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Questioning The Conclusions Of Science
This question arises from the discussion in R&S on the dubious practice of Water Divining. Sometimes the conclusions of science result not from positive evidence that the subject is invalid, but from absence of evidence. Whilst I know the scientifically minded will say ‘until evidence is forthcoming, I won’t consider the possibility’, but the question is do those who accept the conclusions of science ever waver and consider the possibility that evidence could exist that science has missed – or has overlooked – or is currently technologically incapable of recognising or testing?
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Yes, there is, to some extent, and you have to be careful what you tell the patients. If you want to do it properly you have to "double-blind". Each patient is told that they are receiving a new drug, and each person who administers the drug doesn't know if it is the placebo/ current standard drug, or the new one. Tests where the patients thinks they might have received placebo are less valid, but if you have a large enough sample size, hopefully they won't affect the analysis too much. It does need to be taken into account. Thing is, it usually is already, so that some of Naomi's questions, while valid, are hardly new to the scientists conducting the experiments. They try -- and usually succeed -- to take these factors into account.
You need, really, to be able to read the original papers and data for each test. Problem is that most people are either unable to do that (not enough scientific/ statistical education), or unwilling to take the time to do so, and so rely on the media to deliver the news.
You need, really, to be able to read the original papers and data for each test. Problem is that most people are either unable to do that (not enough scientific/ statistical education), or unwilling to take the time to do so, and so rely on the media to deliver the news.
In the case of treatments for guaranteed fatal conditions, the ethics of dishing out placebos to patients is probably worth a discussion in itself.
In fact I was even under the impression that, where medical research is still at the stage of scrabbling around trying to keep a category of patients alive long enough to test further treatments, they sidestep the placebo routine and frantically try anything and everything on them until decent looking numbers of patients start surviving. Then you start using proper methodology.
Next:
You have several persons, each with 1 anecdote about a succesful dowsing session. You don't know if they have 99 failed attempts (each) that they are concealing from you and you don't even know whether they've even indulged in a second dowsing attempt, ever in their lives.
What do you imagine science would make of a dataset of this quality?
Enthusiasm or... 'meh'?
In fact I was even under the impression that, where medical research is still at the stage of scrabbling around trying to keep a category of patients alive long enough to test further treatments, they sidestep the placebo routine and frantically try anything and everything on them until decent looking numbers of patients start surviving. Then you start using proper methodology.
Next:
You have several persons, each with 1 anecdote about a succesful dowsing session. You don't know if they have 99 failed attempts (each) that they are concealing from you and you don't even know whether they've even indulged in a second dowsing attempt, ever in their lives.
What do you imagine science would make of a dataset of this quality?
Enthusiasm or... 'meh'?
Jim, //Then all medical science is invalid, by that standard,//
So now you're an expert in medical science too! That is complete and utter rubbish. I've personally taken part in trials designed to ascertain whether or not a particular substance would improve a specific medical condition. The test wasn't designed as an exercise in psychological reactions - and none of the participants were given placebos.
So now you're an expert in medical science too! That is complete and utter rubbish. I've personally taken part in trials designed to ascertain whether or not a particular substance would improve a specific medical condition. The test wasn't designed as an exercise in psychological reactions - and none of the participants were given placebos.
Yes, I think that first bit is right, Hypo -- I was talking about tests where you are able to have proper methodology. Mind, not all large companies practise it, but more often than not the results are better medicines. If you were to revert to a test where a 10% cured medicine is deemed "effective", it would be a backwards step for medical research.
Naomi -- did you read the paper afterwards?
And even if no-one was given a placebo, in that specific case, more often than not it's the standard baseline. You have to compare against something. No, I'm not an expert in medical science. I hope that in my time I've learned rather a lot more about how it works, though, than most people have.
And even if no-one was given a placebo, in that specific case, more often than not it's the standard baseline. You have to compare against something. No, I'm not an expert in medical science. I hope that in my time I've learned rather a lot more about how it works, though, than most people have.
Jim, //If you were to revert to a test where a 10% cured medicine is deemed "effective", it would be a backwards step for medical research.//
I don’t know what you mean by ‘revert’. Doctors test drugs on volunteers to ascertain the effectiveness or otherwise of those drugs. Unless they’re testing the psychological effect of taking a tablet, they don’t play games. They’re in the serious business of trying to find ways to cure disease.
I don’t know what you mean by ‘revert’. Doctors test drugs on volunteers to ascertain the effectiveness or otherwise of those drugs. Unless they’re testing the psychological effect of taking a tablet, they don’t play games. They’re in the serious business of trying to find ways to cure disease.
If they were testing the psychological effect of taking a tablet, they usually wouldn't tell the patients. I would like to know how often you follow up those studies in which you participate and read the papers afterwards, to see what was being tested and how.
The psychological effect of taking tablets has been studied to the point where I'm fairly sure it's been shown that it makes a difference what colour the pill is; while more people get better from saline injections than from sugar pills. I'll see if I can dig up citations for this later. But the point is that if you just give patients your new drug and nothing else to compare it to, you could have huge rates of success without knowing if it was the drug itself or just a placebo effect. Doesn't always have to be placebo, but you will usually need a control group of some sort.
The psychological effect of taking tablets has been studied to the point where I'm fairly sure it's been shown that it makes a difference what colour the pill is; while more people get better from saline injections than from sugar pills. I'll see if I can dig up citations for this later. But the point is that if you just give patients your new drug and nothing else to compare it to, you could have huge rates of success without knowing if it was the drug itself or just a placebo effect. Doesn't always have to be placebo, but you will usually need a control group of some sort.
It's a little known and unpopular fact that laboratory rats, if supplied with nothing more than adequate food and water, a few percent will spontaneously develop cancer.
They have been bred for generations in such a way as to iron out the genetic variability found in the wild population, with the aim of ensuring that they all respond in roughly the same way to the substances tested on them. So, when some of the control group comes down with tumours, the researcher has to perform a lot of analysis to draw conclusions about whether the test substance is causing cancer at a level "above chance".
Ultimately, it always comes down to proving that an observation goes beyond chance occurrence.
They have been bred for generations in such a way as to iron out the genetic variability found in the wild population, with the aim of ensuring that they all respond in roughly the same way to the substances tested on them. So, when some of the control group comes down with tumours, the researcher has to perform a lot of analysis to draw conclusions about whether the test substance is causing cancer at a level "above chance".
Ultimately, it always comes down to proving that an observation goes beyond chance occurrence.
Fair enough -- I'll reserve judgment until I see those studies for myself.
In the long run, 10% efficacy is better than 0%, but you have to be sure that that 10% was better than what you would get if you did just give sugar, or conventional medicine, or whatever. At the very least, you need a context before you can say that 10% is worth pursuing. If indeed nothing else worked, then ship it out and fast!-- but as a raw figure 10% means very little.
There are very few cases that I know of where you do have a 0% survival rate for some disease -- if you know of any yourself it would do me good to ehar of them. Even one of the deadliest diseases in the world, Ebola, has "only" a 68% mortality rate, and currently there is no known cure beyond supportive treatment. HIV is also deadly, but treatments now exist such that any new drug with a raw 10% survival rate after five years would be discarded as ineffective.
One way or another, you will almost invariably need something to compare to. The only exception would be if there is nothing at all that works, when like Hyopgnosis says, doctors would throw methodology out of the window and take what they can get. But that is indeed the exception rather than the rule, and if you have the time then the proper methodology means comparison with something. Even if it's another study already done, you compare with that.
In the long run, 10% efficacy is better than 0%, but you have to be sure that that 10% was better than what you would get if you did just give sugar, or conventional medicine, or whatever. At the very least, you need a context before you can say that 10% is worth pursuing. If indeed nothing else worked, then ship it out and fast!-- but as a raw figure 10% means very little.
There are very few cases that I know of where you do have a 0% survival rate for some disease -- if you know of any yourself it would do me good to ehar of them. Even one of the deadliest diseases in the world, Ebola, has "only" a 68% mortality rate, and currently there is no known cure beyond supportive treatment. HIV is also deadly, but treatments now exist such that any new drug with a raw 10% survival rate after five years would be discarded as ineffective.
One way or another, you will almost invariably need something to compare to. The only exception would be if there is nothing at all that works, when like Hyopgnosis says, doctors would throw methodology out of the window and take what they can get. But that is indeed the exception rather than the rule, and if you have the time then the proper methodology means comparison with something. Even if it's another study already done, you compare with that.
Not at all sure where this argument is going.
In the process of bringing new drugs to the medical marketplace, there is a well established process. Laboratory tests and proof of concept. Animal studies as proof of efficacy. This is known as the Pre-Clinical Phase. Then Clinical Trials - 3 phases, 1 through 3, each requiring human volunteers, each phase testing for something slightly different, and requiring a different scale of volunteer numbers. I have simplified the process enormously, for space reasons. Each phase is a major undertaking in itself, costing potentially millions of pounds. Wiki has a pretty good page on drug development, if you wish to read further..
http://
In the phase 3 trials, where a drug is being introduced to treat a known disorder or disease, the gold standard of testing is a Randomised Double Blind Clinical Trial. As part of this process the volunteers will be randomised into a group that receives the trial drug, and a group that receives a placebo - although if you are developing a new drug for an existing and known disease, better practice would be to test against the current best performing drug/treatment protocol - This is something pharma companies often fail to do, preferring to use a placebo control instead, for obvious commercial reasons.
If you are developing a brand new drug for a brand new condition, one only recently diagnosed, any drug would still have to follow the same process as above.
Whether a drug is deemed to be successful or not will depend on confidence levels.
Only in those conditions where the disease is invariably fatal will some of these control measures in stage 3 trials be relaxed, to allow for experimental treatment, where patients can sign up under informed consent conditions.
It would obviously be highly unethical to randomise a trial into a drug cohort and a placebo cohort of patients where the disease they were suffering from was terminal.
Some drug trials where you have a treatment cohort and a placebo cohort are terminated early because the early data from the drug cohort shows a significant improvement in the diease being treated for, since it would become unethical to knowingly continue to offer placebo when a truly effective treatment is available.
In the process of bringing new drugs to the medical marketplace, there is a well established process. Laboratory tests and proof of concept. Animal studies as proof of efficacy. This is known as the Pre-Clinical Phase. Then Clinical Trials - 3 phases, 1 through 3, each requiring human volunteers, each phase testing for something slightly different, and requiring a different scale of volunteer numbers. I have simplified the process enormously, for space reasons. Each phase is a major undertaking in itself, costing potentially millions of pounds. Wiki has a pretty good page on drug development, if you wish to read further..
http://
In the phase 3 trials, where a drug is being introduced to treat a known disorder or disease, the gold standard of testing is a Randomised Double Blind Clinical Trial. As part of this process the volunteers will be randomised into a group that receives the trial drug, and a group that receives a placebo - although if you are developing a new drug for an existing and known disease, better practice would be to test against the current best performing drug/treatment protocol - This is something pharma companies often fail to do, preferring to use a placebo control instead, for obvious commercial reasons.
If you are developing a brand new drug for a brand new condition, one only recently diagnosed, any drug would still have to follow the same process as above.
Whether a drug is deemed to be successful or not will depend on confidence levels.
Only in those conditions where the disease is invariably fatal will some of these control measures in stage 3 trials be relaxed, to allow for experimental treatment, where patients can sign up under informed consent conditions.
It would obviously be highly unethical to randomise a trial into a drug cohort and a placebo cohort of patients where the disease they were suffering from was terminal.
Some drug trials where you have a treatment cohort and a placebo cohort are terminated early because the early data from the drug cohort shows a significant improvement in the diease being treated for, since it would become unethical to knowingly continue to offer placebo when a truly effective treatment is available.
@ Jim I have kind of lost track of where the argument has gotten to, so I am not qualified to comment on the sense or otherwise of the argument ;)
Its factually true to say that no new drug is introduced to the market without first having gone through those various development phases. And a phase 3 trial requires at least a placebo arm. I can think of no modern drug which has not gone through that process. If you have an example of one, I would be grateful.
Far better of course, better than placebo, would be to insist that the control arm is the best currently available drug/treatment protocol, rather than placebo, because this would tell you if a new drug is actually better than whats currently available, as good as, or - and this is possible - worse than what is currently available.
And the other option that is desperately needed is a proper register of drug trials, global in extent, regulated by the various Medical Health Authorities, that track the development and performance of a drug, so that trials that show poor results cannot be buried away. At the moment, even given the rigours of the current system, the system can be gamed, and negative data buried, thus skewing the results, which should be disturbing to everyone...
Its factually true to say that no new drug is introduced to the market without first having gone through those various development phases. And a phase 3 trial requires at least a placebo arm. I can think of no modern drug which has not gone through that process. If you have an example of one, I would be grateful.
Far better of course, better than placebo, would be to insist that the control arm is the best currently available drug/treatment protocol, rather than placebo, because this would tell you if a new drug is actually better than whats currently available, as good as, or - and this is possible - worse than what is currently available.
And the other option that is desperately needed is a proper register of drug trials, global in extent, regulated by the various Medical Health Authorities, that track the development and performance of a drug, so that trials that show poor results cannot be buried away. At the moment, even given the rigours of the current system, the system can be gamed, and negative data buried, thus skewing the results, which should be disturbing to everyone...
I probably do go off on a tangent at times... more often than I would like, anyway. Then again, in a topic like this at least I'm fairly sure I have a great deal to offer.
Sometimes I type faster than I think. Perhaps it would be better to allow myself a short five- or ten-minute break between reading your post and replying to it. So I suppose that gives you licence to ignore everything I say if it's time-stamped less than that amount of time after your post!
More seriously now, I'm still learning how to express myself. I hope you get the gist, despite the tangents every now and then.
The "immovable rule" as you put it is not, by the way, that science knows all. Really it isn't. If it seems like that, it's because I'm presenting my final thoughts rather than the journey I took to get there -- and because sometimes I@m less coherent than I think I am. When I'm saying it to myself in my head it always sounds far more convincing. It is, rather, that Science has higher standards for something to be accepted. It seems to me that at the very least you should take the positions adopted by a majority of scientists very seriously indeed. There's very often good reason for those positions. Not always, but often -- and each case has to be taken on its merits. Science is about the method not the results, and that method is highly rigorous and extraordinarily fruitful. It's not always applied correctly, even by scientists, of course. But that doesn't meant that there's a problem with the method. Just, occasionally, with the people who practise it.
Sometimes I type faster than I think. Perhaps it would be better to allow myself a short five- or ten-minute break between reading your post and replying to it. So I suppose that gives you licence to ignore everything I say if it's time-stamped less than that amount of time after your post!
More seriously now, I'm still learning how to express myself. I hope you get the gist, despite the tangents every now and then.
The "immovable rule" as you put it is not, by the way, that science knows all. Really it isn't. If it seems like that, it's because I'm presenting my final thoughts rather than the journey I took to get there -- and because sometimes I@m less coherent than I think I am. When I'm saying it to myself in my head it always sounds far more convincing. It is, rather, that Science has higher standards for something to be accepted. It seems to me that at the very least you should take the positions adopted by a majority of scientists very seriously indeed. There's very often good reason for those positions. Not always, but often -- and each case has to be taken on its merits. Science is about the method not the results, and that method is highly rigorous and extraordinarily fruitful. It's not always applied correctly, even by scientists, of course. But that doesn't meant that there's a problem with the method. Just, occasionally, with the people who practise it.
I think Shakespeare could be invoked to summarise Naomis position, stated in the OP "There are more things in heaven and earth, Horatio,
Than are dreamt of in your philosophy.
- Hamlet (1.5.166-7), Hamlet to Horatio"
And logically, that is true. It is possible that there is a some new breakthrough in science waiting out there that could explain some of the mysteries we now face, or that would allow for FTL.
We can probably find examples of this, if we search back through history - examples of a breakthrough brought about by observation and experimentation, or even by accident.
My point though, with respect to this idea - that there are still transformative ideas out there - is that the opportunities for such revolutionary ideas reduces with increasing scientific knowledge. In modern times, science has become additive, rather than transformative. This is why for me the idea that we can have a breakthrough that allows for some of the sci-fi concepts, like FTL, or teleportation, or Laser Pistols/ swords are extremely improbable.
And I would disagree with another of Naomis premises - which is that some pyschic/paranormal behaviour cannot be tested under controlled conditions.
I would also disagree that it has been established that water dowsing works. We have anecdote and personal belief that it works, but the controlled trials, going back decades, simply do not support that belief. Centuries of belief in dowsing have failed to even come up with a plausible mechanism by which dowsing could actually work. There have been some interesting speculations, not least of which is the idea that it is a piezo-electric effect - but the paper that Naomi offered was from 1988, and nothing has been published since, in the 2 decades or so till now, which suggests that they have been unable to prove the hypothesis.
I guess we are all going to have to agree to disagree :) A most unsatisfying position, I know....
Than are dreamt of in your philosophy.
- Hamlet (1.5.166-7), Hamlet to Horatio"
And logically, that is true. It is possible that there is a some new breakthrough in science waiting out there that could explain some of the mysteries we now face, or that would allow for FTL.
We can probably find examples of this, if we search back through history - examples of a breakthrough brought about by observation and experimentation, or even by accident.
My point though, with respect to this idea - that there are still transformative ideas out there - is that the opportunities for such revolutionary ideas reduces with increasing scientific knowledge. In modern times, science has become additive, rather than transformative. This is why for me the idea that we can have a breakthrough that allows for some of the sci-fi concepts, like FTL, or teleportation, or Laser Pistols/ swords are extremely improbable.
And I would disagree with another of Naomis premises - which is that some pyschic/paranormal behaviour cannot be tested under controlled conditions.
I would also disagree that it has been established that water dowsing works. We have anecdote and personal belief that it works, but the controlled trials, going back decades, simply do not support that belief. Centuries of belief in dowsing have failed to even come up with a plausible mechanism by which dowsing could actually work. There have been some interesting speculations, not least of which is the idea that it is a piezo-electric effect - but the paper that Naomi offered was from 1988, and nothing has been published since, in the 2 decades or so till now, which suggests that they have been unable to prove the hypothesis.
I guess we are all going to have to agree to disagree :) A most unsatisfying position, I know....
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