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Interesting thread on need 4 data in medicine, few thoughts:

1. No one will ask 4 RCTs 4 parachute effects.
If you made a pill that 100% cured advanced Alzheimers, and you gave it to 10 severely demented people and they all were restored, we would use it immediately
2. Trouble is almost nothing in medicine has an effect size this large; Nearly nothing is like a parachute. But maybe a few things once were, like insulin in Type1DM

Much of this low hanging fruit may be picked
3. So you are left with interventions that at best have modest to marginal effect sizes,

And you are left in a world where there are 10^8 or 9 hypotheses per year, and most don't actually work;

So pretest prob = low
and at best your Rx is not a parachute
4. You know what is the best way to sort out the modest and marginal effects from the null effects...

Randomized trials

Which is why people keep asking for them for whatever malarial drug, vitamin, or arthritis medication has the most exciting in vitro activity of the day.
5. And if you want to say, but there is no RCT of smoking

Well, we don't even have a cohort study to show you shouldn't put your hand in the garbage disposal and hit the on switch.

RCTs for interventions of putative benefit, with at best modest effect sizes aka most biomed
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