Posted by bob on May 18, 2000, at 22:53:53
In reply to Editorial Concern, Too, posted by boBB on May 18, 2000, at 18:33:42
boBB, I share your concerns over the objectivity not just of ECT research reports but, in the academic climate these days, ANY research reports from studies that uncovered data contrary to what either a source of funding or the professional body of that field of study might want to hear. A fairly modern example out of physics is string theory, which was slammed as sham science for more than fifteen years because it proposed ideas contrary to the general model of the time (which in those fifteen years was poked through with experimental holes to the point of transparency). It also required an understanding of a branch of mathematics that most physicists knew nothing about, and did not care to learn in order to be better critics of the theory. Or, at least, so goes the story as I've heard it told....
That being said, there is a great deal of difference in a scientific research report between what can be supported by statistical inferences based on hard evidence and what researchers will speculate upon in the conclusions section of their papers. Adam's statements are not necessarily self-contradictory. Findings of no permanent harm from ECT due to a lack of credile evidence sounds like a statistical argument that any data demonstrating some permanent damage is not common enough in controlled studies to rule out random chance or any other number of factors as the cause of that damage. "Suggestions" in journal articles are often speculations on anomalous data or trends (i.e., non-statistically significant results that the researchers want to discuss anyway -- more an indication of researcher bias than of good scientific practice) that can often either appease editorial board members with an agenda or make the article a little "sexier" and atractive as a publication.
It's not how all science is done, but it certainly is how a lot of science gets reported.
Consider also the source for such publications -- usually large university-based research and teaching hospitals. Within those sites, not everyone who receives treatment will be included in any study. And not everyone who receives treatment will get it at a place where research on ECT is being done. Combine that with the fact that over the thousands of people who receive ECT each day/week/month/whatever, very few will respond really well to it, most will have some good results and some side effects, and another few will have extremely horrible responses to it. That this only happens to a few people does nothing to mitigate the damage done, but portraying their stories as what potentially awaits every individual undergoing ECT is IMO more scientifically irresponsible than relying on statitistical models to fill a gap in our understanding of brain function.
Not being scientists, we don't necessarily have to base our own decisions on what science finds support for -- you may not value their standards of "truth". But doctors don't ethically or professionally have that option of disregarding scientific evidence out of hand.
[well, unless they're up for tenure somewhere and they REALLY NEED those pubs on their vitas]