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I believe that it is the case when we should not lower the level because stupid people exist. My anecdotal experience with medicine is the experience of the doc
by ordu 8y ago
I believe that it is the case when we should not lower the level because stupid people exist. My anecdotal experience with medicine is the experience of the doctors making decisions about my body use by themselves, being unable to support my decision making process by their expertise. I suppose it is due to the reasons listed in the article discussed. Doctors rely on unscientific knowledge (it is ok, when there are no scientific knowledge) and lack a mental discipline to demarcate in their mind scientific and unscientific knowledge. So when I start answer questions, like "if I have been riding my bike for 10 years already and there is no retina detachment, might we see it as an evidence that all is ok and a retina detachment is an unlikely outcome in my case", the doctor asked cannot say nothing of importance. All she could is to continue to insist that I should abandon my bike. But it is not her decision, it is my body, so it is my decision. I asked about physiological mechanism behind a retina detachment, to understand it and to be able to limit my physical activities, to find a compromise between no physical activities and retina detachment. She was unable to answer my questions.
Why? Because her knowledge is tribal ritual knowledge, not a scientific one. Her knowledge is a bunch of rules in a form "if <symptom> then <treatment>". Completely useless knowledge for my decision making process.
So it is a good thing when mass-media brings an attention to this sad fact. We need to bring an attention to this, to make medicine to think big phylosophical questions and to change itself. On the way of this we can damage people with a bad decision making process, who could stop brushing their tooth because of headlines. It is bad, but there are upsides of that: next time when they come to a dentist, they will get an evidence that their decision making process is not perfect. So they will be able to learn something. To my mind, a couple of teeth as a payment for an improved decision making process is a good deal.
- mikeash 8y agoI’m not sure if I’ve understood this comment properly. Are you saying that it’s ok if the headline is full of shit, because it serves the more noble purpose of getting people to trust their doctors less?
- ordu 8y agoI see it differently. 1. It is not full of shit, there are only one word in a phrasing that makes the headline misleading. It is "surprisingly". In medicine there are nothing surprising when there are not enough scientific verification for a conventional wisdom. And yes, I'm ok with it. 2. It doesn't serve the purpose of getting people to trust their doctors less. If someone do it the wrong way, the reality would fix it anyway. It is a good outcome. People would learn how to do decision making, doctors would be forced to rethink ways they persuade their patients that doctors know better. It is more contraversial, I agree, but I can live with it. Why should I have less information I need, if someone cannot deal properly with information of this kind? You know, I'm riding bike as I rode before despite of risk of retina detachement. I decided that 10 years of riding is good enough evidence for me. When I have no access to a scientific knowledge on topic, I have no other options except to fall back to use an anecdotal evidence. In any case I'm not going to through out my bike, I like it and I believe that psychological health is more important than physical.
- mikeash 8y agoI don’t understand #1. The article itself says that there’s plenty of evidence to support the basic dental wisdom of brushing and flossing regularly and getting regular checkups. Or are you arguing that the headline is correct and the content of the article is wrong?
- ordu 8y agoThere are a lot of evidence about brushing, and only brushing. Article admits it. Flossing is more contraversial, and the best argument is about problems that could arise decades later: this argument not just a rational argument for flossing, but also explains the weakness of scientific evidence. It must be hard to make a longitudal research while controlling subjects for flossing, I can understand it. But it doesn't mean that there are a lot of evidence, it means there are plausible excuses for a lack of evidence. I see this distinction as an important one. (At the same time I acknowledge, that article doesn't express it in such a wording, it does it more vague, leaving some crucial information behind links and stressing the point of lack of evidence, to justify the headline. It is clumsy.) Also in the article mentioned yearly X-rays, frequency of brushing, scaling and polishing, bonded amalgams, interdental brush, preventive visits. Not every in the exact sense that "little evidence found", and I didn't bother to visit the all linked articles to see what is there, but nevertheless, I want to point, that brushing and flossing is just a part of the article. In any case I see that the headline is good enough. After some thinking I even do not see "surprisingly" as a redundant word: surprise is a subjective feeling and the author can be surprised when I'm not. Moreover I guess that not only the author was surprised but some of his readers also. edit: typo