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Lex maniac

Investigating changes in American English vocabulary over the last 50 years

Tag Archives: medical testing

the science

(2000’s? | “the (scientific) consensus,” “(the best) scientific evidence,” “the latest studies”)

Trust the science. Follow the science. Believe in the science. Government policy will be determined by the science. (“Data” gets the same treatment; you must do what the data tell you. The article is less obtrusive in front of “data” than “science.”) The prescription has drawbacks, most notably that science can’t make up its mind right away and will issue conflicting decisions and rules as the evidence continues to roll in. This lack of certitude does create problems, which scientists themselves may exacerbate by showing certainty before it is warranted or just by talking down to the rest of us. Such problems are not permanent, however; one indication of good medical research is that it gets both more accurate and more sure of itself over time, leading to more effective diagnosis and treatment. Besides, given the complex and uncertain world we live in, the power to adapt to new information ought to inspire confidence rather than undermine it.

One trick of the definite article is that it suggests that science says only one thing, so that it can be counted on for unambiguous guidance. We have all encountered exceptions, but in the case of the coronavirus that has been largely true, I think. Dissension does arise within the scientific ranks; for the most part it is resolved as more tests are run and more results produced.

Of course it has always been possible to plop down a definite article before “science.” But it was almost always followed by something further — the science center, the science headlines, the science of . . . . But science solus has been lumbered constantly with the article during the pandemic, as doctors and public officials implore us to heed infectious-disease specialists. “The science” has become a mantra of sorts, asking us to accept medical research as a reliable source of knowledge that offers maximum protection from a weird and frightening virus. Not everyone wants to listen, of course, and COVID has confounded the experts from time to time, eroding their claim to be the most trustworthy voice.

The plea to “trust the science” is a quasi-religious gesture; we are enjoined to hope that scientists have our best interests at heart and will perform competently. That’s a watered-down version of what Jews, Christians, and Muslims believe about God. Most of us do not understand how the scientists arrive at their results any more than we understand the Lord’s mysterious ways, so our level of helplessness is about the same, for all that scientists can adduce a much longer list of verified empirical results than priests can. Science has what I think is a built-in problem: the more advanced it gets the more it looks like magic, which resembles religion in that it wins loyalty by producing wonders that defy comprehension. Contemporary physics is almost perversely counterintuitive, producing theories that flout what we thought were fundamental principles. Western medicine, whatever its shortcomings, continues to produce cures unthinkable a few generations ago. We can look up almost anything instantly on a cheap handheld device. What comes with these advances? An abandonment of earthbound common sense, and a profession of faith in a select group of mandarins who alone understand how the universe works. That’s not what Paine and Voltaire had in mind.

Ah, the humble definite article — let us not overlook its semantic power. (And prosodic: articles make the iambic a characteristic English meter, even though most of our words are accented on the first syllable.) In English, unlike many European languages, “the” transforms nouns from general to particular. (E.g., “keys” vs. “the keys.” Note that this rule holds in the case of “the science,” if you hear it as a reference to work in epidemiology or another specific branch of medicine.) Sometimes definite articles are indispensable — “make bed,” “walk dog,” or “rock boat” all sound ridiculous — yet other languages get along happily without them. (And their misuse is a quick way to recognize a non-native speaker.) We scatter them thoughtlessly and pay them no mind. We would do better to reckon with the power of “the.”

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(1980’s | academese (science) | “randomly generate”)

A term born of empirical science — experiment design and statistics. Now it is used primarily to talk about clinical trials; an essential part of testing a medication or treatment is “randomizing” the patients — that is, making sure that those getting the treatment and those getting the placebo are sorted by non-human means, to eliminate as much bias in the results as possible. Such processes are easiest to envision in a binary world, where there are only A and B, and the category you belong to is “decided” by mechanical means. Computer programmers picked it up very soon, before most of us knew there was such a thing as computer programming, so by 1980 “randomize” had a number of technical uses, which for the most part it still has. In the eighties and nineties, I found examples from other endeavors as well: poker; esthetics (choreographer Merce Cunningham “randomized” his decisions at particular junctures by throwing the I Ching to determine the outcome); CD players; creating standardized tests; listing candidates on a ballot. It most often has to do with some sort of testing, medical or otherwise.

An “-ize” verb, “randomize” doesn’t sound as clunky (to me, at least) as “incentivize,” “weaponize,” or “monetize.” Probably because it’s rooted in science and mathematics; ize-itis is easier to take with technical terms. And “randomize” hasn’t filtered into everyday speech much. It’s a word you come across in print occasionally, but it hasn’t exactly taken the vernacular by storm. It seems like a modest enough word, filling a need without taking up too much room.

A related yet unrelated word is “rando.” It’s sort of a portmanteau of random and weirdo — the rando has a definite hint of unpleasantness, not someone you want to have to deal with. (Though the highest-ranked definitions on don’t give the term a negative implication, and at least one on-line source thinks randos are a good thing, so the jury is out.) An unrelated yet related word is “anonymize,” to which my attention was drawn by Lovely Liz from Queens, as in “anonymize data.” It’s how to divorce you from your personal information and preferences; more precisely, it’s how internet titans vacuum up everything worth knowing about your on-line habits while creating the illusion that your name and identity can’t be connected with any of it. But anonymizing is also part of randomizing; in fact, removing patients’ names is an essential step in the process.

Random isn’t as simple as it sounds. Take a simple example: if you flipped a coin and it came up heads ten times in a row, you wouldn’t think that was random at all. Some ordering force must be at work, right? Yet it’s perfectly possible for a fair coin to land on the same face ten times in row. There doesn’t even have to be a balancing streak of ten tails later on, but over time the number of heads and tails will even out. In a truly random sequence or assortment, you will almost certainly find stretches that appear to be grouped logically, but that’s just how it shakes out; it’s not proof, or even evidence, of a master intelligence running things. We want to call random only that which is jumbled, devoid of an obvious organizing principle. But the random may look very organized if you focus on a small section.

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false positive

(1980’s | doctorese | “bad diagnosis”)

An example of an older expression that has grown common and become less specialized (other examples: “blowback,” “grounded,” “politically correct,” “template“). In medicine, “false positive” goes back at least to the forties, probably earlier; for some reason, the only results in Google Books from those days have to do with the Wassermann test for syphilis. In the seventies, the phrase got a boost from the popularity of home pregnancy tests. In the eighties, it was employee drug testing. Both developments got plenty of press, so use of the phrase grew sharply, and as it spread it began to turn up outside of strictly medical contexts. Now it can apply to virus or spam detection, security systems, internet search results, or even economic forecasting or earthquake warnings. The last two are notable because they involve not results but predictions, which adds a new twist. You said there will be a recession and it doesn’t materialize — instead of you said there was cancer and there was no cancer there. Another example from the scientific community: “A false positive is a claim that an effect exists when in actuality it doesn’t,” that is, detecting a correlation that exists only because of your misinterpretation of the data. All these meanings rely on presumably preventable misreadings of an empirical result, incorrectly assigning too broad a significance to a single symptom, or maybe just running the test wrong.

False positives are a big problem; they can creep into the work of the most careful scientists. Medical tests that show a disease that isn’t really present can result in unnecessary or dangerous treatment, and all the expense that goes with it. The effect is subtler in empirical science, but pressure to obtain statistically significant results can skew the perspectives even of conscientious experimenters. (This article explains how it happens.) Such errors are dangerous because it’s worse to be sure of something that isn’t true than to fail to know something that is. As a great American philosopher, possibly Josh Billings or maybe Will Rogers, said, “It ain’t what people don’t know that’s the problem; it’s what they know that ain’t so.”

The expression was well settled by 1980, but only in medical contexts. (“False negative” is just as old.) When it turned up in general-interest articles, it often came packaged in quotation marks. It had not become a regulation noun; in those days it was still normally a compound adjective, applied to readings, results, reactions, responses, rates. Now it is more common as a noun than as an adjective.

I’m sure I wasn’t the first or last kid to stumble over the counterintuitive meaning of “positive” in medicine. I thought “the test came back positive” was good news, whereupon my hard-working parents (I kept ’em hopping) had to explain that the word you wanted to hear was “negative.” Doctors test for the presence of a disease or condition, and a positive result means they’ve found it, and you’re stuck with an undesirable disorder. It’s the only zone in everyday language in which “positive” means “negative,” I do believe. (It reminds me of middle-aged parents in the seventies cheerily reminding each other that “bad” meant “good.”) We must ever observe the instructions in the song and accentuate the positive, but not in the lab, please!

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