Re: Medical Research


"Herman Rubin" <hrubin@xxxxxxxxxxxxxxxxxxxx> wrote in message
news:e4g454$1n3i@xxxxxxxxxxxxxxxxxxxxxxx
In article <Wgtag.3211$y4.1569@xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx>,
George Conklin <georgeconklin1@xxxxxxxxxxxxx> wrote:

"Herman Rubin" <hrubin@xxxxxxxxxxxxxxxxxxxx> wrote in message
news:e4d30c$39kq@xxxxxxxxxxxxxxxxxxxxxxx
In article <0AW9g.4721$u4.672@xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx>,
George Conklin <georgeconklin1@xxxxxxxxxxxxx> wrote:

"Herman Rubin" <hrubin@xxxxxxxxxxxxxxxxxxxx> wrote in message
news:e48jb2$1cj8@xxxxxxxxxxxxxxxxxxxxxxx

.....................

Well, Herman, that is just what Skeptic did to me. He sent me to
look
at
a study with a lot of faults which had a test of significance where,
according to the study, "The absolute reduction in the risk of death
after
10 years is small" but signficant statistically on the other hand.
Small.
So you pretty well predicted the response from Skeptic. Now what?


The same answer as before; statistical decision theory.

BTW, the elements of statistical decision theory can be
understood by someone who understands algebra, and has
not been brainwashed into thinking that all mathematical
ideas come from computational experience. Knowing how
to calculate statistical significance definitely will not
help in understanding how to intelligently make decisions.

The medical profession should provide the information
needed to approximate the odds for the various risks and
benefits for the various types of treatments, taking into
account the characteristics of the individual, not just
demographics, or the results from badly designed studies.
This should including drugs which had not been
"sufficiently" tested.

BTW, there was a recent article about the supplement
black cohosh. It seems that most of the material sold
is not black cohosh, which is scarce, but a Chinese
alternative, the effectiveness of which was questioned.
Now regardless of which has the best benefits, our
current laws against fraud should be sufficient here
for some action to be taken, and if anything, they
should be strengthened.


I guess we are back to the old question: who should pay for the good
research we all agree we need. The way the system is set up, there are
almost unlimited funds for treatments, effective or not, but little or
none
for research. Why, when millions of men get prostate cancer, are
treatments
based on just a handful? And how typical is this drop in the bucket?
Often
what is called randomization is just the first person thorough the door.

The number needed to carry out a study does not depend on
the number at risk. If there are only 20 at risk, a study
on the effectiveness of treatments on others who become at
risk later just cannot be done, unless one treatment is so
obviously better than another.

It is the government which allocates much of the funds.
Those medical people who claim that supplements are
inadequately tested are the same ones who would make the
cost of testing a few of the supplements greater than the
whole income of the supplement business. However, it is
possible to test whether the supplements are what it is
stated they are; a rather large proportion of them are.

Governments are not generally in favor of basic research.
Basic medical research has a few recent events of sufficient
interest such that they get funded, like gene sequencing and
complicated studies which MAY get some results. But the drug
companies are also supporting these. Too often, the people
are pushing for a cure; I see little hope for quick cures for
most of the nearly 1000 internal medicine diseases. We are
unlikely to cure heart disease; we may well be able to reduce
the problems which those who have some heart disease, probably
the majority of the population, have in this regard.

With basic research, we are literally exploring in the dark;
if we were not, it would not be basic research. I suggest
that you look up the origin of the word, "serendipity".


At some point Herman many of the long-term diseases will be understood
but not right now, for sure. So treatments seem marginal, like 3% over 10
years being counted as a 'victory.'


.

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