The current reproducibility crisis is fundamentally a crisis of knowledge, thus in reality it is an epistemological crisis. The current reigning paradigm of null hypothesis testing using a P value of <.05 has made the medical literature prone to be filled with spurious correlations rather than true knowledge. This article brings attention to 3 foundational issues to help navigate the current crisis: The problem of induction, the concept of epistemological access, and the iatrogenics of information. Scientific reasoning is inductive reasoning and the problem of induction highlights the limitations of such knowledge. The concept of epistemological access is introduced to describe the inability of low-level data to extract true findings. This lack of true knowledge brings with it the iatrogenics of information, where having more data are in fact harmful and can lead to patients receiving ineffective treatments.
© 2020 Published by Elsevier Inc. on behalf of American Society for Radiation Oncology.