Thread by @ToshiAkima

COVID has unleashed a pandemic of inappropriate use of the RCT/meta-analysis model as an instrument of hyper-scepticism to manufacture doubt as a tool of destructive mass propaganda. 🧵

Let's use the Cochrane model to assess the evidence for the earth being round. Here are some common proofs for the earth being round. All belong to the lowest level of evidence. How can you say we can safely traverse the oceans without falling off the edge of the earth?

To demand that the RCT/meta-analysis model be applied to non-pharmacological settings or in engineered safety systems where they've never been a Gold Standard, is to weaponize it as an instrument of manufacturing doubt. You could question whether the earth is round by this method

You could even use this model to cast doubt on anthropogenic climate change. Look at a climate change journal like @naturesustainab, and you won't see a single RCT being published to demonstrate climate change from rising CO2 levels. nature.com/natsustain/

This is the result of searching the Cochrane Library for “climate change” to see if mitigating rising CO2 levels would make a positive impact on health. The RCT/meta-analysis model is useless in tackling what will be a crucial determinant of health outcomes in the near future.

You can see why I call fetishisation of RCTs as a Gold Standard for all of science, “RCT idiocy”. The methods used in parts of the medical sciences aren't a universal scientific standard. You can't cast doubt on everything by decrying a lack of RCTs.

https://twitter.com/toshiakima/status/1485086525386014722?s=61&t=tzRA1EBqXPKhZXl5j_7Cmw

It's astounding that people take to Twitter to argue that lockdowns and respirators need RCTs, using social media as a medical communication apparatus without its safety/efficacy having been proven by an RCT, writing on devices never tested by RCT.

https://twitter.com/toshiakima/status/1485136989834063872?s=61&t=tzRA1EBqXPKhZXl5j_7Cmw

The problem is not whether science should be evidence-based but as in court what is admissible in the court of scientific arbitration as “evidence”. Through most of science, RCTs have a profoundly limited spectrum of applicability. #PhilosophyofScience