Archive for the 'Science and Medicine' Category

Sep 06 2016

Anatomy of the CAM Scam, NIH Edition

acupuncture2Here is the challenge: how do you take a treatment or set of treatments that clearly do not work, and in fact defy basic sciences like physiology and chemistry, and argue that they are worthwhile. The National Institutes of Health (NIH) was essentially given this challenge when the Office of Alternative Medicine was forced upon them in 1991. This office has since morphed into a center, with its current name, the National Center for Complementary and Integrative Health (NCCIH).

The NCCIH recently put out a document that is, in my opinion, the pinnacle of their strategy for promoting worthless treatments (whether they think that is what they are doing or not). It reads like a blueprint for how to spin a political narrative out of negative medical studies.

Focus of Subjective Symptoms

The paper is, “Evidence-Based Evaluation of Complementary Health Approaches for Pain Management in the United States.” Pain is a favorite target for CAM because it is a subjective symptom and there are known neurological mechanisms by which the perception of pain can be easily manipulated.

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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 »

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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?

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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.

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Aug 02 2016

Supplements and Contract Research

snake-oilI dislike double standards. They are inherently intellectually dishonest. Sometimes double standards are the result of a deliberate campaign to confuse the public or regulators in order to create special privileges.

Alternative medicine is a great example of a double standard. Proponents want their own special standard for research, for evidence, and for practice. They, in fact, have succeeded in passing laws in many states which explicitly create a double standard for practices arbitrarily deemed “alternative”.

Organic farmers can use toxic pesticides while criticizing their competitors for using less toxic pesticides. They also eschew GMO cultivars, while using those resulting from mutation farming or forced hybridization.

One clear double standard is the marketing of supplements – the industry has successfully created a double standard for their products. They criticize the pharmaceutical industry while being guilty of far worse practices.  Continue Reading »

8 responses so far

Aug 01 2016

Exercise and Health

couchpotatoEveryone knows that it is better for your health to exercise regularly, and that a sedentary lifestyle is ultimately unhealthy. The science clearly supports this conclusion as well, so this is one area where popular belief and science are in accord.

Uncertainty sets in, however, when you try to drill down to more detail. The primary question is – can exercise undo or offset the negative effects of being sedentary? Is the problem with sitting only that you are not exercising, or is sitting a risk factor for death in and of itself?

A new review and reanalysis of data from 13 studies hopefully clarifies this question. There is some good and bad news in the results, but overall I think it is good.

The authors looked at the two variables of interest, exercise and sedentary time. Sedentary time includes driving, sitting at a desk, watching TV, and similar activity. Moderate exercise could be just taking a brisk walk, and they mostly considered the total time of exercise.

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11 responses so far

Jul 26 2016

Marketing Conspiracies and Conspiracy Marketing

selling pseudoscience6_nA recent article by Spenser Davis details how Alex Jones uses his conspiracy mongering to sell conspiracy-themed supplements and products. This phenomenon goes way past Alex Jones. This post from Destroyed by Science lists a few of the more popular websites that combine conspiracy theories and dubious supplements and other products.

In my opinion, Jones pales in comparison to Natural News. This online empire closely connects conspiracies about medicine and the government with specific alternative health products and supplements.

The marriage of conspiracy theories and selling snake oil and pseudoscience is an obvious one. My question, however, is in which direction does the arrow of causation go?

Springtime for Charlatans

Pseudoscience, scientific illiteracy in general, and conspiracy thinking are goldmines for the sellers of dubious products. Think about it – what better potential customer is there than someone who is willing to believe fantastical claims does not require claims to even be scientifically plausible, let alone supported by solid science, and is skeptical of the regulatory system designed to protect consumers from fraud?

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21 responses so far

Jul 12 2016

Vitamin Supplements in Pregnancy

vitamins pregnancyFor a moment, imagine that you did not read the title of this article. What if I told you that a drug manufacturer was trying to get the public to use more of their drug, arguing it was necessary when the evidence shows that it isn’t? One trick that they use is to conduct studies in developing countries with a sicker population, and then apply that data to the developed world.

Even in the face of a thorough expert review of the published evidence, that concludes that the public is overusing their product and wasting money, the drug company argues that people still need their drug “just in case.”

Of course, in such a case, there would be cries of “Big Pharma” and the company would be rightly criticized for deceptive marketing and pushing their drug despite the published evidence.

For some reason, when the “drug” is a multivitamin, many people have a different reaction.

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Jul 11 2016

Former FDA Directors Criticize Supplement Regulation

fda1Recently six former directors of the Food and Drug Administration (FDA) met in Aspen to talk about the FDA. According to reports much of their criticism for their former agency was focused on lax regulations for supplements.

I, too, have been a consistent critic of how supplement are regulated in the US and elsewhere. Currently the regulation is determines by the 1994 Dietary Supplement Health and Education Act (DSHEA). This law passed while David Kessler was commissioner of the FDA, a law he vigorous opposed.

The Atlantic reports:

Jane Henney, commissioner from 1998 to 2001, recalled that the DSHEA law actually passed in the wake of the FDA “really trying to get their arms around stronger regulatory authority with dietary supplements.” This attempt at requiring supplement producers to guarantee the quality and safety of their product was countered by one of the most intense lobbying campaigns in history, in which TV commercials warned citizens that the government was coming for their vitamins. “I believe that the amount the Congress heard about this whole issue was greater than what they received about the Vietnam war,” she said. ‘I mean, it was tremendous.”

By all accounts this was a clear case of an industry lobbying the government in order to pass regulation friendly to industry and against the interests of the public. They were successful for a few reasons.

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Jul 08 2016

Should We Ban Homeopathy for Animals?

homeopathy-veterinarianYes. Yes we should.

This is an interesting idea I had not previously considered. Danny Chambers is a UK veterinarian from Devon who started a petition to ban the veterinary use of homeopathy in the UK. He has 1,000 signatures from UK vets so far (out of the 22,000 total UK vets).

Chambers said:

“We think vets these days should be offering 21st Century medicine,” he told BBC News.

“It’s been shown that homeopathy doesn’t work, so it probably shouldn’t be offered any more even if it is offered with good intentions.”

It is absolutely clear that homeopathy is worthless. This is among the most solid conclusions in all of medical science. First, there is no possible way according to our current understanding of physics, chemistry, and physiology that homeopathic potions can have any biological effect. It’s not just unknown – we have very good reasons to conclude that homeopathy cannot work (follow the link above for more details if you are unfamiliar with these reasons).

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