Category: Clinical Trials
The Hazards of “CAM”-Pandering
Steven Salzberg, a friend of this blog and Director of the Center for Bioinformatics and Computational Biology at the University of Maryland, is on the editorial boards of three of the many journals published by BioMed Central (BMC), an important source of open-access, peer-reviewed biomedical reports. He is disturbed by the presence of two other journals under the BMC umbrella: Chinese Medicine...
The benefits and risks of folic acid supplementation
Could a vitamin with proven benefits in one group cause harm to another? That’s the growing concern with folic acid, the vitamin that dramatically reduces the risk of neural tube birth defects such a spina bifida. Studies designed to explore the possible benefits of folic acid for heart disease, stroke and cancer are giving out some worrying signs: At best, folic acid...
EMDR and Acupuncture – Selling Non-specific Effects
The scientific approach to understanding the world includes the process of carefully separating out variables and effects. Experiments, in fact, are designed specifically to control for variables. This can be especially challenging in medicine, since the body is a complex and variable system and there are always numerous factors at play. We often characterize the many variables that can influence the outcome...
Ethics in human experimentation in science-based medicine
Science-based medicine depends upon human experimentation. Scientists can do the most fantastic translational research in the world, starting with elegant hypotheses, tested through in vitro and biochemical experiments, after which they are tested in animals. They can understand disease mechanisms to the individual amino acid level in a protein or nucleotide in a DNA molecule. However, without human testing, they will never...
Of SBM and EBM Redux. Part IV, Continued: More Cochrane and a little Bayes
OK, I admit that I pulled a fast one. I never finished the last post as promised, so here it is. Cochrane Continued In the last post I alluded to the 2006 Cochrane Laetrile review, the conclusion of which was: This systematic review has clearly identified the need for randomised or controlled clinical trials assessing the effectiveness of Laetrile or amygdalin for...
Critique of “Risk of Brain Tumors from Wireless Phone Use”
Following my recent critique here of the book Disconnect by Devra Davis, about the purported dangers of cell phones to health, David Gorski asked me to comment on a recently published “review article” on the same subject. The article is entitled “Risk of Brain Tumors from Wireless Phone Use” by Dubey et al [1] published in the J. Comput Assist Tomography. At...
Ear Infections: To Treat or Not to Treat
Acute otitis media, also known as an ear infection, is a common problem that used to be treated routinely with antibiotics. As more evidence accumulated, it became clear that the practice needed to change. Seven years after the American Academy of Pediatrics and the American Academy of Family Physicians released their guidelines, what has changed?
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,...