Clinical trials
oracknows | March 5, 2008Perusing the news early this morning, I noticed an article on ABC News about placebos. One thing I found interesting about it was that it was a story about a research letter to JAMA, not a full study. Heck, there isn't even an abstract.
Even so, the study was rather interesting and described thusly:
The more expensive your pain medications are, the better the relief you get from taking them -- even if they're fake.
That's according to a study published this week in the Journal of the American Medical Association, which suggests that sugar pills labeled as expensive drugs relieve pain better…
oracknows | February 27, 2008A few days ago, I came across an article on Engadget that mentioned almost in passing some studies that seemed to indicate health problems or no health problems, depending on the specific study, due to the ubiquitous and maligned cellular telephone. Not having dealt with this issue much on my blog, I decided to take a look, mostly out of curiosity. The claims that cell phones somehow cause cancer have been circulating for many years, and the studies marshaled to show such a link have in general been not that impressive. However, even though radiofrequency radiation of the sort used in cell…
oracknows | February 25, 2008Back in late December, I came across an op-ed piece in the New York Times written by Dr. Atul Gawande, general and endocrine surgeon and author of Complications: A Surgeon's Notes on an Imperfect Science and Better: A Surgeon's Notes on Performance, that struck me as a travesty of what our system for protecting human subjects should be, as it did fellow ScienceBlogger Revere.
In brief, the article described an action by the U.S. Department of Health and Human Services' Office of Human Research Protection that, on its surface, appeared to be a case of bureaucracy hewing to the letter of the…
oracknows | February 18, 2008David Colquhoun, eminent scientist and maintainer of the excellent blog DC's Improbable Science, has recently returned home to the U.K. after a trip across the pond to the U.S. and Canada, where, among other things, he gave a lecture at the University of Toronto, as well as the Riker Memorial Lecture at the Oregon Health and Science University. Now that he's back, he's made some observations about the infiltration of quackademic medicine into U.S. medical schools, the same infiltration of woo that I've lamented in my Academic Woo Aggregator.
Among his commentary on several "luminaries" of the…
oracknows | February 15, 2008I've become known as an advocate for evidence-based medicine (EBM) in the three years since I started this little bit of ego gratification known as Respectful Insolenceâ¢. One thing this exercise has taught me that I might never have learned before (and that I've only reluctantly begun to accept as true) is one huge problem with EBM. Not surprisingly, it has to do with how EBM is used to evaluate so-called "complementary and alternative medicine" (CAM) therapies, many of which are highly implausible on a scientific basis, to put it exceedingly generously.
Consider homeopathy, which on a…
oracknows | February 12, 2008Oops, they did it again.
You think the media would learn after the last time, but no....
There it was on Friday greeting me on the ABC News website: "Study: Acupuncture May Boost Pregnancy" in bold blue letters, with the title of the webpage being "Needles Help You Become Pregnant." Wow, what a claim! Naturally, I had to know more. Fortunately (or unfortunately, depending on your point of view) The story began:
It sounds far-fetched sticking needles in women to help them become pregnant but a scientific review suggests that acupuncture might improve the odds of conceiving if done right before…
oracknows | January 24, 2008Word of the day: "Quackademic medicine." I love it.
Dr. R.W. explains.
I very well may have to steal that term. As they say about artists, good ones borrow but great ones steal. (Just living up to the arrogance of my namesake...)
oracknows | January 15, 2008
Today is a very sad day around my lab.
I've just been informed that one of my scientific heroes, the man whose work inspired me to enter the research area that I entered, namely tumor angiogenesis, died last night. Yes, sadly, Dr. Judah Folkman reportedly died of a heart attack last night.
I had the honor of meeting Dr. Folkman on two or three separate occasions, one of which was for a laboratory meeting that involved discussion of our lab's work. A self-effacing and humble man, he was a true scientist, always questioning, always thinking of new hypotheses to test based on answers that…
terrasig | January 4, 2008I'm very excited to announce to Terra Sig readers the kickoff of a new group blog called Science Based Medicine. Yes, it may sound odd that one would need to preface "Medicine" with the qualifier, "Science-Based," but therein lies the goal of this new resource from its mission statement:
Safe and effective health care is critical to to everyone's quality of life; so much so that it is generally considered a basic human right. The best method for determining which interventions and health products are safe and effective is, without question, good science. Therefore it is in everyone's best…
oracknows | January 3, 2008The other day, I happened across an Op-Ed article in the New York Times that left me scratching my head at the seeming insanity of the incident it described. The article, written by Dr. Atul Gawande, author of Complications: A Surgeon's Notes on an Imperfect Science and Better: A Surgeon's Notes on Performance, described what seemed on the surface to be an unbelievable travesty:
In Bethesda, MD, in a squat building off a suburban parkway, sits a small federal agency called the Office for Human Research Protections. Its aim is to protect people. But lately you have to wonder. Consider this…
oracknows | December 20, 2007Evidence-based medicine is not perfect.
There, I've said it. Like anything else humans do in science or any other endeavor, evidence-based medicine (EBM) has its strengths and its weaknesses. On the whole, I consider it to be potentially vastly superior to the way that medicine was practiced in the past, bringing a systematic, scientific rigor to how we practice to replace parts of medicine that tended to be based as much (or more) on tradition or dogma as on evidence. Naturally, a common source of attacks on EBM is advocates of "alternative medicine," who often appeal to "different ways of…
oracknows | December 19, 2007I used to be of the opinion that there might just be something to acupuncture. No, I never thought there was anything to the notion that acupuncture "works" by somehow rerouting the flow of a magical life force (qi) that no scientific instrument can detect and that no practitioner of acupuncture (or other practioners "healing arts" that invoke qi or something like it as the reason that they can heal) can detect either, even as they claim to "release blockages" of or somehow improve its flow. Rather, I wondered whether the simple act of sticking needles into the skin might release some hormone…
oracknows | December 18, 2007If you listen to what advocates of homeopathy, acupuncture, or whatever form of so-called "alternative" medicine you can think of (in reality, non-evidence-based medicine for the most part), you'd think that physicians are in the pockets of Big Pharma, hopeless slaves to its propaganda, addicted to its tchotchkes and swag. Sadly for Big Pharma, they may not be having quite the effect it had hoped, if this roundtable discussion of primary care doctors about a study on NSAIDS and pain is any indication:
Should we believe this study?
Bob: When I decide to read an article, I first look at the…
oracknows | December 18, 2007Several months ago, i wrote quite a few posts about a new anticancer drug that had not yet passed through clinical trials but had demonstrated efficacy against tumors in rat models of cancer. The drug, called dichloroacetate (DCA), is a small molecule that targeted a phenomenon common in cancer cells known as the Warburg effect. Because DCA is a small molecule that is relatively easy to synthesize, the misguided news stories proclaiming it the "cure" for cancer that big pharma wouldn't fund because it was not patentable spawned a cottage industry of charlatans who used the Internet to sell…
terrasig | December 5, 2007A former research director for a complementary and alternative medicine program at a major academic medical center has just released a book that I must get my hands on. I just learned about "Snake Oil Science" by R. Barker Bausell from a Jerry Adler article in the current issue of Newsweek (10 Dec 2007).
To set the proper context, med bloggers like Orac, Dr. R.W., Panda Bear, MD, Sid Schwab, and we here at Terra Sig have been increasingly expressing concern about the seemingly uncritical integration of alternative medicine programs into some of North America's most respected medical schools…
oracknows | December 5, 2007The other village quack of the Chicago Tribune has decided to enter the breast cancer fray again.
No, I'm not talking about the main village quack of the Chicago Tribune. That would be Julie Deardorff. Rather, I'm talking about the Chicago Tribune's newly minted breast cancer crank, Dennis Byrne. We've met him before, parroting credulously an incredibly bad study claiming that it had found a slam-dunk association between abortion and breast cancer. How bad was the study? Well, it was so bad that it was published in that bastion of politically-motivated pseudoscience, the Journal of American…
oracknows | November 28, 2007You've probably heard the oft-repeated charge of "alternative" medicine advocates. If you get into a debate or conversation with one, you can almost count on seeing or hearing it before too long. Indeed, we heard a variant of this very claim yesterday coming from über-woomeister supreme Deepak Chopra. I'm referring, of course, to the rant against "conventional" medicine that medication errors claim 100,000 lives a year. Of course, as Mark pointed out, "conventional" therapies actually work, and because they work there's risk to them. Moreover, its hospitals actually care for seriously ill…
oracknows | November 25, 2007As usual, The Onion gets it right, particularly the part about all acupuncture being "fake" acupuncture.
By the way, this is the study the article is referring to. Meanwhile, Mark Crislip weighs in on this study and some other recent acupuncture studies.
Hmmm. Why should Dr. Crislip have all the fun. True, counting the study above, I have covered three of the studies1, 2, 3 he discussed in his podcast, but maybe I should take a look at the others...
oracknows | November 20, 2007I'm not sure what to think of Michael Siegel. I'm really not. Even now, I remain of two minds on him.
Dr. Siegel first came to my attention back in July, around the time I was getting into online tussles with a certain opponent of indoor smoking bans, before which I had never heard of him. He's a Professor in the Social and Behavioral Sciences Department at Boston University School of Public Health who's made quite a reputation for himself casting a skeptical eye on what he considers to be extreme exaggerations, bad science, and even lies about the risks of tobacco and secondhand smoke. My…
oracknows | November 1, 2007Despite the diatribes that appear here on a regular basis bemoaning the unscientific and sometimes dangerous claims made for so-called "alternative medicine" modalities, I'll be among the first to admit that in some cases it's not always clear what is "alternative" about some therapies. Indeed, there seems to be an intentional effort to "rebrand" some aspects of conventional medicine as being "alternative." Because these methods have a scientific rationale and at least some evidence that they work, by successfully marketing them as "alternative," woo-meisters can then point to them as…