Sep 14 2015

Is Fibromyalgia Real?

The question of whether or not fibromyalgia is a real disease is deceptively complex. The answer, therefore, is not a simple yes or no. A thorough answer requires some background, which makes it challenging to discuss any issue related to fibromyalgia without going on a long tangent about its status as a diagnosis.

What’s In a Name?

Before we get to fibromyalgia specifically, I want to review how diagnostic labels are used in medicine. Health care providers, researchers, and also insurance companies and regulators need a common language to refer to what patients have. As our understanding of disease is incomplete, and also disease entities are often complex and fuzzy around the edges, a coherent and thorough diagnostic system is likewise complex.

For simplicity, however, we can divide diagnostic entities into two broad types. First there are discrete diseases, which are pathophysiological entities. This is a specific problem with a specific tissue or physiological process in the body. A disease diagnosis may refer to a specific genetic mutation, for example, or an alteration in a physiological parameter.

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Sep 11 2015

How To Attack a Public Scientist

I have long held that one of the best ways to gauge the intellectual integrity of an individual or a group is to note how they deal with bad information or a bad argument that seems to support their position. You get points for rejecting an unsound argument or unreliable data even when it could be used to defend your side.

The flip side of this is acknowledging valid points that are on the other side of the argument. I will sometimes present what I feel is a rock-solid point for one side to an opponent, just to see how they will deal with it.

Of course it is far easier to point such behavior out in others, more difficult to police it in yourself. This is why constant reminders to value process, integrity, and fairness over any particular position is critical to skeptical inquiry.

Further, there is a range of bad responses to invalid points that can be exploited to support your position. In extreme cases ideologues will take the bad argument as total vindication. They will do a virtual victory dance, spike their fact in the end-zone, and turn up their self-righteousness to 11. Then you know you are dealing with someone with effectively zero intellectual integrity.

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Sep 10 2015

The Arctic Sea Ice Hubbub

Those who accept the consensus that the Earth is warming due to human activity (anthropogenic global warming or AGW) point to declining Arctic sea ice as one line of evidence to support this conclusion. Those who do not accept the AGW consensus claim that Arctic sea ice is not declining, or at least we have insufficient data to reach such a conclusion.

What I like about this controversy is that it is about data. It is a fake controversy, driven by political ideology, but none-the-less we can sink our teeth into the data and see which side has the better position.

Arctic sea ice varies throughout the year, growing in the winter and melting in the summer. Therefore any year-to-year comparisons need to take this seasonal variation into account. Scientists use the summer minimum as one measure of the extent of Arctic sea ice for that year. You can also look at the winter maximum.

Sea ice can be measured in square miles, essentially the amount of area covered by ice. It can also be measured in thickness, and the two measures can be combined to calculate the overall volume of ice.

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Sep 08 2015

Another Water Scam

There are endless scams and dubious products out there. I could tackle one every day and never get to the end, because more would crop up faster than I could take them down. That is why I try to develop general themes, so that my readers can better identify dubious claims for themselves.

There are also types of scams that involve similar themes. For example, there are many types of “magic water” out there – these are often just plain water, perhaps with vitamins or minerals added, that is said to be treated in some new sciencey way that renders it better water. Water has a pre-existing wholesome health halo around it, so it is a great subject for snake oil.

The bottled water industry has proven that you can get people to pay ridiculous amounts of money for what is essentially tap water. The “magic water” industry is just taking it one step further.

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Sep 04 2015

Mixed Messages on Psychic Detectives

UK’s College of Policing has released their draft Authorised Professional Practice on missing persons investigations (there is a public comment period open until October 9). This might not seem that interesting, but it is getting some attention because of their recommendations regarding the use of psychics.

Here is the entire section under “Psychics:”

High-profile missing person investigations nearly always attract the interest of psychics and others, such as witches and clairvoyants, stating that they possess extrasensory perception. Any information received from psychics should be evaluated in the context of the case, and should never become a distraction to the overall investigation and search strategy unless it can be verified. These contacts usually come from well-intentioned people, but the motive of the individual should always be ascertained, especially where financial gain is included. The person’s methods should be asked for, including the circumstances in which they received the information and any accredited successes.

Let’s break this down a bit: The first half is reasonable. Tips from alleged psychics cannot be ignored because people may have obtained information in some other way – from their own investigation or because they have a connection to the case – and are just claiming the information is “psychic” to obscure how they came by the information or to opportunistically exploit the case for their own reputation. Saying that such information should be viewed “in context” is therefore reasonable.

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Sep 03 2015

Thinking Style and Paranormal Belief

One burning question that comes up in skeptical circles is whether or not people who believe in the paranormal, are highly religious, or are enamored of conspiracy theories think differently than skeptics. Obviously they have different beliefs, but the question is whether or not their brains function differently in some respects from people who are more rational and scientific.

It certainly seems as if this is the case, but being skeptics we understand the irony of relying on intuition to conclude that other people rely more on intuition. Fortunately we have some psychological research to shed light on this question, including a recent study I will discuss below.

First let me dispense with the obvious false dichotomy – we should not think of this question as if there are two distinct types of people. Psychological studies will often do this, but they are simply dividing a continuum down the middle, or are only considering people at either end of the spectrum.

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Comments: 155

Sep 01 2015

Sleep and Health

Getting sufficient sleep is very important to overall health. It is an often overlooked aspect of health. I frequently have patients with multiple complaints who inform me, only when asked, that they have terrible sleep. They did not make the connection between their sleep and their symptoms, however.

Good sleep has been tied to longevity. A review of studies found that getting <6 hours of sleep on average per night was associated with a 12% increased risk of death. The same review found that getting >9 hours of sleep a night was associated with a 30% increased risk of death.

It is difficult to determine cause and effects with these studies. Sleep may simply be a marker for other health variables. People who sleep over 9 hours, for example, may do so because they are unhealthy for other reasons.

Even still, it is plausible that lack of sleep is stressful to the system, especially brain function, and therefore sleep disorders should be identified and treated. Don’t overlook the importance of good sleep.

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Comments: 19

Aug 31 2015

The Reproducibility Problem

A recent massive study attempting to replicate 100 published studies in psychology has been getting a lot of attention, deservedly so. Much of the coverage has been fairly good, actually – probably because the results are rather wonky. Many have been quick to point out that “science isn’t broken” while others ask, “is science broken?”

While many, including the authors, express surprise at the results of the study, I was not surprised at all. The results support what I have been saying in this blog and at SBM for years – we need to take replication more seriously.

Here are the results of the study:

We conducted replications of 100 experimental and correlational studies published in three psychology journals using high-powered designs and original materials when available. Replication effects (Mr = .197, SD = .257) were half the magnitude of original effects (Mr = .403, SD = .188), representing a substantial decline. Ninety-seven percent of original studies had significant results (p < .05). Thirty-six percent of replications had significant results; 47% of original effect sizes were in the 95% confidence interval of the replication effect size; 39% of effects were subjectively rated to have replicated the original result; and, if no bias in original results is assumed, combining original and replication results left 68% with significant effects. Correlational tests suggest that replication success was better predicted by the strength of original evidence than by characteristics of the original and replication teams.

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Aug 28 2015

French Court Awards Disability for Electromagnetic Hypersensitivity

A French court recently awarded a disability allowance ($912 per month for three years) to Marine Richard based upon her claim that she has EHS (electromagnetic hypersensitivity). This is a concerning development because EHS is likely not a real disease. The situation, however, is a bit more nuanced than it may at first appear.

EHS and Non-Specific Symptoms

First for some background on EHS (or Idiopathic Environmental Intolerance attributed to electromagnetic fields, IEI-EMF, as it is now called in the scientific literature) - sufferers claim that they are sensitive to electromagnetic fields and that these fields cause symptoms such as headaches, dizziness, nausea, fatigue, tingling sensation, or palpitations. In one case series of EHS specifically subjects reported:

The most frequently reported symptoms from exposure to smart meters were (1) insomnia, (2) headaches, (3) tinnitus, (4) fatigue, (5) cognitive disturbances, (6) dysesthesias (abnormal sensation), and (7) dizziness. The effects of these symptoms on people’s lives were significant.

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Aug 27 2015

FTC Responds to FDA on Homeopathy

The FDA (Food and Drug Administration) recently asked for public comment on its regulatory policies regarding homeopathy. They probably didn’t figure that a fellow federal agency, the FTC (Federal Trade Commission) would respond.

The FTC also recently asked for public comment on how it can better regulate homeopathic product advertising. While the FDA regulates food and drugs (including supplements), the FTC regulates claims that sellers can make about those foods and drugs. The FTC is now complaining to the FDA that their policies are in inherent conflict. They write:

The staff comment notes that the FDA’s regulatory framework for homeopathic drugs, set forth in a 1988 Compliance Policy Guide, does not require that over-the-counter (OTC) homeopathic drugs be approved by FDA as safe and effective if they satisfy certain conditions, including that the product’s label contains an indication for use. Yet the policy guide does not require sellers to have competent and reliable scientific evidence to support the indication for use.

The comment states that given the FTC’s long-standing advertising substantiation policy that health claims must be substantiated by such evidence the FDA’s current regulatory framework may harm consumers and confuse advertisers.

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