ChristianKl comments on MetaMed: Evidence-Based Healthcare - LessWrong

83 Post author: Eliezer_Yudkowsky 05 March 2013 01:16PM

You are viewing a comment permalink. View the original post to see all comments and the full post content.

Comments (191)

You are viewing a single comment's thread. Show more comments above.

Comment author: ChristianKl 09 March 2013 04:21:44PM 1 point [-]

OTOH, a practitioner of non-evidence-based medicine cannot immediately see that giving a patient this substance diluted in 10^20 times as much water or sticking a needle in this particular spot or whatever will help cure the patient.

That's wrong. If a acupuncturist puts needles in 10 people and 5 of them lose their back pain than he has "unsystematic clinical experience" that provides evidence for his treatment.

The core of evidence-based medicine is the belief that you shouldn't use that kind of evidence for clinical decision making but that doctors should read medicial journals that report clinical trials that show whether or not a treatment works.

Likewise, musicians are normally evidence-based musicians to some extent, but astrologists are not evidence-based astrologists; can you find more examples?

Actually musicians and astrologists are very similar. Both make money with providing entertaining performances for their clients. Members of those professions who ignore evidence about what entertains their clients go out of business.

Comment author: [deleted] 09 March 2013 04:35:19PM 1 point [-]

If a acupuncturist puts needles in 10 people and 5 of them lose their back pain than he has "unsystematic clinical experience" that provides evidence for his treatment.

Maybe some of those 5 would have lost their pain even without needles. Whereas the barber knows what his client would have looked like without the hair cut.

Comment author: Yosarian2 12 May 2013 06:05:57PM 0 points [-]

Maybe some of those 5 would have lost their pain even without needles

Right, that's why it's unsystematic.

In the Bayesian sense of the word, "I stuck a needle in this person and the amount of pain he reported went down" would have to be considered to be evidence that would increase the Bayesian possibility that your hypothesis that acupuncture helps back pain is correct. However, it's not systematic, scientific evidence. To get that kind of evidence, you would have to do systematic studies of a large number of people, give some of them acupuncture and give some of them asprin, and see what the statistical result is.

I think that's what bogging this discussion down here, is that the word "evidence" is being used in two different ways. If we were perfectly rational beings, we would be able to use either kind of evidence, but the problem is that the first kind of evidence (individual unsystematic personal experiences) tends to be warped by all kinds of biases (selection bias, especially) making it hard to use in any kind of reliable way. You use it if it's all you have, but systematic evidence is very much preferable.

Comment author: [deleted] 10 March 2013 03:09:10PM *  0 points [-]

Actually musicians and astrologists are very similar. Both make money with providing entertaining performances for their clients. Members of those professions who ignore evidence about what entertains their clients go out of business.

OK, if you consider the point of astrology to be “making money”, as opposed to “predicting people's personalities and future events”, then it is evidence-based -- but then again, if you consider the point of alternative medicine to be “making money”, as opposed to “improving people's health”, then it is evidence-based as well. (But now that Qiaochu_Yuan has made clear that it's not alternative medicine that he was talking about, this is kind of moot, so I'll tap out now.)

Comment author: ChristianKl 10 March 2013 03:56:09PM 0 points [-]

OK, if you consider the point of astrology to be “making money”, as opposed to “predicting people's personalities and future events”

I didn't. I advocated another goal, entertainment. I don't know that much about astrology but I think a fair percentage of the people who do pay a astrologists do it for entertainement purposes.

Letting someone stick needles inside you, when you go to a acupuncturist is less about getting entertainement.

The kind of people who like astrology often also like other personality tests that they find in magazines. People enjoy going through those tests.

If an astrologer would tell people something about their personality that's accurate but that those people aren't willing to accept, I doubt he would stay long in business.

A bit like the musician who only plays music that he himself considers to be good, but that's "too advanced" for his audience. If the musician only sees his own opinion of his work he's not different than an astrologer who only sees whether his horoscope is good. If you call that musician "evidence-based" than the astrologer who goes after his own judgement of his work is also "evidence-based".

But now that Qiaochu_Yuan has made clear that it's not alternative medicine that he was talking about, this is kind of moot, so I'll tap out now.

Why does that matter to the question whether barbers can be meaningfully to be said to practice evidence-based barbering?

Comment author: [deleted] 10 March 2013 04:10:14PM 0 points [-]

Why does that matter to the question whether barbers can be meaningfully to be said to practice evidence-based barbering?

I was claiming that barbering is more evidence-based than alternative medicine, but if alternative medicine is not what's being discussed, then even if I turned out to be right it still wouldn't be relevant.