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VoiceOfRa comments on Rationality Quotes Thread December 2015 - Less Wrong
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Saurabh Jha
That seems like selection bias.
You do a lot of studies and experiments, and filter out most proposed medicine because it causes harm quickly, or doesn't cause benefits quickly enough or at all. Then you market whatever survived testing. Obviously, if it's still harmful, the harms will show up only slowly, while the benefits will show up quickly - otherwise you would have filtered it out before it reached the consumer.
This is like saying engineering disproportionately channels optimism, because almost all the appliances you buy in the store work now and only fail later. If they had failed immediately, they would have been flagged in QC and never got to the shop.
If an appliance you buy fails than you know that it fails. If a drug reduces your IQ by 5 points you won't know. Drugs also don't get tested for whether or not they reduce your IQ by 5 points.
Yes, it's still a bias.
The difference is, if they fail, you can always buy a new appliance. You can't buy a new body.
For some underwhelming value of "always", and anyway appliances aren't all that engineering makes.
Off the top of my head, cases when "harms take longer to show up & disprove than benefits" outside medicine included leaded gasoline, chlorofluorocarbons, asbestos, cheap O-rings in space shuttles, the 1940 Tacoma Narrows Bridge, the use of two-digit year numbers...
Look at Feynman's analysis. I'd say this is a good example of disproportionate channeling of optimism.
Yes. My point was that disproportionate channeling of optimism isn't something specific to medicine (let alone to evidence-based medicine).
EDIT: Hmm, I guess I originally took "disproportionally" to mean "compared to how much other things channel optimism" whereas it'd make more sense to interpret it as "compared to how much medicine channels pessimism".
Are there any other systems for judging medicine that more accurately reflects reality? I know very little about medicine in general, but it would be interesting to hear about any alternate methods that get good results.
It's hard to say how effective various alternative styls of medicine happen to be.
There's research that suggests Mormon's can recognize other Mormon from non-Mormons by looking at whether the skin of the other person looks healthy. Then Mormon's seem to live 6 to 10 years longer than other Americans.
On the other hand the nature of claims like this is that it's hard to have reliable knowledge about it.