How long before I run out of variations on the same lame joke about answering my Seed overlords?

It seems a reasonable question to ask, given my propensity for it.

Unfortunately that’s not what our Seed overlords asked this week. This week, they ask:

If you could shake the public and make them understand one scientific idea, what would it be?

Predictably, some ScienceBloggers answered: evolution and what it really means, not the parody of evolution presented by creationists or the simplistic version of it that is often taught in school or discussed in the mainstream media. I can’t argue with that answer, but I’m a physician; so my answer will be different:

If I could get the public to understand one scientific idea, it would be the concept of clinical trials. In particular, I would want to make them understand why most anecdotal evidence is a very poor guide to determining what treatments are effective, thanks to the placebo effect, confirmation bias, and regression to the mean (all of which I discussed here), among other confounding factors. I would want them to understand the hierarchy of evidence in evidence-based medicine, and why double-blinded, placebo-controlled, randomized clinical trials (RCTs) are the strongest evidence, while retrospective studies are weaker, and case reports are the weakest of all. Finally, I would want them to understand that lesser evidence should only be used to guide treatment choices only in the absence of stronger evidence (RCTs), particularly for questions where doing a true RCT would be unethical.

An understanding of these concepts would go a long way towards decreasing the susceptibility of the public to the sales pitches of quacks and inject a healthy dose of skepticism towards the claims of pharmaceutical companies for their latest, greatest wonder drugs, as well.