The Importance and Limitations of Peer-Review
Peer-review is a critical part of the functioning of the scientific community, of quality control, and the self corrective nature of science. But it is no panacea. It is helpful to understand what it is, and what it isn’t, its uses and abuses. Overview When the statement is made that research is “peer-reviewed” this is usually meant to refer to the fact...
Attitudes and Public Health
Increasingly there is a cultural trend toward health care freedom and empowerment. This trend is partly a reaction to the paternalism of the past, and reflects an overall change in attitude by the public toward all institutions and authority. Within medicine there has also been a move toward the partnership model of practice – where patients are well-informed full partners in the...
Recognizing Dubious Health Devices
The public is often left to fend for themselves in the marketplace of medical devices and health aids. Current regulations in most countries are inadequate to prevent grossly misleading claims in advertising and to provide adequate evidence for safety and effectiveness for products on the market. So it is helpful for consumers to be aware of the red flags for dubious devices...
Pro-CAM Wikipedia – Skeptics Need Not Apply
The internet is arguably the ultimate expression of democracy and the free market. For the cost of internet access anyone can pull up a virtual soap box and preach to the world. There are no real gatekeepers, and the public can vote with their search entries, clicks, and links. Every point of view can be catered to and every special interest satisfied....
Calories In – Calories Out
There is general agreement that the US, and the West in general, is in the midst of an obesity epidemic. Even if you think this is alarmist or overstating the situation, the data clearly shows a steady expansion of the American waistline. Weight loss is a multi-billion dollar industry and is an active area of research, and yet all the self-help books,...
HIV Treatment Extends Life Expectancy
People with HIV are living longer on the latest anti-retroviral therapy. This is something any infectious disease specialist knows from their own clinical experience – but it’s reassuring (I would even argue necessary) to have objective data to support experience. A study published in the latest issue of Lancet provides this objective data. (Lancet. 2008 Jul 26;372(9635):293-9.) The press release from Bristol...
Autism and Vaccines: Responding to Poling and Kirby
In response to my NeuroLogica blog post on Monday, David Kirby wrote a response in the Huffington Post and Dr. Jon Poling (father of Hannah Poling) wrote an open letter to me, placed in the comment section and posted at Age of Autism. It seems only polite that I respond to their kind attention.The primary focus of my original post (which I...
A Guide for Confronting Patients
I sometimes lecture on science-based medicine to my colleagues and one of the most common questions I get is how to deal with a patient who expresses belief in unscientific treatments. The dilemma for the physician is that professionalism requires that we do not confront patients regarding their personal beliefs. We are there to inform and advise, not preach. And yet proper...
Should We Study Chelation for Autism?
The National Institute of Mental Health (NIMH) supports doing a study on the effects of oral chelation therapy in autism. The proposal is highly controversial, is drawing criticism from many scientists, but has popular support among parents who believe this type of therapy might help their children with autism. The proposal raises many questions about the ethics of biomedical research. Chelation and...
The Bait and Switch of Unscientific Medicine
Savvy consumers are familiar with the classic scam of the “bait and switch” – in practice if not the term itself. My wife and I ran across it when we were shopping for our first car. We needed a bargain and so we were attracted to the ads that promised a new Colt for only $9,000 (that’s the bait). Of course when...