Evidence Thresholds
Defenders of science-based medicine are often confronted with the question (challenged, really): what would it take to convince you that “my sacred cow treatment” works? The challenge contains a thinly veiled accusation — no amount of evidence would convince you because you are a nasty skeptic. There is a threshold of evidence that would convince me of just about anything, however. In...
What Does ND Mean?
Chronic Lyme disease almost certainly does not exist, but a growing number of doctors are diagnosing and treating it with long-term antibiotics and other remedies. They are known as LLMDs (“Lyme Literate” medical doctors). This subject has been covered repeatedly on Science-Based Medicine, here, here, here, here, and elsewhere. I have a correspondent who joined a Yahoo group for Lyme disease (Northern...
Once more into the screening breach: The New York Times did not kill your patient
Dr. George Lombardi thinks that he could have saved a patient from dying of prostate cancer if a prostate specific antigen test had been done. Is he right? Probably not.
A little Swedish interlude
I’ve been remiss in not mentioning this; so I’ll try to make up for it now. Recently, I did an interview on the Skeptikerpodden, a Swedish podcast. Unless you speak Swedish, you won’t understand much else of the podcast, but don’t worry. I don’t speak Swedish either, which is why my interview is in English. It starts at around the 44:00 mark.
Comprehending the Incomprehensible
Medicine is impossible. Really. The amount of information that flows out the interwebs is amazing and the time to absorb it is comparatively tiny. If you work, sleep and have a family, once those responsibilities are complete there is remarkably little time to keep up with the primary literature. I have made two of my hobbies (blogging and podcasting) dovetail with my...
At Your Own Risk
In 2011, Americans spent some $30 billion on dietary supplements. Yet, except for the industry itself and a few politicians and “health freedom” advocates, you’d be hard pressed to find anyone (who’s given it some thought) of the opinion that dietary supplement regulation is adequate. Three recent reports, two from the government and one from a newspaper, demonstrate why this near-universal conclusion...
Clinical Decision-Making Part III
How do doctors make clinical decisions to arrive at a diagnosis? Part 3 of a 3-part series.
Dr. Amen’s Love Affair with SPECT Scans
Daniel Amen loves SPECT scans (Single Photon Emission Computed Tomography). And well he should. They have brought him fame and fortune. They have rewarded him with a chain of Amen Clinics, a presence on PBS, lucrative speaking engagements, a $4.8 million mansion overlooking the Pacific Ocean, and a line of products including books, videos and diet supplements (“nutraceuticals”). He grossed $20 million...
It’s a part of my paleo fantasy, it’s a part of my paleo dream
There are many fallacies that undergird alternative medicine, which evolved into “complementary and alternative medicine” (CAM), and for which the preferred term among its advocates is now “integrative medicine,” meant to imply the “best of both worlds.” If I had to pick one fallacy that rules above all among proponents of CAM/IM, it would have to be either the naturalistic fallacy (i.e.,...
Anti-inflammatory drugs: A closer look at the risks
If science-based medicine reflects the application of the best evidence, then we should expect practices to change when new data emerges. In the long run that’s generally true, and the progressive gains we’ve seen in the management of disease reflect this. But in the short run, change can be maddeningly slow, and there are many areas of medicine where we could be...
Don’t Blame the Patient