Wednesday, October 6, 2010

The Skeptic's Dictionary Adds "Science-Based Medicine"

Bob Carroll writes in "Science-Based Medicine" [as of 2010-10-06]:

"science-based medicine (SBM) evaluates health claims, practices, and products by the best scientific evidence available [aka ALL the evidence]. Central to the idea of science-based [...] is the notion that science exists as an interdependent network of theories, knowledge, and laws [(how, ironically, HOLISTIC!)...while] evidence-based medicine (EBM) [narrowly / merely] considers as scientific evidence any results from a clinical trial [...] regardless of whether that clinical trial was grounded in scientific plausibility [(which isn't ALL the evidence, scientifically speaking)...] some claims are so implausible that clinical trials tend to confuse, rather than clarify the issue [...] when RCTs are performed on ineffective treatments with low prior probabilities, they tend not to yield merely ‘negative’ findings [...] they tend [...] to yield equivocal findings [(favoring the 'not-evident'!)...] it is illogical to give more weight to a set of questionable clinical trials that indicate some minimal level of support for a treatment than to a body of scientific knowledge that indicates the treatment lacks any scientific plausibility. EBM doesn't consider scientific plausibility as significant [...while] SBM considers scientific plausibility a necessary, though not a sufficient, condition [...] SBM holds that Bayesian probability is a superior measure of the data from a clinical trial than is the p-value of 'frequentist statistics' [...and we're reminded with a quote from Bausell] 'it's become politically correct to investigate nonsense' [aka NCCAM!]."

Note: as a moderately frequent commenter to the web page, I think this is a fine addition to the Skeptic's Dictionary.
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