Can science be anecdotal?

[AviatorDoc]

Alright, folks. Lots of people have been dancing around this question on the various threads. So I ask you... Can research that is not single-blind or double-blind research be called research, in the modern scientific sense?

Example: 10 birdwatchers go out and view a nest of small birds in the distance. The most knowledgable birdwatcher calls them redbreasted robins. The other 9 look closely, and remembering that they've seen something like this before, agree that they're robins. Now, do they need to do DNA testing in order to continue field research on the robins?

Clearly, double-blind studies have more rigor than single-blind studies. And single-blind studies likewise hold more water than anecdotal studies. But I contend that anecdotal research is still scientific research. (Ask any birdwatcher). Simple observation is the very basis of scientific rationale. (ref. Newton, Einstein, de Vinci etc.)

Occasionally, double-blind studies have so many controls that either the hypothesis becomes oversimplified or the conclusion becomes meaningless in reality (ex: field research). This of course does not mean the researcher should not strive for the most rigorous study possible.

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[Stillfocused]

Excellent thread.

I will have a lot to about this when I have time.

 

[Sweaty Paul]

NO

 

[bicycle2]

I agree that there are often anecdotal situations when a very capable scientist makes an observation/discovery that is valid. However, the scientific community must have a structured set of 'rules' that all valid resesarch conforms to sort out any novel or bogus results. It's all about repeatability. Especially when the research pertains to human health.

You're right...sometimes valid anecdotal observations are overlooked and at other times the strict structure of research hinders results. But hey, it's sort of like the justice system. We know it aint perfect, but it's the best we've come up with so far!

 

[Dr. Nick]

Not good science.

 

[Stillfocused]

What constitutes "good science" in your estimation?

 

[Neurogirl]

Actually, it MIGHT be considered science (just not the best). It all depends upon how knowledgeable the "most knowledgeable" birdwatcher is.

The "Hierarchy of Evidence" (classes of evidence) is as follows:

I: Evidence from at least one properly designed randomized controlled trial.

II-1: Evidence from well designed controlled trials without randomization.

II-2: Evidence from well designed cohort or case control analytic studies, preferably from more than one center or research group.

II-3: Evidence obtained from multiple time series, with or without the intervention; dramatic results in uncontrolled experiements (eg., first use of penicillin in the 1940's) also are in this category.

III: Opinions of respected authorities, based on clinical experience, descriptive studies, or reports of expert committees.

Also, it is not always possible to achieve complete scientific rigor; for example, randomized controlled trials or cohort studies may be unethical or not feasible. My source is, "A Dictionary of Epidemiology", Third Edition, 1995. I know the source is pretty old, but I don't think the hierarchy has changed. Hope this info helps.

 

[Stillfocused]

what does "objectivity" mean in your estimation?

 

[Stillfocused]

Better yet.

Since so many folks here are so interested in proof, I dare someone find the study that "proves" that "Evidence from at least one properly designed randomized controlled trial" is the best guide for making medical decsions.

 

[Neurogirl]

PLEASE tell me you're kidding...or trying to start a fight!

 

[Stillfocused]

I am not trying to start a fight, but I am trying to make a point.

You cannot "prove" anything with with empirical evidence, you can get very strong correlations.

The "Hierarchy of Evidence" is a value judgement not an empirical statement.

 

[Neurogirl]

Oh, ok...I get it. You HAVE made a point, although probably not the point you THINK you've made. Also, you are wrong about at least one thing, the "Hierarchy of Evidence" IS an empirical statement (of course, I'm using the "oxford dictionary" definition...just to be clear).
I'm curious, what year are you...Premed, MSI, MSII? It's pretty obvious that you haven't yet begun your clinical training. When you have progressed in your career and your daily life consists of taking care of living, breathing human beings and often making life and death decisions, (as opposed to spending your day debating the musings of Sutherland), you WILL come to appreciate and depend upon the empirical nature of the "Hierarchy".

 

[Stillfocused]

Hi Neurogirl,

Oh, ok...I get it. You HAVE made a point, although probably not the point you THINK you've made.

LOL, tell me what my point is then......

Also, you are wrong about at least one thing, the "Hierarchy of Evidence" IS an empirical statement (of course, I'm using the "oxford dictionary" definition...just to be clear).

Tell me how I am wrong? Where is the empirical evidence that the "Hierarchy of Evidence" as an empirical statement and not a value judgement?

By "empirical evidence" I will use your definition, "Evidence from at least one properly designed randomized controlled trial."

By the way, I am not trying to play a sophitic, semantic game. I am building to a serious point about "taking care of living, breathing human beings and often making life and death decisions."

 

[ckent]

•••quote:•••Originally posted by Stillfocused:
•Better yet.

Since so many folks here are so interested in proof, I dare someone find the study that "proves" that "Evidence from at least one properly designed randomized controlled trial" is the best guide for making medical decsions.•••••

Ironically, the evidence that a randomized controlled trial is the best guide for making medical decisions is the randomized controlled trial itself. Sorry if you don't understand that.

 

[AviatorDoc]

Alright, now here's my point. This is an opinion, just like everyone else's, but I think it's a valid one.

1.) All rational, responsible medicine should strive for scientific "proof". (I use this word very loosely.) If you want a strict definition of this, I heard this from a classmate: a p-value less than 0.05 in a controlled, randomized study.
Now, OMM does not lend itself well to controlled studies, since its efficacy depends on a subjective variable, namely, the manipulator. This does NOT mean that these studies cannot and should not be undertaken. It is in the best interest of the patient's health and pocketbook that these studies be done. (This includes OCF). The potency of the discipline may be lost in the controls, but the efficacy should still show a reliability above the placebo effect if the study is well-designed.

2.) Just because something has not been proven by the definition given in #1 does NOT mean that it is not true, or even "proven" to a lesser extent. Thousands of rationally-oriented, educated osteopathic physicians and hundreds-of thousands of patients over the last 100+ years lend me to believe that SOMETHING is going on.
Something needs to be repeatable in order to work, right? These techniques have been repeated over and over in clinics, hospitals, and classrooms. At the most basic level, even the vast majority of MDs agree that manual medicine can relieve musculoskeletal dysfunctions. (Visceral dysfunctions and OCF are much less "mainstream" applications.)

Ok. Enough of my ranting. I'm off my soapbox now.

 

[AviatorDoc]

Hey, even though Stillfocused may sound a little luney, he's right. Science works because it has worked in the past, and therefore we BELIEVE it to work in the future.

 

[Stillfocused]

Ironically, the evidence that a randomized controlled trial is the best guide for making medical decisions is the randomized controlled trial itself.

Then, where is the randomized controlled study that shows that randomized controlled trials are the best guide for making medical decisions?

Or, does the basis for using EMB as the sole factor for making medical decisions come from science at level III on the "Hierarchy of Evidence" "Opinions of respected authorities, based on clinical experience, descriptive studies, or reports of expert committees."