October 14th, 2010 by Steve Novella, M.D. in Better Health Network, Health Policy, Opinion, Quackery Exposed, Research
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Any promoter of science-based medicine often faces the question: “What’s the harm?” What is the harm if people try treatment modalities that are not based upon good science, that are anecdotal, or provide only a placebo benefit? There are generally two premises to this question. The first is that most “alternative” placebo interventions are directly harmless. The second is that direct harm is the only type worth considering. Both of these premises are wrong.
The pages of Science Based Medicine (SBM) are filled with accounts of direct harm from unscientific treatments: Argyria from colloidal silver, death from chelation therapy, infection or other complications from acupuncture, burns from ear candleing, stroke from chiropractic neck manipulation — the list goes on. You can read anecdotal accounts of such harm on the website, whatstheharm.net.
Of course, as we often point out, harm and risk is only one end of the equation — one must also consider benefit. It is the risk-benefit ratio of an intervention that is important. But generally we are talking about interventions that lack any evidence for benefit, and therefore any risk of harm is arguably unacceptable. 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*
May 13th, 2010 by Steve Novella, M.D. 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*
May 6th, 2010 by David H. Gorski, M.D., Ph.D. in Better Health Network, Health Policy, Opinion, Quackery Exposed, Research, True Stories
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[Recently] I participated in a panel discussion at the Northeast Conference of Science and Skepticism (NECSS) with John Snyder, Kimball Atwood, and Steve Novella, who also reported on the conference. What I mentioned to some of the attendees is that I had managed to combine NECSS with a yearly ritual that I seldom miss, namely the yearly meeting of the American Association for Cancer Research (AACR) meeting.
There are two huge cancer meetings every year — AACR and the annual meeting of the American Society for Clinical Oncology (ASCO). AACR is the meeting dedicated to basic and translational research. ASCO, as the word “clinical” in its name implies, is devoted mainly to clinical research.
Personally, being a translational researcher myself and a surgeon, I tend to prefer the AACR meeting over ASCO, not because ASCO isn’t valuable, but mainly because ASCO tends to be devoted mostly to medical oncology and chemotherapy, which are not what I do as a surgeon. Each meeting draws between 10,000 to 15,000 or even more clinicians and researchers dedicated to the eradication of cancer. Read more »
*This blog post was originally published at Science-Based Medicine*
