Archive for July, 2010

Jul 30 2010

Calcium and the Law of Unintended Consequences

Biological systems are extremely complex. This nugget of wisdom may seem trivial but it is a lesson the scientific and medical communities have been learning over and over again for a couple of centuries. Every time we think we understand a biological system we find there is a deeper level of complexity, or another layer of interactions we had not previously taken into consideration.

This is why we need high quality clinical trials to feel confident about the net health effects of any intervention. A treatment may make sense based upon our current understanding of human biology, but that’s not enough. We need to know what it actually does to people.

This is a lesson, however, that the supplement industry has not learned (and does not appear interested in learning). I have nothing against supplements themselves, only how they are regulated and marketed. I prescribe supplements all the time, when they are evidence-based. But the supplement industry has pulled off a marketing coup – the holy grail of marketing: turning their hype into accepted conventional wisdom. For example, the public generally believes that “natural” is always better, that supplements are always safe, and that we all need to take supplements – the more the better. None of these things are true.

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Jul 29 2010

Acupuncture Pseudoscience in the NEJM

Here is the conclusion quoted from a recent New England Journal of Medicine (NEJM) review article on acupuncture for back pain:

As noted above, the most recent wellpowered clinical trials of acupuncture for chronic low back pain showed that sham acupuncture was as effective as real acupuncture. The simplest explanation of such findings is that the specific therapeutic effects of acupuncture, if present, are small, whereas its clinically relevant benefits are mostly attributable to contextual and psychosocial factors, such as patients’ beliefs and expectations, attention from the acupuncturist, and highly focused, spatially directed attention on the part of the patient.

Translation – acupuncture does not work. Why, then, are the same authors in the same paper recommending that acupuncture be used for chronic low back pain? This is the insanity of the bizarro world of CAM (complementary and alternative medicine).

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Jul 27 2010

Maloney Declares Victory

Christopher Maloney does not get it – on many levels. Some of my regular readers may remember a few months ago when a naturopath by the name of Christopher Maloney frequented the comment section of my blog, making outrageous claims and generally getting a smackdown from the other commenters. I occasionally joined in until it was clear that Maloney was not engaging in fair and substantive discussion. Well now Maloney has copied much of this exchange onto his own website and has declared victory.

I will get to the “meat” (perhaps tofu is a better term) of his claims in a moment, but first will recap the exchange. The exchange began with this blog post in which I reported the accusation that Maloney complained about another blogger who was then temporarily shut down by his blog host. Maloney denied the accusation, which I reported as soon as he did, and clarified that the accusations were only alleged. It then came to light that another CAM practitioner, Andreas Mortiz, was responsible for complaining about the blogger, and I immediately updated my original blog post with that information. That is pretty standard blogging practice, and in fact was rather diligent in providing updated and corrected information as it became available.

Maloney, however, wanted something more. I think he just liked playing the role of the injured party. Meanwhile the substance of my original blog post (and a subsequent one naming Maloney) was about the health claims that Maloney was making on his website (more on that below).

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Jul 26 2010

Desiree Jennings on 20/20

Several months ago I was interviewed by 20/20 for a follow up news report on Desiree Jennings – the cheerleader who claims to have acquired severe dystonia from a flu shot – and that show just aired on Friday. I have been following this case as the core claim is neurological and has been grossly misrepresented in the media.

20/20 did a fair job, but it’s hard for me to tell what impression the average viewer will come away with. The first 2/3 of the story was presented from a credulous point of view – essentially just telling Jennings’ story without any hint of skepticism. But then the editorial tone flips, and they give the “other side.” They did a fair job in this section of the segment, and my point of view was reasonably represented. And then at the end they leave the audience with the question – real or fake? Not the best format from a scientific point of view, but it could have been worse.

To summarize the story, Jennings, who was 28 at the time, received a flu shot in August of 2009, after which she started to develop dramatic neurological symptoms including shaking and difficulty speaking. Her story was picked up by a local news station, and from their it was picked up by Inside Edition and became a national story. Jennings spread a considerable amount of unwarranted fear about the flu vaccine, aided by a credulous media who failed to do even basic vetting of her story. In an ideal world, the original reporters would have showed their video to an actual neurologist and the story would have been nipped in the bud right there. But that’s not he world we live in.

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Jul 22 2010

The Animal Connection

Published by under Evolution

We often take our relationship with animals for granted, but humans are unique in their ability to form working relationships with other species. (There are animals that have formed symbiotic relationships, but nothing compared to the multifarious use of animals by humans.) Humans nurture other species, feed and protect them, have guided their evolution in a process of domestication, and can communicate with them to a limited but useful degree. In exchange we use animals for protection, companionship, as a renewable food source, as a source of milk for our children, to provide wool for clothing, to perform strenuous manual labor, and for transportation of goods and people.

Anthropologist Pat Shipman has written a paper and an upcoming book hypothesizing that our relationship with animals was a key component of recent human evolution. Working with animals, she argues, evolved out of our knowledge of animals as prey and predators. Our ancestors intently learned about the animals in their environment, so that they could better hunt prey and avoid becoming prey themselves. This animal knowledge base then allowed them to exploit those same animals. Acquiring and passing on a complex knowledge base requires language, and therefore the benefits of animal knowledge became a key component of the selective pressures in favor of language itself. Those ancestors that were better able to form relationships with animals had a significant advantage over those who did not.

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Jul 21 2010

Music and Brain Plasticity

Published by under Neuroscience

A recent review of the literature on music and brain plasticity was recently published in Nature Neuroscience Reviews. The authors address a very interesting question that I have been writing about now for years – how widespread are the effects of mental training on overall cognitive function?

We know that the vertebrate brain displays considerable plasticity – it learns and remembers. When you train at a task, you get better at it. For example, I can type pretty fast. I don’t have to think about where the keys are, and I don’t even have to look at the keyboard. I just think of the words I want to type and my fingers fly effortless over the keyboard. This is a product of decades of typing.

Anyone who has learned to play a musical instrument is also familiar with brain plasticity. After years of playing, the complexity and subtlety with which you can perform on an instrument becomes impressive. You don’t have to think consciously about every move – you just feel it. Further, your ear is more sensitive to subtle aspects of pitch, tone, timing, and timbre. You notice things other people don’t notice.

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Jul 20 2010

Locked-In Syndrome and the Right to Die

Published by under Neuroscience

Tony Nicklison, 56, had a stroke in 2005 that left him in a locked-in syndrome. This means he is fully conscious but mostly paralyzed. He is able to move his eyes and, unlike some people with locked-in syndrome, he is also able to nod his head. But he cannot speak. He is able to communicate by blinking or by nodding his head when someone indicates the proper letter on a letter board.

Mr. Nicklison says that he wants to die, and is raising the issue of assisted suicide in the UK. Legally he can refuse food and water and would die of dehydration, but he and his wife do not want to use that option. He would rather die quickly at a time of his choosing. But he fears that his wife would face prosecution for murder if she gave him a lethal injection.

Mr. Nicklison says of his own condition:

“I have no privacy or dignity left. I am washed, dressed and put to bed by carers who are, after all, still strangers.

“I am fed up with my life and don’t want to spend the next 20 years or so like this. Am I grateful that the Athens doctors saved my life?

“No, I am not. If I had my time again, and knew then what I know now, I would have not called the ambulance but let nature take its course.”

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Jul 19 2010

Digital Drugs Do Not Cure Stupidity

Published by under Neuroscience

I have never been a fan of the local news, where journalistic standards are often annoying. Often the local news is an exercise in insulting the intelligence of the viewer. But at least the local news was local. With the internet, however, local news reports are increasingly being picked up by larger national outlets and amplified manyfold. So now I get to be subjected to the worst of local news reporting from all over the country.

Local news reporters brought us the Desiree Jennings story, and now they bring us the story of digital drugs, or i-dosing. From Oklahoma News 9 we learn that parents need to be very concerned (maybe they should even panic) – their kids are downloading digital drugs and listening to them on their i-pods, and this may be a gateway drug to the hard stuff.

Read and watch the report. I love the picture of the teenager with a towel on his face listening to headphones – real trippy. I wonder how staged that photo was. If you have ever dealt with a local news reporter you would wonder the same thing.

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Jul 16 2010

Terrible Anti-Vaccine Study, Terrible Reporting

One of my goals in writing for this blog is to educate the general public about how to evaluate a scientific study, specifically medical studies. New studies are being reported in the press all the time, and the analysis provided by your average journalist leaves much to be desired. Generally, they fail to put the study into context, often get the bottom line incorrect, and then some headline writer puts a sensationalistic bow on top.

In addition to mediocre science journalism we also face dedicated ideological groups who go out of their way to spin, distort, and mutilate the scientific literature all in one direction. The anti-vaccine community is a shining example of this – they can dismiss any study whose conclusions they do not like, while promoting any horrible worthless study as long as it casts suspicion on vaccines.

Yesterday on Age of Autism (the propaganda blog for Generation Rescue) Mark Blaxill gave us another example of this, presenting a terrible pilot study as if we could draw any conclusions from it. The study is yet another publication apparently squeezed out of the same data set that Laura Hewitson has been milking for several years now - a study involving macaque infants and vaccinations. In this study Hewitson claims a significant difference in brain maturation between vaccinated and unvaccinated macaque infants, by MRI and PET analysis. Blaxill presents the study without noting any of its crippling limitations, and the commenters predictably gush.

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Jul 15 2010

Beware the Nobel Laureate Argument from Authority

Published by under Skepticism

One of the core components of a skeptical world view is knowledge of logical fallacies – how to recognize and avoid them. And one of the more common fallacies we encounter is the argument from authority – arguing that a particular claim is likely to be correct because it is being made by some authority figure. In practice this is a bit tricky, as defending a claim with a consensus of appropriate scientific authority is perfectly reasonable. But we reject arguments from inappropriate authority (like celebrity endorsements) and recognize the quirkiness of individuals, and so no individual authority is ever very compelling.

There are occasionally extreme examples that demonstrate this latter principle – that no individual, not matter what their scientific history, should be relied upon as a sole authority of scientific truth. In science the Nobel Prize is often looked upon as the ultimate achievement, and Nobel Laureates carry what is probably an unhealthy amount of individual celebrity and authority. Don’t get me wrong – winning a Nobel Prize in science is a tremendous achievement, and only comes to those who have made significant scientific contributions. This is deserving of honor and respect.

But I would add a few caveats. First, there are many scientists who have made very significant scientific contributions who were never honored with a Nobel Prize. Second, winning a Nobel Prize involves a bit of luck. Hardly any scientist can set out to win a Nobel Prize – it is not just a matter of smarts and hard work. You also have to be in the right place at the right time – to make a discovery that turns out to have a huge impact. Impact is hard to predict, and is not always proportional to the difficulty and sophistication of the scientific research itself.

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