Posted by: cochinblogger | March 24, 2010

Whither Modern Medicine?

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“Nobody contends that all of science is wrong, or that it hasn’t compiled an impressive array of truths about the natural world. Still, any single scientific study alone is quite likely to be incorrect, thanks largely to the fact that the standard statistical system for drawing conclusions is, in essence, illogical. “A lot of scientists don’t understand statistics,” says Goodman. “And they don’t understand statistics because the statistics don’t make sense.””

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“Correctly phrased, experimental data yielding a P value of .05 means that there is only a 5 percent chance of obtaining the observed (or more extreme) result if no real effect exists (that is, if the no-difference hypothesis is correct). But many explanations mangle the subtleties in that definition. A recent popular book on issues involving science, for example, states a commonly held misperception about the meaning of statistical significance at the .05 level: “This means that it is 95 percent certain that the observed difference between groups, or sets of samples, is real and could not have arisen by chance.”

That interpretation commits an egregious logical error (technical term: “transposed conditional”): confusing the odds of getting a result (if a hypothesis is true) with the odds favoring the hypothesis if you observe that result. A well-fed dog may seldom bark, but observing the rare bark does not imply that the dog is hungry. A dog may bark 5 percent of the time even if it is well-fed all of the time. (See Box 2)”

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“Statisticians perpetually caution against mistaking statistical significance for practical importance, but scientific papers commit that error often. Ziliak studied journals from various fields — psychology, medicine and economics among others — and reported frequent disregard for the distinction.

“I found that eight or nine of every 10 articles published in the leading journals make the fatal substitution” of equating statistical significance to importance, he said in an interview. Ziliak’s data are documented in the 2008 book The Cult of Statistical Significance, coauthored with Deirdre McCloskey of the University of Illinois at Chicago.”

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““Determining the best treatment for a particular patient is fundamentally different from determining which treatment is best on average,” physicians David Kent and Rodney Hayward wrote in American Scientist in 2007. “Reporting a single number gives the misleading impression that the treatment-effect is a property of the drug rather than of the interaction between the drug and the complex risk-benefit profile of a particular group of patients.””

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Big pharma has often been caught red-handed with its hands in the till. But its cousin, modern medicine, has managed to cloak itself in scientific invincibility, its mantra being “evidence-based medicine.” In fact, big pharma and modern medicine collude for mutual benefit.

Here is a study that makes nonsense of modern medicine’s claim of standing for evidence-based medicine. Instead, write the study authors, the motto should be “marketing-based medicine.” Read the entire study here:

http://freepdfhosting.com/ebaef05bfe.pdf

Now comes a whopper of an article that casts doubt on how statistical hypothesis testing is currently applied in science. See the excerpts above for a flavor of the author’s thesis. I’m no mathematical virgin myself, but even I had to dig deep to understand the Transposed Conditional (or Prosecutor’s) fallacy. I can also understand how the word “significant,” which has a special meaning in statistics, can be misused.

Even the gold standard of modern medicine, random controlled testing, is not infallible. However, the achievements of modern medicine are undeniable. It seems that the key to eliciting the truth is replication, which medical researchers insist on. Other sciences are not so demanding.

Kerala is the home of Ayurveda, and Ayurvedic physicians will be happy to see Excerpt 4 above. They have always contended that medical treatment must be based on the individual, and that the shotgun approach of modern medicine is misguided.

The need of the hour is a happy fusion of modern medicine and alternative medicine. That, however, is not even a speck on the horizon.

Posted from Diigo.

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