Sep 12 2016

Clinton Health Conspiracy Update

clinton12I wrote a couple weeks ago about health conspiracies in the current presidential campaign. I concluded that presidential candidates should be transparent about their health, given the job for which they claim to be qualified. At the same time, it seems to be standard procedure now to use health issues as another source of mudslinging.

As with many things, the public will have to sort through the fog of campaigning and biased reporting to try to figure out where reality lies. Perhaps most challenging is to filter out our own ideology and biases.

Both candidates this cycle are on the older side, 68 and 70 for Clinton and Trump respectively, and so health is more of an issue. There hasn’t been any update for Trump, he has still only released a rather dubious letter from his physician, not actual health records. The situation with Clinton has been very active.

Clinton has Pneumonia

The big news is that yesterday, at a 911 ceremony, Clinton did not feel well and had to abruptly leave. The press was kept in the dark for 90 minutes, after which time they were told that Clinton was “overheated” and dehydrated, and is now feeling better. The campaign later released information that two days earlier, on Friday, Clinton was diagnosed with a mild case of pneumonia and that was the cause of her not feeling well on Sunday. The pneumonia was also blamed for her recent persistent cough.

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Comments: 34

Sep 09 2016

Anti-Vaccine Doctor, Bob Sears, Faces Disciplinary Action

bob-searsDr. Bob Sears is a Capistrano Beach pediatrician who is famous for opposing mandatory vaccinations and the current CDC vaccine schedule. He has promoted his alternate vaccine schedule, which spreads out the vaccines much greater than the standard schedule. This has made him a darling of the anti-vaccine movement, an expert who supports part of their narrative (specifically, “Too many too soon” and parental choice).

Recently the Medical Board of California filed a complaint against Sears for “gross negligence.” There are three counts, the first for recommending a 2 year old patient not receive any further vaccines because of apparent reactions to previous vaccines. The complaint alleges:

Respondent was grossly negligent and departed from the standard of care in that he did not obtain the basic information necessary for decision making prior to determining to exclude the possibility of future vaccines, leaving both patient J.G, the patient’s mother, and his future contacts at risk for preventable and communicable diseases.

The complaint also alleges that Sears failed to adequately assess the patient after a head injury with complaint of headache, and also that he failed to keep adequate records by not filing the letter excusing the patient from vaccines in the chart.

The Standard of Care Continue Reading »

Comments: 16

Sep 08 2016

The Future of Telemedicine

telemedicine_computerTelemedicine is essentially the practice of having a patient visit electronically rather than in person. I think as a practice this is underutilized for various reasons, but we are likely to see much more of it in the future.

Does it Work?

Before we talk about the barriers to the adoption of telemedicine practice, let’s address the key question – is it effective? Further, is it as effective as an in-office visit? The answer, as you might expect, is, it depends. In some situations, however, it can be just as effective.

A recent study, for example, compared telemedicine from an originating clinic to in-person care for patients with asthma and found no difference in outcome over six months. In this study telemedicine patients visited a local clinic staffed with a nurse or respiratory therapist.

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Comments: 8

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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Comments: 7

Sep 01 2016

Bt Brinjal – Destroying the Anti-GMO Narrative

Bt BringalIt is amazing how a rigid ideology can so dramatically alter one’s perception of reality and justify bad behavior. Consider the following summary of events:

One side of the GMO debate opposes the use of seeds that were created in the public interest and given freely to farmers, without any corporate ownership or profit motive. These plants dramatically reduce the use of pesticides and reduce loss due to pest damage.

The activists on this side don’t have any facts at all to back them up, so they willfully spread lies and misinformation, spread propaganda as if it were journalism, and make personal attacks against those on the other side. Yet, they still think they are the good guys.

The Anti-GMO Narrative

The anti-GMO narrative – and that is what it is, a story – has several consistent elements. According to this narrative GMOs are poisonous, bad for farmers, and solely promoted by companies out to make money by controlling the food source and exploiting farmers and the public. The problem with this cartoon is that it does not comport with reality.

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Comments: 49

Aug 30 2016

In Defense of “Pseudoscience”

PhrenologyDon’t be confused by the headline – my intention is not to defend pseudoscience itself but rather the use of the term “pseudoscience.” In a recent commentary for American Scientist, Katie L. Burke argues that journalists and science communicators should stop using the term, “pseudoscience.” I disagree with her position and I think she is committing a number of logical fallacies, which I will now explore.

She writes:

A guiding tenet has emerged through years of climate change discussions and other polarizing scientific debates: Framing issues as “us versus them”—with a clear ingroup and outgroup—encourages polarization. The term pseudoscience inherently creates this framing, pitting those who believe in “real” science against those who believe in “fake” science. But these discussions really indicate whom we trust. And maybe if people trust alleged pseudoscience over science, we should be discussing why, rather than dismissing their values and beliefs.

Ironically Burke is not considering how she is framing her own discussion of use of the term “pseudoscience.” She is framing the distinction as a value judgment, rather than what it is, a judgment regarding scientific process and evidence.

Making objective statements about facts and logic is not a dismissal of someone’s values and beliefs. If Burke had any familiarity with the skeptical literature (and her essay provides much evidence that she does not) she would know that this is a point of heated discussion. In short, we try very hard to separate personal values and beliefs from science. Science is a process of empirically investigating the universe with valid logic.

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Comments: 21

Aug 29 2016

The Trump Doctor Letter and Clinton Health Conspiracies

clinton seizureThe health of the candidates for the presidency is considered fair game, which I think is reasonable. Being president is physically grueling. It requires stamina and if a candidate has health issues that can affect their ability to perform the job, and may also affect whether or not they are likely to live out their term in adequate health.

FDR famously kept his condition from the general public. He had polio when he was 39 (although some researchers think he may have had Guillain-Barre) and was essentially wheelchair bound. This would not affect his ability to function as president, but it was thought that if voters saw him in a wheelchair they would think he was less vigorous and perhaps even less manly.

Woodrow Wilson had a stroke in 1919, and the outside world was kept in the dark. His wife handled all his communication.

In retrospect it seems likely that Ronald Reagan was in the early stages of Alzheimer’s disease toward the end of this eight years in office. His wife and others close to him tried their best to cover for him, but it was clear he had lost his edge. He was later formally diagnosed with Alzheimer’s, which ultimately took his life.

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Comments: 19

Aug 26 2016

Biofuels and the Law of Unintended Consequences

biofuel-carbonI admit to a certain fascination with the informal “law of unintended consequences.” I think this is a very useful concept and should always be kept in mind. Essentially this axiom holds that the world is a complex place with far more variables in play than we could ever anticipate. Therefore our actions are likely to have consequences that we did not intend.

It therefore makes sense to be cautious and humble when taking any big action (like passing a law, establishing a regulation, promoting an industry, etc.), and to build into the process monitoring the effects of the intervention and making course corrections as necessary.

A new study suggests that biofuels may be the latest entry in the book of unintended consequences. The study tries to address a very narrow question – how much of the carbon that is released into the atmosphere when biofuels are burned was offset by the taking up of carbon from the atmosphere when the plants used to create the biofuels (feedstock) were grown?

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Comments: 31

Aug 25 2016

When Will Life Exist?

proximabThe Drake Equation is a thought experiment identifying which variables are needed to calculate the number of intelligent civilizations in the universe. Some people criticize the equation because we can only guess at the values of those variables, but that is not the point. The point was to identify the variables. This allows us to take the next step in the thought experiment, to plug in possible values and see what answers we get. Also, over time we will get better and better estimates of those variables.

Recently astronomers Loeb, Batista and Sloan published a paper in which they did a similar thought experiment, but instead of asking how common life and intelligent life is in the universe right now, they asked how common life is likely to be over the lifetime of the universe.

Their conclusion:

We find that unless habitability around low mass stars is suppressed, life is most likely to exist near ~ 0.1M stars ten trillion years from now.

Ten trillion years is a long time, given that the universe is only 13.82 billion years old. What they are saying is that there are many low mass stars, or red dwarfs, in the universe. Further, low mass stars have a very long lifespan, hundreds of billions and even trillions of years. About 76.45% of all the stars out there are red dwarfs, and a star with 0.1 solar masses (a tenth the mass of our sun) could survive for 10 trillion years according to our models of stellar physics.

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Comments: 24

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 »

Comments: 23

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