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
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  • July 5, 2010
  • 10:30 AM

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 »

  • June 14, 2010
  • 07:00 AM

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
  • 04:00 AM

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 »

  • June 2, 2010
  • 05:00 PM

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
  • 04:00 AM

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 »

  • April 1, 2010
  • 04:00 AM

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
  • 04:01 PM

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
  • 04:00 AM

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 »

  • December 14, 2009
  • 01:01 AM

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
  • 04:20 PM

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 »

  • August 31, 2009
  • 04:00 AM

“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
  • 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 »

  • July 20, 2009
  • 05:00 AM

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 »

  • June 30, 2009
  • 04:00 PM

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 »

  • June 9, 2009
  • 04:27 PM

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 »

  • June 8, 2009
  • 02:01 AM

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
  • 05:00 AM

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 »

  • 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:  

  • 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 1, 2008
  • 04:00 AM

Do 22% of mammographically detected breast cancers spontaneously regress?

by David Gorski in Science-Based Medicine

It figures.

Last Wednesday, right before the four-day Thanksgiving holiday weekend, as I was far more interested in preparing to have family over the next day than in what was going on in the medical news or the blogs, the results of a most fascinating study hit the news. In Medscape, the title of the news [...]... Read more »

Per-Henrik Zahl, MD, PhD, Jan Mæhlen, MD, PhD, & H. Gilbert Welch, MD, MPH. (2008) The Natural History of Invasive Breast Cancers Detected by Screening Mammography. Archives of Internal Medicine, 168(21), 2311-2316. DOI:  

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