September 2nd, 2010 by DrJosephAlbietz in Better Health Network, Health Policy, Health Tips, News, Opinion, Quackery Exposed, True Stories
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I lost a patient this season, an infant, to whooping cough (pertussis). After falling ill, he lived for nearly a month in the intensive care unit on a ventilator, three weeks of which was spent on a heart/lung bypass machine (ECMO) due to the extent of the damage to his lungs. But all our efforts were in vain. The most aggressive and advanced care medicine has to offer couldn’t save his life. The only thing that could have saved him would have been to prevent him from contracting pertussis in the first place.
He was unvaccinated, but that was because of his age. He was part of the population that is fully dependent on herd immunity for protection, and that is exquisitely prone to a life-threatening course once infected. This is a topic we’ve covered ad nauseum, and I’m not inclined to go into greater depth in this post. Suffice it to say his death is a failure at every level. We, both as medical professionals and as a society at large, need to do a better job of protecting our children from preventable diseases. Read more »
*This blog post was originally published at Science-Based Medicine*
August 26th, 2010 by DrSteveNovella in Better Health Network, Health Policy, News, Opinion, Research
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Peer review has been the cornerstone of quality control in academia, including science and medicine, for the past century. The process is slow and laborious, but a necessary filter in order to maintain a certain standard within the literature. Yet more and more scholars are recognizing the speed, immediacy, and openness of the Internet as a tool for exchanging ideas and information, and this is causing some to question the methods of peer review. A recent New York Times article discusses this issue.
This issue is very relevant to Science-Based Medicine (SBM) as this is in part an experiment –- an attempt to produce a high quality, editorially filtered, but not peer-reviewed, online journal. Our process here is simple. Outside submissions are reviewed by two or more editors and typically are either accepted with minor revisions or rejected. In addition we have a staff of regular contributors –- those who have a proven track record of producing high quality articles. There is no pre-publication review for their submissions, and they are able to post directly to SBM. Read more »
*This blog post was originally published at Science-Based Medicine*
August 5th, 2010 by DrDavidGorski in Better Health Network, Health Policy, Opinion, Quackery Exposed, Research
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One of the recurring themes of this blog, not surprisingly given its name, is the proper role of science in medicine. As Dr. Novella has made clear from the very beginning, we advocate science-based medicine (SBM), which is what evidence-based medicine (EBM) should be. SBM tries to overcome the shortcomings of EBM by taking into account all the evidence, both scientific and clinical, in deciding what therapies work, what therapies don’t work, and why.
To recap, a major part of our thesis is that EBM, although a step forward over prior dogma-based medical models, ultimately falls short of making medicine as effective as it can be. As currently practiced, EBM appears to worship clinical trial evidence above all else and nearly completely ignores basic science considerations, relegating them to the lowest form of evidence, lower than even small case series. This blind spot has directly contributed to the infiltration of quackery into academic medicine and so-called EBM because in the cases of ridiculously improbable modalities like homeopathy and reiki, deficiencies in how clinical trials are conducted and analyzed can make it appear that these modalities might actually have efficacy. Read more »
*This blog post was originally published at Science-Based Medicine*
July 29th, 2010 by DrKimballAtwood in Better Health Network, Health Policy, Opinion, Quackery Exposed, Research
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Josephine P. Briggs, M.D.
Director, National Center for Complementary and Alternative Medicine
Dear Dr. Briggs,
As you know, we’ve met twice. The first time was at the Yale “Integrative Medicine” Symposium in March. The second was in April, when Drs. Novella, Gorski and I met with you for an hour at the NCCAM in Bethesda. At the time I concluded that you favor science-based medicine, although you are in the awkward position of having to appear ‘open-minded’ about nonsense.
More about that below, but first let me address the principal reason for this letter: it is disturbing that you will shortly appear at the 25th Anniversary Convention of the American Association of Naturopathic Physicians (AANP). It is disturbing for two reasons. First, it suggests that you know little about the tenets and methods of the group that you’ll be addressing. Second, your presence will be interpreted as an endorsement of those methods and of that group—whether or not that is your intention. Read more »
*This blog post was originally published at Science-Based Medicine*
July 24th, 2010 by DrSteveNovella in Better Health Network, Health Policy, Health Tips, Opinion, Research
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Recently some Science-Based Medicine (SBM) colleagues (David Gorski, Kimball Atwood, Harriet Hall, Rachel Dunlop) and I gave two workshops on how to find reliable health information on the Web. As part of my research for this talk I came across this recent and interesting study that I would like to expand upon further: Quality and Content of Internet-Based Information for Ten Common Orthopaedic Sports Medicine Diagnoses.
The fact that the article focuses on orthopedic diagnoses is probably not relevant to the point of the article itself, which was to assess the accuracy of health information on the Web. They looked at 10 orthopedic diagnoses and searched on them using Google and Yahoo, and then chose the top results. They ultimately evaluated 154 different sites with multiple reviewers for quality of content and also for their HON rating. Read more »
*This blog post was originally published at Science-Based Medicine*
July 22nd, 2010 by DrDavidGorski in Better Health Network, Health Policy, News, Opinion, Quackery Exposed, Research
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I can’t speak for anyone else who blogs here at Science-Based Medicine, but there’s one thing I like to emphasize to people who complain that we exist only to “bash ‘alternative’ medicine.” We don’t. We exist to champion medicine based on science against all manner of dubious practices. Part of that mandate involves understanding and accepting that science-based medicine (SBM) is not perfect. It is not some sort of panacea. Rather, it has many shortcomings and all too often does not live up to its promise.
Our argument is merely that, similar to Winston Churchill’s invocation of the famous saying that “democracy is the worst form of government except all the others that have been tried,” science-based medicine is the worst form of medicine except for all the others that have been tried before. (Look for someone to quote that sentence soon.) It’s not even close, either. Read more »
*This blog post was originally published at Science-Based Medicine*
July 17th, 2010 by DrHarrietHall in Better Health Network, Book Reviews, News, Opinion, Research
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Wouldn’t it be great if we could find a way to prolong our lives and to keep us healthy right up to the end? Ponce de León never found that Fountain of Youth, but science is still looking. What are the chances science will succeed? How’s it doing so far?
In his new book The Youth Pill: Scientists at the Brink of an Anti-Aging Revolution, David Stipp tries to answer those questions. From the title of the book, I expected hype about resveratrol or some other miracle pill, but instead it is a nuanced, levelheaded, entertaining, informative account of the history and current state of longevity research. It makes that research come alive by telling stories about the people involved, the failures and setbacks, and the agonizingly slow process of teasing out the truth with a series of experiments that often seem to contradict each other.
Anti-aging can mean several things. Extending the average lifespan is not the same as extending the maximum lifespan. Extending lifespan is not the same as preventing the degenerative changes characteristic of aging. Read more »
*This blog post was originally published at Science-Based Medicine*
June 3rd, 2010 by DrSteveNovella in Better Health Network, Opinion, Quackery Exposed, Research
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The development of drugs and other treatments for specific symptoms or conditions relies heavily on either serendipity (the chance finding of a beneficial effect) or on an understanding of underlying mechanisms.
In pain, for example, there are limited ways in which we can block pain signals –- such as activating opiate receptors, or inhibiting prostaglandins. There are only so many ways in which you can interact with these systems. The discovery of a novel mechanism of modulating pain is therefore most welcome, and has the potential of leading to entirely new treatments that may have a better side effect profile than existing treatments and also have an additive clinical effect.
A recent study by Nana Goldman et. al., published in Nature Neuroscience, adds to our understanding of pain relief by identifying the role of adenosine in reducing pain activity in the peripheral nervous system. The researchers, in a nice series of experiments, demonstrated that producing a local painful stimulus in mice causes the local release of ATP (adenosine triphosphate) that peaks at about 30 minutes. This correlates with a decreased pain response in the mice. Further, if drugs are given that prolong the effect of adenosine, the analgesic effect itself is prolonged. Read more »
*This blog post was originally published at Science-Based Medicine*
May 13th, 2010 by DrSteveNovella in Better Health Network, Health Policy, Opinion, Research
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On SBM we have documented the many and various ways that science is abused in the pursuit of health (or making money from those who are pursuing health). One such method is to take a new, but reasonable, scientific hypothesis and run with it, long past the current state of the evidence. We see this with the many bogus stem cell therapy clinics that are popping up in parts of the world with lax regulation.
This type of medical pseudoscience is particularly challenging to deal with, because there is a scientific paper trail that seems to support many of the claims of proponents. The claims themselves may have significant plausibility, and parts of the claims may in fact be true. Efforts to educate the public about such treatments are frustrated by the mainstream media’s lazy tendency to discuss every study as if it were the definitive last word on a topic, and to site individual experts as if they represent the consensus of scientific opinion.
Recent claims made for low-dose naltrexone (LDN) fit nicely into this model –- a medical intervention with interesting research, but in a preliminary phase that does not justify clinical use. And yet proponents talk about it as if it’s a medical revolution. Read more »
*This blog post was originally published at Science-Based Medicine*
April 17th, 2010 by DrDavidGorski in Announcements, Better Health Network, Health Policy, Medblogger Shout Outs, Opinion, Quackery Exposed, Research
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One advantage of having a blog is that I can sometimes tap into the knowledge of my readers to help me out.
As many readers know, a few of the SBM bloggers (myself included) will be appearing at the Northeast Conference on Science and Skepticism (NECSS) today (Saturday, April 17). Since the topic of our panel discussion is going to be the infiltration of quackademic medicine into medical academia, I thought that now would be a very good time for me to update my list of medical schools and academic medical centers in the U.S. and Canada that have embraced (or at least decided to tolerate) quackademic medicine in their midst. Read more »
*This blog post was originally published at Science-Based Medicine*
