Clinical trials

Many are the bizarre, dubious, and downright crappy acupuncture studies that I’ve deconstructed over the years. Just type “acupuncture” into the search box of this blog, and you’ll soon see. (If that pulls up too many results, try typing “acupuncture” and “study” or “acupuncture” and “clinical trial” in the search box.) I’m not the only one, either. For instance, my good bud Mark Crislip did his usual excellent and highly sarcastic job of deconstructing the frequent claim by acupuncture apologists that acupuncture “works” by releasing endorphins. So when I first saw an even more bizarre…
Given the study that I’m going to discuss, I can’t help but start out with a brief (for me) reminiscence. Longtime readers know that I graduated from the University of Michigan Medical School in the late 1980s. Back when I attended U. of M., its medical school was considered stodgy and hard core even by 1980s standards. No organ systems approach to education for U. of M.! Oh, no. It didn’t matter that the organ systems approach, in which all classes are organized by organ systems and teach the same organ systems at roughly the same time (e.g., biochemistry teaching the biochemistry of the…
Last week, I wrote about a man named Jim Gass, a former chief legal counsel for Sylvania, who had suffered a debilitating stroke in 2009 that left him without the use of his left arm, and weak left leg. He could still walk with a cane, but was understandably desperate to try anything to be able to walk unaided and function more normally in life. Unfortunately (at least given what ultimately happened), Mr. Gass was both driven enough, credulous enough, and wealthy enough to spend $300,000 pursuing stem cell tourism in China, Mexico, and Argentina over the course of four years. The result is…
One of the most reliable indicators of a quack clinic that I know of (besides its offering homeopathy and reiki) is the inclusion of “detox foot bath” treatments on its roster of services. Detox foot baths, whatever the brand, are of a piece with other “detoxification” pseudoscience involving the feet, such as Kinoki foot pads. Basically, the idea is that you can some how remove toxins through the soles of your feet using either a nice mineral bath with a weak electrical current passed through it or a foot pad. Inevitably, nasty looking stuff is seen apparently coming out of the feet. In the…
One of the most frequent complaints about evidence-based medicine (EBM), in contrast to science-based medicine (SBM), is its elevation of the randomized clinical trial as the be-all and end-all for clinical evidence for an intervention for a particular disease or condition. Unknown but enormous quantities of "digital ink" have been spilled explaining this distinction right here on this blog, and I tened to like to refer to this aspect of EBM as "methodolatry," a term I originally learned from another ScienceBlogs blogger (now moved on) and defined as profane worship of the randomized…
A week ago, I wrote about an example of one of the most common topics on this blog, the infiltration of pseudoscientific medicine and outright fantasy into academic medicine, a trend I like to refer to as quackademic medicine. The institution was George Washington University, and the dubious intervention was something called the MEND™ Protocol, which is sold as a treatment for Alzheimer’s disease by Muses Labs. As I described, it’s a protocol that appears to rely on a proprietary computer algorithm of some kind that, according to Muses Labs, produces a “personalized” treatment plan for…
A recurring theme of this blog is to shine a light on what I like to call “quackademic medicine.” I didn’t invent the term, but I’ve made it mine. Basically, quackademic medicine is a term that very aptly describes what’s going on in far too many academic medical centers these days, which is the infiltration of pseudoscientific medicine and outright quackery in the form of “complementary and alternative medicine” (CAM). Of course, the more recent term for CAM is now “integrative medicine,” which was coined to imply the “integration” of alternative medicine with science-based medicine as…
Most scientists I know get a chuckle out of the Journal of Irreproducible Results (JIR), a humor journal that often parodies scientific papers. Back in the day, we used to chuckle at articles like "Any Eye for an Eye for an Arm and a Leg: Applied Dysfunctional Measurement" and "A Double Blind Efficacy Trial of Placebos, Extra Strength Placebos and Generic Placebos." (What saddens me is that this is basically what research into so-called “complementary and alternative medicine,” now more frequently referred to as “integrative medicine” boils down to.) Unfortunately, these days, reporting on…
One common theme that has been revisited time and time again on this blog since its very founding is the problem of how science and medicine are reported. For example, back when I first started blogging, one thing that used to drive me absolutely bonkers was the tendency of the press to include in any story about vaccines an antivaccine activist to “tell the other side” or for “balance” to the story. So in a story on vaccines, on the one side you would have Paul Offit, a bona fide, legitimate vaccine expert, and on the other side you would have J.B. Handley, Jenny McCarthy, Andrew Wakefield,…
"Complementary and alternative medicine" (CAM), now more frequently referred to as "integrative medicine" by its proponents, consists of a hodge-podge of largely unrelated treatments that range from seemingly reasonable (e.g., diet and exercise) to pure quackery (e.g., acupuncture, reiki and other "energy medicine") that CAM proponents are trying furiously to "integrate" as coequals into science-based medicine. They do this because they have fallen under the sway of an ideology that posits a false dichotomy: To practice true "holistic" and "preventative" medicine, physicians and other health…
it was less than a year ago that I described a bill wending its way through Congress called the 21st Century Cures Act “old vinegary wine in a new bottle.” The reason I characterized the bill that way was because it really was nothing new and it rested on a very old fallacy, namely that the only way to speed up medical “innovation” is to weaken the FDA and its standards for drug and medical device approval, which is exactly what the 21st Century Cures Act would do if passed into law. It’s basically the American cousin to the British Saatchi Bill, which in essence proposed to do very similar…
It is an unquestioned belief among believers in alternative medicine and even just among many people who do not trust conventional medicine that conventional medicine kills. Not only does exaggerating the number of people who die due to medical complications or errors fit in with the world view of people like Mike Adams and Joe Mercola, but it's good for business. After all, if conventional medicine is as dangerous as claimed, then alternative medicine starts looking better in comparison. In contrast, real physicians and real medical scientists are very much interested in making medicine…
I’ve written a lot about the language issue with respect to alternative medicine. As I like to put it (at least in shortened form), first there was quackery. Quacks did not like that name at all, and thus was born alternative medicine. And the quacks did think it good—for a while. There was a problem, however. “Alternative” medicine implied (correctly, of course) that what was being discussed was not real medicine, and the quacks could not abide that. Thus was born “complementary and alternative medicine” (CAM). And the quacks thought this very good indeed. Unfortunately, it was not long…
It’s no secret that I’m a big fan of John Oliver. When my aging body allows me to stay awake late enough on Sunday nights and there’s a new episode on, I’ll almost always be watching. Since starting his own show Last Week Tonight With John Oliver on HBO, Oliver’s become quite the expert at using humor to explain and bring attention to injustices that are widely ignored and to skewer politicians and blowhards. This Sunday, he turned his attention on science reporting: I certainly would have written about this for yesterday, except that at 11:30 PM on Sunday night there’s only one place for…
Arguably, one of the most popular forms of so-called "complementary and alternative medicine" (CAM) being "integrated" with real medicine by those who label their specialty "integrative medicine" is acupuncture. It's particularly popular in academic medical centers as a subject of what I like to refer to as "quackademic medicine"; that is, the study of pseudoscience and quackery as though it were real medicine. Consider this. It's very difficult to find academic medical centers that will proclaim that they offer, for example, The One Quackery To Rule Them All (homeopathy). True, a lot of…
It's no secret that I'm a fan of John Ioannidis. (If you don't believe me, just type Ioannidis' name into the blog search box and see how many posts you find.) Over the last couple of decades, Ioannidis has arguably done more to reveal the shortcomings of the medical research enterprise that undergirds our treatments, revealing the weaknesses in the evidence base and how easily clinical trials can mislead, than any other researcher. Indeed, after reading what is Ioannidis' most famous article, "Why Most Published Research Findings Are False", back in 2005, I was hooked. I even used it for our…
Medical research is a scientific enterprise, but, like most areas of science, nonscientific considerations have a great deal of influence over what sorts of research are funded. This is true regardless of who is funding the research. When it's the government, obviously it's impossible to avoid some degree of politics. (Indeed, politics is largely responsible for why the National Center for Complementary and Integrative Health, or NCCIH, even exists and has been studying quackademic medicine for over 20 years.) The same, however, is true when it comes to foundation funding. Some foundations…
I've written several times over the years about the overblown claims of harm attributed, largely—but not exclusively—by cranks, to cell phone radiation. It's been claimed that radiation from cell phones can cause brain tumors (there's no convincing evidence that this is true), breast cancer (the evidence for these claims is so incredibly flimsy—and featured by Dr. Oz, to boot!—that this is not a credible claim), and a wide variety of other health issues. Indeed, if you believe the cranks, the mobile phone companies are the equivalent of tobacco companies denying that their products cause…
I didn't think I'd be writing about Stanislaw Burzynski again so soon, but to my surprise a very good article in Newsweek describing cancer quack Stanislaw Burzynski popped up in my Google Alerts yesterday. I hadn't expected much in the way of news coverage about Burzynski for several months, given that the second half of Burzynski's trial before the Texas Medical Board had been delayed by his having suffered a heart attack and isn't expected to begin again for several months. Entitled Cancer "visionary" Stanislaw Burzynski stands trial for unprecedented medical malfeasance and by Tamar…
Ever since the beginning of this blog, there's one topic I've explored many, many times, mainly because of its direct relationship to my profession as a cancer surgeon. That topic is, of course, the question of why people fall for alternative medicine cancer "cures." It started with one of my very earliest posts and continued right up to deconstructing Presidential candidate Ben Carson's very own alternative medicine cancer cure testimonial last fall. It continues again now. Regular readers, particularly long time readers, have already come to recognize common themes in these alternative…