[Dylan16807]

> Again, this is the very thing that needs to be shown. You're simply repeating the same mistake.

"This" being the idea that "compelling evidence" and "evidence from randomized controlled trials" are not the same thing? That has been shown. The cliche example is parachutes. We have compelling evidence that they save lives, even though nobody has ever done a proper trial.

Experiments don't have to be perfect to provide valid data. And there are things you can learn from observation even without an explicit experiment.

Nobody is suggesting that we would take an unknown drug and call it a miracle drug without evidence. When someone has a miracle drug in a hypothetical, pretend they're holding a bottle of penicillin and they've gone to a country where nobody has ever heard of penicillin. How should that country react when it immediately cures almost everyone with a certain disease? Do they really need a randomized trial to be confident it works?

[h_r]

I hardly know where to start with this. Parachutes are not a cliche example of anything other than engineered products that are the result of well understood principles of physics, knowledge which was hardly arrived at by magical intuition. And medicine lags far far behind in the maturity of the science (my understanding as a layman).

And your final example of showing up in scientifically illiterate society wielding a miracle drug and declaring that they need no evidence of its efficacy, ignoring the fact that such evidence was all on you prior to arriving there? Sorry, I don't see how this is productive.

[Dylan16807]

Parachutes are a device for saving lives.

We know they work. We have evidence of efficacy. But this evidence does not come from randomized controlled trials.

If it was a pill, the standards for evidence should not change.

Randomized controlled trials make things easier to prove. But they are not the only way to collect evidence of efficacy.

> And your final example of showing up in scientifically illiterate society wielding a miracle drug and declaring that they need no evidence of its efficacy, ignoring the fact that such evidence was all on you prior to arriving there?

No evidence?? That's the exact opposite of what I'm trying to say.

Your objections... okay, would a better thought experiment be an invention of a new antibiotic?

There is no existing proof of anything.

I go to the nearest town and give the pill to every single resident with gonorrhea, 50 of them, and a few days later only 48 of them have the disease any more.

They otherwise took no drugs they hadn't already been taking for months.

I didn't randomize at all, and I didn't set up a control group.

But it's statistically impossible for that to happen by chance.

Also, I and a team of respected researchers searched for confounding factors just as hard as someone performing a randomized controlled trial, and we could not find any.

Did I provide evidence of efficacy? If not, why not?