Using Chess To Understand Medical Research

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Vance917

Medical research is a disaster.  All kinds of tricks are used to give the impression that medications work, when in fact they don't.  How can this be the case?  Well, there are many reasons, not the least of which is the pathetic methods used to evaluate the methodological quality of medical studies.

The Jadad score is a rating scale that is often used to evaluate the methodological quality of randomized clinical trials.  Some very poor trials might, despite their glaring flaws, still obtain a perfect score of five, be accepted and heralded as rigorous, and go on to inform medical policy, even though the results are completely unreliable.

To understand just how deficient the Jadad score is, one might consider as an analogy a Jadad score of chess.  Putting aside Internet chess and looking at chess played over the board, we see immediately that chess players require the arm strength that will enable them to lift the pieces.  They also need the visual acuity to recognize their own pieces and distinguish them from those of their opponent.  Color blind chess players might be at a distinct disadvantage.  Chess players need the eye-hand coordination that will enable them to place pieces on the proper square without knocking down other pieces.  Finally, they need quickness if they are to avoid losing on time.

Putting this all together, a training regimen for chess players might involve lifting weights for arm strength, eye exercises for visual acuity, coordination exercises, and plyometrics for quickness.  The evaluation of a chess player might similarly be based on a five-point Jadad scale that measures 1) the ability of the player to lift a one pound weight 200 times (not many games go beyond 200 moves, and not many pieces weigh more than one pound each); 2) the ability of a chess player to distinguish white from black; 3) the speed with which a player can place a piece on a square in heavy traffic (there are pieces on all adjacent squares) without knocking any other pieces down.

Specifically, a player gets one point for being able to lift a one pound weight 200 times, another point for picking out all 16 white pieces on a randomly arranged chess board with the 32 pieces (16 of each color) arranged in random positions, and a third point for taking less than two seconds to place a piece on a square in heavy traffic without knocking down any other pieces.  Add an extra point if the visual acuity test can be passed without glasses, because this ability confers robustness against such eventualities as heavy fog (outdoor tournaments) or glasses falling off and becoming broken.  Add a fifth point if the piece can be placed in heavy traffic in less than one second without knocking down any others.  The new rating system is to replace the existing one, and shall serve as the basis for selection onto chess teams all over the world.  Players need three or more points to be considered good chess players, and to qualify.

In fact this brave new world exists today.  Medical studies need score only three of five on the real Jadad score to be considered high quality.  You want to keep the invaders out of the building, so you pick five of the many doors, and ask if at least three of them are locked?  If so, then you are content?

DrawMaster

Nice piece, Vance. It's pretty amazing how much bad science is out there masquerading as gospel, mostly made so by either profit or political motives. The politicization of science is my pet peeve. But profit-driven junk science is certainly a contender for 'Bad News for Mankind' as well.

Thanks for the insights.

Vance917

Thank you!  Maybe we should join forces, and clean up this town?

farbror

 

 

”In particular, survival status was updated for all subjects who were alive at last follow-up”

 

THAT  has to be proper science

hater101

i agre with drawmaster

Vance917

Thank you!

Wizard_Esk

Yes, it is like that with animal testing... they don't get a result that they like (for example rats die with such and such drug) so they just alter the testing slightly (test on mice instead) if this then gets a good result, it can be passed as safe for use. And why do they do this, well we all know the reason for that $

Vance917

Tip of the iceburg.  They bury negative studies, spin others to make them look good, cheat in every way imaginable, and then get lauded for saving lives.

Narz

This is why I do not trust medicial statistics.  It's amazing how bad many of the drugs on the market are.  I was given Ritalin for five years from age seven to eleven.  Now scientists have found out it causes brain damage in monkies & increases susceptability towards depression later in life.  Opps!

But don't sweat depression, we've got drugs for that!

This is a subject I'm very passionate about, perscription drugs were a major factor in the death of my best friend, they changed his personality, he gained 70 pounds (at only 5'6" and a naturally skinny kid) & was pretty much the only "support" he got from his psychiatrist.

The best health insurance is clean living, if you do plan to seek drug or invasive treatment I'd suggest doing ALOT of independent research.  From seven to twenty-three I've been on more (legal, perscription, psycoactive) drugs than a small village and I am still recovering.

Vance917

Yes, you are certainly right about all of that, except for one small point.  How can you do independent research when the research is all corrupted?  It's like this.  You are wise not to drink the water handed to you because it is contaminated.  But it is contaminated because the whole damned well is contaminated.  How much better do you do to get your own water?  That takes you out of the frying pan and into the fire.  By the way, I am sorry about your friend, and I hope that you are OK.  I have read some books recently about how difficult it has become to win a settlement even when a link is clear.  Under the guise of tort reform we no longer have any protection against big business.  So buckle up for the ride.  The weather is nasty out there.

Narz

Yeah, well I suppose even supposdely independent research's "independence" is questionable.  It's funny how many otherwise intelligent people will accept as truth something's safety if a "consensus" (which is almost never a real consensus but instead a majority) of research suggests something is safe ignoring any evidence it is as a fluke.  For me if even one study of ten suggests potential hazards my ears are perked.  Of course, as you suggest, even if ten of ten say something is safe doesn't guarentee it is.  I think this country & this world really need to take the precautionary principle to heart.  Out of greed & desperation we shoot (act) first & ask questions later.

I am ok, by the way, thanks for asking.  No one lives forever & I'm grateful for the time I had with my friend (who introduced me to chess in college), he had a lot more problems than just drugs but, like many, he put false hope in them & when he realized they were not working he was made afraid to discontinue them.

Vance917

Prudent avoidance does seem to be the way to go.  But try telling that to a population of chain smokers, heavy drinkers, and consumers of foods known to cause obesity.  Lost cause.

ThePewPewChessGuy
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