>>> Joe Matthews <[log in to unmask]> 4/10/2006 1:07:07 PM >>>
I think the issue of researching intercessory prayer is an example of
confused epistemologies.
..............................
HM : How true.
I'm reminded of the" trial" of remote intercessory prayer by Leibovici
published in the BMJ a while back.
In response to the confused comments of respondents, he wrote :
EDITOR---The purpose of the article was to ask the following question:
Would you believe in a study that looks methodologically correct but
tests something that is completely out of people's frame (or model) of
the physical world---for example, retroactive intervention or badly
distilled water for asthma?
There are three ways to deal with this question:
(1) To answer in the affirmative. But this leads to such paradoxes
(some described by those who responded to this article1) that it is
incompatible with scientific work or even daily life.
(2) To look for methodological or statistical faults. Here an obvious
one was that the duration of fever and the duration of hospital stay are
related. But what if the next study sports perfect methodology and
statistics?
(3) To deny from the beginning that empirical methods can be applied to
questions that are completely outside the scientific model of the
physical world. Or in a more formal way, if the pre-trial probability is
infinitesimally low, the results of the trial will not really change it,
and the trial should not be performed. This, to my mind, turns the
article into a non-study, although the details provided in the
publication (randomisation done only once, statement of a wish,
analysis, etc) are correct.
The article has nothing to do with religion. I believe that prayer is a
real comfort and help to a believer. I do not believe it should be
tested in controlled trials."
[http://bmj.bmjjournals.com/cgi/content/full/324/7344/1037#resp8]
I'm also reminded of a wonderful essay by Sehon and Stanley
[http://www.biomedcentral.com/1472-6963/3/14] who wrote :
" "But there is also a more fundamental way in which RCTs cannot stand
apart from basic science. Even when a clinical trial returns positive
results in the treatment arm that satisfy tests of statistical
significance, we will have more confidence in these results when they
have some antecedent biological plausibility. Put more generally, we
would suggest that the degree of confidence appropriate for a clinically
tested claim is a function of both the strength of the clinical result
and the claim's antecedent biological plausibility. "
and
"The dependence of RCTs upon the backdrop of basic science is
unsurprising from the Quinean perspective. The point is essentially an
application of the Quinean doctrine of holism, the claim that our
theories are put to the test as whole bodies rather than being tested
sentence by sentence. (Tonelli and Callahan [31] make a similar point
about the need for theory in interpreting empirical results. However,
they suggest that evidence concerning alternative medicine should be
weighed and interpreted in terms of its theory of disease, e.g.,
theories involving undetectable spirit essences or the like. This does
not follow at all. If we are judging the effectiveness of alternative
medicinal therapies, then we evaluate the evidence in light of the
theory about disease that we believe to be true. It would be a silly and
pointless exercise to evaluate evidence in light of a theory we believe
to be false.)"
Sehon and Stanley approach the notion of evidence-based medicine -- and
the place of the randomized controlled trial in it -- from the
perspective of the Quinean [W.V. Quine -philosopher] Web of Belief. It's
(and Quine's small book) well worth reading.
Howard Mann
Univ. of Utah
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