Clinical trials
Respectful Insolence
Category archives for Clinical trials
Is a trial of stem cell therapy in autism scientifically and ethically justified?
Posted by Orac on August 23, 2012 Houston, we have a problem. Oh, wait. I’m not talking about Stanislaw Burzynski this time. But we do still have a problem, and it’s a problem that resembles the Burzynski problem I recently discussed. Specifically, it’s a problem of unethical clinical trials somehow winning approval from institutional review boards (IRBs). In academia, IRBs are basically…
Patient-led “clinical trials” versus clinical research (2012 edition)
Posted by Orac on August 2, 2012 Dying of cancer can be a horrible way to go, but as a cancer specialist I sometimes forget that there are diseases that are equally, if not more, horrible. One that always comes to mind is amyotropic lateral sclerosis (ALS), more commonly known as Lou Gehrig’s disease. It is a motor neuron disease whose clinical…
New cancer drugs: Fitter, happier, more productive? Or not?
Posted by Orac on July 27, 2012 It’s known as “targeted” therapy, and it’s the holy grail of cancer research these days. If you listen to its most vocal proponents, it’s the path towards “personalized medicine” that improves survival with much lower toxicity, in which, instead of using the hammer that is chemotherapy, precisely targets specific molecular abnormalities that drive cancer growth.…
I’d rather have a free bottle in front of me than a prefrontal lobotomy
Posted by Orac on June 1, 2012 I’ve pointed out before that pover the last couple of years I’ve become a bit of a fan of old time radio, having discovered Radio Classics on Sirius XM Radio. I don’t remember how I discovered it, but I rapidly became hooked on shows like Suspense, Yours Truly, Johnny Dollar, The Whistler, Gunsmoke, Dragnet, The…
Preclinical research has a problem, but that doesn’t mean religion is better
Posted by Orac on April 30, 2012 Remember Vox Day? Sure, I bet you do, at least if you’ve been a regular reader of this blog more than a year or two. If you’re a really long-timer, you probably remember him even better. Let’s just put it this way. Vox is a guy who has a much higher opinion of his intellectual…
No, Virginia, cancer care in Europe doesn’t suck, contrary to what a recent paper implies
Posted by Orac on April 24, 2012 The U.S. is widely known to have the highest health care expenditures per capita in the world, and not just by a little, but by a lot. I’m not going to go into the reasons for this so much, other than to point out that how to rein in these costs has long been the…
Acupuncture: Not an “essential health benefit” in the Patient Protection and Affordable Care Act
Posted by Orac on March 28, 2012 This week, the Supreme Court is hearing a case that can only be described as historic. Any of you out there (in the U.S. anyway; I realize that my readership is international) who have paid even a passing attention to the news can’t help but avoid reporting, debate, and polemics related to the Patient Protection…
Patient satisfaction versus quality of care, round two
Posted by Orac on March 19, 2012 About a month ago, I wrote about a study that looked at metrics of patient satisfaction and compared them to hard outcomes often used to evaluate quality of care, including frequency of emergency room usage, frequency of hospitalization, and overall mortality. Even though these days there appears to be an implicit assumption that increased patient…
Patient satisfaction versus quality of care
Posted by Orac on February 20, 2012 If there’s one thing that purveyors of “complementary and alternative medicine” (CAM)–or, the preferred term these days, “integrative medicine” (IM)–and hospital administrators seem to agree on, it’s that “patient satisfaction” (whatever that means) is very, very important. Hospital administrators live and die by patient satisfaction surveys, in particular a common measurement derived from Press-Ganey surveys.…
A study that oversells massage therapy
Posted by Orac on February 13, 2012 If there’s one form of so-called “complementary and alternative medicine” (CAM) that I find more tolerable than most, it’s massage therapy. The reason, of course, is that, whatever else anyone claims about massage, there’s no doubt that it feels good. All too often, however, massage therapists ruin a perfectly good massage by imposing pseudoscientific and…
CAM, placebos, and the new paternalism
Posted by Orac on January 9, 2012 Three and a half years ago, I bought a new car. The reason why I mention this as a means of beginning this post is because that car had something I had never had in a car before, namely Sirius XM satellite radio preinstalled. Curious, I subscribed, and I now barely listen to regular radio…
Credulous reporting on placebo effects strikes again
Posted by Orac on January 4, 2012 Let’s face it. The vast majority of “complementary and alternative medicine” (CAM) or “integrative medicine” (IM) therapies are nothing more than placebo medicine. This should be so abundantly clear to readers who have followed this blog, Science-Based Medicine, and/or Neurologica Blog more than a few weeks that I shouldn’t have to repeat it yet again,…
Revisiting the question of “individualization” of treatments in “alternative” medicine
Posted by Orac on January 2, 2012 I kind of miss Peter Lipson on ScienceBlogs and wish he were still around. I realize it’s been nearly a year and a half since he departed, but it’s been a bit lonely here being the only physician blogging about quackery, the role of science in medicine, and other skeptical topics related to medicine. This…
Dr. Burzynski and the cult of personality of the “brave maverick cancer doctor”
Posted by Orac on December 15, 2011 I thought I’d be leaving the topic of Dr. Stanislaw Burzysnki and his combination of Personalized Cancer Therapy for Dummies-level “personalized, gene-targeted cancer therapy” coupled with his “cancer-curing” antineoplastons, which have morphed into an orphan HDAC inhibitor used off-label as part of his pricey everything-but-the-kitchen-sink” combination of targeted therapies and old-fashioned chemotherapy. After all I…
NCCAM in the news: Why does it still exist?
Posted by Orac on December 13, 2011 I’ve made no secret of my admiration for Trine Tsouderos. Whether it be her investigations into the rank quackery of prominent members of the mercury militia wing of the anti-vaccine lunatic fringe, Mark and David Geier, who seem to think that chemical castration is a perfectly fine and dandy treatment for autism because testosterone binds…
What Dr. Stanislaw Burzynski doesn’t want you to know about antineoplastons
Posted by Orac on December 12, 2011 Over the last couple of weeks, I’ve been spending a lot of time (and, characteristically, verbiage) analyzing the phenomenon known as Dr. Stanislaw Burzynski, his “cancer cure” known as antineoplastons, and his incompetent version of “personalized gene-targeted cancer therapy.” In this third and final part, I want to come back to antineoplastons, because it has…
So chemotherapy does work, after all
Posted by Orac on December 7, 2011 One thing I’ve learned over the years is that there is a palpable hostility in the “alternative” medicine world towards chemotherapy. Many are the times I’ve posted examples, including rants by Mike Adams, cartoons, and a post about what I like to call the “2% gambit” that claims that chemotherapy only contributes 2% to survival…
Marc Stephens issues more threats on behalf of the Burzynski Clinic
Posted by Orac on November 28, 2011 Over the Thanksgiving holiday weekend, I was simultaneously alarmed and amused at how someone named Marc Stephens, who claims (although presents no evidence for his claim) that he represents the rogue physician and “researcher” Dr. Stanislaw Burzynski, had taken to threatening skeptical bloggers who criticize Dr. Burzynski’s highly dubious cancer therapy, a therapy Burzynski dubbed…
“Ayurgenomics”: The return of woo-omics
Posted by Orac on November 21, 2011 Every so often, I come across something in the world of woo that leaves my jaw dangling from its joint in utter astonishment that anyone could think such a thing was a good idea. Sometimes these things are investigations into various paranormal phenomena. Sometimes, it’s the latest anti-science denialist screed from a creationist. Other times,…
The return of the Medical Hypotheses anti-vaccine howler
Posted by Orac on November 17, 2011 When it rains it pours, as they say. Yes, sometimes there’s so much going on that I can’t possibly blog about it all, particularly now that I’ve cut back a bit. This week seems to be turning into one of those weeks. Yesterday, I couldn’t resist having a bit of fun with the grande dame…
Echoes of Semmelweis
Posted by Orac on October 26, 2011 As hard as it is to believe, I’ve been a physician for 23 years now and a fully trained surgeon for over 15 years. If there’s one thing I’ve learned in that time, it’s most doctors really, really don’t like to be told what to do. I don’t know if part of it comes from…
Six medical “myths” that aren’t
Posted by Orac on October 25, 2011 I usually don’t do requests, at least not very often. As selfish as it might sound, I do this blog mainly to amuse myself, which means that I choose whatever topics interest me and write about them. Believe it or not, I’d probably still be doing this even if my readership were 1/100 of what…
How not to predict the outcome of clinical trials
Posted by Orac on September 29, 2011 Yesterday, I came across a concept that I had never considered before (or even heard of before). In fact, it’s a concept that took me by surprise. Basically, it’s an application of a concept to a problem that I never considered applying the concept to before–probably with very good reason. Basically, it’s a guy named…
Homeopathy and “plausibility bias” versus science
Posted by Orac on August 24, 2011 One of the things that distinguishes evidence-based medicine (EBM) and science-based medicine (SBM) is how the latter takes into account prior probability that a therapy is likely to work when considering clinical trials. My favorite example to demonstrate this difference, because it’s so stark and obvious, is homeopathy. Homeopathy, as regular readers of this blog…
Better late than never: The Dunning-Kruger effect meets an incompetent anti-vaccine “analysis”
Posted by Orac on August 17, 2011 It never ceases to amaze me just how ignorant of very basic principles of science anti-vaccine activists often are. I mean, seriously. Every time they try to post something, whether they know it or not, they end up making themselves look so very, very stupid–or at least ignorant. The Dunning-Kruger effect takes over, and people…