My confidence in science is not crumbling but it is shaken!

I was reading a post over at Fabius Maximus and could not resist myself. Here was my comment.

My confidence in science is not crumbling but it is shaken. I do not remember whether I was science skeptic before college but I definitely was a skeptic after getting my engineering degree. You had to be very, very careful to get the right answer in lab experiments. It was hard, tedious work. As a result I do not have the high and lows being experienced by some other people. I have seen how easy it is to be wrong despite your best efforts. I believe what you are seeing in crumbling confidence in science is that bad science is being penalized for being wrong and that is a good thing!

Climate science is interesting example of science going off the rails. I find it amazing that even after all of these years I still remember enough of a thermodynamics class I took 30 years ago to question the approach being used by climate scientists to solving what I would call a heat transfer problem. I was not surprised to see climate scientists struggle to explain global warming with temperature graphs. If thermodynamics is settled science, why did the scientists choose this alternate approach?

I think the scientists noticed that they could not unambiguously prove whether we are experiencing warming or cooling so they went with the political group with the most passion and money. There was a fifty-fifty chance they might get the science right without actually doing any science. All they needed was for Mother Nature to continue to do what she had been doing for a few more years. Unfortunately their prayers to Mother Nature went unanswered and the warming stopped. Now these researchers have to explain how they got it wrong. I think the worship of pagan goddesses took a real tumble when the climate scientists went back to doing real science again.

I hate to be picky but vaccinations, global warming, and economic “science” are not even close to what I see as the most serious confidence problems in science. Frankly, I am not surprised that most people get economics wrong. I still hold to the belief that economics is not a science but a conspiracy to make weathermen look smart. In my mind I have been able to write off the climate science problems as problems to be solved by my son’s generation. Unfortunately my generation gets to deal with the false positive problems in health care. Getting this right is a matter of life and death for healthy people like me. The false positive problem in prostate and mammogram testing is severe enough that one part of the medical profession is recommending less testing. At the same time another part of the medical profession thinks it is better to be safe than sorry so the over-diagnosis of prostate and breast cancer is a necessary evil. My inner engineer keeps wondering why doctors are advocating less testing rather than improving their testing? When did reducing false positives cease to be a noble scientific objective? So what is an otherwise healthy person to think in this environment? When I ask my doctor he shrugs his shoulders.

I think the fundamental problems affecting my confidence in health care can be best explained with the ulcer example. Just two months ago I learned via the TodayIFoundOut podcast that ulcers should be treated with antibiotics. I am old enough to remember when the standard diagnosis for ulcers was that it was caused by stress and could only be solved by surgery. This was settled science so it is not surprising that hospitals were the biggest force that prevented ulcers from being treated with antibiotics. Ulcer surgery was a money maker for many doctors and hospitals regardless of its efficacy. From 1984 to the early 1990s Dr. Marshall and his long-time collaborator, Robin Warren, were thought to be quacks. Finally in 1994 the National Institutes of Health (NIH) held a two day summit to discuss his research and the rest is history. In 2005 Dr. Marshall received the Nobel prize for Medicine for his discovery of the bacteria that leads to peptic ulcers. From settled science to a different settled science in 21 years. Doctors were absolutely, positively sure of their diagnosis and treatment until they changed their mind to a completely different treatment. It sounds like a House script. Does anyone wonder why so many people have become born again science skeptics?

So here is the bottom line if you are looking at prostrate and mammogram testing. You are damned if you do, damned if you don’t, and hospitals make money on either outcome. Even if you opt for the safe rather than sorry route, the hospital still has a chance to collect on the daily double. My father went into the hospital after a fall and got an infection. He never left the hospital alive. I am guessing that Tricare/Medicare paid a quarter of million dollars for this mishap. Sepsis is America’s dirty little secret. The NIH factsheet on sepsis says that the “Agency for Healthcare Research and Quality lists sepsis as the most expensive condition treated in U.S. hospitals, costing more than $20 billion in 20115.” It is the mistakes in health care that shakes my confidence in science.