Readit NewsHN has drifted further and further from reality, which has been very strange to watch. The classic example was someone dismissing Dropbox when they first launched, but now it’s turned into dismissing billion dollar companies after they’ve clearly won.
Point is, the effect of the company on the society can’t just be measured by market cap.
Back to the original article, the author was using statistical analysis to provide medical advice. Now, it’s incredibly easy to arrive to false conclusions with statistics. That’s why there’s regulations, peer reviews etc. What if the “Egyptian contractors” screwed the data up. Was the founder qualified to spot an issue?
No, he didn't have a problem.
He proposes that OTC is the target. The reality is, the problem is not very deep here. Without access to prescription medications, you basically have a handful of options that are more of less the same. It's like walking onto a rental car lot. You need to know what category you need, but everything in that category is pretty much the same.
He isn't solving anything for the physician market. His recommendations are very naive and lack the clinical backing to support actual usage. A physician isn't going to buck their go-to's because a random tool suggests something else. This tool needs to provide scientific backing for it's recommendations and why that recommendation is better.
I go to my local grocery store and look at the painkillers they have. There are generic aspirin and Tylenol available for a price almost anyone can afford. There are branded versions which are still reasonably priced. There are reasonable variations such as with caffeine or with decongestant, again priced perfectly fairly. If you want to pay $2 extra for awesome marketing you can. In some stores you might find a 'natural' remedy - essentially a placebo, again priced ok.
Everything on sale is basically safe. Nothing has a business model that relies on addiction. Nothing costs hundreds of dollars. Nothing is adulterated or counterfeit. It's easy to get information about everything available. The vast majority people would be able to choose something to match their own needs (for example, they might be allergic to aspirin, or need to avoid Tylenol because of a kidney condition).
If you bought the worst painkiller on sale in the store, it would be fairly effective and not too expensive. The experience in most stores in large parts of the world would be very similar.
It's basically akin to looking at Google Analytics and trying to predict what your next website visitor will do. You'll have an idea of what someone's going to do, but you can't perfectly predict it.
If you think about it, the author's desire to choose 'the scientifically proven to be the most effective' is just another example of such a superstition. If you could convince him that a particular medication was the winner in the meta-analysis, he would probably objectively feel better, even if it wasn't actually true.
I've not had this experience. For me, Ibuprofen works, aspirin and acetaminophen have zero noticeable affect. It's been that way my entire life. The other two might have some affect on fever? (no idea) but none on pain, at least for me.
I have never smoked or vaped or anything, but it's the homeopathic OTC meds that viscerally upset me, that they should be allowed on the shelves.
I'm reading the epiphany part of this post, to quote:
You have a mind-shattering headache. You're standing in the aisle of your local CVS, massaging your temples while scanning the shelves for something—anything—to make make the pain stop.
What do you reach for? Tylenol? Advil? Aleve?
Most people, I imagine, grab whatever's cheapest, or closest, or whatever they always use. But if you're scrupulous enough to ask Google for the best painkiller, here's how your friendly neighborhood tech behemoth would answer:
[Screenshot of Google Search Results]
Oh thanks Google that's just all of them.
---end quote---
The author immediately identifies that this isn't a real problem, by their own admissions that "Most people, I imagine, grab whatever's cheapest, or closest, or whatever they always use." Yea, most people when they have a headache and know that most painkillers on the market will result in about the same degree of relief, don't bother to cross reference a medical meta-analysis, because they have a headache and if the $0.01 worth of aspirin doesn't make it feel better they will just take a second pill and eat the penny.
I like the author's conclusion about how to quickly validate business ideas, but even in the title the author still holds firm to the belief that this was a "fantastic startup idea" even though reality seems to think otherwise. Was this such a great idea, do most consumers actually want to review a meta-analysis when picking their OTC medicine, or do most people just try a few things, get influenced by advertising, and purchase the most reasonably priced medicine they think will help. I am just a single data point, but I don't normally feel naked and unscrupulous when I just read the symptoms that a medicine treats and pick one, and that strategy generally works just fine.
Solution in search of a problem and also in search of humans that act in this weird atypical fashion.
On the other hand, for depression medication, they don't want their doctor to look at an online tool and choose the most effective antidepressant. They want their doctor to look at THEM and say "hmm, we'll try you on X but if it doesn't help with the intrusive thoughts we'll maybe switch it out to Y and up the dosage of Z". Or they want to tell the doctor what they think they want to be prescribed. They are paying big bucks to see a psychiatrist. Most of them are not on a self-optimization trip, they just want to feel better, and also feel like someone takes an interest in how they are getting on. Using a snazzy tool would probably lead to the patient being less satisfied with the doctor's service, even if they have slightly better outcomes by whatever questionable metric is in the study.
I think people that say things like this overestimate how much we spend on things like this and underestimate social spending. About 50% of US government spending is health and social services. So even cutting everything else to zero is only a doubling of health and social services. A doubling isn't nothing, but a game changer? And not all (or even most) of that other 50% will be spending you feel is frivolous, so it would be much less than doubling.
I get tired trying to explain, and if I'm not convincing anyone, maybe it's me who doesn't understand...but, I feel like the key is to ask yourself, if the placebo effect is something that you can scientifically demonstrate, how would you arrange a control group?
Failure to identify a reason for an apparent effect cannot be turned into proof that "nothing" has an effect. It's just a mental short circuit that people get trapped in.
Easy, just don't give the control group any medicine. Give the other group a placebo. If outcomes are better for the second group, it's evidence that placebos work, just as clearly as the usual trial provides evidence that medicines work.