The Pyramid Schema: The Origins and Impact of Evidence Pyramids

Evidence pyramids are amongst the most recognisable artefacts of the Evidence-Based Medicine movement. Yet no study has established the origins of evidence pyramids, or analysed whether they offer any information beyond simple lists or tables. In this paper, I establish the origins of the first evidence pyramid and argue that the pyramidal turn is a retrograde step in evidence appraisal.

Lumping and splitting: brain tumours in white Britons

A much-publicised report suggests that white Britons’ brain tumour survival rates are lower than other ethnicities. But analysing the ethnicities categories used, and considering the diversity of the “brain tumour” label, complicates the picture, as the ‘Dismal Disease’ of Glioblastoma continues to confound.

The Jurassic Critique of Micozzi on Evidence Hierarchies

AI21 Labs have just released a public demo of their giant language model, Jurassic-1. At 178bn parameters, it rivals GPT-3. Feeding it my own work, it generated some interesting and potentially novel views on evidence hierarchies… and then attributed them to CAM researcher Marc Micozzi! Is Jurassic Micozzi’s critique of evidential pluralism in medicine sound?

On the Global Summit: do critiques of evidence hierarchies favour chiropractic?

The Global Summit systematic review claims that spinal manipulation therapy is not effective in preventing any non-musculoskeletal disorders. But a breakaway group has challenged their findings, in part based on my arguments regarding evidence hierarchies. Are they correct? Does my critique undermine the Global Summit review? If so, does the evidence base favour chiropractic?

Conversion Therapy: Evidence is Irrelevant

Pressure mounts upon equalities minister Kemi Badenoch to resign over the UK government’s failure to ban conversion therapies. Attention has focused on the government’s failure to publish research commissioned in 2018. But evidence about whether conversion therapy works is irrelevant: conversion therapy is not a medical intervention.

The True Causal Effect

Do medical scientists need philosophers of medicine like birds need ornithologists? A quotation often attributed to Richard Feynman claims that “philosophy of science is as useful to scientists as ornithology is to birds”. Feynman, never the intellectual slouch, acutely discounts the value of philosophy of science to him, without actually claiming that philosophers are useless, valueless, …