Steve, I'm a little disappointed in this essay, to be honest. What you seem to be saying is "it's too hard to tell the worthwhile studies from the studies that are powered by bias and agenda, so I'm not going to bother differentiating and just scotch the lot", and I don't really think that's a useful way to think about the subject. There's genuine, worthwhile research going on in all sorts of areas - but it gets misrepresented by the press, and it is hard to tell the actual research from the agenda-driven research unless you know what you're looking for.
For instance, you might see, say, a headline or a popular book that says "smoking is bad for you!", and at this point the largely correct response is to say "well, duh". But that doesn't mean that there isn't value in the continued study of the effects of smoking tobacco (and other drugs), and that doesn't mean that that's what the studies actually say. It might well be that the study actually correlated the use of drugs, including smoking tobacco, with increasingly anti-social behavior (as did a study I co-authored a few years ago) - but the author of the article about the study probably isn't getting or registering all of the detail. He just knows that yet another group of doctors is saying that smoking has bad effects. Just as KeithHandy points out, the press misrepresents the actual findings all the time, because the people who are reporting the findings in the press very often don't actually understand what the findings mean - they're trained as journalists, not epidemiologists.
That's not to say that there aren't some facile studies out there - but the facile studies usually are the ones funded and led by someone with an agenda. Unfortunately, it's often hard to tell who's being funded by what agency unless you read the full text of the study itself; most journals require the authors of a paper to disclose the source of their funding. Even then, it can be difficult, because you run into a "which came first?" problem - did the source ask the investigators to run a study, or did the investigators get an idea for a study and ask for funding? Unfortunately, there isn't a good way to determine that, although you can often tell from the wording of the study. (If the study presents the findings as a fait accompli, for example, you can be pretty sure that there's an agenda in play.)
Anyway. The point I'm trying to make is that by dismissing all health studies as worthless, you're throwing the baby out with the bathwater. If you're okay with that, then go for it - but I suspect that you of all people appreciate the wisdom in knowing what you're throwing away. :)
Two more comments. First, I'm currently participating in an investigation concerning the relationship between medical error and injury or death in the severely mentally ill (specifically, misdiagnosis because of the mental illness). If you'd like, I'll point you to the article when we get it published. :)
Second, your comment about the auto mechanic seems a little off to me. If a human being had designed my body, I'd expect my doctor to be able to say "yeah, I know what that is" every time. ;) But in all honesty, we really don't know everything there is to know about how and why people work, whereas we really do know how and why cars work, so comparing a doctor to an auto mechanic isn't really fair. ;) (Then again, I've had experiences with mechanics who made really serious errors - like the guy who replaced my alternator belt and then forgot to bolt the alternator back onto the rest of the engine...) |