Science trumps patient or clinical experience for making recommendations

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I recently read this article from Scientific American:

This is a good opportunity to remind the reader–in a very schematic way–why science trumps patient or clinical experience for making recommendations.

Sure, this is obvious to many people. But it is worth repeating, because apparently even the editorial staff at the Scientific American needs reminding.

This post will focus on one statement in the article:

“Because if we dismiss everything that isn’t patented or presciption-only [sic], we dismiss people’s lived experiences.”

It is important to preface: nobody denies that patient experiences are very important, only that they cannot be the direct basis for guidelines or recommendations in the popular press or on social media.

If patient experiences became the direct basis for recommendations, then we would literally have to recommend everything. Placebo, regression to the mean, confounding by other simultaneously applied treatments, and any number of other confounding factors will ensure that virtually every treatment has someone to recommend it.

While treating individual patients, their experiences can be useful or at least they can be navigated when they are not harmful. Patient experiences can also lead to new hypotheses to test using science. If science vets these hypotheses, they can become recommendations.

But to imply that patient experiences should OVERRIDE current scientific findings for making population-based recommendations is deeply offensive to those who think that science is superior to hearsay, folk remedies, etc.

Science does not make medical doctors “gods”. It does however place within our therapeutic arsenal (when we know how to use it appropriately) the most powerful system for generating and testing practical knowledge that humanity has yet devised.

In an age of widespread medical nonsense (spread via social media), this is especially important to emphasize. Science protects people from charlatans, who, exploiting plausible-sounding scientific stories, patient testimonials, and science illiteracy, peddle treatments that are useless, harmful, or divert consumers from getting effective medical treatment–leading to real harm.

Scientific American (@sciam), by publishing such statements, promotes thinking that is diametrically opposed to science. This is disappointing. Because this is Science 101.

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