eveidence that it worked. Were those lives saved not "really" saved because of this lack of "scientific" evidence. I think not.
Throughout the history of medical science, MOST treatments have been "informally" evaluated: personal experience, anecdote, professional exchange of ideas. This is not a bad thing. Those of you who worship exclusively at the alter of the prospective, double-blind, placebo-controlled clinical trial have misplaced your faith. There is a place for personal perception and clinical impression based on experience.
I hope my point is made. Please, please, please, before you beat your drum about this "hard, scientific evidence" that you feel is at your fingertips, know the facts. All is not as it seems to be in the scientific world. Corruption around the billions of dollars at stake DOES exist, and statistical manipulation is common. Let's keep this forum as an exchange of ideas, and throw in the studies for each other's thoughtful perusal and possible benefit; let's not throw the studies AT each other, as though we "know" what they truly mean.

'nuff said...

 

[Riker29]

That is such an excellent series of points.

Not only too are these (above) issues to consider, but also the fact that there are some "formal" studies and rulings by the FDA that are just plain wrong. Yup - even THE FDA has done some very wrong thinsg and normally they need (or are supposed to need) HARD evidence.

******

For one, L-Tryptophan was banned by the FDA. This was used by many people for help with depression and sleep issues.

When a small number of people had an adverse reaction to it, the FDA did a quick study and found the L-Try to be at fault and banned it.

Later it was found out that the problems were due to ONE manufacturer which had problems or some type of contamination with THEIR L-Trp product.

And .. to this day the FDA still will not rescind the ban. See because it would take MONEY for them to do it, plus they would be admitting they messed up, and also... it would de-value the array of BS drugs that are used for depression today since a natural therapy would be avilable that would help many (and not being covered by a patent, its comparatively inexpensive). And of course the drug companies dont like the idea of some over-the-counter substances taking dollars away from their profits they get from the likes of Prozac, Wellbutrin, etc etc etc or whatever.

****

I have brought this issue up before, that the best methods WE have here are NOT just "studies" (which I laugh to see how some people interpret these ... LOL) but REAL WORLD EXPERIENCE from people that have actually DONE these things in real life!

So ... watch out when anyone creates a thread which reads "I was reading some studies the other day and started thinking ...." and then gets pissed when people breing up real world examples which dispute this arm-chair quaterback-science.

The ....

- combined knowledge of scientific evidence that we do have,

- plus direct studies (with the substance in question on humans)

- plus indirect studies (the subcstance or similar one used on animals)

- PLUS the combined body of experince we have access to with Boards like this

.... THESE are the FULL set of tools we should be using.

 

[buffdoc]

Very eloquent. I couldn't agree more. Thanks

 

[jboldman]

So does this mean we should ignore any research out there when a question comes up? Just because medical practice is not always founded on "hard evidence?" I think that as long as everyone realizes that just because someone quotes a study does not make it so, we should be OK. On the other hand, if studies exist that are well designed, peer reviewed, and replicated, imo it would be irresponsible not to give them some weight in our decisions otherwise it would all be reduced to he said/she said!

Ryker brings up some valid points particularly since it is a rare event when something that directly pertains to the subjects discussed here is directly sudied in humans. All points of view should be considered and all information evaluated when making important decisions regarding your body.

Critical thinking is the key that will light the way.

jb

 

[buffdoc]

So does this mean we should ignore any research out there when a question comes up? Just because medical practice is not always founded on "hard evidence?" I think that as long as everyone realizes that just because someone quotes a study does not make it so, we should be OK. On the other hand, if studies exist that are well designed, peer reviewed, and replicated, imo it would be irresponsible not to give them some weight in our decisions otherwise it would all be reduced to he said/she said!

Critical thinking is the key that will light the way.

jb

Are you asking me if we should ignore research that's out there? Of course not. I don't think that's the point of my post at all. I'm talking, in part, about people using "studies" as a bludgeon or proof of their superiority. If "ignoring research" is what you got out of my post, perhaps it deserves a re-read.
Thanks

 

[Big-Puncher]

Excellent post. But like jboldman said, do we ignore any research done? I dont think so I just think we need to really think about it is all. Do alot of research on it before opening ones mouth. But again, Excellent post bro.

 

[Riker29]

So does this mean we should ignore any research out there when a question comes up?

(snip)


Critical thinking is the key that will light the way.

jb

No, we should not ignore such evidence.

I for one think we need to strike a balance between all of the types of info we have available, and take into account studies, and also real-world experince.

 

[buffdoc]

Excellent post. But like jboldman said, do we ignore any research done? I dont think so I just think we need to really think about it is all. Do alot of research on it before opening ones mouth. But again, Excellent post bro.

To you and jboldman,
No, I'm pretty big on science and studies; even did some "bench" research as a resident. But as Riker said, true understanding requires a synthesis of available info. There's just a lot of "where's your evidence?" posting and posturing going on (eg., see the carao threads featuring hardbodylawyer).
Thanks

 

[Lift Chief]

Nice post--

 

[drrman]

well put, sometimes things work and we may never know why