Category: Science and Medicine
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,...
The Meaning of Secondary Prevention
A November letter to the editor in American Family Physician chastises that publication for misusing the term “secondary prevention,” even using it in the title of an article that was actually about tertiary prevention. I am guilty of the same sin. I had been influenced by simplistic explanations that distinguished only two kinds of prevention: primary and secondary. I thought primary prevention...
Compare and Contrast
I have been in Infectious Diseases for almost 25 years. I have two major jobs: I see inpatient consults and I chair the Infection Control program. I have been involved in quality improvement, especially as it relates to hospital acquired infections, for my entire career. It has been an interesting quarter century. Year after year we have driven down infection rates and...
For Good Reason…
This one crept up on me by surprise. You see, I recorded an interview with D.J. Grothe, President of the James Randi Educational Foundation and host of the podcast For Good Reason back in November. I wasn’t sure when it would appear. Well, it turns out that it popped up on my iTunes podcast feeds sometime over the last few days. (It’s...
California Forbids Chinese Bloodletting
In November 2010, the California Department of Consumer Affairs (DCA) finally decided to act responsibly and forbid the prevalent practice of Chinese bloodletting by licensed acupuncturists. The practice became a concern for the DCA when allegations of unsanitary bloodletting at a California (CA) acupuncture school surfaced. The incident allegedly occurred during a “doctoral” course for licensed practitioners. The instructor was reportedly demonstrating...
CAM and the Law Part 4: Regulation of Supplements and Homeopathic Remedies
Another major set of legal standards that apply to alternative medicine are the laws and regulations that govern the manufacturing and availability of homeopathic and herbal remedies and dietary supplements. Although there is less ambiguity in these standards than in some of the areas I’ve covered previously, there are certainly loopholes aplenty available to avoid the need for any truly scientific standards...
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...
Good Idea, Bad Execution: Dosing Errors, A Preventable Harm
We spend a lot time at SBM discussing different elements of the art and science of medicine, and how we believe that practice can be improve. Yet our science-based intentions can be thwarted at the last possible moment – in the form of dosing errors. The workup may have been comprehensive, the diagnosis could be correct, the most clinically and cost-effective intervention...