The National Center for Complementary and Alternative Medicine (NCCAM): Your tax dollars hard at work
What’s an advocate of evidence- and science-based medicine to think about the National Center for Complementary and Alternative Medicine, better known by its abbrevation NCCAM? As I’ve pointed out before, I used to be somewhat of a supporter of NCCAM. I really did, back when I was more naïve and idealistic. Indeed, as I mentioned before, when I first read Wally Sampson’s...
Homeopathy and Evidence-Based Medicine: Back to the Future Part IV
Homeopathy and Science This week’s entry† is a summary of some of the tests of homeopathy. It is a necessary prelude to a discussion of how homeopaths and their apologists promote the method. Several tenets of homeopathy lend themselves to tests. The doctrine of similia similibus curantur (“like cures like”) was tested by Hahnemann himself, as introduced in Part I...
Alternative Flight
The following commentary is the first contribution to SBM by guest author, Mark Crislip. The airline industry in the United States is often used as an example of a complex technological system that provides high volume, inexpensive and reliable transportation to millions of people every year, that, despite sending tons of aluminum five miles into the air, has an amazing safety record....
The Role of Anecdotes in Science-Based Medicine
While attending a lecture by a naturopath at my institution I had the opportunity to ask the following question: given the extreme scientific implausibility of homeopathy, and the overall negative clinical evidence, why do you continue to prescribe homeopathic remedies? The answer, as much as my question, exposed a core difference between scientific and sectarian health care providers. She said, “Because I...
Does Glucosamine Really Work?
Glucosamine and chondroitin, used separately or together, are among the more popular diet supplements. They are used widely for osteoarthritis, especially of the knee, and have been better studied than most other diet supplements. But do they really work? The journal of my medical specialty, American Family Physician, recently published an article about the use of dietary supplements in osteoarthritis. They gave...
Science by press release: A helmet to fight Alzheimer’s disease?
Recently, I’ve had a number of people bring to my attention a news story that has apparently been sweeping the wire services and showing up in all sorts of venues. It is, on its surface, a story of hope, hope for the millions of elderly (and even the not-so-elderly) who are or will be afflicted by that scourge of the mind, memory,...
Annals of Questionable Evidence: a new study reveals substantial publication bias in trials of anti-depressants
Part IV of the ongoing Homeopathy series will have to wait a day or two, because it is superceded by a recent, comment-worthy publication. Nevertheless, “H series” fans will find here a bit of grist for that mill, too. An important role for this blog is to discuss problems of interpreting data from clinical studies. Academic medicine has committed itself, on the...
Itching and the Imaginary Passenger Brake
The press and government agencies ally to shine a disproportionate amount of publicity on false and improbable medical ideas. (Danger: Congressmen and reporters at work.) The latest was a press release from either the Centers for Disease Control (and prevention? – I’ll get to the “prevention” part later,) or from Kaiser-Permanente Medical Group. Three Bay Area newspapers carried simultaneous articles. The articles...
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January 24, 2008
The Ethics of Deception in Medicine
A recent study published in the Journal of General Internal Medicine and featured in a Time Magazine article, indicated that of 466 academic physicians in the Chicago area, 45% indicated that they have prescribed a placebo for a patient. This has sparked a discussion of the ethics of prescribing placebos in particular and deception in general in medicine. A placebo is a...
Akavar 20/50 and Truth in Advertising
Over the last few months, I have had a truly surreal experience. It started when I noticed a two-page full color spread in TV Guide magazine advertising a product called Akavar 20/50. It contained the same claims that so many bogus weight loss products do: eat all you want and still lose weight. What attracted my interest was their highlighted statement: “We...