Month: December 2009

Radiation from medical imaging and cancer risk

Science-based medicine consists of a balancing of risks and benefits for various interventions. This is sometimes a difficult topic for the lay public to understand, and sometimes physicians even forget it. My anecdotal experience suggests that probably surgeons are usually more aware of this basic fact because our interventions generally involve taking sharp objects to people’s bodies and using steel to remove...

/ December 21, 2009

Measles

It looks like the H1N1 pandemic is fading fast. I am amazed at how lucky we were, at least in the hospitals where I work. A month ago all the ICU beds were full, most of the ventilators were in use and we were wondering how we were going to triage the next batch of patients who needed advanced life support and...

/ December 18, 2009

Are the benefits of breastfeeding oversold?

As a mother, I am a passionate advocate of breastfeeding and I breastfed my four children. As a clinician, though, I need to be mindful not to counsel patients based on my personal preferences, but rather based on the scientific evidence. While breastfeeding has indisputable advantages, the medical advantages are quite small. Many current efforts to promote breastfeeding, while well meaning, overstate...

/ December 17, 2009

Communicating with the Locked-In

The primary reason that I and others favor science-based medicine, as opposed to the alternatives, is that science works. As Carl Sagan said, “Science delivers the good.” Science has other virtues – it is transparent and self-corrective also. Recently two unrelated news items have provided an opportunity to compare a scientific vs a pseudoscientific approach to the same problem – that of...

/ December 16, 2009

The One True Cause of All Disease

Note: This is a slightly modified version of an article that was published in the magazine Skeptical Inquirer, Volume 34, No. 1, January/Februrary 2010. It is reprinted here with the kind permission of the Committee for Skeptical Inquiry. —————– Chiropractors, homeopaths, naturopaths, acupuncturists, and other alternative medicine practitioners constantly criticize mainstream medicine for “only treating the symptoms,” while alternative medicine allegedly treats “the underlying causes”...

/ December 15, 2009

Acupuncture, the P-Value Fallacy, and Honesty

Credibility alert: the following post contains assertions and speculations by yours truly that are subject to, er, different interpretations by those who actually know what the hell they’re talking about when it comes to statistics. With hat in hand, I thank reader BKsea for calling attention to some of them. I have changed some of the wording—competently, I hope—so as not to...

/ December 15, 2009

Another wrinkle to the USPSTF mammogram guidelines kerfuffle: What about African-American women?

A while back I wrote about rethinking how we screen for breast cancer using mammography. Basically, the USPSTF, an independent panel of physicians and health experts that makes nonbinding recommendations for the government on various health issues, reevaluated the evidence for routine screening mammography and concluded that for women at normal risk for breast cancer, mammography before age 50 should not be...

/ December 14, 2009

Cell phones and cancer again, or: Oh, no! My cell phone’s going to give me cancer! (revisited)

It’s been about a year and a half since I’ve written about this topic; so I thought I’d better update the disclaimer that I wrote at the beginning: Before I start into the meat of this post, I feel the need to emphasize, as strongly as I can, four things: I do not receive any funding from the telecommunications industry in general,...

/ December 14, 2009

The End of Chiropractic

An article written by 3 chiropractors and a PhD in physical education and published on December 2, 2009 in the journal Chiropractic and Osteopathy may have sounded the death knell for chiropractic. The chiropractic subluxation is the essential basis of chiropractic theory. A true subluxation is a partial dislocation: chiropractors originally believed bones were actually out of place. When x-rays proved this was...

/ December 11, 2009

An Influenza Recap: The End of the Second Wave

We are nearing the end of the second wave of the 2009 H1N1 pandemic, and are now a few months out from the release of the vaccine directed against it.  Two topics have dominated the conversation: the safety of the 2009 H1N1 influenza vaccine, and the actual severity of the 2009 H1N1 infection.  Considering the amount of attention SBM has paid the...

/ December 11, 2009