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.
The Canadian National Breast Screening Study ignites a new round in the mammography wars (David Gorski) - This large study compared mammography plus clinical breast exams to usual care in women aged 40-49 and mammography plus clinical breast exams to breast exams alone in women aged 50-59. It found that mammography did not reduce breast cancer mortality; the benefits were offset by overdiagnosis. Nevertheless, Dr. Gorski thinks it would be prudent to stick to current guidelines with perhaps more of a personalized approach to women between the ages of 40 and 49.
Tylenol May Not Be As Safe and Effective As We Thought (Harriet Hall) - Britain’s National Institute of Health and Care Excellence (NICE) issued a 600 page report analyzing the published evidence about Tylenol (acetaminophen or paracetamol) for the relief of pain in osteoarthritis. They initially warned that it should not be used because of serious side effects and low efficacy. After clinicians protested that eliminating acetaminophen would mean using more dangerous drugs, they revised their draft to recommend it as a first-line treatment for osteoarthritis. Tylenol is safer than other pain relievers, but this controversy is a good reminder that all drugs can have side effects.
Hacking the Brain – A New Paradigm in Medicine (Steven Novella) - Electrical stimulation has been used to treat brain function for decades, starting with electroconvulsive therapy. It is entering a new phase with developments like deep brain stimulation for Parkinson’s disease, transcranial magnetic stimulation (TMS) for a variety of conditions, and implantable computer chips that allow one monkey to control the movements of a second monkey. The future holds great promise.
A cure for chiropractic (Jann Bellamy) - About ten years ago, three articles by chiropractors made recommendations to reform their discipline by rejecting the subluxation concept, re-defining chiropractors as spine care specialists, improving chiropractic education, and emphasizing evidence-based treatments. Nothing has changed. If there is a reform movement among chiropractors to limit their practice to the suggested model, it is not evident. Jann Bellamy offers suggestions for a Model Chiropractic Practice Reform Act.
“I want to draw your attention to a special added attraction not advertised on the outside” (Mark Crislip) - Dr. Oz (among others) has recommended grounding or earthing, based on the premise that Earth electrons will ooze into the body, inactivate free radicals, and reverse inflammation. This is bad physics and worse biology, and the research supporting it is laughable.