Archive for the 'Science and Medicine' Category

Jan 01 2015

2014 Was a Bad Year for Homeopathy

I have been saying for several years that if there is a pseudoscientific medical treatment that is especially vulnerable to critical analysis it’s homeopathy. There’s a lot of nonsense in the world of medicine, but homeopathy takes the prize. First, it is complete and utter nonsense.

There is no need to equivocate. Homeopathy violates basic scientific knowledge in physics, chemistry and biology. It is transparent witchcraft that cannot possibly work by any known or even semi-plausible mechanism. Further, clinical studies unsurprisingly show that it does not work, for anything.

And yet the public does not generally understand what homeopathy actually is. The most common belief is that homeopathy is natural or herbal medicine. Rather, homeopathy is based upon several dubious notions. The first is that like cures like, and idea based on sympathetic magic and not science or any knowledge of the real world. Further, the actual starting ingredients are based upon a fanciful and often absurd interpretation of this dubious notion, leading to things like using duck liver to treat the flu.

None of this actually matters, however, because most homeopathic remedies are diluted beyond the point that there is any chance of a single molecule of starting ingredient remaining. All of this is supposed to work, however, because the potion is “activated” by shaking it.

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Dec 29 2014

Pertussis Evolving

New evidence suggests that strains of the bacterium, Bordetella pertussis, which is responsible for whooping cough, may be evolving to evade immune protection afforded by the pertussis vaccine.

The research, led by Dr Andrew Preston from the University of Bath, evaluated surface proteins from the 2012 whooping cough outbreak. They found that surface proteins that are included in the acellular pertussis vaccine were evolving faster than surface proteins not included in the vaccine. The authors point out that this was happening even prior to the introduction of the vaccine, but has accelerated since the vaccine.

It is not yet clear what, if anything, this means for the effectiveness of the acellular pertussis vaccine. However, the concern is that circulating strains of B. pertussis will continue to evolve, diminishing the protection provided by existing vaccines.

Whooping cough is a potentially serious illness, primarily affecting infants. There was an outbreak in the UK in 2012 with 10,000 confirmed cases and 14 infant deaths. In the US that same year there were over 48,000 cases reported (not necessarily confirmed) and 20 deaths.

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Dec 19 2014

Universal Medicine Uses Google To Silence Critics

An Australian based company called Universal Medicine (UM) has been criticized by various skeptical blogs and groups as being a new age alternative medicine cult. Looking through their website, this seems like a reasonable observation. (The term “cult” is fuzzy, but many of the features seem to be present.)

In response to this criticism, UM has apparently issued many complaints to Google, claiming defamation. According to the site Chilling Effect, Google has responded at least in some cases by removing the sites from Google searches, effectively censoring those websites.

Doubtful News was one of the sites censored by Google.

This type of action represents a serious threat to the skeptical mission. Part of that mission is consumer protection, and the primary method of activism is public analysis and criticism of dubious claims, products, services, and organizations. Essentially, we expose charlatans.

Charlatans, it turns out, don’t like to be exposed. They don’t like bad press.

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Dec 11 2014

Another Terrible Anti-Consumer Health Bill

On the desk of New York Governor Andrew Cuomo is a bill that would protect doctors practicing substandard medicine from being investigated by the Office of Professional Medical Conduct. The bill is similar to one unfortunately passed in Connecticut a few years ago – it is meant to protect doctors who prescribe long and recurring courses of IV antibiotics for alleged chronic Lyme disease.

This would be a terrible law on many levels, and I urge Governor Cuomo to veto the bill.

Bad Law

The standard of care in medicine is determined by the consensus of medical opinion and practice, which in turn is based upon the best available evidence. Often this is informed by panels of experts and professional societies who review the evidence and publish practice guidelines or standards.

The standard of care cannot be written in stone because it is a moving target. Scientific evidence is a living changing thing, and so you cannot simply write into law what the standard of care is. Rather the law simply sets up a process by which the standard of care can be determined when necessary.

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Nov 20 2014

How Much Water?

Water is the focus of a great deal of medical myths and snakeoil. This is perhaps due to water’s health halo – it is the very essence of purity, the elixir of life. I wonder if there is an evolved psychological connection to water. The idea of drinking dirty or contaminated water seems to be especially disgusting, while pure clean water is the most wholesome thing in the world.

Perhaps this is why there are so many “magic water” scams out there.  There is structured water, energized water, and ionized water. Homeopathy is essentially magic water with memory.

There is also a persistent belief that simply drinking more water has untold health benefits. You have probably heard that you should drink eight 8 oz glasses of water per day to stay healthy. This, however, is a myth, in that the 64 oz figure is not based on any evidence.

Your water requirements will vary, depending upon your body size, level of activity, humidity and ambient temperature. It will also depend on the type of food you eat. We get on average about 20% of our water intake from our food, but this will also vary depending on the type of food you eat.

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Nov 14 2014

The Seduction of Cancer Quackery

Here’s another instance of the narrative clashing with reality.

I wrote recently about an 11-year-old girl, a member of Canada’s Six Nations community, who has leukemia. Her parents, concerned about the side effects of chemotherapy, would rather treat her with traditional and alternative medicine. They are fighting for their right to do so, and the court seems sympathetic to the rights of the parents to express their cultural identity.

Meanwhile, it seems clear to me that the parents, and more importantly the girl, are simply being victimized by a charlatan, who has nothing to do with their cultural identity.

The seduction, really a con, is fairly straight forward. A seriously ill child is every parent’s worst nightmare, putting them into an extremely vulnerable position. Cancer is especially frightening, and chemotherapy, while it can be effective, is harsh. Leukemia is very treatable, and the girl’s doctors give her a 90-95% chance of being completely cured with a standard course of chemotherapy. However, she will have serious side effects from the chemo, and that is hard for any parent to watch. It can be an emotional dilemma (I think intellectually it’s a no-brainer, but emotionally tough).

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Nov 13 2014

Food Babe Misinformation on Travel

The “Food Babe” is an excellent object lesson in why people who are not qualified should not be dispensing advice to the public. Spouting uninformed opinions is one thing, but presenting information in an authoritative manner as if from an expert should not be attempted by the non-expert.

If you want to dispense useful information on your blog or website (not just opinion) then it is appropriate to cite credible sources and experts and to accurately convey their information. “These are the facts concerning flu vaccines, according to the CDC,” then quote the CDC directly, with a link to the source.

Unfortunately the web is cluttered with people who really have no idea what they are talking about giving advice as if it were authoritative, and often that advice is colored by either an ideological agenda or a commercial interest. The Food Babe is now the poster child for this phenomenon.

She recently published advice for healthy traveling. The page has since been deleted, apparently in response to criticism, but it is cached here. The FB’s advice contains some real howlers, demonstrating that she lacks even the most basic scientific literacy.

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Nov 11 2014

Glenn Beck’s Medical Narrative

Recently Glenn Beck has revealed that he has been struggling with medical issues for the last five years or so. On his show he states:

“Tonight’s show is not for the casual fan or, really, anyone in the press,” Beck said. “This is a one-on-one between friends. No one in the media ever does a show like this, because it is crazy. … But I believe that by not talking with you openly, it destroys everything of real meaning and value — namely, our trust.”

What follows is a common narrative we have heard before. Beck was very sick with a mysterious illness. His symptoms were mainly pain and numbness in the hands and feet, lack of sleep, mental fog, muscle problems, and vocal cord paralysis. He saw many doctors, who were unable to make a definitive diagnosis, while he slowly deteriorated.

Finally he saw a maverick doctor with unconventional treatments. He was able to explain all of Beck’s symptoms, and gave him a comprehensive treatment program which has reversed Beck’s illness. Now Beck is back with a “clean bill of health.”

Even though I am a neurologist and I have my suspicions about what was really going on, I am not going to attempt to diagnose Beck from afar. What I want to discuss is the issue of public figures using their own health to tell a moral narrative. It’s very problematic for several reasons.

The first is that medical stories, especially those involving a complex or difficult-to-diagnose condition, are, well, complex. There are often many nuances to such stories and they are not easily captured with simplistic narratives. For example, it is very difficult to know what Beck’s various physicians were thinking without either talking to them directly or having access to his medical record. Second-hand reports of the what other doctors are thinking are never, in my experience, accurate.

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Oct 30 2014

Homeopathy for Ebola

New Zealand Green MP, Steffan Browning, stepped in it recently when he signed a petition asking the World Health Organization (WHO) to develop and distribute homeopathic remedies to end the Ebola epidemic. Unfortunately this is not an Onion article.

Browning later tried to do damage control by stating that his support of the petition was “unwise” and he blamed it partly on it being late at night when he signed it.

Asked whether he thought homeopathy could cure Ebola, Mr Browning said: “It’s not for me to go down that track at all. The World Health Organisation, world health authorities are doing that.”

This is a common political response. Ask a Republican eyeing national office what they think about global warming or evolution and you might get a similar answer. It is a disingenuous dodge to essentially say, “I’ll let the scientists decide.” when they have already decided. It’s simply a way to stake out a neutral position and not piss anyone off.

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Oct 20 2014

Defending Sick Children

One of the most difficult issues that skeptical physicians face is dealing with children sick with cancer whose parents refuse standard therapy. These cases are always highly charged, because the stakes are extremely high. Obviously the stakes are highest for the child as their life is literally on the line. The stakes are also high for society, however, because they force a specific decision regarding the relative rights of parents vs the responsibility of the state to care for minors.

Two recent cases once again raise these issues. One comes from Western Australia where 10-year-old Tamara Stitt was diagnosed with liver cancer. Her oncologist recommended chemotherapy. Her parents were (understandably) concerned about the side effects of chemotherapy.

He said he and his wife decided against chemotherapy for their daughter because of its horrific side effects and because he felt threatened by doctors.

Mrs Stitt testified that she believed her daughter had a 100 per cent chance of being cured with natural therapies, and she had initially responded well to such treatment.

Her parents decided against chemotherapy and instead chose “alternative” therapies including clay wraps, herbal teas and a healthy diet. Tamara’s cancer predictably progressed until her parents finally relented. Tamara received chemotherapy in El Salvador, but it was too late, and unfortunately she died of her cancer.

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