Can Covid-19 be effectively over?

Here is a possibility for Covid-19.

There is evidence that it could be over effectively, with either Ivermectin, or a Hydroxychloroquine (HCQ) + zinc regime. The evidence on the efficacy of the latter for early stage treatment and prophylaxis is incredibly strong now. See: COVID-19 Treatment – Analysis of 107 global studies, with many showing high effectiveness for early treatment 

 

 

 

PrEP
89%
PEP
100%
Early
100%
Late
63%
All
75%
107 studies (62 peer reviewed)
COVID deaths: 970,478
Global HC Q studies. PrEP, PEP, and early treatment studies show efficacy, while late treatment shows mixed results.

There is something incredibly rotten in various health bureaucracies. This doctor outlines a case of malfeasance going back decades, driven by ruthless profit making: https://jpands.org/vol25no3/merritt.pdf. It rings true to me.

With respect to Hydroxychlorquine, there are 107 studies now. Some are good, some are not so good; some appear designed to fail, and a couple were entirely fraudulent, but overall, the evidence to me says that authorities are killing thousands of people with their approach in various countries, and saving thousands in others. Some of these authorities are undoubtedly rotten to the core, and some are just embracing group think and looking at bad, bad science.

My friend Elizabeth Woodworth has written about the Hydroxychloroquine issues:

  1. The Battle for Pandemic Sanity: Hydroxychloroquine Efficacy vs. Its Suppression By Elizabeth Woodworth, September 17, 2020
  2. Remdesivir for Covid-19: $1.6 Billion for a “Modestly Beneficial” Drug? By Elizabeth Woodworth, August 27, 2020
  3. Leaked: “Deadly” Hydroxychloroquine (HCQ) to treat Covid 19: How the World’s Top Medical Journals, The Lancet and NEJM, Were Cynically Exploited by Big Pharma By Elizabeth Woodworth, August 13, 2020
  4. Academia Stoops to Defamation over Hydroxychloroquine (HCQ). Groundless Accusations against 2 World-class Scientists By Elizabeth Woodworth, August 09, 2020
  5.  The Media Sabotage of Hydroxychloroquine Use for COVID-19: Doctors Worldwide Protest the Disaster By Elizabeth Woodworth, June 30, 2020

In lieu of Hydroxychloroquine, the cheap supplements Quercitin, Zinc, Vitamins D3 and C, and any others you might choose to throw into the mix are, to a high degree of probability, quite protective. Quercitin, a bioflavinoid, is in various fruits and vegetables, but I like to keep my sugar intake low, so use a supplement. Even the evil Dr. Fauci is recommending D and C now. Zinc is well supported as an anti-viral plus.

This is speculation of course, but we may not get a true second wave. It is possible that there is enough pre-existing T-cell immunity (for instance, see https://www.nih.gov/news-events/nih-research-matters/immune-cells-common-cold-may-recognize-sars-cov-2 ) and enough natural immunity (strong immune system – nutrition, stress levels, sleep, genetics, epi-genetics, …) that the infection has peaked in many places, and is now sputtering with a long tail of low deaths. It is to be hoped that such is the case. I wrote this a few days ago: https://ephektikoi.ca/blog/2020/09/16/covid-19-speculation-sept-16-2020/

Diagnosis of cases creeping up, deaths staying low. Reasons? Varied I am sure. However, that long tail on death statistics still represents lives lost unnecessarily.

Not all countries show the same pattern, but if you break the numbers out regionally, things become a little clearer. Areas that have not had bad infection rates start to show worse numbers, and this can make the overall country statistics look like a second wave is occurring, but this may only be a new region starting to develop cases. Speculation again. In any case, this may be what we are seeing with the case numbers.

None of this says that if we are in a vulnerable category – age, existing co-morbidities – we should relax our vigilance, our efforts to control infection. I believe in the efficacy of social distances, limited contacts, wearing a mask when I can’t keep my distance, keeping out of poorly ventilated spaces, and recreating out-of-doors. Also, even if you are not likely to be vulnerable, you can still transmit the infection to those who are. Anything you can do to reduce your personal viral load is to the good. Anything you can do to reduce any viral inoculum you are transmitting is to the good. This is not just the flu in a number of dimensions. See for instance: https://www.youtube.com/watch?v=cy1kdZhXsP8 and also https://www.youtube.com/watch?v=cy1kdZhXsP8

 

 

Philosophy of Mind – The Stanford Encyclopedia of Philosophy

A bibliography of articles on the philosophy of mind and related topics found in The Stanford Encyclopedia of Philosophy

 

  1. Avramides, Anita. “Other Minds.” In The Stanford Encyclopedia of Philosophy, edited by Edward N. Zalta, Summer 2019. Metaphysics Research Lab, Stanford University, 2019. https://plato.stanford.edu/archives/sum2019/entries/other-minds/.
  2. Barlassina, Luca, and Robert M. Gordon. “Folk Psychology as Mental Simulation.” In The Stanford Encyclopedia of Philosophy, edited by Edward N. Zalta, Summer 2017. Metaphysics Research Lab, Stanford University, 2017. https://plato.stanford.edu/archives/sum2017/entries/folkpsych-simulation/.
  3. Bickle, John, Peter Mandik, and Anthony Landreth. “The Philosophy of Neuroscience.” In The Stanford Encyclopedia of Philosophy, edited by Edward N. Zalta, Fall 2019. Metaphysics Research Lab, Stanford University, 2019. https://plato.stanford.edu/archives/fall2019/entries/neuroscience/.
  4. Brook, Andrew. “Kant’s View of the Mind and Consciousness of Self.” In The Stanford Encyclopedia of Philosophy, edited by Edward N. Zalta, Spring 2020. Metaphysics Research Lab, Stanford University, 2020. https://plato.stanford.edu/archives/spr2020/entries/kant-mind/.
  5. Gertler, Brie. “Self-Knowledge.” In The Stanford Encyclopedia of Philosophy, edited by Edward N. Zalta, Spring 2020. Metaphysics Research Lab, Stanford University, 2020. https://plato.stanford.edu/archives/spr2020/entries/self-knowledge/.
  6. Goff, Philip, William Seager, and Sean Allen-Hermanson. “Panpsychism.” In The Stanford Encyclopedia of Philosophy, edited by Edward N. Zalta, Summer 2020. Metaphysics Research Lab, Stanford University, 2020. https://plato.stanford.edu/archives/sum2020/entries/panpsychism/.
  7. Hatfield, Gary. “René Descartes.” In The Stanford Encyclopedia of Philosophy, edited by Edward N. Zalta, Summer 2018. Metaphysics Research Lab, Stanford University, 2018. https://plato.stanford.edu/archives/sum2018/entries/descartes/.
  8. Jacob, Pierre. “Intentionality.” In The Stanford Encyclopedia of Philosophy, edited by Edward N. Zalta, Winter 2019. Metaphysics Research Lab, Stanford University, 2019. https://plato.stanford.edu/archives/win2019/entries/intentionality/.
  9. Kraut, Richard. “Plato.” In The Stanford Encyclopedia of Philosophy, edited by Edward N. Zalta, Fall 2017. Metaphysics Research Lab, Stanford University, 2017. https://plato.stanford.edu/archives/fall2017/entries/plato/.
  10. Kulstad, Mark, and Laurence Carlin. “Leibniz’s Philosophy of Mind.” In The Stanford Encyclopedia of Philosophy, edited by Edward N. Zalta, Fall 2020. Metaphysics Research Lab, Stanford University, 2020. https://plato.stanford.edu/archives/fall2020/entries/leibniz-mind/.
  11. Levin, Janet. “Functionalism.” In The Stanford Encyclopedia of Philosophy, edited by Edward N. Zalta, Fall 2018. Metaphysics Research Lab, Stanford University, 2018. https://plato.stanford.edu/archives/fall2018/entries/functionalism/.
  12. Liao, Shen-yi, and Tamar Gendler. “Imagination.” In The Stanford Encyclopedia of Philosophy, edited by Edward N. Zalta, Summer 2020. Metaphysics Research Lab, Stanford University, 2020. https://plato.stanford.edu/archives/sum2020/entries/imagination/.
  13. Lorenz, Hendrik. “Ancient Theories of Soul.” In The Stanford Encyclopedia of Philosophy, edited by Edward N. Zalta, Summer 2009. Metaphysics Research Lab, Stanford University, 2009. https://plato.stanford.edu/archives/sum2009/entries/ancient-soul/.
  14. Lycan, William. “Representational Theories of Consciousness.” In The Stanford Encyclopedia of Philosophy, edited by Edward N. Zalta, Fall 2019. Metaphysics Research Lab, Stanford University, 2019. https://plato.stanford.edu/archives/fall2019/entries/consciousness-representational/.
  15. Michaelian, Kourken, and John Sutton. “Memory.” In The Stanford Encyclopedia of Philosophy, edited by Edward N. Zalta, Summer 2017. Metaphysics Research Lab, Stanford University, 2017. https://plato.stanford.edu/archives/sum2017/entries/memory/.
  16. Pitt, David. “Mental Representation.” In The Stanford Encyclopedia of Philosophy, edited by Edward N. Zalta, Spring 2020. Metaphysics Research Lab, Stanford University, 2020. https://plato.stanford.edu/archives/spr2020/entries/mental-representation/.
  17. Ravenscroft, Ian. “Folk Psychology as a Theory.” In The Stanford Encyclopedia of Philosophy, edited by Edward N. Zalta, Summer 2019. Metaphysics Research Lab, Stanford University, 2019. https://plato.stanford.edu/archives/sum2019/entries/folkpsych-theory/.
  18. Rescorla, Michael. “The Computational Theory of Mind.” In The Stanford Encyclopedia of Philosophy, edited by Edward N. Zalta, Fall 2020. Metaphysics Research Lab, Stanford University, 2020. https://plato.stanford.edu/archives/fall2020/entries/computational-mind/.
  19. Robinson, Howard. “Dualism.” In The Stanford Encyclopedia of Philosophy, edited by Edward N. Zalta, Fall 2020. Metaphysics Research Lab, Stanford University, 2020. https://plato.stanford.edu/archives/fall2020/entries/dualism/.
  20. Scarantino, Andrea, and Ronald de Sousa. “Emotion.” In The Stanford Encyclopedia of Philosophy, edited by Edward N. Zalta, Winter 2018. Metaphysics Research Lab, Stanford University, 2018. https://plato.stanford.edu/archives/win2018/entries/emotion/.
  21. Schwitzgebel, Eric. “Belief.” In The Stanford Encyclopedia of Philosophy, edited by Edward N. Zalta, Fall 2019. Metaphysics Research Lab, Stanford University, 2019. https://plato.stanford.edu/archives/fall2019/entries/belief/.
  22. Shields, Christopher. “Aristotle.” In The Stanford Encyclopedia of Philosophy, edited by Edward N. Zalta, Fall 2020. Metaphysics Research Lab, Stanford University, 2020. https://plato.stanford.edu/archives/fall2020/entries/aristotle/.
  23. Siewert, Charles. “Consciousness and Intentionality.” In The Stanford Encyclopedia of Philosophy, edited by Edward N. Zalta, Spring 2017. Metaphysics Research Lab, Stanford University, 2017. https://plato.stanford.edu/archives/spr2017/entries/consciousness-intentionality/.
  24. Singer, P. N. “Galen.” In The Stanford Encyclopedia of Philosophy, edited by Edward N. Zalta, Winter 2016. Metaphysics Research Lab, Stanford University, 2016. https://plato.stanford.edu/archives/win2016/entries/galen/.
  25. Smart, J. J. C. “The Mind/Brain Identity Theory.” In The Stanford Encyclopedia of Philosophy, edited by Edward N. Zalta, Spring 2017. Metaphysics Research Lab, Stanford University, 2017. https://plato.stanford.edu/archives/spr2017/entries/mind-identity/.
  26. Smith, Joel. “Self-Consciousness,” July 13, 2017. https://stanford.library.sydney.edu.au/entries/self-consciousness/.
  27. ———. “Self-Consciousness.” In The Stanford Encyclopedia of Philosophy, edited by Edward N. Zalta, Summer 2020. Metaphysics Research Lab, Stanford University, 2020. https://plato.stanford.edu/archives/sum2020/entries/self-consciousness/.
  28. Stoljar, Daniel. “Physicalism.” In The Stanford Encyclopedia of Philosophy, edited by Edward N. Zalta, Winter 2017. Metaphysics Research Lab, Stanford University, 2017. https://plato.stanford.edu/archives/win2017/entries/physicalism/.
  29. “Table of Contents (Stanford Encyclopedia of Philosophy).” Accessed September 19, 2020. https://plato.stanford.edu/contents.html.
  30. Tanney, Julia. “Gilbert Ryle,” December 18, 2007. https://seop.illc.uva.nl/entries/ryle/.
  31. Thagard, Paul. “Cognitive Science.” In The Stanford Encyclopedia of Philosophy, edited by Edward N. Zalta, Spring 2019. Metaphysics Research Lab, Stanford University, 2019. https://plato.stanford.edu/archives/spr2019/entries/cognitive-science/.
  32. Tye, Michael. “Qualia.” In The Stanford Encyclopedia of Philosophy, edited by Edward N. Zalta, Summer 2018. Metaphysics Research Lab, Stanford University, 2018. https://plato.stanford.edu/archives/sum2018/entries/qualia/.
  33. Van Gulick, Robert. “Consciousness.” In The Stanford Encyclopedia of Philosophy, edited by Edward N. Zalta, Spring 2018. Metaphysics Research Lab, Stanford University, 2018. https://plato.stanford.edu/archives/spr2018/entries/consciousness/.
  34. Wilson, Robert A., and Lucia Foglia. “Embodied Cognition.” In The Stanford Encyclopedia of Philosophy, edited by Edward N. Zalta, Spring 2017. Metaphysics Research Lab, Stanford University, 2017. https://plato.stanford.edu/archives/spr2017/entries/embodied-cognition/.
  35. Wu, Wayne. “The Neuroscience of Consciousness.” In The Stanford Encyclopedia of Philosophy, edited by Edward N. Zalta, Winter 2018. Metaphysics Research Lab, Stanford University, 2018. https://plato.stanford.edu/archives/win2018/entries/consciousness-neuroscience/.

The Myth of Objectivity

“The ideal of a knowledge embodied in strictly impersonal statements now appears self-contradictory, meaningless, a fit subject for ridicule. We must learn to accept as our ideal a knowledge that is manifestly personal.”

— MICHAEL POLANYI

 

A bibliography on “The Myth of Objectivity”

  1. Rock Paper Shotgun. “A Philosophical Perspective On The Myth Of Objectivity.” Accessed September 18, 2020. https://www.rockpapershotgun.com/a-philosophical-perspective-on-the-myth-of-objectivity/.
  2. admin. “Critical Thinking Part 1: The Myth of Objectivity.” Dr. Marc D. Baldwin (blog), September 17, 2011. http://www.drmarcdbaldwin.com/2011/09/critical-thinking-part-1-the-myth-of-objectivity/.
  3. Alliger, George M., and Paul J. Hanges. “Objectivity and Science: Reply to Kukla.” Journal of Personality and Social Psychology 47, no. 3 (1984): 676–79. https://doi.org/10.1037/0022-3514.47.3.676.
  4. Armitage, Andrew; “Truths and Realities: An Autobiographical Account of a Researcher’s View from the inside.” Education-Line, December 12, 2007. http://www.leeds.ac.uk/educol/documents/167802.htm.
  5. Armstrong, J. Scott. “Advocacy as a Scientific Strategy: The Mitroff Myth.” Academy of Management Review 5, no. 4 (October 1, 1980): 509–11. https://doi.org/10.5465/amr.1980.4288951.
  6. Bowden, John A., and Pamela J. Green. “Relationality and the Myth of Objectivity in Research Involving Human Participants.” Researching Practice, January 1, 2010, 105–12. https://doi.org/10.1163/9789460911835_013.
  7. Cohen, Amy. “Copyright Law and the Myth of Objectivity: The Idea-Expression Dichotomy and the Inevitability of Artistic Value Judgments.” 66 Indiana Law Journal 175 (1990) 66, no. 1 (January 1, 1990). https://www.repository.law.indiana.edu/ilj/vol66/iss1/4.
  8. The Aggie. “Column: Myth of Objectivity,” March 14, 2013. https://theaggie.org/2013/03/14/column-myth-of-objectivity/.
  9. TED Blog. “Dan Gilbert on the Myth of Objectivity,” April 17, 2006. https://blog.ted.com/dan_gilbert_on/.
  10. The Runner. “Dropping the Myth of Objectivity in Journalism,” November 19, 2018. https://runnermag.ca/2018/11/dropping-the-myth-of-objectivity-in-journalism/.
  11. Duffy, Margaret, Esther Thorson, Fred Vultee, Esther Thorson, and Fred Vultee. “All Communication Is Persuasive: Exploding the Myth of Objectivity.” Persuasion Ethics Today. Routledge, December 7, 2015. https://doi.org/10.4324/9781315651309-8.
  12. Epistemology: A Guide. John Wiley & Sons, 2013.
  13. Dissident Mama. “Fake News, Part 1: The Myth of Objectivity,” March 27, 2017. http://www.dissidentmama.net/fake-news-part-1-the-myth-of-objectivity/.
  14. “Feminist Epistemology.” In The SAGE Encyclopedia of Qualitative Research Methods. 2455 Teller Road, Thousand Oaks California 91320 United States: SAGE Publications, Inc., 2008. https://doi.org/10.4135/9781412963909.n167.
  15. Gadamer, Hans-Georg. Truth and Method. Revised Edition. London ; New York: Bloomsbury Academic, 2004.
  16. Gannon, Kevin. “Objective History Is Impossible. And That’s a Fact.” The Tattooed Professor (blog), May 9, 2016. https://thetattooedprof.com/2016/05/09/objective-history-is-impossible-and-thats-a-fact/.
  17. González Ramos, Ana M., Beatriz Revelles Benavente, Ana M. González Ramos, and Beatriz Revelles Benavente. “Excellence in Science: A Critical Affirmative Response.” Cadernos de Pesquisa 47, no. 166 (December 2017): 1372–94. https://doi.org/10.1590/198053144233.
  18. Kara, Helen. “Not Spock! The Myth of ‘Objectivity’ Damages Public Trust in Science.” Helen Kara (blog), May 13, 2020. https://helenkara.com/2020/05/13/not-spock-the-myth-of-objectivity-damages-public-trust-in-science/.
  19. Kukla, Andre. “The Structure of Self-Fulfilling and Self-Negating Prophecies:” Theory & Psychology, August 19, 2016. https://doi.org/10.1177/0959354394041001.
  20. Malpas, Jeff. “Hans-Georg Gadamer.” In The Stanford Encyclopedia of Philosophy, edited by Edward N. Zalta, Fall 2018. Metaphysics Research Lab, Stanford University, 2018. https://plato.stanford.edu/archives/fall2018/entries/gadamer/.
  21. ———. “Hans-Georg Gadamer.” In The Stanford Encyclopedia of Philosophy, edited by Edward N. Zalta, Fall 2018. Metaphysics Research Lab, Stanford University, 2018. https://plato.stanford.edu/archives/fall2018/entries/gadamer/.
  22. Mayo. “The Myth of ‘The Myth of Objectivity” (i).” Error Statistics Philosophy (blog), September 18, 2016. https://errorstatistics.com/2016/09/18/the-myth-of-the-myth-of-objectivity-i/.
  23. Mayo, Deborah G., ed. “The Myth of ‘The Myth of Objectivity.’” In Statistical Inference as Severe Testing: How to Get Beyond the Statistics Wars, 221–38. Cambridge: Cambridge University Press, 2018. https://doi.org/10.1017/9781107286184.009.
  24. Mikulecky, Donald C. “Causality and Complexity: The Myth of Objectivity in Science.” Chemistry & Biodiversity 4, no. 10 (2007): 2480–91. https://doi.org/10.1002/cbdv.200790202.
  25. ———. “Causality and Complexity: The Myth of Objectivity in Science.” Chemistry & Biodiversity 4, no. 10 (October 2007): 2480–91. https://doi.org/10.1002/cbdv.200790202.
  26. Miller, Arthur. “The Myth of Objectivity in Legal Research and Writing.” Catholic University Law Review 18, no. 3 (January 1, 1969): 290–307.
  27. Mitroff, Ian I. “The Myth of Objectivity OR Why Science Needs a New Psychology of Science.” Management Science 18, no. 10 (1972): 613–18.
  28. ———. “The Myth of Objectivity OR Why Science Needs a New Psychology of Science.” Management Science 18, no. 10 (June 1, 1972): B-613. https://doi.org/10.1287/mnsc.18.10.B613.
  29. ———. “The Myth of Objectivity OR Why Science Needs a New Psychology of Science.” Management Science 18, no. 10 (June 1, 1972): B-613–B-618. https://doi.org/10.1287/mnsc.18.10.B613.
  30. Morgan, Gareth. “Accounting as Reality Construction: Towards a New Epistemology for Accounting Practice.” Accounting, Organizations and Society 13, no. 5 (January 1, 1988): 477–85. https://doi.org/10.1016/0361-3682(88)90018-9.
  31. “Mr. Mailer and the Myth of Objectivity | News | The Harvard Crimson.” Accessed September 18, 2020. https://www.thecrimson.com/article/1968/11/14/mr-mailer-and-the-myth-of/.
  32. 50 Myths of the Internet. “Myth #19: Search Engines Provide Objective Results.” Accessed September 18, 2020. https://www.internetmythen.de/en/?mythen=myth-19-search-engines-provide-objective-results.
  33. “News: Beyond the Myth of Objectivity | Center for Media Literacy | Empowerment through Education | CML MediaLit Kit TM |.” Accessed September 18, 2020. https://www.medialit.org/reading-room/news-beyond-myth-objectivity.
  34. Ormandy, Roman. “The Myth of Objectivity.” Medium, February 26, 2017. https://medium.com/@Romanor/the-myth-of-objectivity-5ac30fbd3c8e.
  35. “Our Mental Prison: The Myth of ‘Objective’ Knowledge.” Accessed September 18, 2020. https://www.catholicculture.org/commentary/our-mental-prison-myth-objective-knowledge/.
  36. ResearchGate. “(PDF) The Myth of Objectivity in the News and Internet Journalism in Turkey.” Accessed September 18, 2020. https://www.researchgate.net/publication/319205354_The_Myth_of_Objectivity_in_the_News_and_Internet_Journalism_in_Turkey.
  37. Piippo, John. “The Myth of Objectivity.” Accessed September 18, 2020. https://www.johnpiippo.com/2009/11/myth-of-objectivity.html.
  38. Pm, Allen, and Varga L. “Complexity: The Co-Evolution of Epistemology, Axiology and Ontology.” Nonlinear Dynamics, Psychology, and Life Sciences 11, no. 1 (January 1, 2007): 19–50.
  39. Podsakoff, Philip M., Scott B. MacKenzie, Jeong-Yeon Lee, and Nathan P. Podsakoff. “Common Method Biases in Behavioral Research: A Critical Review of the Literature and Recommended Remedies.” Journal of Applied Psychology 88, no. 5 (2003): 879–903. https://doi.org/10.1037/0021-9010.88.5.879.
  40. Poerksen, Bernhard. “Theory Review the Ideal and the Myth of Objectivity.” Journalism Studies 9, no. 2 (April 1, 2008): 295–304. https://doi.org/10.1080/14616700701848451.
  41. Polanyi, Michael. Personal Knowledge. Routledge, 2012.
  42. ———. The Study of Man. Martino Publishing, 2014.
  43. ———. The Tacit Dimension. University of Chicago Press, 2009.
  44. Polanyi, Michael, and Harry Prosch. Meaning. University of Chicago Press, 2008.
  45. Research, RTi. “Algorithms and the Myth of Objectivity.” RTi Research (blog), October 17, 2017. https://rtiresearch.com/2017/10/17/algorithms-myth-objectivity/.
  46. Columbia Journalism Review. “Re-Thinking Objectivity.” Accessed September 18, 2020. https://www.cjr.org/feature/rethinking_objectivity.php.
  47. Romagnano, Lew. “The Myth of Objectivity in Mathematics Assessment.” Mathematics Teacher 94, no. 1 (2001): 31–37.
  48. ———. “The Myth of Objectivity in Mathematics Assessment.” Mathematics Teacher 94, no. 1 (2001): 31–37.
  49. Sæther, Ole A. “The Myth of Objectivity—Post-Hennigian Deviations.” Cladistics 2, no. 1 (1986): 1–13. https://doi.org/10.1111/j.1096-0031.1986.tb00438.x.
  50. Segal, L. “The Myth of Objectivity,” 2001. https://doi.org/10.1007/978-1-4613-0115-8_2.
  51. Segal, Lynn. “The Myth of Objectivity.” In The Dream of Reality: Heinz von Foerster’s Constructivism, edited by Lynn Segal, 5–25. New York, NY: Springer, 2001. https://doi.org/10.1007/978-1-4613-0115-8_2.
  52. Soler, Viviana. “Scientific Communication and the Nature of Science: An Illustration of Oscillations from Researcher’s Proximity to Researcher’s Distance in Scientific Titles and Its Pedagogical Implications.” Colombian Applied Linguistics Journal 16, no. 2 (December 2014): 291–302. https://doi.org/10.14483/udistrital.jour.calj.2014.2.a10.
  53. “The Dream of Reality.” In Wikipedia, February 1, 2020. https://en.wikipedia.org/w/index.php?title=The_Dream_of_Reality&oldid=938655510.
  54. Drishtikone. “The Fallacy of Objectivity.” Accessed September 18, 2020. https://drishtikone.com/blog/2020/05/23/the-fallacy-of-objectivity/.
  55. Psychology Today. “The Myth of Objectivity.” Accessed September 18, 2020. http://www.psychologytoday.com/blog/political-intelligence/201206/the-myth-objectivity.
  56. “The Myth of Objectivity.” Accessed September 18, 2020. http://www.emotionalcompetency.com/sci/sm6.htm.
  57. ResearchGate. “The Myth of Objectivity.” Accessed September 18, 2020. https://doi.org/10.1007/978-1-4613-0115-8_2.
  58. “The Myth of Objectivity in Mathematics Assessment – ProQuest.” Accessed September 18, 2020. https://search.proquest.com/openview/9483249e411609284d0b73f3bd5b5841/1?pq-origsite=gscholar&cbl=41299.
  59. “Twitter Forces Media to Confront the Myth of Objectivity – Gigaom.” Accessed September 18, 2020. https://gigaom.com/2010/07/08/twitter-forces-media-to-confront-the-myth-of-objectivity/.
  60. VideoWordMadeFlesh. “The Myth of Objectivity or: Why I Hate Fight Club.” Video Word Made Flesh (blog), March 1, 2012. https://videowordmadefleshdotcom.wordpress.com/2012/03/01/the-myth-of-objectivity-or-why-i-hate-fight-club/.
  61. Wilson, Hamish J. “The Myth of Objectivity: Is Medicine Moving towards a Social Constructivist Medical Paradigm?” Family Practice 17, no. 2 (April 1, 2000): 203–9. https://doi.org/10.1093/fampra/17.2.203.

 

Social Epistemology

From the Stanford Encyclopedia of Philosophyhttps://plato.stanford.edu/entries/epistemology-social/

 

“Until recently, epistemology—the study of knowledge and justified belief—was heavily individualistic in focus. The emphasis was on evaluating doxastic attitudes (beliefs and disbeliefs) of individuals in abstraction from their social environment. Social epistemology seeks to redress this imbalance by investigating the epistemic effects of social interactions and social systems. After giving an introduction, and reviewing the history of the field in sections 1 and 3, we move on to discuss central topics in social epistemology in section 3. These include testimony, peer disagreement, and judgment aggregation, among others. Section 4 turns to recent approaches which have used formal methods to address core topics in social epistemology, as well as wider questions about the functioning of epistemic communities like those in science. In section 5 we briefly turn to questions related to social epistemology and the proper functioning of democratic societies. “

Covid-19 Speculation – Sept 16, 2020

Update 2020-10-11: The trend of deaths going down may be reversing in some places, and needs more investigation. Unfortunately, the main site that I use, Coronavirus Update (Live): 5,304,001 Cases and 340,004 Deaths from COVID-19 Virus Pandemic – Worldometer , does not give the fine-grained breakdown I would like to have. It may be that regional patterns, showing past true case and death rates for a limited geographical area would give a clearer picture, that is obscured by country-wide aggregate figures. Looking at this will be another project for another day.

Looking into Deaths and Cases

The Covid-19 infection appears to be dying down in many, many places. Sometimes infections are going up, but more often they are going down. Deaths are going down a lot in many, many places. There is a caveat: a more thorough survey of Covid-19 statistics from various locations has been done by others; such work needs to be done even more systematically and extensively. The pattern may not be always true. See Coronavirus Update (Live): 5,304,001 Cases and 340,004 Deaths from COVID-19 Virus Pandemic – Worldometer. It is still possible that there will be a resurgence.

If it is the case that infections and deaths are trailing off, what are the possible explanations? There are several possibilities that I can think of: better social distancing and infection control, the virus has mutated to a less deadly strain, those who are most vulnerable are not being put at risk the same way as before, the susceptible have already been infected, there is pre-existing immunity from T-cells and previous Coronoa virus infections, treatment is better, and probably other things. Take your pick. My conjecture: most or all may be playing a role.

Here is a possibility:

Chris Martenson’s X,Y,Z hypothesis says:

X – Natural immunity – nutrition, genetics, epi-genetics, stress, sleep, youth, reduced co-morbidities

Y – long term T-cell immunity from previous Corona virus infections

Z – short term anti-body immunity from Covid-19

The percentages are debatable, but the overall scheme seems sound. We don’t know for sure what we need to have large scale group immunity, but previous estimates may have been on the high side.

Both DrBeen and Dr. Martenson have given their versions of this. Martenson suggested some percentages, just for the sake of argument, knowing that the data was not there.  See: https://www.youtube.com/watch?v=G7TWiweluwA&list=PLRgTUN1zz_oeQpnJxpeaEkFimDeepqyWf&index=11

You have the effectiveness of infection spread measures and possible (likely?) mutation of the virus as factors as well.

There are theories that humidity and that temperature also play a key role in viral suppression. I am not at all certain about the first and think the second seems unlikely looking at worldwide results.

Testing has redefined the term case in an unfortunate way.

The tests are unreliable – false positives and false negative. Testing is showing “cases” increasing wherever testing is widespread, but these counts are something to look at suspiciously. See here:  https://www.youtube.com/watch?v=HSsTCjbNPF0 in “Covid Testing: Bad Science Worse Policy.”

Of course the numbers are inaccurate, both over-counts and under-counts, but the overall trend seems somewhat clear. Look at places that have had a high infection per million, that are reasonably small geographically. The infection grows rapidly, and then goes down with a long tail, not reaching zero. Fatalities lag infections, and move to low numbers. Still, this is bad enough.

Country-wide statistics do not show that there are sub-patterns for each region, and each centre of population. The numbers are not always fine-grained enough. It is complex, but the overall trend seems to be an exponential peak, and a gradual fade out in infections and in deaths, a long tail. Treatment is certainly better, so fewer deaths, but maybe people are distancing enough to get a lower viral load and lessened infection, and the vulnerable in care homes are not being sacrificed.

Viral Loads and Inoculum

I have formed the opinion that reduction of viral load is crucial. I listened to a doctor last night making the claim that the research does not show viral load to be a factor, and that even one virion can be enough to cause an infection. This seems highly unlikely to me. She disparages three scientists for their pro-mask position because they were not medical scientists, and then lauds another scientist (Denis Rancourt) for his anti-mask paper, when he is a physicist. He also comes out with the “one virion can infect you” hypothesis.

I tracked down a paper on the “one virion can infect you” claim. Pretty iffy. One study on some other virus in insects, and some statistical massageleading to conclusions. I am not convinced that the results can be generalized. See: https://royalsocietypublishing.org/doi/10.1098/rspb.2009.0064

I did not find other studies; such may exist. I did not find a rebuttal; such may also exist.

I am still wearing a mask when I can’t keep my distance. There are those who say that the 2 meter distance is not enough and masks are not protective, and can cherry pick studies to prove their point. I guess we all cherry pick.

Masks may or may not work – I lean to the side of probably do, and risk management  says to me that we should wear them when we cannot keep our distance, or ensure good air circulation. Studies are in conflict on this. Wearing them when driving alone, or when sitting on your front lawn, shows a lack of understanding of how things work.

Will there be a resurgence? Maybe, maybe not. Where I live, in British Columbia, and particularly on Vancouver Island, we have not been hit very hard. So, we may still be subject  to rapid growth if social distancing fails to be practised. I don’t know the long term prognosis. Will it disappear completely as SARS and MERS seemed to do? Deadly infections die out faster than less deadly ones, but this one is not as universally deadly as previously thought.

Diagnosis of cases creeping up, deaths staying low. Reasons? Varied I am sure.There are also some patterns with two humps,bi-modal, so a deeper analysis is required.  When deaths decrease into a long-tail pattern, that still represents lives lost unnecessarily. See https://ephektikoi.ca/blog/2020/09/22/could-covid-19-be-effectively-over/

Motivated Reasoning

Biased reasoning? We all do it. Exposure to only some of the evidence? That is the norm. Conflicting studies? Always, in all fields. Poorly done studies, confounded studies, studies with meaningless or uninterpretable variables? Routine. Inability to integrate and interpret voluminous amounts a conflicting and ambiguous evidence? That is the typical case. Reasoning from current beliefs? How could it be otherwise?

Science lurches, sometimes forwards, sometimes off into alternative dimensions.

‘Still a man hears what he wants to hear and disregards the rest.’ — Paul Simon”

Some Graphs Showing a Pattern of Decreasing Deaths

For instance, here are some not unusual patterns:

Also

Also

Also

Also in Australia, a bimodal distribution of cases and deaths. I would like to see this broken down by region.

Even in France, where cases are growing, deaths are not keeping pace. Why is that? Is it an artifact of the amount of testing? I dunno.

Prophylaxis

Also, places using HCQ for prophylaxis and early stage treatment have in general faired a lot better. There are now 102 studies on it, most showing positive results when taken early, preferably with Zinc. Ivermectin seems to be even better, but I have not found a site that collects studies on that yet.
For HCQ, see https://c19study.com/, the most comprehensive study aggregation site. Studies will routinely contradict one and other, all are confounded in one way or another.  It is the job of systematic meta-analysis to try to make sense of them all. This is not for the faint of heart, and the methods require a deep understanding of the field, and of very advanced statistics. There have been several meta-analyses of HCQ studies.  Some studies have looked at the wrong thing – late stage infection.

 

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  98. Smith, Adam. “Masks Are Important but No Cure-All: Prof. Tells of Way to Slow Covid Spread.” TheStreet. Accessed September 10, 2020. https://www.thestreet.com/latest-news/ben-cowling-of-the-university-of-hong-kong-discusses-whats-known-among-doctors-as-shortening-the-serial-interval-distribution.
  99. Smith, Jeffrey D., Colin C. MacDougall, Jennie Johnstone, Ray A. Copes, Brian Schwartz, and Gary E. Garber. “Effectiveness of N95 Respirators versus Surgical Masks in Protecting Health Care Workers from Acute Respiratory Infection: A Systematic Review and Meta-Analysis.” CMAJ 188, no. 8 (May 17, 2016): 567–74. https://doi.org/10.1503/cmaj.150835.
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  102. Spencer, Saranac Hale. “Video Misrepresents the Science Behind Face Masks.” FactCheck.Org (blog), July 24, 2020. https://www.factcheck.org/2020/07/video-misrepresents-the-science-behind-face-masks/.
  103. Staff, Reuters. “Dutch Government Will Not Advise Public to Wear Masks – Minister.” Reuters, July 29, 2020. https://www.reuters.com/article/us-health-coronavirus-netherlands-idUSKCN24U2UJ.
  104. Still Confused About Masks? Here’s the Science Behind How Face Masks Prevent Coronavirus | UC San Francisco. “Still Confused About Masks? Here’s the Science Behind How Face Masks Prevent Coronavirus.” Accessed September 10, 2020. https://www.ucsf.edu/news/2020/06/417906/still-confused-about-masks-heres-science-behind-how-face-masks-prevent.
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  106. Fortune. “Sweden’s Top Virologist Has a Message on How to Defeat Coronavirus: Open Schools and No Masks.” Accessed September 10, 2020. https://fortune.com/2020/08/05/sweden-anders-tegnell-face-masks-school-opening-coronavirus-covid-19-europe/.
  107. The Skeptical Cardiologist. “The Economic Impact of Wearing Face Masks During COVID-19,” July 7, 2020. https://theskepticalcardiologist.com/2020/07/07/the-economic-impact-of-wearing-face-masks-during-covid-19/.
  108. Psychology Today. “The Evidence on Face Masks.” Accessed September 10, 2020. https://www.psychologytoday.com/blog/evidence-based-living/202004/the-evidence-face-masks.
  109. “The Forgotten Science Behind Face Masks.” Accessed September 10, 2020. https://www.webmd.com/lung/news/20200826/the-forgotten-science-behind-face-masks.
  110. MSN. “This Face Mask Claim Is Going Viral—and It’s 100 Percent Wrong.” Accessed September 10, 2020. https://www.msn.com/en-us/Health/medical/this-face-mask-claim-is-going-viral-and-it-s-100-percent-wrong/ar-BB16tUzs.
  111. MSN. “This Is How Many People Need to Wear Masks to Stop the Coronavirus.” Accessed September 10, 2020. https://www.msn.com/en-my/health/wellness/this-is-how-many-people-need-to-wear-masks-to-stop-the-coronavirus/ar-BB13ZGBA.
  112. Tunevall, Th. Göran. “Postoperative Wound Infections and Surgical Face Masks: A Controlled Study.” World Journal of Surgery 15, no. 3 (May 1, 1991): 383–87. https://doi.org/10.1007/BF01658736.
  113. “Tyson Foods, Inc. Releases Covid-19 Test Results At Northwest Arkansas Facilities.” Accessed September 9, 2020. https://www.tysonfoods.com/news/news-releases/2020/6/tyson-foods-inc-releases-covid-19-test-results-northwest-arkansas.
  114. Viola, I. M., B. Peterson, G. Pisetta, G. Pavar, H. Akhtar, F. Menoloascina, E. Mangano, et al. “Face Coverings, Aerosol Dispersion and Mitigation of Virus Transmission Risk,” May 19, 2020. https://arxiv.org/abs/2005.10720v1.
  115. Wang, Xiaowen, Enrico G. Ferro, Guohai Zhou, Dean Hashimoto, and Deepak L. Bhatt. “Association Between Universal Masking in a Health Care System and SARS-CoV-2 Positivity Among Health Care Workers.” JAMA 324, no. 7 (August 18, 2020): 703–4. https://doi.org/10.1001/jama.2020.12897.
  116. Wang, Yu, Huaiyu Tian, Li Zhang, Man Zhang, Dandan Guo, Wenting Wu, Xingxing Zhang, et al. “Reduction of Secondary Transmission of SARS-CoV-2 in Households by Face Mask Use, Disinfection and Social Distancing: A Cohort Study in Beijing, China.” BMJ Global Health 5, no. 5 (May 28, 2020). https://doi.org/10.1136/bmjgh-2020-002794.
  117. Ward, Alex. “How Masks Helped Hong Kong Control the Coronavirus.” Vox, May 18, 2020. https://www.vox.com/2020/5/18/21262273/coronavirus-hong-kong-masks-deaths-new-york.
  118. Ward, John. “Stop Forcing People to Wear Useless Masks.” The Slog (blog), July 24, 2020. https://therealslog.com/2020/07/24/stop-forcing-people-to-wear-useless-masks/.
  119. Fortune. “‘We See No Point in Wearing a Face Mask,’ Sweden’s Top Virus Expert Says as He Touts the Country’s Improving COVID Numbers.” Accessed September 9, 2020. https://fortune.com/2020/07/29/no-point-in-wearing-mask-sweden-covid/.
  120. “Wearing a Mask: Myths and Facts.” Accessed September 10, 2020. https://www.umms.org:443/coronavirus/what-to-know/masks/wearing-mask.
  121. “Welcome to CDC Stacks |.” Accessed September 10, 2020. https://stacks.cdc.gov/view/cdc/90553.
  122. ResearchGate. “What’s Your Point towards Facemask Usage under COVID-19?” Accessed September 9, 2020. https://www.researchgate.net/post/Whats_your_point_towards_facemask_usage_under_COVID-19.
  123. Wu, Katherine J. “Masks May Reduce Viral Dose, Some Experts Say.” The New York Times, July 27, 2020, sec. Health. https://www.nytimes.com/2020/07/27/health/coronavirus-mask-protection.html.
  124. Xiao, Jingyi, Eunice Y. C. Shiu, Huizhi Gao, Jessica Y. Wong, Min W. Fong, Sukhyun Ryu, and Benjamin J. Cowling. “Nonpharmaceutical Measures for Pandemic Influenza in Nonhealthcare Settings—Personal Protective and Environmental Measures – Volume 26, Number 5—May 2020 – Emerging Infectious Diseases Journal – CDC.” Accessed September 8, 2020. https://doi.org/10.3201/eid2605.190994.
  125. Psychology Today. “Yes, Masks Work: Debunking the Pseudoscience.” Accessed September 10, 2020. https://www.psychologytoday.com/blog/logical-take/202007/yes-masks-work-debunking-the-pseudoscience.
  126. UC Davis. “Your Mask Cuts Own Risk by 65 Percent,” July 6, 2020. https://www.ucdavis.edu/coronavirus/news/your-mask-cuts-own-risk-65-percent.
  127. z3508948. “Cloth Masks – Dangerous to Your Health?” Text. UNSW Newsroom, April 23, 2015. https://newsroom.unsw.edu.au/news/health/cloth-masks-%E2%80%93-dangerous-your-health.
  128. Zajenkowski, Marcin, Peter K. Jonason, Maria Leniarska, and Zuzanna Kozakiewicz. “Who Complies with the Restrictions to Reduce the Spread of COVID-19?: Personality and Perceptions of the COVID-19 Situation.” Personality and Individual Differences 166 (November 1, 2020): 110199. https://doi.org/10.1016/j.paid.2020.110199.

 

Randomized Controlled Trials and Experimental Evidence

I am surprised to find that there is so much material on the limitations of randomized controlled trials (RCT). It is funny that this knowledge has not reached the consciousness of many specialists in the medical community.

In order to understand randomized controlled trials, it helps to understand experimental research methods in general. There are big issues pertaining to research designs, controls, confounds, randomization, statistics, bias, incentive and deception which anyone using scientific evidence to make a judgment or buttress an argument should understand. The discussions become very technical. All scientific evidence is underdetermined in some manner; that is another way of saying that our understanding is confounded. One study does not establish a case; it only points in a certain direction.

A Cheat Sheet on Key Ideas Underlying Research

Below is a cheat sheet on some key scientific ideas, of relevance to research, including randomized controlled trials. It may seem peripheral to the topic of RCT, but I think that understanding some basic issues around research and inference will help in better understanding the documents discussed in the second part of the essay.

Epistemology

Epistemology is the study of knowledge. The philosophy of science applies epistemological thinking to scientific research. Those espousing methods of research should really have some familiarity with this discipline, since it underpins science.

Inference

Inference is the process of making a judgment or buttressing an argument from available evidence. It has three varieties:

  1. Deduction is the method of applying the established patterns of formal logic to assertions to assess whether conclusions follow correctly from the premises. There is no guarantee that the original premises are correct, are sound.
  2. Induction is the process of generalizing from past experience to predict future events based on perceived patterns, perceived regular occurrences.
  3. Abduction is sometimes called “inference to the best explanation.”

Scientific evidence

One study does not establish a case; it only points in a certain direction. All scientific evidence is underdetermined. Evidence follows these dictates:

  1. It must be obtained, either produced or found
  2. It must be evaluated for reliability, correctness, provenance
  3. It must be interpreted, the implications made clear, the fit within an existing body of knowledge examined

Is there scientific objectivity? All of this assessment of evidence happens within the context of current beliefs, scientific and other, and biases. It could not be otherwise.

Probabilities

Probabilities are the odds of future events happening. They can be based on deduction and counting, or based on intuition and conjecture, possibly well-informed, but subjective.

Statistics are generally classed as descriptive or inferential. In descriptive statistics, data is collected, sorted, categorized and summarized in various mathematical ways. In inferential statistics, statistics based on samples are generalized to larger populations of interest, based on the odds of any observed results being true.

Frequentist thinking looks at chances as frequencies, or proportions, in similar events or items.

Bayesian thinking looks at prior probabilities, determined in some fashion, and applies the rules of conditional probability to assess fresh probabilities.

Inferential statistics reasons from sample to populations. From samples we can make predictions about the broader population from which the samples are drawn. This has problematic aspects.

Association

Association lets us see that certain things seem to occur together with regularity.

Correlation gives us a measure of how well, how often this association holds. Mathematically a correlation of zero says that there is no relationship, a correlation of positive one says that they are perfectly correlated, always going together, and a correlation of negative one says that they are perfectly inversely correlated.

Causation

Causation gives us the idea that this association is one in which one factor depends, to a lesser or greater extent, on a second factor. By varying the first factor, the independent factor, we can produce a repeatable change in the second factor, the dependent factor. We can quantify these factors and abstract them, or operationalize them, and call them variables.

Methods

Scientific research methods do not necessarily involve experimental studies, or laboratory work. There are many fields where experiment plays a secondary role.

However, in many fields, research does involve the manipulation of various independent factors in order to see the effects on assumed dependent factors. In general, the experiment is designed to test a research hypothesis, which may be part of a larger theory. In order to conduct experiments, certain standard methods have been developed in order to design experiments which have a good chance of providing correct results and allowing for interpretation. This interpretation is always done within the context of a broader set of beliefs about the nature of the research area.

One of the key aspects of all research is that the factors being manipulated are not necessarily the factors determining the experimental outcomes. We call factors which might be affecting the outcome and which are not being manipulated confounders, or confounds. These possible confounds may be identified and controlled for to some extent through good research design. However, not all confounds will be identified, and cannot be controlled for so easily. Matching and stratifying across subgroups on known factors and randomization across subgroups are mechanisms used to control for confounds. There is a lot more to research design than this, but these ideas are basic.

It is sometimes said that randomization controls for unconscious bias and for biasing factors independent of human judgment.  This is at least partially true. We can regard bias as a set of confounding factors. Bias can occur at all stages of a study, from sample selection, to recording of data, analysis of data, and interpretation of results. Randomization will not help with all of these sorts of bias.

By making the subjects, if human, unaware of the experimental group that they are in, a certain sort of bias can be controlled. This is called a blind trial. By making the experimenters unaware of the groups, we can remove some experimenter bias. This, combined with the first method, is called a double blind trial. There are cases where this works, but there is a gap between theory and practice.

Research Samples

In performing an experiment, subjects are required. This means that they must be selected in some fashion. There will be at least two groups in a well designed experiment, a control group and a treatment group. If the sample control group is different on some significant confounding factor from the sample treatment group, we can end up with worthless results due to this bias. We can help control for this confound by matching across groups on factors considered important such as age, sex, weight and so on. We can also assign subjects to the different groups on some randomized basis. We can combine these strategies. In order to have some confidence in our results, we should use the largest samples we can obtain. Randomization is not particularly effective as a strategy for small sized groups.

We can have unconscious bias in our sample selection, and end up with groups that are not equivalent in key dimensions. We do not want to use ad hoc methods of assigning subjects to a group, or in obtaining subjects for the sample, but real life contingencies such as funding, time frames, available subjects, and other things often get in the way of experimental rigour.

Integrity and Research Design

Experimental design cannot control for dishonesty, for deception. This is worse than bias, for it can not be detected in a reliable fashion, and research designs can not control for it.

RCT major themes

There seem to be a number of significant considerations for the use and interpretation of randomized controlled trials in research, and arguments for the use of other methods in many cases. This is not to say that RCTs do not have an important role to play in research, but they are just one of various methods.  For further reading, see Medicine’s fundamentalists and Randomized controlled trials.

I will not attempt to summarize such a voluminous literature on RTC, but instead will focus on a few articles, published in journals, by respected researchers. The first is by Thomas R. Frieden, M.D.,M.P.H., a former director of the Center for Disease Control and Prevention. In the New England Journal of Medicine he writes “Evidence for Health Decision Making – Beyond Randomized, Controlled Trials.”

The second is by Angus Deaton, FBA, Dwight D. Eisenhower Professor of Economics and International Affairs Emeritus at the Princeton School of Public and International Affairs and the Economics Department at Princeton University and a winner of the Nobel Memorial Prize in Economic Sciences and by co-author Nancy Cartwright, FBA FAcSS, Professor of Philosophy at Durham University and a Distinguished Professor at the University of California, San Diego (UCSD). In Social Science & Medicine, they write, “Understanding and misunderstanding randomized controlled trials.”

I also reference in the Bibliography a piece Alexander Krauss in the Annals of Medicine,Why all randomised controlled trials produce biased resultsand a response by Althouse, Andrew D., Abebe, Kaleab Z. , Collins, Gary S. & Harrell Jr, Frank E. , Journal Annals of Medicine,  Response to “Why all randomized controlled trials produce biased results”, without attempting commentary.

Evidence for Health Decision Making – Beyond Randomized, Controlled Trials

In this paper by a healthcare professional, randomized controlled trials are discussed with respect to benefits and limitations, and other methods of gathering evidence for medical research are presented, along with considerations for use.

From the paper by Frieden (above), the author makes the following points (précised here):

  1. There is no single, best approach to the study of health interventions
  2. Clinical and public health decisions are almost always made with imperfect data
  3. We should be promoting transparency in study methods
  4. We should be ensuring standardized data collection for key outcomes
  5. We need to use new approaches to improve data synthesis
  6. Improved data synthesis provides critical steps in the interpretation of findings
  7. Improved data synthesis allows us to better identify data for action
  8. It must be recognized that conclusions may change over time
  9. There will always be an argument for more research and for better data
  10. Waiting for more data is often an implicit decision not to act or to act on the basis of past practice rather than best available evidence
  11. The goal must be actionable data — data that are sufficient for clinical and public health action
  12. We need methods which produce data that have been derived openly and objectively
  13. We need data which enable us to say, “Here’s what we recommend and why.”

Understanding and misunderstanding randomized controlled trials

In this paper by a Nobel prize winning economist and by co-author who is a professor of philosophy discuss various issues in research and in the use of randomized controlled trials.

From the paper by Deaton and Cartwright (above), the authors make the following points:

  1. Randomization does not balance confounders in any single trial.
  2. Unbiasedness is of limited practical value compared with precision.
  3. Asymmetric distributions of treatment effects pose threats to significance testing.
  4. The best method depends on hypothesis tested, what’s known, and cost of mistakes.
  5. RCT results can serve science but are weak ground for inferring ‘what works’.

Bibliography:

Althouse, A. D., Abebe, K. Z., Collins, G. S., & Harrell, F. E. (2018). Response to “Why all randomized controlled trials produce biased results.” Annals of Medicine, 50(7), 545–548. https://doi.org/10.1080/07853890.2018.1514529
Deaton, A., & Cartwright, N. (2018). Understanding and misunderstanding randomized controlled trials. Randomized Controlled Trials and Evidence-Based Policy: A Multidisciplinary Dialogue, 210, 2–21. https://doi.org/10.1016/j.socscimed.2017.12.005
Frieden, T. R. (2017). Evidence for Health Decision Making—Beyond Randomized, Controlled Trials. New England Journal of Medicine, 377(5), 465–475. https://doi.org/10.1056/NEJMra1614394
Krauss, A. (2018). Why all randomised controlled trials produce biased results. Annals of Medicine, 50(4), 312–322. https://doi.org/10.1080/07853890.2018.1453233

 

Randomized Controlled Trials

Overview

There is a great amount of information available from scholars in medical research and research in general who are able to point out the benefits and limitations of random controlled trials (RCT) in research. RCT can be of value in many cases, but in others they are inappropriate. They are not by any stretch of the imagination “the gold standard.” They are just another mechanism for producing evidence, and can help to reduce some sorts of confounds. It is epistemologically naive to suggest that they somehow trump other investigative methods.

Claiming that Random Controlled Trials (RCT) are the only method to gain scientific understanding shows a limited knowledge of the history of science.  Scientific evidence, the production, evaluation and interpretation, is much more complicated than that.

There are big issues pertaining to research designs, controls, confounds, randomization, statistics, bias, incentive and deception which anyone using scientific evidence to make a judgment or buttress an argument should understand. The discussions become very technical. All scientific evidence is underdetermined. One study does not establish a case; it only points in a certain direction.

Limitations of RCT are discussed briefly in the article here and here.

Below is a reading list obtained via Google Internet searching. I have not looked at more than a fraction of these, and have looked carefully at only a very few.

Some Readings on the Topic of Randomized Controlled Trials

 

 

 

Economics https://www.rieti.go.jp/en/publications/summary/19010008.html?ref=rss

Are there ethical issues with randomized controlled trials by economists? Evidence from two online surveys in Japan

Economics 2019 Nobel Prize in Economics: the limits of the clinical trial …

theconversation.com › 2019-nobel-prize-in-economics-…

Oct 31, 2019 – However, the validity and impact of the growing use of randomized control trials require scrutiny. Working from a July 2019 article, we would …

Economics Are there ethical issues with randomized controlled trials by …

ideas.repec.org › eti › rdpsjp

Are there ethical issues with randomized controlled trials by economists? Evidence from two online surveys in Japan (Japanese). Author & abstract; Download …

by Y Hidefumi – ‎2019

Economics Discussion Papers (Japanese) FY2018 – RIETI

www.rieti.go.jp › publications › act_dp_jp2018

Are there ethical issues with randomized controlled trials by economists? Evidence from two online surveys in Japan · YOKOO Hidefumi (Research Associate, …

Economics Experimental economists win Nobel Prize (and deserved to win)

www.brookings.edu › opinions › experimental-econom…

Oct 23, 2019 – … the design of randomized controlled trials (RCTs) and the subsequent influence … applied by the three winners is called a randomized controlled trial, or RCT. … important advantage of randomized trials from the point of view of policymaking. … experiments vastly outweigh their supposed disadvantages.

Economics Media | Professor Sir Angus Deaton – Princeton University

scholar.princeton.edu › deaton › media

(Please skip ahead, as the first 54 seconds are in Swedish) Angus Deaton discusses Poor Economics and the problems with Randomized Controlled Trials at …

Economics Randomized Controlled Trials – OECD

www.oecd.org › derec › sweden › Randomized-Control…

PDF

I also argue that the advantages of including RCTs into Swedish aid practices go beyond just … called Randomized Controlled Trials (RCT) in evaluating aid financed projects and programs. … necessarily a disadvantage. Why is the selection …

by A Olofsgård – ‎Related articles

Economics Randomized Controlled Trials, Development Economics and …

pubdocs.worldbank.org › Esther-Duflo-PRESENTATI…

PDF

The key advantage of RCT was perceived to be a clear identification advantage. • With RCT, since those who received a treatment are randomly selected in a …

by E Duflo – ‎Cited by 3 – ‎Related articles

Economics RCTs — pros and cons | LARS P. SYLL

larspsyll.wordpress.com › 2014/08/14 › rcts-pros-and-c…

Aug 14, 2014 – Randomization is supposed to control for bias from unknown confounders. … Randomized controlled trials (RCTs) do not tell you that. They do …

Economics Regression Discontinuity Designs in Economics – Princeton …

www.princeton.edu › ~davidlee › RDDEconomics

PDF

ent ways (with their advantages and disadvantages) of estimating RD … inability to precisely control the assignment … that RD designs isolate is randomized.

by DS Lee – ‎2010 – ‎Cited by 4290 – ‎Related articles

Economics The limitations of randomised controlled trials | VOX, CEPR …

voxeu.org › article › limitations-randomised-controlled…

Nov 9, 2016 – In recent years, the use of randomised controlled trials has spread from … error of the estimated ATE can give an indication of the importance of …

Economics US Payers: Comparative Effectiveness Research (CER) and …

isrreports.com › Reports › Commercialization Reports

CER Market Dynamics, including definition of CER, influence of CER, and issues with Randomized Controlled Trials (RCTs) and efficacy; Drivers of Formulary …

Education (PDF) Randomised Controlled Trials (RCTs) in practice: an …

www.academia.edu › Randomised_Controlled_Trials_RC…

The Pros and Cons of Randomised Controlled Trials in Policy Evaluation 4-6 pm, … Summary of the disadvantages of using RCTs Cons Difficult to recruit control …

Education A randomised controlled trial of an educational intervention to …

bmcpublichealth.biomedcentral.com › articles

Jun 18, 2019 – The study is Mixed Methods Research (MMR) which will be carried out in two phases. In the first phase, using a qualitative approach, in-depth …

by AZ Harsini – ‎2019 – ‎Cited by 1 – ‎Related articles

Education Avoiding Bias in Randomised Controlled Trials in … – jstor

www.jstor.org › stable

ABSTRACT: Randomised controlled trials (RCTs) are often seen as the ‘gold standard’ of … digm’ war, as to the appropriateness or otherwise of the use of RCTs … be more widely used within educational research it would be helpful for researchers to be … study is an inappropriate design for educational trials. The threat of …

by DJ Torgerson – ‎2003 – ‎Cited by 48 – ‎Related articles

Education randomised controlled trials – National Foundation for …

www.nfer.ac.uk › media › rct01

Education Randomized Controlled Experiments in Education – European …

www.eenee.de › Analytical_Reports › EENEE_AR11

PDF

Feb 21, 2012 – Principles of Randomized Controlled Trials (RCTs) . … Costs and benefits from changing the unit of randomization . … drawbacks. On one hand …

Education Teaching Methods For Kindergarten Pdf – Micol Olivieri

icbo.micololivieri.it › teaching-methods-for-kindergarte…

Methods: Randomized, controlled clinical trial of 18 children aged 5– 13 years … methods and their advantages and disadvantages? then this post is for you.

Education the cognitive outcomes of liberal education – The Andrew W …

mellon.org › henry_braun_on_cognitive_outcomes

PDF

16 A comprehensive review of the problems with randomized controlled trials, including some longitudinal designs, can be found in Ginsberg & Smith (2016).

by H Braun – ‎2019 – ‎Cited by 1 – ‎Related articles

Epidemiology 6. Randomised controlled trial – SlideShare

www.slideshare.net › razifshahril › 6-randomised-contr…

May 10, 2015 – … advantages and disadvantages of randomised controlled trial design. 2; 3. Randomized controlled trials (RCT) • RCT or randomized clinical …

Indigenous Studies Samantha Cunningham – Research Associate – University of …

www.linkedin.com › …

I have also explored the current issues with randomized controlled trials (RCTs) and have recently investigated the marginalization of indigenous groups and the …

Sacramento, California – ‎Research Associate – ‎University of Michigan

Medicine [Full text] Comparing Randomized Controlled Trials and Real …

www.dovepress.com › comparing-randomized-controll…

Jun 2, 2020 – Overall, different study designs have their associated advantages and disadvantages; together, findings from all types of studies bring about …

by DP Tashkin – ‎2020 – ‎Related articles

Medicine … lithotripsy? A prospective, randomized controlled trial‎Chen – Cited by 162
Medicine 4 principles of experimental design

insta-smm.online › nruutg › 4-principles-of-experiment…

Two advantages of the experimental research design are a the assurance that the … analysis advantages and disadvantages Completely Randomized Design CRD CRD is … An experimental design or randomized clinical trial requires careful …

Medicine 8. 7 Randomised, double-blind, placebo-controlled trials …

i-base.info › ttfa › 8-clinical-trials-and-research › 8-7-r…

Jul 21, 2009 – This is a balance of advantages and disadvantages. Disadvantages for the first people using drugs maybe they do not have the best doses, or …

Medicine 8a Randomisation: sequence generation – CONSORT Statement

www.consort-statement.org › view › 32-consort › 86-ra…

However, “random” is often used inappropriately in the literature to describe trials in … used to assign interventions to trial participants is a crucial aspect of clinicaldoes not know in advance which treatment the next person will get, a process …

Medicine 9.1.3.1. Randomised clinical trials vs. observational … – ENCePP

www.encepp.eu › Standards & Guidances

Jul 22, 2020 – While randomised clinical trials (RCT) are considered to provide the most … of the CONSORT statement to facilitate the use of results from such trials in … are needed because randomised trials are unnecessary, inappropriate, … observational studies (with either a cohort or case-control design) did not …

Medicine A guide to performing a peer review of randomised controlled …

bmcmedicine.biomedcentral.com › articles

Nov 2, 2015 – … performing reviewes of randomised controlled trials (RCT), can use … Being aware of the appropriate reporting checklist for the study being …

by C Del Mar – ‎2015 – ‎Cited by 10 – ‎Related articles

Medicine A simplified guide to randomized controlled trials – Bhide …

obgyn.onlinelibrary.wiley.com › doi › full › aogs

Jan 27, 2018 – Abstract A randomized controlled trial is a prospective, comparative, … Finally, the research question also needs to be ethically appropriate to be … Cluster randomization can be used when randomization of individual …

by A Bhide – ‎2018 – ‎Cited by 25 – ‎Related articles

Medicine Academy Submits Recommendations for Development of …

www.eatrightpro.org › regulatory-comments › academ…

Aug 18, 2019 – … there are substantial ethical issues with randomized controlled trials (RCTs) on individuals for standard of care intervention including difficulty …

Medicine Adaptive Clinical Trials: Advantages and Disadvantages of …

academic.oup.com › jnci › article-pdf › djx013 › djx013

Mar 17, 2017 – Outcome-adaptive randomization is an older technique that has recently regained atten- tion; it increases trial complexity and duration without …

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Video

 

VJOncology

 

Ian Tannock, MD, PhD, DSc, from the University of Toronto, Toronto, Canada, discusses the disadvantages of randomised trials at the European Cancer Congress of the European Cancer Organisation (ECCO) 2017 in Amsterdam, Netherlands. Randomised trials are considered the gold standard for testing novel treatments, however, there are some disadvantages. Firstly, participants are carefully selected, and will rarely have a comorbid disease. The drugs tend to therefore be more efficacious in clinical trials than they do in practice. Clinical trials are now commonly funded by pharmaceutical companies. This means that progression free survival is often used as an endpoint, as it is the minimum at which the FDA and the EMA will approve registration. An improvement in progression free survival, however, is not always indicative of an improvement in overall survival. Therapies shown to be statistically significant are usually approved by the FDA and the EMA, and new therapies can be expensive. Their cost, however, has no correlation to their efficacy. ESMO and ASCO have introduced value scales, balancing toxicity with the benefits, in the hope of determining clinically important treatment, not just statistically significant.”

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Understanding and misunderstanding randomized controlled trials

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Consistency and Evidence

In science, there is theory and hypothesis, and evidence supporting these things. There is no proof, only probability.

I can prove something to you, and that works at the level of psychology and belief, it is not mathematical. Even logical and mathematical proof depend on convincing you that the logic is sound. The most carefully constructed logical or mathematical proof may be incorrect, the logic erroneous. Even with the correct logic, something that can not necessarily be established in most real world complex cases, the argument may yield incorrect results, as the premises may be wrong. In the end, the reader of the logical argument must be persuaded that the logic is sound, the mathematics correct. Again, in the end, there are no proofs, in a platonic sense.

“In the empirical sciences, which alone can furnish us with information about the world we live in, proofs do not occur, if we mean by ‘proof’ an argument which establishes once and for ever the truth of a theory.” The Open society and its Enemies by Karl Popper

The Open Society and Its Enemies; Karl Raimund Popper, Alan Ryan, E. H. Gombrich
Princeton University Press, 2013 – Philosophy – 755 pages

Cross-posted from https://vorticity-martial-arts.com/sitchamalth/2015/05/18/consistency-and-evidence/