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All I care about are results and not evidence or science

October 20 2012

This is the number one argument raised when results are questioned for their lack of evidence or when an evidence-based approach is discussed. And you will see this statement said more than a few times by coaches and trainers as if it makes them a cut above from the rest. Surprisingly, I have had friendly debates with people with Ph’d's and who are so-called ‘evidence-based’.

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It is clearly one of the most misunderstood concepts and clearly shows a lack of understanding of the term evidence-based approach and how really research works. 

What is so wrong with this statement?

Evolution of evidence-based medicine: Most folks are unaware that evidence-based medicine evolved because we weren’t getting results. It didn’t evolve so that smart doctors can explain “how things work” or the science behind their results. And it is the exact same reason why an evidence-based approach evolved in other fields too. There are hundred’s of drugs and treatments that we still don’t know how it works- but we know from randomized controlled trials that we get results. So we use them. Read this article about Why we need an evidence-based approach?.

For example, the landmark studies done by Doll and Hill in the 60’s showed that smoking is bad for you. Mind you, it was only after these studies we came to realize that smoking is indeed bad for you.  It showed that as the number of cigarettes being smoked increased, the incidence of lung cancer went up too. These studies never said anything about the how or the mechanisms involved. The largest RCT in women ever conducted is the Women’s Health Initiative study which showed that hormone replacement therapy (HRT) can be bad. This study was largely responsible for women stopping HRT all over the world. And guess what, we still don’t know what are the mechanisms behind it.

Doctors use an evidence-based approach to help their patients live better/live longer. They don’t use an evidence-based approach because they love to discuss science.  Have you heard any doctor saying “all I care about are results” though that’s all they care about. Why is that in our field we trainers and coaches have to say this repeatedly in every facebook post and article?

Basic Science vs applied research: People who think that research or evidence is all about explaining “why”  or “how things happen” are just completely unaware of this distinction. National Institute of Health (NIH) has funding allocation for both these studies and there is always a huge debate about which research should get more money.

  • Basic science studies: These studies looks at the science behind treatments/drugs/ and try to expand our basic knowledge. For example, how does occlusion works in increasing muscle, how does stretch affect protein synthesis and so forth.
  • Applied research: These are basically studies which look to see if a treatment or drug works or look at practical questions. We don’t care what is the mechanism behind it or if we learn anything new.

Evidence based approach mainly looks at applied research or direct studies. Understanding the mechanisms behind a treatment do help us to be more confident about the effectiveness treatment or drug and also helps us to generalize the results to a wider population.

For example, from basic science we know that an increase in load or load progression is primarily causing an increase in muscle growth. Hence we don’t have to repeat a study using load progression for every age group or every ethnic group.

People who look at all those complex physiological and molecular pathways and think that research is all about understanding the ‘why’ are just simply looking at basic science studies or mechanistic studies. They then go on and believe that this is how evidence-based approach works. These basic science studies are only specifically intended to understand the mechanisms and not for application (atleast not in the near future).

Results:  This one deserves its very own post. Your results, for that matter, even my results, doesn’t mean a thing. Find me a trainer who doesn’t get results. Forget training, find me a homeopath or a energy healing practioner or palm reader who doesn’t get results. They all genuinely think that they get results or the positive results they see is due to their intervention. No debate or argument in any field has yet to be resolved by counting results on each side.

If you are getting results, it just could mean a lot of other things and doesn’t say anything about you as a trainer or your program: When you say you are getting great result, it could also mean:

  • You had clients who are genetically gifted
  • You had clients who were really motivated. We know how much your diet and lifestyle can influence how you look. 
  • You had a clients who were beginners or in their developmental stage
  • You clients just happened to be on a really crappy program and/or diet before they came to you
  • You are just consciously or unconsciously ignoring clients who left or didn’t get results and counting just the positive hits


My whole point is that it is really hard to say that it is because of your personal training/coaching or your custom program that made the difference. It could be due to a lot of other factors too. This is the exact reason why millions are spent on studies to find the effective treatments and drugs. If the anecdotal results were indeed true, all we have to do is find the doctor who gets the most results and just use his treatment approach, right?. Just to show that exercise and diet indeed helps lower insulin resistance or your chances of getting diabetes, we spent 180 million on one study (Diabetic prevention trial).

I do understand the marketing /personal gratification aspects of sharing results, but trying to debate with your results or bringing up your results every time in an intelligent discussion do not speak so highly of your critical thinking skills.

Conclusions

  • Evidence-based approach evolved not to understand the mechanisms or explain the why, but to get results
  • Evidence based approach primarily uses applied research and less of basic science research
  • Your results says very little about your program or you as a trainer.  Most good trainers know this
  • .

Random Thoughts

Me: I usually do not like to talk much about my personal life in my site like most other bloggers do. I don’t have much to say. But here we go: I just moved to Miami to start my PhD In Exercise Physiology. Hence the long break in my site updates. If you are somewhere nearby and want to talk a bit about science/exercise, email me.

My Site: Exercise Biology was rated as one of the top 25 fitness sites in 2012.  I remember people telling me that it such a competitive field that a fitness site will never get noticed. People told me the same when I moved to US from India to be in the field. I am in this field because I am passionate about the field and I love helping people. If you have those two qualities in large doses, nothing can stop you nor slow you down. Thanks for reading Exercise Biology and supporting an evidence-based approach in your life. 

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Karky | Sun October 21, 2012  

Reading some evidence based stuff on concurrent training as we speak. Keep up the good work, this site is excellent!

Radi Hadzhiradevi | Sun October 21, 2012  

Another great article!

Anatoly | Sun October 21, 2012  

Great article as usual, Anoop.
However I must say I’m not quite get this point:
How do we suppose to deal with experimental data that supplies different results?
For example if we talking about hormonal hypothesis of muscle growth we have experiments that haven’t find any difference between legs+arms training vs. arms alone,
but we recently got another one that shows some.
So, what we do?

Anoop | Sun October 21, 2012  

Hi Karky,

Thanks! I am glad to have you as a member of Exercise Biology. You always have some well-thought out questions and comments.

H Radi

Thanks for the comment.

Hi Anatoly,

Thanks bro! And good question. In fact on the very specific topic, I wrote an article for Alan Aragon’s newsletter. I will send it you. Also as they say evidence is not enough there are a lot of other things you should look at before you apply the study results. It depends on your goals, benefits vs risks,compliance, practicality and so forth. Most of the exercise studies are efficacy trials; trials which look if somethings works in an ideal situation. But this may not be very practical.

I am working on a book/screencast about why and how to use an evidence based approach. I wanted to finish it in Summer, but couldn’t.

And thanks Anatoly for all your efforts to keep up the site. You have been here from the start.

Anatoly | Sun October 21, 2012  

Thanks, Anoop.
It’s good to be here, Anoop, I enjoy every moment
good luck with all your dreaming for
smile

Israel | Mon October 22, 2012  

Fantastic article. Simple yet makes a very strong point.

Bret Contreras | Mon October 22, 2012  

Hurrah! Great post Anoop and congrats on the PhD program!

sully | Mon October 22, 2012  

Great Article again Anoop.

As an Engineer, my motto is “in God we trust all other bring relevant data”

So many people rely on non-data studies or advertising by some large supplement company.

Keep up the great work,
Sully

Anoop | Tue October 23, 2012  

Thanks Israel. I agree. It is a very important question and I often see it thrown around casually.And yet to see anyone write about it.

Thanks Brett for taking the time comment. You are one of the very few in the performance side who keep it really evidence-based.

Thank Sully! I like you motto. It just goes back tto he way we think: system 1 thinking. Our brains unfortunately are more impressed by anecdotes and personal experiences than data and stats. So it takes some effort and awareness, which the majority wouldn’t bother.

Susan H | Wed December 26, 2012  

Maybe you would want to ask the people who pay for your services which they prefer - results, or that their clinician or trainer is “right” according to a method that is only correct for an average and not all individuals. As a client, I prefer results. I hate to be the party pooper, but as a person looking for pain solutions, I’ve had too much experience with clinicians who were “right” in their own mind, but who didn’t have a solution.

Anoop | Fri December 28, 2012  

Hi Susan,

I don’t think anybody is saying or ever said results doesn’t matter.

In fact, as I wrote in the first para, that is the very reason an evidence based-approach evolved. Bcos we weren’t getting results. This is same reason billions are spent every year in medicine - so that we get results.

Clinicians who were “right” doesn’t say anything about their approach or how well they know their field. There are lot of quacks and homeopaths who think they are ‘right’ too.

TheDane | Tue March 05, 2013  

I’m glad your site is getting noticed Anoop

Anoop | Wed March 06, 2013  

What makes you say that Dane?

What do you think?

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