“It seems to me that such cognitive/epistemological errors are far more insidious than technical errors in p-value interpretation, and much more capable of insinuating themselves into CPGs.”
This @davidcnorrismd post changed my understanding of “Threshold Science” which I have studied for over a decade.
I have long considered Threshold Science (The use of guessed threshold sets as gold standards or endpoints for RCT) a type of “pathological science”, after Langmuir, (wherein the “pathology” of the science is induced by an early undetected technical error in methodology.) Yet it never quite fit. Kuhn’s teachings also failed as the behavior he describes applies to both good science and pathological science.
I see now that Threshold Science comprises a different type of pathological science induced by a fundamental cognitive error rather than a technical error
The distinction between Langmuir’s Type I pathological science (fundamental methodological error) and Type II (fundamental cognitive error) is very important. Trusting, dutiful and particulatly the best trained in the discipline will be not be able to detect the error of Type II Pathological Science whereas they may be be able to detect the error of Type I.
Type II pathological science is probagated by text and mentorship. Indeed, since all in the disipline are unknowingly faithful to the pathologic teaching, its practice is mandated to receive funding and to publish in the top journals.
An entire scientific discipline (eg sleep apnea science), may be based on Type II pathological science. They may recognize that the science is not working but they will be complely confused as they cannot understand why.