Aug 23 2016

Deaths in Alternative Cancer Clinic Investigated

3-BRImagine you or a loved-one has cancer. You have a choice between two treatment options. You can be treated by a physician who is a cancer specialist using therapies that have been extensively researched, where we know the risks vs benefit, we know how to dose the treatments, and how to monitor for and manage potential side effect.

On the other hand you can be treated by someone who is not a physician (let alone a cancer specialist), who will also use powerful chemotherapeutic agents, but ones that have not been adequately studied, reviewed, or approved. We don’t know how to safely dose them, what all the possible risks are, or even if the agents work for your type of cancer (or at all, for that matter).

Which would you chose? It is hard for me to imagine why someone would choose the latter. Yet, if you slap the word “alternative” in front of the name of the latter clinic some people will think that it magically makes it the better choice. Also, some people have been so confused by conspiracy narratives they think that the con artist who isn’t a doctor is more trustworthy than the person who has dedicated their life to treating cancer.

Amazingly, they will argue that they don’t trust the doctors because there is too much money in cancer treatment, and then go to a clinic that will charge them $11,000 for unproven therapy. Continue Reading »

Comments: 6

Aug 22 2016

What Is Precision Medicine?

precision_medicineI feel that a lot of what I do here is separate marketing or ideological hype from reality. It’s a never-ending task, I think because humans have a tendency to view the world through narratives. We build a story about how we think the world works, and then that story drives our perception of the evidence (rather than the other way around).

Not only do we create our own narratives, but we communicate with each other through narratives, especially when we are trying to be persuasive. Marketing is an excellent example, because it has evolved over decades, trying multiple strategies, and preferring those strategies which work best. You may have noticed that many commercials and ads do not try to persuade you with fact, but rather try to convey a feeling, an image – a narrative. The same is also true of politics.

So deep is this tendency to view the world thematically rather than empirically, that even in science-based and highly technical areas like medicine we can encounter it. In the last few years I have been encountering the terms “personalized medicine” and “precision medicine” more often. Frequently this is in the context of blatant pseudoscience, but these terms are used even within respectable science-based medicine.

What do these terms actually mean and how is this different than what we are already doing?

Continue Reading »

Comments: 6

Aug 19 2016

Communicating Risk and Certainty

climate-change-denialA recent article in the Guardian discusses how scientists and experts should communicate risk and certainty to the public. The author, Jack Stilgoe, makes some good points, but unfortunately frames it as part of a defense of Jill Stein:

She said that there were ‘real questions’ about the dangers of vaccines, that GM foods have ‘not been proven safe’ and that ‘more more research is needed’ on the risks of electromagnetic fields.

As with climate change, it is tempting to claim that the science is certain, the evidence is clear and the debate should move on. Things are rarely so black-and-white. In politics, the facts don’t speak for themselves, so it falls to experts to make sense of the shades of grey.

Stilgoe is speaking of a dilemma faced by experts and science communicators when dealing with political or ideological opinions that diverge from the scientific consensus. The real dilemma is that if we communicate the science in technically accurate detail, it seems as if we are equivocating and those on the anti-science side will unfairly exploit this to exaggerate the uncertainty. If we gloss over the uncertainty to emphasize the bottom line, then the anti-science side will unfairly exploit that to say we are engaged in a cover-up and are being uncritical.

It is a no-win scenario, which is often the case when dealing with those who put ideology above science and reason. They aren’t playing fair, which can give them a rhetorical advantage over someone honestly trying to be fair.

Continue Reading »

Comments: 31

Aug 18 2016

Diagnosing Mental Illness in Presidential Candidates

trump-duh-e1453305835771CBS News Sunday Morning contributor Nancy Giles says that, in her opinion, Donald Trump is “clinically insane.” I have to wonder how “clinically insane” is different from regular “insane.”

I think the implication here is that this is a real psychiatric diagnosis of insanity, and not just a colloquial use of the word, like “that’s crazy.” Giles is implying that Trump has a mental illness, not just that she vehemently disagrees with his attitudes and temperament.

Meanwhile, there are conspiracy theories on the right about Clinton’s health and her “bizarre behavior,” with wild speculations about seizures and Parkinson’s disease.

A recent editorial on Medscape Psychiatry by Nassir Ghaemi asks a very interesting question, Is Psychoanalyzing Our Politicians Fair Game?

Armchair vs Professional

There is a range of behaviors going on here, and to some extent they need to be considered separately. Ghaemi was writing exclusively about psychiatrists (and to some extent psychologists) and their duties to patients, the profession, and as citizens.

Continue Reading »

Comments: 18

Aug 16 2016

Delivering Chemotherapy with Nanocarriers

nanocarriersOne of the great promises of nanotechnology is that we will be able to send swarms of these microscopic robots into your body to do all sorts of helpful things, like clean plaque from your arteries, repair cell damage, and kill cancer cells. Theoretically, these are all great ideas. There are, however, non-trivial technological hurdles to realizing the potential of this technology.

Another related great idea is the concept of delivering chemotherapy directly to cancer cells with some sort of targeted nanocarrier. Chemotherapy for cancer primarily refers to toxic drugs that kill cells. Specific drugs are given in specific doses so that they primarily kill rapidly dividing cells, which include cancer cells, but have less of a toxic effect on cells with a more typical rate of division. Still, chemotherapy makes people very sick and we are generally pushing this toxicity to its limits in order to maximize the effect against cancer cells.

What if, however, we could deliver the chemotherapy directly to cancer cells? In fact, anything we can do to increase the concentration of chemotherapy in the cancer and reduce the concentration outside of the cancer will enhance efficacy and reduce side effects.

Continue Reading »

Comments: 15

Aug 15 2016

Peer-Reviewed Chemtrail Smackdown

chemtrailsI love it when regular scientists decide to weigh in on a popular controversy. Recently scientists published a peer-reviewed paper in which they survey experts in atmospheric chemistry and atmospheric deposition over the nature of contrails and the claims that they are due to a secret large-scale atmospheric spraying program (SLAP), more commonly known as chemtrails.

Chemtrails

This is definitely one of the more extreme conspiracy theories out there. In fact, the authors point to a 2015 survey in which only 2.6% of those surveyed said they believed in SLAP. That’s pretty rarefied conspiracy nonsense.

The idea is that those streaks of clouds behind jets are not just the result of jet engine exhaust causing condensation in the air (regular contrails), but that they are seeded with chemicals by the government for some secret and nefarious purpose. That purpose ranges from poisoning the population as a means of population control to controlling the weather.

Continue Reading »

Comments: 20

Aug 12 2016

Augmented Reality and Mental Workload

fNIIRSVirtual reality (VR) and augmented reality (AR) applications are already here, but they still have not hit the steep part of the curve. We appear to be right at the beginning. We are about to experience the rapid adoption and experimentation with this new technology, and it will be interesting to see what applications become popular, and how people end up using these technologies. This is like predicting prior to the iPhone what smart phone apps will be popular.

For background, VR involves wearing goggles that fill your entire field of vision, so that you appear to occupy an entirely virtual world. When you physically move your head, your virtual perspective changes accordingly, so you can actually look around your virtual world.  Wearable devices like gloves are used to manipulate the virtual world.

Augmented reality is similar, but instead of immersive goggles you wear transparent glasses (like Google Glass) or use a handheld device with a camera (like Pokemon Go) which overlays virtual information onto the real world.

Continue Reading »

Comments: 10

Aug 11 2016

Do Superstitious Rituals Help Performance?

superstition-sportsWith the Olympics brings a great deal of attention to sports and sporting culture, including the latest fads that are sweeping athletes. It is well known that athletes, for example, are very superstitious, and it’s fun to talk about their crazy personal rituals.

A 2016 review of the literature confirms the association between sports and superstitions. They find that there are cultural and situational factors at play. The situational factors include:

In agreement with past theories, they increase with the level of challenge, as reflected by the importance of the competition, as well as with the level of uncertainty.

People engage in superstitious behavior to have a sense of control, and they need that sense of control when the stakes are high and uncertainty is high. This explains the observation that more elite athletes engage in more superstitious behavior.

Continue Reading »

Comments: 16

Aug 09 2016

Making the Non-Existent Disappear

Hieronymus_Bosch_051If I told you I could make something nonexistent disappear, you probably would not be very impressed with that as a magic trick. However, magic is all about misdirection. If I could make you think you saw an object that was never there, and then make it disappear, that could be quite impressive.

Psychology and Magic

Increasingly psychologists, neuroscientists, and magicians are converging upon a model of how our brains construct our perceptions of reality. Magicians actually had a head start as they have been working out practical ways to fool human perception for centuries. Psychologists started taking note in the late 19th century, but really have only been seriously examining the techniques of magicians in the last decade or so. Psychologists now routinely use magic tricks as part of experimental setups.

The basic picture that has emerged is that our sensory perceptions have both bottom-up and top-down components. The bottom-up components are essentially using the raw sensory input and constructing an image from that, then passing that construction on to higher brain levels that interpret the image and give it emotional meaning. Top-down construction works the opposite way, with the higher brain areas communicating their expectations to the primary sensory areas and influencing their construction.

Continue Reading »

Comments: 7

Aug 05 2016

Mike Pence Does Not Understand Evolution

Pence-EvolutionIt is my universal experience, after more than thirty years of confronting various forms of evolution denial or creationism, that creationists simply do not understand evolution. If any do understand it, they pretend not to. I guess they have no choice – they are motivated to deny an established scientific theory. They need to pretend they know better than the world’s experts, or that the world’s experts are lying and deceitful.

Mike Pence is a run-of-the-mill creationist. His denial of evolution is unremarkable and unimaginative, but now he is running for Vice President so his views serve as a ripe target for criticism. In a speech before the House he decided, for some reason, to go on a rant against evolution. For those who are interested, it is a good opportunity to play “name that logical fallacy” and you may want to watch the video and count the errors before reading ahead.

Pretty much everything Mike Pence says in the speech is wrong or misleading, except for trivial facts. He starts by setting the stage with Darwin publishing On the Origin of Species and presenting the theory of evolution. That evolution is just a “theory” is a main theme of his speech, which I will get to in a moment, but first he follows up by saying that Darwin expected his theory to be proven correct by the fossil record. He concludes that Darwin did not live to see this happen, and neither have we.

Is Evolutionary Theory Proven? Continue Reading »

Comments: 456

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