Leprosy mailing list – December 3^rd, 2005

Ccn:     all.

From:  B Ji, Paris, France.

---

 Ref.: Noordeen S K, LML Nov. 11^th, 2005

 

 

 

 

 

 

Dear Dr Noto,

 

I would like to share with the readers of your mailing list my reply to Dr Noordeen's comments on my statement about "Absence of evidence is not evidence of absence" described in my review article about MB relapse. (See attachment).

 

Best regards.

 

Baohong Ji, M.D.

>>>>>>>>>>>>>>>>>>>>>

Dear Dr Noordeen,

            Thank you for your comments on my statement about « Absence of evidence is not evidence of absence » described in my review article about MB relapse.

             I don’t think we should waste time on a philosophical discussion, because it is neither your nor my speciality. Nevertheless, I wish to point out that the main reason for my statement is simply because the post-MDT surveillance to detect relapse has been stopped since 1994 by the national programmes, therefore the conclusion that “no relapse” or “very few relapse” has not been based on solid evidence; my statement only reflects this simple fact. Please note that I did not state that “absence of evidence is evidence of presence”; rather, I simply pointed out that it “is not evidence of absence”! Moreover, I believe that your statement “while absence of evidence is not absolute evidence of absence, it is generally evidence of a high probability of absence” basically reflects a wishful thinking.

             Your opinion that “scientific standards demand that the maker of a claim is responsible to presenting valid evidence supporting the claim” is a bit unfair. Do you think that someone who does not have valid evidence cannot question the justification of a claim? Because my review article clearly summarized the evidence of MB relapse after completion of MDT by long-term follow-up, are these evidence not valid enough to justify a challenge of  claim on “no relapse” or “very few relapse”? 

             I agree with you that “it is not correct to challenge the scientific community to test every unsupported claim” if the claim is not of great importance, as in your example of claims that UFOs exists. However, the magnitude of relapse after MDT is the key issue in determining the long-term efficacy of MDT; obviously, we must assess the risk on the basis of solid data, ant not on assumptions or wishful thinking. 

             I also agree with you that “the key question is whether or not people have looked for absence (I think the question might better have been phrased as ‘looked for evidence of absence or presence’)”. I am certain you would agree with me that, thus far the issue of relapse has been largely ignored. To clarify the confusions regarding the relapse rate after MDT has been implemented in the field for a quarter of century, why not working together to measure the magnitude of relapse by collecting solid data?

             With my best regards.

 Baohong Ji, M.D.