The Board of Directors at the ABIM: Will they defend their record? Or were they apathetic, incompetent, or deceived?

For readers that would like more detail, I will refer to my prior post, as well as to Dr. Westby Fisher’s comprehensive coverage of the ABIM scandal, on his blog: http://drwes.blogspot.com/

Today, in Newsweek, Kurt Eichenwald wrote a piece, that updates this scandal on a mainstream media site. Link here: http://www.newsweek.com/ugly-civil-war-american-medicine-312662

With gems such as: “…the ABIM went from being a genial organization…to something more akin to a protection racket.” And, best of all: “the ABIM Foundation that does…well, it’s not quite clear what it does. Its website read like a lot of mumbo-jumbo.”

So, we have here a protection racket with its spin-off “mumbo-jumbo” cousin. For those counting, that’s mumbo-jumbo with a $30,000,000/year payroll (not total budget, just salaries and benefits between the two organizations! [source: tax records as documented by Charles Kroll]).

All of this brings me to this point. Some like to imply that blame for this scandal should be placed mainly on the prior president/CEO (the beleaguered Christine Cassel, currently the head of the National Quality Forum, who was forced to resign last year from high-paying corporate boards due to serious conflicts of interest: http://www.propublica.org/article/payments-to-ceo-raise-new-conflicts-at-top-health-quality-group).

However, sitting on the board of any organization is a serious endeavor that deserves to be treated as such. It is not only a CV-builder and not only a place to nurture relationships. Unless they can prove that they were actively deceived by Dr. Cassel, et al., the board members past and present are ultimately responsible for what the ABIM has become. The current names and bios of board members are readily available at the ABIM and ABIM foundation websites.

These men and women who have served on the board of the ABIM over the last ten to fifteen years have only two possible primary responses to this scandal and their involvement with it:

1) Defend the organization as currently constituted.

No human institution is perfect, of course. An adequate defense, however, would recognize that while there will always be minor shortcomings a clear and convincing argument is necessary regarding both the charges of impropriety (luxury townhouse, etc.) and how it is that the ABIM needs a thirty million dollar payroll. It is not easy to imagine such an argument being a cogent one.

2) Demonstrate that he or she actively voted against or otherwise fought against these developments.


Other than 1 or 2, the only other possible explanations for the board members' work at ABIM are the ones I list in my title: apathy, incompetence, or having been deceived by the leadership.

Which is it?

Five Questions for Richard Baron

First some background:

There is controversy of late regarding the ABIM (American Board of Internal Medicine) and its financial dealings. Allegations range from poor fiscal stewardship to worse. This includes the purchase (and now sale at a loss) of a 2+ million dollar condo in Philadelphia, etc.

Dr. Westby Fisher’s blog has many of the details and links:  http://drwes.blogspot.com

Original piece on the condo: http://drwes.blogspot.com/2014/12/the-abim-foundation-choosing-wisely-and.html

Description of a Philadelphia medicine town hall meeting regarding ABIM and MOC, but also the condo, salaries, poor stewardship of funds at the ABIM, etc. featuring a debate between Charles Cutler (former chair ACP board of regents) and Richard Baron (CEO of ABIM): http://jedismedicine.blogspot.com/2014/12/abim-has-lost-its-way.html

Not to be missed is this excellent video of that debate:

http://www.pamedsoc.org/MainMenuCategories/Education/MOC/Video-MOC-Debate.html

All of which leads to my five questions for Richard Baron, CEO of ABIM:

1. Do you dispute Dr. Cutler’s facts from your recent debate with him in Philadelphia?

2. Were you the Treasurer of the ABIM at the time of the condo purchase?

3. What is the job description of the non-M.D. employee (assistant to the president) at ABIM who made $700,000 in one year?

4. As a follow-up to #3, do you stand by your reply to Dr. Cutler that “salaries get set as salaries get set?”

5. Depending on your replies to questions #1-4, how does ABIM have credibility when it comes to hectoring physicians on the cost-effective use of limited resources?

Picking on Piketty

Much has been written about the weighty bestseller: Thomas Piketty’s Capital in the Twenty-First Century.

For brief, column-length responses that take the other side, consider, e.g. the great Richard Epstein:

The Piketty Fallacy

Piketty's Rickety Economics 

And now, a comprehensive and lengthy review, that, as expected, is an economic education - nay, an education - in itself. For those who are by nature sympathetic to Piketty’s assessment and conclusions, think more clearly about the revolutionary political and economic change in the world over the last two centuries. A better critique, after all, deserves a better initial understanding:

 Measured, Unmeasured, Mismeasured, and Unjustified Pessimism: A Review Essay of Thomas Piketty’s Capital in the Twenty-First Century Deirdre Nansen McCloskey

Is the Examined Life Worth Living?

At Prof. Larry Arnhart’s blog (here:  http://darwinianconservatism.blogspot.com/2013/11/natural-right-and-natural-history.html) I pose a question in the comment section that is, perhaps, unfair in its length.  Here I will attempt to answer my own question.

Like many questions, the answer implies questions:  In this case two, namely the chief philosophic questions of 1) reason vs. revelation and 2) the philosophic life vs. the non-philosophic life (or the philosopher vs. “the gentleman,” or philosophy vs. “the city”).  These two questions are related, in that the non-philosophic life is commonly, if not always, also religious.

Since reason (i.e. philosophy and science) can never disprove theology, and since theology and revelation do not explain through proof, there is an unresolvable mystery, conflict, or tension at some basic level between the two.  

In Arnhart’s extended argument, a human desire for religion is natural, and human happiness comes from leading a good life, one that is overall in accordance with what is best for us by nature over the arc of one’s life.  He lists twenty natural desires, of which one (number nineteen) is this desire for religion.  I will add here, that I find the argument reasonable and empirically cogent.

However, it is still uncertain how this works logically.  How can reason, science, show that human nature desires religious belief - while remaining agnostic itself by necessity - without discussing the truth of the religious belief, and hence without undermining religious belief?  Or, put another way, who leads the fuller and hence happier life in this formulation, the religious believer, or the scientist/philosopher who makes the argument that, among other things, religious belief is one component of a happy life, while at the same time not believing (even if not denying belief)?

Even if we leave the question of reason vs. revelation aside and approach these natural desires (and true human happiness) from the standpoint of reason alone, we do not avoid paradox (I would suggest).  As I claim in my original question, our natural sense of justice typically desires a support that is not fully supplied by reason alone (even if nihilism itself is avoided).  Who then is happier, the just and moral non-philosophic man, or the “philosopher/scientist” who understands better the natural basis for morality (again, within this argument)?  This too would seem to be unresolvable.  Certainly human reason cannot prove itself to be an inferior way of life, using its own tools, or that would simply be a peculiarly circular form of self-destruction.  But how exactly does one show that humans have a natural desire for justice - and then claim that true natural justice is more limited than our desire often demands – yet prove the superiority of living with this understanding (as compared to the simpler but seemingly more fulfilling sense of justice that is innate)?

This question about the superiority, or lack thereof, of the philosophic way of life, is not new, of course, but is coeval with the beginning of the philosophic way of life.  Arnhart has addressed it explicitly on his blog several places, such as here:  http://darwinianconservatism.blogspot.com/2011/07/strauss-on-supremacy-of-philosophic.html. and here:  http://darwinianconservatism.blogspot.com/2012/05/anastaplo-on-strauss-aquinas-and.html




Update 9/2015

Very tardy here, but I should update the above post to note that six months ago Prof Arnhart in responding to my second comment on this post:  http://darwinianconservatism.blogspot.com/2015/03/nietzschean-nihilism-natural-right-and.html  addresses a version of my long question from 2013 that is the first link at the top of this post:

WB:  "Is it possible that - rather than being Nietzschean - Strauss was open to something akin to your extended argument as being true, but still a "deadly truth" at that? (Even, of course, if you reject this conclusion).

You have written that a virtue ethics based on our human nature is narrower than a “cosmic” morality. However, one could argue that when we consider truly ghastly and heinous crimes our natural moral sentiments seem to desire such a cosmic morality, or at least something closer to it. If this is true, then it is our evolved human nature itself that desires a morality grander in scale than can be supplied by the natural right based on that human nature alone.

Perhaps Strauss could have accepted the broad bases of your argument (as he hints at them in the introduction to NRH), but would have been skeptical of them as being a sufficient ground for most "non-philosophers'" conception of justice? "

LA:  "That's a good suggestion. As you indicate, Strauss did say that the lack of cosmic support for what we care about was "the most terrible truth," and a Darwinian natural right would teach that terrible truth.

Similarly, the Nietzsche of "Human, All Too Human" thought that Darwinian science would not satisfy those human beings who needed a metaphysical purposefulness for life."

Arnhart Reviews E.O. Wilson

http://darwinianconservatism.blogspot.com/2013/11/natural-right-and-natural-history.html

Larry Arnhart reviewing E.O. Wilson in the Claremont Review of Books is a must-read, and does not disappoint. 

His blog is excellent, in general.  His books, Darwinian Natural Right, and Darwinian Conservatism, should be required reading.  His writing is clear and erudite and speaks for itself.  "DC" is emphatically not "social darwinism."  It could just as easily be called "How human nature and biology support classic liberalism."

The subtitle to DNR, "The Biological Ethics of Human Nature" is instructive here.  Another summary might be "how modern biology is compatible with an Aristotlean ethics."  I cannot recommend it highly enough.


Links to books:

http://www.amazon.com/Darwinian-Natural-Right-Biological-Philosophy/dp/0791436942/ref=la_B001K8DKAI_1_2?s=books&ie=UTF8&qid=1385253757&sr=1-2

http://www.amazon.com/Darwinian-Conservatism-Disputed-Larry-Arnhart/dp/1845401565/ref=la_B001K8DKAI_1_3?s=books&ie=UTF8&qid=1385253757&sr=1-3

In Praise of Hobbies

It is only recently, in middle age, that I have developed any understanding for the ubiquitous blank on the personal information form:  “hobbies.” 

In my youth, I assumed a hobby – such an antiquated term - must be stamp-collecting, or flying radio controlled airplanes as part of a club, or some such endeavor.  What is more, and what is worse, it seemed like such a commitment.  “These are my hobbies.”  “I collect civil war books, and to the end of my days I will spend all my free time collecting, memorizing, and ruminating on only things pertaining to the civil war.”  “I will join a club with like-minded members.”  Etc.

But a hobby – an avocational pursuit or interest - is in actual fact the non-committal pursuit par excellence.  Whether sport, recreation, simple pleasure, or intense intellectual interest, an avocational pursuit has the virtue that it can be pursued for its own sake.  And like any whim, disregarded whenever time no longer permits, or when the fire of that passion abates; and, if desired, picked back up next month or next year.

The hobbyist need not make the fatal error of confusing vegetable gardening with agriculture.   The landscape gardening enthusiast need never run a nursery nor supervise a crew planting petunias at a strip mall. 

To try one’s hand at learning to cook well may be a simple joy.  How wonderful to not need, in that case, to find employment as a chef!

And in this modern world, one need not always look far to find information about one’s current whim.  An obscure book is always one Amazon click away.   And likely some discussion board exists that may point one to more questions, or occasionally a clear answer.  The “long tail” (http://en.wikipedia.org/wiki/Long_tail) contains every niche interest and is available now to all at the speed of one’s broadband connection.

Vocationally speaking, we are all usually specialists, of one sort or another, in the end.   Ricardian comparative advantage demands it.  And, as the recipients of the resulting productivity and economic growth, we are all much the better for it.  Those of us who love our professions are doubly blessed.

But in a hobby, one need not change careers nor manage disagreeable people nor make payroll - nor collect stamps.  One is never too late to start.  One can always delay, restart, or quit.  This is the realm of the novice, the amateur, the polymath, the autodidact. 

I think I now, finally, understand that blank.    

New vs. Old Keynesian Stimulus (Cochrane)

John Cochrane is a professor at the Univ. of Chicago in financial economics.

His blog, The Grumpy Economist, is quite good.

Friday’s post, New vs. Old Keynesian Stimulus, is simple, clear, and excellent.  Before you talk about the truth of the models, the evidence or lack thereof, or argue about good and bad, better and worse, understand the assumptions.  I’ll leave his post to speak for itself.

Also, if you have any interest in financial economics I’d highly recommending returning to the main section of his blog and reading the posts about his father-in-law (E. Fama)’s recent Nobel prize, shared with two others.  While there read about the two others (Shiller and Hansen).   

If you don’t mind a little math, and want to read a nice in-depth survey of asset-pricing research, you might also try Cochrane’s “Presidential Address: Discount Rates.”  It can be found here:  http://faculty.chicagobooth.edu/john.cochrane/research/papers/discount_rates_jf.pdf

For an excellent book length review of research on expected returns (with less math), Expected Returns By Antti Ilmanen (a Chicago PhD) is well-regarded, and worth reading twice. And what is more he’s a Finn – how often do you see that? 

Amazon link: http://www.amazon.com/Expected-Returns-Investors-Harvesting-Rewards/dp/1119990726

The Second Man Born, the First to Die

Pastoral. 

a (1):  of, relating to, or composed of shepherds or herdsmen (2):  devoted to or based on livestock raising

b:  of or relating to the countryside :  not urban pastoral setting>

c:  portraying or expressive of the life of shepherds or country people especially in an idealized and conventionalized manner <pastoral poetry>

d:  pleasingly peaceful and innocent :  idyllic

2

a:  of or relating to spiritual care or guidance especially of a congregation

b:  of or relating to the pastor of a church

(Merriam-Webster).

Pastoral.  Idyllic.  The Lord is my Shepherd. 

It is not only the nineteenth century, response-to-the-enlightenment, Romantics who have romanticized pastoralism.  Real pastoralism, however, developed in tandem with, or shortly after the pre-historical dawn of agriculture.  Pastoralists may have been  (and still are in some places) nomads, but they were not hunter-gatherers.  Not that they never hunted, nor gathered, of course. Further, they were not peaceful, or at least not more so than people in general.  And in many times and places, they were, indeed, fierce tribal warriors.

The historical, anthropologic, and archaeologic records have limits, naturally, but scholars have described in detail what is known about the complex interactions between sedentary farmers (who often had livestock, as well), and the pastoralists with their nomadic herds.  There is a division, as well, between the pastoralism that existed before and after the development of horsemanship.  There are also important geographic considerations.  In open areas, pastoralists were especially successful.  This is true of the Middle East, North Africa, and the great Eurasian steppe.

One of the best books I have read in the last twenty years is War in Human Civilization by Azar Gat .  It is a thoroughly engaging “big” history that looks at the history of humankind – through the lens of violent conflict - in three broad epochs:  1.  Hunter/Gatherer  2.  Agricultural/Pastoral  3.  Modernity.  It is scholarly and long (673 pages not including 100+ pages of endnotes) but remarkably accessible and clearly written.   As such, while it contains more traditional military history, it is not limited to the “historical” era.  In order to present the history of violent human interaction (the lines necessarily blur between homicide and “war” in this regard) it is necessary to sketch what is known of the history of humankind more generally, and this is accomplished splendidly. Due to these factors, I think the book would be of interest to those who would not normally be interested in military history specifically.  Violence is, unfortunately, a part of human nature.  The reading of this book pays great dividends in my opinion to those interested in understanding human nature.

It is my source for understanding, among other things, the rough outlines of what is known about the pastoralist peoples and their interactions with the agriculturalists.  Often the pastoralists, particularly in more open areas, and particularly after the development of  the horse (but not only after the advent of horsemanship) were the more successful aggressors against the agrarians:

“…pastoral societies in general, for reasons we have already seen, tended to be more menacing to the farmers than the other way around.  The evolution of horseback pastoralist and horseback fighting would vastly increase the pastoral threat. (p. 209)”

In the Near East, examples are given regarding the various interactions, which ranged from outright conquest to theft and “protection-racket” type extortion and over-lordship, to more fluid cooperative and competitive relationships.  The over-lordship of the pastoralists would often develop into a frank aristocratic relationship between the (former) pastoralist warriors and the subservient farmers.  “These rulers, too, boasted that ‘their fathers had lived in tents. (p. 195).’”  Some of this brief summary necessarily simplifies Mr. Gat’s much more thorough presentation, obviously.

But with this in mind, it led me to an insight (unoriginal I am sure) regarding the Cain and Abel story – from which the title of the post derives.  I will note that I mean this reading to be from the standpoint of scholarship more than that of the believer.  However, I will note, that holy scripture demands to be read from the standpoint of belief; or put differently, to read scripture from outside of the position of at least potential belief, is to judge the claims before they are made.  I will leave this difficulty aside, even as I acknowledge it.

As we all know, the second creation story in the Bible begins in Eden when God creates Adam (“Man”) from the Adamah (fertile soil).  “Eve,” created from one of Man’s ribs, has an etymology related to the word for “life.”  So, while the story may not only be allegory, there are clearly archetypes in the original.  Cain, the firstborn, is a farmer, we are told.  “Cain,” evidently means either “created one,” and/or “smith.”  Abel is a shepherd.  “Abel” means “breath.”

The story (KJV): 

  And Adam knew Eve his wife; and she conceived, and bare Cain, and said, I have gotten a man from the Lord.

2 And she again bare his brother Abel. And Abel was a keeper of sheep, but Cain was a tiller of the ground.

3 And in process of time it came to pass, that Cain brought of the fruit of the ground an offering unto the Lord.
4 And Abel, he also brought of the firstlings of his flock and of the fat thereof. And the Lord had respect unto Abel and to his offering:
5 But unto Cain and to his offering he had not respect. And Cain was very wroth, and his countenance fell.
6 And the Lord said unto Cain, Why art thou wroth? and why is thy countenance fallen?
7 If thou doest well, shalt thou not be accepted? and if thou doest not well, sin lieth at the door. And unto thee shall be his desire, and thou shalt rule over him.
8 And Cain talked with Abel his brother: and it came to pass, when they were in the field, that Cain rose up against Abel his brother, and slew him.
9 And the Lord said unto Cain, Where is Abel thy brother? And he said, I know not: Am I my brother's keeper?
10 And he said, What hast thou done? the voice of thy brother's blood crieth unto me from the ground.
11 And now art thou cursed from the earth, which hath opened her mouth to receive thy brother's blood from thy hand;
12 When thou tillest the ground, it shall not henceforth yield unto thee her strength; a fugitive and a vagabond shalt thou be in the earth.
13 And Cain said unto the Lord, My punishment is greater than I can bear.
14 Behold, thou hast driven me out this day from the face of the earth; and from thy face shall I be hid; and I shall be a fugitive and a vagabond in the earth; and it shall come to pass, that every one that findeth me shall slay me.
15 And the Lord said unto him, Therefore whosoever slayeth Cain, vengeance shall be taken on him sevenfold. And the Lord set a mark upon Cain, lest any finding him should kill him.
16 And Cain went out from the presence of the Lord, and dwelt in the land of Nod, on the east of Eden.


Now, what is the meaning?  In particular, why does God seemingly arbitrarily favor Abel’s offerings?  Perhaps this is, among other things, an explanatory tale about the origins of both homicide (fratricide here) and war (here between archetypes of shepherds and farmers). 

In addition – and this was my insight from reading Gat’s book - perhaps it is an explanatory tale about why the shepherds seem to be favored in the world – that is, by God - over the farmers. 

Remember, as well, the nomadic pastoralist-warrior history of the Hebrews - God's chosen people - wandering in the desert before conquering the promised land.  Remember, also that the holiest of holies resided in a tent before the building of the temple.

2 Samuel 7:

 And it came to pass, when the king sat in his house, and the Lord had given him rest round about from all his enemies;

2 That the king said unto Nathan the prophet, See now, I dwell in an house of cedar, but the ark of God dwelleth within curtains.
3 And Nathan said to the king, Go, do all that is in thine heart; for the Lord is with thee.
4 And it came to pass that night, that the word of the Lord came unto Nathan, saying,
5 Go and tell my servant David, Thus saith the Lord, Shalt thou build me an house for me to dwell in?
6 Whereas I have not dwelt in any house since the time that I brought up the children of Israel out of Egypt, even to this day, but have walked in a tent and in a tabernacle.

Other similar textual questions to consider:  Why is Cain, the farmer, the firstborn?  What is the significance?  Why is Cain the aggressor?  Is it significant that the first man to die is a blameless pastoralist?  Is it significant that the first man to die dies unnaturally?

Now, the answers to such questions would be similar in nature to the insight I highlight above.  And while that insight - i.e that pastoralists appear to be favored by God from the standpoint of the ancient Hebrews – perhaps adds some context that is not obvious to us, it clearly falls short of being a full analysis of the story.  None of the above is a discussion of the central mystery of why God acts as He does, or why He favors what He favors, particularly from the standpoint of the believer.  Nor, does it address the troubling question of evil in the world after the fall that is central to the story.  It only serves as one more tool with which to better understand this story about the beginning of humanity, and the beginning of human evil. 

The problem of evil, of course, is a profound theologic question.  The problem of evil, however, is not just a theologic one.  It is not escaped by disbelief.


Amazon link:  http://www.amazon.com/War-Human-Civilization-Azar-Gat/dp/0199236631/ref=cm_cr_pr_pb_t

Dining with General Patton

Nearly twenty years ago, I heard a remarkable story told by a World War II veteran, who, as a young army surgeon visited his friend for one month at George Patton’s headquarters, somewhere in liberated France. 

His friend was Patton’s personal physician, and the veteran tells the story of how Patton and his closest entourage of aides and officers had encamped in a French chateau, using it as their temporary base of operations for what was to be the Third Army’s remarkably successful campaign. 

In this setting, in the midst of this, the world’s most monumental conflict, a formal dinner was served nightly.  Patton, the visitor explained, traveled with his own private, full china, silver, and crystal service.  The officers wore their dress uniforms; civilians, if present, black tie.  And after dinner, the men retired to a large sitting room for brandy and cigars.  Here Patton with great flourish would regale those assembled with stories and lessons from military history.  Which stories, I didn’t get a chance to ask.  With Patton, however, one imagines that they ranged from the Peloponnesian and Punic Wars, to Waterloo and Gettysburg; from Hannibal’s elephants to Pickett’s charge. 

Now, perhaps equally remarkable, was that the veteran who told the story to me and a small group of medical students in 1996 was Michael Debakey, the pioneering cardiovascular surgeon.  Dr. Debakey, himself a larger than life figure, would have been eighty-seven years old at the time when we met in his office (as he did monthly with the students on their surgery rotations).  During the war, he explained, he had helped to coordinate the formation of what would later be known as the MASH units.  However, his regard for that month, this memory of his time in the company of Patton, was clearly evident from the vigor with which he told the tale.

But when Dr. Debakey’s telling of the war-time story ended– as sycophantic medical students are wont to do - my colleagues quickly changed the subject from Patton’s castle, to questions about the good doctor’s early aortic surgeries.  My opportunity to ask more questions had passed, it seemed.

So, the above re-telling is from memory.  A cursory internet search reveals a few mentions of the story, but not in any greater depth.  I wish I would have pushed to politely request a few more details, or offered to – reporter-like – record it for posterity. 

A lesson, perhaps, for the young listening to the old. 


7/5/17  Addendum:  Now I find an unpublished interview (raw material that was meant for a biography which was never written) that I link to here:  Oral History Michael Debakey.  I'd encourage anyone interested to read the short interview.  The Patton story starts on page six.  Here you will find that a few of my remembered details are off (one week instead of one month, SW Germany [exact location forgotten] rather than France) - but the basic thrust of the story is accurate.  In addition, you will get to read about how Dr. Debakey was threatened with a court martial by another general and how a paper he wrote with noted epidemiologist Gilbert Beebe put an end to that. 

11/2/19  Stale link to Debakey interview fixed, thanks to J. Eulert-Grehn on Twitter for pointing it out.  

Science and Statistics

Here:  http://www.economist.com/news/briefing/21588057-scientists-think-science-self-correcting-alarming-degree-it-not-trouble is a link to a very well-done piece in a recent edition of the Economist, summarizing recent controversies in science, ranging from the well-publicized psychology “priming” literature debacle to the equally well-publicized biomedical/oncology bench research problems. 

“Public-choice” theory in economics rigorously studies the incentives for people in government – not a new idea, admittedly, but one that was generally ignored by progressives who assumed experts could dispassionately administer a non-partisan, scientific, ever-expanding state, largely free from bias.  Now, we are witnessing an increased realization that working scientists also respond to the very real incentives at play in the grant process – both directly financial and more generally in terms of career advancement.  This is not a surprising finding, given human nature. 

That said, I want to emphasize and think through the math/theory behind one specific part of the article, namely that pertaining to “positive predictive value” of studies.  For the math here, bear in mind that I am assuming bias-free, perfectly conducted research.  The section I am referring to is that describing the Ioannadis paper and accompanying figure.

Normally what we think of as statistical significance is the “p” value less than .05, meaning that the odds of the “positive” results being due to chance are less than 5%.  This is similar (but not exactly the same, evidently [see below at bottom]) to the false positive error rate.  The false positive error rate (alpha, or type 1 error) is the exact analog of specificity for a test:  false positives/(true negatives + false positives).  Actually, of course the false positive rate is 1- specificity, specificity being true negatives/(true negatives + false positives). 

“Power” is the analog of sensitivity:  true positives/(true positives + false negative).  Power, is a statement about the sample size needed to achieve a p value of less than .05 when measuring differences between two groups, for a given expected magnitude of difference.  Much like a p value of less than .05 is considered standard, a value of .8 (or greater) is considered standard.  We accept four times as many false negatives as false positives, goes the thinking. 

But much like with sensitivity and specificity in diagnostic testing, what we are often most interested in is neither the sensitivity nor the specificity but the positive and negative predictive values.  These depend on both the sensitivity/specificity and the ever-important prevalence. 

Take a diagnostic test that is both 90% sensitive and specific.  If the prevalence of the disease in a population is only 10%, and all are tested, then the positive predictive value is only 50% (negative predictive value is 99%).   The math here is easy.  If there are 100 patients, 10 have disease and 90 are healthy.  Of the ten, there are 9 positive tests and one false negative test (sensitivity of 90%).  Of the ninety healthy, there are 81 negative tests and nine false positives (specificity of 90%).  Of the 18 positive tests, half are false positives.   

Now, if the prevalence is 50%, the positive and negative predictive values are 90%.  Much better without changing either sensitivity nor specificity. 

Now to the studies (and not just in medicine and biomedical research), as opposed to diagnostic tests.  In the link above, the “prevalence” is 10%.  That is, the assumption is that only about 10% of hypotheses studied are likely to be true.  Scientists want to generate interesting, groundbreaking results, etc. is the argument here.  In this case, with a p value of less than .05 and a power of .08, the positive predictive value of all “statistically significant” results is 64%.  It gets worse if the power is lower, as may often be the case.  This also is prior to considering the possibility of sloppy research, fraud, and all of the unconscious bias that may accompany the scientists’ work.

So, clearly, in assessing the validity of results, we should be interested not only in p values, but in the “prevalence” or “pre-test” probability that results are likely to be true.  This is, in the end, an unquantifiable number.  And, since most “negative” studies are not published (unless they are interesting for being negative), this problem is compounded.  Which means, of course, that the positive predictive value of any body of research taken in total is unknown!  The fact that it may be more like 50-60% (or less) rather than 95% should be kept in mind, however. 

With inductive reasoning, there are varying degrees of certainty about what is knowledge.  Engineering demands greater certainty than does paleontology.  In my experience, engineers and physicists when outside of their area tend to look for a degree of certainty that is not possible.  I don’t know any paleontologists, but I suspect, like economists and psychologists, they tend to draw firmer conclusions about what they know than the data justifies. 

Which gives me the excuse to again post a favorite quote:

“for it is the mark of an educated man to look for precision in each class of things just so far as the nature of the subject admits” 

Aristotle Nicomachean ethics, I.iii.1-4.

P.S. 

http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0020124  Original Ionnadis piece.

One criticism is that he mis-identifies the false positive error rate (alpha) with the p-value. In practice, it seems, these are very similar values, however.   Or so I say, as a non-statistician.