Month: March 2013

More shameless self-promotion that is, I hope, at least entertaining

Three weeks ago, I gave a talk to the National Capital Area Skeptics at the National Science Foundation in Arlington, VA. The topic was one near and dear to my heart, namely quackademic medicine. I was informed the other day that the video had finally been posted. Unfortunately, there were some problems with the sound in a couple of places, which our...

/ March 29, 2013
Placebonex

Behold the spin! What a new survey of placebo prescribing really tells us

One of the recurring topics here at SBM is the idea of the placebo: What it is, what it isn’t, and how it complicates our evaluation of the scientific evidence. One my earliest lessons after I started following this blog (I was a reader long before I was a writer) was that I didn’t understand placebos well enough to even describe them...

/ March 28, 2013

Evidence Thresholds

Defenders of science-based medicine are often confronted with the question (challenged, really): what would it take to convince you that “my sacred cow treatment” works? The challenge contains a thinly veiled accusation — no amount of evidence would convince you because you are a nasty skeptic. There is a threshold of evidence that would convince me of just about anything, however. In...

/ March 27, 2013

What Does ND Mean?

Chronic Lyme disease almost certainly does not exist, but a growing number of doctors are diagnosing and treating it with long-term antibiotics and other remedies. They are known as LLMDs (“Lyme Literate” medical doctors). This subject has been covered repeatedly on Science-Based Medicine, here, here, here, here, and elsewhere. I have a correspondent who joined a Yahoo group for Lyme disease (Northern...

/ March 26, 2013

Once more into the screening breach: The New York Times did not kill your patient

One of the more depressing things about getting much more interested in the debate over how we should screen for common cancers, particularly breast and prostate cancer, is my increasing realization of just how little physicians themselves understand about the complexities involved in weighing the value of such tests. It’s become increasingly apparent to me that most physicians believe that early detection...

/ March 25, 2013

A little Swedish interlude

I’ve been remiss in not mentioning this; so I’ll try to make up for it now. Recently, I did an interview on the Skeptikerpodden, a Swedish podcast. Unless you speak Swedish, you won’t understand much else of the podcast, but don’t worry. I don’t speak Swedish either, which is why my interview is in English. It starts at around the 44:00 mark.

/ March 23, 2013

Comprehending the Incomprehensible

Medicine is impossible. Really. The amount of information that flows out the interwebs is amazing and the time to absorb it is comparatively tiny. If you work, sleep and have a family, once those responsibilities are complete there is remarkably little time to keep up with the primary literature. I have made two of my hobbies (blogging and podcasting) dovetail with my...

/ March 22, 2013

At Your Own Risk

In 2011, Americans spent some $30 billion on dietary supplements. Yet, except for the industry itself and a few politicians and “health freedom” advocates, you’d be hard pressed to find anyone (who’s given it some thought) of the opinion that dietary supplement regulation is adequate. Three recent reports, two from the government and one from a newspaper, demonstrate why this near-universal conclusion...

/ March 21, 2013

Clinical Decision-Making Part III

In part I of this series I discussed clinical pathways – how clinicians approach problems and the role of diagnosis in this approach. In part II I discussed the thought processes involved in deciding which diagnostic tests are worth ordering. In this post I will discuss some of the logical fallacies and heuristics that tend to bias and distort clinical reasoning. Many...

/ March 20, 2013

Dr. Amen’s Love Affair with SPECT Scans

Daniel Amen loves SPECT scans (Single Photon Emission Computed Tomography). And well he should. They have brought him fame and fortune. They have rewarded him with a chain of Amen Clinics, a presence on PBS, lucrative speaking engagements, a $4.8 million mansion overlooking the Pacific Ocean, and a line of products including books, videos and diet supplements (“nutraceuticals”).  He grossed $20 million...

/ March 19, 2013