Blog: Artificial intelligence, grassroots rebels and the pharmaceutical cuckoo by Jerome Burne

http://healthinsightuk.org/2019/07/...ssroots-rebels-and-the-pharmaceutical-cuckoo/

 

It's a pity he erroneously calls Chronic Fatigue Syndrome chronic fatigue - otherwise he's good.

 

I know you can't expect GPs to know everything but in these times of apps and easily available tech, I don't know why they don't have databases that they could access to suggest supplements when drugs are prescribed.

 

AI has tremendous potential but on... classical?... science, I guess. The one using the scientific method and relying on objective reality. EBM is clearly a massive mistake and circlejerk, it allows for all sorts of garbage to be accepted as valid just because some people like what it says. It will always suffer from garbage-in-garbage-out distortion.

As far as I can tell, EBM is doing research without the scientific method, just skip straight from imagination to trying to prove it's right and make your conclusion align with your assumptions (or just plain cheat if you can get away with it). It's not rigorous enough to be of value on a brute force approach like machine learning.

PACE is a good example. I'm not sure ML would have identified the flaws since the cheating part is not in the papers themselves and hidden behind lawyers and gaslighting, a hard concept for a ML system. It would certainly rate it as high bias and low validity, however, but that determination does not require confirmation, it's self-evident.

The choice of pretending otherwise, as Cochrane does, is human choice, especially arbitrarily miscategorizing it. As we know the peer review for the Cochrane systematic reviews was brutal and clearly disqualified them and still they were published. It's a choice to allow obvious pseudoscience to grow, no need for a machine to objective show that.

I think AI will be extremely brutal on most EBM, essentially puree the whole concept. The likely response will be to dismiss it since proponents "prefer those results" because they align with their expectations. But it won't reveal much we don't already know. AI is only as good as the data it works with and in EBM most of the data is aspirational and rarely objective.

I'm not sure how an AI would make sense of how useful the series of questionnaires used in CFS research are at evaluating ME, which is sometimes CFS but not always and it depends but if you ask the researchers they say both things so what is a machine to do with all this confusion? Those are all upstream choices that pollute the data and make it all entirely useless to objective analysis.

A unicorn fantasy is a pretty apt description. Especially when you consider that even if you have a unicorn, so what? It may look magical, but it's still a horse with something glued on its face. Except for narwhals, of course, the unicorns of the sea. Still not magical, though.

 

My mind-squirrel kept at it and I can't really find fault but I think the flaw in EBM is that it hijacks the reward system in the same way that casinos exploit. It's a constant reward loop that encourages failure, just to keep the player going. Research is supposed to be hard and usually unrewarding. Most scientists will never produce any positive results, though they will still contribute to science, it's just not the same as making a breakthrough.

When you look at how EBM works, most research seem to either have positive results or be promising in the way of needing more research. It's almost never null. That's highly suspicious, it shows how inflated the whole thing is. But it's constantly rewarding. Even harmful contributions can be awarded with recognition, celebration and titles, as we painfully know. It's rewarding in a way rigorous, boring science isn't, in the form of endless participation trophies and praise for simply being there.

Maybe not all EBM but without a doubt psychosocial EBM badly suffers from it. Everything is special and meaningful and the brain loves it, wants more of it. Useless papers of no merit getting published feels just as rewarding as real science. It's addictive and difficult to break the cycle, no matter how obvious it becomes that the "progress" is no more meaningful than running around in circles hacking at virtual fruits. It's all cheap so funding will not run out and even otherwise smart people can succumb to the satisfaction of hoarding fake rewards as long as others acknowledge those rewards as real.

I think that may explain a lot about the whole MUS thing. It's all entirely useless, but the reward response is real, as are the gains from career advancement and the thrill of being on stage to get yet another participation trophy from the circlejerk committee. MUS has never been about the patients. It's not even about science or anything like this. It's a broken reward loop.

 

I just asked ChatGPT to write a little summary of this article and got:


“Artificial Intelligence, Grassroots Rebels, and the Pharmaceutical Cuckoo" URL: https://healthinsightuk.org/2019/07...assroots-rebels-and-the-pharmaceutical-cuckoo Author: Dr. Trudie Chalder Summary: This article, written by Dr. Trudie Chalder, discusses the potential implications of Artificial Intelligence (AI) on the pharmaceutical industry and the role of "grassroots rebels" in challenging traditional Evidence-Based Medicine (EBM) practices. The article also mentions the PACE trial, which is a controversial study that has been criticized for its methods and conclusions about the treatment of Chronic Fatigue Syndrome (CFS). The article raises important questions about the role of AI in healthcare and the need for transparency and accountability in medical research.”

well that gave me a laugh, this article criticising the PACE trial was very much NOT WRITTEN BY TRUDIE CHALDER )

Though it’s encouraging to know AI’s assessment of the PACE trial anyway. My prompts encourage it to tell me of any controversy surrounding the information it shares with me.