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Quest to eliminate vaccine mandates + EBM is broken but SBM can fix it - C C - Aug 29, 2023

Back to school: The quest to eliminate vaccine mandates
https://pauloffit.substack.com/p/back-to-school-the-quest-to-eliminate

INTRO: In the wake of angry battles against Covid-19 vaccine mandates, resistance to school mandates has grown. According to a recent survey by the Kaiser Family Foundation, 35 percent of parents now oppose school mandates for all vaccines. The pushback against mandates appears to be less about vaccine safety—80 percent of parents believe vaccines are safe and effective—and more about a parent’s right to choose. Because measles is the most contagious of the vaccine-preventable diseases, it will be the first to come back should vaccine rates erode.

The measles vaccine first became available in 1963. At the time, every year in the United States, 3-4 million people would be infected with measles, 48,000 would be hospitalized, and 500 would die. Deaths were primarily caused by pneumonia, severe dehydration, or encephalitis (inflammation of the brain). By the late 1960s, measles vaccination led to a 95 percent drop in the incidence of the disease... (MORE - details)


Evidence-based medicine is broken but science-based medicine can fix it
https://www.acsh.org/news/2023/08/28/evidence-based-medicine-broken-science-based-medicine-can-fix-it-17283

INTRO: America’s Frontline Doctors continue to recommend treatments that have been studied and determined not to work. These anti-vaccine activists threaten public health by continuing to spread misinformation. But, they claim that they are practicing evidence-based medicine. How can they claim that they are practicing within the current paradigm of evidence-based medicine if they are peddling misinformation?

The idea of evidence-based medicine (EBM) has been around since the 1980s, and the term was officially coined in the 1990s. It arose from the realization that medicine was highly dependent upon the individual specific physician and heavily influenced by pharmaceutical companies' marketing...

[...] While this was a well-intentioned step forward in the philosophy and practice of medicine, as is often the case, naïve researchers, bad actors, and ulterior motives have found a way to corrupt this standard of treatment. Given laws of large numbers and how they act, you can find evidence for just about anything. Since the shorthand and practice of evidence-based medicine is often “Is there any evidence at all,” the answer is often yes, regardless of scientific rigor or plausibility.

[...] You can find evidence that ivermectin and hydroxychloroquine are effective treatments and prevention for COVID-19. However, just because evidence exists does not make it good evidence or scientific fact. The good news is we can tweak evidence-based medicine to plug the hole...

[...] Science based medicine (SBM) considers the scientific plausibility of a claim, practice, or product along with what is already known, blending them to assess the plausibility of claims. SBM considers replication, statistical noise, p-hacking, the use of controls, and methodology. Science-based medicine takes us from cherry-picking studies that constitute “evidence” to discounting poorly designed studies that cannot be replicated and may also be scientifically implausible.

Add in the requirement of thoughtful review and consideration of methodologies and statistics, and science-based medicine goes from “there is evidence that hydroxychloroquine is an effective treatment for COVID-19” to “hydroxychloroquine and ivermectin don’t work against COVID-19.” That is the real difference between evidence-based medicine and science-based medicine... (MORE - missing details)