August 20, 2008
Category: Alternative medicine • Medicine • Quackery
My Academic Woo Aggregator has become even more out of date. You remember my Academic Woo Aggregator, don't you? It's my list of medical schools and major academic medical centers in North America that have adopted what Dr. R.W. once so famously dubbed "quackademic medicine" in that they've created divsions, centers, or departments of "complementary and alternative medicine" (CAM) or "integrative medicine" (IM), in which pseudoscientific or mystical woo is "integrated" with scientific medicine in the mistaken belief that it will somehow improve patient care. Whether it's for chasing money from the Bravewell Collaborative or the National Center for Complementary and Alternative Medicine (NCCAM) or whether it's through a desire not to be "judgmental" taken to the level of an open-mindedness that leaves a real danger of brains falling out, these academic centers have decided that evil, reductionist, "cold," "Western" medicine needs to be--shall we say?--supplemented with a heapin' helpin' of pseudoscientific woo. Worse, some really big names are there: Yale, Duke, Stanford, and Harvard. Clearly, going to an academic medical center is no longer an assurance that one will be treated with only the best science- and evidence-based medicine.
Add another one to the Woo Aggregator. Although this university is already in the Woo Aggregator, its entry needs a serious updating, because it looks as though it's expanding its quackademic medicine offerings in a huge way. This time around, it looks as though the University of New Mexico is planning on going full throttle into the world of woo with its newly renamed Center for Life:
Read on »
Posted by Orac at 9:33 AM • 11 Insolent response(s) • View blog reactions
Category: Biology • Humor • Science
Every scientist has had manuscripts rejected by various journals, and most who submit to the really high impact journals like Nature or Science end up being rejected without review. Few, however, have the creativity or cojones to respond to such a rejection in such a creative and amusing manner.
Sadly, in the medical literature, there really are no structures in the body left that can be named in such a manner; there really isn't a way I could respond to a rejection in quite the same manner. I'll have to think of something different the next time it happens.
Posted by Orac at 12:00 AM • 5 Insolent response(s) • View blog reactions
August 19, 2008
Category: Bioethics • Medicine • Religion
Late this afternoon, I happened to be sitting in my office perusing the websites for the latest batch of surgical journals, trying desperately to catch up on my reading, something that I, like most academic surgeons, am chronically behind in, when I happened upon the website of the Archives of Surgery. There, the lead article caught my eye, and I downloaded it for later reading. Then, as I perused a few news sites (yes, I was procrastinating; but who doesn't procrastinate from time to time?), and I came across a story about this very study:
CHICAGO - When it comes to saving lives, God trumps doctors for many Americans.
An eye-opening survey reveals widespread belief that divine intervention can revive dying patients. And, researchers said, doctors "need to be prepared to deal with families who are waiting for a miracle."
More than half of randomly surveyed adults -- 57 percent -- said God's intervention could save a family member even if physicians declared treatment would be futile. And nearly three-quarters said patients have a right to demand such treatment.
My first reaction was: Tell me something I didn't know. Dealing with such situations, especially the ethics of dealing with situations in which science tells us that treatment is futile but the family demands futile patient is among the most difficult task physicians will face. My second reaction was that it was rather jarring to see this so starkly placed in print. I also realized, upon going back to read the actual study, entitled Trauma Death: Views of the Public and Trauma Professionals on Death and Dying From Injuries and coming out of the University of Connecticut (I figure I owe the institution one, given how I trashed a study coming from there yesterday) that there was far more to the study than what was reported in the news report, which focused almost exclusively on the belief among the public that divine intervention could reverse a terminal injury and result in recovery. Although a major result, when taken as a whole, the study tells us a lot more than just that many Americans have religious beliefs that lead them to hope that God will produce miraculous recoveries for their family members from fatal injuries.
Read on »
Posted by Orac at 8:30 AM • 29 Insolent response(s) • View blog reactions
Category: Alternative medicine • Entertainment/culture • Medicine • Quackery
I've written about the ridiculousness of the Kinoki Detox Footpads before. While on the way home from work today, I happened to be listening to NPR, and--wonder of wonders!--I came across a skeptical story about the Kinoki Footpads. In the story, the reporter, Sarah Varney, took used footpads to a laboratory to have them tested. Surprise, surprise! There was no significant difference between the used and unused pads in chemical content, nor was there any evidence of elevated heavy metal content of the "used" pads. She then interviewed a doctor who explained just how ridiculous the concept of "detoxing" through the skin of your feet is. Of course, I said virtually the same thing nearly two years ago for a different brand of detox footpads and then again in April of this year specifically about the Kinoki Detox quack--I mean foot--pads.
Finally, Varney then exposed unused Kinoki Detox Footpads to steam, and--surprise, surprise again!--the footpads turned black, no "toxins" from a wearer's feet needed (or even contact with a person's feet, for that matter).
I suppose NPR actually did do a public service here, and it is truly unusual to see actual skeptical reporting about devices like the Kinoki Detox Footpads, but in this case this is some really old news. The skeptical blogosphere did many thorough explanations of this silliness seemingly eons ago. Better late than never, I suppose.
Posted by Orac at 12:00 AM • 25 Insolent response(s) • View blog reactions
August 18, 2008
Category: Announcements • Blog carnivals • Science • Skepticism/critical thinking • Skeptics' Circle
As the guy who sort of fell into being the keeper of the original Skeptics' Circle after its creator decided to give up blogging three years ago, I'd be remiss in my duties if I didn't mention that I've been made aware of an initiative to set up a local version of the Circle based around trying to foster better communication among South African Science Bloggers being spearheaded by a recent host of the Skeptics Circle, Michael Meadon at Ionian Enchantment. Of course, it's an effort of which I heartily approve, and I hope my readers will check it out.
I would also hope, however, that some of the hosts who have lined up to host this new skeptical blog carnival (as yet unnamed) would consider also hosting a meeting of the Skeptics' Circle at some point, not to mention submitting their work to the Skeptics' Circle on a regular basis if they don't do so already. Michael's already hosted, and he did a fine job. Moreover, most of the hosts lined up thus far are blogs that I haven't encountered before. We need synergy!
Posted by Orac at 5:00 PM • 2 Insolent response(s) • View blog reactions
Category: Religion • Skepticism/critical thinking
Back in the spring, when gas prices shot up to well over $4 a gallon in many markets, a level from which they've fallen back somewhat over the last month or so, there was a great wailing and gnashing of teeth. Never before in U.S. history had gasoline cost so much, and we were starting to get a taste of what our European friends have had to put up with for a very long time. But just a taste. After all, I remember from my trip to the U.K. last August that gas was around £1 per liter, which at the time translated to over $7.50 a gallon. For those who lived in isolated areas or had low incomes, this spike in gas prices was a disaster, especially for truckers, cab drivers, and others whose jobs involved driving. On the other hand, I had little sympathy at all for all the yuppies who had bought enormous SUVs during the years when gasoline was cheap.
Naturally, when faced with a disaster of such proportions, some Americans, being the highly religious people that they are, had the perfect response. Indeed, to them it was the only response possible. No, it wasn't to purchase more fuel-efficient cars (although some did start to drive less). No, it wasn't to lobby the government to support the development of alternative fuels and to increase the CAFE standard. No, it was to Pray at the Pump for lower gas prices. And now that gas prices have come down around 20-30 cents from their historic highs, perish forbid that the fall in prices at the pump or the recent fall in price for a barrel of crude oil had anything to do with the economic principle of supply and demand or the recent strengthening of the dollar. Oh, no, it was clearly Jesus at work:
Read on »
Posted by Orac at 12:30 PM • 26 Insolent response(s) • View blog reactions
Category: Alternative medicine • Clinical trials • Medicine • Quackery
In complaining about the infiltration of pseudoscience in the form of "complementary and alternative medicine" (CAM) into academic medicine, as I have many times, I've made the observation that three common modalities appear to function as "gateway woo, if you will, in that they are the tip of the wedge (not unlike the wedge strategy for "intelligent design" creationism, actually) that slip into any defect or crack it can find and widen it, allowing entrance of more hard core woo like homeopathy behind them.
All of these modalities fall under the rubric of "energy healing" in that the rationale given for how they "work" is that they somehow alter, correct, or "unblock" the flow of qi, or that mystically implausible "life energy" that scientists can't seem to measure but energy healers assure us really, truly does exist. One of these is acupuncture, which has proliferated throughout many areas of medicine despite a lack of evidence that it does anything more than a placebo. However, at least acupuncture actually does something in that it involves introducing needles underneath the skin. It might conceivably do something, although it's virtually certain that, whatever it might do, it isn't achieving it by "unblocking" the flow of anything, much less qi. The next is reiki, which to me is nothing more than faith healing with Eastern mysticism rather than Christian religion as its basis. In reiki, the healer claims to be able to manipulate a patient's qi for therapeutic effect in essence by holding his hands out and willing it. The last of this trio of wedgy woo is a distinctly American form of woo known as therapeutic touch (TT), which tends to be promoted and practiced primarily by nurses. Indeed, I view TT as, in essence, an Americanized form of reiki whose name is a misnomer, in that its practitioners hold their hands very close to the patient without actually touching the patient and will them to be healed by manipulating their "life energy."
As I said, these forms of woo are "gateway woo" that lead the way to the introduction of the harder core stuff, like homeopathy, applied kinesiology, or even reflexology. However, we skeptics are seemingly supposed to accept it when we are told that these are really and truly science, maaaan. Sometimes advocates of these modalities are stung by such criticism to the point where they want to try to prove that there's science behind their mysticism, and when they do there are sometimes truly hilarious results. For instance, not too long ago I discussed a series of experiments published in which reiki was tested for its ability to alleviate the increase in heart rate observed in rats placed under stress. I couldn't help but giggle when I pictured reiki masters doing their mystical hand gestures and concentration on laboratory rats. I wondered what could possibly top that experiment for sheer ridiculousness.
Now I know. Now they're doing therapeutic touch on cell culture and writing glowing press releases about it:
Read on »
Posted by Orac at 8:59 AM • 19 Insolent response(s) • View blog reactions
August 17, 2008
Category: Entertainment/culture • Science fiction/fantasy • Television
After seeing some Doctor Who silliness yesterday, I also came across this great tribute to 45 years of Doctor Who. Since it's a beautiful Sunday afternoon, and I'm again too lazy to post anything substantive until Monday, here we go again. It's every Who story compressed into less than 8 minutes. Truly, a tour de force for surveying the evolution of the show.
Posted by Orac at 3:16 PM • 5 Insolent response(s) • View blog reactions
Category: Announcements • Blog housekeeping • Friday Woo • Skepticism/critical thinking
It's Sunday, which makes it a perfect time for a little blog housekeeping, especially about a feature that used to appear regularly on Fridays.
As you may recall, after the death of Echo I put Your Friday Dose of Woo on hiatus for a while because I just couldn't get myself into the appropriately light-hearted and silly frame of mind. Time has passed, and, although things will never be the same, a semblance of normalcy has (somewhat) returned. The loss still hurts--a lot--but my wife and I are slowly and reluctantly adapting. (We did finally share that third ear of corn, by the way; I don't recall if I ever mentioned that.)
In the five weeks since I put YFDoW on hiatus, though, I've discovered one thing. I actually rather like the freedom to be able to write about whatever I feel like on Fridays. Looking back, I think YFDoW had become a bit of a straightjacket that I had come to feel obligated to do because it was expected and readers generally liked it, rather than because I wanted to do it anymore. Thursday nights would roll around, and I'd sometimes plow through the Folder of Woo only to find nothing much that really got me fired up. I think it was starting to show, too. Sometimes, something big would happen related to my favorite topics to blog about, and I'd have to delay writing about it. Now that I've given YFDoW up for a while, though, I actually rather miss doing the feature, which is why the time is coming when I'll almost certainly resurrect it in some form or another.
What I think I'll probably do is to bring the feature back sometime after Labor Day. However, it will no longer be a weekly feature. Instead, I'll only do an installment when some truly YFDoW-worthy bit of silliness comes to my attention. It may be once every other week; it may be once a month; it may be once a week. It all depends on the woo frequency of any given time. Of course, by sending me your best woo, you can potentially increase the frequency that I do the feature.
Posted by Orac at 11:30 AM • 6 Insolent response(s) • View blog reactions
August 16, 2008
Category: Entertainment/culture • Music • Science fiction/fantasy • Television
Why? Because I love Doctor Who and Benny Hill (although I was never much of an Eminem fan) and because it's funny, that's why. Besides, it's a beautiful Saturday, and I'm feeling too lazy to post anything substantive this morning. That's all the reason I need.
Posted by Orac at 10:20 AM • 7 Insolent response(s) • View blog reactions
Category: Alternative medicine • Medicine • Quackery
I don't know who Kent Sepkowitz is other than that he he's an infectious disease specialist in New York and that he writes for Slate. I also know he's written about penis enlargement, his dislike of magazines' "best doctor" lists (a sentiment with which I can agree, actually), and that he has suggested that Americans should "eat more excrement." What I didn't know is that he was capable of slinging said excrement around (at least, the excrement left over after Americans eat more of it, I suppose), specifically slinging excrement about so-called "complementary and alternative medicine" (CAM) using verbiage of which Andrew Weil and David Katz would applaud enthusiastically.
I'm not amused.
I refer to an article he wrote a couple of days ago and published in Slate entitled Alternative Universe: The Homeopathic Crowd Meets Academic Medicine. He appears to approve heartily. As any regular reader of this blog knows, I do not.
Read on »
Posted by Orac at 9:00 AM • 20 Insolent response(s) • View blog reactions
August 14, 2008
Category: Antivaccination lunacy • Medicine
We seem to have an infestation of a couple of very persistent anti-vaccinationist trolls. (It happens; every so often someone new thinks they can take me and my readers on. They're usually pretty quickly disabused of that notion.) That infestation is why I thought now would be an opportune time to refer my readers to a post that shows the world to which we could return if the anti-vaccine contingent gets its way. Written by the always irascibly sarcastic Dr. Mark Crislip of Quackcast, it's entitled Amanda Peet is My Hero (1).
Remember, Dr. Crislip is an infectious disease specialist. As he tells us, he doesn't "make dime one if people do not get infected." So he's hoping that Jenny McCarthy and her brain dead ilk are successful. Well, not really. Dr. Crislip is very good at sarcasm, so much so that I can't always tell when he is being sarcastic. This time I'm pretty sure he doesn't really mean it.
I think.
Oh, wait, he left a footnote to let us know it was sarcasm. All is well.
Posted by Orac at 4:30 PM • 201 Insolent response(s) • View blog reactions
Category: Alternative medicine • Humor • Medicine • Quackery
It looks as though at least a couple of my readers have taken to heart my suggestion that, if the pro-CAM, "no skeptics need apply" new wikipedia known as Wiki4CAM won't allow any scientific evidence to be posted within its pages if it does not support the CAM therapy being discussed, then perhaps we should go all Sokal on it and post the most outlandish forms of CAM we can think of in order to see whether any of the editors at Wiki4CAM actually notices, and if anyone does how long it takes.
Thus far, we have two skeptics who have taken up the challenge, one choosing a more subtle--shall we say?--faith-based approach, and another going for pure parody. First, we have Bing McGhandi's lovely addition to the entry for faith healing. I particularly like the "science-y" part where he tries to show a relationship between the frequency of laying on of hands and the efficacy of Christian faith healing. Second up, we have a new and fantastic therapy known as flame detox. The entry speaks for itself. Worse, it's not that unbelievable, given the belief that the use of caustic mud like the "black salve," which, it is said, "draws out toxins" or even "draws out tumors," does anything more than induce skin burns. In case the Wiki4CAM administrators get wise to this, I thought I'd save the entry for posterity:
Read on »
Posted by Orac at 1:00 PM • 32 Insolent response(s) • View blog reactions
Category: Alternative medicine • Cancer • Clinical trials • Medicine
It's been quite a while since I wrote about this topic, but, quite frankly, I didn't think anything new was likely to come up that would interest me sufficiently to take it on again. I was almost right; it's been well over two years since the last time I discussed the issue of whether or not vitamin C has any role in treating cancer.
When last I left the topic, two studies had been released that were being widely cited as a "vindication" of Linus Pauling. As you may recall, Pauling was the Nobel Laureate who succumbed to what's sometimes called the "Nobel disease" in that he turned into a major crank late in his life. The main manifestation of his crank tendencies was his major role in the founding of the orthomolecular medicine movement. So-called "orthomolecular medicine" generally involves treating all disease with megadoses of various vitamins and other nutrients, chief among which was vitamin C, also known as ascorbic acid. Thanks largely to Pauling's influence and the power and influence that come with his having been a two-time Nobel Laureate, the concept that megadoses of vitamin C could be used to treat diseases mild and serious, ranging from the common cold to cancer, has hung around far longer than it would likely have if it were judged on a strictly scientific basis. There are endless studies, some of which seem to show a benefit in preclinical models but only at enormous concentrations, and there are clinical studies that fall into two categories: flawed studies that seem to show a benefit (one of which Pauling himself inflicted on the medical literature) or better-designed studies that show no effect. All in all, I remain rather puzzled at the continued interest in vitamin C as some sort of cancer cure, given that the largest effects ever reported were in fact quite modest and given how huge the doses necessary to achieve even those modest responses in animal models had to be. The whole thing strikes me as the proverbial long run for a short slide. But apparently there are a lot of people who like getting their butts dirty sliding into base, because the attraction to vitamin C still lives on. Never mind that there are charges that Pauling could not abide negative data to the point of suppressing them or that there were also data that suggested that vitamin C may may stimulate the growth of some tumors in mice. To many in the world of "complementary and alternative medicine" (CAM), vitamin C at large doses remains a "natural" cure for what ails you.
Most recently, I deconstructed two studies. One study was of the dreaded "best case" series, a type of study I absolutely detest because it's an excuse for purveyors of dubious therapies to cherry pick their "best cases," even if it's a handful out of hundreds or thousands, and this one was no different. Worse, even as "best cases," these cases were not all that impressive as evidence for a therapeutic effect due to vitamin C. The other study, by Qi Chen, Mark Levine, and colleagues at the National Institute of Diabetes and Digestive and Kidney Diseases at the NIH was published in PNAS. Sadly, it wasn't all that striking either, being only an in vitro study looking at the effect of very high concentrations of vitamin C on various tumor cell lines in cell culture. All I could do was to wonder was whether this study was evidence for clinically useful anti-tumor activity due to ascorbic acid or just another example demonstrating that it's possible to kill tumor cells in vitro with almost anything if you jack the concentration high enough. I will admit that it was interesting that the vitamin C-mediated tumor cell killing depended upon the generation of H2O2 (peroxide) and could be abrogated by inhibitors of H2O2 generation. In any case, Levine's conclusion was that vitamin C/ascorbate is a prodrug that results in the selective generation of H2O2 in tumor cells but not in whole blood. All in all it was a mildly interesting result, but hardly a stunning vindication of Linus Pauling.
Now, over two years later, Levine et al are back, this time with another study published in PNAS entitled Pharmacologic doses of ascorbate act as a prooxidant and decrease growth of aggressive tumor xenografts in mice. This time, they've done animal studies. Once again, these studies show mildly positive results. Once again, the whole endeavor strikes me as a long run for a short slide. Once again, I remain puzzled as to why there is such intense interest in what, even if it "works," strikes me as a cumbersome and only mildly effective therapy.
Read on »
Posted by Orac at 8:31 AM • 26 Insolent response(s) • View blog reactions
Category: Announcements • Blog carnivals • Skepticism/critical thinking • Skeptics' Circle
It's that time again. Once again, the best that the skeptical blogosphere has had to offer over the last couple of weeks is on display, this time over at City of Skeptics, where you can now find The 93rd Meeting of the Skeptics' Circle. The dude fooled me though. With the time difference between here and Australia, this Circle appeared yesterday here in the States, before I remembered to do my usual last minute submission of a post to the Circle. Damn. I'll have to be more careful next time.
Go forth, read, and enjoy, nonetheless. That I have become superfluous to most meetings of the Skeptics' Circle is actually a good thing. It means that the Circle is bigger than its organizer and that it doesn't depend on any one blogger.
And the next time the Skeptics' Circle will be landing will be on Thursday, August 28 at Reduce to Common Sense, hosted by Rana Banerjee. So get those skeptical pens twitching or those skeptical fingers tapping away on the keyboard, and get Rana some great material for next week. As always, if you're interested in hosting (and we still don't have the first host for 2009 yet!), check out the guidelines and schedule, as well as the guidelines for hosts, and then drop me a line.
Posted by Orac at 7:30 AM • 0 Insolent response(s) • View blog reactions
Orac is the nom de blog of a (not so) humble pseudonymous surgeon/scientist with an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his miscellaneous verbal meanderings, but just barely small enough to admit to himself that few will. (Continued 
