Archive for the 'Science and Medicine' Category

Aug 21 2015

Risk Factors for Alzheimer’s Disease

A new meta-analysis of 323 studies looks at 93 possible factors associated with the risk of developing Alzheimer’s disease (AD). AD is a neurodegenerative disorder affecting the entire brain that causes a slowly progressive dementia over years.

Dementia is a generic term for a chronic disorder of memory and cognition. AD is a specific disease that causes dementia. It is the most common cause of dementia, responsible for about half of all cases. There are 5.2 million people with AD in the US, most over the age of 65. About one-third of people 85 years or older have AD.

AD, therefore, is a significant cause of a common condition that causes extreme disability and death in the older population. There is currently no cure for AD. Available treatments are considered symptomatic – they improve memory and function modestly but do not alter the course of the disease. Preventing AD, therefore, is very important.

The current meta-analysis looked at cohort studies and case-control studies. These are two different types of observational studies, meaning that they are observing what happens or has happened to people but does not randomize people to different groups. It is difficult to draw conclusion about cause and effect from observational studies because of possible confounding factors. The advantage, however, is that they can observe large populations. In the current analysis the researchers looked at 93 factors with >5,000 subjects in the pooled studies.

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Aug 11 2015

Bishops Meddle in Health Care

The headline almost says it all: Catholic Bishops In Kenya Call For A Boycott Of Polio Vaccines. Catholic Bishops, or any religious officers, have no business meddling in public health care. NPR reports:

“the country’s Conference of Catholic Bishops declared a boycott of the World Health Organization’s vaccination campaign, saying they needed to “test” whether ingredients contain a derivative of estrogen. Dr. Wahome Ngare of the Kenyan Catholic Doctor’s Association alleged that the presence of the female hormone could sterilize children.”

Where did they get this idea? From conspiracy theories. That’s it. There is no medical or scientific reason, no credible investigative journalism, and no evidence to suspect that vaccine (the polio vaccine or any other) contain estrogen compounds that will sterilize children.

This is an old conspiracy theory in Africa, based on the idea that “The West” wants to sterilize Africans in order to control their population and keep them down. This is pretty typical fear mongering – based on fear from outsiders who wish the community harm. It is a form of mass delusion.

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Aug 06 2015

Registering Studies Reduces Positive Outcomes

The science of science itself is critically important. Improvements in our understanding of the world and our technological ability to affect it is arguably the strongest factor determining many aspects of our quality of life. We invest billions of dollars in scientific research, to improve medical practice, feed the world, reduce our impact on the environment, make better use of resources, to do more with less.

It seems obvious that it is in our best interest for that scientific research to be as efficient and effective as possible. Bad scientific research wastes resources, wastes time, and may produce spurious results that are then used to waste further resources.

This is why I have paid a lot of attention to studies which look at the process of science itself, from the lab to the pages of scientific journals. To summarize the identified problems: most studies that are published are small and preliminary (meaning they are not highly rigorous), and this leads to many false positives in the literature. This is exacerbated by the current pressure to publish in academia.

There is researcher bias – researchers want positive outcomes. It is easy to exploit so-called
“researcher degrees of freedom” in order to manufacture positive results even out of dead-negative data.  Researcher can also engage in citation bias to distort the apparent consensus of the published literature.

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Aug 03 2015

The Holistic Doctor Murder Conspiracy

The antivaccine and CAM (complementary and alternative medicine) communities love a good conspiracy. When you live on the fringe of science and reason, conspiracy theories are your bread and butter. You need some reason to explain why the mainstream scientific community does not endorse your version of reality. It can’t be that the evidence doesn’t support your position, so it must be a conspiracy.

It is therefore no surprise that when a series of CAM practitioners die within a short period of time, antivaxxers see a conspiracy. A conspiracy would support their narrative so nicely, they just know it has to be true.

This story started with the death of Jeff Bradstreet, a “holistic” doctor who believed that vaccines caused his son’s autism. He was overtly anti-vaccine, supported the discredited mercury hypothesis of autism, and treated autism (including his son’s) with a variety of biomedical treatments including chelation therapy and hyperbaric oxygen.

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Jul 30 2015

Big Data and Personalized Medicine

Jun Wang, a famous Chinese geneticist, announced that he is going to shift his career into developing an AI (artificial intelligence) system that correlates genetics, behavior, and environmental factors with personal health. The goal is to provide individual recommendations about health and lifestyle based upon those factors.

In this case AI does not refer necessarily to a self-aware computer but just an intelligent system, like the AI that determines the behavior of characters in video games, or that won Jeopardy against human champions.

The real centerpiece of Wang’s vision is the data. He wants to build a database including the genomics data from one million people (and eventually much more), and correlate those genetic factors with lifestyle, environment, and health. What he is proposing, essentially, is using big data and AI systems to take the next step in personalized medicine.

Personalized medicine is currently a popular buzzword – you will find it frequently on alternative medicine sites. This is not because CAM practitioners are ahead of the curve. Rather, they latch onto the latest concepts and then make up the details as they go. It’s easy when you don’t have to do actual research or be science-based.

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Jul 28 2015

Anecdotes and Cannabis Oil

An article making the rounds has this claim in the headline: This Man Was Given 18 Months To Live. Here’s How He Illegally Cured His Cancer. The article further explains that he “cured” his cancer with cannabis oil. This is highly misleading for multiple reasons.

This and other articles tell the story of David Hibbit, a 32 year old man who was diagnosed with bowel cancer in 2012. First, let me say that of course I wish nothing but the best for Mr. Hibbit. I hope his cancer is completely gone and he lives a long life with his family. Cancer is a serious and scary disease. It has touched my family, and I am sure statistically it has touched most people reading this.

That, in fact, is why we have to be so careful when relating stories about cancer. Patients have serious and high-stakes decisions to make about how they are going to treat their cancer. Luring them to bad decisions with false promises and misleading but highly emotional stories is irresponsible.

The core of bad reporting about cancer is the anecdote – the heartfelt story of an individual fighting cancer. Such stories are almost universally highly misleading. The public is being given an emotional narrative, not useful information.

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Jul 23 2015

Stem Cells and the Arc of Technology

I have noticed a common arc to many technologies. First they are known and discussed only by scientists and experts in the field. Then they are picked up technophiles who read nerdy magazines and websites. This is all while the research is preliminary and the technology just a distant hope for the future.

Then something happens that makes awareness of the potential technology go mainstream. This is often a movie depicting the technology, but can also be just an article in a more mainstream magazine or newspaper, an early demonstration of the potential for the technology, or a political controversy surrounding it. Then the hype begins.

The hype phase is driven by the researchers looking for more funding, the technophiles who have already been salivating over the technology for years, and a sensationalist media.

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9 responses so far

Jun 29 2015

Drinking the “Integrative” Kool-Aid at the Atlantic

A recent article at the Atlantic by Jennie Rothenberg Gritzi demonstrates just how thoroughly the alternative medicine movement (I will refer to this as CAM) has been able to influence the cultural conversation over the practice of medicine.  This is great evidence of how successful a persistent marketing campaign can be.

Gritzi relates early on in the article that she was predisposed to CAM from a young age, which might explain her journalistic failures in this piece.  She writes:

After visiting the NIH center and talking to leading integrative physicians, I can say pretty definitively that integrative health is not just another name for alternative medicine.

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Jun 23 2015

Human Breast Milk – The New “Superfood”

This is yet another example of why making decisions based upon ideology, or what feels right, instead of logic and evidence is a terrible idea. There is currently a market for adult consumers of human breast milk, which is being sold as a “superfood” that can treat numerous conditions and optimize athletic performance. These claims are, of course, nonsense. The practice is also risky. A new report in the Journal of the Royal Society of Medicine details the problems.

A market for human breast milk (HBM) exists as a means of providing HBM for infants whose mother cannot produce. A recent survey finds that most HBM exchange happens offline, but facilitated through online sites. There is also a lot of overlap between donors and recipients, with women being donors at one time and recipients at others. This infrastructure exists to provide HBM for infants, and there is good evidence that HBM is the optimal food for infants.

A parallel market is emerging, however, for HBM intended for adult consumers based upon the idea that HBM is a natural superfood. Both of these concepts, however, are problematic. I have discussed many times how the term “natural” is used as a marketing ploy, but has no real meaning and is not rationally regulated. Whether or not a substance occurs in nature is irrelevant to its toxic or health effects, but it is meant to feel good. The idea of “natural” has a health halo, but does not mean anything specific, and is therefore ideal for marketing.

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Jun 19 2015

Are We Seeing the End of Homeopathy?

Several years ago, during a lecture on Science-Based Medicine, I noted that if there were one medical pseudoscience that was vulnerable to extinction it was homeopathy. Homeopathy is perhaps the most obviously absurd medical pseudoscience. It is also widely studied, and has been clearly shown to not work. Further, there is a huge gap in the public understanding of what homeopathy is; it therefore seems plausible that the popularity of homeopathy can take a huge hit just by telling the public what it actually is.

Further, homeopathy is in a precarious regulatory position. Homeopathic products are presented and regulated as drugs, but clearly they are not, and they are also not supplements, herbal drugs, nutrition-based, or natural products. They are simply fraudulent drugs riding a wave of ignorance.

In the last few years homeopathy has had a rough time. While the industry is still growing, there are signs of clear trouble on the horizon. Let’s review:

Some Background

Homeopathy is a 200 year old pre-scientific system of medicine based upon magical thinking. It is mostly based on two notions, the first of which is that like cures like. In other words, a substance that causes a symptom can cure that symptom in extremely low doses. There is no scientific basis for this, despite the desperate attempts by homeopaths to invoke vaccine-like analogies, or their new favorite, hormesis.

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