Like the idea here is that there are some interventions that are so obvious that you don't need rigorous evidence to show they work. However as it turns out people use that analogy to justify interventions that did later turn out to not work.
I’m too lazy to search for it, but there was an organization that collected the top “stop doing these things in medicine because they don’t work”. The polled the major medical societies to put them together. Ranges from emergency medicine to gynecology.
I think most people would be shocked to learn: 1) how many “obvious” interventions don’t work and 2) how common they are in today’s medical practice.
Hmmm… it may have come from Cochrane, but I don’t think so.
They were a collection of two page PDFs with nice formatting and all. Made it easy for any physician to see just how extensive the issue was beyond their own specialty.
But maybe Cochrane drove the initiative? The lists definitely came from the respective medical societies.
I'm not sure I'd classify drinking and incredibly dilute version of the poison you have just ingested to cure you of that poison as an obvious intervention that doesn't work. It seems more of an obviously useless thing to do that doesn't work.
I fully agree, yet here I am with many friends that swear their kids stop having gum aches after applying some stuff that contains 0.5 molecules per tube of whatever. I tell them it could be their attention, the actual rubbing, just the fact that the kid thinks he's being helped. Yet none of them is up for rubbing the kids with water in a double blind way and making structured notes of the effects. "It obviously helps, everybody happy". Yeah, especially the manufacturer of said half molecule*.
(* I get that it means there is just 1 molecule in every 2nd tube, or more likely some tubes have 0, some 1, some 2, some 3, we have to take counting statistics into account.)
My son, who was in training to become an EMT, came to me one day concerned that my wife had several small bottles of aromatherapy (potions?, tinctures?) on her desk. He was deeply concerned that "she believed in that stuff" and felt that we needed to stage an intervention. I assured him that I doubted that she believed they had any therapeutic value, but that I would talk to her about it.
Turns out, they were sent by an acquaintance of hers who was sending out free samples to everyone she knew hoping to drum up sales for her business. My wife was going to throw them out, but wanted to look up how to "properly dispose of the contents" and rinse out the bottles before recycling them. I just laughed: dumping the contents down the drain would likely be no different than washing them--other than saving water and time.
Low doses in homeopathy are indicated by a p nummer, like p13, meaning 10 times diluted, 13 times. Which brings it into individual molecules per tube territory.
Also: MMS, "cleanses", crystals, sonic pest defenders, fuel efficiency devices, zero point energy generators, perpetual motion machines, and magic laundry balls. <-- That's the abbreviated list.
> We think that everyone might benefit if the most radical protagonists of evidence based medicine organised and participated in a double blind, randomised, placebo controlled, crossover trial of the parachute.
I wasn't expecting this. My reaction to what I understood as "Need solid studies? Nobody's preventing you to go kill yourselves to make your point, be our guests, the world will be better without you anyway!" was: what? this can't be serious.
This is indeed not serious as your link outlines:
> Obviously the first parachute study was tongue-in-cheek, but the authors’ point was important: The absence of randomized controlled trials for a certain medical intervention does not mean that the intervention cannot be safe and effective. And an RCT often would be unethical, as I noted in a past blog on the “tyranny of the RCT.” Sometimes, well-designed observational studies must suffice.
This is well done.
Okay, I have my shot of serious fun for the day, let's go back to work.
One of the things that had most annoyed me in medicine since 1995,a slavish dedication to what I've come to call "evidence based nihilism". And a lot of the people who are most rigid do not treat patients but get promoted out of useful work.
The space of actual practice is far more complex and some applied science is actually called for.
What's worse, this kind of sanctimonious stringency (large industry/govt funded placebo DB RCT etc) is selectively applied to only certain practices, never to received wisdom or pet projects.
Masks work but so does the (non-)impression of a shielded face. Those aspects are luxuries maybe, but at some point, even granted the utilitarian outlook, it weights in on the Well-being calculus too. I feel sad for kids especially.
Like the idea here is that there are some interventions that are so obvious that you don't need rigorous evidence to show they work. However as it turns out people use that analogy to justify interventions that did later turn out to not work.