Uproar Over Purported Ban at C.D.C. Of Words Like ‘Evidence-Based’
nytimes.com
nytimes.com
* fetus
* transgender
* vulnerable
* entitlement
* diversity
* evidence-based
* science-based
* evidence-based
Unnecessary. Anything the CDC produces better be science based already
* fetus
annoying, but synonymous words exist
* transgender
Are some diseases suddenly targeting people based on their identified sex? If no, the CDC has no business discussing this anyways.
* vulnerable
Subjective words have no place in scientific discourse
* entitlement
* diversity
Political words also have no place in scientific discourse
Evidence-Based Medicine[1] is a particular movement that makes particular claims about what sorts of evidence are better than other sorts of evidence, and how we should (re-)structure clinical practice to revolve around these.
In other words, EBC != evidence-based medicine. It strongly emphasizes large-scale studies at the expense of other types of empirical knowledge, namely the direct clinical experience of the practitioners.
What might be the harm in doing so? Why shouldn't we all rely only on large-scale meta-analyses to guide treatment?
1. There are important clinical questions that are difficult to measure in a double-blind clinical framework; the risk is that we end up optimizing what we can easily measure over what is truly important, the health of the patient.
2. It increasingly risks turning doctors into assembly-line technicians that are only there to take the indicated 'evidence-based' tests and treatments. It takes agency and decisionmaking effectively from the hands of doctors and transfers it to large research bureaucracies, which may or may not be asking the right questions.
It increases the social and informational distance between the patient and the point of decision-making -- which we've seen can have disastrous consequences (for example, in planned economies), when that distance impeded the smooth flow of information.
3. It presupposes the the studies and meta-analyses in the research pipeline are a good decomposition of the current state of medical knowledge. E.g. if there's an analysis that says 'treat a person with diabetes with treatment X', then that approach would work well, regardless of the specifics of the actual patient at the clinical level. Patients don't come cleanly with a single diagnositic label; most people with chronic conditions have more than one, for example.
Note that the methodology and effectiveness of Evidence-Based Medicine has itself not been subjected to rigorous large-scale scientific evaluation; we are literally being asked to take on faith that this particular 'EBC' implementation of evidence-based medicine will be better.
[1] https://en.wikipedia.org/wiki/Evidence-based_medicine#Limita...
Note: I know this is just for budget note but it's not a great direction.
While perhaps belying the name, the CDC's mandate is broader than only disease, it's general public health, including, among many things, occupational safety and injury prevention. Anything which may lead too injury or death can be considered under their purview.
I think you're mistaking the charter and purpose of the CDC.
Controlling disease has plenty of hard science -- but much of it is messy and full of human factors. That's what those words represent.
Wait crap my statement was too political and subjective
> "Are some diseases suddenly targeting people based on their identified sex? If no, the CDC has no business discussing this anyways."
One study the CDC works on is HIV within transgender communities. Tell me how that isn't within their scope to look at. What about any other public health issues that are more concentrated within transgender individuals? Can they not study that and try to figure out what is causing it and if things can be done?
economics drives everything. we need a different incentive structure for news, and the readers are probably the only ones that can effect change.
It seems like the journalist should have worked to get a recording or at least multiple sources.
Fortunately, there are many ways to get hard copy / digital copy without traceability (eg, Wikileaks but not Reality Winner).
I think the bigger risk is that the source is wrong. Being able to confirm with multiple sources isn’t just about proving yourself as a journalist, but about verifying the story.
I look forward to the follow up stories to confirm or deny what this is about.
Like I said, HHS already has statements saying “that didn’t happen like that” so it’s an issue of HHS credibility vs. New York Times. Having better sources would remove this question.
And unlike the tech industry, people in these positions don't job-hop constantly.
They want the public to know about this [I can think of many unfavorable adjectives] behavior. But they don't want to lose their careers, put their families at economic risk, etc.
Acting as (responsible) intermediary in such circumstances is a time-honored and proven role of journalism, in the U.S. and other countries.
P.S. I'll add that the U.S. scientific community had a good, close look at such behavior as a preview, in the neighboring country of Canada under the Harper government.
To the point where they were collaborating with Canadian scientists to back up data before the Harper government erased it.
They are not merely reacting emotionally. They've seen Conservatives' (on either side of the border) play book for this for nigh on a decade, at least.
As I understand it, the journalists have been supplied with copies of the specific document(s).
They can then ask the relevant administration whether the document is genuine.
If the adminsitration does not deny the legitimacy of the document, there's your proof. (These are not classified documents. There's no "we can't respond" cover for them, in this case.)
This is also a common journalistic practice.
I'd also expect them to pursue multiple sourcing for the story. Although, with the document(s) at hand, and the course I described possible, that's not strictly necessary.
P.S. I'll add that, more broadly, document sharing is not without risk. The government as well as private entities have taken to distributing "marked" documents that can be tracked back to original recipients. Not in all nor anything like the majority of cases. Just some specific ones.
That marking can be overt, or covert. The latter case can include slight variations in content that, particularly if someone has only one exemplar, can be difficult to detect and at best only suspected.
Anyway... speaking VERY generally, a central if sometimes unspoken role of ANY organization is mitigating risk to its participants.
I would not expect anything different from journalism. I would not expect people to take on unnecessary risk. When people name themselves in such circumstances, it's to accomplish something additional. That doesn't seem to be needed, here. I don't see much reasoned doubt of the story, and I've yet to see a denial from "the government".
Ok, too much caffeine, here. Sorry for my runaway keyboard.
P.P.S. I can't yet reply to your reply, but I wanted to say, "fair enough".
With the caveat I already added, above -- apparently, while you were replying -- that original documents sometimes have to be presented in an information-retaining representation, where overt or covert marking may betray the source.
(For example, the woman in Georgia who landed in jail... this past year or so. Win-something or other? The press didn't screen the documents she provided, and they were readily traced back to her. Then apparently corroborated by FBI using system access logs. Apparently, because at the time I last read about it, methodologies were not being confirmed.)