I want to highlight this in particular because it shows the duplicitous, misleading dance that the proponents of the #CassReview are doing.
It is true that in a review, generally, judging something as "low quality" does not mean that it is "thrown out." It is a term of art, and if it were just that in isolation it could even be okay.
But.
They did, very clearly, throw out and discount those results and then manipulate the public on what "low quality" means.
I would argue very firmly that what they are doing is a breach of medical ethics. Not that such will ever lead to consequences.
Because when you interpret "low quality" results you need to consider whether you can even get your "gold standard" results. You consider the context and think of how each study updates your priors.
This is like… 5xx level experiment design, so it isn't like these people don't know this (I would hope), but they are choosing to mislead people.
How this works, ideally (in a bit of a simplified model), is a bayesian process.
So you go through and score the evidentiary value of each and let each contribute. You are saying "what is the probability of X given these results." You can include the evidentiary value of each and calling something "low quality" is not, used appropriately and contextually a slight.
This is how you are seeing the proponents counter arguments here when they say "but this is how it works!"
But this is not what they are doing. They are talking about how "we are treating people without high quality results! This is dangerous!"
This clearly implies that they are discarding the evidence they have labeled as "low quality."
You always have to ask "what would be the study design that would satisfy you for this?" The answer here is not ethical, which leads to the conclusion that no evidence will satisfy them.
Again. I have to assume that they know all of this, because IIRC this was talked about in my 5xx biostatistics course when we were going over experiment design.
So either these preeminent clinicians and researchers, including editors of major medical journals, have a massive gap in their education covered by a low-level grad class in a mid-tier university in the US.
Or they are deliberately misleading people, possibly including themselves.