August 5th, 2010 by David H. Gorski, M.D., Ph.D. 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 Kimball Atwood IV, M.D. 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 Steve Novella, M.D. 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 David H. Gorski, M.D., Ph.D. 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 Harriet Hall, M.D. 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*
