Science, to be at its best, needs to be a social process. The collaboration between individuals fosters the development of research ideas, allows for checks and balances of published findings, improves the dissemination of research and allows for valuable peer review. With the proliferation of social media, this social aspect of science is more rapid and accessible, opening the doors to individuals from wide and varied backgrounds to engage in and contribute to this process. We are fortunate to now exist in an environment that allows research to be shared, discussed and critiqued across a wide variety of mediums. There are several podcasts, blogs, discussion forums and forward thinking publication platforms that provide content, often free of charge, that exemplify science as a social process.Read More
Effective healthcare can be thought of as delivering the most beneficial treatment(s) at the minimum dosage required to produce a positive outcome that outweighs associated side effects and cost. Unfortunately, healthcare is too often wrought with overdiagnosis, overtreatment and exorbitant costs while producing a less than desirable outcome. Pain, in particular, is an overwhelming burden on both individuals and society at large with an estimated economic cost of 560-635 billion dollars a year. This is in part due to an abundance of diagnostic approaches that fail to identify meaningful pathology, leading to numerous treatments that fall short of delivering a meaningful outcome. Unfortunately, many of the treatments designed to address people’s pain have been well studied and found to lack a meaningful benefit, but nevertheless, these interventions continue to be delivered, often by passionate purveyors eager to fill a desperate need.
In the face of evidence demonstrating that many of the treatments offered to patients fail to justify their continued use when adequately controlled and studied, why do ineffective treatments persist in clinical practice? Many of the contributing issues are by no means unique to physical therapy and more broadly are inherent to human nature and reasoning. Nevertheless, I am a physical therapist and as such these issues will be viewed through a physical therapy lens.Read More
The idea of science based physiotherapy (adapted from the popular science based medicine) is a response to the notion that evidence based physiotherapy places too great an emphasis on comparative clinical studies at the expense of basic science. This is to say that evidence based physiotherapy undervalues, or even ignores aspects such as mechanisms, mechanistic reasoning and biological plausibility. This call for a greater emphasis on improving our mechanistic reasoning and our understanding of how and why we achieve the outcomes that we do is important. Sound mechanistic reasoning can improve the manner in which we research and deliver interventions while helping rule out more far-fetched ideas prior to dedicating limited scientific resources to them. This is because it encourages us to ask the question “are we confident that this treatment aligns with current knowledge of biology, physiology and physics?” As with all things, of course, it is important to recognize the limitations of our mechanistic reasoning as means of justifying our treatments.Read More
I am someone who rarely feels compelled to offer my unsolicited advice in a public forum. Therefore, it may seem strange that I am writing for the second time on the issue of intra-professional communication. Despite my desire to remain an impartial observer of the world surrounding me, an unnerving theme persists and motivates my interjection. In many ways, we fail to engage in constructive dialogues regarding professional topics.Read More
Here's another guest post from Jason Eure, who is still a pretty smart dude whose thoughts are worth your time. Follow him on twitter @jmeure
February 3, 2003: Adam Vinatieri lines up to kick a potential game-winning 48 yard field goal to win the Super Bowl for the New England Patriots. The snap and hold go smoothly, the kick is up and on line… but just as it’s about to sail through the uprights, a St. Louis Rams fan pushes the goalposts back 20 yards and the ball falls short: leaving the Patriots to lose in overtime (or at least I wish this above scenario had happened…I view my happiness as inversely proportional to the number of rings in Tom Brady’s possession).
While we (sadly) can’t influence physical goalposts to this extent, this happens metaphorically during many arguments — evidential standards are arbitrarily altered in order to make a counter-argument inadequate or insufficient. This is an informal fallacy known as (wait for it) ... shifting the goalposts.Read More