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patmorgan23last Tuesday at 3:29 PM3 repliesview on HN

Dr. Mike did an incredible job in that interview. He gave Dr. Amen all the rope to hang himself with his own words. When you're hawking a diagnosis method and you're not interested in building up the foundation of evidence for it by doing a double blinded, randomized controlled study. And that the results of said study would change how your treating patients it's pretty clear who the snake oil salesman is


Replies

flatlinelast Tuesday at 5:44 PM

I also thought the rest of the interview was really worthwhile - they talked a lot about real problems in the medical industry from different perspectives. What a great and critical discussion from Dr. Mike. If Amen had conceded the point they could have moved on. There could be real findings to be had there, and some may even match his conclusions, but many likely will not, and the whole thing could also be pure fiction. We should want better answers to these questions. It's unfortunate to watch someone as seemingly intelligent and well-informed as Amen come across as shilling snake oil, and/or just being hung up on his ego, at the end of it all. Scientific literacy is so critical, because it's easy to cloak pseudoscience behind high-tech smokescreens.

jama211last Tuesday at 6:29 PM

Unfortunately I worry about the rebound effect, where even though the entire interview was debunking his claims this could still on average increase amen’s popularity.

rkagererlast Tuesday at 7:58 PM

I'm no expert in medicine, but I watched that entire video and your analogy about performance and rope doesn't fit well with how it came across to me.

I actually thought the interviewer was a little disingenuous. He said things like "We're on the same team" and "I'm not trying to trap you", then proceeded to lob his guest with criticisms from the other team and questions aimed to maneuver him into a contradiction. There's nothing inherently wrong with that, but if you're going to do it, be forthright you're engaging in a debate.

Earlier in the interview he could have put his cards on the table and plainly stated "Myself and others in the medical community are skeptical of the efficacy of imaging on outcomes, and a rigorous, double-blind study would lend dramatic support for us to adopt what you're touting."

Then they could have had the conversation he was clearly after, focused on that issue.

Instead it felt like I was watching for ages as he took a winding route to get there, then the interview cut off abruptly when they finally really did.

The overlays applied in editing while helpful and fair in some cases, at other times came across as one-sided. It's a shame we can't see a follow-up where the interviewee has an opportunity to respond (or squirm) in light of them.

For the record I would very much love to see additional research and gold-standard, double-blind studies. In the meantime I'll treat this as "Hey, we've got this interesting thing we can measure, we're seeing some good results in our practice" without over-emphasizing the confidence in this one diagnostic.

I did find the bit interesting about how having a gauge you can viscerally see impacted patients' engagement in care. Both agreed on the potential usefulness of that aspect, and conceded the difference in profiles between patients coming to Dr. Amen vs. ordinary front-line family physicians.