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• W212590922 abstract "In writing the majority opinion of the U.S. Supreme Court's scientific evidence ruling in Daubert v. Merrell Dow Pharmaceuticals Inc., 509 U.S. 579 (1993), Justice Blackmun explained that subjective impressions are biased by the observer's model of the world, and thus can be misleading. As such, they do not represent definitive scientific evidence or knowledge. Pain as a scientific criterion Take these cases: * A dental patient complains pre-auricular Examination reveals that the pain is from ipsilateral trigger points in sternocleidomastoid or trapezius muscles. Lidocaine injection over the temporomandibular joint results in no pain relief, but injecting the remote trigger point does relieve the This is referred pain. * A patient complains of orofacial pain in the upper right arch, but examination reveals that it is an abscessed tooth in the lower right arch. This is localized pain. * A patient is asked if palpation of a certain area hurts. The patient answers, Not really. This non-definitive phrase doesn't say yes or no. We must recognize that pain is vague and quantification often is unreliable. * If a doctor palpitates the right side of a patient's face, and the patient indicates tenderness on the left, this is an example of pain. The pain exists only in the patient's mind with no known neurological circuitry, but the patient perceives it as real. * There is no pain, but the patient is lying about pain for financial gain. So, one must logically ask: Based on phenomena of pain, poorly localized pain, vagueness of pain, unreliability of quantification, variation in perception, presence of pain, vagueness of pain, unreliability of quantification, variation in perception, presence of psychosomatic pain and people who lie about pain, how accurate can a patient's self-reports of pain be used as evidence or scientific criterion for the study of temporomandibular disorder? The ultimate test for separating science from non-science is the ability of science to pose testable hypotheses. Scientific hypotheses must be possible to refute. A patient's complaint of pain has no observable, testable phenomenology. A patient's subjective complaint of pain is a belief statement and as such is irrefutable, unfalsifiable and therefore unscientific as diagnostic or scientific criteria. Self-reports of a patient's pain are inherently unrestable, obviously unreliable and therefore decidedly unscientific. The ultimate test of scientific knowledge is whether it can be tested. Scientific methodology is based on generating hypotheses and testing them to see if they can be falsified. The criterion of refutability, testability or falsibility is what distinguishes science from pseudoscience. Evidence v. inference Evidence has been defined variously as the means by which a fact is established; a body of facts on which proof is based; and facts that tend to clarify, support or prove a point in question. On the other hand, inference is a probable conclusion, not based on deduction, but loose usage, experience or statistical correlation. Inference does not absolutely establish a premise but constitutes a demonstration of probability. Circumstantial evidence consists of events and occurrences that establish reasonable grounds by which a fact is substantiated. Circumstantial evidence is an example of inference. It is considered soft rather than hard evidence. Epidemiology also exemplifies inference. It is concerned with the incidence of a disease in populations and addresses whether an agent can cause a disease, not whether it did cause any one patient's disease. Specific causation is beyond the domain of epidemiology, which is a soft science based on manipulation of statistics. Often there is confusion between correlation and causality when judgment is based on subjective experience. …" @default.
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• W212590922 title "Daubert, Pain, Evidence and Inference in Treating TMD" @default.
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