this post was submitted on 14 Apr 2024
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Breaking Down Cass Review Myths and Misconceptions: What You Need to Know – The Quackometer (www.quackometer.net)
submitted 8 months ago by Streetlights to c/skeptic
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Seen the "98% of studies were ignored!" one doing the rounds on social media. The editorial in the BMJ put it in much better terms:

"One emerging criticism of the Cass review is that it set the methodological bar too high for research to be included in its analysis and discarded too many studies on the basis of quality. In fact, the reality is different: studies in gender medicine fall woefully short in terms of methodological rigour; the methodological bar for gender medicine studies was set too low, generating research findings that are therefore hard to interpret."

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[–] Streetlights 1 points 8 months ago* (last edited 8 months ago) (1 children)

Don't abdicate responsibility to someone else, you've clearly got a firmer grasp of the issue than the editorial board of the British Medical Journal. You would be neglecting your duty as "part of the scientific community" to abdicate responsibility on such an important matter.

Indeed the whole medical establishment must be told about the critical flaws in the Newcastle-Ottawa scoring system before other medical scandals are allowed to happen. Imagine having that on your conscience.

[–] Cogency 1 points 8 months ago* (last edited 8 months ago) (1 children)

Lol first sign that you might actually be human.

And it has already been widely criticized before that's why there was the parachute joke report. Hence it is already the brunt of jokes to use that scoring scale.

[–] Streetlights 1 points 8 months ago (1 children)

So strange that everyone waited over 20 years and 100's of systematic reviews in medicine and science before, serendipitously, discovering that the Newcastle-Ottawa Scale was infact no good during these two particular reviews into trans care in the UK.

Just what are the odds?

[–] Cogency 1 points 8 months ago* (last edited 8 months ago) (1 children)

No the Cass report is just misusing the scale. It's not a disqualifying tool and the scale still has uses which just means further analysis into the subject matter. Which is why the Cass report needed to be books longer, it's not comprehensive.

[–] Streetlights 1 points 8 months ago (1 children)

That's a new goalpost. It's being used by Cass exactly the way it's supposed to by scoring studies based on their susceptibility to bias.

If you'd bother to read that similar systematic review on postoperative inflammatory bowel disease you would have seen the exact same usage.

[–] Cogency 1 points 8 months ago (1 children)

Again that's a joke to do that.

[–] Streetlights 1 points 8 months ago* (last edited 8 months ago) (1 children)

Damn here's another "joke" about contraceptives and bone fractures

https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD009849.pub3/full

And one another abput yellow fever and HIV

https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD010929.pub2/full

And influenza vaccines in cancer patients

https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD008983.pub3/full

And there's another 96 on the first search tab alone!

Just what are those clowns at the Cochrane Library up to eh?

[–] Cogency 1 points 8 months ago (1 children)

Relevance?

[–] Streetlights 1 points 8 months ago (1 children)

They all use the same Newcastle-Ottawa system to score studies based on their likelihood of bias in the exact same way the Cass reviews do. The method you described as a joke.

[–] Cogency 1 points 8 months ago* (last edited 8 months ago) (1 children)

It's not an indicator of bias, no causal study has been done to show that there is a relationship between bias and the Newcastle Ottawa scale

[–] Streetlights 1 points 8 months ago* (last edited 8 months ago) (1 children)

Studies that self select their cohort and don't include adequate controls are more susceptible to bias than those that do otherwise. Evaluating studies based on their susceptibility to bias is a vital part of the systematic review process.

You can read more about it here https://www.ohri.ca/programs/clinical_epidemiology/oxford.asp

[–] Cogency 1 points 8 months ago (1 children)

But not actually proof of bias.

[–] Streetlights 1 points 8 months ago* (last edited 8 months ago) (1 children)

Ah young padawan, there is no such thing as proof of bias. There is merely the risk of susceptibility of it.

[–] Cogency 1 points 8 months ago (1 children)

Exactly which is why the Ottawa whatever standard is not sufficient to discard a study. You have to do more.

[–] Streetlights 1 points 8 months ago (1 children)

Again, you really need to feed this startling discovery back to the medical community which has been using NOS for over 20 years. What a scandal.

[–] Cogency 1 points 8 months ago (1 children)

No the medical community largely respects the short comings and uses of the Ottawa protocol. That's what made Class's report so insulting.

[–] Streetlights 1 points 8 months ago* (last edited 8 months ago)

Blimey, you're speaking for the medical community itself as a whole now, pray tell then why haven't they binned every systematic review ever carried out using the NOS system?

Why after 20 years of use is this system only being rubbished after two reviews into gender affirming healthcare in the UK were published?

Why are you the only person complaining about the Newcastle-Ottawa system when everyone else online is making up lies like "98% of data was dismissed"?