Science based Medicine -- is it Pseudoscience???

 

Germaine occasionally links or recommends a blog by Steve Novella, the champion of Science Based Medicine.  Rather than something to recommend positively, I consider Novella to be an exemplar of a pseudoscience practitioner.  I also consider the use of Bayesian statistics to be the statistical equivalent of heroin – a really really bad idea to get oneself hooked upon if one is seeking truth.  These thoughts are both  counter to this blog’s general inclinations, so counter arguing these points is something I will try to deliver on.   J

What is Science?  And what is pseudoscience?  I will follow Karl Popper on both of these questions, as I think he thought the answer through well.  Science, per Popper, is an investigative methodology directed toward finding discoveries about the world, which focuses on hypothesis formation and revision based on test.  The process varies in different fields and at different maturities of a field.  A general summary is that it includes exploration, investigation, speculation, guided investigation, hypotheses, derivation of tests, tests and revisions, repeat test/revise cycle. This approach can be used for all sorts of subjects, and has been.  Note, there are no subject areas that are or should be excluded from science – the key question is whether there are usefully testable hypotheses, plus an attitude of seeking and accepting refuting tests.  If Intelligent Design or Astrology had productive hypotheses and engaged in the test/revise cycle, they could in principle be “science”.

Pseudoscience, again per Popper is an approach claiming “truth”, which REJECTS the test/revise process, AND  which claims to be science. 

So –what about SBM?  Here is SBM’s definition of science: https://sciencebasedmedicine.org/what-is-science/  SBM does not come out and explicitly reject Popper’s definition, instead they suggest there are TWO definitions, and they want to use both: 

In common use the word “science” has several meanings, which may or may not be clear in context. Two that readily come to mind are 1) the growing body of knowledge about nature, accumulated over the several hundred years during which a distinctive, rational method of inquiry, or at least parts of it, have been employed; 2) that method of inquiry, also known as the “scientific method,” characterized by the collective tools of science—observation, generation of hypotheses, controlled and repeated testing of hypotheses, the use of mathematics for generating hypotheses, for aiding in complex measurements, for statistical inference, and so on. 

There is no such difference.  In actuality, definition 1 is the result one arrives at when applying definition 2.  Asserting two definitions is an effort to blow smoke, the reason for which becomes clearer later in the essay.  The purpose to asserting two definitions is to provide smoke to obscure the claim that physicalism is irrefutably demonstrated by science.  Here is where the bait/switch of physicalism for science is done:

The late physicist, Milton Rothman, wrote three small books that are useful for a discussion such as this. One of those books, A Physicist’s Guide to Skepticism, has an entire section titled “Laws of Permission and Laws of Denial.” The chapter on “Laws of Denial” begins as follows:

It is fashionable in some circles to insist that “nothing is impossible,” as though to admit the impossibility of some cherished goal is to “give up trying,” to have a closed mind, to be a spoilsport, a pessimist. This cliché is most prevalent in inspirational rhetoric connected with therapeutic, educational, or sporting activities. Nevertheless, one of the basic functions of science is to determine what actions are impossible in this real world. Choosing between the possible and the impossible is a task carried out by means of the laws of denial, which tie us firmly to reality even as imaginations soar unfettered through the universe.

Another fashionable cliché is that “all scientific theories are provisional,” as though physics knows nothing with a certainty, and that anything we think we know is likely to be found false in the future…If all scientific knowledge is tentative, what have we been doing for the past 300 years? How can I be so sure that the computer upon which I am typing will print out the words that I am putting into it?

A more accurate assessment of the situation is to recognize that one of the fundamental tasks of science is to critically examine all knowledge and to separate from the tentative ideas and false notions of the past facts that are so well established that to think them subject to change is to invite wishful thinking and foolishness.

Laws of denial, as explained by Rothman, are the laws of conservation of energy, momentum, angular momentum, and of electric charge; the principle of Lorentz invariance, “from which the conclusions of special relativity follow: no object, energy or information can travel faster than the speed of light”; the principle of causality, by which it is “impossible for an effect to appear earlier in time than its cause”; and the first and second laws of thermodynamics. There are other statements that can be made with a degree of certainty much higher than is necessary to preclude their being overturned by clinical research, even if they are less certain than the laws of denial. For example, since all known interactions can be explained by the 4 forces of the standard model, and since only two of those forces—gravity and electromagnetic force—explain all actions other than those at the subatomic level, there is no reason to invoke fanciful forces (the vital force, ‘biofields’) that have never been detected and that add nothing to our understanding of natural phenomena.

Note what is done here in this quote – falsifiability, and the tentative nature of all empiricism, is explicitly rejected, based on a fallacy (argument by ridicule).  And what is substituted is a concept of science as something like bookkeeping, which offers certainties. 

Applying falsifiability to SBMs definition of science shows that it is FALSE, in every particular. 

·         First – LAWS in science are NOT inviolable!  Laws are just regularities.  SBM’s bookkeeping alternative to science, relies upon the pre-scientific concept of inviolable laws. 

·         Conservation principles are not inviolable either.  Noether’s theorem showed that conservation principles are the outgrowth of symmetries.  And the study of symmetries in physics has showed that they all spontaneously break (IE, the conservation laws do not always hold).  Here is a physics reference that explains why all symmetries break. https://www.pnas.org/content/93/25/14256

·         Note – decades ago for my undergraduate degree one of my essays was on the conservation law breakage needed of the baryon conservation law to there to be any matter.  More recently, I asked, on physics stack exchange, about whether either Hoyle’s proton creation speculation, or the Zero Energy Hypothesis, could be relevant to the plausibility of dualist interaction effects.  https://physics.stackexchange.com/questions/494408/the-zero-energy-hypothesis-and-its-consequences-for-particle-creation-and-dualis Note these speculative violations of conservation laws are common in theoretical physics. 

·         The Bell Inequality demonstrated that physics cannot be both localized (limited by light speed), and real (observer independent), hence the “light speed limit” claims are also untrue

·         Another physicalist and fellow member of CSI, Victor Stenger, noted in one of his books that the average entropy of an expanding universe can decline, explicitly violating the 2^nd law of thermodynamics. 

·         We cannot “explain the interactions” between matter and either dark energy or dark matter, and these interactions cannot be explained by the Standard Model and its four forces. 

·         Additionally, neither the interactions of mind with brain, nor of abstract objects with matter, nor the postulated process of emergence are explained by physical reductionism, nor can they be.

SBM holds by a dogma – reductive physicalism – and rejects the falsification of its dogma.  Asserting a dogma as science, and in particularly a REFUTED one – is pseudoscience. 

SBM then takes the pseudoscience project further – not only rejecting the methodology of science and replacing it with a dogma, but then campaigning to PREVENT THE EXPERIMENTS WHICH FURTHER CHALLENGE ITS DOGMA.  One of the most fruitful sources of evidence for the falsity of reductive physicalism is the experimental success of psi and CAM (complementary and alternative medicine).  SBM, though, considers the experimental data relative to CAM and psi to be ”incorrect”:

Such Trials Don’t Work

The final reason that efficacy trials of highly implausible claims are a bad idea is that they don’t work very well: they tend to yield, in the aggregate, equivocal, rather than merely disconfirming results. Yes, the biases are so serious that they have led to incorrect conclusions about CAM, at least for a substantial period. 

I.E. – the results of good testing do not provide the support that Novella wishes they did for his wish to reject the reality of psi and CAM effects, SO – he wants to PREVENT ANY FURTHER TESTING!!!!!

https://sciencebasedmedicine.org/of-sbm-and-ebm-redux-part-iii/

Note this rejection of testing and evidence is not limited to Novella and SBM – it is a common position across the “skeptic” community.  Here is one skeptic paper making this same point of refusing to even look at evidence supporting phenomena that challenge physicalism.  Susan Blackmore, another CSI fellow, made the rationale explicit in her autobiography -- NO evidence would convince her of the reality of psi-- because she will always consider creating and data fraud to be more likely than the overturning of physicalism.      https://skepticalinquirer.org/2019/07/why-parapsychological-claims-cannot-be-true/ Novella is not alone as an advocate of pseudoscience, he is part of a pseudoscience movement which is much larger than SBM.

OK – second subject – Bayes. 

Bayes developed his statistics in order to emulate how humans actually think – that our conclusions are based on both the evidence, AND OUR PRIOR KNOWLEDGE.  This is NOT actually a good thing to do!  We humans are HIGHLY subject to confirmation biases – which lead us to DRASTICALLY overestimate the likelihood that what we think is true, actually IS true.  Basically anyone can see this, by trying to talk to somebody about what they believe on almost any subject.  One will quickly run into multitudes of poorly supported, but certainly held positions.   Therefore, IF one gives permission to set the probability of priors as a user action, USERS SET PRIORS FAR FAR FAR TOO HIGH (or low, depending on what their beliefs are). 

This effect was in action with SBM and “science”.  Novella wants to believe in physicalism, hence he approaches “physics” with a confirmation bias, and does not look for refutations, but instead falsely thinks science confirms physicalism.  This is not a problem unique to Novella, we ALL suffer form this sort of cognitive bias.    Then he sets the prior for “physicalism” to 1, which under Bayes methods, leads to legitimately rejecting all contrary data.  There is NO HOPE FOR HIM to ever change his mind, as long as he maintains a Bayesian approach to experimental data. 

Using user-independent statistics – frequentist statistics -- is how “paradigm shifts” ever occur in science, and that individuals change their minds.  The “Bayesian method is better” approach will, I fear, basically shut down science.