5 ms·

I think empirical is what he expected, as did I frankly.

shkkmo 7y ago
> I think empirical is what he expected, as did I frankly. I am pretty clear about what he expected. The question is: on what basis was this expected and is it reasonable to start a semantic debate about it on that basis? What is the "big problem" here?
- jaredklewis 7y ago
  Let’s say I think about it for a while and decide that C++ is more prone to bugs than other languages. If I present that opinion as, “Study finds C++ more prone to bugs than other languages,” you don’t find it misleading? I think most people assume the word “study” indicates something is backed by a rigorous method of research, like the scientific method. You can’t just make an opinion and then claim it’s a study.
  - shkkmo 7y ago
    I would say that "C++ is more prone to bugs than other languages" is a quantitative claim and it is difficult to back up a quantitative claim without quantitative evidence. I don't think it calling itself a "study" should have any bearing on your desire to see that quantitative evidence or on your general epistemic stance towards the claims. > I think most people assume the word “study” indicates something is backed by a rigorous method of research, like the scientific method. You can’t just make an opinion and then claim it’s a study. I get that there may be some connotation in the context of headlines that empirical evidence gathering was involved. Does that make it ludicrous to use the term? Not at all. The paper and the article are both clear about what was involved in the study. I really don't see how there is a "big problem" here (especially compared to issues of reproducibility in studies that are back by empirical data.) My big concern is the assertions that papers like this are not part of a "rigorous method of research, like the scientific method" completely discount the important role that such papers play in drawing the solid conclusions from data.
  - candiodari 7y ago
    This is not the same, nor does anyone claim it's the same. People just see "science" and think physics, which is only one standard of science. However physics (70%-80% of it at least, big exceptions are theoretical physics and philosophy of physics) is an empirical science, psychology and psychiatry is not. Or to put it in more clear terms, if proof is how you think of science, then none of the sciences other than physics, chemistry and math are science at all. https://en.wikipedia.org/wiki/Outline_of_academic_disciplines https://en.wikipedia.org/wiki/Outline_of_academic_discipline... Psychology (and psychiatry) fall under the social sciences. These do not claim to be value-free. In other words, they draw conclusions because people feel those conclusions to be "needed", or socially relevant. Not even valid, in terms of truth versus fiction. The problem is that with psychiatry you have quite a few studies that point out it's not empirically valid at all: 1) diagnoses of mental illness are made on factors other than the patient or the symptoms: (for example they are made on available space, how "necessary" bed & meals are for the patient, whether the referring person needs them to be admitted, ...) https://en.wikipedia.org/wiki/Rosenhan_experiment https://en.wikipedia.org/wiki/Rosenhan_experiment Worse, the same goes for involuntary mental treatment and even youth care. All of those interventions, including everything from limiting study choice to locking a kid up for 2 decades, are based on whether a social worker considers such a thing socially needed. These determinations are made not on the child or person, but on the perceived need from the people asking for such a "diagnosis" and intervention. And that's the normal practice, not cases of abuse (which happen regularly, because of course admitting a patient pays, as well as the need for validation these people have) So, for instance, and as shown in the experiment, psychiatrists will lock up, place in isolation, medicate and use violence against patients to get them to admit/confess to a diagnosis by an earlier mental health professional. This is the normal practice, and not exceptional. 2) mental health treatment does not actually make patients better, or at least, despite 2 centuries of searching, there is no empirical or statistical evidence beyond "professionals say it works". Or, more dramatically: https://www.buzzfeednews.com/article/esmewwang/psychiatric-hospital-inpatient-collected-schizophrenias https://www.buzzfeednews.com/article/esmewwang/psychiatric-h... 2b) furthermore effectiveness studies keep, again and again, pointing out that only factors that have nothing to do with mental health theories and nothing to do with mental health treatment matter for the number of afflicted. Chiefly it is pointed out that mental health clinics tend to get filled. So the number of afflicted is determined by supply of care rather than by patient demand. Second studies keep pointing out that the relationship with carers matters for outcomes, and that specifically treatment, medicine, duration, ... doesn't matter at all. Third studies keep pointing out that "care" is used as a coercive social control tool Fourth when it comes to severity of problems the economic situation matters a lot more than anything the professionals do or know. 3) there are many abuses of the system by mental health professionals, and these have persisted over centuries "historical" (which should not be taken as "past" in most cases) https://en.wikipedia.org/wiki/Ten_Days_in_a_Mad-House https://en.wikipedia.org/wiki/Ten_Days_in_a_Mad-House https://en.wikipedia.org/wiki/Aktion_T4 https://en.wikipedia.org/wiki/Aktion_T4 https://en.wikipedia.org/wiki/Political_abuse_of_psychiatry_in_the_Soviet_Union https://en.wikipedia.org/wiki/Political_abuse_of_psychiatry_... https://www.scmp.com/news/world/europe/article/3016435/angels-and-demons-police-italy-arrest-18-accused-brainwashing https://www.scmp.com/news/world/europe/article/3016435/angel... https://www.bbc.com/news/health-48367071 https://www.bbc.com/news/health-48367071 https://www.bbc.co.uk/news/resources/idt-sh/norways_hidden_scandal https://www.bbc.co.uk/news/resources/idt-sh/norways_hidden_s... (pedofile using state power to kidnap children and place them ... with himself) https://www.commissiegeweldjeugdzorg.nl/onderzoek/english/ https://www.commissiegeweldjeugdzorg.nl/onderzoek/english/ https://en.wikipedia.org/wiki/Rotherham_child_sexual_exploitation_scandal https://en.wikipedia.org/wiki/Rotherham_child_sexual_exploit... https://www.bbc.com/news/world-europe-49320260 https://www.bbc.com/news/world-europe-49320260 https://www.washingtonpost.com/nation/2019/06/05/an-anguished-dutch-teenager-who-was-raped-child-is-euthanized-her-request/ https://www.washingtonpost.com/nation/2019/06/05/an-anguishe... ... 4) truth be told there are many abuses of the system by "patients". Just visit a mental health facility or psychiatrist and ask about the homeless that want to be taken "into care". I guarantee details will be forthcoming.
- wahern 7y ago
  It's odd to see a "study" that says psychiatric diagnoses are not evidence-based which itself doesn't actually use empirical evidence. As far as I can tell from the article, the "study" is basically arguing that because most psychiatric diagnoses use circumstantial evidence--that is, they don't rely on tools like an MRI to quantitatively identify and classify a neurologically-based defect--that it's not evidence based. But that doesn't follow. Most of medicine is like psychiatry, at least in the way that that paper seems to criticize. If a person comes into the ER with the symptoms of a cold and you treat them for a cold, you can't say that the diagnosis of a cold wasn't evidence based simply because the doctor didn't run a test to identify rhinovirus fragments. If it's known that the vast majority of such cases would be rhinovirus, that the vast majority of cases for those with something more severe (and where misdiagnosis would be dire) would present with different symptoms, then treating the patient as-if they have rhinovirus is a legitimately evidence-based, experimentally supported activity. It may not be ideal for each particular patient. The doctor isn't searching for some objective truth about each patient's condition. But so what? We do that because we're trying to maximize population wide outcomes. If we abstained from diagnosing every cold without first identifying viral fragments, many people would not only go undiagnosed but completely untreated, including those with much more severe infections. If it walks like a duck and quacks like a duck, it just might be a duck. And if research says that it is a duck 90% of the time, then making that inference is honestly and truly evidence based, even though it leaves open the possibility of 10% misdiagnosis rate. It's also not surprising that the assessment criteria would differ markedly between different types of ailments. The criteria for assessing a sprained ankle wouldn't look anything like that for a cold. It would be highly context based. We can't infer that it's therefore not evidence based. Psychiatry may or may not be evidence based, but you can't show that by an examination of the DSM. You have to affirmatively show the absence of a connection to evidence. Without doing that, you could only at best make a persuasive argument that the evidence itself sucks, or that the disease models are weak. But, again, a weak disease model doesn't imply lack of evidence. Our existing models of most diseases are going to look incredibly weak 200 years from now; but it wouldn't be reasonable to say that late 20th century medicine was unscientific, non-evidence-based hokum.
  - shkkmo 7y ago
    > As far as I can tell from the article, the "study" is basically arguing that because most psychiatric diagnoses use circumstantial evidence Perhaps you would have been better served by reading the linked abstract of the paper. The paper specifically criticizes the heterogeneous and inconsistent of classification of identical symptoms in the the diagnostic criteria for similar diagnosis. >> Selected chapters of the DSM-5 were thematically analysed: schizophrenia spectrum and other psychotic disorders; bipolar and related disorders; depressive disorders; anxiety disorders; and trauma- and stressor-related disorders. Themes identified heterogeneity in specific diagnostic criteria, including symptom comparators, duration of difficulties, indicators of severity, and perspective used to assess difficulties. > If a person comes into the ER with the symptoms of a cold and you treat them for a cold, you can't say that the diagnosis of a cold wasn't evidence based simply because the doctor didn't run a test to identify rhinovirus fragments. You picked a particularly odd example. There is no treatment for colds, all that can be done is to alleviate the patients symptoms. Indeed, there a number of situations in which you would indeed want to confirm that the symptoms are caused by the common cold because there are other potential causes that can be life threatening. [0] [0] https://www.health.com/cold-flu-sinus/signs-more-serious-common-cold?slide=418194#418194 https://www.health.com/cold-flu-sinus/signs-more-serious-com... > And if research says that it is a duck 90% of the time, then making that inference is honestly and truly evidence based, even though it leaves open the possibility of 10% misdiagnosis rate. ... what? A 10% misdiagnosis rate because other possible explanation for symptoms are ignored is considered good science and medicine? > It's also not surprising that the assessment criteria would differ markedly between different types of ailments. The criteria for assessing a sprained ankle wouldn't look anything like that for a cold. Except the study explicitly compares similar ailments (more like "sprained ankle" vs "broken ankle" vs "torn ligament in ankle" The main point of the criticism is that unlike other medical diagnosis, psyciactric diagnosis minimize the role of trauma. This is like a doctor trying to diagnose ankle pain while not really considering the fact that you fell off your bike. > Pragmatic criteria and difficulties that recur across multiple diagnostic categories offer flexibility for the clinician, but undermine the model of discrete categories of disorder. This nevertheless has implications for the way cause is conceptualised, such as implying that trauma affects only a limited number of diagnoses despite increasing evidence to the contrary.

> I think empirical is what he expected, as did I frankly. I am pretty clear about what he expected. The question is: on what basis was this expected and is it reasonable to start a semantic debate about it on that basis? What is the "big problem" here?

jaredklewis 7y ago
Let’s say I think about it for a while and decide that C++ is more prone to bugs than other languages. If I present that opinion as, “Study finds C++ more prone to bugs than other languages,” you don’t find it misleading? I think most people assume the word “study” indicates something is backed by a rigorous method of research, like the scientific method. You can’t just make an opinion and then claim it’s a study.
- shkkmo 7y ago
  I would say that "C++ is more prone to bugs than other languages" is a quantitative claim and it is difficult to back up a quantitative claim without quantitative evidence. I don't think it calling itself a "study" should have any bearing on your desire to see that quantitative evidence or on your general epistemic stance towards the claims. > I think most people assume the word “study” indicates something is backed by a rigorous method of research, like the scientific method. You can’t just make an opinion and then claim it’s a study. I get that there may be some connotation in the context of headlines that empirical evidence gathering was involved. Does that make it ludicrous to use the term? Not at all. The paper and the article are both clear about what was involved in the study. I really don't see how there is a "big problem" here (especially compared to issues of reproducibility in studies that are back by empirical data.) My big concern is the assertions that papers like this are not part of a "rigorous method of research, like the scientific method" completely discount the important role that such papers play in drawing the solid conclusions from data.
- candiodari 7y ago
  This is not the same, nor does anyone claim it's the same. People just see "science" and think physics, which is only one standard of science. However physics (70%-80% of it at least, big exceptions are theoretical physics and philosophy of physics) is an empirical science, psychology and psychiatry is not. Or to put it in more clear terms, if proof is how you think of science, then none of the sciences other than physics, chemistry and math are science at all. https://en.wikipedia.org/wiki/Outline_of_academic_disciplines https://en.wikipedia.org/wiki/Outline_of_academic_discipline... Psychology (and psychiatry) fall under the social sciences. These do not claim to be value-free. In other words, they draw conclusions because people feel those conclusions to be "needed", or socially relevant. Not even valid, in terms of truth versus fiction. The problem is that with psychiatry you have quite a few studies that point out it's not empirically valid at all: 1) diagnoses of mental illness are made on factors other than the patient or the symptoms: (for example they are made on available space, how "necessary" bed & meals are for the patient, whether the referring person needs them to be admitted, ...) https://en.wikipedia.org/wiki/Rosenhan_experiment https://en.wikipedia.org/wiki/Rosenhan_experiment Worse, the same goes for involuntary mental treatment and even youth care. All of those interventions, including everything from limiting study choice to locking a kid up for 2 decades, are based on whether a social worker considers such a thing socially needed. These determinations are made not on the child or person, but on the perceived need from the people asking for such a "diagnosis" and intervention. And that's the normal practice, not cases of abuse (which happen regularly, because of course admitting a patient pays, as well as the need for validation these people have) So, for instance, and as shown in the experiment, psychiatrists will lock up, place in isolation, medicate and use violence against patients to get them to admit/confess to a diagnosis by an earlier mental health professional. This is the normal practice, and not exceptional. 2) mental health treatment does not actually make patients better, or at least, despite 2 centuries of searching, there is no empirical or statistical evidence beyond "professionals say it works". Or, more dramatically: https://www.buzzfeednews.com/article/esmewwang/psychiatric-hospital-inpatient-collected-schizophrenias https://www.buzzfeednews.com/article/esmewwang/psychiatric-h... 2b) furthermore effectiveness studies keep, again and again, pointing out that only factors that have nothing to do with mental health theories and nothing to do with mental health treatment matter for the number of afflicted. Chiefly it is pointed out that mental health clinics tend to get filled. So the number of afflicted is determined by supply of care rather than by patient demand. Second studies keep pointing out that the relationship with carers matters for outcomes, and that specifically treatment, medicine, duration, ... doesn't matter at all. Third studies keep pointing out that "care" is used as a coercive social control tool Fourth when it comes to severity of problems the economic situation matters a lot more than anything the professionals do or know. 3) there are many abuses of the system by mental health professionals, and these have persisted over centuries "historical" (which should not be taken as "past" in most cases) https://en.wikipedia.org/wiki/Ten_Days_in_a_Mad-House https://en.wikipedia.org/wiki/Ten_Days_in_a_Mad-House https://en.wikipedia.org/wiki/Aktion_T4 https://en.wikipedia.org/wiki/Aktion_T4 https://en.wikipedia.org/wiki/Political_abuse_of_psychiatry_in_the_Soviet_Union https://en.wikipedia.org/wiki/Political_abuse_of_psychiatry_... https://www.scmp.com/news/world/europe/article/3016435/angels-and-demons-police-italy-arrest-18-accused-brainwashing https://www.scmp.com/news/world/europe/article/3016435/angel... https://www.bbc.com/news/health-48367071 https://www.bbc.com/news/health-48367071 https://www.bbc.co.uk/news/resources/idt-sh/norways_hidden_scandal https://www.bbc.co.uk/news/resources/idt-sh/norways_hidden_s... (pedofile using state power to kidnap children and place them ... with himself) https://www.commissiegeweldjeugdzorg.nl/onderzoek/english/ https://www.commissiegeweldjeugdzorg.nl/onderzoek/english/ https://en.wikipedia.org/wiki/Rotherham_child_sexual_exploitation_scandal https://en.wikipedia.org/wiki/Rotherham_child_sexual_exploit... https://www.bbc.com/news/world-europe-49320260 https://www.bbc.com/news/world-europe-49320260 https://www.washingtonpost.com/nation/2019/06/05/an-anguished-dutch-teenager-who-was-raped-child-is-euthanized-her-request/ https://www.washingtonpost.com/nation/2019/06/05/an-anguishe... ... 4) truth be told there are many abuses of the system by "patients". Just visit a mental health facility or psychiatrist and ask about the homeless that want to be taken "into care". I guarantee details will be forthcoming.
wahern 7y ago
It's odd to see a "study" that says psychiatric diagnoses are not evidence-based which itself doesn't actually use empirical evidence. As far as I can tell from the article, the "study" is basically arguing that because most psychiatric diagnoses use circumstantial evidence--that is, they don't rely on tools like an MRI to quantitatively identify and classify a neurologically-based defect--that it's not evidence based. But that doesn't follow. Most of medicine is like psychiatry, at least in the way that that paper seems to criticize. If a person comes into the ER with the symptoms of a cold and you treat them for a cold, you can't say that the diagnosis of a cold wasn't evidence based simply because the doctor didn't run a test to identify rhinovirus fragments. If it's known that the vast majority of such cases would be rhinovirus, that the vast majority of cases for those with something more severe (and where misdiagnosis would be dire) would present with different symptoms, then treating the patient as-if they have rhinovirus is a legitimately evidence-based, experimentally supported activity. It may not be ideal for each particular patient. The doctor isn't searching for some objective truth about each patient's condition. But so what? We do that because we're trying to maximize population wide outcomes. If we abstained from diagnosing every cold without first identifying viral fragments, many people would not only go undiagnosed but completely untreated, including those with much more severe infections. If it walks like a duck and quacks like a duck, it just might be a duck. And if research says that it is a duck 90% of the time, then making that inference is honestly and truly evidence based, even though it leaves open the possibility of 10% misdiagnosis rate. It's also not surprising that the assessment criteria would differ markedly between different types of ailments. The criteria for assessing a sprained ankle wouldn't look anything like that for a cold. It would be highly context based. We can't infer that it's therefore not evidence based. Psychiatry may or may not be evidence based, but you can't show that by an examination of the DSM. You have to affirmatively show the absence of a connection to evidence. Without doing that, you could only at best make a persuasive argument that the evidence itself sucks, or that the disease models are weak. But, again, a weak disease model doesn't imply lack of evidence. Our existing models of most diseases are going to look incredibly weak 200 years from now; but it wouldn't be reasonable to say that late 20th century medicine was unscientific, non-evidence-based hokum.
- shkkmo 7y ago
  > As far as I can tell from the article, the "study" is basically arguing that because most psychiatric diagnoses use circumstantial evidence Perhaps you would have been better served by reading the linked abstract of the paper. The paper specifically criticizes the heterogeneous and inconsistent of classification of identical symptoms in the the diagnostic criteria for similar diagnosis. >> Selected chapters of the DSM-5 were thematically analysed: schizophrenia spectrum and other psychotic disorders; bipolar and related disorders; depressive disorders; anxiety disorders; and trauma- and stressor-related disorders. Themes identified heterogeneity in specific diagnostic criteria, including symptom comparators, duration of difficulties, indicators of severity, and perspective used to assess difficulties. > If a person comes into the ER with the symptoms of a cold and you treat them for a cold, you can't say that the diagnosis of a cold wasn't evidence based simply because the doctor didn't run a test to identify rhinovirus fragments. You picked a particularly odd example. There is no treatment for colds, all that can be done is to alleviate the patients symptoms. Indeed, there a number of situations in which you would indeed want to confirm that the symptoms are caused by the common cold because there are other potential causes that can be life threatening. [0] [0] https://www.health.com/cold-flu-sinus/signs-more-serious-common-cold?slide=418194#418194 https://www.health.com/cold-flu-sinus/signs-more-serious-com... > And if research says that it is a duck 90% of the time, then making that inference is honestly and truly evidence based, even though it leaves open the possibility of 10% misdiagnosis rate. ... what? A 10% misdiagnosis rate because other possible explanation for symptoms are ignored is considered good science and medicine? > It's also not surprising that the assessment criteria would differ markedly between different types of ailments. The criteria for assessing a sprained ankle wouldn't look anything like that for a cold. Except the study explicitly compares similar ailments (more like "sprained ankle" vs "broken ankle" vs "torn ligament in ankle" The main point of the criticism is that unlike other medical diagnosis, psyciactric diagnosis minimize the role of trauma. This is like a doctor trying to diagnose ankle pain while not really considering the fact that you fell off your bike. > Pragmatic criteria and difficulties that recur across multiple diagnostic categories offer flexibility for the clinician, but undermine the model of discrete categories of disorder. This nevertheless has implications for the way cause is conceptualised, such as implying that trauma affects only a limited number of diagnoses despite increasing evidence to the contrary.