http://www.scientificamerican.com/blog/ ... 2009-08-10

I don't think you know what a strawman is.

My original posts stated my opinion that "the system" - meaning science, and the provisional nature thereof - is great. It allows old ideas to be rejected or updated on the basis of new evidence. To counter, you provided a single, non-specific example of a legal case involving a medical treatment having been shown to be harmful by later research. This example actually makes my point - "later" research overturned previous PROVISIONAL research and resulted in an improvement.


I didn't need to offer evidence because you offered it for me in your own example.


When I said, "I think the system is great," do you think I was talking about the medical system? Or science, and its provisional nature? Regardless, your premise that the medical system is a massive failure is a ridiculously subjective assertion.


I'm not totally convinced that the 200,000 killed each year by medical mistakes includes "studies later claimed to be wrong...when even the later study may be wrong..." Its possible that there's some bad science in there, but it looks like that 200K is largely due to preventable errors such as bad handwriting, other communication errors, incorrect dosages, sanitation/infections, falls, understaffing, sleep deprivation, and surgical errors such as wrong patient, etc.
http://www.newsweek.com/2008/07/02/patient-protection.html
http://www.medicalnewstoday.com/articles/11856.php
http://www.yumasun.com/articles/deaths-65499-hosptial-medical.html
In other words... they are *true* errors. Unless the latest scientific research says that removing Jane's appendix will fix Bob's appendicitis, I don't think that 200K is what you think it is.

Of course, 200,000 dying due to hospital error is tragic. But how is this the fault of science? Or specifically, the provisional nature of science?

As far as your "massive failure" hyperbole goes:
According to the CDC, in 2007, 34.4 million people were discharged from inpatient care in the US, meaning they survived a night at the hospital without getting killed by a medical mistake. Another 102.0 million people were discharged from the ER. And another 88.9 million people were discharged from outpatient care. So 225.3 million people survived medical treatment at the hospital. The 200,000 that regrettably died from medical mistakes are 0.088% of the population that received sustaining care. So 200,000 people is certainly a lot of unnecessary deaths, but compared to the number of people treated, I think you're depiction of the medical system as being a massive failure is rather absurd. And furthermore, I still don't see how this is an indictment of science.


Your hyperbolic rhetoric aside, the 200,000 deaths appear to be mostly caused by hospital error, not scientific research. So my opinion still stands - the system (meaning science and its provisional nature) is great. But I also think the medical system is very good. Sure, the 200K deaths are tragic, and I would prefer that all people had equal access to healthcare in this country, but overall the state of medical science is very good.


You're obviously an angry person. You need to learn to forgive people and accept that shit happens from time to time. What would Jesus do, Mike?

Bingo.

What I find incredible is your continuing to defend a system that kills 200,000 people a year.

http://www.scientificamerican.com/blog/ ... 2009-08-10

Moreover, it is a fact that many drugs that have supposedly undergone trials are later shown to have side effects that were not antiipated by that "great", "self correcting", scientific method. Why do you think those drug commercials that you constantly see on TV have "cover your ass" warnings about side effects.

Because so much bad stuff has come down that they can't hide it any more.

Are you sure you think the system is "great"?

If the humans have bad scientific advice, and peole die, it is scientific error.

Checkmate.

You got your numbers wrong, Harry.

http://www.scientificamerican.com/blog/ ... 2009-08-10

MikeH, Your Scientific American report is a 3rd-hand report of a Hearst newspaper report (2nd-hand) of an Inspector General report. From the SA: and
The Hearst newspaper is NOT a medical journal. I find the article highly speculative and not much more than using fear tactics to sell the paper. Nothing in the article supports the 200,000 number.

And I repeat -"And even this has nothing to do with science correcting itself. You are talking about human error, not scientific errors." You are comparing apples to oranges.

Again, you make my point. "later shown to have side effects" LATER. That is self-correcting.


Because all drugs have side effects and the law necessitates that companies advise customers of them?


Yup.

And if people are left with only non-scientific remedies (pray to Jebus for your health) they die faster and more needlessly. So, whats the better course?

Mike's "checkmate" reasoning is still faulty.

From the Hearst story, which Mike's Scientific American story is based on:
98,000 people die from medical errors, ie human error
99,000 people die from hospital-acquired infections.
http://www.chron.com/disp/story.mpl/deadbymistake/6555095.html

There is no reason to believe that Mike's claim that 200K die due to medical errors has much, if anything, to do with bad science. These are some common errors according to the same source:
http://www.chron.com/disp/story.mpl/deadbymistake/6556754.html

A system that kills 200,000 people a year is not "great".

I am astounded at the degree of denial that there could be anything wrong with the system when so many die.

Further, your claim that none of this involves scientific error is baseless.

The quality of science depends on its methods. Ideally we like to study a single variable in isolation. Unfortunately in many situations this is not possible. This is particularly problematic in medicine and psychology where one often has to deal with human populations.

Human populations are highly variable. The testing of, for example, a new drug requires statistics. Setting statistical significance too rigorously means that potentially significant results will be overlooked. Setting statistical significance too loosely increases false positives. False positives are indeed a serious problem. The problem is aggravated by academic incentives and by what Irving Langmuir classifies as "pathological science".

The press and the public (often including the professional public) aggravate the problem by confusing correlation with cause-effect and by insufficient caution in interpretation. Increasing rigor on the part of journals may improve the situation slightly, but wherever heterogeneous populations and statistical methods are involved conclusions will always be less rigorous than we'd like.

The problem is not that science is bad, but that its methods are limited.

This glosses over the fact that the articles point out that the deaths are PREVENTABLE.

Solution: Start treating these actions as the CRIMINAL DEEDS they are and not simply CIVIL MATTERS that one can pay one's way out of!

That will get their attention!

I think science is great. I think the medical system is very good. I said that above but you chose not to read it. I think that 200,000 preventable deaths is tragic and needs to be addressed. I think other problems in the medical system, specifically that people have unequal access to healthcare in this country, are tragic as well, and they need to be addressed. But overall, I think the medical system in this country is very good and from a medical *science* point of view, its excellent.

Your repeated astonishment that I think the medical system is great, is both a lie and bordering on ad hom. I never said the medical system is great - I think its very good and twice now I've given two criticisms including your 200K argument as to why I think it could be better. But by repeating this lie, you are trying to make the argument about me (OMG! you're a heartless bastard!) rather than provide evidence to support for your bullshit anti-science rant.



You made the claim, "Apparently you see the 200,000 killed each year by medical mistakes, studies later claimed to be wrong...when even the later study may be wrong... pharmaceutical errors, and many other problems as not enough 'evidence'. " The onus is on you to provide evidence to back your claim. You can't do that, so that is why you repeat nonsensical claims and play, "I am not, you are!"

I have found evidence to suggest that those medical errors *do not* include "studies later claimed to be wrong...when even the later study may be wrong." At least half of those deaths are from preventable infection. The other half are preventable errors, the most common of which the study provides examples (http://www.chron.com/disp/story.mpl/deadbymistake/6556754.html). None of the examples are bad science. All of the examples are human error from poor communication, poor judgment, etc.

This glosses over the fact that you are still unable to support your central claim - that science is killing 200,000 people in hospitals every year.

This kind of irrelevant nonsense is a Red Herring.
Repeating it over and over is Argumentum ad nauseam.