4 ms·

And nothing to do with the pile of research that’s been done in the past few decades identifying exactly which medications actually provide mortality benefit in

And nothing to do with the pile of research that’s been done in the past few decades identifying exactly which medications actually provide mortality benefit in cardiac disease and which don’t, of course.

rscho 8y ago
Well, that's precisely my point. Yes, new drugs help, but often less so than the "dogma of the year" lets you hope at first. The point is that MDs are usually identified as scientists because many people think they actually had an important part to play in the development of new useful technology, and don't see that most of the time those new things come directly from the lab and clinicians just test drive them to find the optimal use case. It's true that test driving is essential, but I have a hard time calling it science when you see what people from hard science can do. Additionally, the proportion of MD researchers who understand nothing about what they do, or who even deliberately cook up results is absolutely alarming. To follow up on your cardiology example, I'd say that pills certainly helped, but the game changers really are the new toys of the interventional cardiologist. And I would also add one of my favourite pseudo quotes: "science advances one funeral at a time." -- Max Planck
- arkades 8y ago
  > To follow up on your cardiology example, I'd say that pills certainly helped, but the game changers really are the new toys of the interventional cardiologist. Balloon caths re-stenosed 30% of the time. Balloon caths with bare metal stents re-stenosed about 15% of the time. Balloon caths with stents and dual-platelet drugs re-stenose about 3% of the time. I think this is one of those "drugs help ... but less so" situations where drugs get less credit than they're worth, and the physician scientists that did the endless slogging to figure out how to optimize interventional cardio's toys deserve real credit. But, yes, I agree: most MD's aren't scientists. Quite a lot of MDs are only barely science-literate. They're engineers: they're taught a body of science and its application, with the expectation that they apply it usefully.

rscho 8y ago

Well, that's precisely my point. Yes, new drugs help, but often less so than the "dogma of the year" lets you hope at first. The point is that MDs are usually identified as scientists because many people think they actually had an important part to play in the development of new useful technology, and don't see that most of the time those new things come directly from the lab and clinicians just test drive them to find the optimal use case. It's true that test driving is essential, but I have a hard time calling it science when you see what people from hard science can do. Additionally, the proportion of MD researchers who understand nothing about what they do, or who even deliberately cook up results is absolutely alarming. To follow up on your cardiology example, I'd say that pills certainly helped, but the game changers really are the new toys of the interventional cardiologist. And I would also add one of my favourite pseudo quotes: "science advances one funeral at a time." -- Max Planck

arkades 8y ago
> To follow up on your cardiology example, I'd say that pills certainly helped, but the game changers really are the new toys of the interventional cardiologist. Balloon caths re-stenosed 30% of the time. Balloon caths with bare metal stents re-stenosed about 15% of the time. Balloon caths with stents and dual-platelet drugs re-stenose about 3% of the time. I think this is one of those "drugs help ... but less so" situations where drugs get less credit than they're worth, and the physician scientists that did the endless slogging to figure out how to optimize interventional cardio's toys deserve real credit. But, yes, I agree: most MD's aren't scientists. Quite a lot of MDs are only barely science-literate. They're engineers: they're taught a body of science and its application, with the expectation that they apply it usefully.