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Pittsburg, Kansas | I agree with almost all you say.
Where I take a bit of an exception is small studies. I think they can be valuable. Not proof but valuable. Let me explain my position.
Big studies take millions and millions of dollars to do. Very expensive, especially if they are done correctly. So any grass roots science is at best going to be a small study. I think these small studies done by interested parties (instead of doing it because they can get grant money for the study) are going to be the ones that have a good possibility of discovering new things, things we didn't know.
That does not make them definitive, but if they get results that other groups can repeat in another five or ten replication studies, then a meta analysis can be meaningful. If there is a big potential for a blockbuster drug that will make billisons of dollars, count on the drug companies to do the studies. If it is going to be some cheap off the shelf non patent or out of patent drug repurposed, a huge trial will NEVER be done. No money for it and any small group could never afford the size of trial needed. But MANY anecdotal case reports along with several small very well run intervention trials CAN be very useful. Especially if the drug has a long history of safety so there would little downside of using it even if it only works in certain conditions or not consistantly.
So I think small, very well run, trials are crucial for discovering repurposed drugs that work. Or perhaps diet interventions. It is the best we can ever expect. Look at some of the stuff Dave Feldman and Nick Norwitz and their associates do. Top notch research, but very small groups done on a shoestring crowd funded budget. Stuff that big drug companies don't want to know and probably don't want anyone else to know or implement.
Sorry for the bad speeling.
Edited by John Burns 12/12/2024 08:05
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Healthy user bias in studies
