Thread by @DoctorAnarchist

The Church of Randomized Controlled Trials must be killed. It has become a net negative.

1) We cannot test everything with an RCT

2) They are frequently wrong

3) They are expensive and take a long time

Waiting for one so you can make a decision delays the decision any paralyzes you. You must make decisions on best judgement and underlying truths.

Example:

It would be great to know whether or not Vit D helped people with covid. We can't expose people to covid knowingly.

Therefore, an RCT is impossible. Does this mean we can't verification whether or not Vit D helps?

No. We use other studies and clinical data.

Meta-analysis have long been held up at the pinnacle of medical information - yes, greater than RCTs

We also make decisions based on underlying anatomy/physiology. We know humans with more Vit D have better immune health. So why wouldn't we supplement based on that?

We also make decisions on clinical experience. If a 30 year physician's clinical experience doesn't match the data, who do you trust?

Studies are done under perfect conditions. Humans are not perfect and don't always follow the textbook.

We must act accordingly.

Many Randomized Controlled Trials will come out over the next 10 years showing at X or Y treatment worked best.

Don't be the person who sat around and did nothing waiting for the data while others acted.

You followed "The Science." They helped people.