Thursday, June 4, 2009

Is There a Dumbass in the House?

Megan picks the weirdest things to opine about. I'm not sure if she's trying to be edgy or if there is some secret personal reason for each of the topics she espouses on, but the only unifying thing I can find is that she's stupid on all of them.

Perhaps her recent foray into best medical practice is motivated by her multitude of chronic aliments. Whatever the cause, we can say for sure that Megan knows better.

She starts with a long excerpt of someone else's writing. The veterans will not need to be notified that it is quite a bit longer than her own musings, though no less well informed.

And so, NICE has decided, on the basis of "the evidence", that acupuncture and chiropractic are a good way to spend the NHS's money.
As Edzard Ernst points out, the Cochrane Institute (the other great temple of evidence-based medicine) actually found chiropractic to be more or less useless, while the evidence for acupuncture is that all of the ancient wisdom and theory of the meridians and qi doesn't actually confer any great benefit over and above that which can be gained from simply lying on a table and being poked with sticks.
I see. So one investigative body says that chiropractors and acupuncture work, and another does not. Naturally, since those two things aren't "modern medicine" this is proof that the skeptics are right. Also, the fact that both report that acupuncture works is central to his point. The real problem here is the acupuncture works even if you're doing it differently than is commonly done, proving that acupuncture doesn't work and is total bullshit.

The rest of the excerpt extols on how medicine is complex and so we can't know anything for sure. This is both insightful and proof that we know for sure that acupuncture and chiropractors are crocks.

Now we get to Megan.
This is part of a broader problem with medicine and other sciences with physics envy. Medicine, like economics, is really messy. You can't do the same kind of controlled experiments that you can do on rats or quarks, and as a result, the results are often hard to interpret.
Hmm, you can't do experiments in medicine? Wow, those MD-PhD's are gonna be pissed to find out they wasted a decade of their life pursuing the impossible. I Love the analogy to economics, too. We all know that studying individual ailments and studying the complex interactions of millions of people are roughly equivalent. That's why medicine and economics have both come out with so few concrete improvements for our day to day lives.
But this doesn't stop doctors, or policymakers, from acting as if the studies or metastudies can deliver vastly more certainty than is possible from such inherently sloppy science.
Which is why our muse calls herself an economist.
This is why, for example, I am broadly sympathetic to Paul Campos' claim that medical guidelines on obesity tell you much more about the attitudes towards fat in the upper middle class social stratum that doctors occupy, than about reliable scientific evidence on same.
Right, the fact that medicine cannot produce reliable evidence is proved by the fact that medical claims aren't backed by the available evidence. The available evidence which cannot be produced.
But policy demands certainty. And so you get obesity guidelines advising everyone to diet and excercise to shed their excess pounds, even though it's as close to a scientific certainty as anything is that most people simply regain any weight they manage to diet off. And you get absurdly precise economic forecasting, even though in many cases, the better answer would be "who knows?"
It's not that Megan is wrong all the time. It's that no one can ever possibly be right about anything. Oh, and the fact that fat people have a hard time losing weight is apparently proof that being overweight is not detrimental to your health. Also, since most people don't lose weight no one should try, ever. Or something. She has a point. She swears.
In both cases, I don't see a better alternative. But we should be more skeptical of both the institutions, and their claims.
Oh, that explains her constant cheer-leading for the implementation of the things she just attempted to disprove.


Susan of Texas said...

According to her next two posts, the answer to your title question is yes.

Anonymous said...

Doctor Megan is in the house, critizin' medicine with her mad science skillz. I love it. The only way this could have been better is if she explained more physics. Quark on, Megan. You know you want to explain what you just read in Physics for Dummies.