[Omeo33] Art 1500 - Eur J Int Med, 2015

[Gino Santini]

Data about (complementary and alternative) medicine are irrelevant, because we are all Bayesians
Harald Walach, Paolo Roberti di Sarsina, Mariateresa Tassinari

Pandolfi and Carreras are to be congratulated on their argument in favor of a Bayesian view on medical decision making and statistics [1]. The authors rightly point out that, given a mildly skeptical stance, even a strongly significant result of a research experiment won't convert this into acceptance or security. What the authors say is much more general and pertains to the whole of medicine, not only to CAM.
We are all Bayesians, because neurobiologically we are prediction engines using disconfirming evidence only if it is strong enough to question our predictions [2]. And this is the reason, why a constructivist approach to human perception, memory and, for that matter, science is biologically and factually more adequate. Science is constructive as well [3]. Hence it is wrong to assume that science “discovers the truth” about the world. Pandolfi and Carreras are Bayesians and constructivists, when it suits their needs, but else conform to a positivist view of science. You can't have it both ways. If you accept that we construct the view of our world, you should stick to it and accept that there are multiple ways of looking at things, even at medicine. And this means: Bayesian principles should be radically applied to all of medicine, not just to CAM. What we call “evidence based medicine” should rather be called a “research trend based medicine” that considers only one type of data and one type of theory as a priori plausible while ignoring the rest. That leads to a host of very expensive and very dangerous errors.

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