Results for: publication bias
Caution vs Alarmism
When I lecture about the need for science-based medicine (SBM), I have to pause about half-way through my list of all the things wrong with the current practice of medical science, and I balance my discussion by emphasizing what I am not saying: I am not saying that medical science is completely broken. It is just really challenging, we need to raise...
Chaperones Needed. On acupuncture.
I receive a monthly newsletter from my medical board. Among other issues discussed are the results of disciplinary actions for physicians. Occasionally a physician who has boundary issues is required to have a chaperone present when doing exams. I was thinking that the concept of a chaperone could be more widely applicable. Consider “You Docs: Amazing acupuncture,” the latest from Drs Oz...
Acupuncture for Menopausal Symptoms
A newly published meta-analysis of studies looking at acupuncture for symptoms resulting from natural menopause (not drug or surgically induced) by Chiu et. al. is entirely negative. That is not what the authors or the press release conclude, however. This disconnect between the study results and the interpretation of those results is a persistent problem in medicine generally to some degree, but...
Prolotherapy
Prolotherapy is a treatment technique used for chronic myofascial pain, back pain, osteoarthritis, or sports injury. It involves repeated injections of dextrose solution or other irritating substances into the joint, tendon, or painful tissue in order to provoke a regenerative tissue response. Similar techniques have been used for about a century, but the first formal publication describing prolotherapy dates back to 1956,...
Open Data
PLOS (the Public Library of Science) is a non-profit open access publisher of science articles. Their goal is to make scientific data accessible to everyone, in the name of transparency and open communication. Now they have taken their approach one step further, announcing their policy that all articles published in a PLOS journal must submit their original data so that anyone can...
Fighting Against Evidence
For the past 17 years Edge magazine has put an interesting question to a group of people they consider to be smart public intellectuals. This year’s question is: What Scientific Idea is Ready for Retirement? Several of the answers display, in my opinion, a hostility toward science itself. Two in particular aim their sights at science in medicine, the first by Dean...
Urinary Tract Infections Cause Depression. Directors Cut.*
As some may know I am infectious disease doctor. Urinary tract infections (UTI) butter my bread. Figuratively speaking. There is an enormous amount known about the pathophysiology of UTI’s. It is both a common and complex problem. But for all our knowledge, chronic and recurrent UTI’s remain a vexing issue for the patient and the doctor. One reason people develop recurrent UTI’s...
Answering Our Critics, Part 1 of 2
Some people don’t like what we have to say on Science-Based Medicine. Some attack specific points while others attack our whole approach. Every mention of complementary and alternative medicine (CAM) elicits protests in the Comments section from “true believer” users and practitioners of CAM. Every mention of a treatment that has been disproven or has not been properly tested elicits testimonials from...
Everything Causes Cancer
It’s likely you know someone who has bought into the notion that nutrition is everything, the source of all health and the cause of all illness. Nutrition is very important, to be sure, but it is only one of many possible causes of disease, and if you live in a Western industrialized nation you probably have adequate nutrition. The notion, however, that...
The Science of Clinical Trials
Science-based medicine is partly an exercise in detailed navel gazing – we are examining the use of science in the practice of medicine. As we use scientific evidence to determine which treatments work, we also have to examine the relationship between science and practice, and the strengths and weaknesses of the current methods for funding, conducting, reviewing, publishing, and implementing scientific research...