Category: Epidemiology

Confusing overdiagnosis for an “epidemic” of thyroid cancer in Japan after Fukushima

One of my favorite topics to blog about for SBM is the topic of overdiagnosis and overtreatment. These are two interrelated phenomena that most people are blissfully unaware of. Unfortunately, I’d also say that the majority of physicians are only marginally more aware than the public about these confounders of screening programs, if even that. Overdiagnosis has long been appreciated to be...

/ March 14, 2016

Are the recommended childhood vaccine schedules evidence-based?

We write about vaccines a lot here at SBM, and for a very good reason. Of all the medical interventions devised by the brains of humans, arguably vaccines have saved more lives and prevented more disability than any other medical treatment. When it comes to infectious disease, vaccination is the ultimate in preventive medicine, at least for diseases for which vaccines can...

/ February 29, 2016

Air Pollution and Public Health

Public health measures are those not aimed at individuals but at society as a whole, or subgroups within society. Physicians are charged not only with promoting the health of their own patients, but as a profession we (and health care professions in general) are charged with promoting the public health. Public health measures, however, are highly likely to cross into politically charged...

/ February 24, 2016

Zika virus, microcephaly, and calls to bring back DDT (Rachel Carson revisionism edition)

In response to the Zika virus threat, predictably the same group of anti-environmentalists are urging that we bring back DDT and "Spray, baby, spray!" To make their questionable case, they overstate the benefits of DDT, downplay its risks, and engage in some major historical revisionism regarding the legacy of Rachel Carson.

/ February 15, 2016

Holding the supplement industry to account: Can we learn from tobacco regulation?

A new paper compares the supplement industry to Big Tobacco and argues that states should use the same tactics to improve consumer safety and protection.

/ December 3, 2015

No, Purell Does Not Breed Super-Anything

Recently, I was sitting in a meeting and reached for the dispenser of Purell hand sanitizer sitting on the conference room table. A colleague of mine gave a small, rueful shake of her head to the person on her other side. Apparently I had erred. I asked what was the matter, and got a brief answer to the effect of “because superbugs.”...

/ November 28, 2015

Do Helmets Prevent Head Injuries?

A cycling enthusiast asked me about helmets. It seems compellingly obvious to me that a head impacting the pavement without a helmet is likely to sustain more damage than a head protected by a helmet. He challenged that, citing a BMJ article by Ben Goldacre that questioned whether the evidence showed that helmets do any good. He said I was making a...

/ May 19, 2015

Screening for disease in people without symptoms: The reality

One of the most contentious questions that come up in science-based medicine that we discuss on this blog is the issue of screening asymptomatic individuals for disease. The most common conditions screened for that we, at least, have discussed on this blog are cancers (e.g., mammography for breast cancer, prostate-specific antigen screening for prostate cancer, ultrasound screening for thyroid cancer), but screening...

/ February 2, 2015

Hot-Zone Schools and Children at Risk: Shedding light on outbreak-prone schools

The subject of parental vaccine refusal and the impact that has on disease outbreaks has been covered many times on SBM and elsewhere. I apologize to our readers who are growing tired of the subject, but there is perhaps no subject more deserving of focus and repetition. There’s also an important angle to the discussion that I’ve written on previously and which...

/ January 30, 2015

Is cancer due mostly to “bad luck”?

One of the more difficult conversations to have with a patient as a cancer doctor occurs when a patient, recently informed of her diagnosis of, for example, breast cancer, asks me, “Why did I get this? What caused it?” What almost inevitably follows is an uncomfortable conversation in which explanations of the multiple known causes of breast cancer do not satisfy the...

/ January 5, 2015