The scientific method and its limitations

[Blumlein 88]

Sure, ride without a helmet if you like - as long as you are fine with forfeiting your insurance coverage in the event of an accident .

So would you feel okay with the same policy for pedestrians or anyone moving about on feet? It actually would make a much larger difference. If you fall on stairs or walkways and sustain an injury without wearing a safety helmet, then no insurance for you. Sound alright?

 

[Blumlein 88]

FWIW, a similar thing applies to boxing and martial arts, which I've been doing recreationally (perhaps a contradiction in terms) on and off for the last 10 years. Boxing with a helmet and padded gloves is often regarded as a more civilized sport than MMA, with all the blood from the face and whatnot. But it turns out there are less serious injuries in MMA. The reason is that people can sustain more blows to the head in the short term with a helmet and boxing gloves, but this wreaks havoc on the brain long term. MMA, on the other hand, has less blows to the head, and people tap out immediately when there's danger. So MMA might actually be a more "civilized" sport than boxing.

Same with gloves. No gloves is safer than with boxing gloves. The IFC mandated the use of the minimal gloves just due to publicity. The no glove days were safe.

 

[oivavoi]

Same with gloves. No gloves is safer than with boxing gloves. The IFC mandated the use of the minimal gloves just due to publicity. The no glove days were safe.

Cool, didn't know that. I ended up doing martial arts which don't involve blows to the head in any case, as I hold the conviction that a fully functioning brain most likely is an asset at work.

 

[Wombat]

Focussing on helmets allows the facts relating to the mixing of incompatible modes of transport and the unpalatable solutions to be avoided.

 

[Analog Scott]

FWIW, a similar thing applies to boxing and martial arts, which I've been doing recreationally (perhaps a contradiction in terms) on and off for the last 10 years. Boxing with a helmet and padded gloves is often regarded as a more civilized sport than MMA, with all the blood from the face and whatnot. But it turns out there are less serious injuries in MMA. The reason is that people can sustain more blows to the head in the short term with a helmet and boxing gloves, but this wreaks havoc on the brain long term. MMA, on the other hand, has less blows to the head, and people tap out immediately when there's danger. So MMA might actually be a more "civilized" sport than boxing.

Head gear does nothing to prevent concussions. Neither do boxing gloves. The gloves protect the hands and the head gear prevents cuts. MMA is most definitely a safer sport than boxing when it comes to head trauma. MMA has greater risks from the chin on down.

 

[Fitzcaraldo215]

No, I think this 'paper' is born from some deep frustration on their part - they aren't just having a laugh by taking the p*ss out of the jargon of their own profession. Clicking on the links, they are serious people, and one of them works a lot in smoking-related health.

This paragraph seems a little bitter:

It could have been written with this topic (and many others) in mind, for example:

Clearly there are people who would love to make cycle helmets compulsory, and they will cite scientific evidence to 'prove' it. They are a certain sort of person. There are other people who resent having their freedom gradually drip-dripped away. They will oppose the proposed legislation by challenging the science, or appealing directly on the grounds that maintaining the freedom to cycle without a helmet (or smoke, or drink, or eat cream cakes) is "life affirming". I think the authors of the parachute 'paper' are the former category of people, and are frustrated in their ambitions by the second category...

We do not, of course, know the authors true motivations. But, I do not see your interpretation at all, and I am frankly mystified by it. Rather, I see a hilarious satire on elaborate, unnecessary customs, rituals, mindsets, formats, etc. in the scientific/academic community, as often required even when the truth is already as plain as day. I see no pokes, no frustration aimed at skydivers who wish to dive 'chuteless, for example, may they rest in peace.

In any case, I would not go overboard on the seriousness or deep meaning of it. Just enjoy its Swiftian brilliance, as in A Modest Proposal.

 

[Brad]

The problem with that article is that it ignores physics and that different fields of science operate differently. Science in the physical sciences works by developing a model and testing the model with experiments and observation. If you have a model with a high degree of confidence, you can make predictions wth a high degree of confidence.

In contrast fields like biological sciences and psychology often don’t have good models, and many parameters that can’t be isolated. Due to the low ability to predict outcomes, many observational experiments are required to ascertain causality.

Audio/hifi it is a combination of engineering and psychology (and some physiology). So it’s necessary to pick your method of testing based on the question being asked. Also, psychology experiments are easier to control than many medical/biological ones, so there aren’t too many things (preference aside) that science can’t answer

 

[Fitzcaraldo215]

The problem with that article is that it ignores physics and that different fields of science operate differently. Science in the physical sciences works by developing a model and testing the model with experiments and observation. If you have a model with a high degree of confidence, you can make predictions wth a high degree of confidence.

In contrast fields like biological sciences and psychology often don’t have good models, and many parameters that can’t be isolated. Due to the low ability to predict outcomes, many observational experiments are required to ascertain causality.

Audio/hifi it is a combination of engineering and psychology (and some physiology). So it’s necessary to pick your method of testing based on the question being asked. Also, psychology experiments are easier to control than many medical/biological ones, so there aren’t too many things (preference aside) that science can’t answer

Earth to Brad. Whatever you do, do not take it so seriously on the surface. It ain't a serious article. It is a satire. Don't try to read so much into it, that you miss the point.

 

[Cosmik]

We do not, of course, know the authors true motivations. But, I do not see your interpretation at all, and I am frankly mystified by it. Rather, I see a hilarious satire on elaborate, unnecessary customs, rituals, mindsets, formats, etc. in the scientific/academic community, as often required even when the truth is already as plain as day. I see no pokes, no frustration aimed at skydivers who wish to dive 'chuteless, for example, may they rest in peace.

In any case, I would not go overboard on the seriousness or deep meaning of it. Just enjoy its Swiftian brilliance, as in A Modest Proposal.

This sentence sums it up:

...we feel assured that those who advocate evidence based medicine and criticise use of interventions that lack an evidence base will not hesitate to demonstrate their commitment by volunteering for a double blind, randomised, placebo controlled, crossover trial.

So I still think it's bitter sarcasm rather than just a joke about scientific jargon.

 

[Wombat]

The answer: https://www.ncbi.nlm.nih.gov/pubmed/26769034

 

[Blumlein 88]

Focussing on helmets allows the facts relating to the mixing of incompatible modes of transport and the unpalatable solutions to be avoided.

One of the benefits for having specified cycling lanes is it reduces pedestrian accidents as well as cycling crashes with cars.

 

[Wayne]

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC300808/

I hope that they are just trying to be funny and nothing more.

Actually they are trying to make a point regarding observations that have not been subjected to rigorous evaluation by using randomised (sic) controlled
trials.

For a longer description see: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3830455/ Which references the above article (#80)

We are of the opinion, however, that the world is knowable and that careful observation of the world has a very important role to
play in knowing it, and even that it is indeed possible to make causal inferences from observational data. One of our favorite
illustrations of this is that we know that jumping out of a plane is deadly, even though there has never been a randomized trial of this
‘treatment.’ One tongue-in-cheek paper that attempted to do a meta-analysis of use concluded: ‘As with many interventions intended
to prevent ill health, the effectiveness of parachutes has not been subjected to rigorous evaluation by using randomised controlled
trials. Advocates of evidence based medicine have criticised the adoption of interventions evaluated by using only observational data.
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’ [80].

 

[Analog Scott]

Actually they are trying to make a point regarding observations that have not been subjected to rigorous evaluation by using randomised (sic) controlled
trials.

For a longer description see: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3830455/ Which references the above article (#80)

We are of the opinion, however, that the world is knowable and that careful observation of the world has a very important role to
play in knowing it, and even that it is indeed possible to make causal inferences from observational data. One of our favorite
illustrations of this is that we know that jumping out of a plane is deadly, even though there has never been a randomized trial of this
‘treatment.’ One tongue-in-cheek paper that attempted to do a meta-analysis of use concluded: ‘As with many interventions intended
to prevent ill health, the effectiveness of parachutes has not been subjected to rigorous evaluation by using randomised controlled
trials. Advocates of evidence based medicine have criticised the adoption of interventions evaluated by using only observational data.
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’ [80].

What an odd point. And it doesn't work really. Gravity has been the subject of a great deal of scientific studies. Human trauma has also been subjected to numerous scientific studies as has the aerodynamics of parachutes. So really, it failed to make that point. And in fact the idea that anecdotal observation has a very important role to play in knowing the world is actually wrong. It's the stuff urban legends are made of. We are truly sh***y when it comes observing the world. Classic case in point. https://www.washingtonpost.com/news...change-human-behavior/?utm_term=.7c55dc3ff4ad

 

[Jakob1863]

We can only speculate about the true meaning/motivation behind the satire but imo the authors try to make an appeal to their colleagues (and in general all advocates of pure EBM) not to forget about common sense .
As usual it will often be treated as a "black or white" question although - if one uses the common sense - in the real world it can´t be so.

From what i´ve read i recall that one of the reason for the EBM was the fact that medical doctors didn´t have time (or did not use enough time) to keep up with the evolution of modern medicine because they used only 1 hour a week (or was it even a month? ) to keep up with new evidence, so it would be much better to publish medical guidelines for every case based on the best available scientific evidence; evidence gathered by studies and systematic review (and meta-analysis) of these studies by qualified people.

And there was a ranking list created where the available evidence was rated in steps; lowest available evidence was opinion of experienced people in the field than the various study grades and on top a systematic review/meta-analysis of several available studies on the same topic.
Which of course looks at first very promising is based on good arguments wrt to available time for further training and the always existing danger of fooling yourself by your common sense fealing.

In the real world it seems to be equally easy to fool yourself (or others) by doing and publishing scientific studies/results, additionally the question remains what to do if no best evidence is available and furthermore only a small proportion of systematic reviews/meta-analysis ends with the result that strong evidence was found for either "beneficial" or "harmful" impact of the EUT (afair it was only around 3 - 5% in each case) while in the remaining proportion the evidence found wasn´t strong or inconclusive and either further research was demanded/recommended or not.

Although the socalled RCT is still known as the "gold standard" the more modern approach is a combination of RCTs and observational studies to overcome some of the problems associated with clinical trials.

Some people have always argued that the most important variables are good hygiene standards and access to healthy food and fresh water while most of the not so serious deseases will heal without medical help, something that the older more experienced doctors knew already.

edit: that is clearly not my area of expertise and might be based on study results that are obsolete by now too, for example the study about review results.....

 

[stalepie]

Some people say seatbelts make people drive less safe because they feel more safe so they're not as careful. That it increases pedestrian fatalities. I've wondered too if the new automated beeping that goes on trying to help people park makes them more reliant on hearing it to know for sure where things are. So they're really worse at parking.

With science, ethical considerations make it hard to do some studies, like on hearing loss. How do you study it precisely without subjecting people to terribly loud sound in controlled conditions? Or to animals.