Clinical Research

This subject is quite complicated and it will be difficult for me to address it coherently in the space of a blog post. Lay people, unfortunately, are prone to many misunderstandings of clinical research and lately political opportunists have taken to exploiting these misunderstandings. Joseph Ladapo, the Florida Surgeon General, is one of these. He either doesn't know what he's doing when it comes to epidemiological research, or he's just a liar. Probably a little bit of both. The entire community of relevant experts rejects his conclusion that young men should not get the Covid vaccine, not because they don't like the conclusion, but because his evidence is not valid.

For some reason, insisting on medical falsehoods has become a passionate cause for the political right in the U.S. Opposing vaccination, promoting ineffective and harmful treatments, opposing sensible measures to protect health and lives -- these have all become emblems of "freedom" for people who are not exercising freedom at all, but championing ignorance and error. Viz:.

 

 

So, let me try to explain a few things quickly.  If you want to know whether an intervention is safe and effective, you face several problems. ("Intervention" is the standard term in clinical and public health research for doing something, basically -- whether it be administering a drug or a vaccine, surgery, changing people's behavior or the physical or social environment, whatever.) The first is being able to make an appropriate comparison. As an obvious example, if you just give a bunch of people who have, let's say, a cold, some sort of a pill, and a week or ten days later they're mostly feeling better, does that mean the pill works? On the other hand, if people have cancer, and you give them a treatment, and six months later most of them are worse off does that mean the treatment harmed them? Obviously you don't actually know either way.

At least it should be obvious, but for 2,000 years, since Hippocrates, it evidently wasn't obvious to physicians. They kept bleeding people and giving them emetics and purgatives. Why? Well, most of them got better anyway and if they didn't, it was because the doctors weren't "heroic" enough, so they bled the people all the more and purged them all the more and if they died, it wasn't the doctor's fault, they'd done the best they could.

I think that's enough for now and I'll continue in the next post. Meanwhile, you can think about this a bit.