Lawrence Lynn
@patientstormdoc.bsky.social
Pulmonary critical care research physician. #medsky CoAuthor of “The Physician’s War” the story of the history of critical care science.
https://a.co/d/5C2A7Sm
https://a.co/d/5C2A7Sm
Pinned
Lawrence Lynn | The Science Monopoly
YouTube video by Consilium Scientific
youtu.be
Don’t miss this brief talk of the next step of the NIH to eliminate “science monopolies”.
We have to deeply understand how the culture of science has devolved over the past 3 decades under the overarching social pressure generated by the NIH grant dependency.
youtu.be/BTgEU07FI9o
We have to deeply understand how the culture of science has devolved over the past 3 decades under the overarching social pressure generated by the NIH grant dependency.
youtu.be/BTgEU07FI9o
Why Science Monopolies Can’t Self-Correct
YouTube video by Consilium Scientific
youtu.be
July 25, 2025 at 9:17 PM
Thread:
This is a conclusion of Grok 3 re: formal symbolic causal modeling prior to RCT.
(Referring specifically to the recently published REMAP CAP RCT testing hydrocortisone for severe community acquired pneumonia (CAP)
a nee era symbolic causal modeling as a @NIH required for grant
This is a conclusion of Grok 3 re: formal symbolic causal modeling prior to RCT.
(Referring specifically to the recently published REMAP CAP RCT testing hydrocortisone for severe community acquired pneumonia (CAP)
a nee era symbolic causal modeling as a @NIH required for grant
June 1, 2025 at 4:34 PM
Thread:
This is a conclusion of Grok 3 re: formal symbolic causal modeling prior to RCT.
(Referring specifically to the recently published REMAP CAP RCT testing hydrocortisone for severe community acquired pneumonia (CAP)
a nee era symbolic causal modeling as a @NIH required for grant
This is a conclusion of Grok 3 re: formal symbolic causal modeling prior to RCT.
(Referring specifically to the recently published REMAP CAP RCT testing hydrocortisone for severe community acquired pneumonia (CAP)
a nee era symbolic causal modeling as a @NIH required for grant
Did you notice that no one cited in these sepsis review articles actually discovered anything.
They just make up the rules and synthetically shift the paradigm.
Learn the history of sepsis science here.
youtu.be/BTgEU07FI9o
They just make up the rules and synthetically shift the paradigm.
Learn the history of sepsis science here.
youtu.be/BTgEU07FI9o
Lawrence Lynn | The Science Monopoly
YouTube video by Consilium Scientific
youtu.be
May 29, 2025 at 8:29 PM
Did you notice that no one cited in these sepsis review articles actually discovered anything.
They just make up the rules and synthetically shift the paradigm.
Learn the history of sepsis science here.
youtu.be/BTgEU07FI9o
They just make up the rules and synthetically shift the paradigm.
Learn the history of sepsis science here.
youtu.be/BTgEU07FI9o
Critical Care Quote of the day.
“…formal causal modeling is a means to add much needed rigor to determine the DoE [design of experiment]. Had causal modeling been required to acquire the [ @NIH ] grants in the past, it might have saved the crit care science decades of wasted research & careers”
“…formal causal modeling is a means to add much needed rigor to determine the DoE [design of experiment]. Had causal modeling been required to acquire the [ @NIH ] grants in the past, it might have saved the crit care science decades of wasted research & careers”
May 28, 2025 at 2:56 PM
Critical Care Quote of the day.
“…formal causal modeling is a means to add much needed rigor to determine the DoE [design of experiment]. Had causal modeling been required to acquire the [ @NIH ] grants in the past, it might have saved the crit care science decades of wasted research & careers”
“…formal causal modeling is a means to add much needed rigor to determine the DoE [design of experiment]. Had causal modeling been required to acquire the [ @NIH ] grants in the past, it might have saved the crit care science decades of wasted research & careers”
As pressure from the NIH grows to generate reproducible RCT outputs in critical care, and with potential defunding of non reproducible result generating RCT.
See this brief video relating to this pressing issue relating to critical care research funding and defunding.
youtu.be/BTgEU07FI9o
See this brief video relating to this pressing issue relating to critical care research funding and defunding.
youtu.be/BTgEU07FI9o
Lawrence Lynn | The Science Monopoly
YouTube video by Consilium Scientific
youtu.be
May 26, 2025 at 7:15 PM
As pressure from the NIH grows to generate reproducible RCT outputs in critical care, and with potential defunding of non reproducible result generating RCT.
See this brief video relating to this pressing issue relating to critical care research funding and defunding.
youtu.be/BTgEU07FI9o
See this brief video relating to this pressing issue relating to critical care research funding and defunding.
youtu.be/BTgEU07FI9o
The PettyBone RCT mimic is an endless cycle of grant generation in critical care.
This video tell the history of “RCT mimics” and “Synthetic Syndrome “ in critical care experimentation science.
youtu.be/BTgEU07FI9o
This video tell the history of “RCT mimics” and “Synthetic Syndrome “ in critical care experimentation science.
youtu.be/BTgEU07FI9o
May 26, 2025 at 6:01 PM
The PettyBone RCT mimic is an endless cycle of grant generation in critical care.
This video tell the history of “RCT mimics” and “Synthetic Syndrome “ in critical care experimentation science.
youtu.be/BTgEU07FI9o
This video tell the history of “RCT mimics” and “Synthetic Syndrome “ in critical care experimentation science.
youtu.be/BTgEU07FI9o
Reposted by Lawrence Lynn
In critical illness, we know patients are “sick” & we use terms like “significant inflammatory process” but we aren’t able to quantify it. Proud to be part of this work where we showed the role of neutrophil extracellular traps in organ injury #sepsis ccforum.biomedcentral.com/articles/10....
Plasma H3.1 nucleosomes as biomarkers of infection, inflammation and organ failure - Critical Care
Background Neutrophil extracellular traps (NETs) are a vital part of the innate immune response, while excessive NET formation can cause tissue damage. H3.1 nucleosomes, a component of NETs, have emer...
ccforum.biomedcentral.com
May 19, 2025 at 4:59 PM
In critical illness, we know patients are “sick” & we use terms like “significant inflammatory process” but we aren’t able to quantify it. Proud to be part of this work where we showed the role of neutrophil extracellular traps in organ injury #sepsis ccforum.biomedcentral.com/articles/10....
Don’t miss this brief talk of the next step of the NIH to eliminate “science monopolies”.
We have to deeply understand how the culture of science has devolved over the past 3 decades under the overarching social pressure generated by the NIH grant dependency.
youtu.be/BTgEU07FI9o
We have to deeply understand how the culture of science has devolved over the past 3 decades under the overarching social pressure generated by the NIH grant dependency.
youtu.be/BTgEU07FI9o
Lawrence Lynn | The Science Monopoly
YouTube video by Consilium Scientific
youtu.be
May 16, 2025 at 2:49 PM
Don’t miss this brief talk of the next step of the NIH to eliminate “science monopolies”.
We have to deeply understand how the culture of science has devolved over the past 3 decades under the overarching social pressure generated by the NIH grant dependency.
youtu.be/BTgEU07FI9o
We have to deeply understand how the culture of science has devolved over the past 3 decades under the overarching social pressure generated by the NIH grant dependency.
youtu.be/BTgEU07FI9o
Discussion of “RCT mods”.
Don’t use the term “RCT” unless it is a classical Bradford Hill RCT. Otherwise, specify the type of RCT mod.
Don’t use the term “RCT” unless it is a classical Bradford Hill RCT. Otherwise, specify the type of RCT mod.
The common approach in critical care is to expand the the sample size by testing the treatment to a diverse set of diseases captured by a triage set of thresholds.
This is an “RCT mod” called the “PettyBone RCT”.
This is an “RCT mod” called the “PettyBone RCT”.
February 17, 2025 at 5:08 PM
Discussion of “RCT mods”.
Don’t use the term “RCT” unless it is a classical Bradford Hill RCT. Otherwise, specify the type of RCT mod.
Don’t use the term “RCT” unless it is a classical Bradford Hill RCT. Otherwise, specify the type of RCT mod.
Wonderful last 2 days new fireworks, debate, & discussion over reform of @NIH driven critical care science. Don’t miss it!!
@CritCareMed @DocEd @CritCareReviews @ATSCritCare @RafaelOliveLeit @DrJBhattacharya
discourse.datamethods.org/t/the-petty-...
@CritCareMed @DocEd @CritCareReviews @ATSCritCare @RafaelOliveLeit @DrJBhattacharya
discourse.datamethods.org/t/the-petty-...
The Petty/Bone RCT
This discussion needs a reframing or a return to its original frame. It is crucial to apprehend the context when many people engage in asynchronous text exchanges. RCTs were developed to test interve...
discourse.datamethods.org
February 7, 2025 at 2:52 AM
Wonderful last 2 days new fireworks, debate, & discussion over reform of @NIH driven critical care science. Don’t miss it!!
@CritCareMed @DocEd @CritCareReviews @ATSCritCare @RafaelOliveLeit @DrJBhattacharya
discourse.datamethods.org/t/the-petty-...
@CritCareMed @DocEd @CritCareReviews @ATSCritCare @RafaelOliveLeit @DrJBhattacharya
discourse.datamethods.org/t/the-petty-...
Reposted by Lawrence Lynn
This has been quite a lively debate on trials in intensive care. I don't think the "pathological science" chat is productive, but I'm always up for a healthy scientific debate. Thoughts on datamethods: discourse.datamethods.org/t/the-petty-... @statsepi.bsky.social @load-dependent.bsky.social
January 26, 2025 at 4:20 PM
This has been quite a lively debate on trials in intensive care. I don't think the "pathological science" chat is productive, but I'm always up for a healthy scientific debate. Thoughts on datamethods: discourse.datamethods.org/t/the-petty-... @statsepi.bsky.social @load-dependent.bsky.social
Wonderful discussion.
On one end we have the 1989 PettyBone RCT and on the other the 1948 Bradford Hill RCT.
Then the spectrum between them.
While we disagree on the history and past mandates of of the PettyBone lumping Paradigm, Ed has hit it out of the park with his thoughtful response.
On one end we have the 1989 PettyBone RCT and on the other the 1948 Bradford Hill RCT.
Then the spectrum between them.
While we disagree on the history and past mandates of of the PettyBone lumping Paradigm, Ed has hit it out of the park with his thoughtful response.
This has been quite a lively debate on trials in intensive care. I don't think the "pathological science" chat is productive, but I'm always up for a healthy scientific debate. Thoughts on datamethods: discourse.datamethods.org/t/the-petty-... @statsepi.bsky.social @load-dependent.bsky.social
January 26, 2025 at 5:03 PM
Wonderful discussion.
On one end we have the 1989 PettyBone RCT and on the other the 1948 Bradford Hill RCT.
Then the spectrum between them.
While we disagree on the history and past mandates of of the PettyBone lumping Paradigm, Ed has hit it out of the park with his thoughtful response.
On one end we have the 1989 PettyBone RCT and on the other the 1948 Bradford Hill RCT.
Then the spectrum between them.
While we disagree on the history and past mandates of of the PettyBone lumping Paradigm, Ed has hit it out of the park with his thoughtful response.
This thread shows why the @NIH should no longer fund PettyBone RCT.
The public deserves and should demand that pathological science and pathological consensus are not supported in any field.
The public deserves and should demand that pathological science and pathological consensus are not supported in any field.
Kuhnian behavior does not require conspiracy esp. when self funded by NIH
That they have been “talking”while continuing this pathological science for yrs is exactly the point & right out of the classic social science texts.
Clearly their tolerance for bad science is high. Public must intervene
That they have been “talking”while continuing this pathological science for yrs is exactly the point & right out of the classic social science texts.
Clearly their tolerance for bad science is high. Public must intervene
January 25, 2025 at 3:27 PM
This thread shows why the @NIH should no longer fund PettyBone RCT.
The public deserves and should demand that pathological science and pathological consensus are not supported in any field.
The public deserves and should demand that pathological science and pathological consensus are not supported in any field.
Masterfully done. Every clinician and clinical medicine focused statistician should listen to this.
Single-centre RCTs don't often replicate in multi-centre RCTs. Find out more with guest skeptic Dr. Scott Weingart on this week's episode of the SGEM. @emcrit.bsky.social thesgem.com/2025/01/sgem... #MedSky #EBM
January 12, 2025 at 8:08 PM
Masterfully done. Every clinician and clinical medicine focused statistician should listen to this.
“Diagnostic momentumed” a beautiful kuhnian neologistic phrase.
Please no, it’s already diagnostic momentumed (is that a word?!) beyond the point of reasonable and into causing harm!
January 7, 2025 at 3:27 PM
“Diagnostic momentumed” a beautiful kuhnian neologistic phrase.
Reposted by Lawrence Lynn
Please no, it’s already diagnostic momentumed (is that a word?!) beyond the point of reasonable and into causing harm!
December 4, 2024 at 7:14 AM
Please no, it’s already diagnostic momentumed (is that a word?!) beyond the point of reasonable and into causing harm!
#Science only self-corrects if the youth are both empowered and have the courage to correct their mentors mistakes.
This is your time. Petty & Bone’s ideas were from their generation.
Start with real inquiry. Send your colleagues to datamethods to discuss & debate. Those are world class statisticians who are not in-the-box at datamethods
Science only self-corrects if the youth correct their mentors mistakes
Start with real inquiry. Send your colleagues to datamethods to discuss & debate. Those are world class statisticians who are not in-the-box at datamethods
Science only self-corrects if the youth correct their mentors mistakes
January 7, 2025 at 2:52 PM
#Science only self-corrects if the youth are both empowered and have the courage to correct their mentors mistakes.
Reposted by Lawrence Lynn
I do actually agree with you (and the connected thread you made on data methods). It’s always been a case of lumpers vs splitters. Interesting how quickly we found treatments in COVID pneumonitis (a singular disease rather than a syndrome).
January 3, 2025 at 9:31 PM
I do actually agree with you (and the connected thread you made on data methods). It’s always been a case of lumpers vs splitters. Interesting how quickly we found treatments in COVID pneumonitis (a singular disease rather than a syndrome).
An informed lay person asked if “steroids” were effective for influenza with cytokine storm.
I was embarrassed to tell the person that we do not know because the requisite RCTs have not been done.
Learn why, after 40 years, these RCT have not been done
discourse.datamethods.org/t/the-petty-...
I was embarrassed to tell the person that we do not know because the requisite RCTs have not been done.
Learn why, after 40 years, these RCT have not been done
discourse.datamethods.org/t/the-petty-...
The Petty/Bone RCT
There is a real and emerging risk of a severe influenza pandemic this year. In response a member of the lay public, clearly informed but afraid that a new flu pandemic may be coming asked me if “ster...
discourse.datamethods.org
January 3, 2025 at 2:30 AM
An informed lay person asked if “steroids” were effective for influenza with cytokine storm.
I was embarrassed to tell the person that we do not know because the requisite RCTs have not been done.
Learn why, after 40 years, these RCT have not been done
discourse.datamethods.org/t/the-petty-...
I was embarrassed to tell the person that we do not know because the requisite RCTs have not been done.
Learn why, after 40 years, these RCT have not been done
discourse.datamethods.org/t/the-petty-...
It is likely that the failed standard method of #criticalcare #RCT will soon be defunded. Young researchers should get ahead of this.
Link shows why so many, especially exUS scientists, are revolting against 20th century failed methodology & demanding reform
substack.com/@thethoughtf...
Link shows why so many, especially exUS scientists, are revolting against 20th century failed methodology & demanding reform
substack.com/@thethoughtf...
Rafael Olivé Leite on Substack
Critical care community!
We are not going anywhere with our fake RCTs. Fake science!
(…)
The methodology described for the PettyBoneRCT, where different diseases are lumped together by using triage...
substack.com
December 28, 2024 at 2:05 PM
It is likely that the failed standard method of #criticalcare #RCT will soon be defunded. Young researchers should get ahead of this.
Link shows why so many, especially exUS scientists, are revolting against 20th century failed methodology & demanding reform
substack.com/@thethoughtf...
Link shows why so many, especially exUS scientists, are revolting against 20th century failed methodology & demanding reform
substack.com/@thethoughtf...
Reposted by Lawrence Lynn
Is a good discussion there for sure. I’d opted for default stopping
December 17, 2024 at 3:53 PM
Is a good discussion there for sure. I’d opted for default stopping
Reposted by Lawrence Lynn
If you are interested in the history of critical care science and how this trip into the intellectual rabbit hole happened, there is a discussion at the Vanderbilt statistics site. 2nd most popular this quarter.
discourse.datamethods.org/t/the-petty-...
discourse.datamethods.org/t/the-petty-...
The Petty/Bone RCT
Yes. The Petty/Bone RCT is a term used for a unique pathological modification of the RCT which dominates critical care science. Two USA pulmonologists, Thomas Petty (1960s) and Roger Bone (1980s) de...
discourse.datamethods.org
November 28, 2024 at 2:03 PM
If you are interested in the history of critical care science and how this trip into the intellectual rabbit hole happened, there is a discussion at the Vanderbilt statistics site. 2nd most popular this quarter.
discourse.datamethods.org/t/the-petty-...
discourse.datamethods.org/t/the-petty-...
Very interesting post explains the lack of reproducibility of critical care RCT
#CriticalCare #RCT
substack.com/@thethoughtf...
#CriticalCare #RCT
substack.com/@thethoughtf...
Rafael Olivé Leite on Substack
Who, coveting NIH grants & the lectern can challenge the Petty and Bone Paradigm?
substack.com
November 27, 2024 at 12:52 PM
Very interesting post explains the lack of reproducibility of critical care RCT
#CriticalCare #RCT
substack.com/@thethoughtf...
#CriticalCare #RCT
substack.com/@thethoughtf...
Reposted by Lawrence Lynn
