science-based medicine
oracknows | November 29, 2016I’m always hesitant to write about matters that are more political than scientific or medical, although sometimes the sorts of topics that I blog about inevitably require it (e.g., the 21st Century Cures Act, an act that buys into the myth that to bring "cures" to patients faster we have to neuter the FDA and a retooled version of which is still being considered). This is one of those times. Yesterday, I woke up to the news that President-Elect Donald Trump had chosen Rep. Tom Price (R-GA) as his new Secretary of Health and Human Services. The Department of Health and Human Services (DHHS),…
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 | April 3, 2016It's no secret that I'm a fan of John Ioannidis. (If you don't believe me, just type Ioannidis' name into the blog search box and see how many posts you find.) Over the last couple of decades, Ioannidis has arguably done more to reveal the shortcomings of the medical research enterprise that undergirds our treatments, revealing the weaknesses in the evidence base and how easily clinical trials can mislead, than any other researcher. Indeed, after reading what is Ioannidis' most famous article, "Why Most Published Research Findings Are False", back in 2005, I was hooked. I even used it for our…
oracknows | March 6, 2016I write about vaccines a lot here at Respectful Insolence, and for a very good reason. Of all the medical interventions devised by the brains of humans, arguably vaccines have saved more lives and prevented more disability than any other medical treatment. When it comes to infectious disease, vaccination is the ultimate in preventive medicine, at least for diseases for which vaccines can be developed. We also know that when vaccination rates fall, it opens the door for diseases once controlled to come roaring back. We saw this phenomenon with the measles a year ago in the Disneyland measles…
oracknows | October 26, 2015I like to point out from time to time that arguably the most striking difference between science-based medicine (and the evidence-based medicine from which we distinguish it) and alternative medicine, "complementary and alternative medicine" (CAM), or (as it's called now) "integrative medicine" is a concerted effort to change practice for the better based on science and evidence. In other words, in SBM, we are continually doing studies to improve practice. These studies take on two general forms: Comparing new treatments with old to determine if the new treatments work better and, as has…
oracknows | October 11, 2015Last week, in response to the awarding of the Nobel Prize in Physiology or Medicine to Chinese scientist Youyou Tu, who isolated Artemisinin and validated it as a useful treatment for malaria back in the 1970s, I pointed out that the discovery was a triumph of natural products pharmacology, not of traditional Chinese medicine (TCM). So did Scott Gavura, a pharmacist who blogs at my favorite other blog, Science-Based Medicine, who also emphasized that the path from TCM remedy for fever to pill used to treat malaria was the very model of how pharmacologists isolate medicines from plants.…
oracknows | September 16, 2015Regular readers of this blog will find it no surprise that I don't think much of Dr. Mehmet Oz. The reason, of course, is that his daily television show, The Dr. Oz Show, has been a font of misinformation about medicine almost since it began airing six years ago. It's not for nothing that I long ago labeled him "America's Quack." Simply searching for the name Mehmet Oz on this blog will quickly produce examples of the many times when he's credulously promoted quackery and pseudoscience such as homeopathy (The One Quackery To Rule Them All), faith healing, fear mongering about GMOs, and…
oracknows | August 10, 2015Alright, alright already! I get the message.
Over the course of the day yesterday I was bombarded by e-mails with a link to a New York Times article that shows a rather shocking lack of understanding of the science—more specifically, the lack of science—behind alternative medicine. Whenever something like this happens and I get so many requests to address a specific article, I'm always torn between my natural contrariness, which tempted me not to touch this article with the proverbial ten foot cattle prod (although something about this needs a cattle prod applied to it) and my desire to give…
oracknows | June 26, 2015Orac note: Congratulations on California and everyone who reads this blog who helped pass SB 277 to protect California's children. Here's hoping Governor Jerry Brown signs the bill! I had a big talk to give this morning that required a massive rewrite of my slide set last night; so there wasn't time for the usual Insolence. Some of you might have seen a different version of this post elsewhere. Some of you might not. Either way, I hope you can enjoy!
Two weeks ago, I attended the Center For Inquiry Reason for Change Conference, where I participated in a panel on—what else?—alternative…
oracknows | May 31, 2015I have some sad news for my readers today. It's even sadder given that it's only been two and a half weeks since I last had to mourn the passing of one of our own, a champion of science-based medicine, a regular commenter of five years, lilady. Unfortunately, this time around, it is my sad duty to inform you that Dr. Wallace Sampson has passed away at the age of 85. I knew about it late last week, but I wanted to wait until official obituaries were published, such as this one in the Mercury News.
I first encountered Wally (as his friends called him) through his writings deconstructing various…
oracknows | February 18, 2015
It often comes as a surprise to proponents of alternative medicine and critics of big pharma that I'm a big fan of John Ioannidis. Evidence of this can easily be found right here on this very blog just by entering Ioannidis' name into the search box. Indeed, my first post about an Ioannidis paper is nearly a decade old now. These posts were about one of Ioannidis' most famous papers, this one published in JAMA and entitled Contradicted and Initially Stronger Effects in Highly Cited Clinical Research. It was a study that suggested that at least 1/3 of highly cited clinical trials may either…
oracknows | September 2, 2014And now for something completely different...
Due to the holiday and suddenly being informed that my revised manuscript for a certain journal (more on that later) is needed NOW, I don't have time for much of a post. However, a certain bit of bombshell landed over the weekend that should keep those of you interested in the skeptics' movement (as I am) discussing until I finish "fixing" a final version of my manuscript. It came in the form of an announcement that appeared on the James Randi Educational Foundation (JREF) website:
In order to achieve cost-savings and greater efficiency, the Los…
oracknows | July 23, 2014If there’s one characteristic of supporters of dubious medicine, it’s that they detest criticism. Whereas your average skeptic might not like criticism—sensitivity to criticism being a human trait and all—science- and evidence-based criticism tends to drive dubious medical practitioners (and, I might add, promoters of various other forms of woo) into paroxysms of anger. Not infrequently, because they can’t refute such criticisms with science and evidence, they respond by lashing out, by going on the attack. That lashing out can take many forms, from simply writing abusive posts about their…
oracknows | July 9, 2014Today, I'm winging my way to sunny Las Vegas. Yes, in the middle of summer, when southern Nevada's weather is most like an oven, I will be there. The reason? I'll be doing a workshop and a panel with fellow supporters of science-based medicine at The Amazing Meeting.
I don't know how many of my readers will be there, but if you're there and see me hanging out at the Del Mar or in the hall between sessions, feel free to introduce yourself. For everyone else, I guess we'll have to consider this an open thread. Don't worry. I plan on doing some blogging while I'm away, but it might be more…
oracknows | February 11, 2013Those of us who dedicate considerable time and effort to combatting quackery generally do it because we think we're doing good. Certainly, I wouldn't spend so much time nearly every evening blogging the way I do if I didn't think so. It's true that I also enjoy it, but if I were doing this just for enjoyment I'm sure I could manage to find other topics that I could write about. In actuality, way back in deepest darkest beginnings of this blog, I did write about a lot of other things. My skeptical topics were more general in nature, encompassing not just medicine but evolution versus "…
oracknows | November 13, 2012Regular readers probably know that I'm into more than just science, skepticism, and promoting science-based medicine (SBM). (If they're regular readers of my other, not-so-super-secret other project, they might also realize that they've seen this post before elsewhere. I had to stay out late for a work-related event and decided to tart it up and recycle. So sue me.) I'm also into science fiction (hence the very name of this blog, not to mention the pseudonym I use), computers, and baseball, not to mention politics (at least more than average). That's why our recent election, coming as it did…
oracknows | July 20, 2012A couple of weeks ago, I had a bit of fun with a rather clueless chiropractor by the name of J.C. Smith (JCS), who decided to take a swipe at an organization with which I'm associated, namely the Institute for Science in Medicine (ISM). It was such an inept attack, filled with misinformation, pseudoscience, and logical fallacies, that it was what I like to call a "teachable moment" when it comes to chiropractors and chiropractic. Even more amusingly, JCS promised at the end of his post lambasting ISM as a new "medical mafia" that he would be writing a followup post. I could hardly wait. The…
terrasig | May 4, 2009My clinical counterpart, surgical oncologist Dr David Gorski, has an excellent post up today at Science-Based Medicine on the irresponsible and misleading information being provided at The Huffington Post during the current H5N1/2009 influenza ("swine flu") outbreak. "The Huffington Post's War on Medical Science: A Brief History" provides a cautionary tale for us in embracing web-based news sources as our excellent print newspapers are going by the wayside.
Within the post, Dr Gorski shows that he is even more familiar with my writing than myself by citing a post at the old Terra Sig on the…