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Comment by rscho | Hacker News Reader

> The average medical doctor has next to zero ability to evaluate a study

Yes, but...

> dismissal of any/all critiques by people much more qualified to make these critiques, because "they're not doctors"

... unfortunately, no. While it's true that most MD clinical researchers are depressingly bad, it is also true that pure scientists who never set foot in the clinics are very limited when evaluating practical aspects. So the situation cannot be trivially solved by allowing scientists to do more. In my experience, the problem has no real solution right now and I expect we'll have to wait on technological progress to allow improvements.

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Yeah, this is the really hard part about medical research. At the individual level for those who are really qualified to do it, the incentives lean in favor of practice, where your comp is 4x-10x higher

Exactly, yes, a hundred times yes! This is the major flaw in our system. But I don't see a way of rebalancing to saner priorities. And apparently, neither do our supreme leaders.

Don't get me started on the loans either -- sometimes those incentives aren't just incentives, but necessary outcomes given your financial state exiting med school. I know folks who emerged from residency (where they moonlighted too!) with 500 credit scores and debt that can be described as multiple new Ferraris. They'd laugh at the idea of anything but practice

> it is also true that pure scientists who never set foot in the clinics are very limited when evaluating practical aspects.

Yes, but most medical/epidemiological papers fall over under the lightest methodological scrutiny. Even advanced scientific concepts like "have a control group" is seemingly beyond the analytical capacity of a fair number of MDs. When you get into things like "comparing small effect sizes with confidence intervals", they're positively adrift. We really are talking about table stakes, here.

I'd love to live in a world where MDs were sufficiently knowledgable of experimental design so that domain expertise is the limiting factor, but I can count the number of such papers I've read in the last two years on one hand.

I could write a much longer post on the arrogance of researchers when interpreting medical data or extrapolating lab results into humans...but that's a different subject.

Any books so I can be better interpreting paper? Thanks

How about an example, please.

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