Subject: Warfare, History Of and Major Topics In

Recommendation: Makers of Modern Strategy from Machiavelli to the Nuclear Age, by Peter Paret, Gordon Craig, and Felix Gilbert.

I recommend this book specifically over 'The Art of War' by Sun Tzu or 'On War' by Clausewitz, which seem to come up as the 'war' books that people have read prior to (poorly) using war as a metaphor. The Art of War is unfortunately vague- most of the recommendations could be used for any course of action, which is sort of a common problem with translations from chinese due to the heavy context requirements of the language. Clausewitz is actually one of the articles in Makers of Modern Strategy- the critical portions of On War are in the book, in historical context.

The important part of Makers of Modern Strategy is that each piece (the book is a collection of the most important essays in the development of military thought through the ages, starting with the medieval period and through nuclear warfare. I have other recommendations for the post-nuclear age of cyberwarfare and insurgency and I'll post them separately.) is placed in context and paraphrased for critical details. Military strategy is an ongoing composition, but the inexperienced read a single strategic author and think they have everything figured out.

This book is great because it walks you through each major strategic innovation, one at a time, showing how each is a response to the last and how each previous generation being sure they've got everything figured out is how their successors defeat them. My overall takeaway was one of humility- even the last section on nuclear war has been supplanted by cyber and insurgent warfare, and it is a sure bet that someone will always find a way to deploy force to defeat an opponent. This book walks you through how to defeat naive and inexperienced combatants in a strategic sense. Tactics, as always, are contingent on circumstances.

Well, here are the thoughts that you provoked from me about this.

Here is the topic for discussion: should we trust psychiatric analysis using frequentist statistics and ignore the outliers, or should we individually analyze psychiatric studies to see if they contain outliers who show symptoms which we personally desire? Should we act differently when seeking nootropics to improve performance than we do when seeking medication for crippling OCD? Should we trust our psychiatrists, who are probably not very statistically savvy and probably don't read the cases of the outliers?

I think we may want to split this up into two questions: What you should do personally, if you feel you have condition X, and what you should do as a government if you want to help treatment for condition X.

For instance, as a government, I would go for repeatability, and size. Just forget the idea of trusting or not trusting suggestive outliers and go for more verification, with a larger sample: If for no other reason then determining the frequency of the outlying effect, which would be important for making large scale medical recommendations.

However, a single person can't generally commission large medical studies, so they might want to just read through the literature and read multiple papers about the effects of such things, perhaps also cross referencing their own medical history. I think Metamed, which was mentioned on Less Wrong a while back, does something like this, if you don't have the time to analyze your health that carefully personally.

If you don't want to do that, (either independently or through commissioning experts), then chances are you will be relying on:

I think that if even the right placebo could cause changes which improve my effectiveness, it would be worth a shot.

Now, psychiatric placebos can be shown to have a variety of effects in papers, and it can get hammed up a bit in headline rereporting.

http://nymag.com/thecut/2014/01/study-placebo-sleep-just-as-good-as-real-sleep.html

But it isn't all hammed up either: it gets rather complicated.

http://en.wikipedia.org/wiki/Placebo

(As a side note, I upvoted you, since that was a good way of provoking thoughts, and it seemed like a placebo for increasing your mental wellbeing.)

How small would the sample size have to be before you would consider trying the drug yourself, just to see if you, too, lived forever as long as you took it?

Reducing sample size also blinds you to any ill effects the drug might have. If you're looking to generalize your idea about outliers, immortality seems to be an especially poor example since it's more unusual than any real outlier you might come across.

As far as I know, psychiatrists cannot reliably predict that a given drug will improve a patient's long-term diagnosis, and psychiatrists/psychologists cannot even reliably agree on what condition a patient is manifesting.

Taboo reliable. How would scrutinizing outliers make them more reliable? Acknowledging people are unique snowflakes doesn't help if you have no tools to know when and how they're unique. Other specialties have the same problem, psychiatrists' tools are just especially crude in comparison.

Mental disorders appear to resist diagnosis and solution, unlike, say, a broken leg or a sucking chest wound

Substitute those surgical conditions with some endocrine condition for example and the contrast may not be so stark.

If you're treating yourself, you're especially prone to bias. Doctors acknowledge this and many think they shouldn't treat themselves. If you want to utilize outliers, at least have someone else do or confirm the research. Doesn't have to be a doctor if you don't trust them.

A small investigational drug trial won't be powered to detect outliers, and you won't be able to reliably solve that by invoking Bayesian statistics.

In large drug trials I think this is to some degree already done, but it's limited by the extreme sketchiness of suddenly inventing new endpoints for your study after you have the data. It would probably take the form of increasing the threshold for an endpoint (for example, "No significant difference between drug and placebo was found with the planned endpoint of decreasing HAM-D ratings by 3 or more, but there were significantly more patients in the drug group who had their HAM-D ratings decrease by 10 or more". Everyone is rightly suspicious of people who do this, because, again, changing endpoints. But if it happened enough someone would take notice. Trust me, "not coming up with clever ways to make their drug look effective for at least some people" is not one of pharmaceutical companies' failure modes.

But keep in mind that you sort of loaded the original example by choosing something that almost never happens (someone living to 110 without any signs of aging). In a psychiatry study, what's the most extreme example you're going to get? Someone's depression remits completely? Big deal. Most people's depressive episodes remit completely after a couple of months anyway, and in 25% of people they never return (in even more people, they take many years to return, and almost no studies continue for the many years it would take to notice). In a drug trial of 10000 people (the number you gave above) hundreds or thousands of people in each group are going to have their depression remit completely; if the drug has a superpowerful effect on one person and cures her depression forever, that will get lost in noise in the way that someone living to 110 with the body of a 30 year old might not.

(it's instructive to compare this to the way studies investigate side effects. If one person in a 10000 person study has their arms fall off, the investigators will notice, because that's sufficiently rare as to raise suspicion it was caused by the drug. The drug will then end up with a black box warning saying "may make arms fall off.")

Another way these sorts of outlier effects might be detected is by subgroup analyses (which are also extremely sketchy). If there is no effect in general, researchers may check whether there is an effect among men, among women, among blacks, among whites, among Latinos, among postmenopausal Burmese women who wear hats and own at least two pets and have a history of disease in their left kidney, anything that turns up a positive result. But again, this is hardly something we want to encourage.

But all these things are for investigational drugs. if we're talking about a drug that's already been approved and has a strong prescription history, then your worries about individualized response would get subsumed into the good responder / bad responder distinction, which is a very very big area of research which we know a lot about and when we don't know it it's not for lack of trying.

For example, among bipolar patients, response to lithium can be (very inconsistently) predicted by selecting for patients who have stronger family history of disease, have fewer depressive symptoms, have slower cycles, have more euthymic periods, have less of a history of drug use, start with a manic episode, demonstrate psychomotor retardation, demonstrate premorbid mood lability, lack premorbid personality disturbance, possibly have deranged serotonin metabolism in platelets, possibly have increased calcium binding to red blood cells, possibly lack the HLA-A3 antigen, possibly have a particular variant of the gene GADL1, etc etc etc.

(in practice we don't expend much effort to check most of these things, because their predictive power is so weak that it's almost always a worse idea than just making a best guess based on the data you have, putting someone on lithium or on an alternative, then switching if it doesn't work)

As far as I know, psychiatrists cannot reliably predict that a given drug will improve a patient's long-term diagnosis, and psychiatrists/psychologists cannot even reliably agree on what condition a patient is manifesting. Mental disorders appear to resist diagnosis and solution, unlike, say, a broken leg or a sucking chest wound.

The whole "medical doctors can always consistently treat medical diseases, but psychiatrists are throwing darts blindfolded" story is something of a myth - see for example Putting the efficacy of psychiatric and general medicine medication into perspective: review of meta-analyses

The basic question to ask is: did he live to 110 because of the drug, or was he going to be unusually long-lived anyway and happened to be enrolled in the trial?

If the drug was developed to combat some mechanism of senescence, one might reasonably entertain the possibility of a causal effect, but if it was for an unrelated matter, I don't see a reason to expect it. Either way, one would want the scientists to do a lot more tests on that individual to discover the mechanisms of his longevity.

("Personally, young man, I attribute my years to a diet of whisky, cigars, and strictly fried food.")

Cultivating a sense of perfectionism in the most mundane aspects of life is probably what most militaries employ. This includes overlearning everything from folding bedsheets and shining your boots to complicated drills and executing all kinds of personal maintenance with minimal amount of time. Apply long enough, and winging it won't even cross your mind anymore. I think this is a very useful idea if correctly and moderately applied. Strict hierarchy helps the practice, obviously.

The well meaning idea didn't get that well applied during my conscription. I learned to fold my bedsheets like a pro, but hardly learned how to shoot a weapon.

And there are earlier echos:

There is a phrase in Latin: Promoveatur ut amoveatur - "Let him be promoted to get him out of the way." It was apparently a pretty common one, not unbelievable considering the nepotist bureaucratic nightmare that was the Roman Empire.

One interesting implication of this is that if you're really good it's possible to have quite a wide impact.

Finland. Please don't scheme to invade us or we'll mop you to submission.

I was exaggerating a bit. What I mean there was no hope of becoming any good with the minimal training. I have fired and know how to handle a pistol, an assault rifle, a machine gun, a shotgun, a sniper rifle, a bazooka, an antiaircraft gun and have thrown a live grenade once. Can't really hit anything with them...

I'm not sure if the lack of training was because of pinching pennies on ammo, but I wouldn't be surprised because of all the other kinds of nonsense. We had an abundance of mops, though.