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Talking Science With Patient Advocate, Laurie Edwards

Laurie Edwards has a rare chronic disease called primary ciliary dyskinesia. Her symptoms are quite similar to those associated with cystic fibrosis, and her young life has been punctuated by numerous hospitalizations, physical limitations and the occasional near-death experience. She is a remarkably upbeat woman, and attributes her self confidence and optimistic outlook to her loving friends and family.

Laurie is part of the patient blogging community online. She reads physician blogs with interest, and wants to protect others like her from snake oil and misinformation. She recently interviewed me about my pro-science views for a new book that she’s writing. People like Laurie play a critical role in accurate health communication, and I welcome the chance to discuss science-based medicine with them. Here are some excerpts from our chat: Read more »

*This blog post was originally published at Science-Based Medicine*

Connecting The Dots: Deer, Car Accidents, Lyme Disease, And You

Thanks to Glenn Reynolds over at InstaPundit, I learned that motor vehicle collisions with deer are up 18% compared to 5 years ago.

State Farm calculates the chances of a West Virginia vehicle striking a deer over the next 12 months at 1 in 39. Michigan remains second on that list.  The likelihood of a specific vehicle striking a deer there is 1 in 78.  Pennsylvania (1 in 94) and Iowa (1 in 104) remain third and fourth respectively.  Montana (1 in 104) moved up three places to fifth.

Now, aside from the fact that deer present challenges to our driving friends in West Virgina, Michigan, and beyond – they are also the definitive host for Lyme disease. Ticks feed on the deer (who, by the way, become infected with Lyme spirochetes but suffer no symptoms) and on unsuspecting humans – passing the infection along. And so when deer populations increase, Lyme disease often does too. Read more »

The iPhone TickDoctor

Dr. Jeremy Joslin is a wilderness medicine aficionado and has without question posted the greatest number of intelligent and useful comments to posts at this blog. So, I’m pleased to learn that he has created a very useful iPhone application named TickDoctor.

TickDoctor provides a stunning visual atlas of the most common ticks encountered in North America. Although not yet comprehensive, most common ticks are represented. For each tick species, the user is able to identify males, females, and nymphs. In many instances, there are included images of the engorged female, which often looks very different from its non-fed state.

More than just a beautiful atlas, TickDoctor provides instructions for prevention of tick bites and how to remove them if bites should occur. If a bite has occurred, or if you’re just plain curious, Dr. Joslin has included medically relevant data on each species, describing which diseases have been associated with it.

While this application should never substitute for the advice of a physician, it will help guide you to the identification of the tick in question and provide a framework of reference for dealing with “what to do next.”

I’ve been informed by Jeremy that, “if you have a great photo of a tick and want it considered for the next application update, let me know. You can do this by posting a comment and I’ll follow up with you. We’re always interested in making the atlas better.”

This post, The iPhone TickDoctor, was originally published on Healthine.com by Paul Auerbach, M.D..

Science Is Hard, And Best Left To Professionals (The Same May Be Said For Journalism)

It might seem a bit undemocratic, but science, like medicine or dentistry, is a profession. One doesn’t become a scientist by fiat but by education and training. I am not a scientist. I apply science. My colleague Dr. Gorski is a scientist (as well as physician). He understands in a way that I never will the practical process of science—funding, experimental design, statistics. While I can read and understand scientific studies in my field, I cannot design and run them (but I probably could in a limited way with some additional training). Even reading and understanding journal articles is difficult, and actually takes training (which can be terribly boring, but I sometimes teach it anyway).

So when I read a newspaper article about science or medicine, I usually end up disappointed—sometimes with the science, and sometimes with the reporting. A recent newspaper article made me weep for both. Local newspapers serve an important role in covering news in smaller communities, and are often jumping off points for young, talented journalists. Or sometimes, not so much.

The article was in the Darien (CT) Times. The headline reads, in part, “surveys refute national Lyme disease findings.” Epidemiologic studies, such as surveys, are very tricky. They require a firm grounding in statistics, among other things. You must know what kind of question to ask, how many people to ask, how to choose these people, etc, etc, etc. So what institution conducted this groundbreaking survey on Lyme disease?

Actually, they are quoting the famous work of one Kent Haydock, chairman of the Deer Management Committee. But I’m sure he outlined his methods carefully. Or not.

Haydock conducted:

[T]wo surveys — which polled 41 Darien households after a showing of the Lyme Disease film, Under Our Skin, at the Darien Library last month… . In the 41 households that completed the questionnaire, 47 total Lyme disease cases were reported. In 64 percent of those cases, the patient had relapses after an initial Lyme treatment, which required additional treatment for a chronic or long-term conditions.

So, Haydock showed the agitprop chronic Lyme advocacy film Under Our Skin to local families, presumably not selected at random, and then asked them if they had signs of Lyme disease and if it was ruining their lives. Not surprisingly, the answers to both questions were “yes” a remarkably high percentage of the time.

His conclusion: the surveys “show that Lyme not only exists in great numbers, but also in debilitating, chronic and long-term cases.”

This is not epidemiology. This is not science. This is an uninformed opinion dressed up with meaningless numbers. If you get together a group of people who are interested in Lyme disease, show them a propaganda film, and query them about it, the only thing you’ve “measured” is your ability to count people who come to a movie and hold a certain belief. If there were any valid conclusions to be drawn (and with these numbers, there probably aren’t) it’s that many people in this small group think they have Lyme disease—and even that’s over-reaching.

It’s bad enough that the deer commissioner did this. But arguably, it’s much worse that the reporter and editor published it. The only thing this accomplishes is fanning the fears of the readers.

*This blog post was originally published at Science-Based Medicine*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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