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Science versus anecdotes

 •  • by Paul Ingraham
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Weekly nuggets of pain science news and insight, usually 100-300 words, with the occasional longer post. The blog is the “director’s commentary” on the core content of a library of major articles and books about common painful problems and popular treatments. See the blog archives or updates for the whole site.

I wish I had a buck for every time I’ve seen someone contradict perfectly good science with anecdotes. This behaviour is analogous to the bullshit of false balance in journalism. Giving an anecdote just as much focus and weight as compelling evidence pointing the other way is a huge foul in evidence-based medicine.

Anecdotes can be just fine; they aren’t a universal evil, forever and completely incompatible with science. Indeed, clinical experience is an official pillar of evidence-based medicine. But context is crucial, and the value of anecdotes depends on why and how they are trotted out.

I am quite picky about which anecdotes I share on I have rules! Anecdotes that support the science are generally fine. I use them sparingly, but I use them. But the need for caution surges as an anecdote diverges from the science, and then it’s all about minimization and transparency. I don’t use such anecdotes much in the first place, or for substantive support at all, and to the extent that I do use them I usually also say something about their limitations. Doing this in a way that isn’t clunky is a creative challenge, but that’s the job.

An anecdote that directly contradicts the science or supports a claim that is highly suspect should either be discarded entirely… or I bend over backwards to explain why I’m using it anyway.  The most prominent example of this on my site is near the beginning of my article Trigger Point Doubts.

Post inspired by a Twitter discussion.

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