Thursday, February 22, 2007

Time magazine discovers a new concept: "Evidence"

Time Magazine has identified a revolutionary new idea in medicine: basing your opinions on evidence. One of the most frustrating things about medicine is how skeptical they are of Evidence. In a world where those that deny evidence for evolution or who deny evidence for climate change are sneeringly derided, doctors often still base decisions, as the article says on "faith, bias or even an educated guess."

The book Complications discussed the difficulties in convincing doctors to accept studies that question doctors' judgment in favor of "evidence-based medicine." Studies that find computers are better at reading EKGs for example.

To be fair to R-'s profession, however, is that it is not so much that they distrust all scientific evidence, it is just that much evidence cannot be trusted. The last study flip flops all the time, with cholesterol being bad then good, low fat diets now not necessarily good, estrogen bad then good, even that overweight people live longer than not overweight people. Ioannidis reports in JAMA that as many as 1/3 of the most cited studies in JAMA in the 90's have already been refuted.

But what the article rightly points out is that this rediscovery is not limited to medicine, but also to many areas like education or climate change. Development economists are gaining prominence in pushing the revolutionary idea that development programs should be based on evidence. It is scary that the idea of "evidence" has to be rediscovered. A concept that predates the invention of science by at least 1600 years, to Aristotle and before. Part of it is a post-modern rejection of objective reality. Part of it is just the poor quality of evidence at these new borders of knowledge.

It's about time.

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