Contra Hanson on Medical Effectiveness > 자유게시판

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EDIT: see his response here, where he says this is an inaccurate summary of his position. This is a strong claim. It would be easy to round Hanson’s position off to something weaker, like "extra health care isn’t valuable on the margin". This is how most people interpret the studies he cites. Still, I think his current, actual position is that medicine doesn’t work. Europeans in 1600 likely prided themselves on the ways in which their "modern" medicine was superior to what "primitives" had to accept. But we today aren’t so sure: seventeenth century medical theory was based on the four humors, and bloodletting was a common treatment. When we look back at those doctors, we think they may well have done more harm than good. When we look at our own medical practices, however, we tend to be confident we are in good hands, and that the money that goes to buying medical care-in 2020, it was 19.7% of our G.D.P.

Most of us know of a family member who credits their life to modern medicine. My own dad said this about his pacemaker, and I, too, am a regular customer: I’m vaccinated, boosted, and recently had surgery to fix a broken arm. We believe in medicine, and GlycoMode Glucose Support this faith has comforted us during the pandemic. But likewise the patients of the seventeenth century; they could probably also have named a relative cured by bloodletting. Yet health outcomes are typically too random for the experience of one family to justify medical confidence. How do we know our belief is justified? This might seem like a silly question: in Europe of the seventeenth century, the average lifespan was in the low 30s. Now it’s the low 80s. Isn’t that difference due to medicine? In fact, the consensus is now that historical lifespan gains are better explained by nutrition, sanitation, and wealth. So let’s turn to medical research.

Every year, there are a million new medical journal articles suggesting positive benefits of specific medical treatments. That’s something they didn’t have in the seventeenth century. Unfortunately, we now know the medical literature to be plagued by serious biases, such as data-dredging, p-hacking, selection, attrition, and publication biases. For example, in a recent attempt to replicate 53 findings from top cancer labs, 30 papers could not be replicated due to issues like vague protocols and uncooperative authors, and less than half of the others yielded results like the original findings. But surely modern science must have some reliable way to study the aggregate value of medicine? Yes, we do. The key is to keep a study so simple, pre-announced, and well-examined that there isn’t much room for authors to "cheat" by data-dredging, p-hacking, GlycoMode glucose support etc. Large trials where we randomly induce some people to consume more medicine overall, and then track how their health differs from a control population-those are the key to reliable estimates.

If trials are big and expensive enough, with lots of patients over many years, no one can possibly hide their results in a file drawer. We spend 20% of G.D.P. Yet our lives are long for other reasons, those articles often show huge biases, and when we look to our few best aggregate studies to assuage our doubts, they do no such thing. Imagine someone claimed that casinos produce, not just entertainment, but also money. I would reply that while some people have indeed walked away from casinos with more money than they arrived with, it is very rare for anyone to be able to reasonably expect this result. There may well be a few such people, but there are severe barriers to creating regular social practices wherein large groups of people can reasonably expect to make money from casinos. We have data suggesting such barriers exist, and we have reasonable theories of what could cause such barriers. Regarding medicine (the stuff doctors do), my claims are similar.