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Why Small, Self-Selected Studies Are A Bad Way To Make Health Care Recommendations

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HuckleB Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Oct-01-11 11:35 AM
Original message
Why Small, Self-Selected Studies Are A Bad Way To Make Health Care Recommendations
Edited on Sat Oct-01-11 11:41 AM by HuckleB
Are Most Medical Studies Wrong?
http://theness.com/neurologicablog/index.php/are-most-m... /

"...

The implications of Ioannidis research, therefore, is not to undermine or abandon scientific medicine, but rather to demonstrate the importance of re-introducing prior probability in our evaluation of the medical literature and in deciding what to research. As much as I am in favor of the Evidence-Based Medicine (EBM) movement, it does not consider prior probability. I have said before that this is a grave mistake, and the work of Ioannidis provides statistical support for this. One of the best ways to minimize false positives is to carefully consider the plausibility of the intervention being studied. CAM proponents are deathly afraid of such consideration for they live in the world of infinitesimal probability.

...

With regard to scientific medicine, I would emphasize what Tabbarok said about evaluating the literature, not a single study. Ioannidis compared single studies to the later literature using the literature as its own gold standard. This does not mean that medical research is wrong. It just means that a research question has to mature, that multiple studies by independent researchers are required before we arrive at a reliable conclusion.

The implications for the practicing physician are clear dont overreact to every study, do not practice knee-jerk medicine. Take a cool and skeptical eye at published research, and follow the rules of thumb above. When this is done it is possible to practice science-based medicine that is very reliable.

The implications for society are also clear a rational health care system must be based upon sound scientific reasoning as well as the best evidence available (what I call science-based medicine, to distinguish it from the laudable but inadequate evidence-based medicine). Also and this applies to individuals as well as the science media any single study must be put into the context of the broader literature. Great mischief has been inflicted upon the public by the media touting the resuls of a single study (almost always described as a breakthrough) without providing any scientific context."


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A bit more on the topic:

We're so good at medical studies that most of them are wrong
http://arstechnica.com/science/news/2010/03/were-so-goo...

Why Most Published Research Findings are False
http://marginalrevolution.com/marginalrevolution/2005/0...


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It's odd to note that this has been used to attack science and medicine, in general. At the same time, it has been ignored by many who use it to attack science, while they find small, select studies to justify the quack treatments they are selling. The repeated use of double-standards, along with ridiculous hyperbole ("health freedom!" = "regulate big pharma but not big supplement!") ought to cause any skeptical consumer to question these pushers every step of the way. (It's not freedom they're selling, btw.)

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HuckleB Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Oct-01-11 05:49 PM
Response to Original message
1. It's funny. They actually have people screaming "THEY don't want us taking control of our health."
When the reality is that Big Supplement is trying to make sure that we are not in charge of our health. They want to ensure that we're always guessing what works and what doesn't, and what's in any product, and on and on.

It's one bizarre but quite successful propaganda campaign.
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HuckleB Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Oct-01-11 09:28 PM
Response to Original message
2. It's bizarre that people unrec basic logic and science.
What sort of delusional constitution is necessary to do that? Are that many unable to question their preconceived beliefs?
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xchrom Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Oct-02-11 10:28 AM
Response to Original message
3. recommend
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HuckleB Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-07-11 08:08 AM
Response to Reply #3
4. Thank you.
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bemildred Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-07-11 10:26 AM
Response to Original message
5. K&R.
Garbage in, garbage out, as we like to say in the IT business.
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HuckleB Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Oct-14-11 09:51 AM
Response to Reply #5
6. Thank you.
And yet the board continues to be spammed by individuals who don't want to understand this.
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bemildred Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Nov-26-11 12:01 AM
Response to Reply #6
9. No problem, pin at the top. nt
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HuckleB Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Nov-25-11 05:21 PM
Response to Original message
7. Apparently this needs to be kicked again.
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laconicsax Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Nov-25-11 11:25 PM
Response to Reply #7
8. I'd be best as a sticky. n/t
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mopinko Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Nov-26-11 01:33 PM
Response to Reply #8
12. we almost never sticky. sorry.
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laconicsax Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Nov-26-11 06:14 PM
Response to Reply #12
13. Almost means there are exceptions.
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mopinko Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Nov-26-11 06:31 PM
Response to Reply #13
14. yeah, but this isn't one.
really, messages from admin is about it. you can take it to ata if you like.
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HuckleB Donating Member (1000+ posts) Send PM | Profile | Ignore Sun Nov-27-11 06:35 PM
Response to Reply #8
15. The health forum could use a few stickies.
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ellenrr Donating Member (619 posts) Send PM | Profile | Ignore Sat Nov-26-11 07:05 AM
Response to Original message
10. I agre...a much better way to conduct a study is to have the pharmaceutical industry fund it, run it
Edited on Sat Nov-26-11 07:05 AM by ellenrr
and choose the participants.....

because it will be sure to be unbiased
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HuckleB Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Nov-26-11 10:08 AM
Response to Reply #10
11. Thanks for responding.
Please read the OP. Thank you.
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laconicsax Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Dec-08-11 07:53 PM
Response to Original message
16. Kick.
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