medicine
oracknows | October 14, 2016It’s no secret that I’m not exactly a fan of Dr. Mark Hyman he of the “Ultrawellness” medical empire and arguably the foremost promoter of the “subspecialty” (if you will) of “integrative medicine” known as functional medicine. Integrative medicine, as I’ve told you time and time again, is a specialty dedicated to “integrating” alternative medicine into conventional science-based medicine; i.e., integrating quackery into medicine. One very prominent, very common strain of integrative medicine is known as functional medicine, and Mark Hyman is, although not its originator, its current main…
oracknows | October 13, 2016I knew it. I just knew it. I knew I couldn’t get through October, a.k.a. Breast Cancer Awareness Month, without a controversial mammography study to sink my teeth into. And I didn’t. I suppose I should just be used to this now. I’m referring to the latest opus from H. Gilbert Welch and colleagues that appeared in the New England Journal of Medicine last night, Breast-Cancer Tumor Size, Overdiagnosis, and Mammography Screening Effectiveness. Yes, it’s about overdiagnosis, something I’ve blogged about more times than I can remember now, but it’s actually a rather interesting take on the issue.…
oracknows | October 11, 2016What is it about Florida and quacks? It’s as though it’s the Wild West there when it comes to regulating the practice of medicine. There, quacks can get away with almost anything, or so it would seem. After all, Brian Clement, who isn’t even a doctor and isn’t even really a naturopath either, has been practicing his quackery for decades, even going so far as to travel to Ontario to look for new marks among the indigenous peoples and to Europe and the UK, leading to at least one preventable death and to a young mother with incurable breast cancer to waste her precious remaining time and effort…
oracknows | October 10, 2016As hard as it is for me to believe, I’ve been writing about homeopathy for more than a decade now. Regular readers, of course, know that homeopathy is quackery, utter pseudoscience based on prescientific vitalism based on two “laws”: the Law of Similars and the Law of Infinitesimals. The former states that, to relieve a symptom, you use a substance that causes that symptom in healthy people. There is, of course, no science or logic to support this as a general principle other than sympathetic magic. The latter Law states that to make a remedy stronger, you must dilute it. That in itself is…
oracknows | October 9, 2016There's a misconception that I frequently hear about evidence-based medicine (EBM), which can equally apply to science-based medicine (SBM). Actually, there are several, but they are related. These misconceptions include the idea that EBM/SBM guidelines are a straightjacket, that they are "cookbook medicine," and that EBM/SBM should be the be-all and end-all of how to practice clinical medicine. New readers might not be familiar with the difference between EBM and SBM, and here is not the place to explain the difference in detail because this post isn't primarily about that difference. The…
oracknows | October 6, 2016A frequent topic of discussion on this blog is the concept of overdiagnosis. It’s a topic I’ve been writing about regularly since around 2007 or so and is defined as the detection in an asymptomatic person of disease that, if left alone, would never progress to endanger that person’s life or well-being within his or her lifetime. The problem with overdiagnosis is that it pretty much always leads to overtreatment, the treatment of overdiagnosed disease that is not health- or life-threatening. The key shortcoming in our knowledge that leads to overtreatment is that, once we detect disease with…
oracknows | October 5, 2016Whenever we discuss vaccines and vaccine hesitancy, thanks to Andrew Wakefield the one vaccine that almost always comes up is the MMR, which is the combined measles-mumps-rubella vaccine. In 1998, Wakefield published a case series of cherry-picked patients in which he strongly inferred that the MMR vaccine was associated with autism and “autistic enterocolitis.” Of course, even the way Wakefield spun it, this wasn’t enough evidence to link the MMR vaccine to autism, which is no doubt why Wakefield never explicitly said that it did in the paper describing his case series. My guess has always…
oracknows | October 4, 2016There’s a class of studies that I sometimes refer to as “Well, duh!” studies because their conclusions are so mind-numbingly obvious that one wonders why anyone did the study in the first place. Sometimes that name is meant sarcastically, as in, “Why did these investigators waste the time, effort, and resources to do this study? No, really, why?” Sometimes, though, “Well, duh!” studies are useful and justified because they confirm a conclusion that everyone strongly suspected but for which there wasn’t direct evidence. So it was with a “Well, duh!” study that was published in the October…
oracknows | October 2, 2016I first became more interested in dubious stem cell clinics nearly two years ago, when I learned that hockey legend Gordie Howe was undergoing stem cell therapy in Mexico to treat his stroke. Being from Detroit, I imbibed the hockey madness of this town growing up, and know that Detroiters hold Gordie Howe in incredibly high esteem. Prominent in stories about Howe were two companies: Stemedica Cell Technologies, a San Diego company marketing stem cell treatments for all manner of ailments, and Novastem a partner company in Mexico that uses Stemedica products. Also prominent in the stories was…
oracknows | September 29, 2016I’ve referred to so-called “right to try” laws as a cruel sham.on more than one occasion. Since 2014, these laws, all based on a template provided by the libertarian Goldwater Institute, have been proliferating at the state level with the help of lobbying by the aforementioned Goldwater Institute and a concept that makes it pitifully easy to caricature opposition to these laws as wanting to heartlessly snatch away from terminally ill patients the last chance at life while laughing and twirling one’s mustache like Snidely Whiplash. Not surprisingly, state legislatures all over the country have…
oracknows | September 29, 2016One of the things that first led me to understand the dangers of quackademic medicine was a trial known as the Trial to Assess Chelation Therapy, or TACT. Chelation therapy, as you might recall, is the infusion of a chelating agent, or a chemical that binds heavy metals and makes it easier for the kidney to secrete them, in order to treat acute heavy metal poisoning. Unfortunately, quacks of all stripes have latched on to chelation therapy to treat a number of diseases and conditions. For instance, antivaccine quacks like to use chelation therapies to treat autistic children using the…
oracknows | September 27, 2016I’m sure that most of you watched the Presidential debate on Monday night, just as I did. Over the years, these debates have always always painful for me to watch, given the candidates’ tendency to answer the question they want to answer rather than the question actually answered; to find ways to spew prepackaged talking points into answers, whether they’re related to the question or not; and, above all, to see how much spin they can get away with. Particularly annoying is when they pander to their base with particularly brain dead bon mots. Candidates from both parties do it, of course, but…
oracknows | September 27, 2016It’s been nearly three weeks since we learned that the Medical Board of California had initiated disciplinary proceedings against the most famous antivaccine physician not named Andrew Wakefield. I’m referring, of course, to “Dr. Bob” Sears, author of The Vaccine Book: Making the Right Decision for Your Child and creator of an “alternate” vaccine schedule that “spreads out the vaccines.” Unfortunately, it’s a book that’s been very influential, in particular promoting the idea of “too many too soon” and claiming that delaying vaccines will reduce a child’s risk of autism. Basically, the…
oracknows | September 25, 2016One of the most effective spin techniques used by advocates of “integrative medicine” (also sometimes called “complementary and alternative medicine,” or CAM for short) to legitimize quackery has been to claim basically all non-pharmacologic, non-surgical interventions as “integrative,” “complementary,” or “alternative.” Thus, science-based interventions such as diet changes to treat and/or prevent disease, exercise, and other lifestyle alterations are portrayed as somehow so special, so outside the mainstream, that they need their own specialty, “integrative medicine,” even though they are…
oracknows | September 22, 2016If there’s one thing that irritates me more than government agencies making bold proclamations about making progress in cancer but not providing sufficient funding to have even a shot of realizing such ambitions (I’m talking to you, Cancer Moonshot), it’s people in other disciplines that are not cancer biology making bold proclamations about how they’re going to “solve” cancer or coming up with new “theories” to explain cancer. That’s not to say that cancer research can’t benefit from new perspectives from different sciences and disciplines can bring or new ways of thinking about the problem…
oracknows | September 20, 2016One of the most pernicious changes in medicine that’s occurred over the last 25 years or so is the infiltration of what I like to refer to as “quackademic medicine.” It’s a term that was, as far as I know, coined by Dr. Robert W. Donnell in 2009 to describe the infiltration of pseudoscience and quackery into medical schools and academic medical centers under the mantle of “complementary and alternative medicine” (CAM), now more commonly referred to as “integrative medicine. However, over the years, I’ve embraced the term to describe the “integration” of quackery and pseudoscience into…
oracknows | September 19, 2016I never in a million years thought I’d be writing a blog post involving Selena Gomez.
Gomez, as many, if not most, of you are probably aware is currently a young pop star and actress who got her start as a child actress. Oddly enough, she was on Barney & Friends with Demi Lovato. These days, Gomez specializes in the variety of overproduced, lightweight pop that I don’t really listen to, although, ever since I subscribed to Apple Music, I’ve been known to listen to songs by performers like Selena Gomez and Demi Lovato just to see if I could figure out why they’re so popular. So far, I…
oracknows | September 18, 2016The Cancer Moonshot. It’s a topic that I’ve been meaning to address ever since President Barack Obama announced it in his State of the Union address this year and tasked Vice President Joe Biden to head up the initiative. Biden, you’ll recall, lost his son to a brain tumor . Yet here it is, eight months later, and somehow I still haven’t gotten around to it. The goal of the initiative is to “eliminate cancer as we know it,” and to that end, with $195 million invested immediately in new cancer activities at the National Institutes of Health and $755 million proposed for FY 2017. My first…
oracknows | September 15, 2016When I first heard that Donald Trump, the Republican nominee for President, was scheduled to appear on The Dr. Oz Show, my first thought was, basically, “Of course he is. What took him so long?” After all, it’s a crank pairing made in heaven. Given that, I considered it my skeptical blogging duty at least to watch the show, even if I never actually blogged about it. So I dutifully set my DVR to record it, and, after I got home from work, did my evening bike ride and ate dinner, I settled down in front of the television to see if this appearance would be as bad as I predicted in my mind.
I’m…
oracknows | September 14, 2016As regular readers know, last Friday I was quite happy to relay the news that the Medical Board of California had finally acted against a rock star among the antivaccine movement, namely pediatrician “Dr. Bob” Sears. Dr. Sears (or Dr. Bob, as he likes to be called) rocketed to prominence among the vaccine-averse and downright antivaccine by writing a book called The Vaccine Book: Making the Right Decision for Your Child. It’s a book that Dr. Bob and his sycophants, toadies, and lackeys portray as being a “middle ground,” complete with an “alternative” vaccine schedule to the one recommended…