Articles

Archive for Science and the Media

Does massage therapy decrease inflammation and stimulate mitochondrial growth? An intriguing study oversold

If there’s one form of so-called “complementary and alternative medicine” (CAM) that I find more tolerable than most, it’s massage therapy. The reason, of course, is that, whatever else anyone claims about massage, there’s no doubt that it feels good. Indeed, I’ve sort of come around to Kimball Atwood’s way of thinking. Back when he and I were on a panel together at TAM9, Kimball said something somewhat surprising, namely that he’s not sure we even need to test massage in randomized clinical trials because we all know that it feels good and if it feels good it can certainly be helpful at the very least to improve patients’ quality of life. Unfortunately, there’s a lot of woo in massage these days, and massage therapists who buy into the woo aren’t satisfied with simply using the rationale that massage feels good to recommend it to patients. They just can’t resist going beyond that to infuse massage therapy with every bit as much woo as any chiropractor or acupuncturist infuses into his respective specialty. For instance, some of the claims for massage include:

  • Decreases muscle pain & tension.
  • Rejuvenates the body and mind and lifts the spirit.
  • Relieves anxiety, stress and tension.
  • Relaxes muscles.
  • Alleviates headaches.
  • Hastens healing.
  • Increases ranges of motion.
  • Facilitates removal of waste and inflammation by-products.
  • Stimulates the immune system.
  • Eases symptoms related to fibromyalgia.
  • Promotes relaxation and comfort.
  • Reduces nausea in pregnant women.
  • Accelerates weight gain in premature infants.
  • Helps premature infants become more active and aware.
  • Increases energy and alertness.
  • Enhances morale and attitude.

Of course, there’s little doubt that a good massage probably can relax muscles, promote relaxation and comfort (which seems like the same thing to me), and enhance morale and attitude. I’d even be willing to concede that massage, properly administered, can probably also alleviate headaches (tension headaches, anyway) and increase range of motion in joints. But facilitate the removal of waste and inflammation byproducts? Stimulate the immune system (the all-purpose meaningless claim)? Hasten healing? Not so much.

All too often massage therapists ruin a perfectly good massage by imposing pseudoscientific and quack claims on it, such as claims that they are stimulating acupressure points or their adoption of the language of “energy healing.” So it was with a bit of trepidation (but also more than a bit of interest) that I took a look at some links that readers sent me about a week ago (too late, alas, for me to write about this last Monday). These links were to news stories with titles like Scientists Uncover Why Massage Heals Sore Muscles and Massage Reduces Inflammation And Promotes Growth Of New Mitochondria Following Strenuous Exercise, Study Finds. My first impression, actually, was that this was somewhat counterintuitive in that one might predict that deep kneading of muscles might actually cause a bit of inflammation and that it’s the counterirritation effect that leads to the perceived reduction in the amount of pain. Yet, according to the press release issued by McMasters University, whose contents were mirrored in many news stories, a study claiming state-of-the-art methods is concluding that massage is reducing inflammation:
(more…)

Posted in: Basic Science, Clinical Trials, Science and the Media

Leave a Comment (23) →

Antipodean CAM

It is one of the pleasures of travel to read the local newspapers of places I visit. I wholly agree with In a Sunburned Country author Bill Bryson, who observed,

It always amazes me how seldom visitors bother with local papers. Personally I can think of nothing more exciting – certainly nothing you could do in a public place with a cup of coffee – than to read newspapers from a part of the world you know almost nothing about. What a comfort it is to find a nation preoccupied by matters of no possible consequence to oneself. I love reading about scandals involving ministers of whom I have never heard, murder hunts in communities whose name sound dusty and remote, features on revered artists and thinkers whose achievements have never reached my ears, whose talents I must take on faith.

In a Sunburned Country chronicles Bryson’s travels in Australia, which I recently visited, along with New Zealand. Lovely places both – friendly people, jaw-dropping scenery, delicious food and wine. And a welcome vacation from American political wars, American economic wars and American war wars.

(more…)

Posted in: Humor, Science and the Media

Leave a Comment (16) →

Joe Mercola: Quackery pays

We’ve written about Joe Mercola’s support for quackery on this blog several times (for instance, here and here). It’s good to see that some of the mainstream media are starting to take notice, as evidenced by this article by Bryan Smith for Chicago Magazine entitled Dr. Mercola: Visionary or Quack? It features comments from a couple of—shall we say?—familiar people.

Although this article did irk me a bit for its tendency to buy into the false “tell both sides” balance, even going so far as to claim that much of what’s on Mercola’s website is actually based in science, I do think it is nonetheless very useful in that it demonstrates just how powerful and influential Mercola has become:

According to traffic-tracking firm Quantcast, Mercola.com draws about 1.9 million unique visitors per month, each of whom returns an average of nearly ten times a month. That remarkable “stickiness” puts the site’s total visits on a par with those to the National Institutes of Health’s website. (Mercola claims his is “the world’s No. 1 natural health website,” citing figures from Alexa.com.) Mercola’s 200,000-plus “likes” on Facebook are more than double the number for WebMD. And two of his eight books—2003’s The No-Grain Diet and 2006’s The Great Bird Flu Hoax—have landed on the New York Times bestseller list.

What a depressing thought that Mercola.com draws about the same traffic as the NIH website!
(more…)

Posted in: Health Fraud, Science and the Media, Vaccines

Leave a Comment (211) →

The New England Journal of Medicine Sinks a Bit Lower

I suppose it was bound to happen, but it still rankles. Here is the back cover of last week’s issue of the decreasingly prestigious New England Journal of Medicine:

 


Here’s the front cover:

It’s the 200th Anniversary issue, no less. Some might protest that ‘probiotics’—live bacteria of ‘good’ varieties, as far as the gut is concerned—aren’t all that implausible, and that there is some trial evidence that they help for some conditions. That’s true, but as is typically the case even for the somewhat plausible end of the “CAM” spectrum, the hype greatly surpasses the evidence. The abstract of the most recent systematic review that I could find for probiotic treatment of irritable bowel syndrome (IBS: symptoms and signs that best match the claims in the advertisement above) concluded:

(more…)

Posted in: Clinical Trials, Herbs & Supplements, History, Legal, Medical Ethics, Pharmaceuticals, Politics and Regulation, Science and Medicine, Science and the Media

Leave a Comment (35) →

Ringing in 2012 with…antivaccine propaganda?

Here we go again.

In fact, I think I’m starting to see a pattern here among antivaccine organizations. You might remember that in November 2010, the antivaccine group SafeMinds bought ad space in AMC Theaters over the Thanksgiving holiday weekend, one of the heaviest moviegoing time periods of the year. This use of pre-movie time to promote antivaccine propaganda resulted in a campaign by skeptics to try to persuade AMC to see the error of its ways, a campaign that was successful.

Then, a few months later, the the grande dame of the antivaccine movement, arguably the woman who started the most recent incarnation of that hoary old anti-science movement back in the 1980s, Barbara Loe Fisher, decided to start advertising the antivaccine message she promotes through her group, the Orwellian-named National Vaccine Information Center (NVIC) using the JumboTron in Times Square. Unfortunately, despite protests from the American Academy of Pediatrics, promoters of science-based medicine, and skeptics, the ads apparently aired for the full buy.

Then, a few months later (just last month, in fact), somehow the NVIC managed to dupe Delta Airlines, through its video provider In-Flight Media into airing a more subtle “public service announcement” whose antivaccine message was cleverly muted so that it wasn’t so obvious, except to those of us who knew the NVIC (and, of course, the buzzwords used by the antivaccine movement) that its message was antivaccine. Of course, it also didn’t help that the PSA urged viewers to go to the NVIC website, which, as I’ve described many times before, is a font of misinformation, pseudoscience, and antivaccine propaganda. (Just type “NVIC” into this blog’s search box to see.) At least Fisher’s response of crying “repression” in response to the AAP’s complaint to Delta Air Lines was good for a chuckle or two. Unfortunately, the NVIC advertorials aired through the entire buy. Meanwhile, this fall a major dump of antivaccine propaganda was circulating around the country in various film festivals in the form of an antivaccine propaganda movie called The Greater Good, whose manipulativeness and misinformation would make a North Korean propagandists planning state media coverage of Kim Jong-il‘s funeral blush.

Now, it would appear, the NVIC wants to close out 2011 and ring in 2012 with a new round of antivaccine propaganda, this time revisiting Times Square at the heart of the New Years Eve celebration, an effort it’s trumpeting through a press release entitled National Vaccine Information Center (NVIC) Educates One Million Plus in Times Square on New Year’s Eve. Here, Barbara, I’ll fix that for you. It should read “National Vaccine Information Center (NVIC) Mis-Educates One Million Plus in Times Square on New Year’s Eve.”

There, that’s better.
(more…)

Posted in: Science and the Media, Vaccines

Leave a Comment (231) →

NCCAM Criticism from a Not-Quite-Opponent

The demographic of SBM readers are likely to remember the early Miller Lite beer television commercials where sports personalities debated as to whether the beverage “tastes great” or was “less filling.” In one classic version, New York Mets’ Marv Throneberry breaks the shouting match to level his decision: “I feel strongly both ways.”

My colleagues at Science-Based Medicine have generally been opposed completely to the existence of the NIH’s National Center for Complementary and Alternative Medicine (NCCAM). The primary objection is that the Center awards roughly $125 million per year in taxpayer dollars to studies that are generally not based on a strong scientific foundation or, in some cases, absolutely no scientific basis. On the other hand, the best NCCAM-supported studies have provided fruitful results, if not negative with regard to clinical outcomes.

The recent series of articles by Trine Tsouderos at the Chicago Tribune (1, 2, 3, 4) has reignited a national debate as to whether NCCAM is needed at all. After all, NCCAM was not because of science but because of politics, particularly the efforts of Senator Tom Harkin and Representative Dan Burton. And other NIH institutes, such as the National Cancer Institute, seem to do a much more rigorous and science-based job of funding studies of alternative cancer therapies through their unfortunately-named Office of Cancer Complementary and Alternative Medicine, or OCCAM.

In fact, I have long argued that if alternative therapies are to be investigated rigorously, they should be done so under each of the specific NIH institutes and centers (ICs) that have been established to focus on organ systems (National Institute of Diabetes and Digestive and Kidney Diseases; NIDDK) or a class of related disorders (National Institute on Drug Abuse; NIDA).

(more…)

Posted in: Herbs & Supplements, Science and the Media

Leave a Comment (9) →

The compassion gambit

I’ve spent the last three weeks writing about a “brave maverick doctor” by the name of Stanislaw Burzynski who claims that he can cure cancers that regular oncologists cannot. He uses a combination of what he calls “antineoplastons” (which, it turns out, are more or less than the active metabolites of an orphan drug known as sodium phenylbutyrate) plus a very expensive cocktail of chemotherapy and targeted agents chosen in a haphazard fashion and thrown together with little rhyme or reason. This week, I had planned to move on. However, I felt that I had to mention the Burzynski saga because it provides me with the most appropriate segue to a topic I’ve been meaning to write about for a long time, possibly since this blog began. In fact, it’s about as perfect a framework as I can think of upon which to drape the points I want to make in this post.

What I will discuss is perhaps the most effective, devastating attack that proponents of quackery, woo, and nonsense aim at supporters of science-based medicine (SBM). As far as that is the case, it is not effective because it’s fact-based, evidence-based, or science-based. Far from it. Rather, it’s effective because it appeals to the emotions and very effectively demonizes SBM proponents to the point where they often have a hard time standing their ground when it is used. Sometimes, it preemptively prevents them from even speaking up in the first place. It’s a little tactic that I like to call the “compassion gambit,” which means trying to discredit critics of “alternative” medicine by painting them as cold, unfeeling, uncaring, arrogant monsters who want to hurt or kill children (and probably get a big smile on their faces when they torture puppies, to boot).
(more…)

Posted in: Cancer, Science and Medicine, Science and the Media, Vaccines

Leave a Comment (11) →

A Seal of Approval

I have never belonged to the American Medical Association.  As a student I didn’t want to pay the dues. As a practicing physician I am of the opinion that the AMA has two often mutually exclusive goals (promoting physician income and patient care)  and they are doing both badly.

In the 1990’s the AMA entered into a contract with Sunbeam to get an AMA seal of approval for Sunbeam products, but due to objections the AMA backed out of the deal, in the end costing them almost 10 million dollars.

As was noted at the time:

“I think if we’d gone to trial,” Dr. Relman said on Saturday, ”probably a lot more relevant information would have been uncovered and made available to the membership. As a result of this settlement, we will never know the truth of what happened. It does not let the sun shine in.”

Yeah AMA. It is probably for good reason that only  around 29% f of US physicians belong to the AMA; I have never seen them as representing me or my patients.  Whether the AMA or physicians, I am automatically suspicious of any person or institution who puts their seal of approval on a product.  I figure they are only doing it for the money.  Not that there is anything wrong for that; I am for sale if anyone can meet my price.  Trusting endorsements is like George Carlin’s (I think) observation that he did not like doing standup for stoners since you never know if was the act or the dope that lead to the laughter. I know celebrities are paid for their endorsements; it is not conflict of interest when it is your job to sell a product. At least actors say they only play a doctor on TV.  But when professionals use their authority to recommend products, I would love to see a conflict of interest statement in the recommendation.

When I give a lecture I have to mention my conflicts of interest (COI)* and I have to specifically confirm or deny that I will mention products in which I have a financial interest^. The COI rules are nice, so you know, sort of, who has an interest in pleasing their corporate masters, although I suspect most doctors do not take COI statements seriously.  At IDSA this year most of the speakers gave their COI statements with a short, dismissive sneer and a roll of the eyes.  Me?  Potentially Biased? Puh-please. (more…)

Posted in: Science and Medicine, Science and the Media

Leave a Comment (34) →

Stanislaw Burzynski: Bad medicine, a bad movie, and bad P.R.

And the Lord spake, saying, “First shalt thou take out the Holy Pin. Then shalt thou count to three, no more, no less. Three shall be the number thou shalt count, and the number of the counting shall be three. Four shalt thou not count, neither count thou two, excepting that thou then proceed to three. Five is right out. Once the number three, being the third number, be reached, then lobbest thou thy Holy Hand Grenade of Antioch towards thy foe, who, being naughty in my sight, shall snuff it.

Cleric from Monty Python and the Holy Grail

I’ve always wondered about the power of the number three. When it comes to quackery propaganda movies, certainly three seems to be the magic number. For example, The Greater Good, an anti-vaccine propaganda film, features three anecdotes, three children allegedly suffering from vaccine injury, and it interspersed its interviews with experts, both real (such as Dr. Paul Offit) and phony (such as Barbara Loe Fisher) with vignettes from these children’s stories interspersed between them in a highly biased manner. I have to wonder whether these cliches are taught in film school, given that they seem to be so common. Such were the thoughts running through my brain as I watched the latest medical propaganda film by writer/producer Eric Merola that’s floating around the blogosphere and the film circuit, Burzynski The Movie: Cancer Is Serious Business. In this movie, there are three testimonials, and, if anything, they are far more manipulative than even the testimonials featured in The Greater Good, because each of them are of the type that portrays doctors as sending a patient home to die; that is, until a “brave maverick doctor,” one Stanislaw R. Burzynski, MD, PhD, comes to the rescue with his unconventional and unproven therapy. The only difference is that this film counts testimonials up to the number three in the beginning as “proof” that Burzynski can cure cancer before lobbing the Holy Hand Grenade of Burzynski towards its foes in the hopes that, being naughty in the filmmaker’s sight, the FDA and Texas Medical Board will snuff it. Or, as a caption says right at very the beginning of the movie:

This is the story of a medical doctor and PhD biochemist who has discovered the genetic mechanism that can cure most human cancers. The opening 30 minutes of this film is designed to thoroughly establish this fact — so the viewer can fully appreciate the events that follow it.

It turns out that the grenade is a dud.
(more…)

Posted in: Basic Science, Cancer, Clinical Trials, Medical Ethics, Politics and Regulation, Science and the Media

Leave a Comment (29) →

Dummy Medicine, Dummy Doctors, and a Dummy Degree, Part 2.3: Harvard Medical School and the Curious Case of Ted Kaptchuk, OMD (concluded)

Dummy Medicine, Dummy Doctors, and a Dummy Degree, Part 2.3: Harvard Medical School and the Curious Case of Ted Kaptchuk, OMD (concluded)

A Loose End

In the last post I wondered if Ted Kaptchuk, when he wrote the article titled “Effect of interpretive bias on clinical research,” had understood this implication of Bayes’s Theorem: that interpretations of most scientific investigations are exercises in inverse probability, and thus cannot logically be done without consideration of knowledge external to the investigation in question. I argued that if Kaptchuk had

…understood the point when he wrote his treatise, he was dishonest in not explaining it and in not citing at least one pertinent article, such as Steven Goodman’s (which I’m willing to bet he had read). If he didn’t understand the point he should have withheld his paper.

In researching more of Kaptchuk’s opinions I’ve discovered that he had certainly read Goodman’s article, but that he either didn’t understand it or preferred to obscure its implications in deference to his ongoing project in belittling scientific knowledge. In a letter to the editor of the Annals of Internal Medicine in 2001, Kaptchuk opined that even if “more trials of distant healing with increased methodologic rigor” were positive, it still would not “be persuasive for the medical community”:

The situation resembles the predicament with homeopathy trials, another seemingly implausible intervention, where the evidence of multiple positive randomized, controlled trials will not convince the medical community of its validity. Additional positive trials of distant healing are only likely to further expose the fact that the underpinning of modern medicine is an unstable balance between British empiricism (in the tradition of Hume) and continental rationalism (in the tradition of Kant).

…It seems that the decision concerning acceptance of evidence (either in medicine or religion) ultimately reflects the beliefs of the person that exist before all arguments and observation. [Kaptchuk cites the second of the two Goodman articles that I referred to above, discussed here]

(more…)

Posted in: Acupuncture, Book & movie reviews, Health Fraud, Legal, Medical Academia, Medical Ethics, Politics and Regulation, Science and Medicine, Science and the Media

Leave a Comment (26) →
Page 9 of 34 «...7891011...»