29 posts · 17,867 views
Exploring issues and controversies in the relationship between science and medicine
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- August 12, 2010
- 03:00 AM
- 22 views
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
- July 8, 2010
- 09:15 AM
- 117 views
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 »
Villa, A., Viera, M., Amini, S., Huo, R., Perez, O., Ruiz, P., Amador, A., Elgart, G., & Berman, B. (2010) Decrease of ultraviolet A light–induced “common deletion” in healthy volunteers after oral Polypodium leucotomos extract supplement in a randomized clinical trial. Journal of the American Academy of Dermatology, 62(3), 511-513. DOI: 10.1016/j.jaad.2009.05.045
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
González S, Pathak MA, Cuevas J, Villarrubia VG, & Fitzpatrick TB. (1997) Topical or oral administration with an extract of Polypodium leucotomos prevents acute sunburn and psoralen-induced phototoxic reactions as well as depletion of Langerhans cells in human skin. Photodermatology, Photoimmunology , 13(1-2), 50-60. PMID: 9361129
- July 5, 2010
- 09:30 AM
- 119 views
Homeopathy in the ICU?
by David Gorski in Science-Based Medicine
Editor’s note: It’s still a holiday weekend in the United States. I had considered simply taking the day off altogether, particularly since I’m busily working on my talk for TAM8–which (holy crap!) is in a mere three days, but then I figured today’s a good time to resurrect a “classic” (if you will) post that [...]... Read more »
Frass, M. (2005) Influence of Potassium Dichromate on Tracheal Secretions in Critically Ill Patients. Chest, 127(3), 936-941. DOI: 10.1378/chest.127.3.936
- June 14, 2010
- 06:00 AM
- 452 views
The genetics of autism
by David Gorski in Science-Based Medicine
Autism and autism spectrum disorders (ASDs) actually represent a rather large continuum of conditions that range from very severe neurodevelopmental delay and abnormalities to the relatively mild. In severe cases, the child is nonverbal and displays a fairly well-characterized set of behaviors, including repetitive behaviors such as “stimming” (for example, hand flapping, making sounds, head [...]... Read more »
Pinto, D., Pagnamenta, A., Klei, L., Anney, R., Merico, D., Regan, R., Conroy, J., Magalhaes, T., Correia, C., Abrahams, B.... (2010) Functional impact of global rare copy number variation in autism spectrum disorders. Nature. DOI: 10.1038/nature09146
- June 3, 2010
- 03:00 AM
- 155 views
Narcotic treatment contracts and the state of the evidence
by Peter Lipson in Science-Based Medicine
Opium derivatives—and later, synthetic opioids—have probably been used for millennia for the relief of pain. Given human biology, they’ve probably been abused for just as long. Opiate use disorders are a daily fact for primary care physicians; the use of these drugs has become more and more common for chronic non-cancer pain. [...]... Read more »
Starrels JL, Becker WC, Alford DP, Kapoor A, Williams AR, & Turner BJ. (2010) Systematic review: treatment agreements and urine drug testing to reduce opioid misuse in patients with chronic pain. Annals of internal medicine, 152(11), 712-20. PMID: 20513829
- June 2, 2010
- 04:00 PM
- 170 views
Another overhyped acupuncture study misinterpreted
by David Gorski in Science-Based Medicine
Perhaps the most heavily studied of “alternative medicine” modalities is acupuncture. Although it’s hard to be sure as to the reason, I tend to speculate that part of the appeal to trying to do research in this area is because acupuncture is among the most popular of actual “alt-med” modalities, as opposed to science-based medical [...]... Read more »
Goldman, N., Chen, M., Fujita, T., Xu, Q., Peng, W., Liu, W., Jensen, T., Pei, Y., Wang, F., Han, X.... (2010) Adenosine A1 receptors mediate local anti-nociceptive effects of acupuncture. Nature Neuroscience. DOI: 10.1038/nn.2562
- May 6, 2010
- 03:00 AM
- 183 views
How do religious-based hospitals affect physician behavior?
by Peter Lipson in Science-Based Medicine
Science-based medicine is, among other things, a tool. Science helps us sequester our biases so that we may better understand reality. Of course, there is no way to avoid being human; our biases and our intuition still betray us, and when they do, we use other tools. Ethics help us think through situations using an [...]... Read more »
Stulberg, D., Lawrence, R., Shattuck, J., & Curlin, F. (2010) Religious Hospitals and Primary Care Physicians: Conflicts over Policies for Patient Care. Journal of General Internal Medicine. DOI: 10.1007/s11606-010-1329-6
- April 1, 2010
- 03:00 AM
- 242 views
Less salt: it’s that simple
by Peter Lipson in Science-Based Medicine
It has been known for decades that dietary sodium is significantly associated with hypertension and coronary heart disease. Despite this knowledge, Americans continue to consume more sodium, most of it coming from processed foods. Various approaches have been used to help individuals modify their behavior, one of the most popular of which is the DASH [...]... Read more »
Bibbins-Domingo K, Chertow GM, Coxson PG, Moran A, Lightwood JM, Pletcher MJ, & Goldman L. (2010) Projected effect of dietary salt reductions on future cardiovascular disease. The New England journal of medicine, 362(7), 590-9. PMID: 20089957
- February 1, 2010
- 03:01 PM
- 335 views
Success in the fight against childhood diarrhea
by Peter Lipson in Science-Based Medicine
Rotavirus is the world’s most common cause of severe childhood diarrhea. In the U.S. alone, rotavirus disease leads to around 70,000 hospitalizations, 3/4 million ER visits, and nearly half-a-million doctor office visits yearly. But it rarely causes death.
The same is not true for the developing world. Rotavirus disease is estimated to kill around a half-million [...]... Read more »
Madhi, S., Cunliffe, N., Steele, D., Witte, D., Kirsten, M., Louw, C., Ngwira, B., Victor, J., Gillard, P., Cheuvart, B.... (2010) Effect of Human Rotavirus Vaccine on Severe Diarrhea in African Infants. New England Journal of Medicine, 362(4), 289-298. DOI: 10.1056/NEJMoa0904797
Richardson, V., Hernandez-Pichardo, J., Quintanar-Solares, M., Esparza-Aguilar, M., Johnson, B., Gomez-Altamirano, C., Parashar, U., & Patel, M. (2010) Effect of Rotavirus Vaccination on Death from Childhood Diarrhea in Mexico. New England Journal of Medicine, 362(4), 299-305. DOI: 10.1056/NEJMoa0905211
Patel, N., Hertel, P., Estes, M., de la Morena, M., Petru, A., Noroski, L., Revell, P., Hanson, I., Paul, M., Rosenblatt, H.... (2010) Vaccine-Acquired Rotavirus in Infants with Severe Combined Immunodeficiency. New England Journal of Medicine, 362(4), 314-319. DOI: 10.1056/NEJMoa0904485
- December 21, 2009
- 03:00 AM
- 408 views
Radiation from medical imaging and cancer risk
by David Gorski in Science-Based Medicine
Science-based medicine consists of a balancing of risks and benefits for various interventions. This is sometimes a difficult topic for the lay public to understand, and sometimes physicians even forget it. My anecdotal experience suggests that probably surgeons are usually more aware of this basic fact because our interventions generally involve taking sharp objects to [...]... Read more »
Berrington de Gonzalez, A., Mahesh, M., Kim, K., Bhargavan, M., Lewis, R., Mettler, F., & Land, C. (2009) Projected Cancer Risks From Computed Tomographic Scans Performed in the United States in 2007. Archives of Internal Medicine_id, 169(22), 2071-2077. http://archinte.ama-assn.org/cgi/doi/10.1001/archinternmed.2009.440
Smith-Bindman, R., Lipson, J., Marcus, R., Kim, K., Mahesh, M., Gould, R., Berrington de Gonzalez, A., & Miglioretti, D. (2009) Radiation Dose Associated With Common Computed Tomography Examinations and the Associated Lifetime Attributable Risk of Cancer. Archives of Internal Medicine, 169(22), 2078-2086. DOI: 10.1001/archinternmed.2009.427
Redberg RF. (2009) Cancer risks and radiation exposure from computed tomographic scans: how can we be sure that the benefits outweigh the risks?. Archives of internal medicine, 169(22), 2049-50. PMID: 20008685
Brenner DJ, & Hall EJ. (2007) Computed tomography--an increasing source of radiation exposure. The New England journal of medicine, 357(22), 2277-84. PMID: 18046031
- December 14, 2009
- 12:01 AM
- 391 views
Cell phones and cancer again, or: Oh, no! My cell phone’s going to give me cancer! (revisited)
by David Gorski in Science-Based Medicine
It’s been about a year and a half since I’ve written about this topic; so I thought I’d better update the disclaimer that I wrote at the beginning:
Before I start into the meat of this post, I feel the need to emphasize, as strongly as I can, four things:
I do not receive any funding from [...]... Read more »
Myung, S., Ju, W., McDonnell, D., Lee, Y., Kazinets, G., Cheng, C., & Moskowitz, J. (2009) Mobile Phone Use and Risk of Tumors: A Meta-Analysis. Journal of Clinical Oncology, 27(33), 5565-5572. DOI: 10.1200/JCO.2008.21.6366
Deltour, I., Johansen, C., Auvinen, A., Feychting, M., Klaeboe, L., & Schuz, J. (2009) Time Trends in Brain Tumor Incidence Rates in Denmark, Finland, Norway, and Sweden, 1974-2003. JNCI Journal of the National Cancer Institute. DOI: 10.1093/jnci/djp415
- September 24, 2009
- 03:20 PM
- 320 views
CAM and Fibromyalgia
by Peter Lipson in Science-Based Medicine
One of the common themes regarding alternative medicine is the reversal of normal scientific thinking. In science, we must generally accept that we will fail to validate many of our hypotheses. Each of these failures moves us closer to the truth. In alternative medicine, hypotheses function more as fixed beliefs, and there [...]... Read more »
Baranowsky, J., Klose, P., Musial, F., Haeuser, W., Dobos, G., & Langhorst, J. (2009) Qualitative systemic review of randomized controlled trials on complementary and alternative medicine treatments in fibromyalgia. Rheumatology International. DOI: 10.1007/s00296-009-0977-5
- August 31, 2009
- 03:00 AM
- 710 views
“There must be a reason,” or how we support our own false beliefs
by David Gorski in Science-Based Medicine
For a change of pace, I want to step back from medicine for this post, although, as you will see (I hope), the study I’m going to discuss has a great deal of relevance to the topics covered regularly on this blog. One of the most frustrating aspects of being a skeptic and championing science-based [...]... Read more »
Prasad, M., Perrin, A., Bezila, K., Hoffman, S., Kindleberger, K., Manturuk, K., & Powers, A. (2009) “There Must Be a Reason”: Osama, Saddam, and Inferred Justification. Sociological Inquiry, 79(2), 142-162. DOI: 10.1111/j.1475-682X.2009.00280.x
- August 17, 2009
- 03:00 AM
- 653 views
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 »
Harris, R., Zubieta, J., Scott, D., Napadow, V., Gracely, R., & Clauw, D. (2009) Traditional Chinese acupuncture and placebo (sham) acupuncture are differentiated by their effects on μ-opioid receptors (MORs). NeuroImage, 47(3), 1077-1085. DOI: 10.1016/j.neuroimage.2009.05.083
- July 20, 2009
- 04:00 AM
- 784 views
Are one in three breast cancers really overdiagnosed and overtreated?
by David Gorski in Science-Based Medicine
Screening for disease is a real pain. I was reminded of this by the publication of a study in BMJ the very day of the Science-Based Medicine Conference a week and a half ago. Unfortunately, between The Amaz!ng Meeting and other activities, I was too busy to give this study the attention it deserved last [...]... Read more »
Jorgensen, K., & Gotzsche, P. (2009) Overdiagnosis in publicly organised mammography screening programmes: systematic review of incidence trends. BMJ, 339(jul09 1). DOI: 10.1136/bmj.b2587
- June 30, 2009
- 03:00 PM
- 671 views
I get mail–chiroquacktic edition
by Peter Lipson in Science-Based Medicine
A long while back, at the original wordpress incarnation of my usual blog, I wrote a piece on the reasons that chiropractic is unscientific nonsense. Because it was popular, I resurrected it. Well, a chiropractor has come to bravely defend his field and left me a comment.
A study in the May 2007 issue [...]... Read more »
SARNAT, R., WINTERSTEIN, J., & CAMBRON, J. (2007) Clinical Utilization and Cost Outcomes From an Integrative Medicine Independent Physician Association: An Additional 3-Year Update. Journal of Manipulative and Physiological Therapeutics, 30(4), 263-269. DOI: 10.1016/j.jmpt.2007.03.004
SARNAT, R., & WINTERSTEIN, J. (2004) Clinical and Cost Outcomes of an Integrative Medicine IPA. Journal of Manipulative and Physiological Therapeutics, 27(5), 336-347. DOI: 10.1016/j.jmpt.2004.04.007
- June 9, 2009
- 03:27 PM
- 756 views
What is disease? Diabetes, diagnosis, and real science
by Peter Lipson in Science-Based Medicine
One of the concepts we often discuss around here is “what is disease?” As we’ve seen in the discussion of Lyme disease and so-called Morgellons syndrome, this is not always an easy question to answer. Knowing what states are disease states does not always yield a black-or-white answer. The first step is [...]... Read more »
The International Expert Committee. (2009) International Expert Committee Report on the Role of the A1C Assay in the Diagnosis of Diabetes. Diabetes Care. DOI: 10.2337/dc09-9033
- June 8, 2009
- 01:01 AM
- 699 views
Applying evolutionary principles to cancer treatment
by David Gorski in Science-Based Medicine
EDITOR’S NOTE: Unfortunately, this weekend, I was forced to get my slides together for the upcoming SBM Conference. What this means is that, alas, I didn’t have any time to prepare one of the new, long posts that you’ve come to love (or hate). Fortunately, there are a lot of other things I’ve written out [...]... Read more »
Gatenby, R., Silva, A., Gillies, R., & Frieden, B. (2009) Adaptive Therapy. Cancer Research, 69(11), 4894-4903. DOI: 10.1158/0008-5472.CAN-08-3658
- April 20, 2009
- 04:00 AM
- 746 views
Mathematically modeling why quackery persists
by David Gorski in Science-Based Medicine
It’s often puzzled me (and, I daresay, many other skeptics and boosters of science- and evidence-based medicine) why various forms of quackery and woo that have either about as close to zero prior probability as you can get and/or have failed to show evidence greater than placebo in clinical trials manage to retain so much [...]... Read more »
Tanaka, M., Kendal, J., & Laland, K. (2009) From Traditional Medicine to Witchcraft: Why Medical Treatments Are Not Always Efficacious. PLoS ONE, 4(4). DOI: 10.1371/journal.pone.0005192
- March 27, 2009
- 03:03 PM
- 960 views
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: http://content.nejm.org/cgi/content/full/360/13/1298
FINK, K., CARSON, C., & DEVELLIS, R. (2002) Adult Circumcision Outcomes Study: Effect on Erectile Function, Penile Sensitivity, Sexual Activity and Satisfaction. The Journal of Urology, 167(5), 2113-2116. DOI: 10.1016/S0022-5347(05)65098-7
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