Multiple Sclerosis and Irrational Exuberance
Multiple sclerosis (MS) is fascinating illness that can range from mild annoyance to debilitating nightmare. The frightening nature and unclear cause of the disease makes it a magnet for questionable medical therapies (i.e. quackery). A piece published last week in (surprise!) The Huffington Post helps fuel the fires of suspicion and paranoia while failing to shed any light on the future of...
Radiation from medical imaging and cancer risk
Science-based medicine consists of a balancing of risks and benefits for various interventions. This is sometimes a difficult topic for the lay public to understand, and sometimes physicians even forget it. My anecdotal experience suggests that probably surgeons are usually more aware of this basic fact because our interventions generally involve taking sharp objects to people’s bodies and using steel to remove...
Measles
It looks like the H1N1 pandemic is fading fast. I am amazed at how lucky we were, at least in the hospitals where I work. A month ago all the ICU beds were full, most of the ventilators were in use and we were wondering how we were going to triage the next batch of patients who needed advanced life support and...
Are the benefits of breastfeeding oversold?
As a mother, I am a passionate advocate of breastfeeding and I breastfed my four children. As a clinician, though, I need to be mindful not to counsel patients based on my personal preferences, but rather based on the scientific evidence. While breastfeeding has indisputable advantages, the medical advantages are quite small. Many current efforts to promote breastfeeding, while well meaning, overstate...
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December 17, 2009
Communicating with the Locked-In
Facilitated communication is exploitation supported by false hope and good intentions. Brain-machine interfaces are progressing with agonizing slowness, but offer true potential in actually permitting paralyzed people to communicate and even regain movement.
Acupuncture, the P-Value Fallacy, and Honesty
Credibility alert: the following post contains assertions and speculations by yours truly that are subject to, er, different interpretations by those who actually know what the hell they’re talking about when it comes to statistics. With hat in hand, I thank reader BKsea for calling attention to some of them. I have changed some of the wording—competently, I hope—so as not to...
Another wrinkle to the USPSTF mammogram guidelines kerfuffle: What about African-American women?
A while back I wrote about rethinking how we screen for breast cancer using mammography. Basically, the USPSTF, an independent panel of physicians and health experts that makes nonbinding recommendations for the government on various health issues, reevaluated the evidence for routine screening mammography and concluded that for women at normal risk for breast cancer, mammography before age 50 should not be...
Cell phones and cancer again, or: Oh, no! My cell phone’s going to give me cancer! (revisited)
It’s been about a year and a half since I’ve written about this topic; so I thought I’d better update the disclaimer that I wrote at the beginning: Before I start into the meat of this post, I feel the need to emphasize, as strongly as I can, four things: I do not receive any funding from the telecommunications industry in general,...
The End of Chiropractic
An article written by 3 chiropractors and a PhD in physical education and published on December 2, 2009 in the journal Chiropractic and Osteopathy may have sounded the death knell for chiropractic. The chiropractic subluxation is the essential basis of chiropractic theory. A true subluxation is a partial dislocation: chiropractors originally believed bones were actually out of place. When x-rays proved this was...