Clinical trials

Category archives for Clinical trials

How should we treat stage 0 breast cancer?

I’ve written more times than I can remember about the phenomenon of overdiagnosis and the phenomenon that is linked at the hip with it, overtreatment. Overdiagnosis is a problem that arises when large populations of asymptomatic, apparently healthy people are screened for a disease or a condition, the idea being that catching the disease at…

Acupuncture is a theatrical placebo, but it’s hard not to grudgingly admire just how—shall we say?—malleable or adaptable a placebo it is. What I mean by this is that, if you believe its practitioners and adherents, acupuncture can treat almost literally any disease or health problem. Any! Pain? Acupuncture. Allergies? Acupuncture. Biliary colic? Acupuncture. Infertility?…

Readers of this blog of a certain age and above are likely to remember a U.S. Senator from Wisconsin named William Proxmire. Sen. Proxmire made a name for himself in the late 1970s and throughout much of the 1980s by issuing what he dubbed “The Golden Fleece Award,” which was meant to “honor” public officials…

The approval of new drugs and medical devices is a process fraught with scientific, political, and ethical landmines. Inherent in any such process is an unavoidable conflict between rigorous science and safety on the one side, which tend to slow the process down by requiring large randomized clinical trials that can take years, versus forces…

I learned over the weekend that a historic figure in science-based medicine has died. If you know anything about the history of the Food and Drug Administration (FDA), you will know this woman’s name, Frances O. Kelsey, MD, PhD. It turns out that Dr. Kelsey died on Friday at the age of 101. Somehow I…

The conspiracy deepens. What conspiracy? You ask. Haven’t you heard? Big pharma is out killing alternative medicine doctors! Or at least that’s what you’ll be told if you venture towards the deep dark underbelly of quack websites. Up until now, the most prominent “victim” was autism quack, Jeff Bradstreet, who, according to police, committed suicide…

Mammography is a topic that, as a breast surgeon, I can’t get away from. It’s a useful tool that those of us who treat breast cancer patients have used for over 30 years to detect breast cancer in asymptomatic women and thus (or so we hope) decrease their risk of dying of breast cancer through…

A homeopathic “debate” in BMJ?

Homeopathy is quackery. There, I’ve said it for the hundredth or even thousandth time, but I don’t care if it’s repetitive because it can’t be emphasized enough times that homeopathy is The One Quackery To Rule Them All, with the possible exception of reiki and other “energy therapies.” I also find it useful to make…

One of my favorite quotes from classic literature comes from Lewis Carroll’s Through the Looking Glass, when Alice encounters a rather strange character named Humpty Dumpty. Humpty Dumpty, as you will likely recall, was a giant egg with whom Alice got into an argument about the meaning of words: And only ONE for birthday presents,…

The overarching goal that proponents of so-called “complementary and alternative medicine” (CAM) or, as is becoming the preferred term, “integrative” medicine is the mainstreaming of the “unconventional” treatments that fall under the rubric of these two terms. Indeed, that’s the very reason why they so insisted on the shift from calling it CAM to calling…

My opinion about medical marijuana has been fairly consistent. First, the claims made by its advocates for it far exceed the evidence for its benefit, which is why I’ve referred to it as the “new herbalism.” Of course, it’s not really very new, but it is herbalism in that medical marijuana advocates make grandiose claims…

When I wrote yesterday about the cruel sham that is “right-to-try,” , one criticism (among many) that I made of these misguided, profoundly patient-unfriendly laws was that I have as yet been unable to find a single example of a patient who has managed to obtain access to an experimental therapeutic through such a law,…

Last year, I did several posts on what I consider to be a profoundly misguided and potentially harmful type of law known as “right-to-try.” Beginning about a year and a half ago, promoted by the libertarian think tank known as the Goldwater Institute, right-to-try laws began popping up in state legislatures. I wrote about how…

Dedicated to lilady. One of the disadvantages of writing for this blog is that sometimes I feel as though I spend so much time deconstructing bad science and pseudoscience in medicine that I’m rarely left with the time or the opportunity to discuss some interesting science. Of course, even when I do that, usually it’s…

So busy was I writing about America’s quack Dr. Mehmet Oz and, of course, the FDA hearing on regulating homeopathy that I didn’t take note of a story that came out the other day examining a study looking at the association between MMR vaccination and autism. More correctly, the study examines the lack of association…

Dr. David Katz is undoubtedly a heavy hitter in the brave new world of “integrative medicine,” a specialty that seeks to “integrate” pseudoscience with science, nonsense, with sense, and quackery with real medicine. In fairness, that’s not the way physicians like Dr. Katz see it. Rather, they see it as “integrating” the “best of both…

Why, oh why, did I look at GreenMedInfo again? You remember GreenMedInfo? It’s yet another wretched hive of scum and quackery, but with a twist. Its proprietor, Sayer Ji, thinks he’s an expert at interpreting the biomedical literature. Unfortunately, as he demonstrates time and time again with depressing regularity, he is nothing of the sort.…

It’s no secret that I don’t have a high opinion of naturopathy. Just enter the word “naturopathy” into the search box of this blog, and you’ll quickly see what I mean. Indeed, when last I mentioned the topic a couple of weeks ago, I was discussing the revelations of Britt Marie Hermes, a former naturopath…

Ancient cancer

As I sat on my couch last night, laptop sitting in front of me, I awaited the Ken Burns adaptation of Siddartha Mukherjee’s excellent book The Emperor of All Maladies into a three part television documentary to air on PBS. I’m not sure whether I’ll blog the show or not, but if I do I’ll…

If there’s one thing that’s become clear to me over the years about acupuncture, it’s that it’s nothing more than a theatrical placebo. Many are the times that I’ve asked: Can we finally just say that acupuncture is nothing more than an elaborate placebo? Most recently, I asked this question in 2012. What science-based medicine…

Yesterday was a very strange day, at least on the Internet. I really should learn to remove Twitter from my iPhone on Wednesdays. Why? Wednesdays tend to be my administrative days. I’m not in clinic seeing patients nor am I in the operating room. That’s why Wednesday tends to be one of the two days…

Now that we’re solidly into 2015, it’s a good time to check in on what the legislative priorities are going to be among various advocates of quackery and “health freedom” (but I repeat myself). There’s a new Republican Congress, and a lot of chairmanships are going to be reshuffled, with various legislators finding themselves in…

So here it is, already a week into 2015. Truth be told, I’m still finding myself having a hard time believing that it’s already 2015, but then I say that about every year in early January. Be that as it may, I’ve already seen one hopeful sign that it could be a decent year when…

Seven years ago I returned to Michigan, where I was born and spent the first quarter century of my life, after an absence of more than 20 years. In the interim, I had done my surgical residency and earned my PhD in Cleveland, a surgical oncology fellowship in Chicago, and worked in New Jersey at…

It should come as a surprise to no one that I’m not exactly a fan of “integrative oncology”—or integrative medicine, or “complementary and alternative medicine” (CAM), or whatever its proponents want to call it these days. After all, I’ve spent nearly ten years writing this blog and nearly seven years running another blog dedicated to…