Science-Based Medicine

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Exploring issues and controversies in the relationship between science and medicine

Peter Lipson
13 posts

5 posts

Scott Gavura
12 posts

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  • August 25, 2011
  • 04:00 PM

When a “scientific study” is neither

by Peter Lipson in Science-Based Medicine

There is quite a bit of art to the practice of medicine: knowing how to get and to give information to a patient, how to create a sense of worry without creating a feeling of panic, how to use the best available science to help them maintain or return to health.  Underlying all of the [...]... Read more »

  • February 17, 2011
  • 09:00 AM

Are you sure you’re allergic to penicillin?

by Scott Gavura in Science-Based Medicine

As a pharmacist, when I dispense medication, it’s my responsibility to ensure that the medication is safe and appropriate for the patient. There are numerous checks we go through including verifying the dose, ensuring there are no interactions with other drugs, and verifying the patient has no history of allergy to the product prescribed. Asking [...]... Read more »

Caubet JC, Kaiser L, Lemaître B, Fellay B, Gervaix A, & Eigenmann PA. (2011) The role of penicillin in benign skin rashes in childhood: a prospective study based on drug rechallenge. The Journal of allergy and clinical immunology, 127(1), 218-22. PMID: 21035175  

  • December 23, 2010
  • 07:00 AM

Vaccines are a pain: What to do about it

by Scott Gavura in Science-Based Medicine

As much as I support vaccines, I see the short term consequences. Vaccines can be painful. Kids don’t like them, and parents don’t like seeing their children suffer. That this transient pain is the most common consequence of gaining  protection from fatal illnesses seems like a fair trade-off to me. But that’s not the case [...]... Read more »

Taddio A, Appleton M, Bortolussi R, Chambers C, Dubey V, Halperin S, Hanrahan A, Ipp M, Lockett D, Macdonald N.... (2010) Reducing the pain of childhood vaccination: an evidence-based clinical practice guideline (summary). CMAJ : Canadian Medical Association journal , 182(18), 1989-95. PMID: 21098067  

  • March 3, 2011
  • 08:30 AM

Topical NSAIDs

by Scott Gavura in Science-Based Medicine

I have a mental basket of drugs that I suspect may be placebos. In that basket were the topical versions of non-steroidal anti-inflammatory drugs (NSAIDs). When the first products were commercially marketed over a decade ago, I found the clinical evidence unconvincing, and I suspected that the modestly positive effects were probably due to simply [...]... Read more »

Massey T, Derry S, Moore RA, & McQuay HJ. (2010) Topical NSAIDs for acute pain in adults. Cochrane database of systematic reviews (Online). PMID: 20556778  

Trelle, S., Reichenbach, S., Wandel, S., Hildebrand, P., Tschannen, B., Villiger, P., Egger, M., & Juni, P. (2011) Cardiovascular safety of non-steroidal anti-inflammatory drugs: network meta-analysis. BMJ, 342(jan11 1). DOI: 10.1136/bmj.c7086  

Haroutiunian, S., Drennan, D., & Lipman, A. (2010) Topical NSAID Therapy for Musculoskeletal Pain. Pain Medicine, 11(4), 535-549. DOI: 10.1111/j.1526-4637.2010.00809.x  

  • September 23, 2008
  • 09:00 AM

FDA approval of drugs and transparency in clinical trial results

by SBMBlogger in Science-Based Medicine

Note: The reason that I am posting today rather than my usual Monday slot is because the article I discuss here was embargoed until last night. Consequently, I asked Harriet if she would trade days with me this week, and she was kind enough to do so.

One thing that science relies on almost absolutely is [...]... Read more »

  • August 18, 2008
  • 10:00 AM

High dose vitamin C and cancer: Has Linus Pauling been vindicated?

by SBMBlogger in Science-Based Medicine


Vitamin C as a treatment for cancer is back in the news again.

I’m not surprised. This is one therapy favored by advocates of “alternative” medicine that keeps popping up periodically (seemingly every couple of years or so). This latest bit of news has turned up almost right on time after the last [...]... Read more »

L Hoffer, M Levine, S Assouline, D Melnychuk, S J Padayatty, K Rosadiuk, C Rousseau, L Robitaille, & W H Miller. (2008) Phase I clinical trial of i.v. ascorbic acid in advanced malignancy. Annals of Oncology. DOI: 10.1093/annonc/mdn377  

  • July 8, 2010
  • 10:15 AM

Sunscreen in a Pill?

by Scott Gavura in Science-Based Medicine

I’ve previously described the consequences of acute and chronic sun exposure, and the rationale for topical sunscreen products. But wouldn’t it be easier to just take a pill that can boost our skin’s resistance to to the harmful effects of the sun? Is it possible to get all the benefits of sunscreen without the bother [...]... Read more »

Middelkamp-Hup MA, Pathak MA, Parrado C, Goukassian D, Rius-Díaz F, Mihm MC, Fitzpatrick TB, & González S. (2004) Oral Polypodium leucotomos extract decreases ultraviolet-induced damage of human skin. Journal of the American Academy of Dermatology, 51(6), 910-8. PMID: 15583582  

Middelkamp-Hup MA, Pathak MA, Parrado C, Garcia-Caballero T, Rius-Díaz F, Fitzpatrick TB, & González S. (2004) Orally administered Polypodium leucotomos extract decreases psoralen-UVA-induced phototoxicity, pigmentation, and damage of human skin. Journal of the American Academy of Dermatology, 50(1), 41-9. PMID: 14699363  

  • October 7, 2010
  • 01:46 PM

Do you have low T?

by Peter Lipson in Science-Based Medicine

If you google “low testosterone” you’ll see lots of ads for testosterone replacement.  Some are from pharmaceutical companies that sell testosterone, others from obvious snake-oil salesmen.
Both types of ads list vague sets of symptoms, encourage you to believe that they are pathologic, and want to sell you something to make you better.  For example, the [...]... Read more »

Bhasin S, Cunningham GR, Hayes FJ, Matsumoto AM, Snyder PJ, Swerdloff RS, Montori VM, & Task Force, Endocrine Society. (2010) Testosterone therapy in men with androgen deficiency syndromes: an Endocrine Society clinical practice guideline. The Journal of clinical endocrinology and metabolism, 95(6), 2536-59. PMID: 20525905  

Araujo, A., Esche, G., Kupelian, V., O'Donnell, A., Travison, T., Williams, R., Clark, R., & McKinlay, J. (2007) Prevalence of Symptomatic Androgen Deficiency in Men. Journal of Clinical Endocrinology , 92(11), 4241-4247. DOI: 10.1210/jc.2007-1245  

  • October 13, 2008
  • 02:01 AM

Fun with homeopaths and meta-analyses of homeopathy trials

by SBMBlogger in Science-Based Medicine

Homeopathy amuses me.

Well, actually it both amuses me and appalls me. The amusement comes from just how utterly ridiculous the concepts between homeopathy are. Think about it. It is nothing but pure magical thinking. Indeed, at the very core of homeopathy is a concept that can only be considered to be magic. In homeopathy, the [...]... Read more »

  • January 6, 2011
  • 07:00 AM

Energy Drinks

by Scott Gavura in Science-Based Medicine

My stimulant of choice is coffee. I started drinking it in first-year university, and never looked back. A tiny four-cup coffee maker became my reliable companion right through graduate school. But since I stopped needing to drink a pot at a time, an entirely new category of products has appeared — the energy drink. Targeting [...]... Read more »

  • July 23, 2011
  • 01:01 AM

Asthma, placebo, and how not to kill your patients

by Peter Lipson in Science-Based Medicine

A number of years ago I was walking along Lake Michigan with a friend (a fellow medical resident) when she turned to me and said, “are you wheezing?  Do you have asthma?”  I had always been physically active and assumed my breathlessness while walking down the trail was due to the thirty extra pounds of [...]... Read more »

Wechsler ME, Kelley JM, Boyd IO, Dutile S, Marigowda G, Kirsch I, Israel E, & Kaptchuk TJ. (2011) Active albuterol or placebo, sham acupuncture, or no intervention in asthma. The New England journal of medicine, 365(2), 119-26. PMID: 21751905  

  • March 23, 2009
  • 05:00 AM

Alternative medicine use and breast cancer

by David Gorski in Science-Based Medicine

Of all the posts I and my cobloggers have written for SBM over the last 15 months, most provoke relatively few comments. However, a few stand out for having provoked hundreds of comments. The very first post that provoked hundreds of comments was Harriet’s excellent discussion of the International Network of Cholesterol Skeptics. In fact, [...]... Read more »

H. J. G. Bloom,, W. W. Richardson, & E. J. Harries. (1962) Natural History of Untreated Breast Cancer (1805-1933). British Medical Journal, 213-221. DOI: PMC1925646  

T Risberg, A Vickers, R.M Bremnes, E.A Wist, S Kaasa, & B.R Cassileth. (2003) Does use of alternative medicine predict survival from cancer?. European Journal of Cancer, 39(3), 372-377. DOI:  

Verkooijen, H., Fioretta, G., Rapiti, E., Bonnefoi, H., Vlastos, G., Kurtz, J., Schaefer, P., Sappino, A., Schubert, H., & Bouchardy, C. (2005) Patients' Refusal of Surgery Strongly Impairs Breast Cancer Survival. Annals of Surgery, 242(2), 276-280. DOI: 10.1097/01.sla.0000171305.31703.84  

  • December 9, 2010
  • 08:00 AM

Good Idea, Bad Execution: Dosing Errors, A Preventable Harm

by Scott Gavura in Science-Based Medicine

We spend a lot time at SBM discussing different elements of the art and science of medicine, and how we believe that practice can be improve. Yet our science-based intentions can be thwarted at the last possible moment – in the form of dosing errors. The workup may have been comprehensive, the diagnosis could be [...]... Read more »

Yin HS, Mendelsohn AL, Wolf MS, Parker RM, Fierman A, van Schaick L, Bazan IS, Kline MD, & Dreyer BP. (2010) Parents' medication administration errors: role of dosing instruments and health literacy. Archives of pediatrics , 164(2), 181-6. PMID: 20124148  

  • March 27, 2009
  • 04:03 PM

The kindest cut?

by Peter Lipson in Science-Based Medicine

The best way to prevent sexually transmitted infections is the proper use of condoms. That being said, it’s not the only way to prevent STI’s. Abstinence is one way, but it involves an amputation of sorts—the removal of a critical human behavior. Another amputation (of sorts) that prevents STIs is circumcision. [...]... Read more »

Aaron A.R. Tobian, M.D., Ph.D., David Serwadda, M.Med., M.P.H., Thomas C. Quinn, M.D., M.Sc., Godfrey Kigozi, M.B., Ch.B., M.P.H., Patti E. Gravitt, Ph.D., Oliver Laeyendecker, M.S., M.B.A., Blake Charvat, M.Sc., Victor Ssempijja, B.Stat., Melissa Riedese. (2009) Male Circumcision for the Prevention of HSV-2 and HPV Infections and Syphilis. The New England Journal of Medicine, 360(13), 1298-1309. DOI:  

  • August 25, 2008
  • 10:00 AM

Threats to science-based medicine: When clinical trials for new drugs are designed by the marketing division

by SBMBlogger in Science-Based Medicine

When the marketing division designs clinical trials, scientific medicine loses.... Read more »

Kevin Hill, Joseph S. Ross, David S. Egilman, & Harlan M. Krumholz. (2008) The ADVANTAGE Seeding Trial: A Review of Internal Documents. Annals of Internal Medicine, 149(4), 251-258.

Harold Sox, & Drummond Rennie. (2008) Seeding Trials: Just Say \"No\". Annals of Internal Medicine, 149(4), 279-280.

  • October 14, 2008
  • 05:00 AM

Massage for AIDS

by SBMBlogger in Science-Based Medicine

I recently learned of a study entitled “Dominican Children with HIV not Receiving Antiretrovirals: Massage Therapy Influences their Behavior and Development.” It disturbed me, and I couldn’t get it out of my head. They’re massaging these kids but letting them die of AIDS? I went back and read the complete article, and it left me [...]... Read more »

M. Hernandez-Reif, G. Shor-Posner, J. Baez, S. Soto, R. Mendoza, R. Castillo, N. Quintero, E. Perez, & G. Zhang. (2006) Dominican Children with HIV not Receiving Antiretrovirals: Massage Therapy Influences their Behavior and Development. Evidence-based Complementary and Alternative Medicine, 5(3), 345-354. DOI: 10.1093/ecam/nem032  

  • August 12, 2010
  • 04:00 AM

Homeoprophylaxis: An idea whose time has come—and gone

by Peter Lipson in Science-Based Medicine

One of the strengths of modern medical education is its emphasis on basic science.  Conversely, the basic weakness of so-called alternative medicine is its profound ignorance of science and its reliance on magical thinking.  Nowhere is this more apparent than in the attempts of altmed cults to conduct and publish research.  From “quantum water memory” [...]... Read more »

Bracho, G., Varela, E., Fernández, R., Ordaz, B., Marzoa, N., Menéndez, J., García, L., Gilling, E., Leyva, R., & Rufín, R. (2010) Large-scale application of highly-diluted bacteria for Leptospirosis epidemic control. Homeopathy, 99(3), 156-166. DOI: 10.1016/j.homp.2010.05.009  

  • August 17, 2009
  • 04:00 AM

Needles in the skin cause changes in the brain, but acupuncture still doesn’t work

by David Gorski in Science-Based Medicine

I don’t recall if I’ve mentioned it on SBM before, but I went to the University of Michigan. In fact, I didn’t go there just for undergraduate studies or medical school, but rather for both, graduating with a B.S. in Chemistry with Honors in 1984 and from medical school in 1988. In my eight years [...]... Read more »

  • May 13, 2011
  • 11:02 AM

Fungus yields new prescription drug for multiple sclerosis

by David J Kroll in Science-Based Medicine

The following post appeared earlier this week at my Chemical & Engineering News CENtral Science blog, Terra Sigillata. For some odd reason – perhaps this week’s frantic academic schedule of commencement activities – it was not highly read there. I thought that our Science-Based Medicine readers would appreciate it because this new prescription drug is [...]... Read more »

  • April 28, 2011
  • 09:00 AM

Do calcium supplements cause heart attacks?

by Scott Gavura in Science-Based Medicine

Calcium is good for us, right? Milk products are great sources of calcium, and we’re told to emphasize milk products in our diets. Don’t (or can’t) eat enough dairy? Calcium supplements are very popular, especially among women seeking to minimize their risk of osteoporosis. Osteoporosis prevention and treatment guidelines recommend calcium and vitamin D as [...]... Read more »

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