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I was quite surprised to find that my question "Evidence-based medicine: Is there any evidence to support its use?" sitting at -1. (NB: This question has now been deleted as it wasn't suitable for this SE.)

Mousing over the down-vote button displays a note to the effect that a question should be down-voted if it is:

  • unclear
  • not useful

To me it is both very clear, and a legitimate question. I take that to mean it is a useful question.

Originally the question made mention of 'begging the question'. A user claimed I didn't know what that means. I'm quite certain I understand what 'begging the question' means, having studied post-graduate philosophy at the University of London.

Nonetheless, I removed the sentence with that controversial statement as it had no impact on the question.

I wonder if someone would give some guidance on where I have erred here? If the question is unclear I can attempt to clarify it. If it is not useful, I'd like to know why it isn't.

Thanks.


It should be noted that I now understand what was wrong with the question. I thank everyone for their comments.

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    well, for starters, I am removing all the irrelevant distracting comments talking about whether or not "begging the question" was used correctly. Feel free to flag comments like this for removal in the future, or mod flag the post itself with a description of what you'd like done. – Jeff Atwood May 7 '11 at 9:40
  • OK Jeff. I didn't want to flag a comment just because someone didn't agree with me. That doesn't seem right. I did want to find out how I'd gone wrong though for future reference. I'll be more mindful of flags in the future. I'm very new to skeptics. The only reason I came here today was because there was a semi-orphaned question in audio that seemed to fit the bill. Accordingly, I'm not sure how things work over here. Perhaps my question would be better suited to a medicine or philosophy stack. – user2466 May 7 '11 at 10:04
  • @boehj A single flag does not do anything, it needs multiple flags or a moderator to remove a comment. You can of course flag comments even if they are directed at yourself. – Mad Scientist May 7 '11 at 10:17
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    I think the problem is merely clarity - the question reads like a circular logic question because of the term "evidence-based medicine" is misleading (albeit perfectly correct to a specialist). I've had to read the wikipedia page to actually understand what you meant, but then again, I'm a layman. – Sklivvz May 7 '11 at 10:19
  • I've been trying to insert some quotes from papers in order to make things a bit clearer but I'm struggling with the formatting (referencing). EBM is a bit misleading, I agree. It's been drilled into me for about a decade so I guess I forget that. Anyway, I'm going to nuke the question. I will say though, so far as I know, there's no evidence to support the use of EBM over other ways of practising medicine. Considering the policy (i.e. $$$) implications of this, it's quite surprising. @Jeff Atwood @Fabian @Sklivvz - sorry for wasting your time. – user2466 May 7 '11 at 10:44
  • Shouldn't you nuke this very question too? I clicked on that link and the question was deleted, so people coming here waste time. – Theta30 May 9 '11 at 21:33
  • @Mielu - Sorry for wasting your time too. – user2466 May 10 '11 at 7:43
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    For the record, I subsequently retracted my claim that the phrase was misused. In that retraction, I explained that I'd seen so many bogus usages of "begs the question" that I mistakenly complained about it that time. – Andrew Grimm Jun 5 '11 at 3:45
  • @Andrew: No problemo. – user2466 Jun 5 '11 at 4:02
  • @boehj: I visited that dead link too. You shouldn't now delete this discussion, but remove the link, and make a short note that it is deleted, so that it is mentioned before reading the comments. – user unknown Jun 5 '11 at 6:22
  • @user: OK, will do. – user2466 Jun 5 '11 at 7:16
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You shouldn't worry about a single downvote, users downvote for a variety of reasons, not necessarily only the ones listed in the tool-tip.

One problem I see in that specific question is that the first sentence seems to suggest that before 1992 medicine was practiced without relying on evidence. While there are certainly enough treatments still that are used without adequate evidence, just because the specific term EBM was not used before, does not mean that evidence was not considered.

As Sklivvz said, for someone who doesn't know the term EBM it is not clear that this refers to a specific methodology, not just medicine based on evidence in general.

Another point is the following paragraph

If medical practitioners are to be held to such standards, shouldn't the theory of EBM itself be held to the same standards? That is to say, shouldn't EBM, as a way of practicing medicine, be studied and demonstrated to possess a better risk-benefit ratio than other ways of practicing medicine?

This looks a bit like a rhetorical questions, and it implies that such studies don't exists. This makes the question somewhat "loaded", because it looks like you just want to confirm a preconceived notion. I'm not saying that this is your intention, but it can be read that way and that might cause some users to downvote. Questions here generally do better when they are phrased as objectively as possible. Even if you do have a strong opinion on the subject, it is often better to exclude that from the question, it will lead to better answers and less discussion.

  • I get exactly what you're saying & I thank you for that explanation. For what it's worth, I'm unaware if such studies have been done but they may well have been. The string of questions does look loaded, I admit. I worded it in this way to try get an idea across with as few words as possible. EBM has become dogma very rapidly and it's pushed (if you're in specific circles) as the final goal for medicine. I'm skeptical of many of its claims. One of those is that it has a better risk/benefit picture than other forms of medicine. I'm going to slink back to unix.SE now with my tail b/w my legs. :) – user2466 May 7 '11 at 11:08
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Your question had a few loaded statement. As you deleted it I created a new question that examines the question whether there evidence for evidence-based medicine: Do physicians that use the paradigm of evidence-based medicine achieve better health outcomes for their patients?

  • Thanks Christian. I hope you don't run into the same sort of problems I had. You make one statement that I don't agree with: "In evidence-based medicine every treatment that a doctor prescribes is supposed to be based on a least one controlled placebo blind study." For example, we can't do placebo controlled studies on insulin for insulin-dependent diabetics because the patient given the placebo will soon realize because they'll be dead. And there are other examples too. But anyway, thanks for asking the question. I'm interested to see how it will be answered. – user2466 May 12 '11 at 12:07

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