Results for: clinical trials
Health and Wellness Coaching: cautious optimism and some concerns
The National Consortium for Credentialing of Health & Wellness Coaches (NCCHWC) and the National Board of Medical Examiners (NBME) signed an agreement last month for the launch of a national certification for individual health and wellness coaches in the U.S. According to a joint press release, the agreement is a landmark in the efforts of a dedicated group of individuals who have...
Uncertainty in Medicine
Medicine is an uncertain business. It is an applied science, applying the results of basic science knowledge and clinical studies to patients who are individuals with differing heredity, environment, and history. It is commonly assumed that modern science-based doctors know what they are doing, but quite often they don’t know for certain. Different doctors interpret the same evidence differently; there is uncertainty...
Nobody licenses quacks in my state! HB 4531 and the licensing of naturopaths in Michigan
Over the years, I’ve taken care of women with locally advanced breast cancer so advanced that it’s eroded through the skin, forming huge, nasty ulcers filled with stinky dead cancer tissue that’s outgrown its blood supply, leaving the patient in chronic pain. If the patient is fortunate, her cancer has not metastasized beyond her axillary lymph nodes (the lymph nodes under her...
Are medical errors really the third most common cause of death in the U.S.?
A regurgitation of existing data suggested that medical error is the third leading cause of death in America. Is it true? Spoiler alert! No. No it's not. While medical error can and should be reduced, this BMJ article does not justify claims that doctors are a leading cause of death in the United States.
Reclassifying thyroid cancer and the willful misunderstanding of overdiagnosis
If there’s one lesson that we here at Science-Based Medicine like to emphasize, it’s that practicing medicine and surgery is complicated. Part of the reason that it’s complicated is that for many diseases our understanding is incomplete, meaning that physicians have to apply existing science to their treatment as well as they can. The biology of cancer, in particular, can be vexing....
When Headaches Are a Pain in the Neck: Spinal Manipulation vs. Mobilization for Cervicogenic Headache
NOTE: Today we offer a double feature on the treatment of cervicogenic headache. My article is about a study that compared manipulation to mobilization; it is followed by retired chiropractor Sam Homola’s guest article on manipulation for cervicogenic headache. The two posts complement each other and also complement my post from last week on the possible risk of stroke with neck manipulation....
Statins for everyone? Not so fast.
People love the idea of preventive medicine. Preventing a disease, before it occurs, seems intuitively obvious. But when it comes to taking medicine to prevent a disease before it occurs, people tend to be much less comfortable. Not only are there the concerns about the “medicalization” of healthy people, there are good questions about benefits, risks, and costs. Cardiovascular disease will kill...
Regulating CAM Aussie Style
CAM proponents view National Health Interview Surveys recording the supposed popularity of CAM, an amorphous conflation of anything from conventional medical advice to mythical methods, as an invitation to unleash even more unproven remedies on the public. My interpretation is quite different. I see the same figures as proof that we are doing too little to protect the public from pseudoscience. In...
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.
The Harm of Integrative Medicine: A Patient’s Perspective
I was diagnosed with cancer and entered treatment, at which point I directly experienced both excellent scientific care, and also the utter nonsense that is alternative medicine, rebranded as integrative medicine. Here are my reflections on the experience.