The purpose of an RCT is to prove something works after we already have enough evidence to pay attention to that particular hypothesis at all. Since the vast majority of things (in an exponentially large space) do not work, most of the bits-of-evidence are needed just to “raise the hypothesis from entropy”—i.e. figure out that the hypothesis is promising enough to spend the resources on an RCT in the first place. The RCT provides only the last few bits of evidence, turning a hunch into near-certainty; most of the bits of evidence must have come from some other source already. It’s exactly the same idea as Einstein’s Arrogance.
You didn’t mean to but you’ve written a critique of using RCT’s to figure out medicine.
Oh I very much mean to do that.
The purpose of an RCT is to prove something works after we already have enough evidence to pay attention to that particular hypothesis at all. Since the vast majority of things (in an exponentially large space) do not work, most of the bits-of-evidence are needed just to “raise the hypothesis from entropy”—i.e. figure out that the hypothesis is promising enough to spend the resources on an RCT in the first place. The RCT provides only the last few bits of evidence, turning a hunch into near-certainty; most of the bits of evidence must have come from some other source already. It’s exactly the same idea as Einstein’s Arrogance.