To nominate the principle authors of the CASS review for this..

[NameChangeCass]

“Advocates of evidence based medicine have criticised the adoption of interventions evaluated by using only observational data. We think that everyone might benefit if the most radical protagonists of evidence based medicine organised and participated in a double blind, randomised, placebo controlled, crossover trial of the parachute.”

https://www.bmj.com/content/327/7429/1459.short?fbclid=IwAR0hTt57o-yFS61aJE-IGCpKSPaDs--rdrPlbiby_wBCF1czpAWDaCcAEcM_aem_ATiWMtvZxiSzw8pj9CX271gyDByuMHTOKwQskBcCXx9aZOj1IPusHJ_z79olcRiFlhE

Their results/findings were discarded on the grounds that they were judged “low quality “ , mainly do to not being a blinded and having a control group.

What do you mean by "discarded"? They're there in the report.

To be clear, intervention studies—particularly of drug and surgical interventions—should include an appropriate control group, ideally be randomised, ensure concealment of treatment allocation (although open label studies are sometimes acceptable), and be designed to evaluate relevant outcomes with adequate follow-up

so which parts of this do you think clinical research on PB being used on children should have been binned off?

Exactly we can see from the graph that more than two were considered.

We can read for ourselves that more than two were considered.

Yet the OP keeps repeating something that is clearly false. 🙈

Their results weren’t considered to have any meaning / value when formulating conclusions and recommendations - the findings were put aside due to the methodology of the study being considered low quality , due to no blinding/ control.

This is perfect

Yet the OP keeps repeating something that is clearly false.

That's what people like the OP do.

Perhaps you could specify which result you found compelling in a study which Cass and her team did not? Then we can discuss the methodology.

Except if you read the thread we are literally making the same points. No facts are in dispute here.
The terms on which people insist on having these debates is literally so manipulative and bizarre.

Missing the point, but why is Cass capitalised? It is not an acronym, it's the woman's name!

"Double blinded randomised control trials aren’t always possible and ethical. This is very normal in paediatric medicine".

Not using drugs that are already known to have very serious effects on adults.

I spent some time working in a huge audit looking at safety of various commonly used medications in pregnancy. The process was time consuming, meticulous and involved the whole of Europe. Whenever any kind of adverse event was found it was highlighted, shared and scrutinised again. The study included things like antibiotics, pain killers, anaesthetic drugs, searching for evidence of the safest medication that could be given to pregnant women. This is what we do if clinical trials are unethical in a particular group.

There has been nothing even close to this for these children.

We are disputing your assertion that all but two studies were discarded.

You are reading that only two were found to be of high quality and making a leap that the rest were discarded.

I've shown you a graph showing more than two were considered.

An excellent point that I will concede. Thoughtless force of habit when writing the OP: “Cass Review” it is.

Their results weren’t considered to have any meaning / value when formulating conclusions and recommendations - the findings were put aside due to the methodology of the study being considered low quality , due to no blinding/ control.

Which is false. They were not put aside, and their value was incorporated.

The value was just low.

I'm sorry they did not have enough significance to override the results from the good studies, but that does not mean they were "put aside".

If I add a lot of small numbers to a big number and do not appreciably change the big number, I did not "put aside" the small numbers. They just didn't change the result.

Exactly why are you advocating for basically experimenting on kids to serve ideological ends and hoping it turns out OK?

What exactly are you going to achieve with that?

It astounds me that online TRAs are trying to justify this stuff and arguing against Cass’s use of high quality evidence in an area of medicine that has lifelong consequences for the children affected. Poor quality research evidence is worse than useless; it can be actively harmful.

The comparison to parachute engineering is not the clever gotcha you imagine. It’s totally irrelevant. Like arguing that social scientists should stop worrying about getting informed consent from participants because physicists don’t require consent from subatomic particles. Yes: that ridiculous a comparison!

Calling for the death of researchers whose sole aim is to improve the health of children through clear, meticulous standards of care? Hmm.

This is not getting us anywhere. For the very last time.

The results of these studies were discounted / put aside/ discarded (whatever word you prefer) in the sense that they were not considered when formulating conclusions or recommendations.

The reasons given for this was that the studies were not . blinded control trials.

These are the facts.

My AIBU is about the sense of discounting evidence / results for these reasons.

And on a serious point. I do think it's a shame that it's come to this because I imagine there are 0.0001 percentage of cases where puberty blockers would be the best option and now they won't be available. But this situation seems to have come about because the services were overwhelmed and started dishing them out like smarties. There was one testimonial in the Hannah Barnes book where GIDS did actually appropriately and gave the girl time to think before starting puberty blockers, and a year or so later she'd realised she was actually a female-identifying female who was also a lesbian and liked playing sports. The number of similar cases where kids have been given puberty blockers which arrest their development, and they're not able to come to that realisation is kind of chilling.

One of the most stupid things I’ve ever seen on MN and by god is there stiff competition.

Yes, there are many children who have been sterilised before they really appreciated the implications.

Exactly. What on earth prompts such an INSANE response?

The results of these studies were discounted / put aside/ discarded (whatever word you prefer) in the sense that they were not considered when formulating conclusions or recommendations.

Whatever word you prefer, it is 100% false that "they were not considered when formulating conclusions or recommendations".

Oh good lord. Ok they were considered long enough to decide that they should be ignored, because they came from studies which were not blinded control trials. These were the reasons given. And all agree.

My AIBU is about the sense of discarding results because they do not come from blinded RCTs,

Was there something specifically in those 100 trials that you think was overlooked? That should have changed the conclusions or recommendations?

If you don't have something specific in mind, do you think it's likely there was something that was overlooked?

We've believed for years that all these studies have been extremely shaky ("not worth the paper they're written on" to use a recently popular phrase). What exactly do you think Cass should have done with these shaky papers?

You know when parachutes were developed over hundreds of years and early experiments were tests on inanimate weights and then animals.
They definitely didn’t just throw children from a great height with an experimental parachute and hope for the best.

For the very last time.

We can read for ourselves that they considered them all.