Medical scientists and philosophers worldwide appeal to EBM to expand the notion of ‘evidence’, BMJ Evidence Based Medicine 2020









It's not about relaxing standards, but making it harder to claim causation without any further evidence of causal mechanisms. A correlation will always be nothing but a correlation, even with the most sophisticated analysis tools. Of course, this depends on the concept of cause.

What we do in CauseHealth, @EBMplus and PhilPharm is to discuss what is causation, as such. There are a number of concepts of cause out there, and different scientific methods latch on to different concepts. We argue that none are perfect for picking out causation.

So what we write in the BMJ letter, are just some common conclusions of our research, which all have slightly different takes but work on the same types of issues: the relationship between scientific methods and the philosophy of causation (ontological and epistemological).

What CauseHealth argues, which is perhaps different from the other research projects, is that "what works" causally depends on the local context and what properties are there interacting with the causal intervention.

This is based on a particular philosophy of causation, where causation is seen as dispositional, qualitative, context-sensitive, complex and singular. We spend a lot of time comparing it to the Humean notion of regularity and difference-making theory.

CauseHealth is the 3rd research project that is developed on that basis in our work. Before looking at causation in medicine, we worked on causation in scientific methods. In CauseHealth we apply it more directly to healthcare and medicine.

I don't know about you (and I cannot see the tweets of the locked account), but some ME-patients are not happy with being told that they should try the treatment that is shown to work for many others. In our version of causal singularism, there is no one size that fits all.
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I don't know about you (and I cannot see the tweets of the locked account), but some ME-patients are not happy with being told that they should try the treatment that is shown to work for many others. In our version of causal singularism, there is no one size that fits all.
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These quacks should be consigned to ripping people off in back alleys with tarot cards or astrology charts. Instead they have taxpayer-funded positions at institutions around the world. It's insane.

Well done to the ME patients calling out this nonsense on twitter. It was quite heartening to read their responses. They were far more polite than I could have been.
 
I read what cause health wrote and I don't understand. I suspect that there is little meaning there actually but if anyone has some knowledge here I'd like to know:

  • what are the various concepts of cause(ation) and how are they applied
  • how can 'what works' be dependent on local context and properties interacting with the cause (all of this sounds like philosophical sophistry (except for the plausible part)
  • does anyone know what a philosophy of causation is that is seen as dispositional, qualitative, context-sensitive, complex and singular.
Does anyone have any idea by what they mean by all this? Or have they just created a bunch of erudite sounding phrases meant to cause one to think there is something there?
 
strategist said:
Is it babble or is there some real insight? If you have to ask the question it's probably babble.
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Yes, pretty much when I pressed post I thought that there was not really any point to it. Yet somehow the group that wrote this seem to think so. I have no real insight into what that thinking is. There is no clarity only obfuscation with words meant to carry a heavy load to give the appearance of depth.
 
I haven't read the book that she's shilling, but I read one of the papers quoted on her website that informs her understanding of ME/CFS. It proposes a model that counts every single case of ME as its own disease, part of a single spectrum of other medically unexplained conditions, such as Fibro, IBS, etc., all requiring their own unique understanding of aetiopathology, and individualized treatment options. This approach also discounts the feasibility of *any* standard biomedical+statistical investigations, since, when conducting RCTs, the nuances of explanatory relevance, that are supposedly vital to successfully treat the condition, would be lost. Rather, they propose this dodgy systems approach, which would require prospectively monitoring the patient with respect to biological, psychological, sociological precipitating (and perpetuating) factors to infer causality, rather than comparing "snapshots" of many individual patients.

Since you can't really biomedically investigate the premorbid patient, unless you invent a time machine or something, you can guess which aspects they focus on instead. Obviously it's competely infeasible to do this right, due to lack of knowledge, money, everything, so they just focus on the patients history, sense of meaning, and the interpretative framing+future perspective of his own disease process instead - with some of the usual crying about Cartesian dualism, and neurobabble handwaving of how it's all supposed to be magically connected somehow. You'd already need perfect understanding of human physiology as well as omniscience regarding all the metabolic processes in an individuals body, in a sort of time series, to understand how the condition developed, to infer how the treatment works - basically anything regarding causality that we could possibly actually care about, but that is just glossed over. But hey, at least it makes for a nice justification to push more BPS garbage on people.

So yeah, it's just masturbatory bullshit. I probably misrepresented something because of my severe cognitive dysfunction, but you can read it yourself here, if you feel like wasting your time: https://sci-hub.st/https://link.springer.com/article/10.1007/s11019-008-9126-2
 
Looking at the CauseHealth sight this appears in the statement of "mission"

OUR MISSION
CauseHealth is a non-profit centre working to improve how causal evidence is understood, produced and used in health science and practice, through transdisciplinary research, education and communication.

The mission will be carried out through the following sub-projects:

Improving conceptual understanding
what is causality; what is probability; what is complexity; what is evidence; what is knowledge.....

Do people claiming to be philosophers ask such silly questions as "What is..." about abstract concepts?
 
Snowdrop said:
I read what cause health wrote and I don't understand. I suspect that there is little meaning there actually but if anyone has some knowledge here I'd like to know:

  • what are the various concepts of cause(ation) and how are they applied
  • how can 'what works' be dependent on local context and properties interacting with the cause (all of this sounds like philosophical sophistry (except for the plausible part)
  • does anyone know what a philosophy of causation is that is seen as dispositional, qualitative, context-sensitive, complex and singular.
Does anyone have any idea by what they mean by all this? Or have they just created a bunch of erudite sounding phrases meant to cause one to think there is something there?
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Philosophers spend eons arguing about what cause is but only because they insist on using language that nobody with common sense would want to use in the context. Causation is a very subtle and complicated business but as applied to science it is usually reasonably easy to see what is meant by a causal claim and whether or to it is useful or valid.

The stuff about Hume indicates that these people have no idea. Hume's conjecture that we can never establish cause is trivially true but of no interest to the study of cause.

It is pure sophistry and unpleasantly bogus sophistry worming its way into science and medicine.

Causation is about dispositions - or in simple terms tendencies - what tends to be followed by what else - the other words add nothing useful.

Real analysis of cause is a fascinating topic. I have just submitted the fourth of a series of papers on causation in the conscious mind (the first three are already or shorty to be published) in which I point out that everything suddenly makes sense if we use modern physics and pure field theory rather than the sort of billiard ball collision physics we get taught at school. But what I am saying would not be anything new to Newton, which started field theory with his gravitation. The problem has been that in recent times biology has tended to make use of a rather oversimplified view physics that obscures what is really going on.
 
Jonathan Edwards said:
Isn't that what they do all the time?
Not to be confused with real (natural) philosophers, of course, who tend not to claim to be philosophers, but these days call themselves scientists.
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Hm. Do students of philosophy and other sciences nowadays still read Karl Popper?
Which kind of 20th century philosophy did he fit in and which kind of philosophy does he fit in today?
 
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I had the thought that if the technologies we use today to see things inside the body (PET, CT, X-ray, MRI, fMRI etc) had some innovative people improving these technologies and making them less costly then all of this philosophising would be moot.

Where is the hand held wand scanner and data tablet from Star Trek?
 
MSEsperanza said:
Hm. Where does Karl Popper fit in there?
Edit: Do students of philosophy and other sciences nowadays still read Popper?
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Sadly I think he fits in rather well. He called himself a philosopher and spent a lot of time trying to say what science is rather than getting on with doing some. His thesis had some merit but the best part of it, hidden away in the first chapter of Conjectures and Refutations, even he seemed to make nothing of - that the most important test of a scientific idea is its internal consistency, not it falsifiability.
 
Snowdrop said:
Perhaps Thomas Kuhn has more to offer us as an example of how science progresses.
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If I were of the philosopher kind
Which thank-the-Lord-I'm-notsir...

I would write about the regression of science - how ideas get lost and we go backwards much of the time.
The longer I live the more I see wheels from the seventeenth century nearly being reinvented.
 
Jonathan Edwards said:
Sadly I think he fits in rather well. He called himself a philosopher and spent a lot of time trying to say what science is rather than getting on with doing some. His thesis had some merit but the best part of it, hidden away in the first chapter of Conjectures and Refutations, even he seemed to make nothing of - that the most important test of a scientific idea is its internal consistency, not it falsifiability.
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That seems to be a fair point.

I don't remember Popper's writings well but I seem to remember they were a good basis that could be argued on as well as criticized, to understand what science is.

Again not remembering what Popper said about this, but isn't internal inconsistency the first thing to check for when you check an idea for falsifiability (rebuttal)?

Perhaps it's bad if people without any relevant expertise can make up scientific claims unless no one who has the required knowledge in the field points out potential inconsistencies. So, relying too much on Popper would produce more research waste than focusing on factual plausibility first?

Or is your point that there are good scientific ideas that are internally consistent but not falsifiable?

(Brain fog and headaches make it difficult to judge whether what I write makes any sense. Apologies if these are dumb questions that just reflect my ignorance that remained from what I learned at 20th century universities. Didn't study philosophy though).
 
I probably shouldn't post references when I don't remember their actual content and reasoning but I just thought it's funny how some of those people with a 'BPS' view on chronic illness seem to complement each other:

In a recent paper, Sharpe and Greco (2019) argue that some clinical conditions, such as chronic fatigue syndrome (sometimes called myalgic encephalomyelitis), should be treated by altering the patient's experience and response to symptoms without necessarily searching for an underlying cause.

As a result, we should allow for the existence of 'illnesses without (underlying) diseases'.
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Discussed here: https://www.s4me.info/threads/micha...-published-responses.9729/page-19#post-304744

I will take my PEM symptoms seriously now and leave it to others to figure out what I was trying to say about 'causes'.
 
MSEsperanza said:
That seems to be a fair point.
Again not remembering what Popper said about this, but isn't internal inconsistency the first thing to check for when you check an idea for falsifiability (rebuttal)?
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Yes, and Popper does say this but in a rather oblique comment in his first chapter. From then on he seems to focus on empirical refutation.

MSEsperanza said:
Perhaps it's bad if people without any relevant expertise can make up scientific claims unless no one who has the required knowledge in the field points out potential inconsistencies. So, relying too much on Popper would produce more research waste than focusing on factual plausibility first?

Or is your point that there are good scientific ideas that are internally consistent but not falsifiable?
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The main point is that the great majority of scientific effort (at least what I get to see) is wasted on testing internally inconsistent theories.

But another point is that if there is only one internally consistent idea that could explain something, because all the others are inconsistent, then you should take that idea as you working hypothesis even if it is not formally refutable by experiment. This is relevant to my work on mental images. There is only one class of physical explanation that is consistent within physics. It is very unexpected but it has to be the working hypothesis. In the words of Sherlock Holmes:

When you have eliminated the impossible, whatever remains, however improbable, must be the truth.

MSEsperanza said:
(Brain fog and headaches make it difficult to judge whether what I write makes any sense. Apologies if these are dumb questions that just reflect my ignorance that remained from what I learned at 20th century universities. Didn't study philosophy though).
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On the contrary, you hit the nail on the head.
 
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