Category: Clinical Trials

The case of John Lykoudis and peptic ulcer disease revisited: Crank or visionary?

One of the themes of SBM has been, since the very beginning, how the paradigm of evidence-based medicine discounts plausibility (or, perhaps more appropriately, implausibility) when evaluating whether or not a given therapy works. One of our favorite examples is homeopathy, a therapy that is so implausible on a strictly scientific basis that, for it to work, huge swaths of well-established science...

/ March 29, 2010

The 2nd Yale Research Symposium on Complementary and Integrative Medicine. Part I

March 4, 2010 Today I went to the one-day, 2nd Yale Research Symposium on Complementary and Integrative Medicine. Many of you will recall that the first version of this conference occurred in April, 2008. According to Yale’s Continuing Medical Education website, the first conference “featured presentations from experts in CAM/IM from Yale and other leading medical institutions and drew national and international...

/ March 5, 2010

Acupuncture for Depression

One of the basic principles of science-based medicine is that a single study rarely tells us much about any complex topic. Reliable conclusions are derived from an assessment of basic science (i.e prior probability or plausibility) and a pattern of effects across multiple clinical trials. However the mainstream media generally report each study as if it is a breakthrough or the definitive...

/ March 3, 2010

Changing Your Mind

Why is my mind so clean and pure?  Because I am always changing it. In medical school the old saying is that half of everything you learn will not be true in 10 years, the problem being they do not tell which half. In medicine, the approach is, one hopes, that data leads to an opinion.  You have to be careful not...

/ February 12, 2010

Yes, Jacqueline: EBM ought to be Synonymous with SBM

“Ridiculing RCTs and EBM” Last week Val Jones posted a short piece on her BetterHealth blog in which she expressed her appreciation for a well-known spoof that had appeared in the British Medical Journal (BMJ) in 2003: Parachute use to prevent death and major trauma related to gravitational challenge: systematic review of randomised controlled trials Dr. Val included the spoof’s abstract in her...

/ February 5, 2010

On the “individualization” of treatments in “alternative medicine”

One of the claims most frequently made by “alternative medicine” advocates regarding why alt-med is supposedly superior (or at least equal) to “conventional” medicine and should not be dismissed, regardless of how scientifically improbable any individual alt-med modality may be, is that the treatments are, if you believe many of the practitioners touting them, highly “individualized.” In other words, the “entire patient”...

/ January 25, 2010

The life cycle of translational research

I’m a translational researcher. To those of you who aren’t familiar with what that means, it means (I hope) that I study potential therapies in the lab and try to translate them into actual therapies that will cure patients of breast cancer — or, at the very least, improve their odds of survival or prolong survival when cure is not possible. Translational...

/ January 4, 2010

Acupuncture, the P-Value Fallacy, and Honesty

Credibility alert: the following post contains assertions and speculations by yours truly that are subject to, er, different interpretations by those who actually know what the hell they’re talking about when it comes to statistics. With hat in hand, I thank reader BKsea for calling attention to some of them. I have changed some of the wording—competently, I hope—so as not to...

/ December 15, 2009

Another wrinkle to the USPSTF mammogram guidelines kerfuffle: What about African-American women?

A while back I wrote about rethinking how we screen for breast cancer using mammography. Basically, the USPSTF, an independent panel of physicians and health experts that makes nonbinding recommendations for the government on various health issues, reevaluated the evidence for routine screening mammography and concluded that for women at normal risk for breast cancer, mammography before age 50 should not be...

/ December 14, 2009

Cell phones and cancer again, or: Oh, no! My cell phone’s going to give me cancer! (revisited)

It’s been about a year and a half since I’ve written about this topic; so I thought I’d better update the disclaimer that I wrote at the beginning: Before I start into the meat of this post, I feel the need to emphasize, as strongly as I can, four things: I do not receive any funding from the telecommunications industry in general,...

/ December 14, 2009