Category: Clinical Trials
The Pollyanna Phenomenon and Non-Inferiority: How Our Experience (and Research) Can Lead to Poor Treatment Choices
Pollyanna, a popular children’s book written in 1913 by Eleanor H. Porter, introduced the world to one of the most optimistic fictional characters ever created. She always saw the good in people and her approach to life frequently involved playing “The Glad Game”, where she attempted to find something to appreciate in every situation no matter how unfortunate. She was glad about...
The return of the revenge of high dose vitamin C for cancer
Vitamin C is back in the news as a cancer cure. Is it? No, no it is not.
Treating Pain Psychologically
One of the goals of rigorous science is to disentangle various causes so we can establish exactly where the lines of cause and effect are. In medicine this allows us to then optimize the real causes (what aspect of treatments actually work) and eliminate anything unnecessary. Eliminating the unnecessary is more than just about efficiency – every intervention in medicine has a...
Osteopathy in the NICU: False Claims and False Dichotomies
I would like to preface this post by stating that I have worked with many DOs (Doctors of Osteopathy), and I have helped train many pediatric residents with DO degrees. I have found no difference in the overall quality of the training these students have received, and some of the very best clinicians I have ever worked with have been DOs. I...
Fighting Against Evidence
For the past 17 years Edge magazine has put an interesting question to a group of people they consider to be smart public intellectuals. This year’s question is: What Scientific Idea is Ready for Retirement? Several of the answers display, in my opinion, a hostility toward science itself. Two in particular aim their sights at science in medicine, the first by Dean...
Urinary Tract Infections Cause Depression. Directors Cut.*
As some may know I am infectious disease doctor. Urinary tract infections (UTI) butter my bread. Figuratively speaking. There is an enormous amount known about the pathophysiology of UTI’s. It is both a common and complex problem. But for all our knowledge, chronic and recurrent UTI’s remain a vexing issue for the patient and the doctor. One reason people develop recurrent UTI’s...
Stanislaw Burzynski: Using 1990s techniques to battle the FDA today
In the 1990s, cancer quack Dr. Stanislaw Burzynski and his lawyer Richard Jaffe perfected a PR strategy in which patients who believed that Burzynski had saved their lives would protest and, often aided by friendly legislators, beg the FDA (or whatever regulatory body was trying to stop Burzynski's abuses at the time) not to let them die. It was very effective political...
Acupuncture Whac-a-Mole ™
Those who cannot remember the past are condemned to repeat it. – George Santayana Most people don’t have that willingness to break bad habits. They have a lot of excuses and they continue to produce bad clinical studies. – Carlos Santana (Well, not the last 4 words.) One is a guitar player, one is a philosopher. I get them confused. I think...
Vitamin E for Alzheimer’s
Recently you may have seen headlines like “Vitamin E slows decline in patients with mild Alzheimer’s” or “There’s still no cure for Alzheimer’s disease, but the latest hope for slowing its progression is already on drugstore shelves.” They were referring to an article in the January 1, 2014 issue of the Journal of the American Medical Association (JAMA) announcing the results of...
An experiment in paying through the nose for “unnecessary care”
Rats. Harriet stole what was going to be the title of this post! This is going to be something completely different than what I usually write about. Well, maybe not completely different, but different from the vast majority of my posts. As Dr. Snyder noted on Friday, it’s easy to find new woo-filled claims or dangerous, evidence-lacking trends to write about. Heck,...