Research shows research doesn't matter

Research shows research doesn't matter

Do the facts matter? 

When Beliefs and Facts Collide, an opinion piece by Brendan Nyhan published over the weekend in the NY Times, thinks not, not when it interferes with identity issues, like religion and politics.  Dismayed scientists have concluded from this that more education is in order. If people just knew the facts! But according to a new study from Yale, cited by Mr. Nyhan, facts don't matter. The study concludes

that the divide over belief in evolution between more and less religious people is wider among people who otherwise show familiarity with math and science, which suggests that the problem isn’t a lack of information. When he instead tested whether respondents knew the theory of evolution, omitting mention of belief, there was virtually no difference between more and less religious people with high scientific familiarity. In other words, religious people knew the science; they just weren’t willing to say that they believed in it. 

According to Mr. Nyhan, this helps explain why he and his colleagues have found that 

factual and scientific evidence is often ineffective at reducing misperceptions . . . .

Tell us about it!  If he thinks it's difficult with issues like health care reform (another stubborn issue he mentions), he should try CAM beliefs. 

What to do?  Mr. Nyhan suggests we need to

break the association between identity and factual beliefs on high-profile issues -- for instance, by making clear that you can belief in human-induced climate change and still be a conservative Republican like former Representative Bob Inglis or an evangelican Christian  like the climate scientists Katharine Hayhoe.  

He also says we should reduce the incentives for "elites to spread misinformation to their followers in the first place" because "once cultural and political views get tied up in their factual beliefs, it's very difficult to undo."  

CAM is a perfect example of this disconnect between the evidence and beliefs. And NCCAM is Exhibit A in demonstrating (at taxpayer expense) that the facts don't matter.  The millions of dollars spent on CAM research by NCCAM hasn't turned up a single treatment worthy of use.  And I don't know of a single instance where research concluding that a treatment is ineffective changed a CAM provider's practice one whit.  

I wish it were only an issue of untangling the belief system and the facts, hard as that is.  That might be possible where the believers and the scientists are at odds in their view of the facts.  There it might be possible to show the believers that the facts and the beliefs aren't irreconcilable. It might even be possible  with some CAM proponents. Perhaps they could be convinced that their beliefs in, say, in all things "natural" doesn't mean the evidence isn't important.  You can have your dietary supplement and vitamin (in some cases, at least) and science-based medicine too. 

But in CAM, the believers and the scientists are sometimes the same people.  It's called "integrative medicine."  With issues like climate change, vaccination and evolution, the opposition is purely belief-based.  The "scientists" on the wrong side are mostly cranks and you may have a chance of disentangling belief and facts.  With integrative medicine, elite institutions are peddling the pseudoscience, making it look like CAM really is backed by science.  

None other than NCCAM itself recently took integrative medicine to task for being slackers in the research department.  In a very politely worded, but nevertheless pointed, musing on her trip to the International Research Congress on Integrative Medicine and Health  meeting in Miami, Emmeline Edwards, Ph.D., Director, Division of Extramural Research, lectured the participants on the qualities of good research, which she found lacking.  Dr. Edwards urged integrative medicine researchers to strive for

research that is conducted at the appropriate stage based on current evidence; research that is statistically powered to assess clinically meaningful outcomes (when the evidence base is sufficient to support an efficacy trial); and research that proposes realistic timeframes and budgets and test hypotheses that will guide future research. We want to encourage our investigators to give strong consideration to the strength and quality of their preliminary data, the appropriateness of the proposed methods to answer their stated hypotheses, the feasibility of a clinical trial as designed, and the potential impact of trial outcome to shape future studies.

Save your breath, Dr. Edwards.  Integrative medicine isn't interested in prior plausibility or properly powered studies and the like.  If they were, they wouldn't be offering patients treatments that have no basis in reality and have already been proven ineffective. (I'll go into Dr. Edwards's comments, as well as the research that provoked it, in greater detail in my Thursday post on Science-Based Medicine.)

Mr. Nyhan concludes his opinion piece with this observation:

Unfortunately, knowing what scientists think is ultimately no substitute for actually believing it. 

True enough. But what if the public thinks it knows what scientists think when, in actuality, the scientists are the believers, what chance do we have of changing anyone's mind?



















Points of Interest 7/7/2014
Hold the Mayo

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