It’s the peak of summer in North America. Posting will become even more sporadic as some well-deserved vacation occurs. Here’s some dockside reading:
To become a world class architect and designing a skyscraper isn’t easy, but we, non-architects, can observe what we see, and accept that the building isn’t going to topple over in a hurricane. Do we presume to know how the foundation has to be built to support the building? Or what materials are used to give flexibility in a wind, but strong enough to not collapse? Mostly, we don’t, we trust that there isn’t a massive conspiracy to build unsafe skyscrapers because architects are being paid off by Big Concrete to use cheaper materials.
It’s the same with science. We can accept a scientific principles without doing the research ourselves. But, and it’s a big but, if you want to dispute accepted science, then you have to bring science to the table not a “debate.” Science isn’t hard, but it isn’t easy either. You cannot deny basic scientific facts without getting a solid education, opening a scientific laboratory staffed with world-class scientists, and then publishing peer-reviewed articles to move the prevailing scientific consensus. You cannot spend an hour or a day or even a week googling a few websites to stand up to the scientific consensus, you need to do the hard work. Until you do, those of us who are skeptics and scientists get to ignore you, and we get to continue with the current consensus.
Pharmacy & Medicine
Why does anyone buy Bayer aspirin — or Tylenol, or Advil — when, almost always, there’s a bottle of cheaper generic pills, with the same active ingredient, sitting right next to the brand-name pills? Matthew Gentzkow, an economist at the University of Chicago’s Booth school, recently tried to answer this question. Along with a few colleagues, Gentzkow set out to test a hypothesis: Maybe people buy the brand-name pills because they just don’t know that the generic version is basically the same thing.
Cage Match: Google Scholar versus PubMed. Which do you prefer?
The Chronic Lyme Conundrum from Steven Novella:
Those who believe they have chronic Lyme (and often the journalists who cover their stories) are quick to argue that they are suffering and need treatment, as if the compassion high-ground is entirely on the side of believers in chronic Lyme. But it is precisely compassion for patients that causes the medical community to follow the best evidence here. Those who believe they have chronic Lyme when they don’t may be missing out on treatment for whatever is really causing their symptoms and may be exposed to the risks of long-term antibiotics without any benefit (beyond the predictable placebo effects). As with any complex medical or scientific question, the evidence is complex, allowing for a variety of interpretations. The majority interpretation, however, is that controlled trials of IV antibiotics in patients identified as having chronic Lyme disease show the treatment to be ineffective. However, the believers can cite evidence as well. A reinterpretation of the above studies argues that they were underpowered and that some outcomes were positive.
Also good: The Lyme Wars, from Micheal Specter:
But nearly everything else about Lyme disease—the symptoms, the diagnosis, the prevalence, the behavior of the borrelia spirochete after it infects the body, and the correct approach to treatment—is contested bitterly and publicly. Even the definition of Lyme disease, and the terminology used to describe it, has fuelled years of acrimonious debate.
Pharmaceutical companies are under increasing pressure to release previously hidden data on how well their drugs work. The primary push for much greater transparency has come from the Cochrane Collaboration, an international network of experts based in Oxford, England; The British Medical Journal; and the European Medicines Agency, which recently proposed that, starting next year, clinical trial data be released once a drug is approved for marketing.
“CAM” Education in Medical Schools—A Critical Opportunity Missed. Excellent. Equally applicable to pharmacy schools (cough University of Toronto cough)
The clinical case illustrates a problem common to “complementary and alternative medicine” (CAM) courses in U.S. medical schools: they are uncritical and promotional [1-3]. This is unfortunate because the topic offers an ideal opportunity to discuss scientific skepticism, other critical thinking skills, accurate information, the history of medicine, medical practice ethics, human studies ethics, and linguistic integrity—all of which are basic to professionalism and excellence in modern medicine.
Alternatives to Medicine
I think there’s a reason that we think that our experience is so important. Our brains must have been wired to notice associations. We tend to link things that occur before and after, and we tend to think of them as cause and effect. You do rain dances – it rains sometimes afterwards. One thing causes the next thing, right? Unfortunately, even though such thinking is a simplification, it has persisted, and it’s persisted because it was a simplification with some practical advantages, because associations are right sometimes. Plus, when it has been wrong it usually hasn’t been wrong often enough to created a big problem (at worst, it didn’t rain, and in modern times, you just waste money).
But as someone who gives advice to people on what they should do with their horse(s) pretty much every day, I’m obliged to dig a little deeper. “It works for me,” isn’t sufficient. I think professionals should be held to higher standards. While, for an individual, his or her own experience is plenty good enough, I look at possibilities that improvement could be due to a lot of other factors.
Along the same lines, Why your personal CAM story is not evidence:
Acupuncture does not work. Yet acupuncture can cause serious harms, such as punctured lungs, as this Olympic athlete learned:
The therapist accidentally pierced Ms. Ribble-Orr’s left lung during acupuncture treatment that was later deemed unnecessary and ill-advised, causing the organ to collapse and leaving it permanently damaged. An Ontario court has just upheld the one-year disciplinary suspension imposed on therapist Scott Spurrell, rejecting his appeal in a case that highlights a rare but well-documented side effect of acupuncture.
Mr. Spurrell, who learned the ancient Chinese art on weekends at a local university, had no reason to stick the needle in his patient’s chest, and had wrongly advised Ms. Ribble-Orr that the chest pain and other symptoms she reported later were likely just from a muscle spasm, a discipline tribunal ruled.
The Fallacy of Electromagnetic Hypersensitivity. A nice summary and explanation of why fake diseases are so problematic.
Tired of seeking ads for fake health products and bogus health treatments from alternative practitioners? Take action, using a new Chrome plugin to immediately register complaints with the Competition Bureau and Advertising Standards Canada.
If not vaccinating only endangered the children who don’t receive protective vaccines, that would be bad enough, but it goes beyond that. Unvaccinated children contribute to the degradation of herd immunity, serve as potential vectors for outbreaks of infectious disease, and tend to cluster, making the effect on herd immunity locally that much worse. In brief, parents who refuse to vaccinated endanger not just their own children, but all children who come into contact with their children.
Extras and Other Stuff
Interesting read, I don’t agree with all of it: How Junk Food Can End Obesity
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Filed under: Weekend Reading | Leave a Comment
Tags: acupuncture, anecdotal evidence, clinical trials, false equivalency, generic drugs, lyme disease, vaccines