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	<title>Comments on: Eternal Medicine</title>
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	<link>http://www.overcomingbias.com/2008/02/eternal-medicin.html</link>
	<description>Overcoming Bias is economist Robin Hanson’s blog, on honesty, signaling, disagreement, forecasting, and the far future.</description>
	<lastBuildDate>Sat, 11 Feb 2012 23:23:58 +0000</lastBuildDate>
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		<title>By: Ddx:dx</title>
		<link>http://www.overcomingbias.com/2008/02/eternal-medicin.html#comment-408388</link>
		<dc:creator>Ddx:dx</dc:creator>
		<pubDate>Sun, 17 Feb 2008 20:16:45 +0000</pubDate>
		<guid isPermaLink="false">http://prod.ob.trike.com.au/2008/02/eternal-medicine.html#comment-408388</guid>
		<description>Even most physicians have little concept of marginal benefit and &quot;number needed to treat&quot; when considering an intervention. It was stated above &quot;survive a heart attck&quot;...So lets look at the numbers. Angiography and thrombolysis for MI were big interventions developed in the 1990&#039;s. Both saved about 2 lives/1000 when compared with &quot;standard treatment&quot;(O2, meds, hospitalization). So, is that the marginal benefit you expect for this level of intervention? This cost? When I share this well-done data with physicians they are mute. I(an MD) would still recommend the intervention, but awareness of our limited marginal benefit is critical for good advice, care...I&#039;m not sure it&#039;s how I&#039;d want to spend my last $100K.
Most increases in longevity in human populations can be attributed to public health measures(water, sewer, dwellings). Most of modern medicine is heroism...
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		<content:encoded><![CDATA[<p>Even most physicians have little concept of marginal benefit and &#8220;number needed to treat&#8221; when considering an intervention. It was stated above &#8220;survive a heart attck&#8221;&#8230;So lets look at the numbers. Angiography and thrombolysis for MI were big interventions developed in the 1990&#8242;s. Both saved about 2 lives/1000 when compared with &#8220;standard treatment&#8221;(O2, meds, hospitalization). So, is that the marginal benefit you expect for this level of intervention? This cost? When I share this well-done data with physicians they are mute. I(an MD) would still recommend the intervention, but awareness of our limited marginal benefit is critical for good advice, care&#8230;I&#8217;m not sure it&#8217;s how I&#8217;d want to spend my last $100K.<br />
Most increases in longevity in human populations can be attributed to public health measures(water, sewer, dwellings). Most of modern medicine is heroism&#8230;</p>
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		<title>By: Zubon</title>
		<link>http://www.overcomingbias.com/2008/02/eternal-medicin.html#comment-408387</link>
		<dc:creator>Zubon</dc:creator>
		<pubDate>Sun, 10 Feb 2008 19:34:08 +0000</pubDate>
		<guid isPermaLink="false">http://prod.ob.trike.com.au/2008/02/eternal-medicine.html#comment-408387</guid>
		<description>For those playing the drinking game at home, we are at three instances of &quot;for a blog called &#039;Overcoming Bias&#039;&quot; so far in this comment thread.
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		<content:encoded><![CDATA[<p>For those playing the drinking game at home, we are at three instances of &#8220;for a blog called &#8216;Overcoming Bias&#8217;&#8221; so far in this comment thread.</p>
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		<title>By: TGGP</title>
		<link>http://www.overcomingbias.com/2008/02/eternal-medicin.html#comment-408386</link>
		<dc:creator>TGGP</dc:creator>
		<pubDate>Sun, 10 Feb 2008 19:29:59 +0000</pubDate>
		<guid isPermaLink="false">http://prod.ob.trike.com.au/2008/02/eternal-medicine.html#comment-408386</guid>
		<description>From Cracked: &lt;a href=&quot;http://www.cracked.com/article_15669_10-most-insane-medical-practices-in-history.html&quot; rel=&quot;nofollow&quot;&gt;The 10 Most Insane Medical Practices in History&lt;/a&gt;.
</description>
		<content:encoded><![CDATA[<p>From Cracked: <a href="http://www.cracked.com/article_15669_10-most-insane-medical-practices-in-history.html" rel="nofollow">The 10 Most Insane Medical Practices in History</a>.</p>
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		<title>By: Brian Jaress</title>
		<link>http://www.overcomingbias.com/2008/02/eternal-medicin.html#comment-408385</link>
		<dc:creator>Brian Jaress</dc:creator>
		<pubDate>Sat, 09 Feb 2008 06:57:27 +0000</pubDate>
		<guid isPermaLink="false">http://prod.ob.trike.com.au/2008/02/eternal-medicine.html#comment-408385</guid>
		<description>I see a few comments pointing out some of the ways that modern medicine is clearly much better than ancient Egyptian medicine, but everyone else seems to be blowing them off.

Think of it this way: If modern medicine has an effective treatment for something that ancient Egypt had no treatment for, where does that show up in the percentages quoted above?

It doesn&#039;t.

The percentages are all percentages of ancient treatments, not modern ones.  If the figure were 100%, it would mean that we kept their treatments, or some equivalent, and went on to develop new treatments for other things.

Considering our bodies haven&#039;t really changed, improving on 36% of what was already shown to work isn&#039;t bad -- but the real improvement is all the additional things we can treat.

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		<content:encoded><![CDATA[<p>I see a few comments pointing out some of the ways that modern medicine is clearly much better than ancient Egyptian medicine, but everyone else seems to be blowing them off.</p>
<p>Think of it this way: If modern medicine has an effective treatment for something that ancient Egypt had no treatment for, where does that show up in the percentages quoted above?</p>
<p>It doesn&#8217;t.</p>
<p>The percentages are all percentages of ancient treatments, not modern ones.  If the figure were 100%, it would mean that we kept their treatments, or some equivalent, and went on to develop new treatments for other things.</p>
<p>Considering our bodies haven&#8217;t really changed, improving on 36% of what was already shown to work isn&#8217;t bad &#8212; but the real improvement is all the additional things we can treat.</p>
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		<title>By: anonymous</title>
		<link>http://www.overcomingbias.com/2008/02/eternal-medicin.html#comment-408384</link>
		<dc:creator>anonymous</dc:creator>
		<pubDate>Sat, 09 Feb 2008 05:06:00 +0000</pubDate>
		<guid isPermaLink="false">http://prod.ob.trike.com.au/2008/02/eternal-medicine.html#comment-408384</guid>
		<description>When I googled define:bias, I got the following definition:

&quot;A bias is a prejudice in a general or specific sense...&quot;

Now I look at your statement:

&quot;As long as he was arrogant, wore a white coat, put his drugs in capsules, and spoke the local language, I doubt most people today could tell the difference if they were treated by an ancient Egyptian doctor.&quot;

So if you&#039;re saying he would have to be arrogant in order for most people to be unable to tell the difference, aren&#039;t you implying that most doctors are arrogant? Isn&#039;t that a bias? Isn&#039;t this blog called &quot;overcoming bias&quot;?

Now I look up arrogant in the OED:

&quot;... aggressively assertive or presumptuous...&quot;

Now for a definition of presumption:

&quot;the act of presuming a thing to be true&quot;

So unless you&#039;ve somehow reliably ascertained that most doctors are arrogant, you&#039;re being presumtpuous, that is, arrogant..

So you&#039;re being biased on a blog called &#039;overcoming bias&#039;, by arrogantly calling doctors arrogant...
I&#039;ll leave you with one last definition:

hypocrisy: &quot;the assumption or postulation of moral standards to which one&#039;s own behaviour does not conform&quot;
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		<content:encoded><![CDATA[<p>When I googled define:bias, I got the following definition:</p>
<p>&#8220;A bias is a prejudice in a general or specific sense&#8230;&#8221;</p>
<p>Now I look at your statement:</p>
<p>&#8220;As long as he was arrogant, wore a white coat, put his drugs in capsules, and spoke the local language, I doubt most people today could tell the difference if they were treated by an ancient Egyptian doctor.&#8221;</p>
<p>So if you&#8217;re saying he would have to be arrogant in order for most people to be unable to tell the difference, aren&#8217;t you implying that most doctors are arrogant? Isn&#8217;t that a bias? Isn&#8217;t this blog called &#8220;overcoming bias&#8221;?</p>
<p>Now I look up arrogant in the OED:</p>
<p>&#8220;&#8230; aggressively assertive or presumptuous&#8230;&#8221;</p>
<p>Now for a definition of presumption:</p>
<p>&#8220;the act of presuming a thing to be true&#8221;</p>
<p>So unless you&#8217;ve somehow reliably ascertained that most doctors are arrogant, you&#8217;re being presumtpuous, that is, arrogant..</p>
<p>So you&#8217;re being biased on a blog called &#8216;overcoming bias&#8217;, by arrogantly calling doctors arrogant&#8230;<br />
I&#8217;ll leave you with one last definition:</p>
<p>hypocrisy: &#8220;the assumption or postulation of moral standards to which one&#8217;s own behaviour does not conform&#8221;</p>
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		<title>By: Douglas Knight</title>
		<link>http://www.overcomingbias.com/2008/02/eternal-medicin.html#comment-408383</link>
		<dc:creator>Douglas Knight</dc:creator>
		<pubDate>Sat, 09 Feb 2008 03:55:57 +0000</pubDate>
		<guid isPermaLink="false">http://prod.ob.trike.com.au/2008/02/eternal-medicine.html#comment-408383</guid>
		<description>Rather than compare ancient Egyptian medicine to today&#039;s medicine, let&#039;s compare it to the medicine of 1900 or 1850. I&#039;m pretty sure 1850 loses.
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		<content:encoded><![CDATA[<p>Rather than compare ancient Egyptian medicine to today&#8217;s medicine, let&#8217;s compare it to the medicine of 1900 or 1850. I&#8217;m pretty sure 1850 loses.</p>
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		<title>By: Max</title>
		<link>http://www.overcomingbias.com/2008/02/eternal-medicin.html#comment-408382</link>
		<dc:creator>Max</dc:creator>
		<pubDate>Fri, 08 Feb 2008 21:43:09 +0000</pubDate>
		<guid isPermaLink="false">http://prod.ob.trike.com.au/2008/02/eternal-medicine.html#comment-408382</guid>
		<description>Ian,

so the modern medicine undoes natural selection? It would be interesting to ponder on the consequences. I know I avoided being voted off this island due to the ulcerative colitis. Bleeding to death ain&#039;t fun.
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		<content:encoded><![CDATA[<p>Ian,</p>
<p>so the modern medicine undoes natural selection? It would be interesting to ponder on the consequences. I know I avoided being voted off this island due to the ulcerative colitis. Bleeding to death ain&#8217;t fun.</p>
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		<title>By: Ian</title>
		<link>http://www.overcomingbias.com/2008/02/eternal-medicin.html#comment-408381</link>
		<dc:creator>Ian</dc:creator>
		<pubDate>Fri, 08 Feb 2008 21:21:48 +0000</pubDate>
		<guid isPermaLink="false">http://prod.ob.trike.com.au/2008/02/eternal-medicine.html#comment-408381</guid>
		<description>I feel that I have definitely gotten my money&#039;s worth from Western medicine. Why? Because I&#039;m still alive. If I lived 2,000 years ago I would be dead now (type I diabetes). So would: my mother and my brother (major childbirth complications), one aunt (like 10 different things), an uncle (alcohol withdrawl resulting in grand mall siezures). My grandmother would have died earlier from skin cancer, and her sister from complications of type II diabetes. My dad had the Hepatitis that can be cured - not sure if that&#039;s lethal if untreated. And I&#039;m sure I&#039;m forgetting stuff.

Think about it - how many people you know would be dead by now without the modern western medicine you pretend to have so much disdain for? And how many of these things would have been fixable in ancient Egypt? If you pray, give thanks every night for not living 2,000 years ago.
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		<content:encoded><![CDATA[<p>I feel that I have definitely gotten my money&#8217;s worth from Western medicine. Why? Because I&#8217;m still alive. If I lived 2,000 years ago I would be dead now (type I diabetes). So would: my mother and my brother (major childbirth complications), one aunt (like 10 different things), an uncle (alcohol withdrawl resulting in grand mall siezures). My grandmother would have died earlier from skin cancer, and her sister from complications of type II diabetes. My dad had the Hepatitis that can be cured &#8211; not sure if that&#8217;s lethal if untreated. And I&#8217;m sure I&#8217;m forgetting stuff.</p>
<p>Think about it &#8211; how many people you know would be dead by now without the modern western medicine you pretend to have so much disdain for? And how many of these things would have been fixable in ancient Egypt? If you pray, give thanks every night for not living 2,000 years ago.</p>
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		<title>By: Psychohistorian</title>
		<link>http://www.overcomingbias.com/2008/02/eternal-medicin.html#comment-408380</link>
		<dc:creator>Psychohistorian</dc:creator>
		<pubDate>Fri, 08 Feb 2008 20:55:56 +0000</pubDate>
		<guid isPermaLink="false">http://prod.ob.trike.com.au/2008/02/eternal-medicine.html#comment-408380</guid>
		<description>The attack on modern medicine is not a claim that it&#039;s the same, it&#039;s a claim that, at the margin, the difference is a lot less than we&#039;re paying for.

If an ancient Egyptian doctor came to our time an took a high school class to learn about sanitation, he could do many functions (though obviously not all) as well as a modern doctor with a twenty-five year long education. This supports the claim is that doctors do a lot of work where they do not provide much added value given their expense.

As such, the claims about vaccinations and antibiotics are not terribly relevant. These do not encompass a large portion of our medical expenditures (to my knowledge). Hanson&#039;s point seems to be that doctors are overpaid or we use doctors for work that does not require their expertise, and that a lot of the advances in medicine have been fairly simple and inexpensive and should not translate into our current costs. This post certainly supports that.

Though &quot;Someone drilled a hole in someone else&#039;s skull, and he didn&#039;t die for at least a few months&quot; doesn&#039;t really count as brain surgery. And the motivation was probably to let out demons or evil spirits or some such, so I&#039;d hardly tout that as the efficacy of ancient medicine.
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		<content:encoded><![CDATA[<p>The attack on modern medicine is not a claim that it&#8217;s the same, it&#8217;s a claim that, at the margin, the difference is a lot less than we&#8217;re paying for.</p>
<p>If an ancient Egyptian doctor came to our time an took a high school class to learn about sanitation, he could do many functions (though obviously not all) as well as a modern doctor with a twenty-five year long education. This supports the claim is that doctors do a lot of work where they do not provide much added value given their expense.</p>
<p>As such, the claims about vaccinations and antibiotics are not terribly relevant. These do not encompass a large portion of our medical expenditures (to my knowledge). Hanson&#8217;s point seems to be that doctors are overpaid or we use doctors for work that does not require their expertise, and that a lot of the advances in medicine have been fairly simple and inexpensive and should not translate into our current costs. This post certainly supports that.</p>
<p>Though &#8220;Someone drilled a hole in someone else&#8217;s skull, and he didn&#8217;t die for at least a few months&#8221; doesn&#8217;t really count as brain surgery. And the motivation was probably to let out demons or evil spirits or some such, so I&#8217;d hardly tout that as the efficacy of ancient medicine.</p>
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		<title>By: Patri Friedman</title>
		<link>http://www.overcomingbias.com/2008/02/eternal-medicin.html#comment-408379</link>
		<dc:creator>Patri Friedman</dc:creator>
		<pubDate>Fri, 08 Feb 2008 20:15:17 +0000</pubDate>
		<guid isPermaLink="false">http://prod.ob.trike.com.au/2008/02/eternal-medicine.html#comment-408379</guid>
		<description>While this article is quite interesting, I think it is using the wrong metric.  A straight percentage of remedies does not reflect the incidence of these conditions.  Most big pharma R&amp;D is focused on a few very common conditions, since that is where the most profit and benefit are to be found.

So this could just be indicating that there is a &quot;long tail&quot; of conditions &amp; remedies where we still use the old treatments because it is not yet cost-effective to find new ones.  Yet we may be getting most of the benefit at the head of the condition distribution.  The biotech revolution seems quite promising for better addressing this long tail.
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		<content:encoded><![CDATA[<p>While this article is quite interesting, I think it is using the wrong metric.  A straight percentage of remedies does not reflect the incidence of these conditions.  Most big pharma R&#038;D is focused on a few very common conditions, since that is where the most profit and benefit are to be found.</p>
<p>So this could just be indicating that there is a &#8220;long tail&#8221; of conditions &#038; remedies where we still use the old treatments because it is not yet cost-effective to find new ones.  Yet we may be getting most of the benefit at the head of the condition distribution.  The biotech revolution seems quite promising for better addressing this long tail.</p>
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