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A characteristic of those who infest the internet with fake science blogs is they desperately crave the respectability and validation which science confers.
Dr David Gorski's "Respectful Insolence" blog over at Science Blogs seems to fall into this category. These kinds of people want to be seen as evidence and science-based but on the other hand, they don't seem to understand what science is. So they do not realize they do not have the confirmation and validation they delude themselves into thinking they do. Relative to the overall population of internet users, Science Blogs' audience tends to be Caucasian; it also appeals more to childless men aged under 25 and 55–65 browsing from school and home. Got the picture? [Science Blogs.com is easily confused with Science Blog.com with just one 's' difference in the names].
When it comes to medicine, the problem Gorski and his readers have is that their ideas about the causes of disease and how to treat it are not based on science. This explains the propensity for medical quacks and some of Science Blogs' apologists for quackery to present medicine as some form of science and try to convince people that it is entirely safe and reliable when not. They seem not to understand and have also entirely lost sight of the fact that the term "quack" is slang used to describe someone who practices medicine.
Their ideas are usually founded on pseudo-scientific methods which none of them appear to understand are not science, including randomized controlled trials [RCTs] and observational studies, [the statistical "tobacco science" studies incorrectly described as epidemiology].
It's not surprising, then, that their ideas are nonsense from the outset.
Imagine if the reliability of aircraft components was established in the same way: the trials show that if say alloy bolts were used in the airframe 70% of the time these will work, so 30% of the time the aircraft fall out of the sky. Or imagine if 70% of the time when an apple comes off a tree it falls down but the rest of the time it falls upwards. In terms of scientific falsification, a theory of gravity would not have lasted long. But that is the quality of what for them passes as "science".
The stupid it burns.
This explains why the pseudo-science skeptics and apologists for pseudo-science speak about medicine as if it were a branch of science. They claim medical "science" is safe and provides effective treatments when most medical treatments are unproven even by their gold standard of RCT. Medicine can be unreliable and dangerous. Normal people understand that all medical interventions carry risks – but not them.
When US broadcasters like Gary Null produced evidence indicating medicine could be killing 600,000 people a year in the US they dismiss this out of hand as patently untrue claiming it would mean more than one in five people in the US who die each year die due to medical treatment. So that obviously to them has to be utter nonsense, as medicine cannot be ineffective or downright dangerous, can it? So what if the figure were 300,000 or 200,000 or 100,000? At what point is it OK? Or are they claiming it is zero? That is nonsensical.
So when Sayer Ji over at Greenmedinfo.com highlights in his recent post "Evidence-based medicine": A coin's flip of certainty more issues with the unreliability of the medical evidence base of published journal papers, Dr David Gorski emerges from his dark cellar, tightens his neck bolt and engages in the usual internet bullying including the usual nonsensical personal attacks and abuse which he seems unable to live without. [Psychologists please form an orderly queue when analysing this behaviour].
In the past when Sayer Ji explained how vaccines can subvert child and adult immune systems Gorski simply could not let that pass. And when Sayer Ji had the temerity to exercise the right of free speech to criticise Saint Bill [Gates] and Melinda in this Active Post article Gates Foundation Funds Surveillance of Anti-Vaccine Groups Gorski was in overdrive.
This time around, Gorski is trying to convince his readers that evidence-based medicine is not completely uncertain, even going so far as to title his post today Evidence-based medicine: More than a "coin flip". It's a cornucopia of antiscience fallacies aimed at pretending medicine is science and that evidence-based medicine has a sound theoretical, philosophical and empirical basis when it has none of these.
Cranks seem to love Gorski's writing. Of course, we can all love Gorski's writing but for different reasons. Gorski acknowledges the limitations of clinical trials but thinks we can overcome them. The pseudo-science cranks seem to love Gorski's writing because he gives them material to attack critics of the excesses of mainstream medicine even though they really do not understand it – but what they fail in understanding they make up for in outright internet bullying, personal attacks and thuggery – the Gawky Dorkski's in action.
Gorski holds forth on his subscription to the beliefs that medicine is self-correcting, will be more likely to get it right over time, is a messier process than anyone would like, that it often takes longer than we might like, and that it produces more dead ends than we might like. He thinks it is science and he thinks it is better than any alternative and "eventually unloads and abandons therapies demonstrated to be ineffective".
Dream on David. Electro-convulsive therapy and some other treatments applied in psychiatry truly take the biscuit when it comes to lacking a sound scientific basis. And when it comes to effective treatments overall, psychiatry is the least successful branch of medicine in history.
Oddly enough Gorski thinks evidence-based medicine is flawed, claiming:
I've pointed out how the hierarchy of evidence in EBM is defective in that it vastly undervalues basic science studies ..... basic science can be enough to close the door on the question of whether a treatment is efficacious and safe."
Of course, what Gorski fails to understand or chooses to ignore is the reason we have RCTs and observational studies is because medical knowledge, by the very nature of medicine, cannot be established by the normal techniques of basic science.
Gorski then drones on and on with the usual drivel and abuse for 2000 words coming out with all the old canards. Jeez, who reads this stuff? Oh, yeah, childless men aged under 25 and 55–65 browsing from school and home.
Hilariously he ends with attacking Sayer Ji with:
Because his favorite woo can't meet the standards of science, Ji wants different standards. "
So the truth is that David Gorski appears unable to come to terms with the fact that his chosen profession of medicine is not like real science at all and is a poor shadow of it. He has been cheated all his life and behaves as if unable to come to terms with the reality.
David, get a mirror.