Belief in research

I was discussing some things on a blog I used to read with some people a few weeks ago. Someone brought up the idea that formula fed, or I suppose bottle fed, babies over eat. Which, you know is possible, but not something an attentive parent necessarily does. I pointed out that babies suffering from reflux, whether they be breast or formula fed will frequently overeat to soothe their throat. And that tongue ties can exacerbate (as in make worse, as that is the meaning of that word right?) reflux. And that tongue tied babies often end up being bottle fed due to lack of correct diagnoses… But I got called to task for saying that tongue tie ’caused’ reflux. Which is not what I said, and then for not providing studies on that. I dutifully provided a few papers and proceedings that referenced reflux being a symptom of untreated tongue tie, but I suppose that wasn’t appropriate or strong enough evidence. Or something, as I’ve now not had any of my further comments on other topics published on the blog. Makes me wonder exactly what I’m being censored over there. Fair enough, perhaps they don’t like me (I suspect people often don’t), but it seems a bit ridiculous. To me it seems like an appropriate place for anecdotal evidence. To me it seems a bit like if you say people with colds often have runny noses. Yes, observed, often anecdotal, and of course since colds are much more studied than tongue tie we know that runny noses are caused by a variety of things and that a cold does not always have a runny nose, and that runny noses can, in fact, happen independently of colds as well. But I can’t think I’ve seen a study talking about the relation of runny noses to colds because it’s something most people have seen enough of to know, ok, yes this can go with that, often but not always, and so on. Also, because we see colds and runny noses from them so often it seems moronic to do such a study because we know that they can, and often do, go together.

At the time I pointed out that studies are difficult to do on tongue tie since even experts have a hard time agreeing on diagnoses. I’ve also heard that doctors can be reluctant to do much about reflux as well. So you kind of have a double whammy of suck there. Regardless, there’s certainly nothing I’ve seen taking a statistically significant number of babies with both reflux and tongue tie (what classification of tongue tie?) and cutting the frenulua (was it done deeply enough? Does that have significance in soothing the problem?) and measuring the severity of the reflux before and after (how do you do that? Count the number of vomiting instances in a 24 hour period? What if it’s silent reflux?). The idea that there are NOT such studies is apparently more satisfying to some people than observations from someone who works with such issues on a daily basis (not me, but one of the articles I provided as evidence). Sure it would be an interesting study to people who care about and deal with those issues, but who’s paying?

I think for some things it’s easy to be over-reliant on published evidence. It hardly seems appropriate to discount the existence of something because there are no popular studies on it. You have to balance that with realizing how studies are designed, funded and carried out. It’s easy to pick apart studies for not taking into account various correlating factors, having confirmation bias and similar, and there are some truly badly designed studies out there. From my molecular biology point of view human health studies are messy and flawed even when they are done well. I understand the reason for it; you can’t do some of the things to people that you’d need to do to have a decent scientific control.

Now, on the other hand I’m not a huge fan of anecdotes as evidence. Mainly as anecdotes often come from someone untrained in what they are extemporizing on and are frequently used to justify doing something that studies and statistical analysis thereof have told us is not necessarily typical. A sort of  ‘nyah nyah nyah take that statistics’. An anecdote by definition is an isolated example. It progresses to an observation or an interesting correlation when the examples are no longer isolated and made by someone who sees a lot of examples. It’s an untested hypothesis at that stage, but just because it is untested does not mean it doesn’t have grounding in strong observation. From there you’d obviously need sponsorship or funding to progress to an actual research article. Probably sloppy language is to blame here somewhere. People can have wild suppositions with no grounding, call them theories (when a theory is really a highly tested hypothesis) and thus lend faux credibility to their imaginings.

Further compounding this is when accurate correlations are noticed by those with otherwise inaccurate suppositions. In short it’s possible to be wrong and right. Just because someone believes the sky is pink, grass is green and rocks are hard does not make them wrong about the grass and the rocks, only the sky. If you are discriminating you can believe some things and not others. It doesn’t have to be all or nothing.

This really goes both ways. Illogic is an equal opportunity employer. And of course things always seem stronger when whatever you are espousing backs up what you want to believe. Sometimes enough to fudge things into to going your way.

One thing that’s annoyed me for years is the insistence that various things are untested. Often coupled with the addendum that the government (or some other entity), by releasing the untested item, is engaging in a conspiracy of some sort to test something on the unsuspecting public. They may indeed be releasing something on the unsuspecting public, but ‘finding out what happens’ is certainly not the goal. It’s often more along the lines, of ‘I hope nothing happens so I can keep my job and this money’. The thing about conspiracies is that generally what looks like a conspiracy is actually a series of incompetent mishaps, and if it is actually some kind of conspiracy (more likely to be a high flow of money from private interests/lobbyists with low public coverage) it’s nearly always profit driven.

One thing regarding this I run into a lot is that something isn’t tested on pregnant women. Well, no. What do these people expect, that some pregnant women are going to be rounded up and subjected to whatever treatment for the benefit of those in the developed world? Of course not! Studies of things on pregnant and breastfeeding women are most often done on an observational and situational basis. Write ups by doctors or other professionals of a group whose care providers decided the treatment, for them, outweighed the risks of the unknown. Observational studies don’t always lend themselves to statistical analysis, because they are just published accounts of professional observations. Sure, statistics will be applied to it to make it more interesting, and conclusions drawn on what it all means, but as we all know since it was observational it wasn’t designed, so naturally there are confounding factors. Well, I guess the problem is that we don’t all know that. And we, as well as policy makers, take these written observations as ultimate truth, when all they are is simply case studies.

The biggest problem with this is that most people are not scientifically minded. They aren’t ok with maybe being wrong. They get all emotionally invested in their beliefs. All you can really do is realize that things are not one-size-fits-all and make educated guesses based on your personal situation.