Meta-Review: The Backbone of Evidence Based Medicine Is Weak

Only about 6 percent of all interventions used in medicine have sufficiently good data and are effective

Our new meta-review shows: The backbone of Evidence Based Medicine is weak

Regular readers of my texts know that I am very sceptical about the postmodern redemption narrative of modern medicine that proclaims: We live so long and do so well because modern medicine has made such tremendous advances. Therefore, everything that modern pharmacology brings us is good, welcome and worthy of support (and should be funded by the public).

Even the legendary social physician Thomas McKeown from Birmingham pointed out in the 1970s that this widespread popular opinion is most likely wrong and said in the introduction to his still very readable work “The Role of Medicine: Dream, Mirage, or Nemesis?” [1,2]: If he were St. Peter, he would only allow two types of doctors into heaven, namely trauma surgeons and dentists. Because those would be the only ones who really contributed to a reduction of suffering. The real progress and thus the extension of life span and the improvement of quality of life would not be due to medicine, but to socio-political progress, better nutrition, hygiene and living conditions without constant fear of hardship and death.

Well, that was in the 70s. Maybe it’s different today? We did a very large meta-study to answer the question of how good the data is for medical interventions in general. It has now been published in the Journal of Clinical Epidemiology [3]. I discuss the study and its findings in a little more detail in this blog. For those in a hurry: the data has not changed much. A maximum of 6 percent of all interventions used in medicine, no matter where, are covered by good data.

Only for a limited time (until 08-22-2022) the meta-review is freely accessible at: https://authors.elsevier.com/c/1fIHz3BcJQAobl

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New and Old – a Journey to Lithuania…

…to a workshop of the Next Society Institute and some thoughts on new and old religions

The Next Society Institute

I was recently in Lithuania for a few days, in the capital Vilnius, for a meeting of the Next Society Institute at the Kazimieras Simonavičius University, which I have been a member of for half a year. This is a think tank of a small group of academics who are developing new concepts for different sectors of society (Fig. 1-4). We are planning a series of annual conferences with constructive models for the future.

Figure 1 – NSI members Lars Clausen, Augusto Sales and Miguel Pérez-Valls listening; Sketches Franz Hoegl

Contrary to the current trend, which squeezes everything into the Procrustean bed of one true perspective and subordinates everything under one truth, we assume that there are many alternatives, many ways of expressing culture, being human, society, and thus also different futures, “futures” (plural), and not only the totalitarian one future, one truth, one health, one form of politics, one religion, one whatever. The conceptual basis is Niklas Luhmann’s theory of social systems [1].

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Practical Conspiracy (Theory)

Conspiracy Theories in the Corona Crisis

Theories

There is nothing more practical than a theory“, Einstein is supposed to have said. Whether real or well invented, this saying is good. This time, I want to shed light on the function of theories in normal science, but also in the Corona crisis, where – stay the hell away from me – people shout “conspiracy theory!”.

So, what is the “useful” thing about a theory? Theories in the broadest sense guide our perception. They express what we expect based on our prior knowledge. The everyday theory that the sun rises in the east and sets in the west is such a bundled experience. The bundling of previous experiences into an expectation according to which we act is useful, or, to speak with Einstein, practical. For it saves us from having to develop everything all over again. Perception without theory hardly works, or at least only in specially purified states of consciousness. Husserl, the founder of phenomenology, spoke of the fact that we have to leave out all our pre-conceptions (i.e. “theories”) if we want to perceive reality as it is [1]. This is a noble call, which is also made again and again by the spiritual meditation traditions: to let go of mental conditioning in order to perceive what is completely in the moment. If you meditate a lot, you can do that from time to time. But it would be too exhausting to do it all the time. We are also historical beings and bundle our experience – individual and cultural – into inner models of the world. In science, such models are called “theories”.

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A Few Thoughts and Arguments on the Current Campaign Against Homeopathy

This is a text which I have written in response to a call by some VOLT-actitivists that the VOLT-Party (a new pan-European party) should support the ban on homoepathy, on the grounds of an alleged death of a child by homeopathy in Italy.

There is an anti-homeopathy campaign ongoing currently in which most arguments used are either wrong or distorted (see below). Supporting such a campaign would simply be plain stupid. The most sensible thing to do is what no one dares doing currently: to organise one or a series of meetings in which an open discourse is started about homeopathy, one that considers data and the pro and con arguments.

I hereby want to clear up some common misconceptions.

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In Praise of Political Incorrectness

Our Political Correctness Culture is as Bad as Any Tribal Taboo: Comments on Two Victims of PC – Peter C. Gøtzsche and Dieter Schönecker

Political Correctness

Tribal taboos, like overstepping an imaginary boundary, eating the wrong type of food, etc. are ridiculed by us modern people. We think they are irrational and we do not need them. Wrong. We have an even worse version of taboo: political correctness (PC). The role and function of such a system of behavior can be illustrated by a nice story, which my friend and colleague Volker Sommer told me, who used to run a primate observation station in Nigeria and has produced lots of data about the behavior of free-ranging primates like bonobos, chimpanzees and gorillas [1].

He observed the behavior of two tribes of chimpanzees, living in close proximity, except they were separated by a river and thus had developed different cultural rituals that served to distinguish them from others: One of them used to poke sticks into an ant-heap and then lick the ants, while the other tribe did not do that. Licking the ants, Volker explained to me, was not particularly funny, as they exude their typical acid that burns and pricks, and for food purposes the ants were not really very useful, as the chimps had plenty of food.

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