Category: Blog

What are Mechanisms?

The term “mechanism” reflects the theoretical steps or processes through which an intervention (or some independent variable) unfolds and produces a change in a patient. For example, a cortisone injection for a frozen shoulder works by stopping the release of regional molecules that cause inflammation and stopping the body from the immune response after an injury. Mechanisms studies involve a unique design that is frequently pre-clinical (animal-based or laboratory-based). The National Institutes of Health (NIH) defines mechanistic studies as designed to understand a biological or behavioral process, the pathophysiology of a disease, or the mechanism of action of an intervention [1].

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Null statistical hypothesis testing aims to prevent confirmation bias [1]. The researcher creates the null hypothesis by converting the research question to a research hypothesis and then converting the research hypothesis to the null hypothesis. This should happen before starting data collection starts. The researcher should use statistical significance (p-values) testing to accept or reject the null hypothesis. Using significance testing to accept or reject a research question or hypothesis may lead to chasing statistically significant findings and confirmation bias. Researchers have called for the death of null statistical hypothesis testing. They have suggested replacing these methods with effect sizes, confidence intervals, and Bayesian methods secondary to researchers not following the intent of this methodology [2]. These different approaches have their strengths and weaknesses. The power of the null statistical hypothesis testing is that it can be a powerful tool used to rule things out [3].

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Overview

         In this blog, I hope to show that there is no proper way to perform a sham orthopaedic manual therapy (OMT) study in a way that unambiguously allows a comparison between an intervention and therapeutic intent. The idea is good. The execution is likely not possible.

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Myths and health

Accordingly to the Oxford dictionary, a myth is a widely held but false belief (or idea). We commonly encounter health-related myths in our daily lives. For example, despite what you may have heard, cracking ones knuckles does not cause arthritis. Coffee doesn’t stunt the growth of children and 10,000 steps per day isn’t necessarily the magic number when it comes to activity levels. Chocolate is not an aphrodisiac and muscle doesn’t necessarily turn to fat when you stop exercising.

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