Here is a recap of the stories that appeared recently at Science-Based Medicine, a multi-author skeptical blog that separates the science from the woo in medicine.
“Motivated reasoning,” alternative medicine, and the anti-vaccine movement (David Gorski) http://www.sciencebasedmedicine.org/?p=12092 Science can be hard for people to accept when it conflicts with what their senses and their common sense seem to be telling them. Chris Mooney has written about the science of why we don’t believe science. The concept of “motivated reasoning” explains that we are driven by emotions and prior beliefs: and reasoning comes afterwards to justify our beliefs.
Hash Oil for Gliomas? What Would You do? (Harriet Hall) http://www.sciencebasedmedicine.org/?p=12401 A patient with a recurrent brain tumor is using hash oil for treatment, hoping for a cure. There is only very weak evidence suggesting that it might help. Is it reasonable to try an untested treatment as a last resort?
European Union “Ban” on Herbal Products (Steven Novella) http://www.sciencebasedmedicine.org/?p=12460 A recent EU regulation has been mis-characterized as a “ban” on herbal products when it is really only a reasonable requirement for registration, designed to protect consumers. The industry wants to continue selling poorly regulated products without any burden of proving that their products are safe or that their health claim are true. It’s important to remember that herbs are drugs too.
Marketing Pharmaceuticals in today’s Regulatory Environment (Martin Lessem) http://www.sciencebasedmedicine.org/?p=7888 The FDA reviews pharmaceutical or CAM advertisements to ensure compliance. Claims on ads and labels must be backed up by accepted science, must include “fair balance,” and must not be misleading. Violations and grey areas are common.
Parasites (Mark Crislip) http://www.sciencebasedmedicine.org/?p=12499 A patient who complains of parasites may have delusions of parasitism or Morgellons, a disease where patients find “filaments” in skin lesions, feel movement sensations, and have accompanying pain, emotional and cognitive problems, and limitations on their functioning in daily life. No parasites have been identified, and some patients have responded to anti-psychotics. Bogus electrodiagnostic devices have been used by naturopaths to diagnose nonexistent parasites.
Vaccines and infant mortality rates: A false relationship promoted by the anti-vaccine movement (David Gorski) http://www.sciencebasedmedicine.org/?p=12516 A new study claims to show that nations requiring the most vaccines tend to have the worst infant mortality rates. Some of its flaws: biased authors, poor science, correlation doesn’t mean causation, different reporting standards in different countries, the ecological fallacy, and the fact that infant mortality includes those too young to have received vaccines.
Chemical castration of autistic children leads to the downfall of Dr. Mark Geier (David Gorski) http://www.sciencebasedmedicine.org/?p=12531 Mark Geier believes that mercury and testosterone contribute to autism; for years, he has been treating children with Lupron (chemical castration) and chelation therapy. For this, and for other ethical offenses, Maryland has finally taken emergency action to suspend his license.
Cognitive Traps (Harriet Hall) http://www.sciencebasedmedicine.org/?p=12520 In medical school, doctors learn about science; but they may not learn to think like a scientist. They (like all humans) fall into various cognitive traps. Diagnostic fetishes, favorite treatments, unwarranted pattern recognition, the rooster syndrome, framing, anchoring, over-generalization, tunnel vision, and other examples are discussed.
Autism Prevalence Higher than Thought (Steven Novella) http://www.sciencebasedmedicine.org/?p=12604 Diagnosis of autism has increased due to expansion of the diagnostic criteria and greater efforts at surveillance. A new study from South Korea estimates a prevalence of one child in 38. The definition may be too broad, and it doesn’t mean that everyone who fits the diagnosis is disabled.
When you can’t win on science, invoke the law… (David Gorski) http://www.sciencebasedmedicine.org/?p=12610 An anti-vaccine press conference announced that the government’s own data show a vaccine-autism link. This claim is based on a misinterpretation of claims settled in the Vaccine Injury Compensation Program. They are trying to use legal decisions to justify a belief not supported by the scientific evidence.
Placebo Prescriptions (Scott Gavura) http://www.sciencebasedmedicine.org/?p=12511 The claim that one in five physicians prescribes placebos may be an over-estimate. Definitions include “pure” and “impure” placebos. While opinions vary, placebos remain ethically unacceptable.
Fungus yields new prescription drug for multiple sclerosis (David Kroll) http://www.sciencebasedmedicine.org/?p=12646 A new drug for multiple sclerosis, fingolimod, has a mechanism of action distinct from other immunosuppressants. Derived from a fungus that infects insects, it’s a good example of how a traditional Chinese medicine was studied and developed into a modern drug. It refutes the argument that drug companies are not interested in studying natural medicines because they don’t generate profits.
Steve Novella and Banachek on Power Balance bracelets (David Gorski) http://www.sciencebasedmedicine.org/?p=12666 A video clip of a TV program includes comments by Dr. Novella and a demonstration by the magician Banachek showing that energy bracelets don’t work and that the sales demonstrations take advantage of simple tricks. But even after being shown that placebo bracelets worked just as well, the test subjects wanted a Power Balance bracelet!
Surprise, surprise! Dr. Andrew Weil doesn’t like evidence-based medicine (David Gorski) http://www.sciencebasedmedicine.org/?p=12661 Andrew Weil, a leader of the “integrative medicine” movement, has co-authored an article claiming that safety and patient preferences, not just effectiveness, should guide medical treatment decisions. In a series of fallacious arguments, he attacks science and appeals to other ways of knowing.
Pragmatic Studies and Cinderella Medicine (Harriet Hall) http://www.sciencebasedmedicine.org/?p=12523 Pragmatic studies are done to assess the practical effectiveness of a treatment in everyday settings. Pragmatic studies of alternative treatments like acupuncture can be misleading because a treatment with no specific effects can appear effective when dressed up like Cinderella in an enhanced package of suggestion, expectation, and other nonspecific effects of the practitioner/patient interaction.
Delusional Parasitosis (Steven Novella) http://www.sciencebasedmedicine.org/?p=12717 Patients with Morgellons believe they are infected by an organism that causes mysterious fibers to come out of their skin, with excessive itching and other symptoms. It is a new psychocultural manifestion of an old condition: delusions of parasitosis.
The Top Ten Pet Supplements: Do They Work? (Brennen McKenzie) http://www.sciencebasedmedicine.org/?p=12582 The veterinary supplement market is booming. A review of the top ten pet supplements shows little or no supporting scientific evidence for their efficacy.
Raw Milk in Modern Times (Mark Crislip) http://www.sciencebasedmedicine.org/?p=12736 In the battle between humans and infectious organisms, some people tip the balance by drinking raw milk, which has caused outbreaks of various preventable diseases. Pasteurization is a good thing.
Editor’s Note: Because of a computer glitch, three weeks worth of SBC stories are included in this one post. We will return to weekly reviews next week. M.B.