clinical trial

One of the most persistent narratives latched on to by advocates of "integrative medicine" is that the "mind" can somehow "heal" the body. Sometimes, the claim is that such interventions work through "powerful placebo" effects. Sometimes it involves the abuse of emerging science, such overblown claims about what can be accomplished through epigenetic modifications of DNA and gene expression. While my wife and I were away on vacation last month, there was another example of this claim popping up in the media under headlines like these: Mindfulness and meditation dampen down inflammation genes…
When I first started to take an interest in medical marijuana, I was struck by how much it reminded me of herbalism. Although herbalism is scientifically the most plausible of modalities commonly associated with "complementary and alternative medicine" (CAM), the use of herbal medicines still involve a number of problems, the biggest of which is what I like to call either the delivery problem or the bioavailability problem. In brief, herbs, when they work, are adulterated drugs. The active ingredient is often a relatively small, embedded in thousands of other constituents that make up herbs,…
Some posts I really enjoy doing. I'm so fired up by the topic that the words flow, and I finish a post in record time. Other posts are more of a chore, written not so much because I'm excited by the topic, but because I feel duty bound to address it. I feel the need to write such posts when, for example, a bit of pseudoscience has gained traction in mainstream groups and readers keep writing me about it, to the point where I finally give in. This is one of the latter posts. None of this is to say that I don't still do my best with these posts to explain and argue my points. Fear not, I'll get…
So I was distracted yesterday from what I had intended to write about by an irresistible target provided me courtesy of Toby Cosgrove, MD, CEO of The Cleveland Clinic, who bemoaned all those nasty pro-science advocates who had had the temerity to link the antivaccine rant by the director of the Clinic's Wellness Institute to the quackery practiced there of whose affinity for antivaccine quackery Cosgrove appears to be oblivious. So I took care of that target, and now I'm back to the topic I had wanted to apply some Insolence to. Yes, there was no way I was going to allow this pseudoscientific…
Back in the day, Deepak Chopra used to be a frequent topic of this blog. He still pops up from time to time, such as when irony meters everywhere immediately self-destructed after Chopra criticized Donald Trump for being insufficiently evidence-based or when, after I wrote a post asking why medical conferences keep inviting Chopra to speak, Chopra was so displeased that he actually posted a video attacking me (and other skeptics who’ve criticized his pseudoscience). Unfortunately, Chopra truly is one of the most influential people in “integrative medicine” today. To be honest, I’ve never…
Given the study that I’m going to discuss, I can’t help but start out with a brief (for me) reminiscence. Longtime readers know that I graduated from the University of Michigan Medical School in the late 1980s. Back when I attended U. of M., its medical school was considered stodgy and hard core even by 1980s standards. No organ systems approach to education for U. of M.! Oh, no. It didn’t matter that the organ systems approach, in which all classes are organized by organ systems and teach the same organ systems at roughly the same time (e.g., biochemistry teaching the biochemistry of the…
One of the most reliable indicators of a quack clinic that I know of (besides its offering homeopathy and reiki) is the inclusion of “detox foot bath” treatments on its roster of services. Detox foot baths, whatever the brand, are of a piece with other “detoxification” pseudoscience involving the feet, such as Kinoki foot pads. Basically, the idea is that you can some how remove toxins through the soles of your feet using either a nice mineral bath with a weak electrical current passed through it or a foot pad. Inevitably, nasty looking stuff is seen apparently coming out of the feet. In the…
A week ago, I wrote about an example of one of the most common topics on this blog, the infiltration of pseudoscientific medicine and outright fantasy into academic medicine, a trend I like to refer to as quackademic medicine. The institution was George Washington University, and the dubious intervention was something called the MEND™ Protocol, which is sold as a treatment for Alzheimer’s disease by Muses Labs. As I described, it’s a protocol that appears to rely on a proprietary computer algorithm of some kind that, according to Muses Labs, produces a “personalized” treatment plan for…
A recurring theme of this blog is to shine a light on what I like to call “quackademic medicine.” I didn’t invent the term, but I’ve made it mine. Basically, quackademic medicine is a term that very aptly describes what’s going on in far too many academic medical centers these days, which is the infiltration of pseudoscientific medicine and outright quackery in the form of “complementary and alternative medicine” (CAM). Of course, the more recent term for CAM is now “integrative medicine,” which was coined to imply the “integration” of alternative medicine with science-based medicine as…
Of all the forms of quackery that have been “integrated” into medicine of late, arguably one of the most popular is acupuncture. It’s offered in fertility clinics. It’s offered in hospitals and medical clinics all over the place. The vast majority of academic medical centers that have embraced quackademic medicine offer acupuncture. (Quackademic medicine, for those not familiar with the term we reserve for the study of alternative medicine in academic medical centers that really should recognize it as quackery.) Hell, quite a few that haven’t embraced quackademic medicine offer acupuncture.…
Ever since the beginning of this blog, there's one topic I've explored many, many times, mainly because of its direct relationship to my profession as a cancer surgeon. That topic is, of course, the question of why people fall for alternative medicine cancer "cures." It started with one of my very earliest posts and continued right up to deconstructing Presidential candidate Ben Carson's very own alternative medicine cancer cure testimonial last fall. It continues again now. Regular readers, particularly long time readers, have already come to recognize common themes in these alternative…
Every so often there are studies that I really mean to write about but, for whatever reason, don't manage to get to. Sometimes I get a chance to get back to them. Sometimes I don't. This time around I'm getting back to such a topic. This time around it's a topic I've been meaning to write about is based on a couple of studies that came out three weeks ago that illustrate why, even if a patient ultimately comes around to science-based treatment of his cancer, the delay due to seeking out unscientific treatments can have real consequences.Consider this (probably) the last unfinished bit of…
Several years ago, Harriet Hall coined a term that is most apt: Tooth fairy science. The term refers to clinical trials and basic science performed on fantasy. More specifically, it refers to doing research on a phenomenon before it has been scientifically established that the phenomenon exists. Harriet put it this way: You could measure how much money the Tooth Fairy leaves under the pillow, whether she leaves more cash for the first or last tooth, whether the payoff is greater if you leave the tooth in a plastic baggie versus wrapped in Kleenex. You can get all kinds of good data that is…
Acupuncture is a theatrical placebo, but it's hard not to grudgingly admire just how—shall we say?—malleable or adaptable a placebo it is. What I mean by this is that, if you believe its practitioners and adherents, acupuncture can treat almost literally any disease or health problem. Any! Pain? Acupuncture. Allergies? Acupuncture. Biliary colic? Acupuncture. Infertility? Acupuncture. Menstrual problems? Acupuncture. Prostate problems? Acupuncture. Asthma? Acupuncture. Well, maybe not asthma, but that doesn't stop acupuncturists from claiming that acupuncture can treat it. Oh, and if you're a…
Two things have reminded me that it's been a while since I've written about Stanislaw Burzynski, nearly five months, to be precise. First, on Wednesday evening I'll be heading to the city where Burzynski preys on unsuspecting cancer patients, Houston, TX, to attend this year's Society of Surgical Oncology meeting to imbibe the latest research on—of course!—surgical oncology. (If you'll be attending the meeting, look me up. If you're in Houston and want to have a meetup, I might be able to pull it off.) Second, you, my readers, have been telling me there's something I need to blog about. This…
If there's one thing that's become clear to me over the years about acupuncture, it's that it's nothing more than a theatrical placebo. Many are the times that I've asked: Can we finally just say that acupuncture is nothing more than an elaborate placebo? Most recently, I asked this question in 2012. What science-based medicine answers is yes. However, there's a large contingent of physicians under the sway of practitioners of traditional Chinese medicine (TCM) who have fallen under the spell of that theatrical placebo, leading to a whole subdiscipline of quackademic medicine in which tooth…
And now for something completely different... (Yes, there's been enough vaccine blogging for the moment.) The date of the Kinsman Sports Celebrity Dinner in Saskatoon is fast approaching on February 6. It reminded me of my discussion of how Gordie Howe was flown to Tijuana to undertake a dubious stem cell therapy for his serious stroke that involved the intravenous and intrathecal (into the cerebrospinal fluid) injection of "stem cells," a treatment that was followed by glowing reports from the family and credulous reporters in the press describing Howe's "miraculous" recovery from his…
Of all the quacks and cranks and purveyors of woo whom I’ve encountered over the years, Deepak Chopra is, without a doubt, one of the most arrogantly obstinate, if not the most arrogantly obstinate. Sure, a quack like Mike Adams wins on sheer obnoxiousness and for the sheer breadth of crankery to which he ascribes, which includes everything from quackery, to New World Order conspiracy theories, to Scientology-like anti-psychiatry rants, to survivalist and gun nut tendencies, but he's so obviously unhinged, as well as intermittently entertaining, that he doesn't quite get under the skin the…
Of all the cranks, quacks, antivaccinationists, and pseudoscientists that I've encountered (and applied a bit of not-so-Respectful Insolence to) over the years, there are a few who belong in the top tier—or, if you prefer, the bottom tier. They stick out in my memory for a variety of reasons, either through their sheer crankitude on a variety of subjects (such as Mike Adams), sheer persistence on one subject (such as Jake Crosby or any of the denizens of the antivaccine crank blogs Age of Autism or The Thinking Moms' Revolution), or fame for promoting quackery (Joe Mercola). One of these…
When I wrote about the Trial to Assess Chelation Therapy (TACT) trial last week, little did I suspect that I would be revisiting the topic again so soon. For those of you not familiar with TACT, it was a trial designed to test a favorite quack treatment for cardiovascular disease, chelation therapy. It is, as I have described many times in the past, an incredibly implausible therapy based on a hugely simplistic concept that because calcium accumulates in atherosclerotic lesions, then using chelation therapy could remove the calcium and reduce the lesions. Chelation therapy is a favorite…