The earliest example of a cumulative meta-analysis is from 1981, in a paper which looked at the routine use of antibiotics during surgery to prevent infection. They showed, by doing a cumulative meta-analysis, that research had continued to be done for years after antibiotics had been shown to be effective, not only at preventing infections during operations, but also in reducing the death rate afterwards. Because this was missed, thousands of patients were randomly allocated to receive placebo control pills in studies, denied acccess to a treatment which was known to be effective, and many of them will have died unnecessarily, simply for the lack of a bit of clever number crunching.
Ideas like cumulative meta-analysis from the world of evidence have saved countless lives, and they could save many more. They are clever and they are fascinating. They are the same tools you hear rubbished by big pharma, by homeopaths, and by lobbyists from the $56bn food supplement industry. But you will never find them celebrated, anywhere, in popular culture.
I have to breathe deeply and count to ten when one of my liberal friends disparages “Western medicine” for its monolithic, overriding focus on getting better. I have to remember that, in all too many people’s minds, the corrupt American healthcare industry (which is bad) is tied in their minds with the basic concept of science (which is very, very good). Science saves lives, science teaches us about the world, science helps you live longer, science helps you live your life better and helps you connect with people you love.
A recent New York Times article, on how undocumented immigrants often have to turn to “traditional healers” for help, bugged me. I felt it underplayed the dangers of not having access to modern healthcare. Its more critical mistake, though, is that it romanticized the role of a sham doctor, one who may genuinely believe in what he or she does but nonetheless is an archaism that no resident of a developed country should be subjected to.
We may turn up our noses at what Stephen Colbert calls “Lab-Coat Larrys” and assume scientists are elitists out of touch with what ails us. But when we dismiss statistics as being incongruous with our personal experience, often we are sacrificing people’s lives at the altar of a romantic whim. That’s why I get angry when I hear about homeopaths or “energy healing” or see yet another acupuncture clinic spring up from the ether; they may be good placebos, certainly, but they’re still placebos, and placebos rely on deception, intentional or not. Their effectiveness as such does not absolve the practitioners of their crime: sowing mistrust, doubt, and misinformation about science, which inevitably leads to deaths down the line. They are “complementary” only in the sense that a lie “complements” the truth.