Episode 11.11 When Evidence Misleads

We sit down with Joshua Oommen to get nerdy about clinical reasoning, FDA standards, and why “good evidence” is harder to define than most of us admit. We challenge the reflex to trust p-values and meta-analyses, then test our instincts against real OBGYN examples where the literature has whiplashed practice. • why the podcast is called Thinking About OBGYN and how clinical reasoning shapes our work • the NEJM proposal to make one pivotal trial the FDA default and what “confirmatory evidence” might mean • medical reversal, surrogate endpoints, and how trust erodes when practice changes late • why Bayesian thinking fits how clinicians interpret tests, trials, and prior beliefs • how meta-analyses fail through small study effects, publication bias, p-hacking, and heterogeneity • the amnioinfusion comeback as a case study in applicability and overconfident conclusions Be sure to check out thinking about obgyn.com for more information and be sure to follow us on Instagram. 0:00 Welcome And Today’s Big Question3:48 Why “Thinking About OBGYN” Exists11:54 The NEJM Push For One Trial16:38 Medical Reversal And Trust Problems24:43 AI Proteins And CRISPR Pressure Tests32:33 Bayes Thinking Beyond P Values36:43 Why Meta-Analyses Often Mislead41:08 Bias And Heterogeneity Red Flags46:24 Amnioinfusion And A Meta-Analysis Comeback1:02:29 Final Warnings And How To LearnFollow us on Instagram @thinkingaboutobgyn.