Tag Archives: medicine

Alternative Medicine and Statistical Validation

“The resistance to statistical evidence is even more pronounced with regard to ‘alternative medicine,’ a vast field that encompasses everything from herbal supplements to energy therapy to yoga…Many adherents and advocates of alternative medicine reject not only Western treatments but the Westernized notion of statistical testing. They sometimes claim that their practices are too ‘individual’ or ‘holistic’ to study scientifically and instead rely on anecdotes and case studies without adequate controls or control groups for comparison. I’m agnostic about whether alternative medicine is effective. But it verges on idiocy to claim that the effectiveness cannot be tested. If it really is important, as alternative medicine advocates claim, to take into account a larger set of information about the patient…then providers who do so should produce better results…When it comes to the back-end inquiry of finding out which treatments are effective, there is no East and West. I throw my lot with two past editors-in-chief of the New England Journal of Medicine, Marcia Angell and Jerome Kassirer: ‘It is time for the scientific community to stop giving alternative medicine a free ride. There cannot be two kinds of medicine–conventional and alternative. There is only one medicine that has been adequately tested and medicine that has not, medicine that works and medicine that may or may not work.” (p. 229)


Evidence Based Medicine and the Aristotelian Approach

“…How do medical myths persist among practicing physicians? Part of the persistence comes from the idea that new studies aren’t really needed. There’s that old Aristotelian pull. The whole idea of empirical testing goes against the Aristotelian approach that has been a guiding principle of research. Under this approach, researchers should first try to understand the nature of the disease. Once you understand the problem, a solution will become self-evident…Instead of focusing on the front-end knowledge about the true nature of disease, [evidence-based medicine] shows the power of asking the back-end question of whether specific treatments work…The Aristotelian approach can go seriously wrong if doctors embrace a mistaken conception or model for how an ailment operates.” (p. 88-89)

Research Says Physical Exams Are Unnecessary, Yet Physicians Persist in Doing Them

“Even when statistical studies exist, doctors are often blissfully unaware of–or, worse yet, deliberately ignore–statistically prescribed treatments just because that’s not the way they were taught to treat. Dozens of studies dating back to 1989 found little support for many of the tests commonly included in a typical annual physical for symptom-less people. Routine pelvic, rectal, and testicular exams for those with no symptoms of illness haven’t made any difference in overall survival rates. The annual physical exam is largely obsolete. Yet physicians insist on doing them, and in very large numbers.”

Doctors Don’t Wash Hands Enough Because They Don’t Trust Statistics

“Doctors today of course know the importance of cleanliness. Medical dramas show them meticulously scrubbing in for operations. But the Semmelweis story remains relevant. Doctors still don’t wash their hands enough. Even today, physicians’ resistance to hand-washing is a deadly problem. But most importantly, it’s still a conflict that is centrally about whether doctors are willing to change their modus operandi because a statistical study says so.” (p. 83)