Monday, January 18, 2016

The Scientific Method Matters Much Less than it Should

With science as my calling and profession, I prefer to think of the scientific (and medical) community, in a positive light.  After all, I along with countless grade-schoolers, learned the scientific method as the gold standard for how we learn and know, well, everything.  As children, the concept of scientific evidence is taught with certainty.  Our readings and countless other examples prove otherwise, of course.
My own irrational faith in the scientific approach caused me to first be taken aback by the statement that Evidence-Based Medicine was really only brought into practice in the '80's.  Yes, the 1980's.  That means we landed on the moon more than 10 years before we thought it would be a good idea to base health care on experimental and reproducible data.
True evidence-based practices need to be receptive of every new piece of evidence to prevent unsupportable biases from controlling common practices.  However, when I realize how many careers and pensions rely on the status quo being upheld, I stop being surprised with blind refusal to greet new evidence with anything other than torches and pitchforks.

Even after the paradigm shift to Evidence-Based Medicine, bias is keeping a dictatorial role over the supposed democracy of the scientific method.  I was immediately reminded of the story of Dr. Barry Marshall, now lauded as Nobel Laureate.  The whole saga of proving a pathogenic cause of stomach ulcers, finally accepted after Dr. Marshall went all medieval on himself and drank an H. pylori soup, is nicely summarized in the video below.  His story underscores the irrational and unnecessary steps scientists/medical professionals must take to overcome bias in the field.  At the time, "Suggesting that ulcers were caused by anything other than stress was career suicide".  This, when the first evidence for a role of bacteria in stomach ulcers was put forward in 1886 by a Polish scientist Dr. W. Jawarski.  The mere fact that his work was published in Polish served as a major stumbling block, but it remained only a 'curiosity' even as evidence continued to grow.  Dr. Lykoudis was thanked for his (successful) treatment of ulcer patients with antibiotics with a rejection of his manuscript and a fine.

In the end, the shift in scientific consensus was not caused by scientific rigor or diligent statistics. It required a visceral, human story of Dr. Marshall putting himself on the line, and turning himself into a case study, where traditional experiments failed.

But when I think about it, this whole story is unsurprising.  Statistics are numbers on a page, no matter how valid they may be.  The same holds true for human interest stories: we can hear that a natural disaster has claimed thousands of lives, but until we hear the personal story of one struggling family.  Yes, rigorous and ethical use of statistics in reporting scientific findings is crucial.  However, often it often has zero impact on how well new ideas are accepted, as seen in Dr. Marshall's vomit-laden path to Stockholm.

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