Evidence based medicine
The 124th Meeting Of The Skeptics’ Circle
Nov/21/09 08:19 Filed in: Pseudoscience | Science | Evidence based medicine | Quackery | Alternative medicine
One of my favorite bloggers on debunking medical quackery and pseudoscience is hosting a little party. Visit, and read some of the best articles on debunking myths, pseudoscience, quacks and anti-science. Read More...
How pseudoscience makes its case, Part 3
Nov/19/09 09:12 Filed in: Pseudoscience | Science | Vaccines | Alternative medicine | Evidence based medicine
This is part of my ongoing discussion on how quacks use pseudoscience to push their myths and potions on the world. Part 1 discussed the scientific method, which allows us to objectively analyze the natural world. Part 2 discussed the best way for us to examine the difference between science and pseudoscience.
I just read an outstanding analysis, by Steven Novella, MD, a clinical neurologist at Yale University, of how pseudoscience (those who pretend to praise the scientific method, yet do it in a way that is not actually science) and anti-science (those who repudiate science outright, or even undermine science, with subjective analysis and untestable spirituality) to reject evidence-based medicine.
Dr. Novella clearly states how science in medicine works:
I just read an outstanding analysis, by Steven Novella, MD, a clinical neurologist at Yale University, of how pseudoscience (those who pretend to praise the scientific method, yet do it in a way that is not actually science) and anti-science (those who repudiate science outright, or even undermine science, with subjective analysis and untestable spirituality) to reject evidence-based medicine.
Dr. Novella clearly states how science in medicine works:
This leads us to the final continuum – the consensus of expert opinion based upon systematic reviews can either result in a solid and confident unanimous opinion, a reliable opinion with serious minority objections, a genuine controversy with no objective resolution, or simply the conclusion that we currently lack sufficient evidence and do not know the answer. It can also lead, of course, to a solid consensus of expert opinion combined with a fake controversy manufactured by a group driven by ideology or greed and not science. The tobacco industry’s campaign of doubt against the conclusion that smoking is a risk factor for lung cancer is one example.The anti-vaccine movement’s fear-mongering about vaccines and autism is another. Read More...
How pseudoscience makes its case, Part 2
Nov/04/09 16:30 Filed in: Pseudoscience | Science | Vaccines | Alternative medicine | Evidence based medicine
A few days ago, I discussed how science works. It's not a belief. It's not a random set of rules. It is a rational and logical process to determine cause and effect in the natural world. Pseudoscience, by its very nature, ignores the scientific process; instead, it pretends to come to conclusions through science, although it does not.
Again, be very wary if you hear someone say, "it's proven." I've heard those words from both alternative medicine pushers and from well-trained physicians. I have previously discussed the ineffectiveness of almost every alternative medicine therapy. But what about your physician? They are, by far, devoted to your health and well-being. But they cannot know everything about medicine (thus, why we have specialists), so they may repeat information that is not valid. Read More...
Again, be very wary if you hear someone say, "it's proven." I've heard those words from both alternative medicine pushers and from well-trained physicians. I have previously discussed the ineffectiveness of almost every alternative medicine therapy. But what about your physician? They are, by far, devoted to your health and well-being. But they cannot know everything about medicine (thus, why we have specialists), so they may repeat information that is not valid. Read More...
How pseudoscience makes its case, Part 1
Nov/02/09 09:38 Filed in: Pseudoscience | Science | Vaccines | Alternative medicine | Evidence based medicine
I always get suspicious when someone makes an argument with the statement of "it's been proven to work", "the link is proven", or, alternatively, they state the negative. Typically, I hear these kinds of statements from the pseudoscience pushing group. Many of us have debunked the "there is a proven link between vaccines and autism." Or that any number of alternative medicine (CAM) therapies don't actually work. In fact, science rarely uses the term "proven", because the scientific method is not a system to make a definitive answer on any question–scientists always leave open the possibility of an alternative hypothesis that can be tested. If the alternate hypothesis can be supported through experimentation, then it can replace the original one. When an alternative medicine or junk science supporter states "it has been proven" then you can be assured that conclusion is unsupported by scientific research. Read More...
Civilized Medicine, Part III. My Proposal
Originally, I was going to make my proposals for healthcare reform as the last item. But now there is so much debating, amending, backtracking, and all around lying, I can’t figure out what’s being proposed. Well, I do know there are no death panels, even if Sarah Palin makes stuff up. Since I’ve installed myself as health care czar (in my own mind), let me make my proposals. Read More...
Alternative medicine–waste of money
As I’ve discussed before, Complementary and Alternative Medicine (CAM) are so-called treatments that lack any scientific or medical support. The National Center for Complementary and Alternative Medicine (NCCAM), which was funded by the US Congress to be a part of the National Institutes of Health, continues to discover that these treatments do not work. And it wasted $2.5 billion to discover that they don’t work. I would have done it for $1.5 billion. In fact, given that most of the CAM therapies rely upon ideas that have no foundation in physics, chemistry, biology, physiology or any other science, most of the studies shouldn’t have been done at all. Read More...
Swine flu
Apr/29/09 15:34 Filed in: Pharmaceuticals | Pseudoscience | Vaccines | Healthcare Policy | Evidence based medicine
Well, actually I’m not going to say too much about swine flu, except that my initial impression is that it’s not that much different from other types of flu in terms of severity. For example, during the 2007-2008 flu season, there were 83 pediatric mortalities in the US that resulted from influenza infections. In other words, like a lot of diseases that we think are minor, there are serious health consequences that often fly “under the radar.” There is a certain fascination with this disease because of where it started (Mexico), conspiracy theories, and for other reasons that are beyond my ability to understand. I am personally not concerned, because, as I mentioned above, the morbidity of the infection probably is similar to other types of influenza.
There are a number of bloggers who are passing along sage and sane advice. Basically, don’t panic. Wash your hands. And that’s about it for really good medical information.
Of course, the woo-meisters have weighed in with their useless advice. I won’t even begin to explain the logical and scientific fallacies of colon cleansing, but it isn’t going to either prevent or lessen the severity of swine flu. Read More...
There are a number of bloggers who are passing along sage and sane advice. Basically, don’t panic. Wash your hands. And that’s about it for really good medical information.
Of course, the woo-meisters have weighed in with their useless advice. I won’t even begin to explain the logical and scientific fallacies of colon cleansing, but it isn’t going to either prevent or lessen the severity of swine flu. Read More...
Denialism and pseudoscience
Apr/21/09 14:18 Filed in: Pseudoscience | Healthcare Policy
Today, I commented to a blog entry at Beyond the Short Coat, which is one of my daily stops on the medical blogosphere. The author, like a lot of bloggers in the medical arena, has been taking on the world of medical woo, that is, those ideas in medicine that completely lack verifiability and scientific credibility. I have a similar disdain for woo, for essentially the same reasons as the physicians who write in those various blogs. Mostly, they are troubled that patients turn to these useless therapies because they may not be getting adequate medical care, or even that those fake therapies may have terrible consequences for the patient. I take it a step further in that I believe that this woo has a substantial economic consequence with increased costs for patients, providers, and third-party payors. Read More...
The cost of medical woo
Apr/15/09 22:45 Filed in: Pseudoscience | Pharmaceuticals | Quackery | Vaccines | Evidence based medicine
My blog entries wander between three broad topics: medical woo (pseudoscience, science denialism, vaccine denialism, and alternative medicine), market opportunities for medical products and healthcare policy. And one discussion about my beloved Syracuse Orange. My three broad interests in the medical arena are interrelated in such a fashion that medical companies (both pharmaceutical and medical devices) need to prepare strategic plans that maximize their success despite some difficult market forces.
First, let’s talk about the whole area of medical woo. The anti-vaccine movement (which I will continue to label as vaccine denialism), if it continues to gain traction in social consciousness, will require more investment in studies that continue to confirm that there is no link between vaccines and autism (OK, yes the proper scientific method would force me to say that there is a possibility that a link could be found, but after 100’s of clinical papers, I’m firmly on the side that this issue has been decided). If this movement becomes problematic, we might be dealing with infectious disease epidemics unseen in a generation. Can hospitals and clinics deal with these diseases? How large are the infectious disease wards in hospitals? How many infectious disease specialists are there? And what kinds of medical products will need to be available to treat these diseases? Read More...
First, let’s talk about the whole area of medical woo. The anti-vaccine movement (which I will continue to label as vaccine denialism), if it continues to gain traction in social consciousness, will require more investment in studies that continue to confirm that there is no link between vaccines and autism (OK, yes the proper scientific method would force me to say that there is a possibility that a link could be found, but after 100’s of clinical papers, I’m firmly on the side that this issue has been decided). If this movement becomes problematic, we might be dealing with infectious disease epidemics unseen in a generation. Can hospitals and clinics deal with these diseases? How large are the infectious disease wards in hospitals? How many infectious disease specialists are there? And what kinds of medical products will need to be available to treat these diseases? Read More...
Scientific medicine and Big Pharma
Apr/08/09 08:42 Filed in: Medical devices | Pharmaceuticals | Pseudoscience | Healthcare Policy | Evidence based medicine | Medical products
I keep reading across the blogosphere that Big Pharma (for the sake of this discussion, defined as all medical products companies, including ones that don’t manufacture or market pharmaceuticals) somehow blocks either positive or negative results to further their profits. The accusations come from a wide variety of sources, some of the more vocal being the anti-science proponents, such as the anti-vaccination movement. Utilizing an ad hominem argument of personalizing the issues and then attacking the motives or character of others, usually those who dispute the claims made by pseudoscience. Read More...
The anti-vaccination tragedy
Mar/31/09 10:07 Filed in: Vaccines | Healthcare Policy | Pseudoscience | Pharmaceuticals | Evidence based medicine
I have written about the anti-vaccination movement several times recently, yet every day, I read another article or another comment somewhere that reminds me of this situation. Today, I came across a recently published article in The Lancet, one of the most respected peer-reviewed medical journals, which reinforced one of the consequences of the anti-vaccination movement. The article, Measles in Europe: an epidemiological assessment, states that there were 12,232 cases of measles in Europe during 2006 and 2007. Most cases were unvaccinated or improperly vaccinated children. Read More...
If it looks like a duck...then it must be Quack medicine
One of the largest wastelands of medical science is something that has evolved into being called Complementary and Alternative Medicine (CAM). What is CAM? There’s no clear definition, but the epicenter for this pseudo-medicine is the National Center for Complementary and Alternative Medicine (NCCAM) which was funded by the US Congress to be a part of the National Institutes of Health. They define CAM as CAM is a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine. The most common CAM therapies are homeopathy, chiropractic, acupuncture, naturopathy and herbalism. Typical of most pseudosciences, it does not rely upon the scientific method to generate results, it usually appeals to emotion, such as the great Big Pharma conspiracy against these potentially life-saving therapies.
I think that individuals should choose the therapy that they want, especially if it does no harm. If I had a chronic and terminal disease, I might choose an alternative therapy. If someone chooses to consume vast amounts of vitamin C to prevent cancer, despite little or no evidence that it works, that is their choice. What is troubling is when CAM is offered as an appropriate replacement to evidence based medicine, that is, “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients.” Best evidence relies upon scientific and clinical research, publication in peer-reviewed (and respected) journals, and sometimes, the opinions of respected authorities in the field.
The National Institutes of Health is a US government agency responsible for biomedical and health related research. One of the “centers” of NIH is NCCAM, which was established in 1991 by order of Congress. In fact, Senator Tom Harkin (D, Iowa) pushed for the formation of the center because he had been cured of allergies by taking bee pollen supplements, despite the fact that there is no scientific evidence that bee pollen would do so. In fact, there’s more evidence that bee pollen will cause an adverse allergic reaction. Read More...
I think that individuals should choose the therapy that they want, especially if it does no harm. If I had a chronic and terminal disease, I might choose an alternative therapy. If someone chooses to consume vast amounts of vitamin C to prevent cancer, despite little or no evidence that it works, that is their choice. What is troubling is when CAM is offered as an appropriate replacement to evidence based medicine, that is, “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients.” Best evidence relies upon scientific and clinical research, publication in peer-reviewed (and respected) journals, and sometimes, the opinions of respected authorities in the field.
The National Institutes of Health is a US government agency responsible for biomedical and health related research. One of the “centers” of NIH is NCCAM, which was established in 1991 by order of Congress. In fact, Senator Tom Harkin (D, Iowa) pushed for the formation of the center because he had been cured of allergies by taking bee pollen supplements, despite the fact that there is no scientific evidence that bee pollen would do so. In fact, there’s more evidence that bee pollen will cause an adverse allergic reaction. Read More...