Category: Clinical Trials
Glucosamine Update
Osteoarthritis, the “wear-and-tear” type of arthritis, affects a great many of us as we grow older. Knee pain is a common symptom. The diet supplements glucosamine and chondroitin have been proposed as a more “natural” treatment than pharmaceuticals, and they are components of a number of proprietary “joint health” formulations like Osteo Bi-Flex. The GAIT study (Glucosamine/Chondroitin Arthritis Intervention Trial), compared glucosamine,...
A Scientist in Wonderland
Edzard Ernst is one of those rare people who dare to question their own beliefs, look at the evidence without bias, and change their minds. He went from practicing alternative medicine to questioning it, to researching it, to becoming its most prolific critic. I have long admired his work, and I finally met him in person when we were invited to speak...
Is the Ebola Crisis a Reason to Skip RCTs?
In a recent “Perspective” article in The New England Journal of Medicine, three physicians (Drs. Cox, Borio, and Temple) make a strong case for not letting the rush to save Ebola patients tempt us to deviate from good science and skip the randomized controlled trial (RCT). Their arguments cut to the essence of the scientific approach to medicine, and they deserve careful...
Acupuncture for Withdrawal Symptoms in Critically Ill Infants
The practice of medicine, particularly our pharmaceutical and surgical interventions, involves a constant struggle between risk and benefit. If the physiology or anatomy of the human body is altered, even with the best of intentions, there is always a potential downside. There are certainly instances where the risk to benefit ratio is extremely favorable or unfavorable and the right recommendation is obvious,...
Stem cells versus Gordie Howe’s stroke, part 2
Another Christmas has come and gone, surprisingly fast, as always. I had thought that it might make a good “last of 2014” post—well, last of 2014 for me, anyway; Harriet and Steve, at least, will be posting before 2014 ends—to do an end of year list of the best and worst of the year. Unfortunately, there remains a pressing issue that doesn’t...
Stem cells versus Gordie Howe’s stroke
Note: There is now a major update to this story published here, which explains a lot of the questions remaining in this blog post. Seven years ago I returned to Michigan, where I was born and spent the first quarter century of my life, after an absence of more than 20 years. In the interim, I had done my surgical residency and...
Study of “Acupressure” for Constipation
A recent study in the Journal of General Internal Medicine evaluated a treatment for constipation. It tested whether training patients to massage the perineum (the area between the vagina or scrotum and the anus) would improve their reported bowel function and quality of life at 4 weeks after training. They found that it did. It’s a simple, innocuous treatment that may be...
Selling “integrative oncology” as a monograph in JNCI
The Society of Integrative Oncology publishes its "evidence-based" guidelines for the supportive care of breast cancer patients, along with a whole lot of musings on integrating quackery with medicine. But are the guidelines science-based? I think you know the answer to that one.
Eminent Harvard psychologist, mother of positive psychology, New Age quack?
Be less curious about people and more curious about ideas. – Marie Curie’s advice to journalists Harvard psychologist Ellen Langer was on CBS This Morning News explaining plans for a psychosocial intervention study with women with Stage IV metastatic breast cancer. The project would attempt to shrink women’s tumors by shifting their mental perspective back to before they were diagnosed. Seeing her...