Stats.con - How weve been fooled by statistics-based research in medicine
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491_9781907313332
About Stats.con - How weve been fooled by statistics-based research in medicine: Statistics-based research is the method by which the causes of disease and the effectiveness of new treatments are investigated. Epidemiological studies and large-scale randomised controlled trials dominate medical research. Judged by the number of papers published each year, this type of research would appear to be a success. Yet it’s a triumph of appearance over substance. We’ve been cajoled into believing that great advances in medicine have occurred when, in fact, this isn’t the case.Large RCTs are placed at the summit of the hierarchy of evidence and are claimed to be the most reliable means of establishing causal relationships in medical research. They are highly complex structures designed to identify small differences in outcome between the active treatment group and controls. But how do we know that the observed difference is caused by the drug? Proponents of RCTs assert that the method excludes alternative explanations – namely, the unequal distribution of other causal factors, bias in the assessment of the outcome and chance. In other words, they believe that these studies have internal validity. The primary thesis of stats.con is that the grounds for causal inference in statistics-based research are lacking. Firstly, the components of the RCT – including randomisation, allocation concealment, double-blind administration of treatment, the handling of withdrawals and drop-outs, and the statistical tests – don’t guarantee that the conditions for internal validity have been satisfied. Secondly, the frequentist approach to statistics, which continues to be used in almost all medical research studies despite being subjected to serious criticisms in recent years, is unsound. Thirdly, and most importantly, the inference from a small difference in outcome to the presence of a causal relationship is highly questionable.Given these arguments, it’s of some importance to note that ne
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