Here is a recap of the stories that appeared last week at Science-Based Medicine, a multi-author skeptical blog that separates the science from the woo in medicine.
On the “individualization” of treatments in “alternative medicine,” revisited (David Gorski) http://www.sciencebasedmedicine.org/index.php/individualization-of-alt-med-treatments/ “Bedside manner” has been undermined by the time constraints of modern medicine and CAM proponents have jumped into the breach. They claim
to “individualize” treatment but are really just making things up as they go along. They use individualization as a convenient excuse to discredit scientific studies showing
that their treatments are ineffective. Meanwhile, scientific medicine increasingly individualizes treatment on a rational basis.
Reducing the Risk of Adverse Drug Events (Harriet Hall) http://www.sciencebasedmedicine.org/index.php/reducing-the-risk-of-adverse-drug-events/ Adverse reactions to drugs are a serious problem, but one that could be largely solved. 4 drugs cause 2/3 of the reactions: warfarin, insulin, antiplatelet agents and oral hypoglycemic agents; and most incidents are due to unintentional overdoses. Medicine is making efforts to reduce the risks, and a new book Are Your Meds Making You Sick? offers 16 rules for patients to minimize their own risk.
The Cancer Cure Anecdote (Steven Novella) http://www.sciencebasedmedicine.org/index.php/the-cancer-cure-anecdote/ A reevaluation of Ian Gawler’s alleged recovery
from metastatic bone cancer illustrates the typical errors of alternative cancer cure claims. The lesions he believed were metastases may have been due to his tuberculosis, resolving when his TB was effectively treated. His coffee enemas, diet, and meditation likely had nothing to do with it. Without biopsy evidence of cancer, anecdotes of “cures” are meaningless.
Generic Drugs: Are they Equivalent? (Scott Gavura) http://www.sciencebasedmedicine.org/index.php/generic-drugs-are-they-equivalent/ Generic versions of drugs generally work as well as the brand-name versions, and are less expensive. Regulatory measures have been very effective in insuring bioequivalence, and most of the concerns about generic drugs are myths.
Why Do We Really Need Clinical Trials? (Brennen McKenzie) http://www.sciencebasedmedicine.org/index.php/why-do-we-really-need-clinical-trials/ No matter how impressive the plausibility and the prior lower level evidence, the only way to know if a treatment is effective and safe is to do rigorous clinical trials. A study of selenium and vitamin E for prostate cancer prevention is a prime example of a treatment that was believed to reduce risk but was found to actually increase the risk of cancer.