Scivillage.com Casual Discussion Science Forum

https://theness.com/neurologicablog/inde...more-12081

INTRO (Steven Novella): A recent interview published in Scientific American is a good case study in what can happen when you have journalism without skepticism. By skepticism I mean a working knowledge of the discipline of scientific skepticism, which combines our current understanding of the philosophy of science, the nature of pseudoscience, critical thinking, mechanisms of self-deception, deliberate deception, and specific knowledge about individual pseudoscientific and paranormal topics.

The interview was conducted by John Horgan, who I have trashed in the past{*} for criticizing skepticism while demonstrating an almost complete ignorance of it. The subject of the interview was Leslie Kean, a journalist who has written a book on UFOs and another on life after death. Doing a deep dive into these two issues is beyond this one article, and they have already been covered at length here and elsewhere. I want to focus on what the interview itself reveals.

Kean appears to take a solid journalistic approach to these issues, but there is a massive hole in her approach. She does not seem to be aware that there is already a thorough investigation into these questions, showing convincingly in my opinion that they are not genuine. She ignores it because she thinks she already understands it, when she doesn’t – so she is missing the skeptical take on these issues. She is dismissive of skeptics as deniers and as closed-minded. She then goes on to make rookie mistakes, that any well-informed skeptic could have pointed out to her. The result is a repetition of long debunked fallacious arguments, but with a patina of serious journalism.

Here are some examples on the UFO front. First, she is being coy by saying she is not concluding UFOs are aliens. She is just concluding that they are real physical objects displaying characteristics that cannot be man-made or natural. This is the “Intelligent Design” approach – we’re not saying it’s God, it’s just a god-like intelligent designer. Right. To be fair, this is better than concluding UFOs are aliens, but it does not make her approach more serious or her conclusions more solid. She writes... (MORE)

- - - footnote - - -

{*} John Horgan's response to responses to his critique of "skepticism" - May 18, 2016
https://blogs.scientificamerican.com/cro...kepticism/

EXCERPTS: . . . I gave a talk Sunday at the Northeast Conference on Science and Skepticism (NECSS), and then posted the talk here yesterday. [...] My slot was only 30 minutes long, and I wanted to give the audience time to tell me if I had been unfair. I was looking forward to a vigorous debate. But Emcee Jamy Ian Swiss didn’t let me take questions. After I left the stage, Swiss said, “Oops!” He spent the next 10 minutes denouncing me, defending physicist Lawrence Krauss ... Oh well, failed experiment.

Before I got to the door, however, a man who identified himself as a conference speaker grabbed me and apologized for Swiss’s behavior. He didn’t agree with everything I said, but he thanked me for saying it, because the skeptic movement needs shaking up.

In the lobby outside the auditorium, a bunch of people approached me to say pretty much the same thing: Don’t agree with everything you said, but… Several apologized for Swiss’s behavior, and I said I loved it, because he was demonstrating the tribalism I had just criticized.

Then I got the debate I’d hoped for. We argued about… all sorts of things. [...] Skeptics are much more diverse than my critique implied, several informed me. Skeptics constantly debate their priorities, and some express concerns about the same "hard targets" that concern me, such as medical over-testing. ... I left feeling that my experiment wasn’t a failure after all.

[...] Some skeptics are angrily denouncing me, notably physician/skeptics Steve Novella and David Gorski. Both reiterate points I heard at NECSS: Skeptics are more diverse and self-critical than my critique implies... [Other complaints of Novella and Gorski aren’t worth responding to, except for one too important to ignore...(see blog entry)] Unlike the people I spoke to at NECSS, neither Novella nor Gorski give me any credit for raising any reasonable points. They say, essentially: How dare I criticize capital-S Skepticism when I’m so ignorant of it?

[...] Others are a bit more generous. Dan Broadbent ... concedes: “Horgan actually did make some valid points. I often see other Skeptics mocking peddlers of pseudoscience, or even consumers of pseudoscience, then slapping each other on the back with a solid ‘attaboy!’ afterwards. Hell, I’ve even engaged in this type of behavior at times. Essentially what Horgan is saying is that Skeptics have created an echo chamber of self-gratification for ourselves which our target audience (consumers of pseudoscience) ignore.”

Thanks, Dan, for restating my thesis so eloquently. Moreover, biologist/atheist PZ Myers, who has a long, contentious history with skeptics (and so cannot be accused of ignorance), agrees with me about skeptics’ “screwy priorities.” He writes that “skeptics have a peculiar fondness for picking the easiest targets, especially targets that are safely outside the mainstream.” (MORE - details)

Quick question. Why did you edit and remove the portion regarding mammograms?

Quote:Skeptics are more diverse and self-critical than my critique implies, and they—meaning Novella and Gorski, specifically—have addressed problems of mainstream medicine, such as the downside of mammograms.

Dear Skeptics

That something that I didn’t know about. I’ve never heard that before. Do you think that we’re placing undue faith in a screening program that has way too many flaws?

(Jun 3, 2020 10:11 PM)Secular Sanity Wrote: [ -> ]Quick question. Why did you edit and remove the portion regarding mammograms?

Just one of numerous, speedy judgment calls made to keep the excerpt(s) as minimal in size as possible while trying to leave an overall take on what's going on. If a general statement is made about _X_ territory, then that's more likely to be left, whereas the specific details subsumed under it get removed. In this case, all(?) the hither and thither homeopathy-medical-medicine-psychiatric comments were taken out so the latter two paragraphs could be squeezed in.

If, OTOH, the footnote topic was specifically about homeopathy-medical-medicine-psychiatric subject matter rather than the broadness of indicating that Horgan did respond to his critics, then it would/should have been otherwise.

They're hasty, never perfect decisions (inconsistent), and occasionally arbitrary. The more gigantic in size an article or essay is the more that can survive, but ideally it should still be a massive extermination (when possible). Sometimes narrow meat does have to remain because a key bit later on or before is dependent upon such for clarification or meaning.

Quote:

Quote:Skeptics are more diverse and self-critical than my critique implies, and they—meaning Novella and Gorski, specifically—have addressed problems of mainstream medicine, such as the downside of mammograms.

Dear Skeptics

That something that I didn’t know about. I’ve never heard that before. Do you think that we’re placing undue faith in a screening program that has way too many flaws?

The idea of too much exposure to radiation didn't even enter my radar until back when hubby's parents mentioned the ridiculous number of times the physicians had been urging and issuing appointments for his mother for more than just an annual mammogram. OTOH, it's a necessary, delicate balancing act if there's a family risk of that along with additional potential ailments congesting the future.

CT scans that use the contrast dye are murder on the kidneys. Too many of those and hello dialysis machine. (RoboMenu: "Please choose how you wish to die. We can allow the cardiovascular events to happen or repeatedly stop them and bring about renal system failure.")

If taking Metformin for type-2 diabetes, at a certain age that should be substituted with different medication to avoid kidney damage.

(Jun 4, 2020 04:11 AM)C C Wrote: [ -> ]The idea of too much exposure to radiation didn't even enter my radar until back when hubby's parents mentioned the ridiculous number of times the physicians had been urging and issuing appointments for his mother for more than just an annual mammogram. OTOH, it's a necessary, delicate balancing act if there's a family risk of that along with additional potential ailments congesting the future.

It wasn’t the harmful effects of radiation that caught my attention. It was the high level of overdiagnosis and unnecessary treatment.

Quote:The practice of oncology in the United States is in need of a host of reforms and initiatives to mitigate the problem of overdiagnosis and overtreatment of cancer, according to a working group sanctioned by the National Cancer Institute.

Perhaps most dramatically, the group says that a number of premalignant conditions, including ductal carcinoma in situ and high-grade prostatic intraepithelial neoplasia, should no longer be called "cancer."

Instead, the conditions should be labeled something more appropriate, such as indolent lesions of epithelial origin (IDLE), the working group suggests.

"Use of the term 'cancer' should be reserved for describing lesions with a reasonable likelihood of lethal progression if left untreated," write the 3 people who make up the working group — Laura Esserman, MD, MBA, from the University of California at San Francisco; Ian Thompson, MD, from the University of Texas Health Science Center at San Antonio; and Brian Reid, MD, PhD, from the Fred Hutchinson Cancer Research Center in Seattle.

The group was charged with creating recommendations after a National Institutes of Health conference in March 2012.

They make a concrete proposal for change: "A multidisciplinary effort across the pathology, imaging, surgical, advocate, and medical communities could be convened by an independent group (e.g., the Institute of Medicine) to revise the taxonomy of lesions now called cancer and to create reclassification criteria for IDLE conditions."
This change of cancer terminology to reflect validated diagnostic tests that can identify indolent and low-risk lesions is 1 of 5 major reforms proposed by the working group. The scope of these initiatives ranges from cancer screening to cancer prevention.

The reforms are needed because, over the past 30 years or so, cancer screening in the United States has become highly problematic, the group explains.

https://www.medscape.com/viewarticle/808654

And this guy was spot on, I couldn’t find the term pseudo-cancer of the breast either.

Quote:As a histopathologist who participates in the breast screening process, I am alarmed to read that "1 in 4 cancers detected by mammography are pseudocancers.

Rapidly searching my textbooks, I can't find descriptions of pseudocancers of the breast, and I don’t know any pathologist who has made such a diagnosis. Perhaps you need to find a way of saying that 1 in 4 such cancers (which are true cancers) won’t harm the patient during their lifespan.

Before anyone gets too agitated, this is the dilemma at the heart of medical treatment: lots of patients have to be treated for only a few to benefit. The statistics for treatment of hypertension demonstrate this rather well, and if my arithmetic is correct, it would  appear that for every 100 patients with early breast cancer treated with Herceptin only 8 will actually benefit (improvement of disease-free survival in short studies from 77% to 85%).

https://www.bmj.com/rapid-response/2011/...eudocancer

One doctor went as far as to say that cancer should be defined, not only by the appearance of cells under a microscope, but also its behavior such as the symptoms it may cause, or whether or not it spreads and how quickly, or whether or not it kills. If pseudo-cancer or IDLE or whatever you want to call it isn’t going to bother a patient during his or her lifetime, then we shouldn’t look so hard for it in the first place. Less aggressive approaches to screening are an integral part of this.

The US Center for Medical Consumers called our leaflet "the first honest mammography information for women written by health professionals...

(Jun 4, 2020 01:26 PM)Secular Sanity Wrote: [ -> ]

(Jun 4, 2020 04:11 AM)C C Wrote: [ -> ]The idea of too much exposure to radiation didn't even enter my radar until back when hubby's parents mentioned the ridiculous number of times the physicians had been urging and issuing appointments for his mother for more than just an annual mammogram. OTOH, it's a necessary, delicate balancing act if there's a family risk of that along with additional potential ailments congesting the future.

It wasn’t the harmful effects of radiation that caught my attention. It was the high level of overdiagnosis and unnecessary treatment.

Yah, overdoing everything in general is part of the industry's profitable prevention strategy. In addition to gouging medicare and private health insurance.

If you don't have any coverage, hospitals actually charge far less. A self-employed, younger relative recently had extensive back surgery for circa $800 -- cheaper than what it takes to repair a medium-serious automobile problem nowadays. Even with the auxiliary charges from the overall medical team and other items tacked on, he's paying less per year without insurance than with the $400-$600 monthly premium. If he'd take better care of himself than what he does (i.e., dodge serious strings of events in the coming years), then he'd truly be paying less in the long run than his insured parents.

Also, he has type-2 diabetes, so I assume he does need some appointments to get his prescriptions filled -- he can't avoid visiting a clinic except when something's wrong with him. The latter would still be more the than the rate that I visit a doctor, which is virtually nil. EDIT#1: OTOH, I might learn to my dismay that he's not even taking medication. What I actually heard a couple of years ago about such is that he got a device to check his blood sugar after they removed the gallstone that was blocking his pancreatic duct. Not that he's taking pills or shooting insulin. Although that might seem a "duh" that he is, it's still not a done deal with him.

EDIT#2

(Jun 4, 2020 01:26 PM)Secular Sanity Wrote: [ -> ][...] One doctor went as far as to say that cancer should be defined, not only by the appearance of cells under a microscope, but also its behavior such as the symptoms it may cause, or whether or not it spreads and how quickly, or whether or not it kills. If pseudo-cancer or IDLE or whatever you want to call it isn’t going to bother a patient during his or her lifetime, then we shouldn’t look so hard for it in the first place. Less aggressive approaches to screening are an integral part of this.

The US Center for Medical Consumers called our leaflet "the first honest mammography information for women written by health professionals...
{spoiler}***The information women receive when they are invited to attend for screening with mammography is insufficient, one-sided and erroneous. The letters of invitation emphasize the benefits of screening, but they do not describe how many healthy women will experience the most important harms, overdiagnosis and overtreatment.

To be fair (with respect to what I opened with above), it's probably fear of litigation and notoriety as much or more than profit motivation. I recall a small town doctor who got the life and his reputation sued out of him when he failed to detect developing cancer in a patient. So even with reform and better training/educational updating in the system, the aggressive approach to diagnosis and treatment will probably continue to some extent if the consequences are more severe for not doing enough than doing too much.

A reason why I tend to like not having medical insurance is it makes it less likely get such unnecessary or risky treatments as radiological scans.

(Jun 4, 2020 05:44 PM)elte Wrote: [ -> ]A reason why I tend to like not having medical insurance is it makes it less likely get such unnecessary or risky treatments as radiological scans.

Indeed. Earlier in the year I was sicker than Tallulah Bankhead after she spent time at the Garden of Allah in 1933. But I didn't seek medical attention. If it was Hubby's old geezer, I'd knew he'd set another appointment, and another, and then the "let's give you that routine physical check-up you've been sorely missing for _X_ number of eons and discover the plethora of alarming things gradually creeping up on you or already in late stage."

"No thanks, doc." Whatever it was -- cold, flu, coronavirus, allergy problems, etc -- it took me less than three days to near-completely expunge it.

I blame the initial seed of this rogue female solipsism of mine (as those creeps might categorize it) on getting snake-bit twice by copperheads in my younger days and remedying a darkened, grossly swollen foot both times entirely on my own within 36 to 48 hours. (Well, the chest freezer definitely made it possible -- you and I, General Electric).

Those incidents and one aunt whose seeming invincibility and irrational spurning of physicians may have unfortunately rubbed off on me (the latter, not the former). At least I'm fully aware of my insanity and keep my own approaches largely confined to myself and do not knock what experts slash the establishment recommend or condemn as crackpot.

One in ten skeptics probably likewise has something dastardly hypocritical hiding in their closet or writhing with tentacles in their basement. "Personal experience" as they say, trumping statistical inferences from data collections. Private revelations which would be irresponsible to preach to the masses. "What has been succor for me may be peril to thee."

Thomas Paine: "It is a contradiction in terms and ideas, to call anything a revelation that comes to us at second-hand, either verbally or in writing. Revelation is necessarily limited to the first communication -- after this, it is only an account of something which that person says was a revelation made to him; and though he may find himself obliged to believe it, it cannot be incumbent on me to believe it in the same manner; for it was not a revelation made to me..."

Pretty good use of the chest freezer.. Something I could use from Medicine, though without the often necessary subjugation of will, is something like a few pills to take over the course of a couple of days that would turn back my epigenetics to a much earlier state.. Otherwise, medicine usually isn't very helpful to me. A relatively recent incident was being prodded to take daily aspirin with the apparent result being a bad case of tendonosis.

(Jun 4, 2020 09:23 PM)elte Wrote: [ -> ]Pretty good use of the chest freezer..

Very lucky that it was a foot that got injected on both occasions. Didn't have an ice-maker out there, so constantly freezing big blocks of water in what was formerly one-gallon ice cream containers had to suffice. Maybe I've got natural immunity to copperhead venom and even if I had done nothing my horrendous-looking foot would have still returned to almost normal after 2 days. Other "victims" told me it took weeks or a month to fully recover even after hospital treatment, especially if there was significant tissue damage. A guy on the internet once photo documented the progress along his arm and body(?) for days (and weeks?) without seeking any medical attention.

Highly unlikely I'm blessed with innate protection, though, and the DIY treatment (which no one else should ever attempt and rely on) had correlation to the same outcome not just once but twice.

She was a crazy girl, but I wish I still had her ability to memorize things, as well as her tolerance for pain. Now I struggle just to remember what I intended to do thirty seconds ago. And I dread the cold.

Quote:Something I could use from Medicine, though without the often necessary subjugation of will, is something like a few pills to take over the course of a couple of days that would turn back my epigenetics to a much earlier state.. Otherwise, medicine usually isn't very helpful to me. A relatively recent incident was being prodded to take daily aspirin with the apparent result being a bad case of tendonosis.

Can have adverse effects for some. Neighbor seems to skin-bleed from even minor amounts of aspirin.

I expect the opposing studies (below), which claim that aspirin doesn't accelerate macular degeneration, only concern low dose (81 MG) or average dose (325 to 650 MG). Rather than the large amount for back and body pain. So without the latter to use for neck aches with the intensity of migraines, I've given it up altogether for the past couple of months. Taking a 200MG magnesium capsule only when such flares up seems to accomplish the same.

I do similar with heavy dosage 475MG quercetin capsules -- only take them when something respiratory related is coming on, whether allergy or virus. Never daily when all is well. (I know the unreliable supplement peddlers hawk it is as a preventive, but I don't buy that -- I'm pretty sure taking it daily would nuke the effects I experience and expect when needed, if not also have other consequences.)

Well-documented cardiovascular benefits of aspirin outweigh unproven added risk of AMD
https://www.retinalphysician.com/issues/...generation

The AMD, aspirin balancing act
https://www.aoa.org/news/clinical-eye-ca...ancing-act