True or false? I don''t know yet.

July 23, 2008

Bernard,

I hope you don't mind my starting a new thread on the back of one of your

comments, but it seems to me to be an interesting comment - How do we know

whether things are true or not?

As Jim points out, Dr. Barrett of quackwatch.com has made a career out

of rubbishing the claims of just about everyone and has attracted the anger of

many with his unique and individual approach to diplomacy. However, IMO, he is

not short of legitimate targets as there are plenty of companies out there

trying to sell products that amount to nothing better than snake oil.

Personally, I admire Bernard's approach - he looks at the scientific

evidence for various claims and trys to see if the science supports the

claim, but I'm not sure that even this approach gives us the whole story. The

only people who can afford to run clinical trials to remove chance and bias and

prove something really works are big pharma companies, so they get to choose

what gets investigated. They only investigate what they can patent and profit

from, so natural substances or healing methods tend not to get any high quality

investigation and evidence to support (or disprove) any claims for their

benefits. So another form of bias is introduced at fundamental level against

natural products and healing methods.

Does lack of evidence mean lack of benefit? I don't think this is true. There

is no 'evidence' from clinical trials to prove that parachutes decrease

mortality in skydivers, but the benefit of wearing a parachute seems pretty

clear to me. But then, that leaves us in a situation where we are trying to

tell the difference between something with a real benefit but inadequate proof

and something with little or no benefit and devious marketting.

There seem to be so many 'experts' and so much marketting competing for our

attention and

money and everyone seems to have an angle and a vested interest. It is

really difficult to navigate a way through and assess the various

claims. I have been trying to form my own views (which are no more valid than

anyone else's) on how to go about this, and would be keen to see if there is

anything more I can learn here. What do the people on this group think is the

best way forward?

Thanks,

Alistair

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