Articles

Archive for August, 2012

Related by coincidence only? University and medical journal press releases versus journal articles

There are certain topics in Science-Based Medicine (or, in this case, considering the difference between SBM and quackery) that keep recurring over and over. One of these, which is of particular interest to me because I am a cancer surgeon specializing in breast cancer, is the issue of alternative medicine use for cancer therapy. Yesterday, I posted a link to an interview that I did for Uprising Radio that aired on KPFK 90.7 Los Angeles. My original intent was to do a followup post about how that interview came about and to discuss the Gerson therapy, a particularly pernicious and persistent form of quackery. However, it occurred to me as I began to write the article that it would be better to wait a week. The reason is that part of how this interview came about involved three movies, one of which I’ve seen and reviewed before, two of which I have not. In other words, there appears to be a concerted effort to promote the Gerson therapy more than ever before, and it seems to be bearing fruit. In order to give you, our readers, the best discussion possible, I felt it was essential to watch the other two movies. So discussion of the Gerson protocol will have to wait a week or two.

In the meantime, there’s something else that’s been eating me. Whether it’s confirmation bias or something else, whenever something’s been bugging me it’s usually not long before I find a paper or online source to discuss it. In this case, it’s the issue of why scientific studies are reported so badly in the press. It’s a common theme, one that’s popped upon SBM time and time again. Why are medical and scientific studies reported so badly in the lay press? Some would argue that it has something to do with the decline of old-fashioned dead tree media. With content all moving online and newspapers, magazines, and other media are struggling to find a way to provide content (which Internet users have come to expect to be free online) and still make a profit. The result has been the decline of specialized journalists, such as science and medical writers. That’s too easy of an answer, though. As is usually the case, things are a bit more complicated. More importantly, we in academia need to take our share of the blame. A few months ago, Lisa Schwartz and colleagues (the same Lisa Schwartz who with Steven Woloshin at Dartmouth University co-authored an editorial criticizing the Susan G. Komen Foundation for having used an inappropriate measure in one of its ads) actually attempted to look at how much we as an academic community might be responsible for bad reporting of new scientific findings by examining the relationship between the quality of press releases issued by medical journals to describe research findings by their physicians and scientists and the subsequent media reports of those very same findings. The CliffsNotes version of their findings is that we have a problem in academia, and our hands are not entirely clean of the taint of misleading and exaggerated reporting. The version as reported by Schwartz et al in their article published in BMJ entitled Influence of medical journal press releases on the quality of associated newspaper coverage: retrospective cohort study. It’s an article I can’t believe I missed when it came out earlier this year.
(more…)

Posted in: Clinical Trials, Medical Academia, Science and the Media

Leave a Comment (11) →

Dr. Gorski pontificates about the Gerson Therapy on Uprising Radio

Every so often I get requests to be interviewed on the radio about skeptical topics. Now, why anyone would ever want to interview me, who knows? But they do, and when I can manage to accommodate reporters or interviewers, I do. Last week, I was interviewed on Uprising Radio, in which I discussed alternative medicine (particularly the Gerson therapy for cancer). My segment is around 10 or 15 minutes, and I invite SBM readers to take a listen. I’m afraid I might have been a bit “strident” in my dismissal of various bits of quackery for some. Whether I was too “strident” or not, the interview request came about in response to another radio personality on the same radio station shilling for the Gerson therapy, which reminds me. Perhaps I should revisit Max Gerson; for some reason there appears to be a flurry of promotion of that hoary old quackery. Stay tuned on Monday to see if that’s what I decide to blog about. :-)

Posted in: Cancer, Nutrition

Leave a Comment (20) →

Chiropractic gimmickry

[Editor's Note: Today, we have a guest post from Sam Homola, who, as you recall, practiced as a chiropractor until he ultimately realized that there is no evidence that subluxations exist. Since then, he's discussed in various places, including, we are pleased to say, SBM, his skepticism regarding chiropractic. Enjoy!]

Much has been written (and published on this site) about the implausibility of chiropractic vertebral subluxation theory which proposes that a vertebral subluxation complex or a spinal joint dysfunction “may affect organ system function and general health.” Associated chiropractic gimmickry that might be harmful as well as a waste of time and money should be also be brought to the attention of concerned consumers. As a chiropractor (retired) who has renounced subluxation theory, it might be helpful to share my concerns about some dubious chiropractic methods that are foisted upon an unsuspecting public, unchallenged in the market place.
(more…)

Posted in: Chiropractic

Leave a Comment (54) →

Cinnamon for diabetes? The consequences of “natural alternatives”

A customer strolled up to the counter one night when I was working in a retail pharmacy:

“My doctor says I have prediabetes. I don’t want to take any drugs. Do you have something natural I can use to cut my blood sugar?”

I looked at him in the eye, and pointed at his sizeable midsection. “Sir, if you’re at risk for diabetes, and you don’t want to take medication, the single best thing you can do for yourself is lose some weight.”

He grinned and asked, “Great – what supplement can I take to help me?”

This type of discussion occurs all the time. A patient has been assessed by their physician, and informed that they have a medical problem of some sort. The patient, reluctant to accept the physician’s evaluation, heads to the pharmacy for a second opinion. In some cases, the patient may question the physician’s advice: “All my physician wants to do is prescribe drugs.” Yet there’s a disconnect when it comes to strategies for management. More often than not, non-drug approaches are rejected out-of-hand (probably because the sample I speak with have already made the decision to buy something). And in those that are leery of medical management, there’s often a willingness to consider anything that’s available without a prescription – particularly if it’s perceived as “natural.” Natural products are gentle, safe, and effective, while medicine is thought of as unnatural, harsh, and potentially dangerous. This is the naturalistic fallacy, nothing more. Purveyors of supplements leverage the naturalistic fallacy into the marketing strategy of choice for almost all supplements and “alternative” medicines.  And it leads to bad health care decisions. (more…)

Posted in: Herbs & Supplements

Leave a Comment (16) →

Eggs and Atherosclerosis

The headline of a recent Los Angeles Times article is, “No yolk: eating the whole egg as dangerous as smoking?” The question mark is meant to convey uncertainty or surprise, or perhaps both. The article represents much of what is wrong with science and health reporting by mainstream media.

The news report is based upon an article published in Atherosclerosis – Egg yolk consumption and carotid plaque. The study is highly problematic in ways not explored at all in the LA Times article. The researchers surveyed 1,262 patients seen in a vascular prevention clinic, asking them about their egg consumption, smoking history, and other lifestyle factors. They created a measure known as “egg yolk years” – the number of egg yolks consumed on average per week times the number of years of consumption. They compared this to pack years of smoking – packs per day times number of years, a routine method of reporting smoking history.

Their conclusion:

“Our findings suggest that regular consumption of egg yolk should be avoided by persons at risk of cardiovascular disease. This hypothesis should be tested in a prospective study with more detailed information about diet, and other possible confounders such as exercise and waist circumference.”

(more…)

Posted in: Nutrition

Leave a Comment (162) →

Chiropractic Strokes Again: An Update

The risk of stroke with neck manipulation has been addressed on SBM before by Dr. Crislip, by myself, by chiropractor Samuel Homola, and by Jann Bellamy. I have listed the links at the end of this article for the convenience of interested readers. Recent studies merit a followup.

A case report published in the Annals of Internal Medicine July 17, 2012, describes a 37 year old nurse who had a history of chronic neck pain. She had been getting neck manipulations from her chiropractor once a month for 12-15 years! (One can only conclude that the manipulations had not accomplished much.) She developed a new symptom (pain when turning her head up and to the right), and at her 4th visit in a week, during neck manipulation, she heard a loud pop and immediately had the sensation that the room was spinning. She developed visual disturbances, vomited, and had a loss of balance, persistently falling to the left. The chiropractor failed to recognize her symptoms as signs of a stroke. Instead of rushing her to the ER, he performed an  “occipital adjustment” in an attempt to relieve her symptoms. She went to the ER 1.5 hours after the event and was found to have a cervical artery dissection. She was discharged from the hospital after 48 hours but has residual symptoms. The authors’ conclusion:

Although incidence of cervical artery dissection precipitated by chiropractic neck manipulation is unknown, it is an important risk. Given that risk, physical therapy exercises may be a safer option than spinal manipulation for patients with neck pain.

(more…)

Posted in: Chiropractic

Leave a Comment (107) →

Oriental Medicine: a Tall Tale of Outdated Lore

Editor’s Note: Dr. Gorski was on a rare vacation last week, recharging his batteries. As a result, there is no new material by him this week. Fortunately, Ben Kavoussi was ready with another in his series of posts on traditional Chinese medicine. Dr. Gorski will return next week; that is, if he doesn’t return even sooner because he can’t stand to be away from SBM for two whole weeks.

The established laws of nature do not support Oriental Medicine’s claim of Yin and Yang and Five-Phases Theory. Oriental Medicine’s main theory was constructed when our civilization had limited methods to understand our surroundings, and as such, it is only an ancient illusion.1

— Yong-Sang Yoo, MD, PhD, Chairman of the Committee for Medical Unification, Korean Medical Association, 2010

Yong-Sang Yoo is one of the strong and growing voices in Korea that is calling for an end to the national insurance coverage for Oriental Medicine.

Similarly, Professor Zhang Gongyao of the Central South China University petitioned the central government of China in 2006 to abolish support for Oriental Medicine because it has “no clear understanding of the human body, of the functions of medicines and their links to disease. It is more like a boat without a compass: it may reach the shore finally but it’s all up to luck.”2 Zhang Gongyao and fellow critics have consequently blasted China’s traditional medicine as an often ineffective, even dangerous derivative of witchcraft that relies on untested concoctions and obscure ingredients to trick patients, and employs a host of excuses if the treatments do not work.3

Bloodletting is used in Oriental Medicine to relieve excess “heat,” meaning fever, sore throat, joint pain, muscle sprain, as well as inflammation. It is often practiced in unsanitary conditions.

A Product of Archaic Thinking

The arguments of Yong-Sang Yoo and Zhang Gongyao are reminiscent of those of William R. Morse, Dean of Medical School at West China Union University, who wrote in 1934 that China’s traditional medicine was a “weird medley of philosophy, religion, superstition, magic, alchemy, astrology, feng shui, divination, sorcery, demonology and quackery.” Morse added that Chinese diagnostic methods “border on the ridiculous and possibly cross the line into absurdity.” Harvey J. Howard — a Dean at the Peking Union Medical College — also wrote in 1934 that “the great majority of these Chinese medicines reminds one of the list of remedies suggested by the third witch in Shakespeare’s Hamlet.”4

(more…)

Posted in: Acupuncture, Health Fraud, History

Leave a Comment (26) →

Jurassic Farce

It feels like I live in the real world example of Ray Bradbury’s All the Summer in a Day but for the last two weeks we have had sun and heat and it has been glorious. I get Christmas and Thanksgiving and New Years as vacation, but who needs that? I need July and August to live the vida loca in the Oregon summer. Who wants to blog when I can be outside, at concerts, golfing, hiking and…

Yes Dr. Gorski. I did agree to write an entry every other Friday. Yes Dr. Gorski. I know you have the documentation. Yes Dr. Gorski, I do not want any of that information made public. No one needs to know that I wanted to be a naturopath when I was young. Sigh. Yes, Sir, I will get to blogging. Damn those youthful indiscretions. Let’s see how little I can do and meet my obligations with the powers that be.

My professional career is based upon inflicting death, and in my time I  have obliterated uncountable numbers of unicellular organisms. If there were such a thing as Karma, I would certainly return in the next life as a rabbit in a syphilis lab. But there isn’t, and I can kill and kill with a clean soul. There is no guilt or hesitation in killing unicellular life, or even multi-cellular life, as long as it cannot be seen without a microscope. I start to get a wee bit squeamish as soon as I can see a life form. I tend to not kill bugs or animals, unless, of course, they can be eaten. If it tastes good, all bets are off. But as a tree hugger, I tend to look upon killing wildlife and extinctions as a bad thing. (more…)

Posted in: Basic Science, Humor

Leave a Comment (37) →

Stem cell therapy regulation plays catch up

The burgeoning U.S. stem cell therapy industry was delivered a setback last month in the form of a U.S. District Court injunction against use of the “Regenexx™ Procedure,” which purports to treat joint, muscle, tendon or bone pain due to injury or other conditions. The court agreed with the FDA that the cell product used in the procedure is both a drug and a “biological product” subject to FDA regulation. Because a similar process is used in other stem cell therapies the decision increases the possibility that the FDA will take a like position in other cases.

The general term “stem cell therapy” comprises an array of treatments which range from the clinically proven to quackery. On one end of the spectrum is blood stem cell transplantation to treat diseases and conditions of the blood and immune system. On the other lies the kind of stem cell therapy tourism addressed by both Steve Novella (here and here) and Orac (here and here), which involves the injection of what may, or may not be, stem cells from what may, or may not be, humans. In between fall therapies which are plausible and have promise but have not been adequately tested in clinical trials. There is a concern that these therapies are being oversold by clinics which charge thousands of dollars (not reimbursed by insurance) to treat conditions including multiple sclerosis, musculoskeletal pain, and cardiac disease.

(more…)

Posted in: Legal, Medical Ethics, Politics and Regulation, Science and Medicine

Leave a Comment (4) →

Are Berries the New Snake Oil?

I have nothing against berries. I, in fact, enjoy many kinds of berries in my diet. My favorite fruit, the banana, is actually a berry (botanically speaking). I am disturbed, however, at the extent to which various kinds of berries are being sold as the latest superfood cure-all.

Dr. Oz, for example, has been pushing the lingonberry (a relative of the cranberry and blueberry) as “a new superfruit for longevity.” An attached article on his site states:

“Today, scientists are showing its value in both human and animal studies that are proving to have positive results.”

Curiously, there are no links or references to these studies.

Polyphenols and Antioxidants

We are still in the midst of the “antioxidant craze” – if you read the justification for just about any so-called “superfood” or longevity supplement you are sure to read about antioxidants. I have already covered antioxidants, but briefly: Cell metabolism in part creates oxygen free radicals which are molecules that steal electrons from other molecules, causing a cascade of reactions that can damage proteins and other chemicals in the body. Anti-oxidants are chemicals that can stop free radicals and limit the damage. They therefore decrease “oxidative stress” on cells. So far it sounds like anti-oxidants are therefore a good thing and we should be gobbling up as much as we can. However – free radicals and anti-oxidants exist in cells in a homeostasis. Free radicals are used by the immune system, for example, to fight invading organisms. They are also important signaling molecules, triggering other cell-protective mechanisms.

(more…)

Posted in: Herbs & Supplements

Leave a Comment (33) →
Page 2 of 3 123