When impressive science fails to impress patients

One of the greatest challenges in medicine can sometimes be to convince patients that the results of scientific and medical research apply to them, or, at the very least, to explain how such results apply. One of the reasons that medicine based not on science or evidence fluorishes is because it can be so hard to explain to patients why a particular...

/ March 24, 2008

The Weekly Waluation of the Weasel Words of Woo #2

You Can’t Foo’ Stu with Woo! A Spitzerian (“pointed”) analysis Last week’s inaugural game elicited several amusing and penetrating analyses, including that of the hands-down Gold Medal Winner, Stu. His was the first entry, introduced in a concise and alliterative imperative, and was both hilarious and timely. It implied most of the points discussed by others. This distinctive combination has moved me to grant Stu a legacy here at the W^5....

/ March 21, 2008

Where Are We Going?

Where is it all headed? Medicine on another threshold. Allow me to present several previously unconnected news articles that illuminate the serious problem we face in today’s increasingly scientifically rootless world. Who are scientific medicine’s friends; on whom can we rely for support of reason and common sense, unbiased approaches to funding, unbiased efficacy evaluation, fair law enforcement, and a return to...

/ March 20, 2008

Be Wary of Stem Cell Pseudoscience

At the end of the 18th and beginning of the 19th century electricity and magnetism were cutting edge science, full of excitement and unknown potential. Capitalizing on this excitement, Franz Anton Mesmer captured the imagination of the European intelligentsia with his bogus claims of animal magnetism. At the turning of the next century radioactivity was the new and fascinating scientific discovery, and...

/ March 19, 2008

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...

/ March 18, 2008

The ultimate in “integrative medicine”: Integrating the unscientific into the medical school curriculum

For the second week in a row I find myself throwing out the original post that I had planned on doing in favor of a different topic. The reason this week is, quite simply, having read Dr. Atwood’s excellent two part post Misleading Language: The Common Currency of “CAM” Characterizations (Part I; Part II). I don’t at this time intend to expand...

/ March 17, 2008

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...

/ March 14, 2008

Persistence of Memory

I have steadily endeavored to keep my mind free so as to give up any hypothesis, however much beloved (and I cannot resist forming one on every subject), as soon as the facts are shown to be opposed to it. — Charles R. Darwin I’m getting old: 50, almost 51, and that’s over 350 in dog years. As a result of my...

/ March 13, 2008

Do Antidepressants Work? The Effect of Publication Bias

A recent meta-analysis of the most commonly prescribed antidepressant drugs raises some very important questions for science-based medicine. The study: Initial Severity and Antidepressant Benefits: A Meta-Analysis of Data Submitted to the Food and Drug Administration, was conducted by Irving Kirsch and colleagues, who reviewed clinical trials of six antidepressants (fluoxetine, venlafaxine, nefazodone, paroxetine, sertraline, and citalopram). They looked at all studies...

/ March 12, 2008

Science and Chiropractic

In the comments to a previous blog entry, a chiropractor made the following statements: 1. Chiropractic is a science. 2. Chiropractic is based on neurology, anatomy and physiology. 3. Chiropractors are doctors of the nervous system. 4. Chiropractic improves health and quality of life. I offered to write a blog entry on the “science” of chiropractic, and I asked him, both in...

/ March 11, 2008