Results for: acupuncture
Pragmatic Studies and Cinderella Medicine
Explanatory studies are done under controlled conditions to determine whether a treatment has any efficacy compared to a placebo. Pragmatic studies are designed to assess how the intervention performs in everyday real world practice. Pragmatic studies measure practical success but don’t determine actual efficacy: that requires a proper randomized controlled trial (RCT) with an appropriate control. Pragmatic studies have their place, but...
Surprise, surprise! Dr. Andrew Weil doesn’t like evidence-based medicine
Dr. Andrew Weil is a rock star in the “complementary and alternative medicine” (CAM) and “integrative medicine” (IM) movement. Indeed, it can be persuasively argued that he is one of its founders, at least a founder of the its most modern iteration, and I am hard-pressed to think of anyone who did more in the early days of the CAM/IM movement, back...
Placebo Prescriptions
Whether it’s acupuncture, homeopathy or the latest supplement, placebo effects can be difficult to distinguish from real effects. Today’s post sets aside the challenge of identifying placebo effects and look at how placebos are used in routine medical practice. I’ve been a pharmacist for almost 20 years, and have never seen a placebo in practice, where the patient was actively deceived by...
Parasites
I saw a patient recently for parasites. I get a sinking feeling when I see that diagnosis on the schedule, as it rarely means a real parasite. The great Pacific NW is mostly parasite free, so either it is a traveler or someone with delusions of parasitism. The latter comes in two forms: the classic form and Morgellons. Neither are likely to...
Dr. Oz on alternative medicine: Bread and circuses
NOTE: Dr. Novella has written up a detailed description of his experiences on The Dr. Oz Show. Please read it. Also note that the online video for Dr. Novella’s appearance is now available: Controversial Medicine: Alternative Health, Part 1 Controversial Medicine: Alternative Health, Part 2 Controversial Medicine: Alternative Health, Part 3 When I first learned that our fearless leader and partner in...
Conflicts of Interest
When an article is published in a medical journal, the authors must disclose any conflicts of interest. This is important, because even if they think owning stock in the drug company won’t influence their scientific judgment, we know that subtle biases can creep in to somehow affect the findings of studies. It has been shown that studies funded by drug companies are...
A Skeptic In Oz
UPDATE 4/27/2011: Here’s the online video of Dr. Novella’s appearance on The Dr. Oz Show: Controversial Medicine: Alternative Health, Part 1 Controversial Medicine: Alternative Health, Part 2 Controversial Medicine: Alternative Health, Part 3 I must say I was a bit shocked two weeks ago when I was contacted by a producer for The Dr. Oz Show inviting me on to discuss alternative...
Without Borders
Take up the White Man’s burden– The savage wars of peace– Fill full the mouth of Famine And bid the sickness cease; And when your goal is nearest The end for others sought, Watch CAM and woo Folly Bring all your hopes to nought. Rudyard Kipling. Sort of. The White Man’s burden, a bit of racism from the 19th century: The term...
CAM In Medical Schools
A recent US News and World Report article on the incorporation of complementary and alternative medicine (CAM) into US medical schools credulously repeats the pro-CAM marketing hype. There is no evidence that the author, Meryl Davids Landau, spoke to a single critic of CAM, or is even aware that such criticism exists. The result looks more like marketing copy than serious journalism....
The World Has Moved On
I do a lot of driving as part of my job. I am the sole Infectious Disease doctor at three hospitals and I can spend an hour or two a day in the car, depending on traffic. What prevents me from going crazy sitting in traffic is listening to podcasts and audible books. I especially like reading (and yes, audio books is...