Kardashian Psychiatrist Doesn't Understand Studies | What the Fitness | Biolayne

After highlighting the weaknesses of cohort data, Norton provides a concrete description of what a proper RCT would look like. He outlines a 3-group design: one group gets real SPECT imaging and receives customized treatment based on the results; a second gets real imaging but only standard care advice; a third undergoes a sham scan—sitting in the machine, hearing the noises, but no actual imaging—and receives standard care. This design separates the effects of (a) the imaging ritual and expectation, (b) the image itself, and (c) the personalized advice. He explains that without such a design, any observed improvement cannot be attributed to the scan because baseline group differences and placebo are unaccounted for. The sham group is critical because it tests the hypothesis that being told you had a "super duper special imaging" is what drives improvement, not the scan or the tailored advice.

Norton recounts how Mike immediately seized on the nebulous term and then asked why the American Psychiatric Association and American Academy of Neurology oppose SPECT imaging. When Aemon dodged, Mike pressed for a specific RCT. Norton analyses each dodge—appeal to authority ("I have more experience than anybody"), deflection ("why the most studies?"), and finally "Google it bro"—and frames Mike's persistence as a textbook example of the burden of proof: the claimant must provide evidence, not the questioner. He notes this is a refreshing departure from how such figures are usually treated and that Mike's approach left Aemon unable to cite even one study.

Norton walks through the exchange frame by frame. After Mike asks for an example of RCT data, Aemon says "Which one do you want to talk about?" and then, when Mike asks him to name one, Aemon dodges: "Well, which one do you want to talk about?" and later says "if you go on PubMed." Norton points out this is a classic evasion—"basically Google it bro"—and stresses that the burden of proof is on the claimant. He argues that if you have done the most studies ever, you should be able to immediately name at least one RCT. The failure betrays that Aemon either does not understand what an RCT is or that he has no such data. Norton concludes it is "pretty scary" for someone who promotes himself as a world-renowned psychiatrist.

Norton contrasts Aemon’s claim that his published outcomes validate the imaging with the reality of the placebo effect. He walks the viewer through the typical scenario: a patient is told they are getting a "super duper special imaging" that will reveal hidden brain issues, then they receive tailored advice. The psychological boost of this narrative—the belief that a high-tech scan has pinpointed the problem—can itself produce symptom relief. He notes that placebo effects are well-documented and can rival pharmaceutical treatments in size. Therefore, any study without a sham arm (where participants undergo a dummy scan but believe it is real) cannot distinguish the specific effect of the scan from the enormous expectation effect. The failure to account for this renders Aemon’s cohort data incapable of establishing that the SPECT scan itself adds value.