[spacetimeuser5]

>>By striving to cleave the drug’s effects from the context in which it’s given—to a patient by a therapist, both of whom are hoping for healing—blinded studies may fail to capture the full picture.

The amount of monkey types amongst these researchers is spectacular. In the current AI boom, with various RAG and prompt engineering, everyone is striving to maximize context, and no-one would deny that modern AI emulates parts of human mind/brain. And context sensitivity of quantum systems is also pretty much obvious.

Modern astronomy, for example, can pretty much as well challenge the standard of randomized controlled trials: no one uses experimental planets and galaxies to test their null hypotheses. No engineer would strive to falsify the objects they are developing by deliberately designing non-working engines etc. And this is pretty much considered science.

While these "social scientists" are still full of medieval bullshit, so that it is more optimal to commit suicide than use their evidence-skewed medicine, which under the hood by default considers the subjects are either rocks or dead.

[nathan_compton]

I don't really get what you are saying here. RTCs are designed precisely to allow one to draw statistical conclusions which would be untenable due to confounding effects that would be impossible to disentangle otherwise, particularly in regimes where effect sizes are small and results are sometimes difficult to quantify.

I'm having trouble understanding what you are even getting at with comparisons to astronomy, where the absence of controlled experiments isn't some grand innovation astronomers cooked up but a basic constraint imposed by studying stuff that is light years away. Any decent epistemologist would tell you that the character of knowledge generated by astronomical observations is of a lower quality than that of a RCT. I'm sure some astronomers or cosmologists would give their left arm to do a randomized controlled trial!

[spacetimeuser5]

With astronomy, where the data are mainly derived from observations and simulations, no one is spreading alarms that it is not science. While with RCTs - and specifically RCTs in the filed of human cognitive neuroscience and psychedelics - there is all this monkey circus regarding whether placebos or psychedelic experiences are real. In human neuroscience ~80% of data is derived as well from observations and is effectively non-reverse-engineerable, while the hype regarding pseudoscience is much higher.

You buy aspirin in a pharmacy and the drug's instruction label lists tons of adverse effects - this is obviously a seemingly high quality of knowledge resulting from hard work in RCTs. Yet, there's absolutely no information predicting which exact adverse/beneficial effects will manifest in a specific person in a specific state of consciousness - and this is the actual empirical level where RCT derived information should actually matter and where it is ~50% useless (due to lack of context in RCTs themselves).

[nathan_compton]

I still don't see what you are getting at. It is hard to generate good information about the risks and benefits of drugs and doing RTCs is very difficult, for the reasons to which you refer and others. Are you advocating that we just give up on knowing this stuff? That we do large RTCs that have the statistical power to characterize more "context"? I'm having trouble understanding whether your comment just comes down to "getting knowledge is hard and I'm tired of people trying to do it."

[spacetimeuser5]

I am not advocating for anything, just exercising my English and typing skills. But you can try measuring more parameters in every person, integrate various findings from science and plan experiment design more carefully. I have heard about only one startup using AI to facilitate RCTs. A more optimal option is of course suicide, as the more of these RCT researchers will be out of the game, the more newer and more flexible brains will come in.

[chongli]

Modern astronomy, for example, can pretty much as well challenge the standard of randomized controlled trials: no one uses experimental planets and galaxies to test their null hypotheses.

Modern astronomy and astrophysics is just about the most rigorous experimental science outside of particle physics. Models are developed against simulations and past observations. Then new observations are proposed, selected, scheduled, and performed. The null hypothesis is almost always based on the standard models and can only be overturned by new models using new data.

A future observation of some phenomenon "out there" is, in principle, no different from a future observation of some phenomenon in the lab. We don't call them "experiments" but they are every bit as difficult to falsify. Perhaps even moreso, since those who collect the data are generally not the same people as those who design and test the models. Since data is eventually released publicly, anyone is free to re-run the simulations and re-test the models against the same data, as well as propose future planned observations to test any weaknesses in the models.

[refurb]

This may be a peak HN comment. Calling researchers who are experts in their fields and have dedicated a lifetime towards gaining knowledge and experience in the field are described as "monkey types".