Sometimes there is a causative link; sometimes the presence of an exposure modifies the effect of a causative exposure; and sometimes a close association is only that, an association, a version of the link between carrying a cigarette lighter and developing lung cancer.
This makes me reflect on quantum physics and the idea that everything is energy. The future is simply possibilities of a wave of energy rendering into a physical form. It still, thoughts, actions, environments, all part of the game of probability.
Patients often ask me “how long will this last?” after I restore a tooth. I don’t know how they sleep, what and how much they eat with what frequency, how they breathe, what they drink, what tics they have, how much stress they are under, etc., every minute of everyday.
This topic brings to mind a lecture and discussion posted by Dr. Prasad. He and an internist were speaking to a group of medical students and house staff. I don't remember the topic but, in the Q&A, the first question was about the role of diet in preventing the disease. Dr. Prasad politely pointed out that there was no evidence linking the disease in question to diet and turned to his co-speaker and asked "What do you eat?" His answer was "I eat whatever tastes good." As explanation he cited an episode where he was having dinner with a colleague who was a cardiologist and his wife who was an oncologist. The cardiologist was thin from a rigorous exercise schedule and very limited in his diet---practically a vegetarian. The internist noted that the wife of the cardiologist was somewhat overweight and wolfing down everything on her plate with gusto. When he asked why the couple exhibited such different diets, the wife said "He thinks he is going to live forever and I spend most of my days seeing people that did everything "right" and they have cancer."
Nitpicky here - sorry… But what is proof? It is for me a word I don’t use in a scientific context as it is too often misunderstood. In mathematics it is sensible, but otherwise it is not so much. In court, it is qualified as ‘proof beyond a reasonable doubt’, but this means that the evidence is so strong that doubts become unreasonable. In science, skepticism - which must remain an active prophylactic - may be overcome by very strong evidence, but ‘proofs’ should always be treated as worthy of doubts…
"GM cancels the colonoscopy because he does not have anyone to pick him up after the procedure."
Why aren't more colonoscopies performed with water as the working fluid ? No anesthetic required, and no adult supervision required afterward. One just drives home. And as an added bonus, you can watch the whole examination on the big screen color monitor if you so desire. It was fascinating !
One wonders how they created the confidence intervals on the alcohol graph. I would suggest that they widen them about 10-fold and we agree that we are unlikely to have the answer at low levels of consumption, but that high levels of alcohol consumption are probably bad for you.
This makes me reflect on quantum physics and the idea that everything is energy. The future is simply possibilities of a wave of energy rendering into a physical form. It still, thoughts, actions, environments, all part of the game of probability.
Patients often ask me “how long will this last?” after I restore a tooth. I don’t know how they sleep, what and how much they eat with what frequency, how they breathe, what they drink, what tics they have, how much stress they are under, etc., every minute of everyday.
Lots of possibilities…
This topic brings to mind a lecture and discussion posted by Dr. Prasad. He and an internist were speaking to a group of medical students and house staff. I don't remember the topic but, in the Q&A, the first question was about the role of diet in preventing the disease. Dr. Prasad politely pointed out that there was no evidence linking the disease in question to diet and turned to his co-speaker and asked "What do you eat?" His answer was "I eat whatever tastes good." As explanation he cited an episode where he was having dinner with a colleague who was a cardiologist and his wife who was an oncologist. The cardiologist was thin from a rigorous exercise schedule and very limited in his diet---practically a vegetarian. The internist noted that the wife of the cardiologist was somewhat overweight and wolfing down everything on her plate with gusto. When he asked why the couple exhibited such different diets, the wife said "He thinks he is going to live forever and I spend most of my days seeing people that did everything "right" and they have cancer."
Main qualifier for what to eat is the fact it can’t be fed through a feeding tube…..
Nitpicky here - sorry… But what is proof? It is for me a word I don’t use in a scientific context as it is too often misunderstood. In mathematics it is sensible, but otherwise it is not so much. In court, it is qualified as ‘proof beyond a reasonable doubt’, but this means that the evidence is so strong that doubts become unreasonable. In science, skepticism - which must remain an active prophylactic - may be overcome by very strong evidence, but ‘proofs’ should always be treated as worthy of doubts…
Reproducibility ?
Absolutely. I don't consider there to be proofs in the natural sciences. Only evidence of different strengths in one direction or the other.
So true.
Terrific piece! The bridge example in particular resonated, but really all of them. Well done.
Thanks!
"GM cancels the colonoscopy because he does not have anyone to pick him up after the procedure."
Why aren't more colonoscopies performed with water as the working fluid ? No anesthetic required, and no adult supervision required afterward. One just drives home. And as an added bonus, you can watch the whole examination on the big screen color monitor if you so desire. It was fascinating !
It's all associated and correlated!
Unless it's not.
What a beautiful article. It points at the charm of primary care medicine in addition to illustrating the thesis nicely.
One wonders how they created the confidence intervals on the alcohol graph. I would suggest that they widen them about 10-fold and we agree that we are unlikely to have the answer at low levels of consumption, but that high levels of alcohol consumption are probably bad for you.