I am incredulous that the current administration wants to ban the use of the words 'science-based' or 'evidence-based' because they are "unnecessary" or redundant. It seems far more likely that this is the same kind of political maneuvering that led Gov. Scott to instruct Florida officials to not use the words "climate-change." It's a deliberate attempt to obscure facts from the public.
Yes, I'm seeing a lot of people who say "science-based" and "evidence-based" are non-informative. If that were true there would be no need for a ban, unless you think this is a bold new approach to copy-editing. What's worrisome is precisely that words like "science-based" and "evidence-based" are informative in the context of this administration--which is why they're banned.
Readability and censorship are two very different things. At its surface, using plain language should not hinder any communication of ideas and would generally have benefits to achieving goals. Unless the standard prevents communication of ideas, I don't see any problem here.
Evidence-Based Medicine[1] is a particular movement that makes particular claims about what sorts of evidence are better than other sorts of evidence, and how we should (re-)structure clinical practice to revolve around these.
In other words, EBC != evidence-based medicine. It strongly emphasizes large-scale studies at the expense of other types of empirical knowledge, namely the direct clinical experience of the practitioners.
What might be the harm in doing so? Why shouldn't we all rely only on large-scale meta-analyses to guide treatment?
1. There are important clinical questions that are difficult to measure in a double-blind clinical framework; the risk is that we end up optimizing what we can easily measure over what is truly important, the health of the patient.
2. It increasingly risks turning doctors into assembly-line technicians that are only there to take the indicated 'evidence-based' tests and treatments. It takes agency and decisionmaking effectively from the hands of doctors and transfers it to large research bureaucracies, which may or may not be asking the right questions.
It increases the social and informational distance between the patient and the point of decision-making -- which we've seen can have disastrous consequences (for example, in planned economies), when that distance impeded the smooth flow of information.
3. It presupposes the the studies and meta-analyses in the research pipeline are a good decomposition of the current state of medical knowledge. E.g. if there's an analysis that says 'treat a person with diabetes with treatment X', then that approach would work well, regardless of the specifics of the actual patient at the clinical level. Patients don't come cleanly with a single diagnositic label; most people with chronic conditions have more than one, for example.
Note that the methodology and effectiveness of Evidence-Based Medicine has itself not been subjected to rigorous large-scale scientific evaluation; we are literally being asked to take on faith that this particular 'EBC' implementation of evidence-based medicine will be better.
The CDC does studies on populations though. So now they can't say if the health outcomes for those on medical entitlements are on par with private insurances. Or propose studies on learning techniques to help deal with transgender issues. This is just more of Republicans denying funding for facts they don't want to know because the answers will probably not help their agenda. Similarly to how they say the CDC can't study any gun control outcomes related to mental health or really any reason.
Note: I know this is just for budget note but it's not a great direction.
> "Are some diseases suddenly targeting people..."
While perhaps belying the name, the CDC's mandate is broader than only disease, it's general public health, including, among many things, occupational safety and injury prevention. Anything which may lead too injury or death can be considered under their purview.
I think you're coming into this with a lot of baggage. "Vulnerable" isn't necessarily subjective, e.g. "poor populations are vulnerable to diabetes" is a statement that evidence can be brought to bear on.
> "Are some diseases suddenly targeting people based on their identified sex? If no, the CDC has no business discussing this anyways."
One study the CDC works on is HIV within transgender communities. Tell me how that isn't within their scope to look at. What about any other public health issues that are more concentrated within transgender individuals? Can they not study that and try to figure out what is causing it and if things can be done?
All word of mouth based on an unnamed analyst as a brief part of a meeting. So in spite of the disturbing nature of it, I'm calling it unsubstantiated hearsay until otherwise.
I've read articles now on three news sites about this. All of them cite "CDC analysts" but provide no names or credible sources. If these analysts are upset, why aren't they providing their names? Why do newspapers allow these anonymous sources?
I can understand a hypothetical analyst being eager to complain to the press yet scared to jeopardize an "analyst" job, whatever that is. What I don't understand is why, in the age of "fake news", journalists are not being more diligent about credibility of sources. This sloppiness empowers the exact thing they claim to be against. The only purpose I can imagine is to foment social media outrage and drive clicks and advertisement impressions.
I agree. I really want a journalism source to which I can give a monthly or annual fee which doesn't allow anonymity for anything less than a real scandal.
And it is up to the journalist to decide when anonymity is warranted. We aren't talking about Watergate or the Pentagon Papers. This is gossip. Promoting gossip serves Trump, not the public.
What evidence do you have that they have been sloppy or not diligent with regard to their sources here? The fact that the sources are anonymous is certainly not such evidence; anonymous sources have been considered crucial to journalism for a very long time.
Letting sources be anonymous doesn't preclude you from being diligent about the veracity of your sources' claims. The sources aren't anonymous to the journalist.
I'm aware that it was posted to the New York Times. I saw the same thing presented on several news sites yesterday. The New York Times does not get a pass because of some appeal to authority. I don't want the Trump administration to make the CDC less useful. The New York Times publishing gossip doesn't improve the situation.
And to be completely fair, this was originally broken by Washington Post, which has a long history of corroborating their sources. I understand that an appeal to authority is hard to stomach these days, but I believe that Washington Post has shown more than enough evidence that they investigate their sources' claims thoroughly before publishing. If you don't want to trust this right now, that's your prerogative, and you can wait for the official comment by the administration.
The appeal to authority is completely unacceptable, in my opinion. I don't want another Iraq War. I want administrations held accountable. I want Trump held accountable. Journalists are playing into his game by publishing gossip as news.
This makes the article much less potent. Without knowing the analysts and being able to confirm it, it’s just a case of he said, she said. HHS has a statement that says this didn’t happen.
It seems like the journalist should have worked to get a recording or at least multiple sources.
As a rule journalists do not make stuff up. And the few exceptions to that rule, if and when found out are dealt with rather harshly. Wish that we would hold politicians to the same standards.
I'm not suggesting that journalists made something up. I would like to see a list of banned words presented to CDC staff. It's not clear to me how serious this is. Is it an exaggeration? A miscommunication? We are not talking about Watergate or the Pentagon Papers. It's hard to tell if this is gossip. Anybody taking ownership of the claim could clear that up.
So? If I were a CDC employee and I were fired for publishing policy, I would be proud of that. I'm sure many lawyers would love to represent such a person.
That’s a good point and I don’t think the journalist is making it up, although there have been quite a few cases of journalists being wrong or outright lying (eg, Dan Rather).
I think the bigger risk is that the source is wrong. Being able to confirm with multiple sources isn’t just about proving yourself as a journalist, but about verifying the story.
I look forward to the follow up stories to confirm or deny what this is about.
Like I said, HHS already has statements saying “that didn’t happen like that” so it’s an issue of HHS credibility vs. New York Times. Having better sources would remove this question.
Because these people are career government employees. If they are specifically named, under this administration their career is likely ended.
And unlike the tech industry, people in these positions don't job-hop constantly.
They want the public to know about this [I can think of many unfavorable adjectives] behavior. But they don't want to lose their careers, put their families at economic risk, etc.
Acting as (responsible) intermediary in such circumstances is a time-honored and proven role of journalism, in the U.S. and other countries.
P.S. I'll add that the U.S. scientific community had a good, close look at such behavior as a preview, in the neighboring country of Canada under the Harper government.
To the point where they were collaborating with Canadian scientists to back up data before the Harper government erased it.
They are not merely reacting emotionally. They've seen Conservatives' (on either side of the border) play book for this for nigh on a decade, at least.
I agree that journalists protecting sources is important for some matters (e.g., Watergate, the Pentagon Papers). I think the allowance of anonymous sources has swung too far in the other direction, allowing for gossip as news. Journalists need to hold their sources to a higher standard and make clear that they must accept some risk.
In this case, there is no need for such risk taking.
As I understand it, the journalists have been supplied with copies of the specific document(s).
They can then ask the relevant administration whether the document is genuine.
If the adminsitration does not deny the legitimacy of the document, there's your proof. (These are not classified documents. There's no "we can't respond" cover for them, in this case.)
This is also a common journalistic practice.
I'd also expect them to pursue multiple sourcing for the story. Although, with the document(s) at hand, and the course I described possible, that's not strictly necessary.
P.S. I'll add that, more broadly, document sharing is not without risk. The government as well as private entities have taken to distributing "marked" documents that can be tracked back to original recipients. Not in all nor anything like the majority of cases. Just some specific ones.
That marking can be overt, or covert. The latter case can include slight variations in content that, particularly if someone has only one exemplar, can be difficult to detect and at best only suspected.
Anyway... speaking VERY generally, a central if sometimes unspoken role of ANY organization is mitigating risk to its participants.
I would not expect anything different from journalism. I would not expect people to take on unnecessary risk. When people name themselves in such circumstances, it's to accomplish something additional. That doesn't seem to be needed, here. I don't see much reasoned doubt of the story, and I've yet to see a denial from "the government".
Ok, too much caffeine, here. Sorry for my runaway keyboard.
P.P.S. I can't yet reply to your reply, but I wanted to say, "fair enough".
With the caveat I already added, above -- apparently, while you were replying -- that original documents sometimes have to be presented in an information-retaining representation, where overt or covert marking may betray the source.
(For example, the woman in Georgia who landed in jail... this past year or so. Win-something or other? The press didn't screen the documents she provided, and they were readily traced back to her. Then apparently corroborated by FBI using system access logs. Apparently, because at the time I last read about it, methodologies were not being confirmed.)
I'm amused by the overall reaction and the downvotes. My perception of the general ethos of Hacker News that we should be able to get to original sources without gatekeepers. Such disintermediation is exemplified by e.g., arXiv, but when it comes to news, journalists are given a pass on what might be gossip.
52 comments
[ 4.8 ms ] story [ 76.7 ms ] thread* fetus
* transgender
* vulnerable
* entitlement
* diversity
* evidence-based
* science-based
* evidence-based
Unnecessary. Anything the CDC produces better be science based already
* fetus
annoying, but synonymous words exist
* transgender
Are some diseases suddenly targeting people based on their identified sex? If no, the CDC has no business discussing this anyways.
* vulnerable
Subjective words have no place in scientific discourse
* entitlement
* diversity
Political words also have no place in scientific discourse
https://www.plainlanguage.gov/law/
Evidence-Based Medicine[1] is a particular movement that makes particular claims about what sorts of evidence are better than other sorts of evidence, and how we should (re-)structure clinical practice to revolve around these.
In other words, EBC != evidence-based medicine. It strongly emphasizes large-scale studies at the expense of other types of empirical knowledge, namely the direct clinical experience of the practitioners.
What might be the harm in doing so? Why shouldn't we all rely only on large-scale meta-analyses to guide treatment?
1. There are important clinical questions that are difficult to measure in a double-blind clinical framework; the risk is that we end up optimizing what we can easily measure over what is truly important, the health of the patient.
2. It increasingly risks turning doctors into assembly-line technicians that are only there to take the indicated 'evidence-based' tests and treatments. It takes agency and decisionmaking effectively from the hands of doctors and transfers it to large research bureaucracies, which may or may not be asking the right questions.
It increases the social and informational distance between the patient and the point of decision-making -- which we've seen can have disastrous consequences (for example, in planned economies), when that distance impeded the smooth flow of information.
3. It presupposes the the studies and meta-analyses in the research pipeline are a good decomposition of the current state of medical knowledge. E.g. if there's an analysis that says 'treat a person with diabetes with treatment X', then that approach would work well, regardless of the specifics of the actual patient at the clinical level. Patients don't come cleanly with a single diagnositic label; most people with chronic conditions have more than one, for example.
Note that the methodology and effectiveness of Evidence-Based Medicine has itself not been subjected to rigorous large-scale scientific evaluation; we are literally being asked to take on faith that this particular 'EBC' implementation of evidence-based medicine will be better.
[1] https://en.wikipedia.org/wiki/Evidence-based_medicine#Limita...
Note: I know this is just for budget note but it's not a great direction.
While perhaps belying the name, the CDC's mandate is broader than only disease, it's general public health, including, among many things, occupational safety and injury prevention. Anything which may lead too injury or death can be considered under their purview.
I think you're mistaking the charter and purpose of the CDC.
Controlling disease has plenty of hard science -- but much of it is messy and full of human factors. That's what those words represent.
Wait crap my statement was too political and subjective
> "Are some diseases suddenly targeting people based on their identified sex? If no, the CDC has no business discussing this anyways."
One study the CDC works on is HIV within transgender communities. Tell me how that isn't within their scope to look at. What about any other public health issues that are more concentrated within transgender individuals? Can they not study that and try to figure out what is causing it and if things can be done?
economics drives everything. we need a different incentive structure for news, and the readers are probably the only ones that can effect change.
It seems like the journalist should have worked to get a recording or at least multiple sources.
Fortunately, there are many ways to get hard copy / digital copy without traceability (eg, Wikileaks but not Reality Winner).
I think the bigger risk is that the source is wrong. Being able to confirm with multiple sources isn’t just about proving yourself as a journalist, but about verifying the story.
I look forward to the follow up stories to confirm or deny what this is about.
Like I said, HHS already has statements saying “that didn’t happen like that” so it’s an issue of HHS credibility vs. New York Times. Having better sources would remove this question.
And unlike the tech industry, people in these positions don't job-hop constantly.
They want the public to know about this [I can think of many unfavorable adjectives] behavior. But they don't want to lose their careers, put their families at economic risk, etc.
Acting as (responsible) intermediary in such circumstances is a time-honored and proven role of journalism, in the U.S. and other countries.
P.S. I'll add that the U.S. scientific community had a good, close look at such behavior as a preview, in the neighboring country of Canada under the Harper government.
To the point where they were collaborating with Canadian scientists to back up data before the Harper government erased it.
They are not merely reacting emotionally. They've seen Conservatives' (on either side of the border) play book for this for nigh on a decade, at least.
As I understand it, the journalists have been supplied with copies of the specific document(s).
They can then ask the relevant administration whether the document is genuine.
If the adminsitration does not deny the legitimacy of the document, there's your proof. (These are not classified documents. There's no "we can't respond" cover for them, in this case.)
This is also a common journalistic practice.
I'd also expect them to pursue multiple sourcing for the story. Although, with the document(s) at hand, and the course I described possible, that's not strictly necessary.
P.S. I'll add that, more broadly, document sharing is not without risk. The government as well as private entities have taken to distributing "marked" documents that can be tracked back to original recipients. Not in all nor anything like the majority of cases. Just some specific ones.
That marking can be overt, or covert. The latter case can include slight variations in content that, particularly if someone has only one exemplar, can be difficult to detect and at best only suspected.
Anyway... speaking VERY generally, a central if sometimes unspoken role of ANY organization is mitigating risk to its participants.
I would not expect anything different from journalism. I would not expect people to take on unnecessary risk. When people name themselves in such circumstances, it's to accomplish something additional. That doesn't seem to be needed, here. I don't see much reasoned doubt of the story, and I've yet to see a denial from "the government".
Ok, too much caffeine, here. Sorry for my runaway keyboard.
P.P.S. I can't yet reply to your reply, but I wanted to say, "fair enough".
With the caveat I already added, above -- apparently, while you were replying -- that original documents sometimes have to be presented in an information-retaining representation, where overt or covert marking may betray the source.
(For example, the woman in Georgia who landed in jail... this past year or so. Win-something or other? The press didn't screen the documents she provided, and they were readily traced back to her. Then apparently corroborated by FBI using system access logs. Apparently, because at the time I last read about it, methodologies were not being confirmed.)