Denialism Blog

Month: August 2008

  • I am embarrassed

    by the San Francisco Chronicle for giving a lot of uncritical coverage to a pet psychic in “Marla Steele makes pet talk a two-way street.” This “psychic” discusses Reiki (and the ability to do it from a distance–“energy broadcasting”), among other thing. And here’s the reporter’s hardball question:

    What do you say to skeptics? I completely appreciate people’s skepticism. I first heard about animal communication from a coworker at Nordstrom’s who was paying $100 to talk to a pet psychic in Oregon about her German Shepherd. I always listened politely to her stories, but secretly thought she must just have money to burn, or be crazy, or both. Now we laugh because I not only became a pet psychic, I also appear on radio and television talk shows all over the country.

    Pathetic!

  • Doctors aren't preachers (or at least they shouldn't be)

    I’ve written a number of times about how a physician must be careful not impose his or her personal beliefs on patients.

    Another interesting case has hit the news. The decision of the California Supreme Court hinged on interpretation of state non-discrimination law. I’m not a lawyer, but I do know a bit about medicine and medical ethics. Regardless of law, this doctor’s behavior was wrong. The details are a little sketchy, but an unmarried lesbian woman was denied fertility treatments by a California doctor because the treatment conflicted with the doctor’s faith.

    Conflicted with the doctor’s faith. There’s the rub.
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  • Seeding trials—no relation to Seed Media Group, LLC

    ResearchBlogging.orgI’ve been having an internal debate about whether to write on this issue, not because it isn’t interesting, not because it isn’t important, but because it’s getting so much coverage and I’m not sure how much I can add to the conversation.

    But it so infuriated me that I must blog. Science-based medicine relies on medical evidence. It relies on being able to grade medical evidence by its quality and strength, and to do this, there must be a certain level of transparency.

    I’m only a little bit idealistic. I know that drug companies must fund clinical trials if we ever want to see new drugs. That is why we have “conflict of interest” statements included in most medical studies—so that we may view the data with a somewhat jaundiced eye, if necessary.

    Until two days ago, I’d never heard of a “seeding trial”. Now I have, and I’m not happy.
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  • Trick or Treat! Alternative Medicine Book Review in the Journal

    Today’s Journal is worth a read for this important development: something reasonable actually appeared in the Opinions section! Scott Gottlieb, one of the AEI’s ogres, penned a review of Trick or Treatment, a book on America’s obsession with alternative medicines, by Simon Singh and Edzard Ernst. This apparently is not your typical rant against alternative medicines. Gottlieb notes:

    …Based at the University of Exeter in England, [Dr. Ernst] leads a research group that has spent 15 years studying alternative remedies, trying to separate snake oil from science. Mr. Singh, his co-author, is a science journalist whose books include “Fermat’s Enigma” and “Big Bang.” Together they conclude, after cataloging the evidence, that most of the popular forms of alternative medicine are “a throwback to the dark ages.” Too many alternative practitioners, they say, are “uninterested in determining the safety and efficacy of their interventions.”

    Why do Americans stick to alternative medicines? The answer given by the authors is one observed my many Sciencebloggers:

    “Alternative medicine is not so much about the treatments we discuss in this book,” the authors write, “but about the therapeutic relationship. Many alternative practitioners develop an excellent relationship with their patients that helps to maximize the placebo effect of an otherwise useless treatment.” To bring all treatments in line with rigorous science, an “excellent relationship” between doctor and patient is a good place to start.

    I only have one, general observation about these remedies and their hype: being in California, it’s interesting to meet so many people who are very skeptical of the Pharmaceutical industry’s claims that at the same time gobble vitamins and unknown (probably fully leaded) “ancient”/”herbal”/”natural” remedies that make totally outlandish health claims. I think this is attributable to Ernst & Singh’s observation about managing excellent patient relationships. It makes no sense to be so skeptical of big pharma while being an evangelist of enzyte.

  • How we know what we know

    Over the last few decades, the nature of medical knowledge has changed significantly. Before the revolution in evidence-based medicine, clinical medicine was practiced as more of an art (in the “artisan” sense). Individuals were treated empirically with a strong knowledge of medical biology, and the guidance of “The Giants”, or particularly skilled and respected practitioners. While the opinions of skilled practitioners is still valued, EBM adds a new value—one of “show me the evidence”.

    Evidence-based medicine refers to the entire practice of gathering and applying medical knowledge. This includes evaluating diagnostic tests (e.g. how well does an CT scan diagnose pulmonary embolism?) and evaluating treatments (e.g. which anticoagulant is most effective, which one is safer, how long should you treat, etc.) There will always be some questions that are untestable, and some for which no testing is needed, and practices for which evidence is sketchy.

    In corresponding with a friend recently, I started thinking about how we look at the quality of medical evidence, and how we can communicate this to the lay public.

    Let’s take, for example, cholesterol.
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  • Helpful hints for Creationist Cults

    Answers Research Journal, the teleologic, Apologetic, unscientific screed put out by Answers in Genesis has so far done nothing resembling science. But I now have an idea for them, although I’m not sure if it’s been proposed.

    So far, their “research” has taken the form of trying to find “facts” to fit their conclusions that the Bible is an inerrant science and history text. Well, here’s an idea for them. Since I’m not a biologist, it will ned some cleaning up.

    Hypothesis: The Biblical Deluge occured at a certain time which is knowable from scripture. The events surrounding it is known from scripture. Therefore, scientific facts should confirm these events.

    What is one of the singular biological events of the Flood? Two. By. Two. A small founder population of each species to repopulate the globe. If this in fact happened, it should be possible to do genomic analysis to show a founder that dates back to the year of the flood.

    This is actual science. Either genetic history of extant species bears out this few thousand year old founder hypothesis, or it doesn’t.

    Onward Christian scientists! Show us what ya’ got!

  • Live forever!

    Look, whether you like it or not, you can’t live forever. I bring this up because there is always a new book or new add purporting to have “the answer” to long life and good health, which never includes modern, evidence-based medicine. Still, perhaps some of these books contains good advice. Or not. Let me explain.
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  • Open thread—troll anmesty

    The recent uptick in troll traffic here and at Orac’s place got me thinking. Many of the trolls have been making unsophisticated attacks on the truth without actually stating a hypothesis. And that got me thinking even more. If they could only state their questions properly, there would be some useful fodder for discussion. There are few stupid questions, but questions can be asked in a fairly useless way. Why not invite people to make interesting assertions, and help them frame the question properly?

    The object of this thread is to invite folks to ask questions that are sometimes dismissed as being wacky, and to show them how to properly ask a question, and perhaps even answer some of them. Many true trolls will refuse to ask a proper question, so this may also serve to separate real questions from simple idiocy.

    So welcome to the troll amnesty thread. Try to state actual medical/scientific questions that have been bothering you. Feel free to post under a new ‘nym if you wish. And if you have a special knowledge, feel free to chime in to help re-frame and answer questions.

  • DrPal, tell us more about HPV and cancer

    OK, if you insist. This comes with the usual caveat directed at scientists that I know this is oversimplified, but I wish to reach the largest audience possible. Feel free to correct my mistakes, but please don’t bother me about oversimplification.

    So here’s the deal. Several decades ago, it became scientifically fashionable to believe that most cancer had a viral cause. This belief coincided with the discovery that some viruses do cause cancer. And while it turns out that most cancers are not caused by viruses (probably), many of them are. Viruses can cause cancers in a number of ways, but since you said you were interested in HPV (human papilloma virus) we can use this as an example.

    First, there is no scientific question about the causal relationship between HPV and cervical cancer (and certain oral cancers, anal cancers, and penile cancers, but we’ll use cervical cancer as shorthand for all of them). There is excellent epidemiologic evidence to support this, and virologic evidence that proves it.

    Now that we’ve got that out of the way, how does this cancer virus thing work?
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  • $30M in Fines for Scam "Created by a Teacher"

    The FTC has piled on Airborne, one of the most annoying consumer scams in the market. The vitamin pill was advertised to prevent colds. And it was created by a teacher! But the FTC concluded:

    …there is no competent and reliable scientific evidence to support the claims made by the defendants that Airborne tablets can prevent or reduce the risk of colds, sickness, or infection; protect against or help fight germs; reduce the severity or duration of a cold; and protect against colds, sickness, or infection in crowded places such as airplanes, offices, or schools.

    If you’ve ever bought Airborne, you can collect on the settlement by visiting http://www.airbornehealthsettlement.com/.

    One interesting aspect of the FTC settlement is that at least one of the agency’s five Commissioners thinks the remedy is too weak. Commissioner Rosch wrote in a dissenting statement that:

    …I believe that the Order provision allowing the defendants to deplete their existing inventory of paper cartons and display trays until October 31, 2008 will continue to perpetuate misperceptions about the products’ ability to prevent or reduce colds…I also believe that the Complaint and the Order should address claims on the current packaging that assert that the product has “immune-boosting” qualities. Finally, and most importantly, it is my opinion that the only way to effectively remove these lingering misperceptions about the qualities of the Airborne Health Products would be to require the defendants to engage in corrective advertising. Therefore, I respectfully dissent.

    Amen! Why let them continue to sell off their bogus products? And I wonder whether $30 million is enough to discourage this behavior? They very well could have made more than that on the unsubstantiated anti-cold claims.

    Now it’s time to go after Airborne’s scam competitors, Walgreen’s Wal-Borne and Air Armor.