July 2nd, 2011 by DavedeBronkart in Opinion
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e-Patients who want to collaborate with their physicians, and be responsible for their medical decisions, need to clearly understand what constitutes good evidence. It’s not always easy.
Now Richard Smith, a 25 year editor of the British Medical Journal, has written another piece for the BMJ blog, citing a JAMA study showing “that of the 49 most highly cited papers on medical interventions published in high profile journals between 1990 and 2004 a quarter of the randomised trials and five of six non-randomised studies had been contradicted or found to be exaggerated by 2005.”
What’s an e-patient to do?? Especially when we “patients who google” are so often sneered at by physicians who rely on these same journals.
Well, we need to educate ourselves, and learn to speak calmly, confidently and understandingly to anyone who doesn’t understand – just as we expect clinicians to do with us.:–) In short, we need to Read more »
*This blog post was originally published at e-Patients.net*
June 10th, 2011 by PJSkerrett in Health Tips, News
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If the recent announcement by the International Agency for Research on Cancer (IARC) that cell phones may cause brain cancer has you worried, you might want to wait a bit before trashing your mobile phone and going back to a land line.
Last week, the IARC convened experts from around the world to assess what, if any, cancer threat cell phones pose to the 5 billion or so people who use them. After reviewing hundreds of studies, the IARC panel concluded that cell phone use may be connected to two types of brain cancer, glioma and acoustic neuroma.
That sounds mighty scary. But the IARC said the evidence for this conclusion was “limited.” Most studies have shown no connection between cell phone use and brain cancer. In the relatively small number of studies that have observed a connection between the two, the positive result could be due to chance, bias, or confounding.
The decision puts cell phones in IARC’s Group 2B category of agents that definitely or might cause cancer. Group 1 are things like asbestos, cigarette smoke, and ultraviolet radiation. Things in Group 2B are “possibly carcinogenic to humans.” Other denizens of this group include coffee, pickled vegetables, bracken ferns, and talcum powder.
I think the IARC decision puts cell phones on notice—a formal “we’ve got our eyes on you” warning—more than it fingers phones as a cause of brain cancer. For one thing, the evidence so far is pretty weak. Writing on the Cancer Research UK Web site, blogger Ed Yong offers a peak at the data through 2009, taken from a review by Swedish researchers. A graph from the paper shows that only one of 28 studies shows a statistically significant association between cell phone use and cancer. We’ll know more about the strength or weakness of the evidence when the panel publishes its report online later this week and in the July 1 issue of The Lancet Oncology.
For now, I’m far more concerned about being rammed by someone talking on his or her cell phone while driving than I am about getting brain cancer from a phone. If you think the IARC report warrants action, the FDA offers suggestions for reducing your exposure to radiofrequency energy from a cell phone, like using the phone less, texting instead of talking, and using speaker mode or a headset to place more distance between your head and the cell phone.
*This blog post was originally published at Harvard Health Blog*
May 31st, 2011 by ErikDavis in Health Tips, Research
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Here at Skeptic North, we’ve often been a sharp critic of those herbal remedies that are unable to withstand the scrutiny of science. Yet nature does indeed house many pharmacologically active compounds, and it stands to reason that some of them will have medicinal value. So today, we’re going to turn the tables and look at 5 herbal remedies that have held up well in repeated studies and are generally regarded as effective.
1) St. John’s Wort for Depression
If there’s one herbal medicine that consistently gets high marks for effectiveness, it’s St. John’s Wort as a treatment for mild depression. A 2008 Cochrane Review looked at 29 trials totaling over 5000 patients, including 18 comparisons with placebo and 17 comparisons with synthetic standard antidepressants, and found significant effects in both cases. The Natural Medicines Comprehensive Database indicates that St. John’s Wort is likely as effective as both first generation antidepressants (low-dose tricyclics) and the current generation of selective serotonin reuptake inhibitors like Prozac, Zoloft, and Paxil. Read more »
*This blog post was originally published at Skeptic North » Erik Davis*
June 27th, 2010 by GarySchwitzer in Better Health Network, Health Policy, News, Opinion, Research, True Stories
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People aren’t dumb. Even if — or maybe especially if — news stories don’t point out the limitations of observational studies and the fact that they can’t establish cause-and-effect, many readers seem to get it.
Here are some of the online user comments in response to a CNN.com story that is headlined, “Coffee may cut risk for some cancers“:
* “I love how an article starts with something positive and then slowly becomes a little gloomy. So is it good or not? I’m still where I was with coffee, it’s all in moderation, it ain’t gonna solve your health woes.”
* “The statistics book in a class I’m taking uses coffee as an example of statistics run amuck. It seems coffee has caused all the cancers and cures them at the same time.” Read more »
*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*
February 25th, 2010 by Harriet Hall, M.D. in Better Health Network, Opinion, Research
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Everybody knows that colonoscopy is the best test to screen for colorectal cancer and that colonoscopies save lives. Everybody may be wrong. Colonoscopy is increasingly viewed as the gold standard for colorectal cancer screening, but its reputation is not based on solid evidence. In reality, it is not yet known for certain whether colonoscopy can help reduce the number of deaths from colorectal cancer. Screening with fecal occult blood testing (FOBT) and flexible sigmoidoscopy are supported by better evidence, but questions remain. It seems our zeal for screening tests has outstripped the evidence.
Statistics show that the life-time risk for an adult American to develop colorectal cancer (CRC) is approximately 6%. Colorectal cancer is the second leading cause of cancer deaths in the United States. In the US there are currently 146,970 new cases and 50,630 deaths each year. Between 1973 and 1995, mortality from CRC declined by 20.5%, and incidence declined by 7.4% in the United States. Read more »
*This blog post was originally published at Science-Based Medicine*
