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Guardian exemplifies the placebo control gold standard fallacy (–> being, Logic and First Principles, 37)

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Shortly after I posted yesterday on whether placebo based studies are properly a gold standard, one of our common objectors, JT, linked the Guardian. Perhaps, he did not realise just how aptly it illustrates my point.

I therefore responded, as I now headline as a shop window case- in- point illustration of what is going wrong with medical testing, linked statistics and linked ethics . . . not to mention, too much of the media and the way we tend to think:

This is part of why I have written as I have in the OP:

[Guardian, annotated:] >>The French doctor Didier Raoult has claimed [–> has reported, on now almost 3,000 patients, under a test protocol approved by relevant authorities] the combination is a cure, leading to public clamour for the drugs in France. [–> Actually, after the 80 patient test, there was an initial approval in France, and a second level in the US] President Macron visited Raoult’s hospital in Marseille last week, giving him tentative support but suggesting that trials [–> not, further trials, i.e. precisely the dismissiveness that is not warranted] were needed . . . . hydroxychloroquine and azithromycin are being tested separately [–> have they heard of synergy? The results in hand point to synergy. And where is the Zn?] as part of the Recovery trial, and if there is any effect in patients given those drugs alone [–> so, you load in lack of effect at the design phase], compared with those given no drugs [–> in the face of a fast-acting deadly disease, given deliberately mislabelled sugar pills], they can be combined later. [–> as synergy is clearly involved on tests and cases in hand, this boils down to loading the dice against a result not wanted, based on locking out evidence in hand willfully ignored]

For now, said Horby, the data flying around in emails from enthusiasts and posted on social media [–> deliberately misreprresents results and context in hand, refusing to acknowledge Dr Didier Raoult, i.e. classic no true Sassenach] about patients who have recovered after taking hydroxychloroquine proves [–> inductive evidence never amounts to proof, but may provide good cogency] nothing. He says there is no real evidence [–> Classic no true Sassenach, and selective hyperskeptical dismissal] to support its use yet.>>

In short, here we see the precise problems identified in the OP. And besides, I think in S Dakota tests of 100,000 are beginning.

In short, precisely as expected.

I then pointed to a pre-emptive correction by Locke, in Section 5 of his introduction to his Essay on Human Understanding:

[Essay on Human Understanding, Intro, Sec 5:] Men have reason to be well satisfied with what God hath thought fit for them, since he hath given them (as St. Peter says [NB: i.e. 2 Pet 1:2 – 4]) pana pros zoen kaieusebeian, whatsoever is necessary for the conveniences of life and information of virtue; and has put within the reach of their discovery, the comfortable provision for this life, and the way that leads to a better. How short soever their knowledge may come of an universal or perfect comprehension of whatsoever is, it yet secures their great concernments [Prov 1: 1 – 7], that they have light enough to lead them to the knowledge of their Maker, and the sight of their own duties [cf Rom 1 – 2, Ac 17, etc, etc]. Men may find matter sufficient to busy their heads, and employ their hands with variety, delight, and satisfaction, if they will not boldly quarrel with their own constitution, and throw away the blessings their hands are filled with, because they are not big enough to grasp everything . . . It will be no excuse to an idle and untoward servant [Matt 24:42 – 51], who would not attend his business by candle light, to plead that he had not broad sunshine. The Candle that is set up in us [Prov 20:27] shines bright enough for all our purposes . . . If we will disbelieve everything, because we cannot certainly know all things, we shall do muchwhat as wisely as he who would not use his legs, but sit still and perish, because he had no wings to fly.

In short, we have been warned about what we are doing, over 300 years ago, by one of the leading lights of our civilisation.

Will we listen? (I frankly doubt it, until we undeniably go over the cliff.) END

19 Replies to “Guardian exemplifies the placebo control gold standard fallacy (–> being, Logic and First Principles, 37)

  1. 1
    kairosfocus says:

    Guardian exemplifies the placebo control gold standard fallacy

  2. 2
    Jim Thibodeau says:

    Can anybody explain to me what Kairosfocus is trying to say here?

  3. 3
    kairosfocus says:

    JT,

    you know full well just what Guardian’s words and my highlights and comments point to, given the concerns in the OP linked within the first few words above.

    The OP you were trying to shoot down by linking Guardian, only to instead illustrate my concerns by capital example. Oh, things like

    * characterising a leading, widely respected researcher in the field who heads a relevant Institute as simply a “French Doctor.” Then,

    * suggesting that he touts “the combination [HCQ + Z-Pak] is a cure” while omitting his evidential base, then

    * going on to summarise Macron as suggesting “that trials were needed.” As in,

    * Guardian suggests [with your appaarent approval] that whatever Dr Raoult did, they do not constitute empirical tests of any credibility, when in fact his protocol was officially approved — as I have posted courtesy Google Translate. Then,

    * proceeding to promote trials that are structured to ignore synergy, in the teeth of Raoult’s work, which in context is a clear hit job. Next,

    * we see possibly out of context citation of an expert seeming to dismiss social media buzz as promoting data that PROVES — diagnostic word — nothing. Proof is not in the gift of inductive logic exploring empirical circumstances, though cogency and in some cases moral certainty might obtain.

    * The diagnosis of selective hyperskepticism is then confirmed by the dismissive claim “no REAL evidence.” And of course,

    * regarding the ethical and practical issues of placebo based testing in the face of a plague, we find little or nothing.

    All of which, speaks volumes. KF

    PS: Let me add, Greenleaf’s remarks:

    Evidence, in legal acceptation, includes all the means by which any alleged matter of fact, the truth of which is submitted to investigation, is established or disproved . . . None but mathematical truth is susceptible of that high degree of evidence, called demonstration, which excludes all possibility of error [–> Greenleaf wrote almost 100 years before Godel], and which, therefore, may reasonably be required in support of every mathematical deduction. [–> that is, his focus is on the logic of good support for in principle uncertain conclusions, i.e. in the modern sense, inductive logic and reasoning in real world, momentous contexts with potentially serious consequences.]

    Matters of fact are proved by moral evidence alone; by which is meant, not only that kind of evidence which is employed on subjects connected with moral conduct, but all the evidence which is not obtained either from intuition, or from demonstration. In the ordinary affairs of life, we do not require demonstrative evidence, because it is not consistent with the nature of the subject, and to insist upon it would be unreasonable and absurd. [–> the issue of warrant to moral certainty, beyond reasonable doubt; and the contrasted absurdity of selective hyperskepticism.]

    The most that can be affirmed of such things, is, that there is no reasonable doubt concerning them. [–> moral certainty standard, and this is for the proverbial man in the Clapham bus stop, not some clever determined advocate or skeptic motivated not to see or assent to what is warranted.]

    The true question, therefore, in trials of fact, is not whether it is possible that the testimony may be false, but, whether there is sufficient probability of its truth; that is, whether the facts are shown by competent and satisfactory evidence. Things established by competent and satisfactory evidence are said to be proved. [–> pistis enters; we might as well learn the underlying classical Greek word that addresses the three levers of persuasion, pathos- ethos- logos and its extension to address worldview level warranted faith-commitment and confident trust on good grounding, through the impact of the Judaeo-Christian tradition in C1 as was energised by the 500 key witnesses.]

    By competent evidence, is meant that which the very-nature of the thing to be proved requires, as the fit and appropriate proof in the particular case, such as the production of a writing, where its contents are the subject of inquiry. By satisfactory evidence, which is sometimes called sufficient evidence, is intended that amount of proof, which ordinarily satisfies an unprejudiced mind [–> in British usage, the man in the Clapham bus stop], beyond reasonable doubt.

    The circumstances which will amount to this degree of proof can never be previously defined; the only legal [–> and responsible] test of which they are susceptible, is their sufficiency to satisfy the mind and conscience of a common man; and so to convince him, that he would venture to act upon that conviction, in matters of the highest concern and importance to his own interest.

    [= definition of moral certainty as a balanced unprejudiced judgement beyond reasonable, responsible doubt. Obviously, i/l/o wider concerns, while scientific facts as actually observed may meet this standard, scientific explanatory frameworks such as hypotheses, models, laws and theories cannot as they are necessarily provisional and in many cases have had to be materially modified, substantially re-interpreted to the point of implied modification, or outright replaced; so a modicum of prudent caution is warranted in such contexts — explanatory frameworks are empirically reliable so far on various tests, not utterly certain. Morally certain facts of observation and experience in our common world are not necessary truths.]

    [A Treatise on Evidence, Vol I, 11th edn. (Boston: Little, Brown, 1888) ch 1., sections 1 and 2. Shorter paragraphs added. (NB: Greenleaf was a founder of the modern Harvard Law School and is regarded as a founding father of the modern Anglophone school of thought on evidence, in large part on the strength of this classic work.)]

  4. 4
    Jim Thibodeau says:

    KF, that first block quote of yours is incomprehensible.

  5. 5
    jerry says:

    Kf

    The Guardian is a very liberal newspaper. Had Trump disparaged HCQ and CQ the headline “Blood on His Hands” would be the only meme traveling the world today. Everyone here knows that and so does the Guardian.

    I just wish we could have done a controlled experiment with half the world getting that headline and half getting the real one. As it is hypocrisy is running rampant as people reveal who they really are.

    The best thing Trump has done is reveal who people are internally as they react to what he has done and what he says.

  6. 6
    daveS says:

    KF,

    If we will disbelieve everything, because we cannot certainly know all things, we shall do much what as wisely as he who would not use his legs, but sit still and perish, because he had no wings to fly.

    I believe this would be a strawman in this context. Clearly no one is suggesting that we should disbelieve everything.

    Even we laypeople understand that the conclusions of these studies fall somewhere on a spectrum of reliability. And that the choice of what actions to take based on more-or-less reliable studies to depends on values to some extent.

  7. 7
    kairosfocus says:

    JT, YOU provided the original link. If you did not read the article and understand what you were in effect endorsing, perhaps you should re-read it. KF

    PS: Let me provide the text chunk I for cause find unacceptable, from your link, more or less:

    The French doctor Didier Raoult has claimed the combination is a cure, leading to public clamour for the drugs in France. President Macron visited Raoult’s hospital in Marseille last week, giving him tentative support but suggesting that trials were needed.

    Both hydroxychloroquine and azithromycin are being tested separately as part of the Recovery trial, and if there is any effect in patients given those drugs alone, compared with those given no drugs, they can be combined later.

    For now, said Horby, the data flying around in emails from enthusiasts and posted on social media about patients who have recovered after taking hydroxychloroquine proves nothing. He says there is no real evidence to support its use yet.

    “I would say no,” said Horby. “There is in-vitro evidence that it is inhibitory against the virus [in the lab]. But I haven’t seen any sound clinical data.

  8. 8
    kairosfocus says:

    Jerry, yes, it is one of the “quality press” voices of the UK progressives. I first learned of it as a kid when a teacher — all the way across the Atlantic — had a subscription. This article is a capital case in point of what is going wrong. KF

  9. 9
    kairosfocus says:

    DS, Locke specifically spoke to global skepticism. Were he alive, he would readily agree that the point holds a fortiori for selective hyperskepticism, which targets what it does not like; begging big questions. Next, yes, there is a spectrum of warrant, which in prudence must then be addressed in light of consequences of alternative errors and ethical issues on the difference between love of learning and vicious curiosity. In our current context, setting up placebo based studies as a gold standard, suppressing their limitations and significant ethical challenges then dismissing case based clinical studies as failing to provide proof, or of being “no evidence” or the like, and belittling those who actually have outstanding records and are presenting fair bodies of work under officially approved protocols does not make the grade. Unfortunately, we have here an evident case in point. KF

  10. 10
    jerry says:

    yes, it is one of the “quality press” voices of the UK progressives. I first learned of it as a kid

    The choir wants to be preached to and is a natural human emotion because we want our emotions reinforced. There were many who actually believed Pravda.

    The real issue here as in most places is seeing if anyone can rise above their emotions and use evidence and reason. Unfortunately we have our answer too clearly presented with the comments made. Faux reasons and faux logic are on display.

  11. 11
    daveS says:

    KF,

    Were he alive, he would readily agree that the point holds a fortiori for selective hyperskepticism, which targets what it does not like; begging big questions.

    He would also readily agree that one should take one’s culture-warrior goggles off occasionally. 😛

  12. 12
    kairosfocus says:

    DS, yes, he would. However the issue on the table is clear. When a top rated paper’s editors pass a story like that, things are bad. KF

  13. 13
    kairosfocus says:

    Jerry, I am thinking we have been seriously mis-taught. Here, regarding experiment design, observation/clinical studies and linked statistics. At root is a Cartesian doubt issue, leading to imagining hyperskepticism to be an intellectual virtue. At basic stats level, I am wondering if a little ANOVA blocking by plots and treatments with “variances add” tossed in might at least give a glimmer of possibilities? Some exploratory data analysis? Some introduction to graphing tools? Esp tools that build on spreadsheets? Maybe, some systems analysis, use of block diagrams and i/o analysis? I am left to wonder. KF

  14. 14
    Truthfreedom says:

    @Jerry

    The Guardian is a very liberal newspaper. Had Trump disparaged HCQ and CQ the headline “Blood on His Hands” would be the only meme traveling the world today. Everyone here knows that and so does the Guardian.

    Wise words.

  15. 15
    Truthfreedom says:

    @Kairosfocus

    JT, YOU provided the original link. If you did not read the article and understand what you were in effect endorsing, perhaps you should re-read it. KF

    JT posts links without reading them. Quite an example.

  16. 16
    rhampton7 says:

    More than five dozen people with chronic ailments like lupus and rheumatoid arthritis were taking medications such as hydroxychloroquine before being diagnosed with the coronavirus, according to data compiled by the Global Rheumatology Alliance, a coalition of rheumatologists,… a sign the drugs may not protect people from the new coronavirus.

  17. 17
    rhampton7 says:

    Yasser Rodriguez, M.D., M.B.A., F.A.C.C. Board Certified in Cardiology and Cardiac Electrophysiology

    Why are patients with pre-existing heart disease and hypertension at higher risk?

    The answer is thought to be two-fold. Patients with hypertension have a higher risk since they tend to have an increased expression of a receptor (protein on the cell surface) called ACE-2. This ACE-2 receptor is the main target that the virus uses to enter our cells.

    Additionally, patients with preexisting heart conditions may have a lower baseline that compromises their ability to keep up with the increased demands on the body caused by an infection.

    What are your thoughts about Plaquenil (Hydroxychloroquine) and Azithromycin (Z-Pack)?

    There is conflicting data arising from both China and Italy regarding the use of this medication. This medication should not be started at home without first consulting a physician given a possible life threatening side-effect (QT Prolongation leading to sudden cardiac death).

  18. 18
    kairosfocus says:

    RH7, yes, that may count towards that (especially given dosage), we shall see on balance. KF

  19. 19
    jerry says:

    This medication should not be started at home without first consulting a physician

    I believe you need a prescription from a doctor to get this drug. Also this doctor did not comment on the use of zinc with HCQ.

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