IVF and CAM Use
Perhaps the biggest hurdle to broader acceptance of the need for a consistent scientific basis for medical interventions is the attitude that worthless treatments are harmless. I often have the experience, after reviewing the evidence showing lack of efficacy for a specific intervention, of getting the head-tilt and shrug along with some variation of the dismissive attitude, “Well, if people feel better,...
“The Disappearing Male” – A Pinch of Science, a Pound of Speculation
A documentary film entitled “The Disappearing Male” was first shown on CBC in June, 2009. It can be viewed online here. Some of its rhetoric is reminiscent of Chicken Little: “Where have all the boys gone?” “Millions of males are disappearing.” “We’re on the Titanic and we see the iceberg but we just can’t turn the ship.” “It may be a threat...
If you’re sick, even the ridiculous can seem sublime
Let’s say you have cancer. And let’s say you’re really, really sick of having cancer. And let’s say that you’re also pretty tired of scans, chemo, radiation, hair loss, nausea. And let’s say you’re not really sick and tired of living, but actually pretty happy to be alive. Finally, let’s say someone says that they can get rid of your cancer, without...
“There must be a reason,” or how we support our own false beliefs
For a change of pace, I want to step back from medicine for this post, although, as you will see (I hope), the study I’m going to discuss has a great deal of relevance to the topics covered regularly on this blog. One of the most frustrating aspects of being a skeptic and championing science-based medicine is just how unyielding belief in...
Oriental Medicine or Medical Orientalism?
The following is the second adapted excerpt of an upcoming article called “The Untold Story of Acupuncture.” It is scheduled to be published in December 2009 in Focus in Alternative and Complementary Therapies (FACT), a review journal that presents the evidence on alternative medicine in an analytical and impartial manner. This section argues that the current flurry of interest in acupuncture and...
Neck Manipulation: Risk vs. Benefit
While manipulation of any kind has the potential to cause injury, stroke caused by neck manipulation is of greatest concern. Risk must always be weighed against benefit when upper neck manipulation is considered. Risk of stroke caused by neck manipulation is statistically low, but the risk is serious enough to outweigh benefit in all but a few rare, carefully selected cases. When...
SBM in primary practice: one student’s experience
EDITOR’S NOTE: Dr. Jones is off this week; fortunately, we have this guest post by Tim Kreider, our science-based medical student. Enjoy! My first clerkship of my third year of medical school was Family Medicine, and I had a great experience. After the first two years spent mostly with books and then a three-year interlude in a basic science lab, these past...
Off-Label Use of Prescription Drugs
A recent survey of 599 primary care physicians and 600 psychiatrists found that: The adjusted response rate was 47%, respondents were similar to non-respondents, and physicians commonly prescribed the drugs examined. The average respondent accurately identified the FDA-approval status of just over half of the drug-indication pairs queried (mean 55%; median 57%). Accuracy increased modestly (mean 60%, median 63%) when limited to...
James Reston’s Tooth of Gold
One of the fathers of critical thinking and skeptical inquiry, the French philosopher Bernard le Bovier de Fontenelle (1657–1757) recounts in 1687 in his Histoire des oracles–a debunking book on popular beliefs, myths and superstitions that caused tremendous stir in theological and philosophical circles of his time–a colorful story that could very well illustrate the flurry of interest and research in acupuncture...
Don’t Blame the Patient