I want to upvote this thing so hard.
ancientcampus
Karma: 373
I agree that Occam’s razor is clearly the answer, clearly what was missing to support the George Hypothesis. I didn’t mention it in the original post because I can’t really quantify what is meant by that, and it kind of felt like a thought-stopper. 2 important questions:
1) When/how/under what conditions would you consider Occam’s razor satisfied in this example? (Feel free to add onto the fictional scenario). What if giants really did exist (though were few in number), and the tribe had seen one as recently as 20 years ago? [In this example, the earthquake is still caused by plate tectonics, not giants, but the tribe has never heard of such things.]
2) Is it ever acceptable to take on a belief like this, even if you’re not sure it satisfies Occam’s razor? Remember—the belief is USEFUL to these people—over the next 200 years it allows them to make apparently accurate predictions about the future (that the rumblings will continue sporadically, as opposed to being a 1-time thing)
Real-world analogies:
-Shminux mentioned neutrinos—GREAT example (link to his comment: http://tinyurl.com/97tkabf); as we CAN detect those nowadays, but at the time most folk couldn’t think of a good test to confirm/deny it.
-”Gravitons” spring to my mind—I don’t remember much quantum physics from undergrad, so I’m not on a position to judge, but in my ignorant opinion they seem like a very similar scenario—fit with the model of quantum physics, not much evidence against the idea, potentially useful, but not a lot of actual evidence (empirical or otherwise). (Would the Higgs Boson be a better metaphor?)
Sometimes, it works really well for me, other times it doesn’t. Which is kind of my base-line, so my results are “not enough data yet” I guess. I intend to try it for a while longer.
Suggestion: if slacking off while you intendet to work is a problem for you (like it is for me), keep the pomodoro checklist in a google doc, share it with a few people, and record any slacking-off you do.
At risk of getting shunned: I read a list of predictions in the Old Testament/Tanakh about the Jewish messiah that are said to be fulfilled by Jesus. They’re… awfully specific. And numerous. On matters of common historical fact, that couldn’t be orchestrated by him or faked by his supporters.
...so now I have to reconsider my rejection of theism. :\
Re: talking about problems in the biochemistry field in general:
I’m sure that there are lots of problems, and I don’t mean to invalidate anyone’s points, but on the bright side, genetic sequencing has been getting faster and cheaper FASTER than moore’s law predicts. http://www.forbes.com/sites/techonomy/2012/01/12/dna-sequencing-is-now-improving-faster-than-moores-law/
We’re ALMOST to the point where we do full-genome sequencing on a tumor biopsy to adjust a patient’s chemo drugs. The results unfortunately haven’t been reproducible yet, so it’s not quite ready for clinical practice, but by golly we’re close. It currently costs about $4,000 per genome, and we’re less than 10 years after the Human Genome Project which was 13 years and 3 billion dollars for a single genome. One company claims its soon-to-be-released machine will do it in 4-5 days for $900.
“I think you accidentally a word here or something.”—whoops! Thanks.
Re: “i.e.” Wow, thanks! I never knew that. Mind = blown.
True, the example I gave didn’t specifically illustrate any particular bias. However, I think there was a little bit of anchoring and confirmation bias involved. He expected to see an alcohol-OD patient. He saw a lot of symptoms that fit the diagnosis. I don’t know her specific case, if there were symptoms he missed or disregarded, but it’s probably a safe assumption.
The thing is—yes, alcoholism is the most likely hypothesis. However, anyone could say that alcoholism was the most likely hypothesis; it’s the doctor’s job to also consider the unlikely ones (especially the potentially fatal ones). That concept gets drilled into our head constantly over here. You’re right—“pretending it’s the worst-case-scenario” is wrong, but seriously considering the worst-case scenario is essential. A CT would have been wrong, but there are other tests (i.e. finding problems with one side of the body but not the other is a dead-giveaway).
I don’t want to rag on this doc—this patient was coming from a party, and I don’t know if her specific case could easily be distinguished from excessive alcohol use. But it did help drive home the importance to keep my eyes open.
The list I have is far from perfect, but there’s enough to not dismiss out of hand.
All the predictions are from the Hebrew Bible / Old Testament. The fulfillments are all in the New Testament. Many of them could be fictions added to the New Testament, but that looks doubtful for several of them—Jesus was a pretty public figure (we have Roman texts talking about the near-revolution of the Jews and the Christians), and a lot of the the fulfilments would be matters of public record / knowledge (like some specifics from his manner of death and burial). I still want to analyze each part, and I plan to compile a “short-list” of the ones that hold up (i.e. ones that would be improbable to be fictionalized or deliberately orchestrated by Jesus himself).
Fair point, though the line’s pretty blurry in “biotechnology”. (Typo: I meant “biotechnolgy” instead of “biochemistry”). What I mean is that people are complaining that the field is doing a lot of “quick-fix” solutions to problems, and I’m saying—“hey, some of those ‘quick-fixes’ look pretty promising.”
Good question, To make a list of criteria for what is “reasonable threshold” for each disease, given each symptom, and each test, such a thing would probably be more trouble than it’s worth for the simple in-the-room tests, but I’m sure they exist for expensive/harmful things like biopsies or CT scans. In this case, I think the presentation exceeds the threshold to consider a stroke, but not enough to do costly tests.
In general, we’re drilled with the general algorithm: 1) a long list of “triggers” that says, “if you see this/these symptom(s), you should immediately put dangerous diseases X, Y, and Z on your differential.” e.g. disorientation and slurred speech, the word “stroke” should AT LEAST enter your mind temporarily. 2) Then, rule-out X Y and Z with cheap and easy tests, which is usually something like: Y and Z are unlikely because he lacks (certain other traits or symptoms) I can rule out X with a quick check, like a 2-minute neurological exam. 3) Think horses, not zebras.
A fair point! Some of those “predictions” only look like predictions in retrospect, i.e. the ones in Psalms. Others are blatantly prophetic, and I think constitute a falsifiable test IF the text was written before Jesus’ time and IF it appears to be a true historical fact and not fabricated by the New-Testament author. (The second one is the big “if” in the equation.)
How so? I’d like to avoid such a fate if possible. (I will agree that, as a constantly changing field, many things doctors learn is later disproven. ACE inhibitors use to be contraindicated in congestive heart failure, but now they’re first line. That’s not so much irrationality, though, but a lack of data.)
Yep! Specifically, in a patient who is constantly aspirating food (say, someone who’s throat muscles are messed up), sometimes remodeling occurs that blocks off a section of the lung, making an air-free area.
The problem is, if someone, say, has a seizure and inhales their own vomit (one time), some doctors might give antibiotics that specifically target anaerobes (as they were trained to), but they really shouldn’t, and there isn’t even any research saying that they should.
No offense, but they’re not. The NIH article lists various types of aspiration pneumonia. To quote directly from my textbook, “Robbins Basic Pathology”:
“Although it is commonly assumed that anaerobic bacteria predominate, recent studies implicate aerobes more commonly than anaerobes”.
(Reliability of the source: “Robbins Patholgy” is like the Grey’s Anatomy of pathology. Robbins Basic Pathology is the mildly abridged version.)
(According to my professor, this was just assumed, but there weren’t any studies supporting that assumption.)
You’re right about the abscesses, hence my statement, “In reality it takes frequent aspirations over a long period of time to block off an area of the lungs.” However, one aspiration usually won’t cause such a scenario.
Shhh. My school administration might hear you!
Yes. Aspiration pneumonia is any pneumonia caused by aspirating fluids or solids. Anaerobic pneumonia is pneumonia caused by an infection of anaerobic bacteria.
I do not know of any anaerobic pneumonia that is not brought on by aspirating something, but there definitely are aspiration pneumonias that aren’t anaerobic pneumonias, such as the vomit example I gave in my above comment.
Thank you for this concise summary. I would not have finished his essay otherwise. :) (That’s actually my complaint about a lot of the sequences here, too.)
Woah, nice, thanks for all that research! Yeah, it looks pretty much just how you described it. So, my statement, “no research backs it up” was wrong—there was research in the 70s and 80s that DID indicate it, so there WAS evidence. Thus, this is a case of “Old ideas in the process of getting overturned… maybe” and not “people doing it without science backing it up”.
I don’t have access to UpToDate here (because they recently skyrocketed their prices so my school is switching), so I only read emedicine.
EDIT: I can only read the abstracts, and nothing from the 70s article, so this input is limited. That said, the 80s article seemed to look at all aspiration pneumonias (most of which was are caused by chronic aspiration), while my professor’s point was specifically about one-time aspiration (i.e. aspirating vomit). I did not make that distinction clear in my OP. So, you’re right, though I wanted to defend my professor, because I think his point might still stand, though my post did not present the full story. I’d look more into the research, but I probably won’t find the time. Yvain’s a real trooper for wading through all those articles.
Huh, I’m surprised that I’m not at all the first lurker to make an account just for this.