Archive for the 'Science and Medicine' Category

Oct 16 2017

Clean Eating Antiscience

Eating “clean” is the latest fad diet pseudoscience. A recent article in The Guardian goes over the many aspects of this movement in great detail, and is worth a read. My only complaint is that the author, Bee Wilson, buys into misinformation about the medical profession and nutrition.

Wilson claims that the medical profession was unhelpful when it came to nutrition. I disagree – the medical profession was at the forefront of nutritional research and advice. The problem was that the science-based answers were not what everyone wanted to hear.

There are many aspects to the clean-eating movement, which Wilson does do an excellent job discussing. It is mostly marketing, a way for self-proclaimed “gurus” to make millions selling cookbooks, diet plans, and detox programs with outrageous claims that it will transform you health and cure whatever ails you.

The movement is also partly a reaction to the realities of modern Western culture. There is an obesity epidemic in our culture, and while the exact causes are debated it seems clear that the food industry is partly to blame. Market forces also favor tasty food, which tends to be calorie dense, and supersized portions.

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13 responses so far

Oct 12 2017

Another Antivaccine Retraction

Retracted-950x633Science only works when it works.

In other words – science itself does not lead to an understanding of the universe unless that science is done correctly, rigorously, and honestly. This is a lot harder than I think is generally appreciated. In order to really reach firm scientific conclusions about any complex question we need to follow the arch of the research as it matures. We need to see what overall patterns emerge in the evidence. Eventually a tentative but reliable scientific consensus can be achieved.

There are many ways in which this process can go off the rails, however. With ESP we see researchers chasing the noise – trying to find tiny signals but only chasing their tails. With acupuncture we see proponents choosing to ignore, misinterpret, and then abandon well-controlled clinical trials in favor of “pragmatic” studies that will show them what they want. There is “cargo cult” science that goes through the superficial motions but lacks true scientific methodology. There is “Tooth Fairy” science that nibbles around the edges but never addresses the core premise – is the phenomenon actually real?

There is a huge positive bias in science – researchers have a tendency to tweak their methods to get the results they want, publishers have a tendency to publish positive exciting research, and other scientists have a bias toward citing positive interesting research. Funding sources affect research outcome. When pharmaceutical companies fund research the results are much more likely to be favorable to their drug than independent research. Scientists make mistakes, take shortcuts, and often have blinders on. And then there is outright fraud, which is uncommon but still crops up on a regular basis.

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5 responses so far

Oct 06 2017

Unnecessary Medical Interventions

clinical-decision-making-46-638A recent JAMA article is an update on a systematic review of overused interventions in medicine. They list the top ten overused tests and treatments, meant to highlight this problem in medicine. They conclude:

The body of empirical work continues to expand related to medical services that are provided for inappropriate or uncertain indications. Engaging patients in conversations aimed at shared decision making and giving practitioners feedback about their performance relative to peers appear to be useful in reducing overuse.

You can read a summary of the ten overused interventions here.  The one you are likely already familiar with is antibiotic overuse. The others are very specific tests or interventions in specific situations, like Computed Tomography Pulmonary Angiography to help diagnose acute pulmonary embolism.

Reviewing each of these interventions in the top ten list would require a deep dive into the literature and detailed discussion, which is not my intent here. If you want that level of detail, read the original article. What I want to discuss is, in general terms, why this is a problem in the first place.

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Sep 28 2017

Health Blogger Gibson Fined

BelleGibsonBelle Gibson is an Australian wellness blogger who made a lot of money selling her cookbooks and apps for healthy eating. What elevated her profile above the sea of competitors, however, was her claim to have cured herself of brain cancer with her diet. The problem with her story, however, is that she never had brain cancer.

Now an Australian court has fined Gibson $410,000 for  fraud.

Gibson doesn’t really tell a coherent story, and it is full of red flags, but here is what she says. She claims she was diagnosed with terminal brain cancer by a German alternative medicine practitioner. She believed the diagnosis, and was just “living her truth.” Therefore, she says, she never lied to her followers, she was lied to herself.

But her story of being a victim does not really hold together. In 2011 she was given a brain scan which found her to be perfectly healthy. So she knew at that time that she never had brain cancer. However, two years later she launched her wellness app in which she claimed her diet cured her of brain cancer. She also claims that she was about to come clean with her readers, but the media got to her first. Right.

Her claim of being a victim also doesn’t explain why the money that was apparently donated to charity via sales of her app never made it to the charity.

Those are a pretty damning set of facts, and her explanations don’t really cover them. I guess the Australian court agreed.

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Sep 25 2017

Lying About Vaccines

Robert F. Kennedy Jr. talks with reporters in the lobby of Trump Tower in New York, Tuesday, Jan. 10, 2017, after meeting with President-elect Donald Trump. (AP Photo/Evan Vucci) Robert F. Kennedy Jr. talks with reporters in the lobby of Trump Tower in New York, Tuesday, Jan. 10, 2017, after meeting with President-elect Donald Trump. (AP Photo/Evan Vucci)[/caption]

Robert F. Kennedy Jr. considers himself an environmentalist. While advocating for the environment, he has become particularly concerned about the effects of mercury on human health. This in itself is reasonable, and there is broad scientific agreement that we should make efforts to minimize human exposure to mercury.

But Kennedy goes beyond reasonable recommendations based upon scientific consensus. He has become part of what we call, “The Mercury Militia” who have become unmoored from reality in their zeal to combat the perceived evils of mercury. The mercury militia further became tied to the anti-vaccine movement when it was claimed that the mercury in some vaccines was causing harm (it doesn’t). He has become a visible example of how someone can cocoon themselves in their own reality.

In a recent interview for Stat News Kennedy tells a number of falsehoods about vaccines. In essence he is lying, although it is possible he believes the lies he tells. Kennedy has apparently dedicated a large portion of his life to this issue, publicly advocates for his position, and certainly has resources at his disposal. And yet he gets basic facts about vaccines hopelessly wrong. How does that happen?

Paul Offit has written an excellent take down of Kennedy’s interview, explaining many of his falsehoods. For example, in the interview Kennedy claims: Continue Reading »

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Sep 14 2017

India Opens Homeopathy Laboratory

homeopathy-803_250pxAs I continue my efforts to fight against pseudoscience in medicine, I often ask myself – how bad can it theoretically get? I have had this discussion with others as well, some of whom argue that we should not worry because science will win out in the long run. Science is self-corrective, and pseudoscience will become marginalized over time. I hope this optimistic view is correct, but I am not reassured by the evidence.

Let’s consider a recent article in the Hindustan Times, written completely without skepticism or irony, which details how the government of India has opened a state-of-the art laboratory to study homeopathy.

Howrah-based Centre of Excellence in Fundamental Research in Homoeopathy will also undertake fundamental research studies in homoeopathy with an interdisciplinary approach.

“This institute has undertaken several clinical research studies such as autism, psoriasis, vitiligo, breast cancer, hypertension, migraine etc. along with proving of new drugs in homoeopathy with their clinical validations,” said Naik.

The lab will support PhD students in homeopathy and focus on research into viral and other infectious diseases. This is all part of the Ministry of Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy (AYUSH). In India, pseudoscience in medicine, including homeopathy, have been fully institutionalized and are explicitly endorsed by the government.

This is how bad it can get.

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Sep 07 2017

Eliminating Personal Belief Exemptions for Vaccines

ExImmunMap15-TuesdayIn the US routine childhood vaccination is required for entry into public school, and in some states even private school. This is a reasonable public health policy. Vaccination not only protects the individual against common infectious diseases, but when enough people get vaccinated this creates community immunity (often referred to as herd immunity) which protects everyone.

Any parent knows first hand that children are seething vectors for germs. Their concept of hygiene, generally speaking, is often not the same as the average adult. Put a large group of children together in a close environment like a school, and you have basically created a disease factory.

Further, some children cannot be vaccinated for medical reasons. They may have a chronic illness that makes their immune systems too weak to handle the vaccine, or they have an intolerance to vaccines. For these children, if they want to attend school, their only protection is the community immunity that results from all the more healthy children being vaccinated.  Continue Reading »

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Aug 17 2017

Alternative Medicine Kills

alternative medicine killsI find it ironic that proponents of alternative medicine often accuse their critics (including yours truly) of not caring about patients. They try to take the moral high ground, claiming they are just trying to help people anyway they can.

Of course, this entirely misses the point of the criticism (which is either deliberate or convenient). Proponents of science-based medicine want one thing – the best chance that our treatments are safe and effective. Determining whether a treatment or any medical intervention has more benefit than risk can be very tricky – much more tricky than most non-experts realize. That is precisely why we need the best science available to help us make these critical determinations.

Meanwhile, alternative medicine proponents, it seems to me, fall into two broad camps: those who simply don’t understand the science of medicine, and con-artists. This is actually a continuum, with many people having a combination of naivete and a willingness to cut corners or engage in a little deception. The one thing they don’t have, however, is any legitimate moral high ground. They are either being reckless, despite their intentions, or they are robbing people of their health and money.

For some so-called alternative treatments there is little quality scientific evidence to evaluate claims. For such treatments we can still make judgments based upon plausibility, but such arguments are rarely compelling to the lay public. We also have an extensive history over the last century at least of new possible medical treatments. We know from experience that most new treatments will not turn out to be safe and effective. So, just playing the odds, any new untested implausible treatment is overwhelmingly likely to be either worthless or harmful. But again, people buy lottery tickets.

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3 responses so far

Aug 11 2017

Alex Jones – Snake Oil Salesman

Patent-medicine5If Alex Jones lived 150 years ago he would have traveled around with a horse-drawn wagon selling his patent medicine with a medicine show featuring amazing stories about hacking his way through the jungle to find cures and sitting down with Indian medicine-men to learn their secrets.

Today he has his own TV show where he tells amazing stories of conspiracies in order to sell dubious supplements.

I have to admit, Jones had me fooled for a while. I was only paying slight attention to the nonsense he spewed on InfoWars, enough to know that he was a raving conspiracy theorist. I paid closer attention when he claimed that the Sandy Hook school shooting was a false flag operation. Anyone as popular and flamboyant as Jones is likely supplementing their true belief with showmanship. I now, however, think it’s more likely that Jones is pure showmanship.

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Aug 04 2017

Lectin – The New Food Bogeyman

red-kidney-beans-on-a-wooden-tableDo you want to get rich on the internet? Here is a simple formula. First, purge yourself of any ethics or scruples you may have. Suppress any urge for intellectual honesty.

Next, pretend you are an expert. Actual expertise is not necessary. In fact, you don’t even need a basic 5th grade level of knowledge. There are titles you can grant yourself to easily accomplish this step: life coach, nutritionist, health ranger, food chick, whatever.

Now you are almost there. All you have to do is create a demand for some useless snake oil that you can sell online for a ridiculous markup. At this point you might be thinking – why would anyone buy my useless snake oil? It’s actually a lot easier than you think, and marketers have been using some version of this strategy since the barter system was invented. In a word – fear.

Just make your marks (I mean customers) afraid of something and then sell them the solution. It’s easier than you might think, everything you need is already on the internet. Recently John Oliver showed how Alex Jones uses crazy conspiracy theories to stoke fear and rage in his audience then sell them water filters and supplements as a solution. He is also selling a conspiracy culture and convinces his gullible audience that they need to support him so that he can get the truth out there. Jones can even admit it’s all an act and it doesn’t matter, because he successfully created an environment in which facts and truth are whatever he says they are – a marketer’s dream.

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