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Re: Statistical question on SSRIs - ADDENDUM » Larry Hoover

Posted by Squiggles on May 15, 2006, at 16:57:28

In reply to Re: Statistical question on SSRIs - ADDENDUM » Squiggles, posted by Larry Hoover on May 15, 2006, at 14:57:10

...........


> Statistical significance is not proof of anything at all. One underlying assumption that never goes to zero is that the results are purely and entirely due to chance.
>
> If you sample a population enough times, you can always find a significant result, no matter how absurd the hypothesis being tested.
>
> Much of the research that has been published is not proof of anything at all.
>
> Lar

Is this an opinion that you hold Larry or
is it one that the medical community and
especially the psychopharmacology community
goes by? Because Dr. Nemeroff (and the others,
e.g. Kessler) in this early 1991 FDA hearing on suicidality and antidepressants, states the following:

"The real issue is how can we, scientifically, as a profession, come to grips with this difficult issue? Clearly, what we need are double-blind placebo-controlled trials. I would like to read a quote from David Kessler, Commissioner Od
the FDA. In his recent article in the New England Journal of Medicine, he said, "scientific rigor requires that data presented during an activity be reliable, that is, capable of
forming an appropriate basis for medical decision making."

Scientifically rigorous data are developed through study designs that minimize bias. Anecdotal evidence and unsupported opinion should play no part in a scientifically rigorous program."


So the issue, then, is what, on the one hand, can we learn from case reports and anecdotal data, and I think it car give us a signal for prospective studies. I remind all of you that the history of medicine is replete with examples of
medical decision making based on anecdotal case reports, to wit, the use of widespread tonsillectomies in all of our
children -- at least not our children, but there are very few people in this room who have tonsils. We have now discovered that that was unnecessary surgery, and how did we discover it? By prospective controlled trials.".....

pp. 201-202

I don't mean to say that I know what scientific
proof is, but it certainly seems that statistical significance is the lingua franca of what is acceptable as scientifically valid today. Even if this method proved nothing, it certainly has a great impact on public health care if it is universally accepted by clinicians and doctors.

Squiggles


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