I see that we are still slavishly worshipping at the idol of RCTs in epidemiologic science as the evidentiary warrant for public health action. I have written LOTS on the foolishness of this, its disastrous ethical & policy implications, & it's role in #ManufactureOfDoubt.

It's almost as if people have never heard of the #PrecautionaryPrinciple. If we demanded evidence of exposure-harm or intervention-benefit that flowed from RCTs to warrant public health interventions, we would have essentially NO public health action AT ALL.

2/ Even granting the presumption that RCTs are a categorically
More on this, from my 2016 paper on importance of maintaining epistemically reasonable standards for proof of harm (& benefit!) as warrant for public health action:

(The subject of the paper is COIs and lays out my arg for regarding them as ordinary epidemiologic exposures)

3/ robust as we might like. If evidence of the kind envisioned
Finally, in a very real sense almost the entire #ThirdBook, which is on traumatic brain injury, collision sports, & public health law/ethics, addresses this question of the sufficient evidentiary warrant for public health law interventions.

If we are not discussing what the #PrecautionaryPrinciples does in relaxing the standards of evidence we require to justify at least some kinds of public health interventions, we are missing the boat IMO.


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More from @prof_goldberg

Nov 11, 2021
I've been studying chronic pain for going on 15 years now. I have some thoughts on this, many of which I've articulated elsewhere and for some time now:


The Quiet Scientific Revolution That May Solve Chronic Pain nytimes.com/2021/11/09/wel…
The headline and the article fundamentally misconstrues the primary causes of the devastating and highly inequitable undertreatment of pain in the US (and globally, but that's another conversation).

The primary causes for our failures in treating people in pain humanely and effectively are not connected to lack of technical, clinical, or scientific knowledge.

Read 17 tweets
Jul 21, 2021
Speaking as someone who studies anxieties about malingering and their connections to health, disability, & social policy, the framing of this NYT article is enormously problematic.


The Man Who Filed More Than 180 Disability Lawsuits nytimes.com/2021/07/21/mag…
The article is well-written, but it leaves out an enormous amount of context. Most importantly, ADA and disability law violations are de rigeur. They are common, frequent, every day occurrences. Ask people w/ mobility impairments how airlines handle their wheelchairs.

Ask hearing-impaired or Deaf people about the availability of SL-fluent interpreters in public accommodations. And on and on and on. It's endless.

As w/ most forms of civil rights and antidiscrimination laws in the US, the rules are observed in the breach.

Read 17 tweets
May 25, 2021
Look, I'm angry, so I am just going to say it:

I really, really wish that non-Jews would immediately cease trying to define Jewish identity on here. It's transgressive and a basic violation of any commitment to antiracist and anti-oppressive praxis.

Jewish identity, like many other social identities, is extraordinarily complex. Jewish people who live it often passionately disagree with each other on identity. If you don't live it, the odds that you're going to get anywhere close to the mark are vanishingly small.

The odds that you are going to screw it up and perpetuate one of the most vicious and enduring racisms on the planet is a heckuva lot higher than you think.

Read 9 tweets
Dec 20, 2020
I would just like to point out that Nate Silver's nonsense today didn't merely insult public health scientists, epidemiologists, and officials.

It also insulted public health ethicists, implying that it takes no special expertise or training to unpack and offer guidance

On the deep and fraught complexities in vaccine allocation and prioritization.

I have noted in @AMJPublicHealth that public health ethics is fundamentally about priority-setting:


Some of us have spent years working on exactly these kinds of probs.

@AMJPublicHealth The idea that you can just barge into the subject with no training in either public health or applied ethics, wave a gatdang magic wand, and "solve" all of these problems is so absurd I've been wanting to #Hulksmash all day

Read 11 tweets

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