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Mere anecdote: evidence and stories in medicine

2011· article· en· W1911295571 on OpenAlexaff
Robin Nunn

Bibliographic record

VenueJournal of Evaluation in Clinical Practice · 2011
Typearticle
Languageen
FieldMedicine
TopicClinical Reasoning and Diagnostic Skills
Canadian institutionsUniversity of VictoriaUniversity of Toronto
Fundersnot available
KeywordsAnecdoteAlternative medicineMedicinePsychologyLiteratureArtPathology

Abstract

fetched live from OpenAlex

In evidence-based medicine, randomized controlled trials are said to be the highest evidence of what works, while anecdotes have low value or are not even considered to be medical evidence. Similar hierarchical views of evidence have infected other disciplines, including evidence-based education and evidence-based government. Here, I explore the artificial divisions of acceptable from unacceptable evidence, numbers from narrative and sciences from humanities. I challenge the deprecation of stories in medicine. Some stories are based on experiments while others are based on more or less plausible theories. Some stories offer vast and impressive statistics gathered from many observations while others present one noteworthy event. Published reports are themselves stories of what experimenters did. Systematic reviewers generate their own observations of collected stories of experiments. Reviewers of systematic reviews in turn report their observations of systematic reviews. All of these stories become evidence of what works in medicine.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.060
metaresearch head score (Gemma)0.262
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesMetaresearch
Consensus categoriesnone
DomainCandidate signal: Methods · Consensus signal: none
Study designCandidate signal: Theoretical or conceptual · Consensus signal: Theoretical or conceptual
GenreCandidate signal: Empirical · Consensus signal: none
Teacher disagreement score0.940
Threshold uncertainty score0.319

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0600.262
Meta-epidemiology (narrow)0.0010.001
Meta-epidemiology (broad)0.0010.001
Bibliometrics0.0060.005
Science and technology studies0.0070.051
Scholarly communication0.0160.040
Open science0.0030.012
Research integrity0.0080.013
Insufficient payload (model declined to judge)0.0030.001

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.380
GPT teacher head0.579
Teacher spread0.199 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

Study designTheoretical or conceptual
DomainMethods
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations30
Published2011
Admission routes1
Has abstractyes

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