Same thing happened to me about 6 years ago. Told me to relax and not eat spicy foods. Makes me wonder how long medical advancements like this take to really spread to most doctors.
For example, several years ago significant cataract improvement was achieved by applying to eyes lanasterol (chemical in your body clearing cataract naturally) with DMSO (well known widely used solvent which is used in particular to deliver various medicine through the skin, etc., and some adventurous people are also using it to for example deliver dye into eyes to change the eye color). Several other scientific teams at different places tried to reproduce the result by applying lanasterol without DMSO, and no improvement happened. They concluded that the original study effect is non-reproducible and that the application of lanasterol is non-effective. I'm not kidding - you can google these articles yourselves.
More specifically Max Planck wrote: "A new scientific truth does not triumph by convincing its opponents and making them see the light, but rather because its opponents eventually die and a new generation grows up that is familiar with it ..."
How long medical advancements take to spread, and also how long the ineffective or outright harmful practices persist.
I guess on HN we're all relatively pro-science. But the world would be a better place if we recognised that our scientific knowledge in some areas is poorer than we like to pretend.
I started feeling that way when I worked alongside some "Evidence-Based Medicine" advocates. Years later I've landed in data science and the standards of statistical analysis and understanding I see especially in the biological sciences has only made me more sceptical.
Way back in 2007 the BMJ as part of its Clinical Evidence project published its systematic research into standards of evidence in support of common medical treatments. Some 2500 treatments were evaluated to determine whether they are supported by sufficient reliable evidence.
• 13% were found to be beneficial.
• 23% were likely to be beneficial.
• 8% were as likely to be harmful as beneficial.
• 6% were unlikely to be beneficial.
• 4% were likely to be harmful or ineffective.
• 46% were unknown whether they were efficacious or harmful.
It's quite hard to find the original Clinical Evidence project resources (might be a job for the wayback machine) but you can find it referenced all over, e.g. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2071976/ .
In the 1970s the US Office of Technology Assessment conducted a similar evaluation of medical treatments' efficacy and found that only 10% to 20% of medical treatments had evidence of efficacy. I would love to see more recent research in this vein.
There are clearly many complications and caveats around all this. Not all "common treatments" are easily studied -- the gold standard of the RCT is not always feasible or ethical. And of course absence of evidence is not evidence of absence, etc... but it sometimes feels we should be a bit more humble about even our best science.
Continuing education in medicine is a big problem. Once someone graduates med school, their knowledge mostly freezes. The good ones keep up on latest developments but some don't.
That’s “translational medicine” or “translational science” —> getting lab proven stuff to the bedside.
And yeah, it can take a while.
My dream is to a have a dumb doctor/mechanic/plumber/blah that just researches even the most basic questions unless it’s something really odd-ball and only then defaulting to their “expert opinion”.
I've thought for a long time that medicine in the AI era would end up with nurses being even more important than they are today but with doctors being drastically less so. (I know next to nothing about healthcare; this is just a guess!)
This is a problem with alot of thirdwirld surgery. If some old doctor gets to operate your appendix, he might gut you like fish,like they did back in the 80s, scar from heart to hip.not even due to missing equipment but a lack of schooling and experience on newer techniques.
I went to an ear doctor recently, who was so old that I think he graduated when I was a toddler. But when I describe my symptom he says "Well, let's also see what ChatGPT says."
So some part of new medical information might spread faster than I had thought.
* My ear problem turned out to be that my ear canal was full of wax. I guess we didn't really need ChatGPT that day.. ¯\_(ツ)_/¯
Unless things have changed fundamentally since I was in medical school (UCLA Class of 1974), a doctor's visit should start with taking a history and move on to a physical examination. I would think ChatGPT wouldn't even have been mentioned once your PE revealed a wax-filled external ear canal.
kevinmchugh|1 year ago
trhway|1 year ago
For example, several years ago significant cataract improvement was achieved by applying to eyes lanasterol (chemical in your body clearing cataract naturally) with DMSO (well known widely used solvent which is used in particular to deliver various medicine through the skin, etc., and some adventurous people are also using it to for example deliver dye into eyes to change the eye color). Several other scientific teams at different places tried to reproduce the result by applying lanasterol without DMSO, and no improvement happened. They concluded that the original study effect is non-reproducible and that the application of lanasterol is non-effective. I'm not kidding - you can google these articles yourselves.
jcynix|1 year ago
https://en.wikipedia.org/wiki/Planck%27s_principle
MichaelDickens|1 year ago
BurningFrog|1 year ago
potkin|1 year ago
I guess on HN we're all relatively pro-science. But the world would be a better place if we recognised that our scientific knowledge in some areas is poorer than we like to pretend.
I started feeling that way when I worked alongside some "Evidence-Based Medicine" advocates. Years later I've landed in data science and the standards of statistical analysis and understanding I see especially in the biological sciences has only made me more sceptical.
Way back in 2007 the BMJ as part of its Clinical Evidence project published its systematic research into standards of evidence in support of common medical treatments. Some 2500 treatments were evaluated to determine whether they are supported by sufficient reliable evidence.
• 13% were found to be beneficial. • 23% were likely to be beneficial. • 8% were as likely to be harmful as beneficial. • 6% were unlikely to be beneficial. • 4% were likely to be harmful or ineffective. • 46% were unknown whether they were efficacious or harmful.
It's quite hard to find the original Clinical Evidence project resources (might be a job for the wayback machine) but you can find it referenced all over, e.g. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2071976/ .
In the 1970s the US Office of Technology Assessment conducted a similar evaluation of medical treatments' efficacy and found that only 10% to 20% of medical treatments had evidence of efficacy. I would love to see more recent research in this vein.
There are clearly many complications and caveats around all this. Not all "common treatments" are easily studied -- the gold standard of the RCT is not always feasible or ethical. And of course absence of evidence is not evidence of absence, etc... but it sometimes feels we should be a bit more humble about even our best science.
jorblumesea|1 year ago
Scoundreller|1 year ago
And yeah, it can take a while.
My dream is to a have a dumb doctor/mechanic/plumber/blah that just researches even the most basic questions unless it’s something really odd-ball and only then defaulting to their “expert opinion”.
glhaynes|1 year ago
I_complete_me|1 year ago
Log_out_|1 year ago
cbsmith|1 year ago
yongjik|1 year ago
So some part of new medical information might spread faster than I had thought.
* My ear problem turned out to be that my ear canal was full of wax. I guess we didn't really need ChatGPT that day.. ¯\_(ツ)_/¯
bookofjoe|1 year ago