Some meta on medical research

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Some meta on medical research

Post by Panache on Wed Aug 26, 2015 9:49 pm

We’ve been talking about several medical-related topics recently, and I can see how doing medical research might be specifically applicable in several ways to antisexuals: the neurological and physiological effects of sexual behaviors, the psychiatric community’s attitude towards negative or disinterested attitudes towards sexual relationships, the psychology and neurobiology of sexual attraction – besides which antisexuals are a very marginalized population and we each need as many skills and resources at our disposal as possible, to protect ourselves. We’re also very counterculture and many of us probably value finding the truth for our own selves. And just because we all live in bodies and the health of the body and mind is essential for getting anything at all accomplished in life. So I thought I would write a post on my philosophy on medical research, incase it might be useful for people who are just starting to dip their toes into this area.


A vital component, before you do anything, is you have to be able to actually change your mind. If you can’t change your mind there’s no point in even trying to do any research, because everything you find will only confirm what you already believe, and you’ll never learn anything more about reality or get any closer to the truth. Changing your mind can be a very painful process. Even doubt or uncertainty can be painful. I’d recommend trying to recall the last time you learned something new and changed your beliefs or behaviors based on the new information: if you can’t remember the last time you did that, there’s a problem. In that case, I’d recommend just starting out with reading nonfiction books on any subject you’re interested in, and working on feeling more comfortable with feeling uncomfortable, before you get into research.


So, first off, there is no such thing as an unbiased study. Somebody funded every study: sometimes the bias is transparent, sometimes it’s obscure. Not only is there the matter of who funded the study, but also of who funds the organization that funded the study. What can seem perfectly unbiased at first glance, like the American Cancer Society funding a study on colon cancer, frequently leads back to the American Cattlemen’s Beef Association, or somesuch. When the government funds a study, corporations “sponsored” the funding, and determined which studies would be selected to be conducted over other proposals, so that also requires looking into.


The authors of the study can also have profound biases, either personal or financial. It’s important to look at what institutions the authors are employed by, what organizations or research groups they spearhead, and whom they’ve received research grants from. There are also personal biases. Sometimes these are obvious, like a leader of the paleo movement finding wildly different dietary patterns among an indigenous population than other researchers have found. Sometimes they’re subtle, and the authors themselves are probably not aware of their influence; these can be hard to tell, except by learning more about the authors as people and learning about their careers.


Following financial trails requires its own set of research skills that’s rather different from the skills needed for medical research, but unfortunately it’s a necessary additional ability that one needs to cultivate in order to figure out the potential validity of medical information.


There are also cultural biases, and necessarily underlying cultural assumptions which affect both us and the researchers and can’t be weeded out unless one becomes conscious of them. This is why it was powerful evidence to me to see studies conclude that obviously sex is addictive, and then turn right around and start talking about encouraging recovering sex addicts to engage in “healthy” sex. When a culture is that blinders-on biased and finds the evidence incontrovertible anyway, that’s some strong evidence. However, if a culture is biased towards certain outcomes or conclusions and those are the ones they draw, it merits putting less weight on that evidence, until it’s coupled with other evidence, preferably looking at the subject from a different angle, or looking at a different specific component.


Related to cultural biases, I put little stock in most Japanese studies (though with exceptions), because I’ve never seen a Japanese study that found results that were both bad and unexpected. Almost always they find what they expect to find, and if they find something unexpected, it’s always good news. It’s led me to wonder whether Japanese culture having such an emphasis on harmony over truth has made it almost impossible for Japanese people to see the unfiltered truth, even with all the best and most rigorously scientific intentions. I’m not saying this is a stance other people should automatically take as well; however, it might be something to keep in mind as you consider evidence.


It cannot really be overstated: every single study is financially motivated. They’re all biased. It gives me a special sort of pain to know this, because the truth is so important to me. I wish I wish I wish there were pure research being done, an untainted quest for the truth. But, at least in the medical world, there’s not. If your interests tend towards the metamorphic and igneous composition of the coastline of South America, or something, that might be more unbiased.


I use medical studies for learning about the world, even knowing they’re all biased, because – what else is there? What else do we have available to us to figure out the truth about these issues? Perhaps historical and multicultural beliefs and practices, but I would be extremely reluctant to eliminate scientific evidence from my body of medical information.


It also helps, whenever possible, to find the original data and the full methodology of the study. It’s important to learn about data analysis, not to be able to do much of any of your own (unless you’re really good at math and willing to invest a whole lot of effort in learning about it), but because it helps to spot potential bias in the studies: data that is unusually orderly, among other things, will then raise red flags as a possible sign that the author was, either intentionally or unintentionally, filtering the results.


One of the most direct (and most awesome) ways of learning more of the truth and finding out lickety split whether a study shows bias, is to find and read the actual peer reviews of the study. I love these because they’re written by people who also really know what they’re talking about, and yet often also take completely the opposite view found by the study they’re criticizing. And they tend to be snarky.


And please, for the love of biscuits, ALWAYS read the original studies. If you read predigested accounts of research, in books or articles or documentaries or somesuch, never believe it. Hold that information in a big floating limbo category until you’ve had a chance to examine the evidence for yourself. This is an issue I’ve had to learn to be rigorous about the hard way, as I’ve more than once believed somebody’s account of a study, and then later, when I actually read the study, found they were profoundly skewing the information. Not something you want to find out after you’ve based decisions on wrong interpretations.


There are many different types of study.


There are experiments in controlled environments, what people typically envision when they think of medical research. Scientists in a lab, experimenting on albino rats or growing cultures in petri dishes or somesuch, looking at a very specific element within a very narrow subject. Such controlled assays are useful for figuring out how one specific element of a subject influences the whole: does a specific strain of E. coli outcompete a specific strain of Prevotella sp., or vice versa, when fed on various substrates and at various temperatures? As you can imagine from this example: the more controlled the environment of the experiment is, the more accurate and replicable the results will be, but the less relevance the results will have for reality, because reality is complex. It’s never just one strain of Prevotella sp. vs. one strain of E. coli, the environment of our digestive tract is very different from the environment of a lab, and they’re never getting fed just one thing through our digestion.


There are other types of studies too, however, and they are also weighty components to figuring out the truth.


There are population surveys. These are generally pretty straight-forward: American adults reported having sex an average of 132 times a year, while Japanese adults reported having sex an average of 36 times a year. Even in surveys there’s the possibility of distorting information, based on the way the questions were worded, the types of questions that were asked, the response options that were offered, the population size of the survey, the way the survey participants were found and contacted, what sort of people refused to participate in the survey, the way the statistics were analyzed and reported, cultural differences in the way people define concepts, the likelihoods the participants were telling the truth, the percentage of participants who refused to answer the question, etc.


There are population studies, like the Nurses’ Health Study, where all kinds of records are kept on often thousands of people, often over the span of decades, and then epidemiologists take all this massive amount of information and look for patterns and correlations. These are incredibly informative, but also vulnerable to misinterpretation and misrepresentation, and to reporting bias, since so many detailed pieces of information were collected from so many people over such an extended period of time. Fortunately, with these sorts of studies, all kinds of people are analyzing the data and working on drawing conclusions, so one can look for some elimination of bias through conflicts of opinion.


There are experiments on small populations of people. Take 20 people, fast them for 24 hours, feed them 200 g sucrose, and test their blood sugar over the course of 8 hours to see what happens. Obviously with controls, double-blind if possible, etc.


There are longer-term studies on small populations of people. Add a daily multivitamin to the diets of 20 people with Alzheimer’s in a nursing home, follow them indefinitely and compare their outcomes to the other people with Alzheimer’s in the nursing home who aren’t taking a multivitamin. I put a lot of weight on these types of studies, when they’re reliably conducted, because they’re conducted in reality, which is what we need information about, and yet are relatively controlled, and the outcomes are more straightforward than when one must rely on data analysis.


And, my favorite, the meta-analyses. In metas an epidemiologist (or a group of epidemiologists working together) has collected all the relevant research they can find on a subject, weighted it, collated it, and looked for patterns. They often draw brilliant conclusions based on body of evidence and the underlying patterns they’ve abstracted. Metas are also massive information downloads, organized and systematized by somebody who really knows what the heck they’re talking about. Often metas have hundreds of references, and I’d recommend looking for metas as an excellent starting point if you’re just getting into a subject.


All these types of studies come together to help us get closer to the truth. People who don’t know much about science tend to put an imbalanced weight on results found in controlled assays, because they think of that as stereotypical “real science.” However, all these types of research are pieces of the puzzle and come together powerfully to form an understanding of the way things work.


Another unscientific mental trap that people can fall into is not believing evidence, even good evidence, if they don’t understand the why and the how. If you find many collectively-less-biased studies that conclude the same thing, and you don’t see how it could possibly be true, it doesn’t matter. The world is freakin’ complicated: you don’t need to know why something is the case, to be convinced it’s the case. You should always work backwards from evidence if you want to speculate on the why and the how, not work forward from general things you already know to try to logic out how reality is going to work in this new instance. Seriously, truth is stranger than fiction: there is so much stuff I’ve learned where the only possible response is, “Holy ####.” Reality is so weird and unpredictable, you couldn’t make it up if you tried.


You need to have a certain attitude when you’re doing medical research. It’s kind of a zen experience: “I release all my attachments. I receive reality as it is revealed to me. I want nothing, I desire nothing. What is, is, and I seek only truth.” You’re not looking for evidence to back up your already-held beliefs: you’re looking for more information on a subject of interest. Truth must be the absolute priority, or your conclusions will be biased.


You’ll know whether you’re accepting the truth or not because, if you are, you’ll feel relaxed and happy from doing research, and enriched with more ideas about how the world works, even if you don’t understand them all yet and some of them seem to contradict each other. If you’re biased, you’ll feel stressed, angry, unhappy, and nervous while doing research, because around every bend is the risk of finding out something that contradicts what you want to be true. If you’re biased, you’ll skip over reading or learning about things that might shake your beliefs, and if you’re unbiased, those are the sorts of things you’ll be especially eager to learn about, because it’s new information that isn’t currently part of your understanding of the world.


This can be really incredibly hard to do. It gets easier with practice.


I believe there’s also a great deal to be said for body of evidence, especially because each individual study is biased. They’re not all biased in the same ways (one hopes), and so when you take the body of evidence as a whole, the biases can cancel each other out somewhat. Once you know enough about a subject, all the individual studies and bits of information start to make sense together, and you start to see patterns and systems in a way that lets you almost predict what studies on specific details related to the subject are likely to find. It’s an understanding that also makes incongruous studies stand out to you like a blaring signal. And on the flip side, information that appeared conflicting before suddenly resolves itself and you understand how both could be true at once, because you see the system. That’s when you start to feel more comfortable with your understanding of an issue, and can start to feel safer drawing your own conclusions.


My brother would string me up by my toes for saying this, but: it’s okay if you do medical research and don’t always do all these things. The more important the information is to you, the more it’s going to influence your understanding of the world and has the potential to dictate future decisions, the more important it is to be rigorous and supremely skeptical. But sometimes you just want to know because you’re curious and you just want to see what’s out there. That’s okay. It’s okay to scan abstracts, bounce around from one subject to the other, pick up bits here and there, skip over parts you don’t understand and save things for looking into later. The world is freakin’ complicated, and being empowered enough to learn something, anything for yourself and try to understand and figure things out, is miles ahead of just blindly waiting for authority figures to tell you what life-determining things you should do. In the quest for truth and knowledge, you have to start somewhere, and begin as if you mean to go on.


And then, after all this, there’s reality. However much you think you know about the truth, reality trumps everything. It trumps studies, it trumps logic. Reality is, and it doesn’t go away. Personal experience and best available evidence in real-life situations are powerful forces for figuring out the truth. Too often these are sources of information discounted by people who fancy themselves as “logical,” because they imagine truth can only be found in hair-splitting details in a controlled environment in the laboratory. They forget that the whole point of such experiments is to get closer to understanding reality, which we all happen to be learning more about right this minute, because we’re living in it.


I will never know the truth, the whole truth, and nothing but the truth, on any subject. It’s impossible. All we can do is get closer to the truth than we were before.


I wish the very best of luck to anyone who’s getting interested in this subject, and I hope this encourages (and doesn’t discourage) people in the quest for knowledge.
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Re: Some meta on medical research

Post by Admin on Wed Aug 26, 2015 10:31 pm

This is amazing! cheers

When possible, I look at medical research, from full text, and from sources that host peer-reviewed articles, though I haven't yet seen where the reviews of the article are. It'd be interesting to see those reviews, especially the opposing reviews.

It is difficult to reconcile the importance of looking at medical research, with the fact that it all inevitably has biases because of interests funding the research, but what you said about how biases from other articles may cancel each other out. I have a background in psychology, which includes an understanding of research methods. I can find obvious biases and misuse of statistics right away, but those other biases you mentioned are so much more sneakier.

In regards to cultures that value group harmony, there will always be individuals within it that value the truth over harmony, but it can be an especially difficult path to take. But those kind of studies wouldn't get a lot of funding, wouldn't they? Just like how it's difficult for a study without any commercial or political interests backing it, to get enough funding to get off the ground.

As I was getting back into reading research articles, I tried to avoid assumptions. What I've read about romantic love was often confusing to me, and some of it challenged my expectations, but I agree it's important to keep an open mind. Sometimes it can get overwhelming when what I read may answer one question, but raise several more. Where do I go from there, to avoid being overloaded by all of those questions?

I felt like the toughest part with this research is finding the starting point. Those articles you linked to in the overview thread worked as a great starting point in looking into the nature of romantic love, and start to make sense of it. Smile
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Re: Some meta on medical research

Post by Snowflake_ on Wed Aug 26, 2015 10:42 pm

You just want to say "I don't really trust those damn thing."

This is dreary and lengthy.
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Re: Some meta on medical research

Post by Panache on Thu Aug 27, 2015 12:16 am

Razz  I'm so happy you like it, Admin!

@Admin wrote:I have a background in psychology...
silent  I didn't mince words very much about the DSM earlier, did I? I hope you weren't having to hold back from telling me off.

@Admin wrote:Just like how it's difficult for a study without any commercial or political interests backing it, to get enough funding to get off the ground.
Exactly. I so wish there were pure medical research being done. Sad  I don't know what could be done to improve the situation, however. I wish I had some over-arching idea of how the current system might be changed, even if the solution were never anything but entirely hypothetical.

@Admin wrote:Sometimes it can get overwhelming when what I read may answer one question, but raise several more. Where do I go from there, to avoid being overloaded by all of those questions?
Regarding romantic attraction specifically, I hope I can help with that one at least somewhat by presenting my own collection of research, as soon as I can get it prepared. However, for your own research and for other subjects in general, I generally go about starting this way (not saying at all that this is the best way, it's just the way I generally do it):

Starting to get interested in a subject - predigested research: books, documentaries, lectures given by doctors and researchers in the field, even TED talks. Based on bibliographies and things that get mentioned, keeping a (more and more extensive) list of books and names, and relevant words that might be able to be used as search terms. Generally at this point realizing the subject is way more huge than I thought it was going to be, and connects to subjects I wasn't expecting. Psychopathy? #### - reactive attachment disorder, attachment theory, parenting, child development, neurobiology, pair bonds, addiction, human origins, behavioral theory, RUN! Also keeping notes in general: comments, questions, concerns, summaries of issues I think I understand, ranting about how XY&Z are so confusing, (occasionally ranting about the ideas of people who I can already tell are idiots...). Important to focus on what's interesting to you, so you stay curious and not bogged down in things you don't understand or don't care about yet but feel obligated to read.

By that point I generally have somewhat of an overview of what to expect, as well as a collection of studies to look up that were sourced in the books. I also have a fairer idea of which researchers are going to be biased about what, and I know more field-specific terms to do research with. At this point I generally crack open the research and see what I find, using the referenced studies, researchers' names, and specific terms for specific issues I'm trying to get more information on. I start keeping a record of every even remotely relevant study I find and (at least partially) read, with the name of the first researcher and the title, and a link to it, a summary of what it's saying, and sometimes quotations and notes on the bits I thought were very interesting. Wherever I find obvious bias or I'm worried there's bias, I mark it very clearly so I don't forget.

Sometimes this approach means I enter into the research kind of sideways, but you have to start somewhere. I also immediately start looking for metas, as they're another way of getting a major overview of the issues, as well as taproots to hundreds of more studies. You can generally find metas by their awesome titles: "Diet-induced protection against lipopolysaccharide includes increased hepatic NO production."? Probably not a meta. "Neurobiology of addiction."? Probably a meta!

And I suppose that's how I get started with a subject. By that point I'm pretty well into it, and have an idea of the issues that need pursuing. I hope that helps at all? As I get more into it I pursue specifics in greater detail, get into validity, follow up on questions of bias, pursue financial trails and all that fun stuff, but I try to start with whatever mild and understandable things I happen to be interested in. Smile

Lol, now you probably can see why my research is so unorganized! What I'm trying to work on is to write some sort of step-by-step explanation of how sexual behaviors and limerence are related to addiction, starting from the very beginning: definitions of emotions and drives, definitions of addiction and compulsive behaviors, the neurobiology of addiction, etc. and working through the issues and evidence in as logical and understandable a progression as possible, and sourcing the bejeezus out of it. I'm hoping that will be more useful than just a big information dump of all my research, but it's taking some untangling. I'm actually really enjoying getting it all synthesized like that, though.
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Re: Some meta on medical research

Post by Panache on Thu Aug 27, 2015 2:41 am

@Snowflake_ wrote:You just want to say "I don't really trust those damn thing."

This is dreary and lengthy.
Well, I put enough stock in them that I became antisexual.

Are you interested in doing medical research?
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Re: Some meta on medical research

Post by Admin on Thu Aug 27, 2015 9:54 pm

Don't worry, I didn't feel any need to tell you off for what you said about the DSM, or to hold back. I know the DSM has its flaws, including biases. I'd like to see the system be reformed, and I agree with the ideas you mentioned about the reform that would be needed.

When doing research now, I've seen articles about one subject lead to multiple others, like what you described. How do you stay on track, and not get overwhelmed by seeing all of these other subjects pop up at once? Do you try to focus on them one or a few at a time?

I've been keeping notes, including names and keywords, and summaries. That's okay that your research is unorganized. Mine is too! Would you want to write articles for the main page about your research when it is organized?
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Re: Some meta on medical research

Post by Panache on Fri Aug 28, 2015 12:09 am

@Admin wrote:Don't worry, I didn't feel any need to tell you off for what you said about the DSM, or to hold back. I know the DSM has its flaws, including biases. I'd like to see the system be reformed, and I agree with the ideas you mentioned about the reform that would be needed.

When doing research now, I've seen articles about one subject lead to multiple others, like what you described. How do you stay on track, and not get overwhelmed by seeing all of these other subjects pop up at once? Do you try to focus on them one or a few at a time?

I've been keeping notes, including names and keywords, and summaries. That's okay that your research is unorganized. Mine is too! Would you want to write articles for the main page about your research when it is organized?
Phew. I appreciate that. I know I can come over kind of strong sometimes.

I suspect how one handles many unknowns at once has a lot to do with personality. I'm pretty comfortable with ever-expanding systems: actually it's the underlying systems that I'm generally the most interested in (you might have noticed, lol). I write down a lot of questions and sort of keep a narrative of what I'm figuring out while I'm working on it, which helps me think through issues I'm confused about. Talking to people about what I've been wondering about is also really helpful to me for getting my thoughts sorted. If you can find someone who's patient and interested and is happy to just listen while you ramble on about the stuff you're currently wondering about, that's a real blessing. I don't mind keeping problems in limbo and waiting for them to sort themselves out as I continue learning new things - it all connects around eventually.

Writing down questions really helps a lot, actually, because I can go back over them down the line and see how my thinking has developed and clarified. It's very satisfying to see that you now know the answers to questions you were once terribly confused about - and even more satisfying when you see you were asking the wrong questions!


If you wouldn't be comfortable with this way of doing things and would like a more linear approach - perhaps write down a very specific question you'd like to know the answer to (preferably not a Why question, lol), and then focus on answering just that one question? As you get more related questions you could write those down, and just go back to working on learning more about the first question, until you're either satisfied with your answer, or the question becomes irrelevant.

The thing that gets me overwhelmed is not knowing the right questions to ask or terms to use to find the information I need. It's like drifting in space, and needing something solid to push off of. I also get overwhelmed by impending paradigm shifts: when I start to get the inkling that I might have entirely wrong idea about how something works, or what's a good idea to do. That's still very scary for me. In those instances I tend to drop the subject and mull on it internally for awhile. Whether that's a very effective way of handling feeling overwhelmed, I don't know; it's what I do though.

Once I get the thing related to sexual behaviors, limerence, and addiction written up, I definitely hope to post it to the forum. The use it will hopefully serve for the antisexual community is my driving reason for writing it.  Smile 

I've been interested in the studies you've found and posted about so far. If you find interesting research related to these issues, I'd be very happy if you posted it and talked about the things you're working on, and I could see if I could incorporate that research into the overall thing. (Please don't feel any pressure to do this if you don't want to, or if it would be more a burden than a use to you.) I really wish I could discuss the details better in isolation, especially since that might be useful to you; it's just these subjects are all so closely interrelated, it seems to me, I have trouble selecting out just one strand and talking about it. The neurobiology of romantic attraction leads to  the way the dopamine system works, which leads to - what makes something addictive? - what effect does an addictive behavior have on someone who's not addicted? - can you be addicted to a person, or is that obsession? - what is addiction? - what makes some things that stimulate the reward system addictive, and others not? - why does the reward system work the way it does? - are there factors that make people less likely to become addicted to addictive processes? - how do the attachment systems influence the dopamine pathways? - is oxytocin dopaminergic? - what effect does being in love have on attachment? - what's the difference between love and being in love? - what is love? - how does being in love influence the development of pair bonds? - what are the neurological differences between romantic-sexual and maternal pair bonds? - what makes a behavior adaptive? - what does friendship-type bonding look like neurologically? Maybe it's just the way I tend to think about things, but it all seems so tied up together! Maybe it's this vast interconnectedness that you're feeling too, and has got you a bit overwhelmed. Hence my desire to get it all down in one piece.

Since you're working on these issues as well, maybe what I'm writing can be used as just sort of a first draft, and then we can start working on the issues together. With your interest being first psychology and my interest coming more from the medical side of things, it might make something pretty cool. Smile
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Re: Some meta on medical research

Post by Snowflake_ on Fri Aug 28, 2015 12:46 am

@Panache wrote:

Since you're working on these issues as well, maybe what I'm writing can be used as just sort of a first draft, and then we can start working on the issues together. With your interest being first psychology and my interest coming more from the medical side of things, it might make something pretty cool. Smile

So boring.
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Re: Some meta on medical research

Post by Panache on Fri Aug 28, 2015 1:17 am

Snowflake wrote:This is dreary and lengthy.

Snowflake wrote:So boring.

Doesn't help. If you're not interested, then don't comment on this thread. Please comment only if you have something useful to add, or a question to ask.
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