Our friend Jane Orient, lead doc at Association of American Physicians and Surgeons, put out the release below, in which she very kindly mentions Yours Truly.
The AAPS runs a yearly conference at which I have spoken. The video above is one of the talks. Here is the press release, officially from the Journal of American Physicians and Surgeons.
“Science” is said to be dictating “evidence-based” policy with far-reaching effects on American life, but seriously flawed methods could lead to disastrous results, states Jane Orient, M.D., managing editor of the Journal of American Physicians and Surgeons. The fall issue scrutinizes such methods, with specific application to affordable electricity, advanced X-ray imaging, and personalized medicine.
We are doing it all wrong with regard to everything having to do with evidence, according to a book that is reviewed in the issue, Uncertainty: The Soul of Modeling, Probability & Statistics, by William Briggs. “We are suffering from a crisis of over-certainty,” Briggs states. We place far too much faith in meaningless (or misunderstood) statistical parameters. We also rely on invalidated models—e.g. global climate models. The “true and only test of model goodness,” Briggs writes, “is how well that model predicts data, never before seen or used in any way. That means traditional tricks like cross validation, boot strapping, hind- or back-casting and the like all ‘cheat’ and re-use what is already known as if it were unknown; they repackage the old as new.”
Briggs debunks many logical fallacies, with special attention to what he calls “the epidemiologist’s fallacy” because it is so common and so harmful. It occurs whenever an epidemiologist says “X causes Y” but never measures X. The most egregious example that he mentions is the assertion that a tiny increase in small particulates called PM2.5s (dust) causes enormous numbers of deaths. This is being used, Dr. Orient notes, for the U.S. Environmental Protection Agency’s Clean Power Rule, through which the coal industry, which fuels 40 percent of our electricity-generating capacity, is being destroyed.
Epidemiological studies that instill fear of radiation from CT scans are analyzed by Dr. Bobby Scott. He states that there is no evidence for excess cancer from low-dose radiation (less than 100 mGy) from diagnostic imaging. Claims of predicted risks are in fact “phantom” risks linked to forced application of the linear-no-threshold model and extrapolating to low doses, he points out. His analytic method and tables to correct for sampling variability and bias are broadly applicable to epidemiologic studies of other environmental exposures, states Dr. Orient.
“Evidence-based medicine” (EBM), which is largely applied epidemiology, supports the “guidelines” that increasingly dictate medical treatment. Its flaws are so serious that even its former ardent proponents are beginning to recognize that EBM is in crisis, writes Dr. Hermann W. Børg.
“Policy is increasingly justified by politicized, outcome-based science,” states Dr. Orient. “Citizens need to learn to scrutinize the methods.”
The Journal of American Physicians and Surgeons is published by the Association of American Physicians and Surgeons (AAPS), a national organization representing physicians in all specialties since 1943.
One of the clues there is a problem is the list of “side effects”. I was once told by a drug company that anything that occurred in more than 2% of the participants in a drug trial had to be listed as a “side effect”, including colds, menstrual pain, runny nose, headaches, etc. I can’t recall what the side effect I called the company about was, but it was so ridiculous I actually called the company to ask how in the world this was a side effect. This kind of explained the list of “side effects” you hear on drug ads. I’m sure part of this is a CYA on the part of the drug companies (not that it helps—lawyers always claim people are too stupid to understand what the drug they are being given may do) but it makes understanding actual drug effects very difficult.
Congratulations on being heard by some in the medical community. Hope it helps.
Ok, *FINE*, I ordered your damn book.
Sheesh, the last time I spent this much money on a book was Knuth volume 2.
I think we want to be careful not to completely disregard outcome bases. Just because we can’t measure something, that does not mean we should as it doesn’t exist. We can measure it later. Briggs seems to be calling for the sort of pragmatics that held American theoretical sciences back in the 19th century. I agree with much of his critiques of statistical modelling, but let’s not get carried away. We can surely agree spewing unlimited pollution into the air would probably not be a good thing without having to measure anything.
Milton: The question is “Are you happy now”?
JMJ: Watch it. Michael Mann nearly lost his job with that claim—we don’t need him anymore if we can just look out the window and see climate change. Plus, without measurement, how would you know what pollutants are out there and if they are being reduced or removed? I think Exxon would love your idea though—they could just change the color of the steam coming out of the stacks and claim they took care of the problem. Maybe measurement isn’t such a bad thing in the long run? (Then, of course, we have to define “pollution”, which is another whole scientific quandary. There are tons of pictures of water vapor coming out of stacks and that’s with the articles on the colorless, invisible gas CO2—a clear attempt to associate CO2 with pollution and calling water vapor pollution hoping no one knows the difference). Things are never as simple as some would like them to be.)
Pharmacology and toxicology 101 is thus: dose and route make both the medicine and the poison. A poison chemically is simply the situation where desired chemical reactions can’t happen sufficiently in the face of competition from undesired chemical reactions. Thus it is the case that oxygen concentrations above a locally tolerable limit are poisonous for anaerobically metabolizing organisms, while for aerobes, it is the lack of the sufficient concentration of oxygen which is a poison.
It seems to me that if these folk understood the chemical realities of embodied life, they’d not be so quick to call emissions pollution without taking chemical realities into account. On the other hand, this political sitation is just what the progressive tyrants want. That is one reason why the physically absurd notion of linear-no threshold harm is used.