Results for: right to try
Thoughts on Neuroplasticity
I recently read a fascinating book, The Brain That Changes Itself by Norman Doidge. He describes case histories and research indicating that the brain is far more malleable than we once thought. We used to think each function was localized to a small area of the brain and if you lost that area of brain tissue the function was gone forever. We once thought...
Misleading Language: the Common Currency of “CAM” Characterizations Part II
Background I promised readers the “Advanced Course” for this week, which undoubtedly has you shaking in your boots. Fear not: you’ve already had a taste of advanced, subtle, misleading “CAM” language, and most of you probably “got” it. That was R. Barker Bausell’s analysis of how homeopathy is “hypothesized to work.” In the interest of civility, let me reiterate that I don’t...
The Hannah Poling case and the rebranding of autism by antivaccinationists as a mitochondrial disorder
Regular readers of this blog may have noticed that I seem to have taken on the role of the primary vaccine blogger of this little group of bloggers trying desperately to hold the forces of pseudoscience and magical thinking at bay in the face of powerful forces trying to “integrate” prescientific belief systems with science- and evidence-based medicine, a process that would...
Misleading Language: the Common Currency of “CAM” Characterizations. Part I
The Best Policy From time to time I have been reiterating that correct use of the language has much to do with logic; I should add that it entails also honesty. I use the word “honesty” in its broadest sense… Concision is honesty, honesty concision—that’s one thing you need to know. —John Simon. Paradigms Lost: Reflections on Literacy and its Decline. New York, NY:...
Ultrasound Screening: Misleading the Public
There is a new industry offering preventive health screening services direct to the public. A few years ago it was common to see ads for whole body CT scan screening at free-standing CT centers. That fad sort of faded away after numerous organizations pointed out that there was considerable radiation involved and the dangers outweighed any potential benefits. Now what I most commonly...
When the popularity of new surgical procedures outpaces science
In science- and evidence-based medicine, the evaluation of surgical procedures represents a unique challenge that is truly qualitatively different from the challenges in medical specialties. Perhaps the most daunting of these challenges is that it is often either ethically unacceptable or logistically impossible to do the gold-standard clinical trial, a double-blind, randomized placebo trial for an operation. After all, the “placebo” in...
Prior Probability: the Dirty Little Secret of “Evidence-Based Alternative Medicine”—Continued
This is an addendum to my previous entry on Bayesian statistics for clinical research.† After that posting, a few comments made it clear that I needed to add some words about estimating prior probabilities of therapeutic hypotheses. This is a huge topic that I will discuss briefly. In that, happily, I am abetted by my own ignorance. Thus I apologize in advance for simplistic or incomplete...
Antibiotics for Sinusitis
You’re a patient. That cold just isn’t getting better and you have purulent drainage from your nose, and your face hurts and your teeth hurt. You probably have sinusitis, right? You go to a doctor to get an antibiotic. You’re a doctor. Deep down, you know there’s a good chance the patient has a self-resolving condition. You’d rather not do x-rays on every patient who...
Toxic myths about vaccines
Antivaccine activists would have you believe that vaccines are loaded with "toxins" and are therefore dangerous. While there are some chemicals that sound scary in some vaccines, they dose makes the poison, and at the tiny amounts used in vaccines none of these "toxins" are harmful.