X-Message-Number: 11320
Date: Thu, 25 Feb 1999 21:58:21 EST
Subject: Again, anecdotes & studies

By private email I have comments of a certain doctor regarding remarks I
recently made on Cryonet about MSM, DMSO, and anecdotal evidence. The
medico makes some good points, including:  

1. Web sites devoted to MSM and DMSO offer very little information, only
snakeoil. (I haven't looked; I have only reported some of what is in the
Jacob/Lawrence/Zucker book.)  

2. Dr. Jacob wrote an article for the NY Academy of Sciences which lacked
precision, for example saying that MSM helps "lung dysfunction," which is
so vague as to be meaningless. A plausible mechanism of action is also
lacking, with scavenging of free radicals not an adequate explanation. (I
haven't seen the article.)  

3. LD-50 can be a very misleading indicator of adverse effect. Lethality
is not the only question; and results vary among species--sometimes
dramatically even from rats to mice.  

He also makes one statement I find much too broad, viz., that "*any*
compound with major clinical effects will also have major side-effects." I
can think of many compounds that have fairly dramatic effects as intended,
but few if any adverse side effects--e.g. water for someone dehydrated,
milk of magnesia for the constipated, vitamin C for scurvy,..a long list.

But my main disagreement is with his comments on anecdotal evidence vs.
"scientific" studies.  

First--as he apparently didn't notice--I understand the possible traps of
anecdotal evidence, and specifically said it must be treated warily.  

Second, he did not come to grips with my observation that EVERY serious
investigation of therapies or medications MUST begin with isolated
observations or mere ideas. Full-blown studies are NEVER undertaken unless
there is enough preliminary evidence--usually including observations or
anecdotes--to justify the effort and expense.  

Third, he did not acknowledge that most physicians take seriously the
reports of their patients--and these, after all, are mere "anecdotes." For
that matter, the individual observations of physicians, examining their
patients, are only "anecdotes"--even if the observations are perfectly
clear and objective, such as the presence or absence of a pronounced rash.
If I wanted to get sarcastic, I might say that, presumably, if a patient's
report were at odds with conclusions of a scientific study, he would
ignore the patient's report; and if the testimony of his own eyes were at
variance with the study, he would ignore what he saw.  

Fourth, not all "scientific" studies are by any means all that scientific.
Notoriously, different studies not infrequently draw different or even
opposite conclusions. A "scientific study" might have all the trappings of
exquisite sophistication, yet blunder badly.  

As just one category of misleading results, a large study might show no
correlation of a medication with a result (positive or negative), simply
because people vary--like the famous statistician who drowned in the deep
end of a swimming pool that averaged only 4 feet deep. With luck, of
course, we will get measures of variance, or a bimodal or multimodal
graph, that will alert us to the hidden information, but we can't always
count on that.  

I also remember, from many years back, looking at a slew of studies
purportedly refuting the claims of Linus Pauling for vitamin C for colds.
Not one of them used doses anywhere near those recommended by Pauling!
Neither did they discriminate for promptness of use.  

(In my personal experience, over many years and many instances, vitamin C
works wonderfully to suppress colds--if taken in heavy doses at the first
hint of illness. And I do not respond to placebos; sometimes I don't even
respond to standard medications with FDA-endorsed efficacy.)  

In sum: Not all anecdotes are created equal, nor all "scientific" studies.
Life isn't that simple.  

Robert Ettinger Cryonics Institute Immortalist Society

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