Clinical trials
oracknows | November 20, 2011Every 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, it's a contortion of science so egregious that I can't believe anyone would actually do it--or that anyone would actually mistake that woo for good science.
This time around, it's genomics that's being abused.
This is a topic that, although I don't…
oracknows | November 17, 2011When 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 of the anti-vaccine movement, Barbara Loe Fisher when she released a seriously hypocritical and silly press release whining about how mistreated she thinks her organization, the Orwellian-named National Vaccine Information Center (NVIC) has been because the American Academy of Pediatrics (AAP) had the audacity…
tsmith | November 15, 2011Oh, Discover. You're such a tease. You have Ed and Carl and Razib and Phil and Sean, an (all-male, ahem) cluster of science bloggy goodness. But then you also fawn over HIV deniers Lynn Margulis and Peter Duesberg. Why can't you just stick with the science and keep the denial out?*
But no, now they've let it spill into their esteemed blogs. I was interested to see a new blog pop up there, The Crux, a group blog "on big ideas in science and how these ideas are playing out in the world. The blog is written by an outstanding group of writer/bloggers and scientist/writers who will bring you the…
oracknows | October 26, 2011As 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 all the long years of medical school and residency, with fellowship tacked on for many, during which we're relentlessly told what to do by more senior residents, fellows, and attendings or if it has something to do with the personality traits that lead young people to go into medicine, particularly surgery. It's probably a little…
oracknows | October 25, 2011I 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 it is. After all, I did it seven years ago before anyone had ever caught on to the glory (and ego) that is Orac. I've just been fortunate in that, for the most part, the topics that interest me enough to write about them are generally interesting enough to a bunch of people every day to read them. That…
oracknows | September 29, 2011Yesterday, 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 Michael Slattery writing about The Wisdom Of The Crowds And Sangamo's Phase II B Clinical Trial Results.
I've never been convinced that there is a such thing as the "wisdom of crowds." Certainly, the numerous examples throughout history of mob behavior and downright idiotic…
oracknows | August 24, 2011One 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 no doubt know by now, is a mystical, magical system of medicine based on two principles. The first is the law of similars, commonly phrased as "like cures like"; i.e., the way to treat symptoms is to use a smaller amount of…
oracknows | August 17, 2011It 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 who may actually be very successful--intelligent, even--in other fields of knowledge make newbie mistakes and draw egregiously misinterpreted conclusions from existing data. Worse, they have no clue that they don't know what they're doing. In the arrogance of…
oracknows | August 14, 2011NOTE: I was on a lovely vacation for three days in Chicago over the weekend, where I visited old haunts. (Bathroom attendants? At one of my favorite pub hangouts when I lived in Lincoln Park, John Barleycorn? Handing out crappy brown paper towels? Plastering the walls there with endless rows of flat screen TVs turned continuously on sports and news? Really? Oh, the pain.) In any case, what that means is that I didn't write anything new for today (other than this introduction). I did, however, find a lovely post from over two and a half years ago to recycle and update. Remember: If you haven't…
oracknows | August 12, 2011A week ago, I took someone who has normally been a hero of mine, Brian Deer, to task for what I considered to be a seriously cheap shot at scientists based on no hard data, at least no hard data that he bothered to present. To make a long, Orac-ian magnum opus short, Deer advocated increased governmental regulation of science in the U.K. based apparently on anecdotes like that of Andrew Wakefield. Worse, rather than presenting even the limited data that exist regarding the prevalence of scientific fraud, he chose instead to devote too much of his limited word count to characterizing…
oracknows | July 26, 2011Yesterday, I wrote about how two anti-vaccine activists, Barbara Loe Fisher and Joe Mercola, were unhappy that bloggers targeted their advertisement that they put on the CBS Times Square JumboTron for a letter-writing campaign to try to persuade CBS Outdoors to do the right thing and stop selling ad time to groups who promote a philosophy that is a threat to public health. Thats why I have to love it when by coincidence a paper is released that provides yet one more example of the benefits of vaccination. In this case, it even deals with one of the "lesser" vaccines. Well, it's not really a "…
oracknows | July 17, 2011Note: I just got back from TAM; so if you happened to see a different version of this post somewhere else, now you know why.
Last week while I was at TAM, a study appeared in the New England Journal of Medicine (NEJM). It is another beautiful example of how proponents of complementary and alternative medicine (CAM) are able to spin even hugely negative results into something that supports CAM. Because I was at TAM, I didn't actually notice the article at first, but notice it I did eventually. Upon seeing it, my first question was: What on earth are the editors of NEJM smoking. Oddly enough,…
oracknows | June 23, 2011Remember Michael Egnor?
I bet many of you do. If you were reading this blog three or four years ago, Dr. Egnor was a fairly regular target topic of my excretions of not-so-Respectful Insolence. The reason for that was, at the time, I was quite annoyed that a fellow surgeon could so regularly lay down such incredible blasts of pseudoscientific nonsense in the defense of his "intelligent design" creationism views. Back then he did this as a semi-regular blogger for a blog that is a propaganda outlet for the crank ID propagandists at Discovery Institute in much the same way that Age of Autism is…
oracknows | June 20, 2011Note: Grant writing ruled again this weekend; so I took this post, which first appeared elsewhere, and decided to revise and repost it. It seems appropriate, given what I've been discussing lately. Enjoy, and hopefully there'll be something new tomorrow..
I've been complaining a lot about a certain journalist lately, specifically one named David Freedman. Before the most recent paean to unscientific medicine written by him, he wrote another article. The article, which was trumpeted by Tara Parker-Pope, came under the heading of "Brave Thinkers" and is entitled Lies, Damned Lies, and Medical…
oracknows | June 13, 2011Orac note: Grant season is in full swing, and that's what I spent my weekend doing: writing grants. Consequently, here's a rerun from, hard as it is to believe, four and a half years ago. It's the first appearance of one of the most hilarious "alt-med" attacks on science-based medicine I've ever seen, calling us "microfascists." Unfortunately, little has changed coming from CAM supporters in the nearly five years since I first applied some not-so-Respectful Insolence to this little chew toy of an article. Enjoy, I hope. Remember, if you haven't been reading at least four and a half years, it'…
oracknows | May 23, 2011Let's face it, Dr. Andrew Weil is a rock star in the "complementary and alternative medicine" (CAM) and "integrative medicine" (IM) movement. He is one of its founders, at least a founder of the its most modern iteration, and I am hard-pressed to think of anyone who did more in the early days of the CAM/IM movement, back before it ever managed to achieve a modicum of unearned respectability, to popularize CAM. In fact, no physician that I can think of has over the course of his lifetime done more to promote the rise of quackademic medicine than Dr. Weil. The only forces greater than Dr. Weil…
oracknows | May 18, 2011One of the stranger Internet-based quackery phenomena of the last decade is Morgellon's disease. This is a topic I haven't visited that much on this blog, its having last come up in a big way a little more than a year ago, when I discussed it in the context of Dr. Rolando Arafiles and the other quackery he was promoting. This led to extreme unhappiness on the part of self-proclaimed Morgellons disease "expert" Marc Neumann, who later bombarded me with threatening e-mail rants. In any case, whatever Morgellons disease is, its cause is almost certainly not what patients think it is, namely the…
oracknows | May 16, 2011Remember dichloroacetate, also known as DCA?
This is a relatively simple compound that showed promise in rodent models of cancer four years ago, leading to an Internet meme that "scientists cure cancer, but no one notices." It also lead to scammers trying to take advantage of desperately ill cancer patients. The whole sordid story is detailed in my series of posts, the most recent of which I wrote about a year ago and link to here. I've also appended a list of every post I've written on the subject since I first discovered DCA in January 2007. It's a story of hope, fascinating cancer biology…
oracknows | March 15, 2011Yesterday, I did a post about ethics in human experimentation. The reason I mention that is because in the comments, a commenter named Paul pointed out an editorial of the sort of variety that we frequently see whenever there is a revelation of misdeeds in human research and a response to that article that is far too mild for the level of idiocy in the editorial. The editorial was written by Justin Goodman of People for the Ethical Treatment of Animals (PETA). Appearing in the Sacramento Bee, Goodman's article makes a dubious and typical false analogy for an animal rights activist,…
oracknows | March 13, 2011Progress in science-based medicine depends upon human experimentation. Scientists can do the most fantastic translational research in the world, starting with elegant hypotheses, tested through in vitro and biochemical experiments, after which they are tested in animals. They can understand disease mechanisms to the individual amino acid level in a protein or nucleotide in a DNA molecule. However, without human testing, they will never know if the end result of all that elegant science will actually do what it is intended to do and to make real human patients better. They will never know if…