completely true. the problem is that efficacy studies (like I want) are not that exciting to report. as a result, the lay press reports only mechanism studies

completely true. the problem is that efficacy studies (like I want) are not that exciting to report. as a result, the lay press reports only mechanism studies (because their readers like to be "wowed" and think about things, like the poster I originally replied to). that wouldn't matter at all, but we all get sick. and when a person gets sick with this mentality that they need to understand the mechanism, then they start overthinking the treatments that are available today, drawing all kinds of spurious conclusions, and making medical decisions that are unjustified at best and harmful at worst. and in my experience, the smarter the patient is, the more willing (and insistent) they are to take this approach (witness Steve Jobs). This is absolutely not the patient being "dumb" or stubborn: it's completely understandable given how they understand science. But it hurts them, which no physician likes to see. let's note how incredible it is that we are having this conversation in the setting of some incredibly expert scientists (albeit in other fields). it really shows how hard science can be to understand sometimes.