Here is a recap of the stories that appeared over the last month at Science-Based Medicine, a multi-author skeptical blog that separates the science from the woo in medicine.
The College of Physicians and Surgeons of Ontario’s muddled draft policy on “non-allopathic” medicine (David Gorski) http://www.sciencebasedmedicine.org/index.php/cpsos-muddled-draft-policy-on-non-allopathic-medicine/ CPSO is working on an update of their policy on nonconventional medical therapies. The draft is disturbing for its wishy-washy approach to the scientific basis of medicine, its pro-CAM bias, and its manipulative use of language such as the derogatory term “allopathy.”
Testing a Chinese Herbal Flu Remedy (Harriet Hall) http://www.sciencebasedmedicine.org/index.php/testing-a-chinese-herbal-flu-remedy/ A new study compared a Chinese herbal influenza remedy consisting of a mixture of 12 herbs to the antiviral drug oseltamivir and claimed to have shown that they were equally effective. The herbal mixture reduced the duration of fever but had no effect on symptoms or viral shedding. The study was not placebo-controlled or blinded, and was questionable for other reasons.
Homeopathy and Plausibility (Steven Novella) http://www.sciencebasedmedicine.org/index.php/homeopathy-and-plausibility/ Homeopathy is extremely implausible and the clinical evidence shows it doesn’t work. A homeopath argues that there is scientific evidence for homeopathy but that it has been rejected because of a “negative plausibility bias.” His facts are wrong and his reasoning is fallacious.
Legislative Alchemy I: Naturopathy (Jann Bellamy) http://www.sciencebasedmedicine.org/index.php/legislative-alchemy-i-naturopath/ State legislatures can transform implausible and unproven diagnostic method and treatments into perfectly legal health care practices. Licensing gives them an undeserved air of legitimacy. The legal status of naturopathy is examined; legislation is pending in 5 states.
When a “scientific study” is neither (Peter Lipson) http://www.sciencebasedmedicine.org/index.php/legislative-alchemy-i-naturopath/ There is nothing that isn’t wrong with a recently published study of complementary medicine in breast cancer survivors. It tested “energy chelation” – a therapy based on imaginary “biofields.” The editors of the journal Cancer should be embarrassed.
The Annals of Internal Medicine Qualifies for Fail Blog (Mark Crislip) http://www.sciencebasedmedicine.org/index.php/the-annals-of-internal-medicine-qualifies-for-fail-blog/ Dr. Crislip examines the same herbal flu remedy study that Dr. Hall commented on (see above): he is not impressed. The effects on fever are probably not real, are clinically irrelevant, and are probably counterproductive.
“Integrative medicine”: A brand, not a specialty (David Gorski) http://www.sciencebasedmedicine.org/index.php/integrative-medicine-a-brand-not-a-specialty/ Quackery has been re-branded, first as “alternative medicine” then as “CAM” and now as “integrative medicine.” Proponents claim to support evidence-based treatments, but they fail to understand what scientific evidence means; they are advocating the integration of quackery with science-based medicine.
Wishing Away Warts (Harriet Hall) http://www.sciencebasedmedicine.org/index.php/wishing-away-warts/ Some people erroneously think warts can be wished away (mind over matter). The science of warts and their treatment is reviewed. Since warts usually resolve spontaneously, bogus remedies can seem to work.
Homeopathic Thuggery (Steven Novella) http://www.sciencebasedmedicine.org/index.php/homeopathic-thuggery/ A homeopathic manufacturer, Boiron, is suing a blogger for criticizing the cold remedy Oscillococcinum. They are thuggishly using corporate resources to try to silence legitimate criticism of their pseudoscientific products.Oh yeah? Thalidomide! Where’s your science now? (Scott Gavura) http://www.sciencebasedmedicine.org/index.php/oh-yeah-thalidomide-wheres-your-science-now/ Critics of science-based medicine point to the Thalidomide disaster as a failure of science. In reality, it demonstrates the importance of science and of regulation, and highlights the potential risks of inadequately tested CAM treatments.
Dummy Medicine, Dummy Doctors, and a Dummy Degree, Part 2.0: Harvard Medical School and the Curious Case of Ted Kaptchuk, OMD (Kimball Atwood) http://www.sciencebasedmedicine.org/index.php/dummy-medicine-dummy-doctors-and-a-dummy-degree-part-2-0-harvard-medical-school-and-the-curious-case-of-ted-kaptchuk-omd/ Continues a critique of The New England Journal of Medicine’s apparent approval of treating asthma with placebos and accepting subjective improvement without objective improvement; with special reference to one author, Ted Kaptchuk, and his questionable background.
Revisiting Daniel Moerman and “placebo effects” (David Gorski) http://www.sciencebasedmedicine.org/index.php/revisiting-daniel-moerman-and-placebo-effects/ An anthropologist values the patient’s subjective responses over objective measurable improvement. He searches for what he calls “meaning” and misinterprets published studies. He is misguided: doctors are obligated to make the patient actually get better, not just to make the patient “feel” better.
What to Expect When You’re Expecting (Harriet Hall) http://www.sciencebasedmedicine.org/index.php/what-to-expect-when-youre-expecting/ The number one bestselling pregnancy book unfortunately mixes good medical information with misinformation about CAM. For instance, it advises patients to “go CAM crazy” and try all sorts of unproven remedies for morning sickness.
The Scam Scam (Steven Novella) http://www.sciencebasedmedicine.org/index.php/the-scam-scam/ Diet supplement marketers have recognized that consumers will search for the words skeptic and scam, so they are deceptively using those words in their marketing. Once you have been hooked, they tell you their product is not a scam and proceed with the usual unsupported advertising claims.
Everything Old is New Again! (David Ramey) http://www.sciencebasedmedicine.org/index.php/everthing-old-is-new-again/ Old ads for quack remedies are laughable, but they reveal that not much has changed. Similar claims are still being made for supplements.
Train Therapy (Mark Crislip) http://www.sciencebasedmedicine.org/index.php/train-therapy/ Indonesians are lying down on electric railroad tracks to cure various diseases. Train therapy sounds crazy, but anecdotes and studies of uncontrolled interventions with soft endpoints are being used to justify equally nonsensical treatments in the Western world of CAM.
Answering another criticism of science-based medicine (David Gorski) http://www.sciencebasedmedicine.org/index.php/answering-another-criticism-of-sbm/ An article by Stewart Leavitt attacking Drs. Gorski and Novella is so off-base that it presents a “teachable moment.” He confuses skepticism with cynicism, misperceives rational arguments as “emotive,” invents false dichotomies, commits logical fallacies, and fails to produce a single concrete example of the alleged offenses he complains about.
Belief in Echinacea (Harriet Hall) http://www.sciencebasedmedicine.org/index.php/belief-in-echinacea/ A study that supposedly showed that placebos worked for the common cold actually only showed that subjects who thought they had a cold and who thought Echinacea was effective and who got either Echinacea or a placebo and who either knew they were getting Echinacea or thought they might be getting Echinacea were more likely to think their cold was gone sooner than if they got no pills.
The Power of Faith and Prayer? (Steven Novella) http://www.sciencebasedmedicine.org/index.php/the-power-of-faith-and-prayer/ Studies of intercessory prayer fail to show that prayer improves health outcomes. These studies are flawed, and researchers mix scientific with theological arguments. Studying the health effects of having faith is even more problematic. Any attempt to mingle faith with science raises serious concerns.
Tylenol: Safe painkiller, or drug of hepatic destruction? (Scott Gavura) http://www.sciencebasedmedicine.org/index.php/tylenol-safe-painkiller-or-drug-of-hepatic-destruction/ Acetaminophen is a remarkably safe and effective drug when used appropriately, but high doses cause fatal liver damage. Accidental poisonings are frequent and are often due to simultaneously using multiple products that contain it. New, lower dosage recommendations are intended to protect the public by reducing the risk of overdose.
New Dietary Ingredient (NDI) rules planned for the supplement industry (David Kroll) http://www.sciencebasedmedicine.org/index.php/new-dietary-ingredient-rules-planned-for-the-supplement-industry/ The FDA’s proposed new rules for dietary supplements are complicated and commonly misunderstood. Dietary supplement products will be required to file a claim of a New Dietary Ingredient (NDI) for any supplement component that was not part of the diet before 1994. These rules are consistent with rules for pharmaceuticals but less stringent.