> In most other contexts we encounter, stuffing an adjective in there means "NOT".

No, in most contexts in English, modifying a noun with an adjective doesn't invert the meaning of the noun.

A “respiratory infection” is a real infection.

A “premeditated homicide” is a real homicide.

Or, from your post:

A “big part” is a real part.

A “better word” is a real word.

The “scientific method” is a real method.

“Real study” is real study and “real treatment” is real treatment.