medicine
oracknows | September 22, 2010I've expounded on the principle of crank magnetism. Basically, crank magnetism is the tendency of cranks not to mind the crankery of other cranks, even if the two forms of crankery are mutually exclusive. But it's more than that. It's the tendency of a single crank to be attracted to several forms of crankery. We've seen it in creationists who are also attracted to "alternative medicine," in anti-vaccine loons who are also attracted to alternative medicine and various conspiracy theories, including "9/11 Truth." I've seen it in Holocaust deniers who are also attracted to both "alternative"…
oracknows | September 21, 2010Way, way back in the deepest darkest depths of history, before I entered the Knowledge Room and sold my soul to big pharma to become a pharma blogger (in other words, way back in 2005), my inauguration as a skeptical blogger taking on anti-vaccine misinformation, pseudoscience, and lies occurred in a big way when I referred to Robert F. Kennedy, Jr.'s infamous article Deadly Immunity as flushing Salon.com's credibility down the toilet. That was when I discovered the mercury militia, that subset of the anti-vaccine movement that believes that mercury in the thimerosal preservative that used to…
oracknows | September 20, 2010This guy would appear to be screwed:
The rat running by the acupuncturist's door is a nice touch, too. And so appropriate.
tfk | September 20, 2010
That's the full video from my panel at Netroots Nation this summer. Mark Sumner (DailyKos's DevilsTower, and the author most recently of The Evolution of Everything), Greg Dworkin (DailyKos's DemfromCT), and Naomi Oreskes and Erik Conway (co-authors of the excellent and important Merchants of Doubt.), joined me to talk about threats to science in today's society, and what scientists have done to fight back.
Don't miss my discussion of Leviathan melvillei and the Fail Whale.
oracknows | September 20, 2010A critical aspect of both evidence-based medicine (EBM) and science-based medicine (SBM) is the randomized clinical trial. Ideally, particularly for conditions with a large subjective component in symptomatology, the trial should be randomized, double-blind, and placebo-controlled. As Kimball Atwood pointed out just last week (me too), in EBM, scientific prior probability tends to be discounted while in SBM it is not, particularly for therapies that are wildly improbable strictly on the basis of basic science, but for both the randomized clinical trial remains, in essence, where the "rubber…
oracknows | September 17, 2010On the blogging front, I started out this week with a part facetious, part serious, part the highly detailed analysis of a new study of interest that you've come to know and love (or hate). The study was Price et al, and it was yet another nail in the coffin of the scientifically discredited notion that mercury in vaccines causes autism, a notion whose coffin already had so many nails in it that Price et al probably had a hard time finding even a tiny area of virgin wood into which to pound even a tiny nail of a study published in an impact factor one journal, much less the spike that their…
oracknows | September 15, 2010I'm a cancer surgeon.
I started out as a general surgeon, but my passion and scientific interest goaded me into specializing in cancer. Ultimately, I ended up subspecializing even more, ultimately becoming a breast cancer surgeon, but through it all cancer, not just breast cancer, has remained my clinical and scientific passion. So has science-based medicine. Developed as a response to the concept of "evidence-based medicine" (EBM), SBM postulates that clinical care should be based on the best science available, including the consideration of basic sciences and prior probability. EBM…
oracknows | September 14, 2010Yesterday, I had a bit of fun while taking on a serious topic, namely yet another study that failed to find a link between mercury in vaccines and autism. Fortunately, though, I wasn't the only one. Oh, no, not by any means.
Liz Ditz has done what she does best and provided a comprehensive linkfest of reaction to the study.
A few of my favorites from the list:
They DID a study! (Photon in the Darkness)
More evidence that mercury in vaccines doesn't cause autism (Science-Based Pharmacy)
The Long Awaited CDC Trial on Thimerosal and Autism (NeuroLogica Blog)
New thimerosal/autism paper - signal…
oracknows | September 12, 2010THE PAST IS PROLOGUE
Location: Central New Jersey, deep within the brick and steel of a secret pharma base.
Year: 1999.
A shadowy figure dressed in gray, bald, and stroking a white cat enters a nondescript room in the middle of which sits a massive conference table. More than a dozen men and women leap to their feet at attention and wait until the man pauses at the head of the table and then very deliberately sits in high-backed leather chair.
Shadowy figure: Have they arrived?
Lackey #1: Yes, Leader.
Shadowy figure: Let them wait a few minutes. First, we have pressing business. You have…
oracknows | September 12, 2010Fresh from the comments last night:
I just want to say that JM nor Wakefield had anything to do with my decision not to vax. My doc in fact doesn't recommend it. I have plenty of studies from CDC's site that did the convincing for me. Maybe ya'll should read it too, you may be surprised at what you actually find. I'd love to see the groups seperate if that's what it has to come down to. If you vaxed folks start saying things like "Ew you're not vaccinated, gross." Then hey- you and your toxic children-- who are shedding the viruses and causing new outbreaks--can go and live together in a…
oracknows | September 10, 2010I hate to do this to Bora again. I really do. I'm also getting tired of blogging all these crappy acupuncture studies. I really am. However, sometimes a skeptic's gotta do what a skeptic's gotta do, and this is one of those times.
As you may recall, a mere week ago I was disturbed to have discovered the publication of a truly horrifically bad acupuncture study in PLoS ONE. It had all the hallmarks of quackademic medicine: an implausible hypothesis, trying to correlate mystical concepts of meridians and qi to anatomy and failing miserably, and dubious statistical modeling. That PLoS ONE…
oracknows | September 9, 2010It's been a while since we've heard from CBS News' resident anti-vaccine propagandist Sharyl Attkisson. When last we saw her, she was sucking up to the man whose discredited pseudoscience started the modern anti-vaccine movement, Andrew Wakefield, a man who went on to have his medical license ignominiously taken away. Prior to that, she had tried to out-crank the mercury militia's most famous anti-vaccine kook, Robert F. Kennedy, Jr.; laid down some seriously incompetent and biased "journalism" promoting the myth that vaccines cause autism; and may even have been feeding information to…
oracknows | September 9, 2010Here and elsewhere in the blogosphere, over the last several years, what started out as a more general interest in skepticism and science with a natural focus on medicine and a side interest in combatting Holocaust denial became more focused on promoting science-based medicine. As the saying goes, "Science, it works, bitches," and I make no apologies for promoting science-based medicine as the best medicine and applying skepticism and science to claims of purveyors of unscientific so-called "alternative" medicine advocates and anti-vaccine loons. However, I am not blind to the shortcomings of…
oracknows | September 8, 2010I must admit that, after having taken it easy over the last few days, when the time came to sit down and get back into the swing of things, I had a bit of a hard time. No, it's not just blogging. That's actually a rather minor component of the whole malaise that descended upon me like a shroud. Rather, it's the simple fact that the Labor Day weekend in the U.S. represents the unofficial end of the summer season. After that, it's all back to school, back to work, back to the grind.
Back to real life after summer.
This reluctance, not surprisingly, seeped out of real life and started to permeat…
oracknows | September 7, 2010After chilling out for part of the weekend, yesterday I became so engrossed in writing my part of a training grant for my postdoc that, before I knew it, it was way too late to provide you with the Insolence you crave for today. Oh, well. Tomorrow for sure; there's a lot that has been waiting for my attention. Besides, I haven't even really taken a vacation this summer; so I deserve a day or two (or three) off from time to time. In the meantime, I'll post a couple of bits of "classic" (if you can call it that) Insolence. This particular bit of insolence dates back nearly four years, all the…
oracknows | September 6, 2010After chilling out for part of the weekend, yesterday I became so engrossed in writing my part of a training grant for my postdoc that, before I knew it, it was way too late to provide you with the Insolence you crave. Oh, well. Tomorrow for sure. In the meantime, I'll post a couple of bits of "classic" (if you can call it that) Insolence. This particular bit of insolence dates back nearly four years, all the way back to November 2006. Remember, if you haven't been reading at least four years, it's new to you! Besides, it's always fun (or disturbing) to me to see how well some of my older…
oracknows | September 5, 2010In case you hadn't guessed, because of the holiday weekend, blogging's been rather slow. This is in general a good thing, a chance to rest and rethink, but occasionally, even while chilling out, I see things that I can't resist mentioning briefly. Things like this.
If there's one thing about "complementary and alternative medicine" (CAM) that has always puzzled me, it's that, at least here in the "West," there seems to be an inordinate fascination with ancient "Eastern" medical systems. These include, of course, traditional Chinese medicine (TCM) and Indian Ayruvedic medicine, both of which…
oracknows | September 3, 2010One of the most frustrating aspects of taking care of cancer patients is that in general, with a handful of specific exceptions, we do not have good curative therapies for patients with stage IV cancer, particularly solid tumors. Consequently, we are forced to view patients with stage IV cancer as "incurable" because, the vast majority of the time, they are incurable. Over the years, we have thrown everything but the kitchen sink at patients with stage IV disease, largely with dissapointing results. That's not to say that the few specific exceptions to which I alluded are not a reason for…
oracknows | September 2, 2010Nearly a month ago, I expressed my dismay and displeasure at the infiltration fo quackademic medicine into what is arguably the premier medical journal in the world, The New England Journal of Medicine (NEJM) in the form of a highly credulous review on the use of acupuncture for low back pain that brought eternal shame on the hallowed pages of a once-great journal. As Mark Crislip put it, trust, once damaged or lost, is very hard to restore, and I definitely lost a lot of trust for the NEJM compared to what I had for it a month ago. Since then, I've been keeping my eyes out for other examples…
drorzel | September 1, 2010There's a new medical study of the effects of alcohol consumption that finds a surprising result:
Controlling only for age and gender, compared to moderate drinkers, abstainers had a more than 2 times increased mortality risk, heavy drinkers had 70% increased risk, and light drinkers had 23% increased risk. A model controlling for former problem drinking status, existing health problems, and key sociodemographic and social-behavioral factors, as well as for age and gender, substantially reduced the mortality effect for abstainers compared to moderate drinkers. However, even after adjusting…