Archive for the 'Science and Medicine' Category

May 24 2016

Naturopaths Are Not Doctors

Herbal Medicine

This is the title of a change.org petition started by former naturopath, Britt Hermes. Please take some time to read and hopefully sign it.

Hermes has a significant insight into the state of naturopathic practice and education, since she was trained as a naturopath. She came to the conclusion that she was duped into a scam of a profession and now she tries to raise awareness of naturopathy to protect others from this scam.

Pseudosciences often depend upon ignorance of what they actually are in order to promote themselves and gain public approval. In the case of naturopaths they also depend upon the ignorance of politicians as they seek licensure, and then to expand their practice privileges and to force insurance companies to pay for their services.

In short, naturopaths desire all the status and privileges of medical doctors, but without the training, experience, or science-based standard of care.

You may think I am being hard on naturopaths, but that is likely because they have been successful in selling their narrative and confusing the public about what they actually do.

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8 responses so far

May 23 2016

Who Owns Your Genetic information?

genetic codeA genetic testing company, Myriad, is embroiled in a controversy over who owns genetic information. The company performs genetic testing, such as for BRCA1 and BRCA2 genes with variants that are associated with higher risk of breast cancer.

It has been the company’s policy to release information to their clients on any pathological gene variants, those known or suspected of being associated with higher breast cancer risk. If, however, the client has what is currently believed to be a benign variant, that is all they are told. They aren’t given the specific information about the gene sequence, just a note that it is benign.

Further, the company has declined to share its vast database of information with open source databases being used for research. The company cited patient privacy as their reason for not sharing data.

Now, several clients have sued Myriad to have their full genetic information released to them. It turns out a new rule under HIPPA (the Health Insurance Portability and Accountability Act) requires that companies release full genetic information to patients. Faced with this the company has decided to release the information to those who request it, but insist that it is voluntary and will still not release such information routinely (only to individuals who request it).

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5 responses so far

May 16 2016

Review of Probiotics

probioticsThe idea behind probiotics superficially sounds reasonable – friendly bacteria are important to the functioning of our gastrointestinal (GI) system and immune system. Probiotic products are supposed to supplement those friendly bacteria with live bacteria from certain foods, such as yogurt, or even in capsules.

A recent paper, however, reviews studies looking at probiotics in healthy subjects, finding no evidence for benefit. Let’s take a close look at this study and the science of probiotics.

The systematic review focused on studies looking at the change in the composition of bacteria in feces in healthy adults taking probiotics compared to placebo. They found:

Seven RCTs investigating the effect of probiotic supplementation on fecal microbiota in healthy adults were identified and included in the present systematic review. The quality of the studies was assessed as medium to high. Still, no effects were observed on the fecal microbiota composition in terms of α-diversity, richness, or evenness in any of the included studies when compared to placebo. Only one study found that probiotic supplementation significantly modified the overall structure of the fecal bacterial community in terms of β-diversity when compared to placebo.

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201 responses so far

May 09 2016

Still No Association of Cell Phones and Brain Cancer

cell.phone.giI have been following the scientific research looking into any possible association between cell phones and brain cancer. A new study coming out of Australia adds to this literature and argues against any association.

The question is obviously an important one, and has drawn some public attention. However, scientists argue about whether or not a causal relationship between cell phones and cancer is impossible or just really low. I fall into the really low camp, but the distinction is minor.

Plausibility

The key fact to understand about cell phones is that they produce non-ionizing radiation. By definition, ionizing radiation is powerful enough to break chemical bonds. This is a health concern because breaking such bonds could cause mutations in DNA, and some of those mutations may turn a healthy cell into a cancerous cell. This is the primary reason that radiation causes cancer.

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7 responses so far

May 06 2016

Acupuncture for Tension-Type Headache

acupuncture2A newly updated Cochrane systematic review of 12 studies looking at acupuncture for the treatment of tension-type headaches (TTH) concluded:

The available evidence suggests that a course of acupuncture consisting of at least six treatment sessions can be a valuable option for people with frequent tension-type headache.

This has led to another round of headlines that, “Acupuncture works but no one knows how.”

A closer look at the data, however, does not back up that conclusion, in my opinion. Cochrane is generally considered to be the gold standard for evidence-based systematic reviews, but their history is dodgy when it comes to unconventional treatments. For example, they famously had to withdraw their review of homeopathic occillococcinum for the flu because they concluded, although the evidence was insufficient to recommend, it was “promising” and deserved further research.

Their updated review is not much better, however:

There is insufficient good evidence to enable robust conclusions to be made about Oscillococcinum® in the prevention or treatment of influenza and influenza-like illness. Our findings do not rule out the possibility that Oscillococcinum® could have a clinically useful treatment effect but, given the low quality of the eligible studies, the evidence is not compelling.

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26 responses so far

Apr 28 2016

What Is Biohacking?

bulletproof-butter-coffeeAfter reading up on biohacking and listening to its proponents, I have come to the conclusion that biohacking is not a real thing. It doesn’t really exist.

Here is how one biohacking site describes what they think it is:

Biohacking is a crazy-sounding name for something not crazy at all—the desire to be the absolute best version of ourselves.

The main thing that separates a biohacker from the rest of the self-improvement world is a systems-thinking approach to our own biology.

You know how coffee feels like a shot of energy to your brain?

Pre-coffee you is sleepy….zzzzzz…

Post-coffee you is WIDE AWAKE!!

The only difference is the coffee in your stomach.

The lesson is this: What you put into your body has an ENORMOUS impact on how you feel.

See what I mean? So, drinking coffee is “biohacking?” If you look at what is considered biohacking it essentially amounts to living a healthy lifestyle through diet and exercise, with the addition of the usual assortment of pseudoscientific nonsense. This is nothing but a rebranding of standard self-help quackery.

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22 responses so far

Apr 07 2016

Pig Heart Kept Alive in Baboon

xenofunAbout 3,500 heart transplants are performed worldwide each year. This is the standard of care treatment for end stage heart failure. However, more people need hearts than receive them. About half of the recipients of a donor heart have been on the waiting list for more than a year. About a third for more than two years.

In short, there are not enough hearts to go around. Artificial hearts exist, but only as a bridging technology – keeping people alive while on the transplant waiting list. Stem cell therapy looks promising as a treatment for heart failure, but also is years away. Growing hearts is probably decades away.

Genetically modifying animal hearts is probably the option for a human donor heart replacement that is closest to becoming a reality. Recently researchers report that they have made progress along those lines – keeping a pig heart alive in a baboon for over two years.

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4 responses so far

Apr 04 2016

The NCCIH Draft Strategic Plan

NCCIHThe National Center for Complementary and Integrative Health (NCCIH), formerly the National Center for Complementary and Alternative Medicine, and prior to that the Office of Alternative Medicine, is developing their strategic plan for 2016-2021. They are seeking public comment, and my colleagues and I at science-based medicine (SBM) will be sending it to them.

The NCCIH is a center at the National Institutes for Health (NIH), which uses federal money to fund biomedical research. The center is largely the child of senator Tom Harkin, who is enamored of alternative medicine (I will use the term CAM for convenience) and wanted a separate office (then center) at the NIH specifically to fund research into CAM therapies.

About his center and its purpose, Harkin has famously said:

One of the purposes of this center was to investigate and validate alternative approaches. Quite frankly, I must say publicly that it has fallen short. It think quite frankly that in this center and in the office previously before it, most of its focus has been on disproving things rather than seeking out and approving.

If anything science should be tilted toward demonstrating that any new claim is false, and only ideas and claims that survive dedicated attempts to do so should gain tentative approval. Harkin gives away the game in this statement – that the purpose of NCCIH is to put a huge ideological thumb on the scale of medical science, to give special preference to exactly those claims in medicine which are least plausible, and then flip science on its head by seeking to approve them, rather than critically testing them.

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3 responses so far

Mar 28 2016

Tribeca Film Festival Pulls Anti-Vaccine Film

tribecaThis has been a typical saga, one we have seen played out many times. An organization (company, institution, etc.) provides a venue for an irresponsible anti-science article, speaker, or film. There is then a public outcry that the venue is being exploited to promote pseudoscience. The organization initially defends their decision, then reconsiders. The author, speaker, director then cries “censorship.”

It’s a predictable script.

Recently the Tribeca Film Festival announced its list of movies it will be screening this year, and among them was Vaxxed: From Cover-Up to Catastrophe, a movie perpetuating the idea that the Center for Disease Control (CDC) is covering up data that shows a link between the MMR vaccine and autism.

Orac discusses the content of the movie in detail, but here is a quick summary. The movie is produced by Andrew Wakefield, the disgraced struck-off British doctor who published a study in the Lancet claiming evidence for a connection between MMR and autism. The paper was later retracted and found to be fraudulent.

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4 responses so far

Mar 18 2016

Ioannidis – Evidence-Based Medicine Has Been Hijacked

In a recent commentary, framed as an open letter to David Sackett (the father of evidence-based medicine), John Ioannidis argues that EBM has been hijacked by various interests. He also clarifies his position in an interview with Retraction Watch.

Ioannidis hits many interesting points: EBM has become a way to market products and services, clinical studies are largely in the hands of corporations with vested interests, academics are under their own pressures which emphasize getting grant money, practitioners are likewise struggling to survive in an era of managed care, and quacks and charlatans are exploiting the whole mess.

It is an eye-opening roller-coaster ride, including many personal stories, through the mind of perhaps the most famous current critic of the industry of medical science. I agree with much of what he says, and in fact they coincide with a great deal of commentary here and at science-based medicine. He takes a more cynical and pessimistic tone than I would, but that is subjective.

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10 responses so far

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