Clinical trials
oracknows | May 4, 2009It's times like these when I'm happy that I haven't published in too many Elsevier Journals during the course of my career. I say that because on Thursday, it was revealed that pharmaceutical company Merck, Sharp & Dohme paid Elsevier to produce a fake medical journal that, to any superficial examination, looked like a real medical journal but was in reality nothing more than advertising for Merck. As reported by The Scientist:
Merck paid an undisclosed sum to Elsevier to produce several volumes of a publication that had the look of a peer-reviewed medical journal, but contained only…
oracknows | April 23, 2009Better late than never, given that DrugMonkey has already been all over this. Unfortunately, there was another serious outbreak of antivaccine idiocy over at HuffPo that I felt I had to deal with before this:
Embedded video from CNN Video
It was a great day indeed. For far too long, animal rights terrorists have intimidated reesarchers into silence. According to the L.A. Times:
Competing rallies at UCLA today over the controversial issue of animal research are peaceful so far, with supporters of the research appearing to outnumber opponents by more than 10 to 1.
About 400 people,…
oracknows | March 29, 2009Last week, there was a bit of a scandal of sorts over an editorial published by the Journal of the American Medical Association (JAMA), which I blogged about in a rather long post. The short version is that a flawed study that tested using Lexapro that neglected to report a rather important comparison that would have changed the conclusion to finding no difference between cognitive therapy and Lexapro in relieving the symptoms of depression after a stroke resulted in a complaint by Dr. Jonathan Leo of Lincoln Memorial University in Harrogate, TN. Dr. Leo wrote a letter pointing inquiring…
oracknows | March 20, 2009Oh, goody! Vox Day wants to play.
You remember Vox "Hey, it worked for Hitler" Day," don't you? It's been a long time. In fact, I had to do a search to find the last time I had a run-in with him, and it appears that it's been about a year since I last noted him mindlessly parroting antivaccinationist myths and spouting his usual misogyny. Alas, Vox has been a regular irritant to this blog since very early on, when he didn't like my likening his views towards women to the Taliban for his arguing that women shouldn't be allowed to vote because they are "fascists at heart." Since then, every so…
oracknows | March 19, 2009Given that I'm the proverbial lapsed Catholic cum agnostic, religion just doesn't play that large a role in my life and hasn't since around six years ago. I don't know if I'll ever discuss or explain on this blog what the last straw resulting in that transformation was (it's too personal), but a couple of years ago I did go through a period where I became hostile to religion, perhaps spurred on by PZ and the whole anti-religion gestalt of the ScienceBlogs Collective here. That lasted maybe a year or two, during which time I did what every new disillusioned ex-religious person seems to do (…
terrasig | March 18, 2009I just had a chance to check in on a triad of posts by Prof Janet Stemwedel at Adventures in Ethics and Science (1, 2, 3) on the ethical issues of the conduct of studies, particularly clinical trials, supported by the US NIH's National Center for Complementary and Alternative Medicine (NCCAM).
For background, NCCAM was originally established for political, not scientific reasons, as the NIH Office of Alternative Medicine in October 1991. It received a token budget of $2 million at the time. They still only get $120-ish million; modest by NIH standards as compared, say, with the 2007 NCI…
oracknows | March 18, 2009It's probably an understatement to say that I've been critical of the National Center for Complementary and Alternative Medicine (NCCAM). Indeed, I consider it not only to be a boondoggle that wastes the taxpayers' money funding pseudoscience, but a key promoter of quackery. Worse, its promotion of highly implausible (one might even say magical) modalities gives these modalities a patina of scientific respectability that they do not deserve, especially given that, even under the most favorable conditions possible, they routinely fail to demonstrate any efficacy above and beyond that of a…
oracknows | March 17, 2009Until recently, most of my research was laboratory-based. It included cell culture, biochemical assays, molecular biology, and experiments using mouse tumor models. However, one of the reasons that I got both an MD and a PhD was so that I could ultimately test ideas for new treatments on patients and, if I'm good enough and lucky enough, ultimately improve the care for cancer patients. If there's one thing, though, that I've learned in my nearly nine years in academic surgery, it's that far fewer patients end up enrolled on clinical trials than are eligible to participate in them. Every…
oracknows | March 12, 2009Science as it is practiced today relies on a fair measure of trust. Part of the reason is that the culture of science values openness, hypothesis testing, and vigorous debate. The general assumption is that most scientists are honest and, although we all generally try to present our data in the most favorable light possible, we do not blatantly lie about it or make it up. Of course, we are also all human, and none of us is immune to the temptation to leave out that inconvenient bit of data that doesn't fit with our hypothesis or to cherry pick the absolutely best-looking blot for use in our…
oracknows | March 4, 2009As this posts I should be on an airplane winging its way to much warmer climes than where I reside in order to attend the Society of Surgical Oncology 62nd Annual Cancer Symposium. There, in Phoenix, I will eagerly absorb all the latest and greatest knowledge in the realm of cancer surgery, commune with friends whom I often don't see more than once every year or two at this meeting, and, hopefully, drink much good beer.
I'll likely still be blogging, but if I'm learning too much or having too much fun, you may see a couple of reruns again. As for any sort of meetups, I don't know if I'll have…
oracknows | March 4, 2009If there's' one theme, one cause, that this blog has emphasized throughout the four years of its existence and the three years of its having resided on ScienceBlogs, it's been to champion science- and evidence-based medicine over pseudoscience and quackery. Whether it's refuting the lies of antivaccine zealots, having a little fun with some of the more outrageously bizarre forms of pseudoscience, railing against cancer quackery, lamenting how easily pseudoscientific quackery has infiltrated medical academia, complaining about drug companies rigging clinical studies, or trying to educate my…
oracknows | February 11, 2009I have to say, this is getting monotonous.
Let me back up a minute. One of the most common beliefs among users and advocates of "complementary and alternative" medicine (CAM) is that supplementation with vitamins will have all sorts of beneficial health effects. True, this belief is also pervasive among people who wouldn't go to an acupuncturist if you held a gun to their head, but it has become most associated with CAM. That this is so can actually be viewed as evidence of just how successful CAM activists have been in completely yoking all manner of lifestyle interventions to prevent or…
oracknows | February 10, 2009I'm not as big a fan of Keith Olbermann as I used to be. Indeed, sometimes he strikes me as the liberal version of Rush Limbaugh, not to mention a blowhard. However, occasionally, he still has it, and when he's on, no one skewers the dishonest better than he does. For instance, after a media flack and the usual inclusion of Bill O'Reilly as runners up, meet Andrew Wakefield, the Worst Person in the World for February 10, 2009:
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Visit msnbc.com for Breaking News, World News, and News about the Economy
That about sums it up right now.
I wonder how long before the antivaccinationist loons…
oracknows | January 29, 2009I think my title says it all: Can we finally just say that acupuncture is nothing more than an elaborate placebo? Can we?
The reason I ask this question is because yet another large meta-analysis has been released that is entirely consistent with the hypothesis that acupuncture is a placebo. Because I've written about so many of these sorts of studies over the last year or two that I really had a hard time mustering up the will to write about one more. But I got in pretty late last night and therefore knew I could handle this in a reasonably expeditious fashion. Besides, it is a fairly…
oracknows | January 22, 2009Being involved in clinical research makes me aware of the ethical quandaries that can arise. Fortunately for me, for the most part my studies are straightforward and don't provoke much in the way of angst over whether what I am doing is ethical or whether I'm approaching a line I shouldn't approach or crossing a line I shouldn't cross. However, there's lots of research that flirts with the unethical and sometimes even crosses the line. Institutional review boards are there to oversee the ethics of clinical trials and protect the human subjects who participate in them, but they don't always…
oracknows | January 20, 2009About a year ago, I discussed an article by Dr. Atul Gawande describing a quality improvement initiative that appeared to have been stalled by the Office for Human Research Protections and its apparent tendency to apply human subjects research protection rules to initiatives that are not exactly research using human subjects. The problem appeared to be an excessively legalistic and a "CYA" attitude more than a genuine concern for protecting human subjects. At the time, I was more concerned with the ethical and policy implications of the story rather than the actual research itself. After all…
oracknows | January 19, 2009I almost feel sorry for homeopathy Jeremy Sherr. Almost. You see, he is busily learning a lesson that HIV/AIDS denialist Celia Farber learned a couple of weeks ago, namely that, unlike the fictional nation of Oceania in George Orwell's Nineteen Eighty-Four, memory holes do not work very well in the Internet age.
I'll backtrack a bit and explain. Last week, several readers sent me reports about a homeopath named Jeremy Sherr, who apparently in November went to Tanzania in Africa and has been busted by the skeptical blogosphere for proposing on his blog Jeremy's Journal from Africa completely…
oracknows | January 15, 2009P.Z. Myers turned me on to a phenomenal proposal at Change.gov, the website of President-Elect Barack Obama's transition team:
Defund the National Center for Complementary and Alternative Medicine:
Here's a way to increase the available funding to NIH without increasing the NIH budget: halt funding to NCCAM, the National Center for Complementary and Alternative Medicine. This Center was created not by scientists, who never thought it was a good idea, but by Congress, and specifically by just two Congressmen in the 1990's who believed in particular "alternative" (but scientifically dubious)…
oracknows | December 22, 2008The zombie has arisen once again to eat the brains of the Air Force.
I'm referring to so-called "battlefield acupuncture," a topic that I wrote about last week for this very blog. I didn't think there'd be a reason to revisit the subject again so soon, but I was wrong for three reasons. First, I remain appalled at how one ideologue, Col. (Dr.) Richard Niemtzow, a radiation oncologist and Air Force physician turned woo-meister-in-chief and number one advocate of acupuncture use in the military, has succeeded in introducing acupuncture into not only formerly hard-nosed and science-based…
oracknows | December 12, 2008It figures.
Right around the time of my blogiversary yesterday, when I had intended nothing more than a brief by characteristically self-indulgent bit of navel-gazing twaddle (at which, I succeeded brilliantly, I might add; no one--and I mean no one--does self-indulgent navel-gazing twaddle better than I do), what should be there tempting me from my intended day off? Lots of news stories about a report published by the Centers for Disease Control about a yearly survey regarding the usage of so-called complementary and alternative medicine (CAM) therapies in the U.S. Predictably, headlines in…