Category: Science and Medicine

Changing the Rules of Evidence

My daughter, Julia, loves to play games and has a bit of a competitive streak. She can make any activity into a game and is adept at making up rules on the spot. When she was younger, like most children, she had a tendency to add to or change the rules on the fly – usually to ensure a favorable outcome for...

/ May 21, 2008

Reading Medical Literature with a Critical Eye

A long time ago I read a study about what makes a good doctor. Some things you might think were important, like grades in medical school, were irrelevant. What correlated the best was the number of medical journals a doctor read. I don’t know whether that means good doctors read more journals or reading more journals makes a better doctor. One thing...

/ May 20, 2008

The “Art” of Clinical Decision-Making

Much nonsense has been written about the “art” of medicine. All too often, it amounts to a rationalization for doctors doing what they want to do instead of following the evidence. Medicine is not an art like painting. Neither is it a science like physics. It’s an applied science. Since patients are not all identical, it can be very tricky to decide...

/ May 13, 2008

The early detection of cancer and improved survival: More complicated than most people think

“Early detection of cancer saves lives.” How many times have you heard this statement or something resembling it? It’s a common assumption (indeed, a seemingly common sense assumption) that detecting cancer early is always a good thing. Why wouldn’t it always be a good thing, after all? For many cancers, such as breast cancer and colon cancer, there’s little doubt tha early...

/ May 12, 2008

“CAL”: a Medico-Legal Parable

Preamble From the fall of 2000 to the winter of 2002, the Commonwealth of Massachusetts convened a Special Commission on Complementary and Alternative Medical Practitioners. There were 12 members: 6 legislators, 3 MDs, a naturopath, a lawyer who represented the New England School of Acupuncture, and the chairman, who was also the Director of the Massachusetts Division of Professional Licensure. At the...

/ May 9, 2008

The Weekly Waluation of the Weasel Words of Woo #5

The Master Speaks It was a delightful surprise for me, and I hope for you fans of the W^5/2, to log onto SBM on Thursday and find this blog by Dr. Wallace Sampson. As I mentioned in that long-ago posting that introduced the topic that eventually hatched the W^5/2, Dr. Sampson is my Yoda, when it comes to the topic that he named: Language Distortions. More about that below....

/ May 4, 2008

The Ethics of “CAM” Trials: Gonzo (Part VI)

Part V of this Blog argued that the NCCAM-sponsored trial of the “Gonzalez regimen” for cancer of the pancreas is unethical by numerous criteria.† To provide an illustration, it quoted a case history of one of the trial’s subjects, who had died in 2002.¹ It had been written by the subject’s friend, mathematician Susan Gurney. A similar story was told on ABC 20/20 in 2000, albeit...

/ May 2, 2008

Integrative Medicine – Sectarians’ Trojan Horse

Integrative Medicine – Sectarians’ Trojan Horse leapfrogs science (Or, I can misuse language with the best of them…) I stumbled across an article from Archives of Internal Medicine, 2002 (Integrative Medicine: Bringing medicine back to its roots. Arch Intern Med. 2002 Feb 25;162(4):395-7). It is one of the first authored by Andrew Weil on “Integrative Medicine “ – another is BMJ in...

/ May 1, 2008

One Hand Clapping

CUSTOMER: Here’s one — nine pence. DEAD PERSON: I’m not dead! MORTICIAN: What? CUSTOMER: Nothing — here’s your nine pence. DEAD PERSON: I’m not dead! MORTICIAN: Here — he says he’s not dead! CUSTOMER: Yes, he is. DEAD PERSON: I’m not! MORTICIAN: He isn’t. CUSTOMER: Well, he will be soon, he’s very ill. DEAD PERSON: I’m getting better! CUSTOMER: No, you’re not...

/ April 30, 2008

The Weekly Waluation of the Weasel Words of Woo #4

That’s What I’m Talkin’ ’bout! The new single-paragraph paradigm for the W^5/2 seems to have worked: there were 13 Waluations for the paragraph submitted in W^5/2 #3, every one of ’em good. Several themes emerged; I’ll discuss them in no particular order. When did you stop beating your wife? The passage charges that the “biomedical model,” by which is apparently meant modern medicine, does...

/ April 20, 2008