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Woah, you're way off when talking about sciencebasedmedicine.org. That's Steve Novella's site - and he's about as respected as you get in the sceptic community.

Woah, you're way off when talking about sciencebasedmedicine.org. That's Steve Novella's site - and he's about as respected as you get in the sceptic community. If you want to claim that it's mostly industry propaganda, you'd better have some good evidence to back up the claim!

Alex3917 14y ago
"He's about as respected as you get in the sceptic community" Ever look up how respected skepticism is within the larger philosophical community? I mean look at my pastebin post: http://pastebin.com/cniysd82 http://pastebin.com/cniysd82 And this encompasses only a small fraction of the corruption within the pharmaceutical industry, because I wanted to make it readable. There are literally dozens of book published on this. But does SBM actually address any of the criticism? Not a single point of it, because there is no defense; in fact, it's all coming from high-level 'insiders' in the medical community -- JAMA, NEJM, the IOM, etc. Instead they just spin it in order to trick people who are predisposed to have faith in modern medicine. (And I use the term faith, because if you're familiar with these issues then it's unmistakably clear that this is really what it is.) What science-based medicine does (again, the blog, not the concept) is really no different than what the evangelical megachurches do, it's just dressed up in different language.
- shrikant 14y ago
  Honestly, a lot of the points you make about SBM (the blog) are quite disturbing to me, as it is one of my primary resources as a lay-person to keep up with developments in woo, quackery and general commentary on popular medical reporting. I hope you don't see these questions as confrontational because I genuinely would like to be pointed in the right direction for the some of these claims. (speaking as a relatively liberal person who recently joined a host of strongly conservative forums to get a picture of "the other side"...) > Ever look up how respected skepticism is within the larger philosophical community? I gather this means that it's not respected? Why is that? I find it hard to believe that scientific skepticism (and not the truther/birther/moon-landing-was-a-hoax kind) can find widespread opposition in any sort of critical thinking community. > Instead they just spin it in order to trick people who are predisposed to have faith in modern medicine. Are there any examples of this from the blog? I was (and am) under the impression that a lot of writing is backed up by fairly solid reasoning, references and such. > What science-based medicine does (again, the blog, not the concept) is really no different than what the evangelical megachurches do, it's just dressed up in different language. How so? This analogy sounds suspiciously like fundamentalists' claims of "scientism" and "science is just another religion!". If you mean something else, then do elaborate.
  - Alex3917 14y ago
    "I gather this means that it's not respected?" Firstly, skepticism is basically just a new name for a discredited philosophical movement called 'logical positivism', in the same way that intelligent design is basically just a new name for creationism. The section on positivism here has a brief summary: http://plover.net/~bonds/nolongeraskeptic.html http://plover.net/~bonds/nolongeraskeptic.html I'm not sure where the best place to go for information on this would be though to be honest. Wikipedia has a brief article also but it's not especially helpful: http://en.wikipedia.org/wiki/Logical_positivism http://en.wikipedia.org/wiki/Logical_positivism "Are there any examples of this from the blog?" - "It turns out that physicians view pharma funding sources negatively" When there is disclosure that the studies were pharma funded. Often times this isn't disclosed even though it's supposed to be. Additionally, it's been proven beyond a doubt that pharma reps, dinners, gifts, etc. influence doctor's prescribing habits, but this is never mentioned, even though the point of the blog post is supposedly to show that it's rare for doctors to be under the influence of pharma. - "On the other hand, this study also made me wonder if perhaps we place too much confidence in research funded by the NIH. [...] NIH funding is not a guarantee of quality science by any means." Again the research unambiguously shows that pharma-funded research is vastly for more likely to find positive results for the drug in question than NIH research. - "For example, a recent study found a correlation with government funding of a trial and positive results, and another study found no higher likelihood of positive outcomes in industry-sponsored trials but a higher likelihood of reporting double-blinding" Even when he mentions that pharma sponsored studies are 'associated with' increased likelihood of favorable results, he cites one or two minor studies instead of the most important meta-studies on this topic. - "Moreover, several studies have suggested that from a methodological standpoint industry-funded studies published in peer-reviewed journals are of equivalent or higher quality than clinical trials funded by other mechanisms." Citation needed. - "This is not surprising, given that many clinical trials funded by pharmaceutical companies are done for the purpose of winning FDA approval for a drug, either initially or for expanded indications, and the FDA has stringent requirements for these clinical trials." So what he's really saying is that he's comparing apples and oranges. - "Indeed, as I mentioned, this NEJM study doesn’t tell me anything that I didn’t already know" The classic tactic of claiming that everything negative isn't important because it's 'something we already knew' - "I’ve come to the conclusion that most doctors, at least in this sample, probably have it about right or may even be a little more skeptical of pharma than necessary." You've got to be freaking kidding me. Again, look at the list of the most prescribed drugs, both psychiatric and non-psychiatric. And then look at what percentage of those are actually better than placebos or generics. > "If you mean something else, then do elaborate. In this case I was kind of referring to how preachers will get up on stage and do the gish gallup as an attempt to discredit evolution, as well as using emotional arguments and emotional tricks rather than facts or logic. I generally do think that a lot of science falls into the category of scientism, but that isn't what I was getting at here. I also generally think there are good reasons for considering science to be a religion, but that's also not what I was getting at.
- lambda 14y ago
  > Ever look up how respected skepticism is within the larger philosophical community? I'm a little unclear on what point you're trying to make here. Can you clarify? > I mean look at my pastebin post: http://pastebin.com/cniysd82 http://pastebin.com/cniysd82 I took a look at your pastebin post. There are a lot of criticisms there of various kinds of bad practices, but not all of them have anything to do with whether the medicines actually work. For instance, the patent issue; while that's a fair issue in its own right, whether large pharmaceutical companies can prevent people from making generic equivalents by using patents does not affect whether the drug works or not. Or direct to consumer advertising; again, it may be a bad idea, but it doesn't have anything to do with whether the drugs actually work. Many of the other criticisms here are fairly hypothetical. Yes, there are places where the system isn't ideal, where there's potential for the wrong incentives. There are places where it would be nice to do research that covered a broader spectrum. But that doesn't mean that it's all invalid. We live in an imperfect world. We should try to fight those cases when we can, try to get better results, but you shouldn't write off the entire industry merely because it's imperfect. Here's another example. In the software industry, I see bad practices all the time. People not writing unit tests, not doing full regression tests, writing sloppy code that doesn't handle all of the error conditions, and so on. And yet, somehow, we manage to get by. Software generally works, it does what it says, it improves whatever it was setting out to improve. Sure, there are some big expensive failures you can point to. Sure, it would be nice if we did a better job at this, and should try to continue to fight for higher quality software. But just because there is some software imperfectly written doesn't mean that you should just write off the software industry. > But does SBM actually address any of the criticism? Not a single point of it, because there is no defense; in fact, it's all coming from high-level 'insiders' in the medical community -- JAMA, NEJM, the IOM, etc. Really? I just decided to take a look at SBM; I wasn't familiar with it before this thread, but decided to take a look at it. Here's an article on reducing prescriptions for elderly patients, because they may do more harm than good: http://www.sciencebasedmedicine.org/index.php/how-do-we-avoid-harming-the-elderly-with-prescription-drugs/ http://www.sciencebasedmedicine.org/index.php/how-do-we-avoi... (addressing one of your concerns about differences in how medications effect the elderly). Or here's an example where they do address one of the concerns that you mention; they demonstrate that doctors actually are more skeptical of research funded by the pharmaceutical industry: http://www.sciencebasedmedicine.org/index.php/news-flash-doctors-arent-all-compliant-pharma-drones/ http://www.sciencebasedmedicine.org/index.php/news-flash-doc.... > Instead they just spin it in order to trick people who are predisposed to have faith in modern medicine. (And I use the term faith, because if you're familiar with these issues then it's unmistakably clear that this is really what it is.) You know, I do tend to be skeptical of pharmaceutical remedies, and so try to minimize them myself. But to say that you have to have faith to buy into modern medicine is a bit of a stretch. How do you explain ever increasing life expectancies? Clearly, there is something going right in modern medicine. > What science-based medicine does (again, the blog, not the concept) is really no different than what the evangelical megachurches do, it's just dressed up in different language. Citing actual scientific studies, which may be flawed in certain ways, is the same as merely preaching mythology from a 2000 year old book based on no science whatsoever? Remember, "science" is not some binary thing, where if there's one flaw, it's all false. It's a process, by which we attempt to come up with better models of the world, and try to reduce bias in the process. Sometimes there will still be some bias; you won't necessarily be able to eliminate it all. But that doesn't mean it's worthless. There are definitely a lot of ways in which I wish that pharmaceutical research would be improved; but the fact that there are people now who are living perfectly normal lives while HIV positive with anti-retroviral therapies, when just 10 or 20 years ago they would have died of the same disease, leads me to believe that it's not all bad. I wish those drugs were cheaper, that they weren't so tied up with patents, and so on; but you know, I wish I had a pony too. To equate the research and development that went into such life-saving measures as equivalent to an evangelical megachurch is quite frankly ridiculous.

Alex3917 14y ago

"He's about as respected as you get in the sceptic community" Ever look up how respected skepticism is within the larger philosophical community? I mean look at my pastebin post: http://pastebin.com/cniysd82 http://pastebin.com/cniysd82 And this encompasses only a small fraction of the corruption within the pharmaceutical industry, because I wanted to make it readable. There are literally dozens of book published on this. But does SBM actually address any of the criticism? Not a single point of it, because there is no defense; in fact, it's all coming from high-level 'insiders' in the medical community -- JAMA, NEJM, the IOM, etc. Instead they just spin it in order to trick people who are predisposed to have faith in modern medicine. (And I use the term faith, because if you're familiar with these issues then it's unmistakably clear that this is really what it is.) What science-based medicine does (again, the blog, not the concept) is really no different than what the evangelical megachurches do, it's just dressed up in different language.

shrikant 14y ago
Honestly, a lot of the points you make about SBM (the blog) are quite disturbing to me, as it is one of my primary resources as a lay-person to keep up with developments in woo, quackery and general commentary on popular medical reporting. I hope you don't see these questions as confrontational because I genuinely would like to be pointed in the right direction for the some of these claims. (speaking as a relatively liberal person who recently joined a host of strongly conservative forums to get a picture of "the other side"...) > Ever look up how respected skepticism is within the larger philosophical community? I gather this means that it's not respected? Why is that? I find it hard to believe that scientific skepticism (and not the truther/birther/moon-landing-was-a-hoax kind) can find widespread opposition in any sort of critical thinking community. > Instead they just spin it in order to trick people who are predisposed to have faith in modern medicine. Are there any examples of this from the blog? I was (and am) under the impression that a lot of writing is backed up by fairly solid reasoning, references and such. > What science-based medicine does (again, the blog, not the concept) is really no different than what the evangelical megachurches do, it's just dressed up in different language. How so? This analogy sounds suspiciously like fundamentalists' claims of "scientism" and "science is just another religion!". If you mean something else, then do elaborate.
- Alex3917 14y ago
  "I gather this means that it's not respected?" Firstly, skepticism is basically just a new name for a discredited philosophical movement called 'logical positivism', in the same way that intelligent design is basically just a new name for creationism. The section on positivism here has a brief summary: http://plover.net/~bonds/nolongeraskeptic.html http://plover.net/~bonds/nolongeraskeptic.html I'm not sure where the best place to go for information on this would be though to be honest. Wikipedia has a brief article also but it's not especially helpful: http://en.wikipedia.org/wiki/Logical_positivism http://en.wikipedia.org/wiki/Logical_positivism "Are there any examples of this from the blog?" - "It turns out that physicians view pharma funding sources negatively" When there is disclosure that the studies were pharma funded. Often times this isn't disclosed even though it's supposed to be. Additionally, it's been proven beyond a doubt that pharma reps, dinners, gifts, etc. influence doctor's prescribing habits, but this is never mentioned, even though the point of the blog post is supposedly to show that it's rare for doctors to be under the influence of pharma. - "On the other hand, this study also made me wonder if perhaps we place too much confidence in research funded by the NIH. [...] NIH funding is not a guarantee of quality science by any means." Again the research unambiguously shows that pharma-funded research is vastly for more likely to find positive results for the drug in question than NIH research. - "For example, a recent study found a correlation with government funding of a trial and positive results, and another study found no higher likelihood of positive outcomes in industry-sponsored trials but a higher likelihood of reporting double-blinding" Even when he mentions that pharma sponsored studies are 'associated with' increased likelihood of favorable results, he cites one or two minor studies instead of the most important meta-studies on this topic. - "Moreover, several studies have suggested that from a methodological standpoint industry-funded studies published in peer-reviewed journals are of equivalent or higher quality than clinical trials funded by other mechanisms." Citation needed. - "This is not surprising, given that many clinical trials funded by pharmaceutical companies are done for the purpose of winning FDA approval for a drug, either initially or for expanded indications, and the FDA has stringent requirements for these clinical trials." So what he's really saying is that he's comparing apples and oranges. - "Indeed, as I mentioned, this NEJM study doesn’t tell me anything that I didn’t already know" The classic tactic of claiming that everything negative isn't important because it's 'something we already knew' - "I’ve come to the conclusion that most doctors, at least in this sample, probably have it about right or may even be a little more skeptical of pharma than necessary." You've got to be freaking kidding me. Again, look at the list of the most prescribed drugs, both psychiatric and non-psychiatric. And then look at what percentage of those are actually better than placebos or generics. > "If you mean something else, then do elaborate. In this case I was kind of referring to how preachers will get up on stage and do the gish gallup as an attempt to discredit evolution, as well as using emotional arguments and emotional tricks rather than facts or logic. I generally do think that a lot of science falls into the category of scientism, but that isn't what I was getting at here. I also generally think there are good reasons for considering science to be a religion, but that's also not what I was getting at.
lambda 14y ago
> Ever look up how respected skepticism is within the larger philosophical community? I'm a little unclear on what point you're trying to make here. Can you clarify? > I mean look at my pastebin post: http://pastebin.com/cniysd82 http://pastebin.com/cniysd82 I took a look at your pastebin post. There are a lot of criticisms there of various kinds of bad practices, but not all of them have anything to do with whether the medicines actually work. For instance, the patent issue; while that's a fair issue in its own right, whether large pharmaceutical companies can prevent people from making generic equivalents by using patents does not affect whether the drug works or not. Or direct to consumer advertising; again, it may be a bad idea, but it doesn't have anything to do with whether the drugs actually work. Many of the other criticisms here are fairly hypothetical. Yes, there are places where the system isn't ideal, where there's potential for the wrong incentives. There are places where it would be nice to do research that covered a broader spectrum. But that doesn't mean that it's all invalid. We live in an imperfect world. We should try to fight those cases when we can, try to get better results, but you shouldn't write off the entire industry merely because it's imperfect. Here's another example. In the software industry, I see bad practices all the time. People not writing unit tests, not doing full regression tests, writing sloppy code that doesn't handle all of the error conditions, and so on. And yet, somehow, we manage to get by. Software generally works, it does what it says, it improves whatever it was setting out to improve. Sure, there are some big expensive failures you can point to. Sure, it would be nice if we did a better job at this, and should try to continue to fight for higher quality software. But just because there is some software imperfectly written doesn't mean that you should just write off the software industry. > But does SBM actually address any of the criticism? Not a single point of it, because there is no defense; in fact, it's all coming from high-level 'insiders' in the medical community -- JAMA, NEJM, the IOM, etc. Really? I just decided to take a look at SBM; I wasn't familiar with it before this thread, but decided to take a look at it. Here's an article on reducing prescriptions for elderly patients, because they may do more harm than good: http://www.sciencebasedmedicine.org/index.php/how-do-we-avoid-harming-the-elderly-with-prescription-drugs/ http://www.sciencebasedmedicine.org/index.php/how-do-we-avoi... (addressing one of your concerns about differences in how medications effect the elderly). Or here's an example where they do address one of the concerns that you mention; they demonstrate that doctors actually are more skeptical of research funded by the pharmaceutical industry: http://www.sciencebasedmedicine.org/index.php/news-flash-doctors-arent-all-compliant-pharma-drones/ http://www.sciencebasedmedicine.org/index.php/news-flash-doc.... > Instead they just spin it in order to trick people who are predisposed to have faith in modern medicine. (And I use the term faith, because if you're familiar with these issues then it's unmistakably clear that this is really what it is.) You know, I do tend to be skeptical of pharmaceutical remedies, and so try to minimize them myself. But to say that you have to have faith to buy into modern medicine is a bit of a stretch. How do you explain ever increasing life expectancies? Clearly, there is something going right in modern medicine. > What science-based medicine does (again, the blog, not the concept) is really no different than what the evangelical megachurches do, it's just dressed up in different language. Citing actual scientific studies, which may be flawed in certain ways, is the same as merely preaching mythology from a 2000 year old book based on no science whatsoever? Remember, "science" is not some binary thing, where if there's one flaw, it's all false. It's a process, by which we attempt to come up with better models of the world, and try to reduce bias in the process. Sometimes there will still be some bias; you won't necessarily be able to eliminate it all. But that doesn't mean it's worthless. There are definitely a lot of ways in which I wish that pharmaceutical research would be improved; but the fact that there are people now who are living perfectly normal lives while HIV positive with anti-retroviral therapies, when just 10 or 20 years ago they would have died of the same disease, leads me to believe that it's not all bad. I wish those drugs were cheaper, that they weren't so tied up with patents, and so on; but you know, I wish I had a pony too. To equate the research and development that went into such life-saving measures as equivalent to an evangelical megachurch is quite frankly ridiculous.