I am often told by people who are frustrated at their inability to lose weight that they are not overeating. They insist that their caloric intake is low, which for most unsuccessful dieters is implausible (barring some medical condition). New research suggests that they may be sincere, but just suffering from a misleading heuristic.

A heuristic is a mental short cut – a down a dirty estimate or rule of thumb that we use subconsciously to quickly arrive at a conclusion that is mostly true. The presumed evolutionary advantage of heuristics is that they enable us to think and react quickly. A heuristic is a mental trade off of accuracy for speed.

An example of a common heuristic is the availability heuristic. Whenever we encounter a novel situation we reach for an available example from our own experience. We then assume that the available example is representative and will inform us about the novel situation.  When shopping for a dog, for example, and considering a doberman, one might observe – “my cousin had a doberman, and he was a mean and nasty dog.” This is the available example – and we will tend to make our decision based upon this one available example, without considering that it may not be representative.

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According to the British Homeopathic Association (does that mean the fewer members they have the more powerful the group?) June 14-21 is Homeopathy Awareness Week. I would like to do my part to increase awareness of homeopathy.

I would like people to be aware of the fact that homeopathy is a pre-scientific philosophy, that it is based entirely on magical thinking and is out of step with the last 200 years of science. People should know that typical homeopathic remedies are diluted to the point that no active ingredient remains, and that homeopaths invoke mysterious vibrations or implausible and highly fanciful water chemistry.  I would further like people to know that clinical research with homeopathic remedies, when taken as a whole, show no effect for any such remedy.

In short, homeopathy is bunk. But here is a somewhat longer description of its history.

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Everyone knows that the purpose of fingerprints is to increase friction and therefore improve our grip. New research calls this common belief into question – sort of.

The media, and it seems the researchers themselves (if they are being presented accurately) are presenting this as scientific evidence debunking a myth – but the real story is more complex.

Dr. Roland Ennos did a number of experiments looking at the friction between a finger pad and a plate of glass. He found that the friction did not increase by much when the force between the finger and glass increased – less than predicted. However, the friction did increase in proportion to the surface area of the finger pad that was in contact with the glass.

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After a decade of research, and 2.5 billion dollars of taxpayer money, government funded research into so-called “alternative” medicine has little to show for it. The AP has put out a fairly insightful review of this research, which echos many of the points I have been making over the years.

They report:

Echinacea for colds. Ginkgo biloba for memory. Glucosamine and chondroitin for arthritis. Black cohosh for menopausal hot flashes. Saw palmetto for prostate problems. Shark cartilage for cancer. All proved no better than dummy pills in big studies funded by the National Center for Complementary and Alternative Medicine. The lone exception: ginger capsules may help chemotherapy nausea.

As for therapies, acupuncture has been shown to help certain conditions, and yoga, massage, meditation and other relaxation methods may relieve symptoms like pain, anxiety and fatigue.

And to reinforce that point:

(Dr. Josephine Briggs) conceded there were no big wins from its first decade, other than a study that found acupuncture helped knee arthritis. That finding was called into question when a later, larger study found that sham treatment worked just as well.

Dr. Briggs is the current director of the National Center for Complementary and Alternative Medicine (NCCAM) – the NIH center that funds this research.

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In response to my post yesterday on Chronic Lyme Disease, commenter “tnkrbell” raised some new points that will take more than a brief comment to address.

Tnkrbell wrote:

Perhaps there is more to this situation then you are aware of considering that the CT Attorney General was forced to intervene here. They did just finish an investigation into wrong-doings with respect to ISDA guidelines for Lyme disease. That entire panel was found to be implicated in wrong doings including monetary dealings with insurance companies and a whole lot more. The whole panel was fired, allowing for new unbiased guidelines to be created (hopefully it will be unbiased anyway).The link for that press release is: http://www.ct.gov/ag/cwp/view.asp?A=2341&Q=414290

This is not quite what the press release says, and includes a bit of spin. First, the IDSA guidelines remain in effect, as per a settlement with the attorney general, and they are now in the process of external review. This is a good thing – the more independent review the better. We will see what effect this has on the guidelines.

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Yesterday I wrote about a bill that has recently passed the CT state House and Senate that will exempt physicians who prescribe antibiotics for chronic Lyme disease (CLD) from being held to the standard of care. In my opinion this bill (likely soon to be law) represents an arrogant and counterproductive intrusion by the legislature into a complex area of medicine.

This bill is not an isolated case. There is already a similar law in Rhode Island, and there have been similar bills proposed in Pennsylvania, Massachusetts, and New York, and a bill in Maryland that would compel insurance companies to pay for antibiotic treatment for CLD.   This is part of a coordinated effort by individuals and organizations who hold an ideological opinion regarding the cause and treatment of CLD. They wish to use the political process to win a victory for their view that they have been unable to win in the arena of science (sound familiar).

Today I will summarize the current scientific and medical issues surrounding the concept of CLD, which in my opinion will highlight the folly of trying to capture this complex and rapidly evolving scientific question with a snapshot of political opinion.

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The Connecticut state senate unanimously passed Public Act No. 09-128: AN ACT CONCERNING THE USE OF LONG-TERM ANTIBIOTICS FOR THE TREATMENT OF LYME DISEASE.The bill had previously passed the state House, also unanimously.

This is a terrible bill that is both anti-science and anti-consumer protection. How it passed both houses without dissent reflects exactly why such micro-management decisions should not be made by politicians.  It is the result of lobbying by a narrow interest group and does not reflect either the state of the science on Lyme disease nor the proper role of regulation to ensure standards of care within medicine.

The bill now awaits Governor Rell’s signature, which given the heavy political support for this bill seems almost certain.

This bill represents much which is wrong with the state of science and medicine in the US.

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If you needed an organ transplant, how would you feel about receiving an organ donated from a serial killer? Would it bother you to have the heart of a psychotic murderer beating in your chest? Should it?

There are two factors at work here – one intellectual, and one emotional. The intellectual factor is easier to deal with. There is no compelling evidence nor any plausible mechanism by which the transplantation of any organ will confer any of the personality of the donor to the recipient. You might be tempted to quip – unless it is a brain transplant. But I maintain that there is no such thing as a brain transplant. If such were possible (which is currently is not) it would be better understood as a body transplant – but I digress.

The notion that transplants convey some of the spirit or psychic energy of the donor is pure pseudoscience. This does not stop some from claiming just that. Gary Schwartz, professor of Psychology at the University of Arizona, infamous in skeptical circles for his so-called After Life Experiments, believes he has documented cases of personality transplant.

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Simon Singh was sued by the British Chiropractic Association for correctly pointing out that they promote therapies that are not backed by adequate scientific evidence – therapies which Simon called “bogus.” In a pre-trial hearing the judge ruled that was Simon meant by that statement was that all the members of the BCA know that their treatments do not work and promote them anyway, as an act of deliberate fraud.This means that if Simon is to go forward defending himself against libel, he has the burden of proof that the judge’s interpretation of what he said is true – an impossible task.

That is an absurd ruling, especially since Singh clarified exactly what he meant elsewhere in the article, that the chiropractors are simply deluded true-believers.

Simon announced today that he will appeal the judges decision and continue to go forward with his defense. This is good news for the cause of free speech, especially in the realm of educating the public about science and the fight against quackery and nonsense.

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Maybe David Kirby, author of Evidence of Harm and one of the major proponents of the notion that thimerosal in vaccines was largely responsible for the recent increase in autism diagnoses, is sincere when he claims he is not anti-vaccine. I say that because he has backed so far off from his stance that vaccines are the culprit – not completely, and without overtly acknowledging his past errors, but has put some significant distance between him current position and his prior certainty.

In his 2005 book Kirby asks the question:

Did the injection of organic mercury directly into the developing systems of small children cause irreparable harm? It’s a plausible proposition, and a hugely important question. If the answer is affirmative, someone will have to pay to pick up the pieces.

He coyly insists he was just asking questions, but the book makes a strong and, in my opinion, one sided case that there is “evidence of harm” – specifically evidence that thimerosal was a major contributor to autism. It also builds a case for a grand conspiracy to hide this fact from the public. Kirby then made a career out of promoting the notion of a link between vaccines and autism with government and professional malfeasance. He became a hero of the anti-vaccine movement.

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