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Archive for 2014

Vani Hari, a.k.a. “The Food Babe,” finally responds to critics

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It’s no secret that we here at Science-Based Medicine (and many scientists and skeptics with a knowledge of basic chemistry and biology) have been very critical of Vani Hari, better known to her fans as The Food Babe. The reasons for our criticisms of her are legion. Basically, she is a seemingly-never-ending font of misinformation and fear mongering about food ingredients, particularly any ingredient with a scary, “chemically”-sounding name.

Not surprisingly, as the Food Babe has gained prominence her antics have attracted more and more criticism for her toxic combination of ignorance of chemistry coupled with fear mongering. The criticism started with science and medical bloggers and leaked into the mainstream press, most recently in the form of a recent NPR blog entry entitled “Is The Food Babe A Fearmonger? Scientists Are Speaking Out” that liberally quotes from yours truly and our fearless founder Steve Novella, as well the professor and chair of the Horticultural Sciences Department at the University of Florida, Kevin Folta, who in October complained about the Hari being invited to speak at his university, where she didn’t take questions after spewing her usual disinformation. Indeed, her most recent foray into fear mongering, an attempt to attack Starbucks for its pumpkin spice latte because it not only contains “no real pumpkin” but also contains a “toxic dose of sugar,” and—brace yourself—uses dairy from “Monsanto milk cows fed GMO,” failed.

With a book and media tour scheduled for early 2015, apparently the Food Babe is feeling the heat and has finally responded to criticism on Saturday in a rather long post entitled “Food Babe Scam: My Response To The Attacks On Me and Our Movement“. Utterly predictably, she started with a quote commonly attributed to Mahatma Gandhi, “First they ignore you, then they laugh at you, then they fight you, then you win.” Never mind that Gandhi almost certainly never actually said it. Rather, Nicholas Klein of the Amalgamated Clothing Workers of America did. It’s also a misquote of what Klein did say. What Klein actually said was, “First they ignore you. Then they ridicule you. And then they attack you and want to burn you. And then they build monuments to you.”

Yes, they did build monuments to Gandhi, but I highly doubt anyone will be building monuments to The Food Babe, either now or many years from now. Her response to criticism is worth examining, however, because her defense itself reveals the many flaws in science and reasoning that led to the criticisms in the first place. (more…)

Posted in: Nutrition, Public Health, Science and the Media, Vaccines

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No, the CDC did not just “admit” that this year’s flu vaccine doesn’t work

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Since the press release was originally issued on Thursday by now surely most of you have seen the news stories that popped up beginning yesterday morning with headlines like “CDC Warning: Flu Viruses Mutate and Evade Current Vaccine“, or “Flu vaccine protects against wrong strain, US health officials warn“, or “Flu shots may not be good match for 2014-15 virus, CDC says“, or “Health Officials Warn This Year’s Flu Vaccine Won’t Prevent New H3N2 Strain Of Influenza“. You get the idea. This year, apparently, the flu vaccine isn’t as effective as health officials and physicians would like. How could this have happened?

Those of you who are knowledgeable about the flu vaccine know that, as useful as it is, it’s not one of the greatest vaccines as far as effectiveness. Actually, that’s not true. Its effectiveness can and does vary considerably from year to year. The reason is simple. There are many strains of influenza, and the vaccine as currently formulated generally only covers a handful of strains. Basically, every year the World Health Organization, in collaboration with the CDC and other health organizations throughout the world, has to make an educated guess which strains of influenza will be circulating the following winter. Many months’ lead time is required because vaccine manufacturers require it to develop and test the new formulations and then to ramp up their manufacturing capabilities and distribute the vaccine. Generally, the WHO chooses the three strains it deems most likely to cause significant human suffering and death in the coming flu season. Specifically, the chosen strains are the H1N1, H3N2, and Type-B, although, starting with the 2012–2013 Northern Hemisphere influenza season, the WHO has also recommended a second B-strain for use in quadrivalent (four strain) vaccines. Basically, the WHO coordinates the contents of the vaccine each year to contain the most likely strains of the virus to attack the next year. Wikipedia has a helpful article that lists the formulations of all the flu vaccines recommended for the Northern and Southern Hemispheres dating back to 1998, to give you an idea what’s been recommended in the past. Also, there are exceptions. In the 2009-2010 season, for example, the H1N1 pandemic was occurring, and it was recommended that everyone be vaccinated against H1N1 in addition to the normal flu vaccine.
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Posted in: Vaccines

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Outcome Bias in Clinical Decision Making and the Assessment of Our Peers

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There are many mental pitfalls and logical stumbling blocks faced by healthcare professionals when attempting to untangle the complex web of patient history and physical exam findings. They can impede our ability to practice high quality medicine at every step in the process, interfering with our ability to establish an accurate diagnosis and to provide comfort or cure. And we are all susceptible, even the most intelligent and experienced among us. In fact, having more intelligence and experience may even enlarge our bias blind spots.

Steven Novella discussed the complexities of clinical decision making in early 2013, specifically tackling some of the more common ways that physicians can come to a faulty conclusion in the third installment of the series. One cognitive bias yet to be specifically addressed on the pages of Science-Based Medicine, and it is one that I encounter regularly in practice, is outcome bias. Simply put, outcome bias in medicine occurs when the assessment of the quality of a clinical decision, such as the ordering of a particular test or treatment, is affected by knowledge of the outcome of that decision. We are prone to assigning more positive significance to a decision when the outcome is positive, and we often react more harshly when the outcome is negative. This bias is particularly obvious when the result of a decision largely comes down to chance.

I see outcome bias rear its ugly head in two contexts for the most part: the Lucky Catch and the Bad Call.

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Posted in: Science and Medicine

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Homeopaths Threaten Public Health Selling Sugar Pills as Vaccine Alternatives

Alternative medicine is ascendant in Canada. From the dubious remedies that are now stocked by nearly every pharmacy, to the questionable “integrative” medicine at universities, there’s a serious move to embrace treatments and practices that are not backed by credible evidence. Canada’s support for alternative medicine, and for its “integration” into conventional health care is arguably is worse than many other countries. Canada’s drugs regulator, Health Canada, has approved hundreds of varieties of sugar pills and declared them to be “safe and effective” homeopathic remedies. Some provinces are even moving to regulate homeopaths as health professionals, just like physicians, nurses and pharmacists. Given the regulatory and legislative “veneer of legitimacy” that homeopathy is being granted, you can see how consumers might be led to believe that homeopathic remedies are effective, or that homeopaths are capable of providing a form of health care. The reality is far uglier, and the consequences may be tragic. Canadian homeopaths are putting the most vulnerable in society at risk by selling sugar pills to consumers, while telling them that they’re getting protection from communicable diseases. (more…)

Posted in: Homeopathy, Science and Medicine, Vaccines

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The Central Dogma of Alternative Medicine

Steve still happens to be galavanting about Australia, spreading science, skepticism, and, of course, science-based medicine Down Under. Given that, he has been unable to produce new content for today. Never one to let such an opportunity pass, I decided to take advantage in order to do a little shameless self promotion.

A week and a half ago, I gave a talk at Skepticon 7 in Springfield, MO, entitled “The Central Dogma of Alternative Medicine”. It has now been posted on YouTube:

Because some of the sound didn’t come through as well as one might hope, I’m also including the full video of Kim Tinkham that I used early in the talk to illustrate a point. I only used about two minutes’ worth of it, but here is the whole thing, in case you’re interested:

Let me know what you think! And don’t forget to donate to Skepticon, to keep the skeptical goodness coming next year and beyond.

Posted in: Cancer, Religion, Science and Medicine

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Vitamin D: To Screen or Not to Screen?

Vitamin D, the so-called sunshine vitamin, has generated a lot of attention in recent years. It has been claimed to benefit a wide variety of diseases, everything from cancer to multiple sclerosis. It is widely used along with calcium for bone health. It is added to milk and prenatal vitamins and is prescribed for breastfed babies. Some doctors are recommending everyone take it for prevention. Some CAM advocates are recommending it as a more natural way to prevent the flu than getting a flu shot.

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It has been touted as a panacea; Michael Holick even wrote a book titled The Vitamin D Solution: A 3-Step Strategy to Cure Our Most Common Health Problems. Christiane Northrup praised it, saying “This information can save your life. Really.” (Really? I’m skeptical, and her recommendation is not enough to make me want to read the book.) Then there’s Jeff Bowles’ book The Miraculous Results of Extremely High Doses of the Sunshine Hormone Vitamin D3 My Experiment With Huge Doses of D3 From 25,000 To 50,000 Iu A Day Over A 1 Year Period. That one’s not on my reading list either; the tolerable upper intake level is 4,000 IU a day.

It’s hard to avoid the hype and just examine the actual scientific evidence without any bias. The United States Preventive Services Task Force has tried to do just that. It recently evaluated screening for vitamin D deficiency and concluded that the current evidence is insufficient to recommend either for or against screening. Predictably, their announcement has already led to misunderstandings and protests.

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Posted in: Herbs & Supplements

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Selling “integrative oncology” as a monograph in JNCI

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Sometimes, it’s hard not to get the feeling that my fellow bloggers at Science-Based Medicine and I are trying to hold back the tide in terms the infiltration of pseudoscience and quackery into conventional medicine, a term I like to refer to as quackademic medicine. In most cases, this infiltration occurs under the rubric of “complementary and alternative medicine” (CAM), which these days is increasingly referred to as “integrative medicine,” the better to banish any impression of inferior status implied by the name “CAM” and replace it with the implication of a happy, harmonious “integration” of the “best of both worlds.” (As I like to point out, analogies to another “best of both worlds” are hard to resist.) Of course, as my good buddy Mark Crislip has put it, the passionate protestations of CAM advocates otherwise notwithstanding, integrating cow pie with apple pie doesn’t make the cow pie better. Rather, it makes the apple pie worse.

In any case, over the last three months, Steve Novella and I published a solid commentary in Trends in Molecular Medicine decrying the testing in randomized clinical trials of, in essence, magic, while I managed to score a commentary in Nature Reviews Cancer criticizing “integrative oncology.” Pretty good, right? What do I see this month in the Journal of the National Cancer Institute (or JNCI, as we like to call it)? An entire monograph devoted to a the topic, “The Role of Integrative Oncology for Cancer Survivorship”, touting integrative oncology, of course. And where did I find out about this monograph? I found out about it from Josephine Briggs, the director of the National Center for Complementary and Alternative Medicine (NCCAM) herself, on the NCCAM blog in a post entitled “The Evidence Base for Integrative Approaches to Cancer Care“, in which she touts her perspective piece in the JNCI issue entitled “Building the Evidence Base for Integrative Approaches to Care of Cancer Survivors.” In an introductory article, Jun J. Mao and Lorenzo Cohen of the Department of Family Medicine and Community Health, Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania and the University of Texas M.D. Anderson Cancer Center, respectively, line up this monograph thusly:
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Posted in: Cancer, Clinical Trials, Medical Academia

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In the Spirit of Choosing Wisely

Oh, loneliness and cheeseburgers are a dangerous mix.
- Comic Book Guy

Same can be said of viral syndromes and Thanksgiving. My brain has been in an interferon-induced haze for the last week that is not lifting anytime soon. Tell me about the rabbits, George. But no excuses. I have been reading the works of Chuck Wendig over at Terrible Minds. (Really, really like the Miriam Black books). Writers write and finish what they start and only posers use excuses for not completing their work.

Recently I attended an excellent Grand Rounds on some of the reasons doctors do what they do. Partly it is habit. We learn to a certain way of practice early in our training and it carries on into practice and it is not always best practice. Patients also learn from us and have expectations on what diagnostics or treatments they should receive, and that too it is not always the best practice.

So to educate physicians and patients, the American Board of Internal Medicine (ABIM) started the Choosing Wisely initiative. (more…)

Posted in: Acupuncture, Chiropractic, Critical Thinking, Energy Medicine, Homeopathy, Science and Medicine

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Announcement: The Society for Science-Based Medicine is co-sponsoring NECSS

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Steve is off today, so I thought it would be a good idea to use this slot for a little shameless self-promotion (of Science-Based Medicine and the Society for Science-Based Medicine, of course).

The Northeast Conference on Science & Skepticism (April 9-12, 2015 in New York City) will be bigger than ever in 2015 with fabulous presenters, exciting panels, and engaging workshops.

We’re thrilled to announce that NECSS 2015 will be co-sponsored by the Society for Science-Based Medicine and will expand to include a third full day of programming! Friday’s schedule will be curated by the team at SfSBM and features content available exclusively at NECSS 2015. Saturday and Sunday schedules will once again feature the best of science and skepticism.

NECSS weekend also includes a special evening performance on Friday, two workshop tracks on Thursday for the early-birds, our popular “Drinking Skeptically” socializers, and more!

The full NECSS speaker line up will be announced shortly, but, as always, Rationally Speaking and the Skeptics’ Guide to the Universe will record live podcasts during the conference.

We have secured discounted room rates at the Hilton Fashion District, located one block from the main conference hall. These rates are available exclusively to NECSS attendees and we will be available shortly.

Conference registration will open in December, but you can like the NECSS Facebook page or follow us on Twitter for updates.

See you in April!

Posted in: Announcements, Science and Medicine

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