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Insufficient repetition is a huge problem in medical science. There is no incentive to replicate existing studies, as it doesn't advance your career. A related problem is that there is no incentive to publish negative results.

Exactly. Science isn't broken, but it seems that way because the incentives that drive it are wrong. Especially with medical science.

Personally I think medical science and the health care industry are so broken that they should just be rebooted from scratch.

What does that even mean?

It means someone could in theory create a vertically integrated alternative to the entire field of medicine rebooted from the ground up with more modern understandings of things like statistics (e.g. Bayesianism) and more efficient bureaucratic constructs, and it'd probably be considerably better than what we have.

I say in theory because this would cost a rather large fortune and would probably be illegal in most nations, so it's not likely to actually happen.

Well you gotta pinch your doctors nose while inserting a paper clip in his ear and wait thirty seconds. Factory reboot

It means doctors no longer have to wash their hands prior to a trepanning.

You say that like "Science" is a thing. It's not. There is no platonic "science" that exists independently of the human institutions actually doing science. To imagine there is is to make science into a religion.

That's because you're unfortunately incorrect. There is a thing called capital-s Science, distinct from lowercase-s science. The former is a religion, just like you said, and the latter is merely an updating empirical process. The former is what Scott Adams and most other people discussing the article are talking about, and the latter is, hundreds of years later, so banal that it doesn't merit discussion.

"Science isn't broken, but it seems that way because the incentives that drive it are wrong."

Which sounds pretty similar to "science is broken", from an outsider's perspective.

The incentive to publish negative results is: "to not be labelled a charlatan".

The widespread non-publication of negative studies (and, tragically, their datasets) has, rightly, tarnished the validity of all published scientific results.

You can't blame normal people for doubting "scientific" results. It doesn't take a rocket scientist to deduce the worthlessness of published results, when it is disclosed that negative results have been withheld:

Just do studies until you get the results you want, then publish that one.

This has been de rigeur in medical science for some time.

For shame...

> And yet the needle moves forward, slowly.

This is the expected input; candidate scientists are told to only expect to move their field forward by a tiny amount.

The expected output, however, is off the charts. Every time I see one of those "Here's what NASA has contributed to the consumer lifestyle" news pieces, I cringe. There is way too much unhealthy pressure on scientists to say, "well, look what we did!"

The general path of science is much more like a progressive series of "hmmm. HMMM!"s than these astounding chains of discrete discoveries that people are being conditioned to expect. But I guess when money has to pay for science, and tax money to boot, a certain type of person needs the dog and pony show. Bah.

I would also argue that the general public often wants easy fixes and shortcuts.

The basics of nutrition and health are well-known and easy to understand. You can see them in action on The Biggest Loser in prime time on ABC. It's this: eat the basic food groups in moderation, and get enough exercise and sleep. That's it. Every contestant on that show improves their health markedly by following that simple formula.

So I would argue that a lot of people don't want just good nutrition; they want nutrition so good that it can make up for failings in other areas of health. That's a MUCH taller order, and no surprise when it fails.

If no one says anything, then is there any motivation for it to get any better? Is the article is totally wrong or can it be translated into a problem statement whose solution is an improvement? IMO, it is equivalent to a user complaint about a software product. Possibly science researchers would not be the ones to solve the problem, but rather science journalists (I don't know). But still, if the public devalues the results of scientific research due to lack of confidence then that could conceivably result in less funding for scientific endeavors and less scientific progress.

> Is the article is totally wrong or can it be translated into a problem statement whose solution is an improvement?

The article isn't totally wrong, but I think reflects a misunderstanding on how science works, and where the problem actually lies. What the author describes is (generally) science working as intended, but it doesn't mesh well with bite-size news headlines. You can think of it in terms of a leaky abstraction, if you want. People think of science as a relentless progression of improvement, but that's an abstraction that leaks when you react to ideas coming out of it too quickly.

And that is how it works until it gets the public's attention. Then it becomes something else entirely. Once people start looking to "science" for a policy recommendation, the dialogue immediately becomes polarized and extreme.

No one in the public discourse is saying our thinking on vaccinations is being continuously refined. No one is publicly urging caution and moderation in evaluating the risks and benefits, or calling for better longitudinal studies. Instead, on the one had, you have the white house saying "the science is clear," people calling anti-vaxers morons on social media, and on the other side people yelling that its poison pushed by a global conspiracy. Whatever calm, analytic discussions are being held behind closed doors at the NIH, the public discourse has degenerated into a screaming match.

Adam's problem with that is that the pro-science people are screaming just as loudly as their opponents... but they should be the ones that know better! Unfortunately, people of a certain age have seen dogmatic claims from "the scientific community" before, and then seen those claims be overturned and reversed countless times. That's a problem. If you really are "pro-science" you should ALWAYS be couching your recommendations in uncertain terms, but there are lots of demagogues out there doing exactly the opposite.

> And yet the needle moves forward, slowly.

The problem is that it takes giant leaps backwards, too. See the discussion in other comments about margarine, saturated fats, and the links to heart disease. The scientific recommendations that were made promoted the very problem they were trying to address. As others have pointed out, this problem may largely be attributed to misinterpretation and miscommunication (rather than bad science). But since the vast, vast majority of people get their scientific information from schools or media rather than reading papers directly (which isn't a bad thing, since scientific papers are not written for interpretation by non-scientists), that's not a helpful distinction.

It does move backwards. But that's good, too (for science, at least). Sometimes, when people generate hypotheses, and those hypotheses are wrong, they still seem to work when tested. That's just statistics. So someone tried something, it worked, and they reported it. Eventually other people will try it too, and will realize that the original hypothesis was wrong. And thus it gets corrected. But there's no way to avoid that apart from not sharing ideas, and it's vastly preferable to the other option—that wrong ideas never get corrected in the first place.

My takeaway from the article wasn't "science is broken", but "we should be more understanding of people who mistrust science". That interpretation reflects my own biases, of course.

Whether or not that was the author's intention, that's a good takeaway.