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-woo in medicine.
Obamacare, the Oregon Experiment, and Medicaid (David Gorski) http://www.sciencebasedmedicine.org/obamacare-the-oregon-experiment-and-medicaid/ One provision of the Affordable Care Act was ruled unconstitutional: the mandatory expansion of Medicare to cover all people under 65 up to 133% of the federal poverty level. In Michigan, the expansion was voluntarily adopted, despite the assertion that Medicaid doesn’t improve health outcomes. Does it? The evidence is complicated.
Answering Our Critics, Part 2 of 2: What’s the Harm? (Harriet Hall) http://www.sciencebasedmedicine.org/answering-our-critics-part-2-of-2-whats-the-harm/ Part 2 continues the list of rebuttals to critics of science-based medicine. What’s the harm if people want to try a treatment that is unproven or even disproven? There are several kinds of harm, even occasional deaths; and it is unethical to offer placebos except perhaps as “comfort measures” without promise of therapeutic benefit. Doctors can sometimes relax scientific rigor in the interests of compassion, but in general they should do what is best for patients rather than what patients think they want.
Chiropractor Breaks Baby’s Neck – A Risk vs. Benefit Analysis (Steven Novella) http://www.sciencebasedmedicine.org/chiropractor-breaks-babys-neck-a-risk-vs-benefit-analysis/ In Australia, a chiropractor reportedly fractured a 4-month-old’s neck during a manipulation for torticollis, a benign disorder. The chiropractic board merely gave the chiropractor a slap on the wrist, requiring him to get more education in pediatric chiropractic. All chiropractic manipulation of children should be condemned: there is no evidence of benefit and a real possibility of harm.
Dietary supplement industry says “no” to more information for consumers (again) (Jann Bellamy) http://www.sciencebasedmedicine.org/big-supp-resists-giving-consumers-safety-and-effectiveness-information/ The diet supplement industry is fighting legislation that would provide consumers with the information they need to make informed decisions about taking supplements. It would require manufacturers to add warnings to labels when appropriate and to release to the FDA information they are already required to have, such as substantiation of “structure and function” claims. Unfortunately, the bill is not likely to pass.
Pump it up: osteopathic manipulation and influenza (Mark Crislip) http://www.sciencebasedmedicine.org/pump-it-up-osteopathic-manipulation-and-influenza/ In the US, Doctors of Osteopathy are interchangeable with MDs; they are also trained in osteopathic manipulation (OM), but they seldom use it after graduation. Osteopathic claims that OM is useful in treating influenza are not based on valid evidence, and the idea that the “lymphatic pump technique” boosts the immune system is nothing but fantasy.