Clinical trials
oracknows | November 16, 2009The New York Times has been periodically running a series about the "40 years' war" on cancer, with most articles by Gina Kolata. I've touched on this series before, liking some parts of it, while others not so much. In particular, I criticized an article one article that I thought to be so misguided about how the NIH grant system leads researchers to "play it safe" and how we could cure cancer if we could just fund "riskier" research that I had to write an extended screed about the misconceptions in the article. The latest installment, Medicines to Deter Some Cancers Are Not Taken, also by…
oracknows | November 12, 2009Over two weeks ago, I wrote a rather withering assessment of a truly bad article published by one of my favorite magazines, a magazine to which I've subscribed continuously since the mid-1980s. I'm referring, of course, to Shannon Brownlee's and Jeanne Lenzer's execrable article about the H1N1 vaccine entitled Does the vaccine matter?
I have been surpassed.
I say that because Mark Crislip has written what is to my mind the very best fisking of Brownlee and Lenzer's article I have yet come across, entitled Yes, But. The Annotated Atlantic. Stick a fork in Brownlee and Lenzer. They're done.
oracknows | November 10, 2009Here we go again.
I see that the kerfuffle over screening for cancer has erupted again to the point where it's found its way out of the rarified air of specialty journals to general medical journals and hence into the mainstream press. This is something that seems to pop up every so often, much to the consternation of lay people and primary care doctors alike, often trumpeted with breathless headlines along the lines of "What if everything you knew about screening was wrong?
It isn't, but some of it may be. The problem is the shaking out process. I'll try to explain.
Over the last couple of…
oracknows | September 17, 2009Pity poor Nick Gonzalez.
Sorry, I couldn't resist. After having used the same line when discussing the hugely enjoyable humiliation of the Godfather of HIV/AIDS denialism, Peter Duesberg, I couldn't resist using the same line to introduce my response to Dr. Gonzalez's woo-ful whine in response to the publication of the disastrous (for him and any patient unfortunate enough to be in the arm receiving his protocol) clinical trial that demonstrated about as unequivocally as it is possible to demonstrate that his "protocol" to treat pancreatic cancer is nothing more than as steaming and stinking…
oracknows | September 12, 2009Three weeks ago or so, I expressed dismay at what I perceived as an autism quackfest being held at the University of Toronto. Worse, that quackfest had been partially funded by a grant from a very prestigious children's charity, The SickKids Foundation, which in response to complaints about its sponsoring the autism quackfest known as AutismOne/Autism Canada 2009 Conference, wrote a limp and pusillanimous form e-mail that it sent to everyone who complained. It was truly disappointing to see that an organization that should be supporting science-based research into the treatment of children's…
oracknows | September 1, 2009For a change of pace, I want to step back from medicine for this post, although, as you will see (I hope), the study I'm going to discuss has a great deal of relevance to the topics covered regularly on this blog. One of the most frustrating aspects of being a skeptic and championing critical thinking, science, and science-based medicine is just how unyielding belief in pseudscience is. Whatever realm of science in which there is pseudoscience Orac happens to wander into, he find beliefs that simply will not yield to science or reason. Whether it be creationism, quackery such as homeopathy,…
oracknows | August 20, 2009One of the advantages of hanging out around home on the proverbial staycation is that, instead of actually paying more attention to the news, I've paid less attention to the news. That's why I didn't notice some stories from earlier this week about what the new director of the NIH, Francis Collins, plans to do.
Regular readers probably know that, other than the occasional snarky comment on other people's blogs, I haven't (much) engaged in the blogospheric kerfuffle over Collins' religion and the (in my opinion) vastly overblown fear in some quarters that he would inject his religion into his…
oracknows | August 17, 2009Believe it or not, I happen to be on vacation this week. Fear not, it's a stay-at-home vacation (sometimes the best kind) and therefore my vacation doesn't mean I'll stop blogging. In fact, I consider blogging to be part of my recreation. What my vacation does mean is that I will probably slow down a bit and not do posts that force me to do a lot of background reading. It also means that, because I went to an actual rock concert last night (something I haven't done in years), not only did I sleep in a bit and therefore not have that post that usually goes up here by 8 or 9 AM, but I didn't…
oracknows | August 10, 2009If there's one theme that's run through this blog since the very beginning, it's that the best medical care should be based on the best science. In other words, I like to think of myself as being far more for science- and evidence-based medicine, than I am against against so-called "complementary and alternative medicine" (CAM).
Unfortunately, even though the proportion of medical therapies not based on science is far lower than CAM advocates would like you to believe, there are still more treatments in "conventional" medicine that are insufficiently based on science or that have never been…
oracknows | August 6, 2009There is no doubt that the infiltration of quackademic medicine into medical schools in this country represents a profound threat to science-based medicine. By mixing mysticism, non-science, and pseudoscience along with science-based medicine, medical schools are in essence endorsing quackery and elevating it to the same level as science-based and science-tested modalities. Worse, they're running the risk of training a generation of medical students accepting of this "integrating" woo with science, who can't recognize highly implausible treatments or recognize obvious quackery. By letting…
oracknows | August 4, 2009During the month of June on this blog, I got annoyed not once, but twice. First, I got annoyed at Sharon Begley for a truly annoying and evidence-free (other than cherry-picked anecdotes) broadside against the NIH for its "culture of caution" that, according to her, is largely responsible for the "lack of progress" against cancer over the last 38 years since President Richard Nixon declared "war on cancer." In essence, Begley blamed the need scientists have for publishing in the highest impact journals they can get their manuscripts into for "delaying" cures or, as I put it, "keeping teh…
oracknows | July 6, 2009Two of the major themes on this blog since the very beginning has been the application of science- and evidence-based medicine to the care of patients and why so much of so-called "complementary and alternative" medicine, as well as fringe movements like the anti-vaccine movement, have little or--more commonly--virtually no science to support their claims and recommendations. One major shortcoming of the more commonly used evidence-based medicine paradigm (EBM) that has been in ascendance as the preferred method of evaluating clinical evidence. Specifically, as Dr. Kimball Atwood IV (1, 2, 3…
oracknows | July 2, 2009Last year, a seeming victory for the protection of human subjects from being subjected to pseudoscience. It began when Kimball C. Atwood IV, MD; Elizabeth Woeckner, AB, MA; Robert S. Baratz, MD, DDS, PhD; and Wallace I. Sampson, MD published a lengthy criticism of the NIH Trial to Assess Chelation Therapy (TACT) in Medscape, pointing out that it was a boondoggle that was not only not based on sound science but was in fact risky to patients and riddled with conflicts of interest and administered by highly dubious practitioners. If you want to know just how bad the National Center for…
oracknows | June 29, 2009This is just a brief followup to my post this morning about yesterday's NYT article on cancer research. An excellent discussion of the NYT article can be found here (and is well worth reading in its entirety). In it, Jim Hu did something I should have done, namely check the CRISP database in addition to PubMed. A couple of key points follow about the examples cited in the NYT article.
Regarding Dennis Slamon:
I hate to criticize Dennis Slamon, because the HER2 to Herceptin story is a great one. But the image one gets of his research program being saved by a friend from Revlon while the NCI…
oracknows | June 15, 2009On Friday, I expressed my irritation at the misunderstanding of science by NEWSWEEK's science columnist Sharon Begley, in which she opines that it is those nasty basic scientists who insist on learning new science and new physiological mechanisms of disease that are devaluing translational and clinical research, in effect ghettoizing them in low impact journals, and, as I sarcastically put it, "keeping teh curez from sick babiez!!!!!"
It turns out that both Steve Novella, Mike the Mad Biologist, and Tim Kreider have also weighed in. All are worth reading.
I also thought of another thing…
oracknows | June 12, 2009I was very happy with NEWSWEEK recently, specifically because of its lengthy expose of Oprah Winfrey and her promotion of pseudoscience, mysticism, and quackery on her talk show. However, I haven't always been that thrilled with NEWSWEEK's coverage of medicine and science. For example, NEWSWEEK's science columnist Sharon Begley has gotten on my nerves on more than one occasion, most recently when she castigated doctors for not enthusiastically embracing comparative effectiveness research, making the unjustified slur against physicians that they "hate science." Indeed, she even managed to…
oracknows | June 3, 2009What should a drug company do if it spends millions of dollars on a compound and it doesn't do anything? Easy:
(Click on the panel to see the whole cartoon.)
In fact, I'm surprised more pharmaceutical companies don't do this...
oracknows | May 30, 2009One reason I (and most people involved in cancer research) don't like the frequently used term "cure for cancer." The reason is simple. Embedded within this term is the assumption that cancer is just one disease, when it is most definitely not. Rather, it is many diseases affecting many organs, each with its own mechanism of pathogenesis and each often requiring different treatments. For example, for "liquid" tumors arising from hematopoietic organs, the treatment usually consists primarily of chemotherapy, sometimes with radiation therapy in the case of lymphomas, while "solid" tumors often…
oracknows | May 13, 2009I have to hand it to acupuncture mavens. They are persistent. Despite numerous studies failing to find any evidence that acupuncture is anything more than an elaborate placebo whose effects, such as they are, derive from nonspecifice mechanisms having nothing to do with meridians, qi, or "unblocking" qi. Moreover, consistent with the contention that acupuncture is no more than an elaborate placebo, various forms of "sham" acupuncture (needles that appear to insert but don't or acupuncture in the "wrong" locations, for example) produce results indistinguishable from "real" acupuncture.
That…
oracknows | May 11, 2009Remember about a week ago, when I lamented how scientific publisher Elsevier had created a fake journal for Merck that reprinted content from other Elsevier journals favorable to Merck products in a format that looked every bit like a peer-reviewed journal but without any disclaimers to let the unwary know that it wasn't a peer-reviewed journal?
Whoops, Elsevier did it again. Six times:
Scientific publishing giant Elsevier put out a total of six publications between 2000 and 2005 that were sponsored by unnamed pharmaceutical companies and looked like peer reviewed medical journals, but did…