22 Comments
User's avatar
TerriM's avatar

This therapy at least makes sense to me - for those who are having trouble absorbing vitamins and minerals or who are on chemo and don't feel like eating, this gets them into the bloodstream. Seems like the same thing as giving someone a B12 shot because they can't absorb the nutrient from their food. I do appreciate though that a RCT would be a good thing.

Expand full comment
Ben's avatar

The lemonade suggestion has some obvious problems, lol. Lemonade has lots of sugar but no salt. Saline has lots of salt but no sugar. Obviously one is better for repleting intravascular volume than the other. ;)

Expand full comment
John Perry's avatar

Can Doctors Cifu, Prasad, Mandrola (or anyone else) recommend any books or other resources for a layperson who wants to sharpen their critical thinking about health research? I did look at two sources recommended in some of the comments: "Causal Inference: What If" by Miguel A. Hernán, James M. Robins; and the Stanford Encyclopedia of Philosophy entry on the "Philosophy of Medicine". I found the latter useful, but very condensed; the former was too technical, especially the mathematical notation. Thank you.

Expand full comment
User's avatar
Comment deleted
Sep 29, 2022
Comment deleted
Expand full comment
John Perry's avatar

Thank you very much, Sarah, for this interesting and detailed list! It's most helpful. Many thanks again.

John

Expand full comment
Andrew Heard's avatar

Really good to see someone actually discussing these issues honestly. Sadly you're one of the only places it's happening.

Expand full comment
Adam Cifu, MD's avatar

Thanks.

Expand full comment
Andrew Heard's avatar

What concerns me most is that even people who I generally respected for being critical of the scientific process failed to do so. For instance, John Oliver of Last Week Tonight was known to highlight things like p-hacking and marketing to doctors in the past. Yet he didn’t seem as critical of news reporting on medical research.

Expand full comment
Linda McConnell's avatar

Sad, but doesn't have to be true. Quoted from Hillel: "If not you, who? If not now, when?"

Or, how about Martin Luther King, Jr., "If you can't fly then run, if you can't run then walk, if you can't walk then crawl, but whatever you do you have to keep moving forward.".

Expand full comment
Thomas Ferrara's avatar

Post hoc ergo proptor hoc. ???

Expand full comment
Rainbow's avatar

I don't need feeling good from any given thing I do to be proven or backed up by data. I trust my body to tell me the truth and I trust my intuition to guide me to things that I need.

Expand full comment
Adam Cifu, MD's avatar

Totally. That is all that is necessary for many things. An article should just say that, rather than wrapping it in "sciencey mumbo jumbo"

Expand full comment
Rainbow's avatar

Where can I flag down that van??!

Expand full comment
Linda McConnell's avatar

Sensible medicine. Post after post, blog after blog, podcast after podcast. I understand that with change comes appropriate and necessary steps that need to occur. First is to identify the issue/problem/concern/situation. The informed motivators of this group are doing that. But that is where it has stalled or at least has not met its desired purpose. Short of having the President announce that the medical system needs to be studied and changed and the media's reporting should be taken with a grain of salt, or a billboard on every highway across the country, or a commercial on every channel repeating routinely for days, how and when will the identification process have reached its goal so step II can begin. Step II being developing and initializing the means to fix it; or whatever this group deems is next.

Expand full comment
Adam Cifu, MD's avatar

Yes. I totally agree that “complaining about a problem without proposing a solution is called whining.” I do think we have been pointing out solutions in these articles. How researchers should pitch their researchers. How writers should push back against lazy research. But, to be honest, after pointing flaws like this in medicine and journalism for years, it sometimes seems hopeless.

Expand full comment
Jen Worth's avatar

Those Iv therapy places have a pretty expensive menu. I knew of someone who worked in one of these Drip places and the physicians (who were not doing the work) demanded a portion of the tips.

Expand full comment
Adam Cifu, MD's avatar

Ikkkk

Expand full comment
HardeeHo's avatar

The Hawthorn effect (https://en.wikipedia.org/wiki/Hawthorne_effect) comes to mind in looking at some of the experiments being conducted. Not sure if we can ever remove the observer from the data. And we always have confirmation bias leaking in. But the press is now always seeking clicks and headlines that draw the reader in. I had thought that advertisement would see diminishing returns so that we would get some calm to our webpages; instead many sites with less traffic load up even more ads to pay for the bandwidth used.

Expand full comment
Alex Livingston's avatar

Isn't this piece itself an example of what you're calling “churnalism”, or worse? You've made observations of journalism, or at least one infers that you have, and then you generalize from those observations, citing only a single example, asserting them as if they were unarguable truths! Where's the analysis? What is your hypothesis? That all cases of “churnalism” are informationally vacuous? Wherever the correlation is that you hypothesize, have you shown that it is also case of causation? It strikes me that this is a work of propaganda in the service of the currently dominant medical regime, seeking to pour scorn on any practice or intervention that might bring about its unravelling.

Expand full comment
Kevin Murphy's avatar

You’ve missed the point, they aren’t testing a hypothesis, they are pointing out that frequently claims made are not fully supported by data and methodology. They are providing rough ways of determining how reliable what you read is supported, red flags to look out for. So for example, they aren’t making a claim about the effect of vitamin IVs, they are saying anecdote isn’t data, so who knows the effect, and here is a quick sketch of how a real trial should be conducted. They aren’t claiming that 72% of stories in the popular press are BS (I happen to believe Sturgeon was an optimist), they are just saying many stories make claims that aren’t fully supported. They aren’t saying bad journalism leads to 104,567 deaths a year, they are saying be careful when you do something based on an article you read because it may not have the effect you want. Let’s be honest, it’s far harder to build fully supported structures than knock down flimsy ones, and that’s what they are doing.

I’m waiting for their exploration of Brian Wansink’s career.

Expand full comment
Adam Cifu, MD's avatar

Thanks. A good reply. I was formulating on in my head but you did a better job than I could have. Alex Livingston, thanks for reading, ,taking the time to comment, and holding us to a high standard -- I honestly appreciate it.

Expand full comment
HardeeHo's avatar

Perhaps a read of past articles on this topic might be helpful in understanding this one.

Expand full comment
marlon1492's avatar

The dark-skin, red flag experiment produced surprising results. Naively, I would have thought that there would be some objective truth in the data.

One question about the study: was there a "known to be correct" answer in the dataset that was given out for analysis?

Will AI that is able to look at patterns be able to come up with an unbiased answer? (I'm not talking about the problem of classifying images of people where the classifier was trained with a biased set of images. Or maybe, this is the problem.)

Love your article! Great food for thought.

Expand full comment