Paul Alper writes:
I do not believe your blog has ever dealt with the following phenomenon which might be called “(widening) moving the goalposts.” Drug companies and the medical world at large often create powerful drugs and procedures for people who are far (many standard deviations) from the norm (mean) and via randomized clinical trials, the relevant authorities approve. But there aren’t enough of those people to be truly profitable so the next step is to ask for approval to prescribe the same for people who aren’t that far (fewer standard deviations) from the norm. Or, just move the norm (center) so as to pick up a much larger number of patients. Afflictions include hypertension, cholesterol, overweight, osteoporosis.
The result is what is often called “the worried well,” who receive little or no benefit but suffer harms from the treatment.
H. Gilbert Welch has written extensively on this “goalpost” issue. He is the author of
He also has spoken on NPR
I wrote this for Chance News regarding his book:
See his pages 64 and 66 which shows graphs which illustrate how diagnoses increase markedly while deaths are flatlined. The Guardian’s Ben Goldacre often writes about the goalpost issue.