Systematic reviews do not (yet) represent the ‘gold standard’ of evidence: A position paper, 2022, Moore et al

[rvallee]

However, it requires more money, effort (from researchers), breaking away from the familiar questionnaires

There's nothing wrong with questionnaire. What's wrong is questionnaires that only use vague pseudoratings about things that don't have any answer that means anything in real life.

Asking about hours worked, etc., objective things happening, is perfectly fine and useful in most cases. The issue isn't really questionnaires, it's biased questionnaires of little relevance to the problem. These people are only interested in answering their own questions, they're not working at a solution to the problem. So their questionnaires are vague and useless on purpose.

All of this happened out of belief that illness is all about perception, so asking about perception of illness is fine. The damned BPS model of illness. This is the core of the systemic failure, it's simply not a serious process, so nothing that follows is serious. It's not that hard to ask relevant questions, they're not failing at this, rather they know they can't ask about anything relevant because it breaks the delusion and exposes the con.

 

[Mithriel]

OK pretty much everyone on this site agrees that unblinded studies with subjective outcome criteria=useless crap (or worse)

The question seems to be why are career scientists publishing systemic studies derived from crap primary studies --- what is the incentive? Maybe the answer (referred to above) is that they (scientists) simply don't care enough to dismiss this as useless crap and move on to something more useful.

The great and the good (GRADE/Cochrane) tout useless crap (systemic studies) as evidence and NICE have now joined up with Cochrane. OK we can challenge that but what is the driver ---- is it that gloss is all you need ---- it's cheaper than doing something meaningful ---- the problem (sick people unlikely to return to their normal life) isn't easy to fix --- something must be done and this is something (Sir Humphrey)

I have a biology degree and thinking back to my time and university I was very young and naive. You took notes at lectures then memorised them to pass exams. It was only later that I realised there were some glaring problems.

For instance, we were told about spontaneous generation of mice from haystacks being disproved down to Pasteur's experiments showing there was no spontaneous generation of bacteria but the next day we were told that life was generated spontaneously from the primordial soup! Took me years to see that one.

The other thing that happened was that I simply could not believe in the simple Darwinian notion that all mutations happened one drip at a time. Well, you would have thought I was a creationist! I have since been vindicated by work on genetic drift and epigenetics (smug ) but the point is that I was not brave enough to answer an exam that way or step out of line in any meaningful way.

If you have to believe in somatisation to get grant money it is easy to persuade yourself that they know more than you, You take the grant money, write the paper and add your superior's name to it and you are now compromised for life. It has been said it is impossible to change the mind of someone whose salary depends on them believing it.