Here is a recap of the stories that appeared over the past several weeks at Science-Based Medicine, a multi-author skeptical blog that separates the science from the woo-woo in medicine.
Chiropractic Defense: Tempest in a Teapot (Sam Homola)
When Forbes published an article by Steven Salzberg about money wasted on chiropractors, chiropractors protested, characterizing critics of chiropractic as “disgruntled practitioners” and “medical bigots” rather than addressing the content of the article. Subluxation theory is alive and well despite a total absence of supporting evidence. Skeptical chiropractor Sam Homola has been criticizing chiropractic since 1963, when he wrote Bonesetting, Chiropractic and Cultism.
Forskolin: Here We Go Again (Harriet Hall)
Dr. Oz has done it again: hyped yet another miracle weight loss supplement, forskolin. He calls it “lightning in a bottle” and claims it burns fat without burning muscle. There are only two published studies in humans: they both showed that taking forskolin did not result in weight loss, and one said it changed body fat/muscle composition while the other said it didn’t. And there are concerns about its safety.
Delaying Vaccines Not A Good Idea (Steven Novella)
The anti-vaccine movement argues that vaccines are “Too Many, Too Soon,” and recommends delayed schedules. The recommended schedule is based on good evidence, and there are many studies showing that delayed or reduced schedules increase the risk of vaccine-preventable diseases. Now a new study indicates that delaying vaccines can be dangerous for yet another reason: the delayed schedule increases the risk of seizures following vaccination.
Don’t supplement users deserve consumer protection, too? (Scott Gavura)
Proposed legislation in Canada would exempt “natural” health products from improved safety standards for prescription drugs. Natural does not mean safe, and there is no rationale for this double standard.
VacciShield: Pixie dust for an imaginary threat (John Snyder)
A product developed by a naturopath is a mixture of vitamins, nutrients, and probiotics designed to “support” children during vaccinations. There is no need for such “support,” and a review of published studies on the ingredients shows there is no evidence to provide a rationale that any of them would benefit vaccinated children.
What’s in a name? NCCAM tries to polish a turd (David Gorski)
Dr. Briggs, director of the National Center for Complementary and Alternative Medicine, wants to change its name to the National Center for Research on Complementary and Integrative Health, in order to “better align the name with the evolution in health care.” NCCAM continues to promote unproven practices, and this proposed “rebranding” is based on the fallacy of appeal to popularity. It is just another ploy to rationalize integrating quackery with science; it amounts to polishing a turd.
Precision Medicine: The Coolest Part of Medicine (Harriet Hall)
One size seldom fits all. Science is making great strides towards individualized medical care with innovations like genomic deep sequencing, detecting cancer genes, stem cell manipulations, automated and miniaturized high-throughput screening that can perform over 1500 tests at once, and testing an individual’s cancer cells directly to see which drugs they respond best to. CAM claims to individualize treatment based on fantasy and speculation; science is learning to individualize treatments based on reality and evidence.
Vaccines Still Not Linked to Autism (Steven Novella)
Despite 15 years of evidence to the contrary, some people still want to believe vaccines cause autism. A new meta-analysis of 1,256,407 children provides icing on the cake: it showed no increased risk of autism following MMR, mercury, or thimerosal exposure. And the evidence suggests that the rate of autism is not increasing and that it is primarily a genetic disorder.
Beware the Integrative Pharmacy (Scott Gavura)
In addition to standard medications, most pharmacies sell products that we know are useless, like homeopathic remedies, just because they are popular and profitable. Pharmacists should eliminate quackery from their shelves and stop confusing and misleading customers. “Integrative” pharmacies are ethically troubling.
Separating Fact from Fiction in Pediatric Medicine: Infant Gastroesophageal Reflux (Clay Jones)
One of the pediatric recommendations from the Choosing Wisely initiative is to stop prescribing acid blockers and motility agents for physiologic reflux. Most babies spit up; it’s a normal aspect of physiology that is usually harmless and only requires reassuring the parents. Even true GERD (gastroesophageal reflux disease, diagnosed by endoscopy) can often be managed without drugs.
In which Dr. Gorski is taken to task by an eminent radiologist for his posts on mammography (David Gorski)
Dr. Kopans was unhappy when Dr. Gorski criticized his critique of the Canadian National Breast Screening Study. Kopans portrays any questioning of the value of mammography as motivated by rationing, and he essentially accused the researchers of fraud and misrepresented their research design. Dr. Kopans insists screening mammography should begin at age 40; Dr. Gorski continues to recommend universal screening after age 50 and personalized screening below that age only for high-risk patients.
Rope Worms: C’est la Merde (Harriet Hall)
Rope worms are alleged rope-like meter-long human intestinal parasites that have only been observed by devotees of cleansing enemas. There is no such critter: analysis shows only human DNA, and the “worms” are almost certainly an artifact produced when enema ingredients combine with intestinal mucus. Researchers have published two amusing pseudoscientific papers with an elaborate explanation of the worm’s anatomy, its 5-stage life cycle and other claims. They were fooled by pareidolia, apophenia, and other errors in thinking.
PETA Embraces Autism Pseudoscience (Steven Novella)
PETA is claiming a link between dairy products and autism, based on uncontrolled observations that have been refuted by scientific studies. Their claims that dairy products cause cancer and Crohn’s are also questionable. They are distorting the scientific evidence to promote their ideological agenda and argue for a vegan diet.
Harkin’s folly, or how forcing insurers to cover CAM undermines the ACA (Jann Bellamy)
Sen. Harkin inserted a provision into the ACA with the intention of requiring insurers to cover all licensed CAM providers. The interpretation of the law is being questioned, and HHS is asking the public for comments. Applying the provision mechanically would ignore cost effectiveness and safety and would undermine the very purposes of the ACA.
Of the Trial to Assess Chelation Therapy, Bayes, the NIH, and Human Studies Ethics (Kimball Atwood)
The TACT study was ill-conceived; it violated the principles of equipoise, informed consent, appropriate medical care of subjects, Bayesian prior probability, and the need to carry out phase I and II trials before phase III trials. As predicted, it yielded ambiguous results that were misinterpreted as justifying chelation therapy, if only for diabetics. Chelationists see it as a free pass to apply their favorite lucrative remedy for over 70 disparate indications.