Category: Clinical Trials
The NCCAM Strategic Plan 2011-2015: The Good, The Bad, and The Ugly
The NCCAM has a new strategic plan that involves funding good science on meaningful topics, which is good. But it's still talking about nonsense like reiki, which is bad, and mixing it with real, scientifically proven treatments, which is ugly.
Of SBM and EBM Redux. Part IV: More Cochrane and a little Bayes
NB: This is a partial posting; I was up all night ‘on-call’ and too tired to continue. I’ll post the rest of the essay later… Review This is the fourth and final part of a series-within-a-series* inspired by statistician Steve Simon. Professor Simon had challenged the view, held by several bloggers here at SBM, that Evidence-Based Medicine (EBM) has been mostly inadequate...
Rambling Musings on Using the Medical Literature
For those who are new to the blog, I am nobody from nowhere. I am a clinician, taking care of patients with infectious diseases at several hospitals in the Portland area. I am not part of an academic center (although we are affiliated with OHSU and have a medicine residency program). I have not done any research since I was a fellow,...
Molecular breast imaging (MBI): A promising technology oversold in a TED Talk?
Occasionally, there are topics that our readers want — nay, demand — that I cover. This next topic, it turns out, is one of them. It’s a link to a TED Talk. I’m guessing that most of our readers have either viewed (or at least heard of) TED talks. Typically, they are 20-minute talks, with few or no slides, by various experts...
Placebo effects without deception? Well, not exactly…
In discussing “alternative” medicine it’s impossible not to discuss, at least briefly, placebo effects. Indeed, one of the most common complaints we at SBM voice about clinical trials of alternative medicine is the lack of adequate controls — meaning adequate controls for placebo and nonspecific effects. Just type “acupuncture” in the search box in the upper left hand corner of the blog...
The “decline effect”: Is it a real decline or just science correcting itself?
‘Tis the season, it would seem, for questioning the scientific method. You might recall that back in October, I was a bit miffed by an article in The Atlantic entitled Lies, Damned Lies, and Medical Science and expressed my annoyance in one of my typical logorrheic posts. Then, a mere couple of weeks later, Steve Simon wrote a rather scathing criticism of...
Of SBM and EBM Redux. Part II: Is it a Good Idea to test Highly Implausible Health Claims?
Review This is the second post in a series* prompted by an essay by statistician Stephen Simon, who argued that Evidence-Based Medicine (EBM) is not lacking in the ways that we at Science-Based Medicine have argued. David Gorski responded here, and Prof. Simon responded to Dr. Gorski here. Between that response and the comments following Dr. Gorski’s post it became clear to...
Science-based medicine and improving patient safety and quality of care
The last couple of weeks, I feel as though I may have been slumming a bit. After all, comparatively speaking it’s not that difficult to take on claims that homeopathy benefits fibromyalgia or Oprah Winfrey promoting faith healing quackery. Don’t get me wrong. Taking on such topics is important (otherwise I wouldn’t do it). For one thing, some quackery is so harmful...
Integrating patient experience into research and clinical medicine: Towards true “personalized medicine”
We advocate science-based medicine (SBM) on this blog. However, from time to time, I feel it necessary to point out that science-based medicine is not the same thing as turning medicine into a science. Rather, we argue that what we do as clinicians should be based in science. This is not a distinction without a difference. If we were practicing pure science,...