Thread by @ToshiAkima

I am sorry to say that clinicians don't know what evidence is. And YES, you ARE an idiot if you reply that RCTs are the pinnacle of scientific methodology. Nobody in aerospace safety or automobile safety uses RCTs. Einstein's theory of relativity has never been subjected to RCTs

https://twitter.com/DamianTheAussie/status/1484673093658316803

There is no doubt about this: the idea that all science progresses through RCTs is a MASSIVE lie. If you showed this pyramid to physicists, they would laugh at you. In physics and engineering, the ability of your model to make correct predictions is considered more important

Because the biological sciences are primitive, we are forced into the crude empiricism of RCTs. But aerosol science is more about physics and engineering, where predictive mathematical modelling remains valid. It isn't necessary to be abjectly reduced to primitive empiricism

Precedents for biomedical principles of physical methods of prevention exist, which were established without RCTs eg condoms for HIV, water sanitation systems for cholera. There are no RCTs either for parachutes because you can use predictive mathematical modelling

RCT advocates said there were no RCTs of parachutes because of the magnitude of effect. That too is a massive LIE! It is because you can use primary mathematical modelling and physics to establish safety without being reduced to doing a pathetic RCT

Idiots demanding RCTs for condom use to prevent HIV or of respirators for COVID transmission are like fools who demand RCTs of parachutes with a placebo arm who jump out of their plane with a placebo parachute

The classic example of predictive modelling as the basis of good scientific method is how Einstein's general theory of relativity predicted the curvature of light, making a star visible during a solar eclipse. In 1919, he was proven right (hint: no RCT) earthsky.org/human-world/ma…

This is not to say physicists and engineers don't do empirical testing of predictive models. Hint: they do. But sorry, dear RCT idiot, there are no people involved and no control arm. Same laboratory crash testing principles apply to respirators

Refusing to deploy the best high-grade masks that have passed laboratory crash testing is like refusing to get on board a commercial airline because aerospace safety principles aren't tested by RCTs

Any idiots who still want to say all science progresses by RCTs must consider that the engineering and physics (eg quantum mechanics) underlying the processor on their computer aren't tested by RCTs. If you don't believe your computer works because of this, stop using it…NOW!