Kershaw Jane <[log in to unmask]> wrote:

> The first thing I want to point out is - you are making an absolute
> statement when you say there are no absolutes.  This is a self-refuting
> statement.  And, if you accept this point, then there is NO point in
> doing any evidence-based research, 

Evidence-based research isn't about producing absolute answers.

One of the really basic tenets of the hypothetico-deductive scientific
method, Science 101, is that you can't _prove_ anything: that there are
no absolutes. Results may support your hypothesis or not support it, but
they don't absolutely prove your hypothesis. Conclusions are always a
matter of weighing all the evidence and coming up with probabilities.
This is why statistical results are reported in terms of their
uncertainty, the likelihood that the result was obtained by chance
alone.

Growth curves themselves are based on probabilities, not absolutes. The
3rd-97th centiles depict the range of weights that 94% of completely
normal babies will fall between. This doesn't mean that a baby outside
those weights is by definition abnormal! There will still be six percent
of normal babies that fall outside the 3-97th. Same with growth
velocities, laboratory tests, everything we work with.

In the case of a baby gaining less weight than average, the LC is in a
position of deciding whether that baby is in trouble, or whether she is
smaller than average by chance alone (i.e. whether she is the size she
is "meant" to be). This means forming hypotheses, testing them (whether
by history/examination/observative/deductively or by trying
interventions). She weighs all the evidence together, she doesn't just
take her growth curve in isolation and pronounce with absolute certainty
that there is a problem. This IS the scientific method in action; it's
not incompatible with science at all.

Lara Hopkins
family doc Down Under

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