Month: July 2011

Pictured: A really delicious pair of beer goggles ready to be put in my face.  I mean on my face.

CAM: The Beer Goggles of Medicine

It is summer, the kids are off, and time to write dwindles in the face of sun and golf. Nonsense knows no season, and in my readings this week I came across the phrase “the undeniable power of the placebo.” I will do my best to deny that power at least three times before I crow my conclusion. One of my first...

/ July 29, 2011

Consumer Reports drops the ball on alternative medicine

Ever since I was a teenager, I’ve intermittently read Consumer Reports, relying on it for guidance in all manner of purchase decisions. CR has been known for rigorous testing of all manner of consumer products and the rating of various services, arriving at its rankings through a systematic testing method that, while not necessarily bulletproof, has been far more organized and consistent...

/ July 28, 2011

Varicella Vaccination Program Success

One of the basic human “needs” is the desire for simplicity. We have limited cognitive resources, and when we feel overwhelmed by complexity one adaptive strategy is to simplify things in our mind. This can be useful as long as we know we are oversimplifying. Problems arise when we mistake our schematic version for reality. In this same vein we also like...

/ July 27, 2011

Angell’s Review of Psychiatry

Marcia Angell has written a two-part article for The New York Review of Books: “The Epidemic of Mental Illness: Why?” and “The Illusions of Psychiatry.” It is a favorable review of 3 recent books: The Emperor’s New Drugs: Exploding the Antidepressant Myth by Irving Kirsch Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America...

/ July 26, 2011

On the Orwellian language and bad science of the anti-vaccine movement: “SmartVax” versus “MaxVax”?

If there’s one thing that’s true of the human race, it’s that when it comes to persuasion language is has power. Words have power. Just ask the advertising industry or politicians, who rely on their skills manipulating language to persuade for their very livelihood and authority. In the specific bailiwick of this blog, Science-Based Medicine, many of us have spent considerable verbiage...

/ July 25, 2011

Asthma, placebo, and how not to kill your patients

A number of years ago I was walking along Lake Michigan with a friend (a fellow medical resident) when she turned to me and said, “are you wheezing?  Do you have asthma?”  I had always been physically active and assumed my breathlessness while walking down the trail was due to the thirty extra pounds of pizza and doughnuts I’d acquired during residency....

/ July 23, 2011

Dummy Medicines, Dummy Doctors, and a Dummy Degree, Part 1: a Curious Editorial Choice for the New England Journal of Medicine

Background This post concerns the recent article in the New England Journal of Medicine (NEJM) titled “Active Albuterol or Placebo, Sham Acupuncture, or No Intervention in Asthma.” It was ably reviewed by Dr. Gorski on Monday, so I will merely summarize its findings: of the three interventions used—inhaled albuterol (a bronchodilator), a placebo inhaler designed to mimic albuterol, or ‘sham acupuncture’—only albuterol...

/ July 22, 2011

Salt: More confirmation bias for your preferred narrative

Judging by the recent press reports, the latest Cochrane review reveals that everything we’ve been told about eating salt, and cardiovascular disease, is wrong: The New York Times: Nostrums: Cutting Salt Has Little Effect on Heart Risk The Daily Mail: Cutting back on salt ‘does not make you healthier’ (despite nanny state warnings) Scientific American: It’s Time to End the War on...

/ July 21, 2011

Behavior and Public Health – To Nudge or Legislate

As health care costs rise and great attention is being paid to the health care system in many countries (perhaps especially the US), the debate is heating up over how to improve public health. Many health problems are greatly increased by the lifestyle choices individuals make – smoking, weight control, and exercise to name a few. The problem is that it is...

/ July 20, 2011

Antidepressants and Effect Size

Antidepressant drugs have been getting a bad rap in the media. I’ll just give 3 examples: On the Today show, prominent medical expert 🙂 Tom Cruise told us Brooke Shields shouldn’t have taken these drugs for her postpartum depression. In Natural News, “Health Ranger” Mike Adams accused pharmaceutical companies and the FDA of covering up negative information about antidepressants, saying it would be considered...

/ July 19, 2011