Category: Science and Medicine
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...
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...
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...
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. ...
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
Evolution in Medicine
A recent series of article in the Proceedings of the National Academy of Sciences (PNAS) discusses the role of evolutionary biology in modern medicine. The authors collectively make a forceful point – medicine is an applied science. It is based upon a number of basic sciences, and one of those basic sciences is evolution. The most obvious example is bacterial antibiotic resistance....
On the “individualization” of treatments in “alternative medicine”
One of the claims most frequently made by “alternative medicine” advocates regarding why alt-med is supposedly superior (or at least equal) to “conventional” medicine and should not be dismissed, regardless of how scientifically improbable any individual alt-med modality may be, is that the treatments are, if you believe many of the practitioners touting them, highly “individualized.” In other words, the “entire patient”...
You can’t hide in the herd
Can you hide in the herd? Well, I suppose the title has given away the punch line. Herd immunity is a fascinating effect, and one of the mainstays of a public vaccination effort. The idea is that if enough people in the community are immune to a particular disease, then those who are susceptible will rarely come into contact with a person...
Big Placebo says Medicine never cures anything
Kudos to Lindsay Beyerstein of Majikthise for coining a new appellation “Big Placebo.” Big Placebo is the alternative health counterpart to Big Pharma. Both are special interest groups designed to promote their products, whether they are worthy of promotion or not. There is one big difference between them: Big Pharma makes products that usually work (though not always, and sometimes not safely)....
/
January 21, 2010