All posts by Steven Novella

Founder and currently Executive Editor of Science-Based Medicine Steven Novella, MD is an academic clinical neurologist at the Yale University School of Medicine. He is also the president and co-founder of the New England Skeptical Society, the host and producer of the popular weekly science podcast, The Skeptics’ Guide to the Universe, and the author of the NeuroLogicaBlog, a daily blog that covers news and issues in neuroscience, but also general science, scientific skepticism, philosophy of science, critical thinking, and the intersection of science with the media and society. Dr. Novella also contributes every Sunday to The Rogues Gallery, the official blog of the SGU.

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

Clinical Decision-Making: Part II

This is the second in a brief series of posts about how clinicians think. My purpose here is to elucidate how skeptical principles apply to clinical decision-making, but also as background to provide context to many of the articles we publish here.  In this installment I will review the factors that clinicians consider when deciding what tests to order for screening and...

/ March 13, 2013

Clinical Decision Making: Part I

I practice in a university clinic which functions partly as a tertiary referral center, which means we get referrals from other specialists. I also get many referrals for second opinions. Sometimes the entire cause for the patient’s desire for a second opinion, it seems to me, is the simple fact that they did not understand the reasoning of the previous specialist. They...

/ March 6, 2013

Doctors and Dying

“I intend to live forever. So far, so good.” – Steven Wright The humor in many of comedian Steven Wright’s famous one-liners is that they are simultaneously familiar and absurd. At some level we all know that we are going to die, but as long as we are still alive (or a loved-one is alive) we can cling to the irrational hope,...

/ February 27, 2013

SBM e-Books

[NEW POSTS JUST BELOW THIS POST] I am happy to announce that Science-Based Medicine has published three e-Books: Science-Based Medicine’s Guide to Naturopathy Kindle | iBooks | Nook Science-Based Medicine’s Guide to Miscellaneous CAM Kindle | iBooks | Nook Science-Based Medicine’s Guide to Homeopathy Kindle | iBooks | Nook

/ February 20, 2013

Mouse Model of Sepsis Challenged

A recent study published in the Proceedings of the National Academy of Sciences calls into question the standard mouse model of sepsis, trauma, and infection. The research is an excellent example of how proper science investigates its own methods. Mouse and other animal models are essential to biomedical research. The goal is to find a specific animal model of a human disease...

/ February 13, 2013

Dynamic Neural Retraining

Snake oil often resides on the apparent cutting edge of medical advance. This is a marketing strategy – exploiting the media hype that often precedes actual scientific advances (even ones that don’t eventually pan out). The slogan of this approach could be, “Turning tomorrow’s possible cures into today’s pseudoscientific snake oil.” The strategy works because, to the average person, the claims will...

/ February 6, 2013

Are You Ready For the Oz Manifesto

“Medicine is a very religious experience. I have my religion and you have yours. It becomes difficult for us to agree on what we think works, since so much of it is in the eye of the beholder. Data is rarely clean. You find the arguments that support your data, and it’s my fact versus your fact.” – Mehmet Oz The above...

/ January 30, 2013

Pandemrix and Narcolepsy

In 2010, following the H1N1 pandemic and the vaccination campaign to reduce its impact, researchers noted a significant increase in a rare neurological disorder, narcolepsy, in Sweden and Finland. Since then researchers have been studying a possible association between a specific H1N1 flu vaccine, Pandemrix by Glaxo-Smith-Kline (GSK) and a sudden onset of the sleep disorder narcolepsy. In those two countries the...

/ January 23, 2013
Yes, it's true that placebos are just as powerful as homeopathy. Unfortunately, that doesn't mean what believers in integrative medicine think it does.

The Placebo Narrative

Science journalist Sharon Begley wrote a recent piece in The Saturday Evening Post about Placebo Power. The piece, while generally better than the typical popular writing on placebos, still falls into the standard placebo narrative that is ubiquitous in the mainstream media. The article is virtually identical to a dozen other articles I have read on placebo effects in the popular press,...

/ January 16, 2013