Article  EPA uses shoddy science + EBM versus SBM in medical school

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The EPA uses shoddy science and the courts to drive activist regulation

INTRO: During his long-overdue testimony before the House Committee on Agriculture in April, Environmental Protection Agency Administrator Michael Regan complained about antipesticide groups tying up his agency’s resources via the courts, but he and his agency only have themselves to blame. The courts are forcing change largely because EPA invites lawsuits — perpetuating its reputation for a lack of scientific integrity in the process.

For years, antipesticide groups have sued EPA in the famously liberal 9th Circuit for allegedly making registration decisions without substantial scientific evidence, which would violate EPA’s mandate under the Federal Insecticide, Fungicide, and Rodenticide Act.

The EPA has been sympathetic to the very activist groups that were suing it, even requesting permission from the courts to “reevaluate” the accuracy of its own work.

The EPA then uses faulty models, outdated data, and junk studies to propose and justify new regulations clearly designed to satisfy antipesticide activists, placate the courts, and play to President Joe Biden’s liberal base — all under the guise of “following the science.” (MORE - details)

Evidence-based medicine vs. basic science in medical school

Last week Dr. Vinay Prasad wrote a Substack arguing that medical students should learn the principles of evidence-based medicine before basic science.This is a recipe for amplifying the main flaw in EBM that science-based medicine was meant to correct, and Dr. Prasad’s arguments would have been right at home on an integrative medicine blog.

EXCERPTS (David Gorski): Since we hit the 15-year anniversary of this blog, I’ve been thinking more about the overall concept of science-based medicine (SBM) as compared to the evidence-based medicine (EBM) [...]

[....] I will also add this caution: EBM is correct that “first principles” in basic science cannot tell you whether a treatment works or not—except for scientifically impossible treatment modalities like homeopathy, that is. Aside from testing treatments that violate multiple well-established laws of physics, RCTs are indeed necessary to determine if a treatment is safe and effective.

It is also true that history is littered with treatments that appeared effective in preclinical in vitro and animal models but failed to pan out in clinical trials, a point that Dr. Prasad alludes to, as you will see, but using an argument that can backfire. However, in contrast, if very well-established basic science tells you that a treatment modality is impossible and cannot work, that (like homeopathy) and would require that multiple well-established laws and theories of chemistry and physics be not just wrong, but spectacularly wrong, in order for it to “work,” then that should be enough. RCTs should not be necessary. Indeed, they would arguably be unethical, because one of the major ethical requirements for clinical trials is that the treatment being tested be grounded in good science based on what is known at the time of the trial, and clinical trials of many alternative medicine modalities (e.g., homeopathy, reflexology, reiki, and more) violate this precept.

Contrary to straw man attacks against SBM, we only ever intended the idea of considering prior plausibility as a way of ruling out impossible treatments like homeopathy without RCTs... (MORE - missing details)

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