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On December 17 2017 04:47 Jockmcplop wrote:Show nested quote +On December 17 2017 04:40 NewSunshine wrote:On December 17 2017 04:01 mozoku wrote:"Evidence-based" and "science-based" in the medical field is a very specific term that describes a decision making process that is essentially requires a study for any clinical decision and EBM (evidence-based medicine) has been under criticism for a while by some of the most well-respected statisticians in the field in part because of the low quality of most published medical studies. This actually has nothing to do with Orwellian-ism and everyone to do with your guys' ignorance. Doctors that don't practice EBM (which is most of them I believe) aren't doing exorcisms, they just don't require a published study for every decision. In theory, EBM is a good idea but in practice it doesn't work out so well for various reasons. Evidence-based medicineCriticismThis is definitely not a thread high-point. I'm going to humor you, and assume that you are correct. So we should be totally cool with the fact that our administration is now telling the CDC what it can and cannot say, in an attempt to police their thoughts and shape their policies. You can't play dumb on this, that's exactly what these people are trying to do. Tell me how policing their choice of words in a budget jives with any notion of freedom of speech, and that it is somehow a good thing. The question you need to be asking is "why is this good?", not "but does this really end America as we know it?" But yeah, everyone else is ignorant and the thread has gone to shit. Nice jab. To be fair, language guidelines are fairly standard. Its not particularly standard for this kind of language to be banned, but the current government are anti-trans, anti-science and anti-evidence so its not really a surprise at all.
Language guidelines as a concept I have no problem with, it can be a useful tool to maintain standards and ensure consistency in communications. The problem is they aren't inherently good or bad, and they can very easily cross a line. While I agree with you that this isn't surprising at all, it does cross that line. It deserves to be called out for what it is, and it can't be the kind of thing that gets normalized.
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On December 17 2017 04:01 mozoku wrote:"Evidence-based" and "science-based" in the medical field is a very specific term that describes a decision making process that is essentially requires a study for any clinical decision and EBM (evidence-based medicine) has been under criticism for a while by some of the most well-respected statisticians in the field in part because of the low quality of most published medical studies. This actually has nothing to do with Orwellian-ism and everyone to do with your guys' ignorance. Doctors that don't practice EBM (which is most of them I believe) aren't doing exorcisms, they just don't require a published study for every decision. In theory, EBM is a good idea but in practice it doesn't work out so well for various reasons. Evidence-based medicineCriticismThis is definitely not a thread high-point.
I would agree with you if the far worse "expert opinion" wasn't the only alternative to "evidence-based" medicine. The solution to poor studies isn't to not be evidence based, it's to actually have good studies.
"Expert opinion" tends to be just "practitioner n of 1" studies writ large, which are one of the major problems plaguing medicine.
Expert opinion was behind years of deleterious prostate cancer screening.
On December 17 2017 04:56 radscorpion9 wrote:Just in case new people show up: The CDC banned words story is false according to the HHS: ABC News Link. You could call this...FAKE NEWS haha I finally get an appropriate chance to say that
The HHS said it was a mischaracterization but didn't go the extra mile to actually say the meeting didn't happen, which is a frequently used tool of this admin (see: Trump's modus operandi). So something probably did happen.
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Just in case new people show up: The CDC banned words story is false according to the HHS: ABC News Link.
You could call this...FAKE NEWS haha I finally get an appropriate chance to say that
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I wouldn't call it necessarily false yet either; that's not much of a denial, leaves a lot of room still.
furthermore, the very nature of an orwellian setup would mean they deny what they did; and tdhis administration has a long line of spokespeople denying what they clearly did.
so wait and see for more info.
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I'll be willing to hear the story is false from anyone but the HHS themselves. Of course they're going to say it was a mischaracterization, they're the ones who did it.
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On December 17 2017 05:06 NewSunshine wrote:
I'll be willing to hear the story is false from anyone but the HHS themselves. Of course they're going to say it was a mischaracterization, they're the ones who did it.
This. From the ABC article itself, I think this is important:
"The assertion that HHS has 'banned words' is a complete mischaracterization of discussions regarding the budget formulation process," the HHS statement said. "HHS will continue to use the best scientific evidence available to improve the health of all Americans. HHS also strongly encourages the use of outcome and evidence data in program evaluations and budget decisions.”
ABC News asked HHS for further clarification but has not yet received a response.
Note they say it is a mischaracterisation, and that they continue to use the best evidence, but do not yet deny or clarify on the actual accusation.
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Zlefin and Zero:The rest of the words are literally just his political agenda. Which I don't even agree with, but there's nothing "Orwellian" about opposing transgender rights, diversity, and abortion. If he wants nothing to do with them, a pretty easy way to send the message down is to just ban the words
It's for his 2018 budget only. He's not banning the words for all use at the CDC permanently or anything. The only potentially Orwellian part of the banned words list were those two that your wonderful choice of publication took horribly out of context. Which is sort of ironic actually.
Ciaus_Dronu: I doubt Trump when knows what EBM tbh. EBM isn't a left/right political issue at all, as evidenced by the fact that nobody here even knew what it was. He has nothing to gain by banning it, and CDC officials wouldn't use that phrase when referencing research anyway because of its potential for ambiguity. The decision to add it was likely made by a healthcare expert in the administration, and I doubt anyone with actual knowledge of healthcare is criticizing the move.
I work at a large company that receives significant press coverage. When we do press releases, there are phrases we are not allowed to use. I'm guessing the ban on EBM is to avoid ambiguity with the public and to enforce consistency.
How would one with a hypothetical anti-science agenda even gain something from the phrase? Nobody says "this is an evidence-based technique", and even if they did, they just change it to "this technique is supported by academic research" and it's better phrased anyway as it avoids ambiguity.
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On December 17 2017 04:52 TheTenthDoc wrote:Show nested quote +On December 17 2017 04:01 mozoku wrote:"Evidence-based" and "science-based" in the medical field is a very specific term that describes a decision making process that is essentially requires a study for any clinical decision and EBM (evidence-based medicine) has been under criticism for a while by some of the most well-respected statisticians in the field in part because of the low quality of most published medical studies. This actually has nothing to do with Orwellian-ism and everyone to do with your guys' ignorance. Doctors that don't practice EBM (which is most of them I believe) aren't doing exorcisms, they just don't require a published study for every decision. In theory, EBM is a good idea but in practice it doesn't work out so well for various reasons. Evidence-based medicineCriticismThis is definitely not a thread high-point. I would agree with you if the far worse "expert opinion" wasn't the only alternative to "evidence-based" medicine. The solution to poor studies isn't to not be evidence based, it's to actually have good studies. "Expert opinion" tends to be just "practitioner n of 1" studies writ large, which are one of the major problems plaguing medicine. Expert opinion was behind years of deleterious prostate cancer screening.
You clearly don't understand what EBM actually is and what the problems with it are. Read the links again.
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On December 17 2017 05:14 mozoku wrote:Show nested quote +On December 17 2017 04:52 TheTenthDoc wrote:On December 17 2017 04:01 mozoku wrote:"Evidence-based" and "science-based" in the medical field is a very specific term that describes a decision making process that is essentially requires a study for any clinical decision and EBM (evidence-based medicine) has been under criticism for a while by some of the most well-respected statisticians in the field in part because of the low quality of most published medical studies. This actually has nothing to do with Orwellian-ism and everyone to do with your guys' ignorance. Doctors that don't practice EBM (which is most of them I believe) aren't doing exorcisms, they just don't require a published study for every decision. In theory, EBM is a good idea but in practice it doesn't work out so well for various reasons. Evidence-based medicineCriticismThis is definitely not a thread high-point. I would agree with you if the far worse "expert opinion" wasn't the only alternative to "evidence-based" medicine. The solution to poor studies isn't to not be evidence based, it's to actually have good studies. "Expert opinion" tends to be just "practitioner n of 1" studies writ large, which are one of the major problems plaguing medicine. Expert opinion was behind years of deleterious prostate cancer screening. You clearly don't understand what EBM actually is and what the problems with it are. Read the links again.
I actually do? I work in the field. I made decisions for patients based on clinical evidence. From your first link:
"Evidence-based medicine (EBM) is an approach to medical practice intended to optimize decision-making by emphasizing the use of evidence from well-designed and well-conducted research."
Please explain to me what you prefer to this paradigm.
I take issue with the specifics (particularly the hierarchical approach to evidence) but this is a problem throughout medicine even outside this paradigm, independent of making decision using evidence from well-designed and well-conducted research.
Show me an alternative paradigm that isn't expert opinion. Please. In fact, the problems of evidence-based medicine's implementation are when expert opinion is allowed to creep in to form the hierarchy.
Edit: for fuck's sake, your second link even says it's a worthy goal to be obtained but has been hijacked! The solution to hijacking isn't just to make a new identical thing up! That's how you get stupidity like "real-world medicine" and "comparative effectiveness research" being "new" terms when they've been studied for decades, if not century.
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On December 17 2017 05:14 mozoku wrote:Show nested quote +On December 17 2017 04:52 TheTenthDoc wrote:On December 17 2017 04:01 mozoku wrote:"Evidence-based" and "science-based" in the medical field is a very specific term that describes a decision making process that is essentially requires a study for any clinical decision and EBM (evidence-based medicine) has been under criticism for a while by some of the most well-respected statisticians in the field in part because of the low quality of most published medical studies. This actually has nothing to do with Orwellian-ism and everyone to do with your guys' ignorance. Doctors that don't practice EBM (which is most of them I believe) aren't doing exorcisms, they just don't require a published study for every decision. In theory, EBM is a good idea but in practice it doesn't work out so well for various reasons. Evidence-based medicineCriticismThis is definitely not a thread high-point. I would agree with you if the far worse "expert opinion" wasn't the only alternative to "evidence-based" medicine. The solution to poor studies isn't to not be evidence based, it's to actually have good studies. "Expert opinion" tends to be just "practitioner n of 1" studies writ large, which are one of the major problems plaguing medicine. Expert opinion was behind years of deleterious prostate cancer screening. You clearly don't understand what EBM actually is and what the problems with it are. Read the links again.
Maybe people would read your article if it wasn't written by an insufferable blowhard with an axe to grind. Yeah, there's definitely issues with how research is funded, "eminence based medicine", etc. but if a better alternative isn't proposed then all you have is 12 pages of bitching.
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On December 17 2017 05:09 mozoku wrote:
Zlefin and Zero:The rest of the words are literally just his political agenda. Which I don't even agree with, but there's nothing "Orwellian" about opposing transgender rights, diversity, and abortion. If he wants nothing to do with them, a pretty easy way to send the message down is to just ban the words
It's for his 2018 budget only. He's not banning the words for all use at the CDC permanently or anything. The only potentially Orwellian part of the banned words list were those two that your wonderful choice of publication took horribly out of context. Which is sort of ironic actually.
Ciaus_Dronu: I doubt Trump when knows what EBM tbh. EBM isn't a left/right political issue at all, as evidenced by the fact that nobody here even knew what it was. He has nothing to gain by banning it, and CDC officials wouldn't use that phrase when referencing research anyway because of its potential for ambiguity. The decision to add it was likely made by a healthcare expert in the administration, and I doubt anyone with actual knowledge of healthcare is criticizing the move.
I work at a large company that receives significant press coverage. When we do press releases, there are phrases we are not allowed to use. I'm guessing the ban on EBM is to avoid ambiguity with the public and to enforce consistency.
How would one with a hypothetical anti-science agenda even gain something from the phrase? Nobody says "this is an evidence-based technique", and even if they did, they just change it to "this technique is supported by academic research" and it's better phrased anyway as it avoids ambiguity.
To answer your "what would they have to gain", in the broader context of the authoritation bullshit the administration is pushing, any notion or detail of evidence and actual scientific process is bad. It literally doesn't matter whether such phrasing would actually be used regularly to ambiguous effect, the point is that the phrase immediately references ideas challenging to the goals of an authoritarian administration (particularly one using religious dogma to fuel a large portion of its base).
You can't look at such a decision outside of the broader context of the goals of an authoritarian state.
Why not? Because of how many incredibly dangerous authoritarian things said state is doing. In just the last week Trump has discussed militarization of police. If you don't see these trends, or refuse to acknowledge the pattern, that is on you. There are serious consequences to these things, and the idea that the regimes of the past can't happen in the US or won't happen again is stupid and blinding.
Also in reference to your potential alternate reasoning, the phrase they wanted to replace EBM with was this:
“CDC bases its recommendations on science in consideration with community standards and wishes,”
Do you think that "addressing ambiguity" is at all what that replacement of phrasing does here?
Also seriously
but there's nothing "Orwellian" about opposing transgender rights, diversity, and abortion.
This quote won't age well. Actively pushing that agenda to the CDC has life-altering consequences for many, if opposing rights for transgender individuals isn't some fucked up societal purity scape-goating crap then I don't know what is. "Nothing fascist about opposing rights for jews it's just politics."
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In a shocking twist, Trump wants to be back in front of crowds praising him rather than actually doing work.
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The CDC story is now being overshadowed by the NYT story on Harry Reid. I'll admit it is a WTF story. Also where is Travis?
He should be here right now regarding said story.
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mozoku -> yeah, you have no good argument, as expected, nor do you own up to the amply pointed out problems with your prior ones.
there's a difference between opposing those things, and forbidding an arm of the government from mentioning them in its budget; especially seeing as some of those thins are rather important and undre its purview.
it is orwellian, and you're unable to see you're bein ga partisan shill for it. such is the sadness of these days.
it's not HIS budget; it's the budget of the CDC, acting on behalf of the american people.
danglars -> who is that person and why should I care about their opinion on the matter?
especially seeing as they don' tlink to any facts, so all that is provided is their own opinion.
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On December 17 2017 05:23 TheTenthDoc wrote:Show nested quote +On December 17 2017 05:14 mozoku wrote:On December 17 2017 04:52 TheTenthDoc wrote:On December 17 2017 04:01 mozoku wrote:"Evidence-based" and "science-based" in the medical field is a very specific term that describes a decision making process that is essentially requires a study for any clinical decision and EBM (evidence-based medicine) has been under criticism for a while by some of the most well-respected statisticians in the field in part because of the low quality of most published medical studies. This actually has nothing to do with Orwellian-ism and everyone to do with your guys' ignorance. Doctors that don't practice EBM (which is most of them I believe) aren't doing exorcisms, they just don't require a published study for every decision. In theory, EBM is a good idea but in practice it doesn't work out so well for various reasons. Evidence-based medicineCriticismThis is definitely not a thread high-point. I would agree with you if the far worse "expert opinion" wasn't the only alternative to "evidence-based" medicine. The solution to poor studies isn't to not be evidence based, it's to actually have good studies. "Expert opinion" tends to be just "practitioner n of 1" studies writ large, which are one of the major problems plaguing medicine. Expert opinion was behind years of deleterious prostate cancer screening. You clearly don't understand what EBM actually is and what the problems with it are. Read the links again. I actually do? I work in the field. I made decisions for patients based on clinical evidence. From your first link: "Evidence-based medicine (EBM) is an approach to medical practice intended to optimize decision-making by emphasizing the use of evidence from well-designed and well-conducted research." Please explain to me what you prefer to this paradigm. I take issue with the specifics (particularly the hierarchical approach to evidence) but this is a problem throughout medicine even outside this paradigm, independent of making decision using evidence from well-designed and well-conducted research. Show me an alternative paradigm that isn't expert opinion. Please. In fact, the problems of evidence-based medicine's implementation are when expert opinion is allowed to creep in to form the hierarchy. Edit: for fuck's sake, your second link even says it's a worthy goal to be obtained but has been hijacked! The solution to hijacking isn't just to make a new identical thing up! That's how you get stupidity like "real-world medicine" and "comparative effectiveness research" being "new" terms when they've been studied for decades, if not century.
To your edit, I literally acknowledged the same thing:
In theory, EBM is a good idea but in practice it doesn't work out so well for various reasons.
The issue with EBM isn't the fact that it uses evidence, obviously. Its name is about as accurate as the name of the average congressional act. The issue is that, in practice, it precludes a practitioner from pursuing treatment options outside of the literature. And the literature is a) not comprehensive, b) often flawed as medical studies are usually badly underpowered, and c) distorted by the incentives that EBM creates.
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On December 17 2017 05:49 {CC}StealthBlue wrote:
The CDC story is now being overshadowed by the NYT story on Harry Reid. I'll admit it is a WTF story. Also where is Travis?
He should be here right now regarding said story.
I think it's conclusive evidence that the government doesn't know shit about UFOs
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On December 17 2017 05:59 mozoku wrote:Show nested quote +On December 17 2017 05:23 TheTenthDoc wrote:On December 17 2017 05:14 mozoku wrote:On December 17 2017 04:52 TheTenthDoc wrote:On December 17 2017 04:01 mozoku wrote:"Evidence-based" and "science-based" in the medical field is a very specific term that describes a decision making process that is essentially requires a study for any clinical decision and EBM (evidence-based medicine) has been under criticism for a while by some of the most well-respected statisticians in the field in part because of the low quality of most published medical studies. This actually has nothing to do with Orwellian-ism and everyone to do with your guys' ignorance. Doctors that don't practice EBM (which is most of them I believe) aren't doing exorcisms, they just don't require a published study for every decision. In theory, EBM is a good idea but in practice it doesn't work out so well for various reasons. Evidence-based medicineCriticismThis is definitely not a thread high-point. I would agree with you if the far worse "expert opinion" wasn't the only alternative to "evidence-based" medicine. The solution to poor studies isn't to not be evidence based, it's to actually have good studies. "Expert opinion" tends to be just "practitioner n of 1" studies writ large, which are one of the major problems plaguing medicine. Expert opinion was behind years of deleterious prostate cancer screening. You clearly don't understand what EBM actually is and what the problems with it are. Read the links again. I actually do? I work in the field. I made decisions for patients based on clinical evidence. From your first link: "Evidence-based medicine (EBM) is an approach to medical practice intended to optimize decision-making by emphasizing the use of evidence from well-designed and well-conducted research." Please explain to me what you prefer to this paradigm. I take issue with the specifics (particularly the hierarchical approach to evidence) but this is a problem throughout medicine even outside this paradigm, independent of making decision using evidence from well-designed and well-conducted research. Show me an alternative paradigm that isn't expert opinion. Please. In fact, the problems of evidence-based medicine's implementation are when expert opinion is allowed to creep in to form the hierarchy. Edit: for fuck's sake, your second link even says it's a worthy goal to be obtained but has been hijacked! The solution to hijacking isn't just to make a new identical thing up! That's how you get stupidity like "real-world medicine" and "comparative effectiveness research" being "new" terms when they've been studied for decades, if not century. To your edit, I literally acknowledged the same thing: Show nested quote +In theory, EBM is a good idea but in practice it doesn't work out so well for various reasons. The issue with EBM isn't the fact that it uses evidence, obviously. Its name is about as accurate as the name of the average congressional act. The issue is that, in practice, it precludes a practitioner from pursuing treatment options outside of the literature. And the literature is a) not comprehensive, b) often flawed as medical studies are usually badly underpowered, and c) distorted by the incentives that EBM creates.
So wouldn't you want the CDC to be able to say "this funding announcement is to expand the literature base to enhance the quality of evidence-based medicine?"
Going outside the "literature" is a great way to end up in the land of Doctor Oz. And has even worse financial incentives for many treatments-"expert opinion" is a lot easier to buy than a study, even a poorly done one.
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EPT
