Issue link: https://www.massageandbodyworkdigital.com/i/1208028
Ta k e 5 a n d t r y A B M P F i v e - M i n u t e M u s c l e s a t w w w. a b m p . c o m / f i v e - m i n u t e - m u s c l e s . 47 A Cautionary Tale All that Glitters is Not Gold—Including RCTs By Sasha Chaitow, PhD Picture, if you will, a decrepit wooden sailing ship not much different from those that carried the early pioneers. On board the HMS Salisbury, the ship's doctor is desperate. Twelve sailors are suffering from advanced gum rot, weakness, and malaise—a well-known, frequently fatal condition expected to strike those at sea for more than a few weeks. Since the doctor has few choices, and knowing some of the men are doomed anyway, he splits them into six groups and asks each pair to take a different substance. The pair given oranges and lemons recovered and were able to care for the rest until they returned to dry land. Later hailed as the father of the systematic clinical trial, that naval surgeon—Scotsman James Lind (1716– 1794)—documented his findings in his Treatise of the Scurvy (1753), which eventually contributed both to the British navy's decision to make lemon juice a mandatory addition to sailors' diets from 1795 onward and to the evolution of the modern randomized controlled trial (RCT). However, it took the British admiralty 42 years to reach this decision (a year after Lind's death). MODERN SCIENTIFIC EXPERIMENTATION: ITS ACCIDENTAL BIRTH Lind's scurvy experiment is often held up as a significant turning point in the history of medicine, heralding the birth of modern scientific experimentation (and an easier life for sailors). Yet, in fact, he was neither the first to introduce the idea of systematically testing different variables, nor did he perfect the method (See "Evolution of RCTs" on page 50 for more on this). Lind did not even understand the importance of what he discovered when he wrote his treatise. Even though Lind had devised a valid scientific experiment, he missed the significance of his results and instead interpreted them as an indication of a digestive issue. Lind lacked confidence in his findings, 1 which, in part, was responsible for the long delay in authorities realizing the value of his experiments. Lind's story is valuable not only because it lit the spark that eventually led to more rigorous scientific experimentation, but also because it is a cautionary tale, since we now know: • Rigorous scientific evidence must underpin all medical and therapeutic practice. • We should ensure that all therapeutic measures we apply are based on research. • The RCT is the gold standard of evidence, 2 and published findings should not be questioned. Is that not the case? Or did I just make a few rather glaring and inaccurate assumptions in these three bullet points? I certainly did, and deliberately so. MAKING ASSUMPTIONS: NAÏVE TO BORDERLINE DANGEROUS We make assumptions on a daily basis about a range of issues, and neither the practitioner nor the researcher is immune to them. Assumptions might be relatively harmless (such as my earlier assumption that readers are familiar with scurvy, a potentially fatal disease caused by a severe lack of vitamin C), yet they may also be entirely education SOMATIC RESEARCH