The methodolatry of EBM is why @stevennovella and the original crew of @ScienceBasedMed proposed the concept of SBM. Plausibility based on basic science/preclinical data is not enough to demonstrate efficacy but is rather a minimum requirement to justify an RCT. 2/
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On the other hand, implausibility based on basic science that is so extreme as to render a proposition for all intents and purposes impossible (e.g.,
#homeopathy, energy medicine) is enough to rule out the need for a clinical trial to test such propositions. 3/Show this thread -
Indeed, clinical trials of interventions based on extremely implausible mechanisms based on well-established science, so much so as to be functionally indistinguishable from impossible, are inherently unethical. 4/
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Let's put it this way. For
#homeopathy to "work," huge swaths of well-established physics, chemistry, and biology would have to be not just wrong, but spectacularly wrong. Ditto energy medicine. Barring spectacular new evidence, they both may safely be dismissed. 5/Show this thread -
Similarly, modalities based on nonexistent anatomic structures or physiologic functions (e.g., acupuncture meridians, craniosacral therapy) have a level of implausibility almost as great as that of homeopathy. 6/
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Bottom line: Not every bullshit claim based on pseudoscience (e.g.,
#homeopathy again) needs to be tested in an RCT to be safely dismissed. 7/7Show this thread
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