Archive for June, 2016

Jun 13 2016

Stem Cell Treatment for Multiple Sclerosis

ms cortex-above-ventriclesThere has been a lot of reporting about a new stem cell treatment for multiple sclerosis (MS). The results are genuinely interesting, even exciting, but preliminary and need to be put into perspective.

MS is an autoimmune disease of the central nervous system, affecting the brain and spinal cord. Actually, it is a category of several diseases that are largely defined clinically, such as relapsing remitting MS and chronic progressive MS. These distinctions are meaningful because they do predict response to certain existing treatments. Relapsing forms of MS tend to respond to chronic immune modulating drugs, while progressive forms tend not to respond.

The immune system in MS patients is faulty, targeting the myelin around axons in the brain and spinal cord. Myelin is the insulation that allows axons to conduct. When the myelin breaks down due to inflammation this slows conduction, and if severe enough can even stop it completely. Symptoms depend on where these inflammatory lesions occur in the nervous system. If a motor pathway is affected, then weakness will result.

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7 responses so far

Jun 10 2016

How to Argue in the Comments

Published by under Logic/Philosophy

duty_callsI love a good disagreement. I seek them out, sometimes to the annoyance of family and friends who may not be in the mood for a heated discussion. I would actually argue with people who came to my door to spread their religion.

Judging by the typical comments section beneath just about any article or video on the internet, I am not alone. People love to argue, and the relative distance and anonymity of social media seems to have a disinhibiting effect.

How to effectively engage in various situations is one of the more common questions that I receive, and in fact I did a workshop on this question at the last TAM and NECSS. One section of the workshops focused on how to argue online, in a forum or the comments section.

Here are some of my thoughts. Keep in mind, I am not saying this is what you should do. My goal here is not to be a “tone troll” or dictate how people interact, even in the comments to my own blog. Frequent readers will recognize that I rarely moderate the comments, and only for the more egregious offences. Rather, I am just providing my thoughts and perspective, in the form of, “If your goal is X, you might want to consider these factors.”

What is your goal? Continue Reading »

66 responses so far

Jun 09 2016

Liberal vs Conservative Antiscience

Published by under Skepticism

tysonmaher

On a recent Bill Maher show, Maher repeated his frequent claim that the Republicans are the party of antiscience. Neil deGrasse Tyson, who was a guest on that episode, countered:

“Don’t be too high and mighty there, because there are certain aspects of science denials that are squarely in the liberal left.”

There is no doubt that there are science deniers across the political spectrum. There are two points that I feel are in contention, however. Is there relatively more antiscience on the right than the left, and if so, what are the causes of the asymmetry?

Immediately there is a problem with this framing, as the political spectrum is more complicated than left vs right. However, most surveys use a three-point political designation: liberal (Democrat), conservative (Republican), Independent. So that is the data we have.

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57 responses so far

Jun 07 2016

Integrating Magic and Religion into Health Care

CARE-spoon bendingThe University of Alberta has become the latest battleground between advocates of science-based medicine and proponents of integrating magic and religion into our health care systems. In 2014 the university founded an Integrative Health Institute (IHI), which is headed by Sunita Vorha, who also is the director of their CARE program for integrative health and healing.

The debate has not changed, and it gets to the core foundation of modern health care. The SBM position is quite straightforward – as a profession, health care providers owe it to the public to base their advice and interventions on the best available science and evidence. It is our duty to establish and enforce a standard of care that includes adequate due diligence in determining the safety and effectiveness of interventions. The standard of care also includes giving patients proper informed consent and ethical standards of professionalism. There is also a well-established standard for conducting research on humans.

Essentially, we need to be reasonably sure that our interventions have more benefit than harm, and we need to tell our patients what they need to know so they can make informed decisions about their own health care. Continue Reading »

8 responses so far

Jun 06 2016

The Lost City

ZakynthosWe often don’t give nature enough credit. In many contexts, scientists or explorers find an anomaly and immediately the interest and speculation turns to intelligent agents at work. The ultimate expression of this, of course, is intelligent design creationism, where nature is denied credit for biology itself.

For example, snorklers discovered some odd shaped stones off the coast of the Greek island Zakynthos. The stones were surprisingly round, and so the immediate speculation was that these were the bases of pillars and are therefore the remains of an ancient Greek port, since lost to the sea.

I am not saying that this hypothesis is unreasonable, just that it seems to be the preferred hypothesis. This preference is also not unreasonable, because the remains of an ancient city are a lot more interesting than some oddly shapes stones (unless you’re a geologist).

Of course, there is always going to be someone taking such speculation too far, and prematurely concluding they have evidence for an intelligent artifact, even when further scientific investigation finds otherwise. It’s important to remember that in order to conclude that an anomaly is the product of deliberate artifice, we need further evidence. Greek ruins, for example, are lousy with pot shards. They are just everywhere. None have been found in the vicinity of the alleged pillars, however. This should give any ancient Greek port proponents extreme pause.

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8 responses so far

Jun 03 2016

Human Genome Project Write

Published by under Technology

Human-genome-001In 1990 the Human Genome Project (HGP) was launched, with a goal of sequences all the euchromatic DNA in the human genome within 15 years. The project was completed in 2003, two years ahead of schedule, at a cost of $3 billion. This was one of the great scientific achievements of our species – we set out to complete a huge goal, and we did, similar to going to the moon.

Over the course of the HGP the technology to sequence genes improved by orders of magnitude, becoming faster and cheaper. Not only did we gain a fantastic resource of knowledge that would fuel further science for decades, but the technological advances allowed us to sequence the genomes of many other organisms with still more scientific benefits.

Yesterday scientists announced HGP-Write, a plan to synthesize from scratch an entire human genome. Clearly they hope to replicate the success of the HGP. The plan is to organize an international effort to synthesize a human genome, advancing the technology to do so along the way. The proposed budget is $3 billion, the same as for the HGP.

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6 responses so far

Jun 02 2016

Theranos Exposed

Published by under Skepticism,Technology

Holmes-Summit-e1460127673162-1200x945I love a good cautionary tale. Perhaps my medical background predisposes me to “post mortem” analysis – what exactly went wrong and why? There is a risk of the cautionary tale, however, in that it is easy to impose a preexisting narrative onto events. The tale can be easily coopted, and then you are not learning a lesson but just reinforcing an existing belief.

I will try to avoid that trap while discussing the story of Theranos, but I am picking this story because it does support a cautionary tale skeptics like to tell.

Theranos was a hot tech startup based on a “disruptive” technology developed by its young maverick founder, Elizabeth Holmes. The story was perfect for the tech industry, who ate it up. It seemed a little dodgy to the medical industry, however, who viewed it with skepticism.

Here is a good overview of the story, with a list of tech news articles fawning over the new startup. Even some news sites who should have known better, like Smithsonian Magazine, were taken in. Read this article – it reads like a marketing brochure for the company. It overstates the limitations and problems with current technology, and overhypes how revolutionary the new technology will be. It asks, but does not answer, the key question – how is this new alleged technology supposed to work.

The claimed breakthrough of Theranos was a streamlined process for laboratory blood analysis that promised to perform 30 tests on a single drop of blood with same-day results. This would eliminate the need for drawing vials of blood and replace that with a simple finger prick.

For any scientist there are immediate red flags. Each blood test, in a way, is its own technology. You don’t measure sodium in the blood the same way you measure glucose, or test for the presence of antibodies to a virus. Yet Theranos claimed to have revolutionized dozens of standard laboratory tests. This would require a massive amount of research and development, or the introduction of an entirely new technology.

Such technology does not come out of nowhere. Research builds upon other research and then is translated into practical applications. The myth of the lone researcher making breakthroughs in their garage is largely just that, a myth. But that image clings tightly to the public consciousness. This makes it easier to sell the narrative of the lone genius making breakthrough technology.

Perhaps the tech industry is especially susceptible to this narrative. A team of coders with a great idea can create a disruptive app that will change the game. Investors are looking for disruptive startups, nerds with a great idea and the next billion dollar company. Medical technology is different, however. There needs to be a paper trail, years of research leading up to the application.

Now that the true story of Theranos is coming out, it seems obvious in retrospect that the whole thing was a scam. First, their labs were conducting 70% of their blood tests on conventional machines using conventional blood draws. They claim this is just while they were waiting for FDA approval of individual tests, but still they were not delivering on their promise.

Second, Theranos just voided the last two years of study results that were being conducted with their technology, what they called the Edison machine. In essence they just admitted that their technology does not work, and the lab test results they provided were not accurate. The company, essentially, has completely evaporated. The company now faces a class action lawsuit.

Last year Forbes estimated Holmes net worth at $4.5 billion. Yesterday they revised their estimate down a bit – to zero.

Conclusion

If this is a cautionary tale, what are the lessons? The obvious one, of course, is to be skeptical. Treat every new exciting claim as if it is a scam until proven otherwise. Don’t buy corporate marketing propaganda. Ask the hard questions, like exactly how does this work?

There are genuine breakthroughs, but most claimed breakthroughs aren’t. The market is currently being flooded with snake oil and medical pseudoscience, so again, it is a good default position that any new claimed medical breakthrough is probably a scam, or at least overhyped.

Also, be skeptical of nice neat narratives. If a story sounds ready made for movie plot, it probably is just that – a fiction. We love stories of underdogs rising from obscurity by challenging the big boys. We love the lone maverick narrative, the young genius, the rugged individual not afraid to break with convention.

The truth is often much less glamorous and exciting. Progress in science is more often made by various teams each contributing their incremental advance. Ideas rarely come out of nowhere. The big advancements are ones that we saw coming 1-2 decades before they became a reality.

Be aware of common red flags: A company selling a new technology should be able to describe, at least in general terms, how the technology works. You can do this without giving away technical secrets. If they refuse to give a satisfying answer for whatever reason, be suspicious.

If the relevant scientific community is skeptical, you should be too.

If they are using science-sounding jargon but do not really make sense (such as talking about frequencies, or quantum mechanics) it is almost certainly a scam.

Theranos is certainly not a rare case. Companies selling pure snake oil are out there in the thousands. Theranos was perhaps just the biggest one. I also doubt that the tech industry has learned its lesson. The allure of billion dollar  disruptive technology is just too great.

 

17 responses so far

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