March 9th, 2011 by RamonaBatesMD in Opinion, Research
Tags: Breast Cancer Surgery, Breast Reconstruction, Dr. Ramona Bates, Healthcare Decision Making, Informed Medical Decision Making, Journal of Plastic and Reconstructive Surgery, Patient Education, Patient Knowledge, Personal Health Decisions, Plastic Surgery, Post-Mastectomy, Shared Medical Decision Making
No Comments »
An outcomes article in the January 2011 issue of the Journal of Plastic and Reconstructive Surgery asks the question: “Are patients making high-quality decisions about breast reconstruction after mastectomy?”
The objective of the study was to “measure women’s knowledge about reconstruction and to evaluate the degree to which treatments reflected patients’ goals and preferences.” Their conclusion (bold emphasis is mine):
Women treated with mastectomy in this study were not well-informed about breast reconstruction. Treatments were associated with patients’ goals and concerns, however, and patients were highly involved in their decisions. Knowledge deficits suggest that breast cancer patients would benefit from interventions to support their decision making.
Granted the study was small, but it left me wondering if we the medical community fails to educate these women.
The study involved a cross-sectional survey of early-stage breast cancer survivors from four university medical centers. The survey included measures of knowledge about specific reconstruction facts, personal goals and concerns, and involvement in decision making. Only 84 patients participated (59 percent response rate). Participants answered only 37.9 percent of knowledge questions correctly. Read more »
*This blog post was originally published at Suture for a Living*
March 8th, 2011 by ErikDavis in Opinion, Quackery Exposed
Tags: Atrium Innovations, Big Herba, Big Pharma, Boiron, CAM, Complimentary and Alternative Medicine, Delton Group, Federal Regulation, Health Canada, Heel, Herbal Medicine, Herbal Remedies, Herbal Supplements, Homeopathy, Hyland's, Irresponsible Medical Marketing, Natural Health Products, Nature's Sunshine, Non-Evidence-Based Medicine, Nutrition Business Journal, Pierre Fitzgibbon, Pseudomedicine, Research Deficit, Research Funding, Schwabe, Science-Based Doctors, Skeptic North, Standard Homeopathic, Stefan Quandt, Waleda
1 Comment »
This is a guest post from Erik Davis of Skeptic North.
**********
Bankers, Buyouts & Billionaires: Why Big Herba’s Research Deficit Isn’t About The Money
It’s a scene from the blogosphere that’s become all too familiar. A skeptic challenges a natural health product for the lack of an evidentiary base. A proponent of that product responds that the skeptic has made a logical error — an absence of evidence is not evidence of absence, and in such a scenario it’s not unreasonable to rely on patient reporting and traditional uses as a guide. The skeptic chimes back with a dissertation on the limits of anecdotal evidence and arguments from antiquity — especially when the corresponding pharma products have a data trail supporting their safety and efficacy. The proponent responds that it’s unfair to hold natural health products to the same evidentiary standard, because only pharma has the money to fund proper research, and they only do so for products they can patent. You can’t patent nature, so no research into natural health products gets done.
Okay, so maybe this isn’t a scene from an actual blog. The participants are way too civil, the arguments too coherent, and no one has been compared to Hitler. But it’s not a straw man either (look here, here, and here for recent examples), merely a distillation of an argument I’ve seen made repeatedly — that the deck has been stacked by Big Pharma, which has set a research bar that the much poorer natural health industry can’t possibly meet given the costs and lack of financial upside.
In my observation, skeptics don’t often have a good response to this argument beyond their basic scientific disposition toward only making assertions based on positive evidence. Typically, that’s not a disposition shared by the proponent, and thus they simply agree to disagree (read: trade barbs until the thread peters out from fatigue). Yet this need not be a purely philosophical debate. After all, there’s a testable premise embedded in this disagreement — that the natural health industry isn’t rich enough to sustain proper research. Is that true? Read more »
March 8th, 2011 by GarySchwitzer in News, Opinion, Research
Tags: American Academy of Neurology, Association Vs. Causation, Cause-And-Effect, Disease Risk, Dr. James Bower, Epidemiology, Evidence-Based Health Reporting, Gary Schwitzer, Health News Coverage, Health Reporting, HealthNewsReview.org, Ibuprofen-Parkinson's Study, Inaccurate Health Reporting, Journalism Credibility, Mayo Clinic, Medical Journalism, Misinterpreted Observational Studies, News Organizations, News-Wire Health Reporting, Parkinson's Disease, Reporting Health News, Responsible Health Reporting, Reuters, Science and Medicine Reporting, Science Journalism, Sound Health Journalism, USA Today, WebMD
No Comments »
We’re delighted to see that USA Today, Reuters, and WebMD were among the news organizations that included what an editorial writer said about an observational study linking ibuprofen use with fewer cases of Parkinson’s disease. All three news organizations used some version of what editorial writer Dr. James Bower of the Mayo Clinic wrote or said:
“Whenever in epidemiology you find an association, that does not mean causation.”
“An association does not prove causation.”
“There could be other explanations for the ibuprofen-Parkinson’s connection.”
Kudos to those news organizations. And some praise goes to the journal Neurology for publishing Dr. Bower’s editorial to accompany the study. His piece is entitled, “Is the answer for Parkinson disease already in the medicine cabinet? Unfortunately not.”
And unfortunately not all news organizations got that message. Because many don’t read the journals, so they certainly never get to the editorials. Instead, they rewrite quick hits off a wire service story. As a result, we end up with some of the following:
A FoxNews.com story was particularly deaf to Bower’s caveat, stating: “That bottle of ibuprofen in your medicine cabinet is more powerful than you may think.”
A CBSNews.com story never addressed the observational study limitation, instead whimsically writing: “Pop a pill to prevent Parkinson’s disease? A new study says it’s possible, and the pill in question isn’t some experimental marvel that’s still years away from drugstore shelves. It’s plain old ibuprofen.” Read more »
*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*
March 7th, 2011 by DrRich in Health Policy, Opinion
Tags: ACP, AMA, American College Of Physicians, American Medical Association, CEJA, Council on Ethical and Judicial Affairs, Dr. Rich Fogoros, DrRich, Fake Sick Excuses, Health Affairs, Healthcare Politics, JAMA, Journal of the American Medical Association, Lying Doctors, Mainstream Media and Medicine, Media Coverage of Healthcare, Media Misinterpretation, Medical Ethics, Medical Professionalism, Medicine and Lying, Professional Ethics, Truth In The Medical Profession, University of Wisconsin-Madison, Wisconsin Doctors
1 Comment »
In his last post, DrRich analyzed whether the young Wisconsin doctors who stood out on street corners proudly offering fake “sick excuses” to protesting teachers were engaging in an act of civil disobedience. DrRich respectfully kept an open mind on this question, but after careful deliberation concluded that it is very unlikely that their actions constituted classic civil disobedience as espoused by Thoreau or Gandhi.
Instead, these doctors were, in a professional capacity, lying. They did not lie in any truly malicious way, however. They lied because they have been trained to believe in a higher cause than mere professional ethics, namely, the cause of social justice. They lied in full confidence that telling lies to advance such a noble cause is a natural duty of the medical profession. They never expected to be criticized for it (except perhaps by Rush Limbaugh and sundry teabaggers and the like), and they almost certainly will be stunned into indignant incoherence if they end up actually receiving the full punishments their actions allow.
But what really interests DrRich is the near-perfect silence we have seen from the mainstream news media regarding this sad episode. While it’s easy to find stories about the phony sick excuses all over Fox News and conservative websites, major outlets like the New York Times, Washington Post, CNN, CBS and NBC — sources one might expect to express at least some sympathy for these doctors and their work to advance a just cause – have reported next to nothing about it. When a left-leaning mainstream outlet does report on the episode (for instance, this article appearing in the Atlantic), rather than expressing any support for the Wisconsin doctors, they express at least mild dismay. It seems plain to DrRich that the mainstream media wish the whole thing hadn’t happened, and that perhaps their silence might help it go away as soon as possible.
So here we’ve got a small cadre of youthful and idealistic physicians, behaving in a manner entirely consistent with what they’ve just learned during their medical training, and not only are they facing formal investigations and potential punishment, but also the very people and organizations whom they were surely counting on for support have retreated into an embarrassed silence, or worse, criticism. What gives? Read more »
*This blog post was originally published at The Covert Rationing Blog*
March 7th, 2011 by Elaine Schattner, M.D. in Health Policy, Opinion
Tags: Dr. Elaine Schattner, Healthcare Policy, Healthcare Rationing, Healthcare reform, Lack of Organ Donors, Limited Healthcare Resources, Medical Ethics, Medical Lessons, Monetary Value of Life, New York Times, Organ Donation, Organ Transplantation, United Network for Organ Sharing, Washington Post
No Comments »
[Recently] a short article in the New York Times, New Kidney Transplant Policy Would Favor Younger Patients, [drew] my attention to a very basic problem in medical ethics: Rationing.
According to the Washington Post coverage, the proposal comes from the United Network for Organ Sharing, a Richmond-based private non-profit group the federal government contracts for allocation of donated organs. From the Times piece:
Under the proposal, patients and kidneys would each be graded, and the healthiest and youngest 20 percent of patients and kidneys would be segregated into a separate pool so that the best kidneys would be given to patients with the longest life expectancies.
This all follows [the recent] front-page business story on the monetary value of life.
I have to admit, I’m glad to see these stories in the media. Any reasoned discussion of policy and reform requires frank talk on healthcare resources which, even in the best of economic times, are limited.
*This blog post was originally published at Medical Lessons*
