The Fallacy Of Relying On Anecdotes In Medicine

[HuckleB]

http://getbetterhealth.com/the-fallacy-of-relying-on-anecdotes-in-medicine/2012.01.06

"...

Gawler decided to embark on an alternative treatment regimen, involving coffee enemas, a vegetarian diet, and meditation. Eventually he was completely cured of his terminal metastatic cancer. He has since become Australia’s most famous cancer survivor, promoting his alternative approach to cancer treatment, has published five books, and now runs the Gawler Foundation.

At least, that is the story he believes. There is one major problem with this medical tale, however – while the original cancer was confirmed by biopsy, the subsequent lesions were not. His oncologist at the time, Dr. John Doyle, assumed the new lesions were metastatic disease and never performed a biopsy. It was highly probable – the timing and the location of the new lumps following a highly aggressive cancer. But even a diagnosis that is 95% likely will be wrong in 1 patient out of 20 – which means a working physician will have patients with the 5% diagnosis about once a week. The standard of practice today would be to do a biopsy to get tissue confirmation of the diagnosis, and rule out the less likely alternatives.

...

Gawler has believed for the last three decades that diet and meditation can cure cancer. He has spent that time writing books and promoting his personal story, convincing many others of his beliefs. While he may mean well, the far better course of action would have been to study the hypotheses that stemmed from his dramatic experience, not to conclude that he must be correct and proceed with premature conviction. That is the difference between a crank and a scientist.

In medicine well-meaning (and not-so-well-meaning, for that matter) cranks can do a lot of harm. It’s good to see mainstream doctors recognizing the risk and doing something about it."


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A nice illustration of this common fallacy.

[EvolveOrConvolve]

1. What's ironic

is that Gawler, through his "well-meaning" advise, may actually be killing people. (I used quotes around "well-meaning" because at this point he's making a pile of money through his "cures&quot

At what point does something like this become criminal?

[HuckleB]

2. That's a difficult to answer.

However, it does seem like it's a question that should be explored at length.

[Warpy]

3. Then again, some cancers might be best treated with palliative care

which would provide the best quality and length of survival.

The problem with Gawler is that he had one of those freakish reversals of disease people in the medical profession see from time to time. He then assumed that he'd been doing all the right things and, with messianic zeal, set forth to teach everyone else what he'd done, assuming they'd also survive as he had. His lack of knowledge of evidence based medicine also contributed to the relative lack of care he received: the lack of followup on the initial biopsy was criminal. Whatever he had, and it might not have been neoplasm, just benign tumors, disappeared. He thought he'd done that himself.

Two years ago, I was in stage III renal failure. It has since reversed, giving me the chronic renal insufficiency I've had all my life. My rheumatologist would love to know what I did to reverse it. Certainly, I watched my diet and meditated, but it was the same thing I'd been doing when I went into failure. I don't have the conceit that anything I did fixed my kidneys. However, had I not been in the field, I might have been tempted to crow that living the way I always lived was some sort of miraculous cure that could save the suffering multitudes.

I'm sure people at the Gawler Center are pampered and petted and, minus the coffee enemas, kept as comfortable as possible. With some aggressive cancers, that's probably a very good idea and very likely contributes to longevity as well as quality of life. However, promoting that stuff as a cure is what reduces it to quackery.