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So, I walk under a ladder leaning against my house, and 5 minutes later I hammer my thumb instead of a nail. You think those two things are connected? Some people do. Of course, you know (if your head is attached to your neck) that it’s superstition – completely irrational, right? Or, listen to this. When I was a kid, they used to advertise a purported medicine called Carter’s Little Liver Pills. It was good for everything (headaches, indigestion, fatigue and “bile flow,” etc.) – except they weren’t. Maybe good for constipation – and the guy who owned the company – but for everything else, worthless. This so-called healing potion was around for over 80 years when, finally, the FTC (forerunner to the FDA) stepped in and said what the guy in the Carter’s ads, wearing the white coat and gushing about bile flow, was “false and misleading.” But, notwithstanding that, Carter’s Little Liver Pills had loads of people buying the stuff, and swearing about how good it was.
Consider the following, too: If I go to the bathroom at the WTTC, and chance the toilet seat with no paper covering it, am I destined to have an STD? And if I just had lunch and go swimming directly afterwards, am I gonna have a cramp and croak? And should I really put butter on a burn? My mother said so, but should I really do that? The answers are No, No and No to the above (including the toilet seat – provided you don’t have a skin cut). First of all, anecdotal reports do not constitute good evidence. They are not reliable. They are someone’s ideas based on his or her experience, and sometimes it’s just gossip and unfounded. Yeah, a forecasted outcome may have happened, but it doesn’t meant it’s gonna happen again. Ditto for testimonials and other debunked practices. In all of these cases, you can’t necessarily replicate the same results. For example, a guy walking under a ladder may not subsequently hammer his thumb as I did (maybe the doofus will just fall from a scaffold). None of the above is good science. None of it is considered evidence based medicine which relates to the scientific method. (Remember the scientific method that you studied in junior high? It’s the hypothesis, testing and drawing a conclusion thing.) “Evidence based medicine (EBM) is the conscientious, explicit, judicious and reasonable use of modern, best evidence in making decisions about the care of individual patients. EBM integrates clinical experience and patient values with the best available research information” ( this, from the NIH – National Institute of Health). “One of the greatest achievements of evidence-based medicine has been the development of systematic reviews and meta-analyses, methods by which researchers identify multiple studies on a topic, separate the best ones and then critically analyze them to come up with a summary of the best available evidence” (again, from the NIH). We’ll talk about meta-analyses and Random Controlled Trials next time … if I can type – my thumb is killin’ me. Meanwhile, I aint goin’ under that ladder again! Lao Du
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