Astral Codex Ten

NICE

6 min read

NICE

Article

NICE is a recurring organization in the Astral Codex Ten archive, appearing 5 times across 5 issues between February 16, 2021 and April 30, 2024. The archive places it in contexts such as “NICE, the UK health system’s guideline-making authority”; “no major academic or popular resource (eg UpToDate, NICE, Wikipedia, WebMD)”; “Vitamin D is not generally recognized (eg NICE)“. It most often appears alongside COVID, UpToDate, Vitamin D.

Metadata

  • Category: Organizations
  • Mention count: 5
  • Issue count: 5
  • First seen: February 16, 2021
  • Last seen: April 30, 2024

Appears In

Source Context

Recovered passages from the original issue text. When the raw archive preserved outbound links inside the source passage, they are listed directly under the quote.

Vitamin D: Much More Than You Wanted To Know
February 16, 2021 · Original source
I've waited until now to bring in the argument from authority. NICE, the UK health system's guideline-making authority, says that "there [is] little evidence for using vitamin D supplements to prevent or treat COVID‑19", which is a terrible framing (give me time to write a post on this) but gets the point across well enough. UpToDate, the private company that produces semi-canonical evidence aggregation for US doctors, says that "there is no clear evidence that vitamin D supplementation reduces the risk or severity of COVID-19" (sorry, you won't be able to read that link without a subscription). Stuart Ritchie, who literally wrote the book on how to tell good science from bad, says he's unsure, but in a way that sounds a bit skeptical. This seems like a pretty common position.
Inline links: says that, says that, wrote the book, unsure, a pretty common position
A Look Down Track B
February 22, 2021 · Original source
...forward to seeing further attempts to replicate and explicate these interesting results. Prediction: 90% chance that no major academic or popular resource (eg UpToDate, NICE, Wikipedia, WebMD) will give this theory prominence equal to or greater than the standard serotonin theory in its explanation of antidepressant effects by 2030, unless t...
...F -> TrkB -> nerve growth theory for now, but I look forward to seeing further attempts to replicate and explicate these interesting results. Prediction: 90% chance that no major academic or popular resource (eg UpToDate, NICE, Wikipedia, WebMD) will give this theory prominence equal to or greater than the standard serotonin theory in its explanation of antidepressant effects by 2030, unless this is because some...
Grading My 2021 Predictions
January 24, 2022 · Original source
COVID 23. Fewer than 10K daily average official COVID cases in US in December 2021: 30% 24. Fewer than 50K daily average COVID cases worldwide in December 2021: 1% 25. Greater than 66% of US population vaccinated against COVID: 50% 26. India's official case count is higher than US: 50% 27. Vitamin D is not generally recognized (eg NICE, UpToDate) as effective COVID treatment: 70% 28. Something else not currently used becomes first-line treatment for COVID: 40% 29. Some new variant not currently known is greater than 25% of cases: 50% 30. Some new variant where no existing vaccine is more than 50% effective: 40% 31. US approves AstraZeneca vaccine: 20% 32. Most people I see in the local grocery store aren't wearing a mask: 60%
All Medications Are Insignificant In The Eyes Of God And Traditional Effect Size Criteria
May 31, 2023 · Original source
Others are even stricter. Leucht et al investigate when doctors subjectively feel like their patients have gotten better, and find that even effect size 0.50 correlates to doctors saying they see little or no change. Based on this research, Irving Kirsch, author of some of the earliest credible antidepressant effect size estimates, argues that “[the] thresholds suggested by NICE were not empirically based and are presumably too small”, and says that “minimal improvement” should be defined as an effect size of 0.875 or more. No antidepressant consistently attains this. He wrote:
Inline links: Leucht et al, argues that, wrote
Only D, E, and F pass NICE’s 0.50 threshold. And only F passes Kirsch’s higher 0.875 threshold. So a drug that completely cured 40% of people who took it would be “clinically insignificant” for NICE. And even a drug that completely cured 80% of the people who took it would be clinically insignificant for Kirsch! Clearly this use of “clinically insignificant” doesn’t match our intuitive standards of “meh, doesn’t matter”.
Here we find that only E and F meet NICE’s criteria, and nobody meets Kirsch’s criteria! A drug that significantly improves 60% of patients is clinically insignificant for NICE, and even a drug that significantly improves 100% of patients improve is clinically insignificant for Kirsch!
Response to Hanson On Health Care
April 30, 2024 · Original source
Obviously this doesn’t mean that there’s no possible way medical studies could ever be biased. But I worry that people act like “studies can be p-hacked” is some sort of secret knowledge that elevates them above domain experts. Medical evidence is processed by groups like NICE and the Cochrane Collaboration that have been worrying about p-hacking since 2004, trying to factor its existence into their recommendations, and organizing pretty successful campaigns among journals and other stakeholders to minimize it. This doesn’t mean everything is perfect, but I think we’re beyond the level where you can say “what about p-hacking” and use it to throw out every clinical study in favor of three social science experiments that explicitly admit they don’t have enough power to test these kinds of questions.