@Klaus said in The "Replication Crisis":
So I think the implicit message of your statement - today's FACTS are just as unreliable - is not appropriate.
Well, facts are facts.
There's certainly progress in many things, like oncology as you point out.
But, my point is that many of the things that have caused the progress were, in fact, just guesses. We'll never know how many of the guesses fell by the wayside because they were not reproducible, or just plain wrong.
An example is the use of the Swan-Ganz catheter - gonna get nerdy here, so bear with me. The SG catheter is a device inserted into a patient's heart via a peripheral or central vein. The catheter measures pressures in various chambers of the right heart, and is supposed to tell you how the heart is functioning. It can determine blood flow (cardiac output), oxygen levels as well as just pressure. In the early 1980s it became standard practice to insert this in critically ill patients. I have inserted, literally, hundreds of these. Yes, hundreds.
Then...things started to change. Looking at mortality and morbidity in ICU patients, turns out that patients who had these things put in did worse than those without, probably because of poor decision making when looking at the data they provide. Toward the end of my career, it had become a rare thing.
Look at the use of beta-blockers during surgery. Same thing.
So, my point is that, basically, I agree. Medicine is not "hard science" as you put it. It's trial and error. Sometimes the trial works, but it takes a long time to reproduce and become standard.
