5 ms·

This is, unfortunately, rampant in healthcare. The natural variation amongst people as well as the natural variation of our health throughout out life makes act

This is, unfortunately, rampant in healthcare. The natural variation amongst people as well as the natural variation of our health throughout out life makes actually analyzing healthcare outcomes incredibly difficult. 90%+ of published outcomes can be invalidated by simply looking at the published data. If you want some chuckles, read blog posts by Al Lewis ripping on research publised by companies touting their own performance. He's acerbic and condescending but also, mostly, correct.

api 11y ago
In a bio class a professor summed it up with "the hardest thing about medicine is being able to tell whether anything actually works." I told a friend of mine who's into alt.med once that yes I think a lot of alt.med is bunk but percentage wise it's probably not that much more bunk than "mainstream" medicine. It's easy for emergency medicine. Customer comes in with bullet wound, leaves alive and healthy and without bullet wound. But outside of domains like that it's crushingly hard to tell the difference between treatment and noise. Compounding the fact is that humans aren't a standardized item that can be compared against reference performance metrics. We're all different and our genome and environment are constantly changing.
- bonoboTP 11y ago
  > alt.med is bunk but percentage wise it's probably not that much more bunk than "mainstream" medicine Oh yes it is! First of all, the actual effort is there in real medicine, while alternative medicine just doesn't care about evidence. Also, most real drugs work as intended. The fringe cases get emphasized a lot, but still, the basic things, like antibiotics, painkillers etc. work very well. Medicine has advanced A LOT in the last 100-150 years. Fake medicine, like homeopathy, is nothing like this. Don't mislead people.
  - api 11y ago
    I agree to some extent, but not completely. Some day population-wide studies fishing for a p value below a certain threshold will be looked at with the same disdain that we look at homeopathy. "They actually believed you could do studies across genetically diverse populations like that?!?! wow! Didn't they understand that everyone's metabolism is different?" Throw in a bit of pharma companies funding their own studies and I don't think the situation is as black and white as you say. Preachy overconfidence in the clear superiority of enlightened scientific medicine actually bolsters public support for alt.med as a reactionary movement.
    - bunderbunder 11y ago
      I hate being the guy to call fallacy,* but this reminds me of the Nirvana fallacy here. You're not comparing the level of scientific rigor in mainstream medicine to the level of scientific rigor in alternative medicine. You're comparing it to the level of scientific rigor that we wish existed in a perfect world. Are you also willing to measure alternative medicine against the same standard so that they can be compared on an equal footing? P-value fishing is hardly the exclusive province of mainstream medicine. And in the "funding their own studies" department the most notable difference between mainstream pharma and alt med is that the mainstream pharma companies are legally required to disclose this fact (and preregister their studies in order to discourage fishing, too), while in alt med it's standard practice to use cute little financial engineering tricks to try and hide where the funding came from. * But I don't hate lying on occasion.
      - api 11y ago
        I'm pointing out that as a social movement alt.med is driven in part by a mismatch between the real success and reliability of scientific medicine vs. the claims made by its authorities. Is fat good for your or bad for you this week?
        bunderbunder 11y ago
        Pointing out that the core of the movement consists of throwing the baby out with the bathwater isn't really an effective defense.
  - Asbostos 11y ago
    I think depends on the medicine. Like fixing a bullet wound, some medicines obviously work and you don't need a study to know that (for blood pressure, insulin, severe pain, etc). But those are perhaps the ones we take for granted and don't really include when we think about the idea of medicine being bunk. What's more suspicious is medicine that people use just because they're in a culture of taking medicine for everything. Reliefs for colds, coughs, mild pain, sore throat, psychological problems, etc. These illnesses have a strong get-better-anyway effect so it's very easy for people to believe that whatever they took cured them. Don't believe me? Go to China and you'll see people taking herb drinks for the same illnesses and having just as much faith in their effectiveness. Other popular cures include drinking warm water and "growing a pair".
    - dalke 11y ago
      While you wrote "I think depends on the medicine", I think it actually depends on the disease. I think you are correct in that many people confuse palliative treatment/medicines (eg, cough drops, warm water, gargling with salt water) with curative treatment/medicines. However, in doing so I think you've changed the topic from the differences in medical vs. alt. med., as measured in patient outcomes, to the differences in how patients subjectively view the different forms of treatment.
    - scott_s 11y ago
      I'm not sure if your second paragraph is aimed at mainstream medicine, or "alternative" medicine. Mainstream medicine does not claim to have a cure for a cold. Mainstream medicine masks the symptoms so that people are less miserable while the cold runs its natural course. What's curious with your list is that one is a disease ("cold"; the rhinovirus) while the others are symptoms ("cough, mild pain, sore throat"), and the other is an entire class ("psychological problems"). It's hard to respond to what you said because you called them all "illnesses".

api 11y ago

In a bio class a professor summed it up with "the hardest thing about medicine is being able to tell whether anything actually works." I told a friend of mine who's into alt.med once that yes I think a lot of alt.med is bunk but percentage wise it's probably not that much more bunk than "mainstream" medicine. It's easy for emergency medicine. Customer comes in with bullet wound, leaves alive and healthy and without bullet wound. But outside of domains like that it's crushingly hard to tell the difference between treatment and noise. Compounding the fact is that humans aren't a standardized item that can be compared against reference performance metrics. We're all different and our genome and environment are constantly changing.

bonoboTP 11y ago
> alt.med is bunk but percentage wise it's probably not that much more bunk than "mainstream" medicine Oh yes it is! First of all, the actual effort is there in real medicine, while alternative medicine just doesn't care about evidence. Also, most real drugs work as intended. The fringe cases get emphasized a lot, but still, the basic things, like antibiotics, painkillers etc. work very well. Medicine has advanced A LOT in the last 100-150 years. Fake medicine, like homeopathy, is nothing like this. Don't mislead people.
- api 11y ago
  I agree to some extent, but not completely. Some day population-wide studies fishing for a p value below a certain threshold will be looked at with the same disdain that we look at homeopathy. "They actually believed you could do studies across genetically diverse populations like that?!?! wow! Didn't they understand that everyone's metabolism is different?" Throw in a bit of pharma companies funding their own studies and I don't think the situation is as black and white as you say. Preachy overconfidence in the clear superiority of enlightened scientific medicine actually bolsters public support for alt.med as a reactionary movement.
  - bunderbunder 11y ago
    I hate being the guy to call fallacy,* but this reminds me of the Nirvana fallacy here. You're not comparing the level of scientific rigor in mainstream medicine to the level of scientific rigor in alternative medicine. You're comparing it to the level of scientific rigor that we wish existed in a perfect world. Are you also willing to measure alternative medicine against the same standard so that they can be compared on an equal footing? P-value fishing is hardly the exclusive province of mainstream medicine. And in the "funding their own studies" department the most notable difference between mainstream pharma and alt med is that the mainstream pharma companies are legally required to disclose this fact (and preregister their studies in order to discourage fishing, too), while in alt med it's standard practice to use cute little financial engineering tricks to try and hide where the funding came from. * But I don't hate lying on occasion.
    - api 11y ago
      I'm pointing out that as a social movement alt.med is driven in part by a mismatch between the real success and reliability of scientific medicine vs. the claims made by its authorities. Is fat good for your or bad for you this week?
      - bunderbunder 11y ago
        Pointing out that the core of the movement consists of throwing the baby out with the bathwater isn't really an effective defense.
- Asbostos 11y ago
  I think depends on the medicine. Like fixing a bullet wound, some medicines obviously work and you don't need a study to know that (for blood pressure, insulin, severe pain, etc). But those are perhaps the ones we take for granted and don't really include when we think about the idea of medicine being bunk. What's more suspicious is medicine that people use just because they're in a culture of taking medicine for everything. Reliefs for colds, coughs, mild pain, sore throat, psychological problems, etc. These illnesses have a strong get-better-anyway effect so it's very easy for people to believe that whatever they took cured them. Don't believe me? Go to China and you'll see people taking herb drinks for the same illnesses and having just as much faith in their effectiveness. Other popular cures include drinking warm water and "growing a pair".
  - dalke 11y ago
    While you wrote "I think depends on the medicine", I think it actually depends on the disease. I think you are correct in that many people confuse palliative treatment/medicines (eg, cough drops, warm water, gargling with salt water) with curative treatment/medicines. However, in doing so I think you've changed the topic from the differences in medical vs. alt. med., as measured in patient outcomes, to the differences in how patients subjectively view the different forms of treatment.
  - scott_s 11y ago
    I'm not sure if your second paragraph is aimed at mainstream medicine, or "alternative" medicine. Mainstream medicine does not claim to have a cure for a cold. Mainstream medicine masks the symptoms so that people are less miserable while the cold runs its natural course. What's curious with your list is that one is a disease ("cold"; the rhinovirus) while the others are symptoms ("cough, mild pain, sore throat"), and the other is an entire class ("psychological problems"). It's hard to respond to what you said because you called them all "illnesses".