Denialism Blog

Denialism Blog

  • Another assault on Evidence-based medicine

    Except this time it’s from the right! Richard Dolinar of the Heartland Institute (a crank tank) writes in TCS Daily that evidence-based medicine (EBM) is bad for patients.

    A new buzzword entered the medical lexicon in 1992 when the Evidence-Based Medicine Working Group published one of the first articles on the phenomenon in the Journal of the American Medical Association (JAMA). In the years since, the role that evidence-based medicine (EBM) plays in medical care has increased exponentially. Some now question whether it should play such a prominent role.

    “[EBM is not] medicine based on evidence, but the equivalent in the field of medicine of a cult with its unique dogma, high priest … and fervent disciples,” says Dr. John Service, editor-in-chief of Endocrine Practice. Indeed, if a doctor questions EBM today, it seems he or she runs the risk of being branded an infidel or heretic, or worse.

    Now there is a bad sign. When someone calls medicine a cult, you know you’re about to hear some real nonsense, usually from an altie. But hey, I’ll give them a chance. Why exactly is it that I’m supposedly studying to be a priest in this cult?

    Proponents of EBM assume it will improve the quality of health care by basing medical decisions primarily on statistically valid clinical trials; therefore, information gained from randomized clinical trials (RCT) preempts information from all other sources. Yet, isn’t it ironic that a review of the literature by this author and others turns up no evidence as defined by EBM to validate this assumption?

    Holy FSM! He searched the entire medical literature and found that there aren’t any articles scientifically showing that science works! Wait what? That can’t be right.

    “The failure to conduct a randomized controlled trial, the recognized best form of evidence according to EBM, and reliance on expert opinion, namely theirs (the worst form of evidence according to them), hoist EBM by its own petard,” notes Service. EBM purports to provide “statistical proof” when in fact what it provides is “statistical data.” Data does not necessarily equate to proof. Data is open to interpretation, which can change over time or vary depending upon one’s perspective.

    Page epistemiology! We have an emergency – our patient is having a crank attack! I guess they have a point, we’re clearly ignoring all those other methods of acquiring medical knowledge besides the RCT. I mean, we don’t really know they work. All they do is provide highly replicable data showing the efficacy of various medical interventions in different patient populations. That’s just data, not “truth”. Now divining, that must be how you find truth. I also think that he’s not just being cranky, he’s also just completely wrong. As I’ve pointed out many times John Ioannidis does just this kind of work (note the presentation, not the PLoS paper, is more relevant to RCTs).

    It gets worse, and I mean, much much worse. And I’m left wondering what the hell kind of denialism the Heartland Institute is up to now?

    Continued…

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  • Good news on the HIV/AIDS front? Mbeki is out

    While I can’t say for sure the new guy will be any better on HIV/AIDS denialism, it’s hard to image he’d be worse than South African President Thabo Mbeki, who just lost power.

    The new guy sounds like a nutbag, but maybe we can see this issue, which negatively affects the lives of millions of South Africans, improve under new leadership. The LA Times coverage suggests Zuma will be more assertive on AIDS, but at the same time, there are serious criminal allegations against him and some really disgusting behaviors and actions which diminish enthusiasm.

    Time will tell.

  • Obesity Crankery – A growing problem

    Recently, it seems there has been a backlash against medicine and the current knowledge of the relationship between diet, weight and overall health. I don’t actually believe this is directly the fault of scientists or doctors, who react to the trashy mainstream reporting of science with little more than the occasional raised eyebrow. However, many people in response to all these silly health pronouncements, which seemingly come from on high but really are from press coverage of often minor reports in the medical literature, have lost their trust in what science has to offer as a solution to what Michael Pollan refers to as “the Omnivore’s Dilemma”. That is, what should we be eating?

    The result of this confusion is a mixture of distrust, cynicism, and receptivity to crankery and lies about diet. After all, if science ostensibly can’t keep their message straight, who knows what to believe?

    The fact is, science knows many things about the relationship between diet, obesity, and health with great confidence and it hasn’t changed nearly so much as the popular press would have you believe. The failure to state clear messages about nutrition is a reflection on the haphazard way in which nutritional health is reported, the often confusing nature of epidemiologic science, and the various parties that are interested in cashing in the confusion by promoting their own nonsensical ideas about diet.

    Take, for example, Sandy Szwarc. Sandy doesn’t believe obesity or any food choices are actually bad for you. To help spread this nonsense she dismisses valid sources of information like WebMD (which has quite good information) based on the rather silly conspiracy that they have designed their entire website and health enterprise around misleading people into using their products – especially weight-loss products. Because, you know, it’s impossible for a corporation to offer free health advice as a public service without conspiring to grab you buy the ankles and shake the money from your pockets. But it doesn’t end there. We see rest of the standard denialist tactics of course!

    Case in point, in a recent article she makes the astonishing assertion that her mortal enemy – bariatric or gastric-bypass surgeons – have admitted that obesity makes you healthier!

    Today brought another unbelievable example of ad-hoc reasoning, as well as a remarkable admission that the war on obesity is without scientific merit. It appeared in a paper published in the journal for the American Society for Bariatric Surgery (now calling itself the American Society for Metabolic and Bariatric Surgery), which is edited by the Society’s president, Dr. Harvey Sugerman, M.D. FACS.

    The article, “Do current body mass index criteria for obesity surgery reflect cardiovascular risk?” was “work presented at the 2005 American Society for Bariatric Surgery Meeting in poster form.” The authors, led by Edward H. Livingston M.D. at the University of Texas Southwestern School of Medicine, reported that the conventional risk factors for cardiovascular disease “decreased with increasing degrees of obesity.”

    Yes, you read that correctly, decreased.

    “Therefore,” the authors argued …

    “the criteria for obesity surgery should be changed to lower BMIs than are currently used.”

    Now, boys and girls, what is the very first thing you do when a suspected denialist feeds you some nonsense in quotes? Check the source! Always, always, always, check the source. Let’s expand those six words that Sandy lifted out of the abstract and see what else the authors had to say:

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  • Sexism or just idiocy from Cato?

    I’m flattered that Pandagon liked our post on a terrible ad campaign for diamonds.

    But if Amanda thought that was bad, she should see some of the latest “reason” coming from our libertarian friends at Cato. David Boaz writes a post for Cato entitled “All Those Who’d Like to Live in Rwanda, Vietnam, or Cuba, Raise Your Hands” in response to a Parade article complaining about the lack of female representatives in Congress:

    Parade magazine frets:

    In the current U.S. Congress, women account for only 16.3% of the members: 16 of 100 in the Senate and 71 of 435 in the House of Representatives. Eighty-four nations have a greater percentage of female legislators than the U.S., including our neighbors Mexico and Canada, as well as Rwanda, Vietnam and Cuba.

    It’s not exactly clear that legislatures with more women produce better government. So why, then, as Parade notes, does the United States demand that emerging democracies have gender quotas that we would never accept in our own politics?

    After the overthrow of the Taliban in Afghanistan and of Saddam Hussein in Iraq, the United States made sure that when those two countries held elections, 25% of the seats in their legislatures would be reserved for women.

    So what do we think people? Stupid? Sexist? Both?

    No one in their right mind would read the quoted paragraph from Parade and make the idiotic leap that they were suggesting those governments are better. In fact, it’s a sign of how pathetic it is that our government lacks women that these governments we consider repressive still manage to surpass us in female representation. It’s a little bit like being behind Alabama in adult literacy. Gender quotas, further, are necessary to prevent countries that have deep problems with female equality from oppressing 50% of their population.

    Why is Boaz playing stupid with us? He knows full well the purpose and reasoning in both cases. Is there no better argument sexists can use for the promotion of the status quo than the “duh” card?
    i-718334aad1cbe6244e3c870624c6a80d-8s.jpg

    It is pathetic we don’t have more women in congress because after all these years, almost 90 now since women’s suffrage, we still don’t have anything approaching equal representation in government. We have never elected a female president. Why does it matter? Because as long as moralizing cranks are going to occupy office and make decisions impinging on women’s health, and not men’s we’ve got a problem. When Viagra gets covered by government health programs but contraception is cut, we’ve got a huge problem. When the best solution government can come up with for improving families is covenant marriage, and abstinence education in the face of higher teen pregancy rates, we’ve got a ridiculous problem. Other than just fundamental fairness, recognition of the equality of females, and human decency there are specific instances in which women are having decisions made for them that affect their health and their bodies by a majority male government, and I don’t think that’s a coincidence.

    Surely these are arguments for advocating women in government that even an libertarian could understand. I hope we don’t have to dumb it down even more.

  • A question for Mathematicians – What is (monogamy)100

    So asks the copyranter over this latest example of human stupidity:

    i-953473e0ce0597981fe8907060f97950-HOF.jpg

    What’s even funnier than the absurd notion that a “Hearts on Fire” diamond will buy you monogamy (or that diamond purchases aren’t so frequently given in penitence for the sins of infidelity) is that really all it says is your man is a sucker.

    Not everyone agrees that the cut is special. If you wander New York’s diamond district on 47th Street and ask about Hearts on Fire, you’ll hear that it’s just another ideal-cut diamond, differentiated only by its marketing.

    Charles Rosario, a senior vice-president at Lazare Kaplan, another company that makes an ideal-cut branded diamond, says that even a cubic zirconia can display a hearts-and-arrows pattern, and that the pattern is not a “scientific criterion for brilliance.” Some of the disparagement, though, stems from annoyance that Rothman was the one to capitalize on the marketing potential of the hearts-and-arrows pattern.

    Basically, this diamond costs you about 30% more, but there is no actual value added by the branding. In other words, it’s just a scam. You can get any diamond cut in this pattern, but they put a slogan on it, and therefore can charge you more. I find it astounding how easy it is to part a fool and their money, and that slogans like (monogamy)100 work. What does that even mean?

    Like the Copyranter asks “If my future wife bangs the entire roster of the Manchester United football squad a week after I give her a HOF diamond, do I get 100 times my money back?”

    I don’t know. Maybe he should. Is it an explicit guarantee? If not, then you’re just (stupid)100 for spending 30% more on a slogan.

  • Cectic, keeping the fight against dogmatic parentism alive

    I’m in DC this week working for Dr. Mom and getting my physical exam skills back up to snuff, so I’ll be a little quiet. In the meantime, Cectic is keeping the dream alive:

    I love these guys.

  • Surely we can get KBR under RICO

    Reading about the latest atrocity by KBR that is the cover up of a rape of a US citizen by its contractors (apparently one of many), I ask the lawyers a question. Surely there is enough on KBR (formerly known as the evil wing of Halliburton – now independent) now to get a RICO indictment on them, correct?

    I realize they do this all overseas where they apparently enjoy complete immunity from anything ranging from fraud to cannibalism. But I have difficulty believing that they manage to keep 100% of their criminal misbehavior overseas. I mean, every time we hear some bad news about Halliburton, it isn’t actually Halliburton. It’s always these crooks at KBR. I would ask where are the Democrats on this, but what seems more apt is where are the Republicans? They’re supposed to be the law and order party. Where’s the law and order? This poor woman gets raped, and then after reporting it imprisoned in a shipping crate by KBR. Probably the only reason she didn’t end up in a shallow grave in the desert is she got a cell phone call in to her father who then contacted their congressman and the state department.

    And what is with this arbitration nonsense? At a certain point, such as after gang rape, your contract with your company is no longer valid and you get to sue them in federal court for civil rights abuse.

  • Mike Adams is so stupid it hurts

    Yes, I know, I’m stating the obvious again. But I just couldn’t resist when I saw this. In his never-ending quest to attack all science that doesn’t affirm his belief that vitamin D and fruit smoothies will cure all disease, he’s gone after the new new induced pluripotent stem cell findings. As far as I know, he’s the only one to criticize the new technology as a whole, and his reasoning?

    Really I can’t believe he’s this stupid. Reasoning, is the wrong word for this.

    Let’s ask instead, what is his demented, completely ignorant, insipid, moronic justification?

    While less controversial, the stem cells produced by the new technique appear to be carcinogenic. When Yamanaka’s team implanted the cells into mouse embryos, those embryos developed as expected — with the DNA of the original stem cell, not of the embryo. But mice cloned in this fashion eventually developed neck tumors.

    “It seems that everyone in the mainstream media is so excited about this new stem cell technique that they forgot to notice the fact that it leads to the growth of cancer tumors,” said consumer health advocate Mike Adams.

    That’s right, they cause “cancer tumors”. I’m not sure what I find the most stupid about Adams’ analysis. Is it that he acts like he’s discovered something that everyone, including our blog, has acknowledged is a current problem with the technology? Is it the idiotic assumption that we are already thinking about injecting these cells willy-nilly into embryos? Is it his knee-jerk tendency to attack any legitimate medical advance? Or is it his description of the problem as “cancer tumors”?

    Ah well, what can you expect from a guy who publishes germ theory denial on his website. If you want a laugh read the explanation of how raising your blood pH (generally considered a really bad idea – luckily your body won’t let you alter its pH easily) is the solution to all disease.

    I can’t really bring myself to do more than just point and laugh at this denialism. I’m too busy studying real medicine.

  • So That's What Anesthesiologists Do

    I have to spend a few days doing anesthesiology during my surgery rotation, luckily one of the other med students forwarded this helpful video.

    I had no idea it was so complicated.

    I also like the drug song:

  • Here's my impression of Barry Arrington

    I don’t have the time to be anything but a jerk today so I’m going to imitate Barry Arrington of Uncommon Descent, who tried to place the blame for the most recent shootings at a church on atheist writers.

    You see, yesterday, there was an attack on the New York subway. In one of those events generally embarrassing (and oddly redeeming) for humanity, a man was attacked for replying “Happy Hanukkah” when someone wished him “Merry Christmas”. Oddly, the fight was broken up when a Muslim guy rescued the Jewish guy from the Christian guy.

    Now, if I was a giant screaming asshole like Barry A, I’d say something like, “People like Bill O’Reilly who make up the imaginary ‘war on Christmas’ or Ann Coulter and her remarks about Christians being ‘perfected Jews’ should consider themselves responsible for this event. If they didn’t promote their pro-Christmas, pro-Christian agenda, no one would feel the need to attack Jewish people for wishing them a Happy Hanukkah.”

    After all, crazy assholes aren’t responsible for their behavior. It’s the people who write books! They were just following orders (still looking for those “kill Christians” orders in The God Delusion). Just like the Matrix made the DC sniper kid shoot all those people – it was the movie’s fault, not the kid’s. And this bus stop shooting over a girl, if right wingers weren’t constantly pushing a heterosexual agenda, maybe we wouldn’t see people killing over heterosexual sex.

    You see? It’s easy to be a giant asshole. All you have to do is take your ideology, ghoulishly apply it to recent tragedies so as to scapegoat whoever you dislike, and then act surprised when people think you’re a monster. How’d I do?