Category: Science and Medicine

The Early Course of Autism

Understanding the natural history of a disease is an important framework to have. It not only is critical for prognosis, but also informs us about diagnostic and screening strategies, is important to assessing interventions, and provides clues to causation. There has been much debate about the early course of autism, specifically the earliest age at which autism may be detected. At present...

/ February 17, 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

CardioFuel—another magic pill

I get a lot of email asking me about various alternative therapies and supplements. A recurring theme on this blog has been the hyperbolic claims of alternative practitioners and supplement makers, and while I can’t answer every email, I can at least address some of them in the blog. Supplements are often marketed using unsupported health claims to which is appended the Quack...

/ February 11, 2010

Science by press release

Last week I wrote about a study that purported to show that antidepressants have no effect in mild to moderate depression. A careful reading of the paper shows that the authors dramatically overstated their findings, particularly in their public statements to the media. The study has another implication beyond the misleading claims about antidepressants. It is an object lesson in an ongoing...

/ February 11, 2010

Checklists and Culture in Medicine

Surgeon and journalist, Atul Gawande, is getting quite a bit of deserved press and blog attention for his new book, The Checklist Manifesto: How to Get Things Right. The premise of his book is simple – checklists are an effective way to reduce error. But behind that simple message are some powerful ideas with significant implications for the culture of medicine. One...

/ February 10, 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
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Study shows antidepressants useless for mild to moderate depression? Not exactly.

As Harriet Hall has written, psychiatry bashing is a popular media sport. There seems to be a bias against treatment of psychiatric disabilities, and a common claim is that antidepressants are no better than placebo. The New York Times illustrated both the perpetuation of the myth that antidepressants are ineffective, and the increasing and disturbing tendency of major media organizations to confuse...

/ February 4, 2010

The Lancet retracts Andrew Wakefield’s article

In 1998 Andrew Wakefield and 11 other co-authors published a study with the unremarkable title: Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. Such a title would hardly grab a science journalist’s attention, but the small study sparked widespread hysteria about a possible connection between the mumps-measles-rubella (MMR) vaccine and autism spectrum disorder (ASD). The study itself has not stood...

/ February 3, 2010

Success in the fight against childhood diarrhea

Rotavirus is the world’s most common cause of severe childhood diarrhea.  In the U.S. alone, rotavirus disease leads to around 70,000 hospitalizations, 3/4 million ER visits, and nearly half-a-million doctor office visits yearly.  But it rarely causes death. The same is not true for the developing world.  Rotavirus disease is estimated to kill around a half-million children a year world wide.  ...

/ February 1, 2010

Reflexive doubt

Those of us who study, practice and write about medicine cherish the hope that explaining the science behind medicine (or the lack of science behind “alternative” treatments) will promote a better understanding of medicine. Certainly, I would not bother to write about medical topics if I did not believe that promoting science based medicine would lead to increased understanding of medical recommendations...

/ January 28, 2010