Articles

Antivaccine hero Andrew Wakefield: Scientific fraud?

Pity poor Andrew Wakefield.

Actually, on second thought, Wakefield deserves no pity at all. After all, he is the man who almost single-handedly launched the scare over the MMR vaccine in Britain when he published his infamous Lancet paper in 1998 in which he claimed to have linked the MMR vaccine to regressive autism and inflammation of the colon, a study that was followed up four years later with a paper that claimed to have found the strain of attenuated measles virus in the MMR in the colons of autistic children by polymerase chain reaction (PCR). It would be one thing if these studies were sound science. If that were the case, then Wakefield’s work would have been very important and would have correctly cast doubt on the safety of the MMR. Unfortunately, they were not, and, indeed, most of the authors of the 1998 Lancet paper later withdrew their names from it.

Over the next decade, aided and abetted by useful idiots in the media, by British newspapers and other media that sensationalized the story, and the antivaccine movement, which hailed Wakefield as a hero, Wakefield managed to drive MMR vaccination rates in the U.K. below the level of herd immunity, from 93% to 75% (and as low as 50% in some parts of London). As a result Wakefield has been frequently sarcastically “thanked” for his leadership role in bringing the measles back to the U.K. to the point where, fourteen years after measles had been declared under control in the U.K., it was in 2008 declared endemic again.

(more…)

Posted in: Science and the Media, Vaccines

Leave a Comment (41) →

Yes We Can! We Can Abolish the NCCAM! Part III

A Reminder…

…of why we keep harping on this. A couple of days ago The Scientist reported that the “economic stimulus package” may include a windfall for the NIH:

Senate OKs big NIH bump

Posted by Bob Grant

[Entry posted at 4th February 2009 04:12 PM GMT]

The US Senate, which is furiously debating the details of the economic stimulus package making its way through Congress, passed an amendment yesterday (Feb. 3) to add $6.5 billion in National Institutes of Health funding on top of the $3.5 billion already allotted to the agency in the bill…

Exactly how an NIH funding increase will be spent remains to be determined.

You can bet that if this happens, the NCCAM will be licking its chops for some of that lettuce. Let’s continue to explore why it shouldn’t get any…

(more…)

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

Leave a Comment (4) →

The Anniversary

I received a surprising morning call several weeks ago

“Wally?”

“This is he.”

“This is Judy V…. I just wanted to call and thank you again for what you did for me. It’s the 35th anniversary of my cancer…“

Judy V. is a physician’s widow. Her husband, a surgical specialist died in his 40s, 20plus years ago.   She had a Stage II breast cancer; the surgeon had done a modified radical, and I was consulted for possible adjuvant chemotherapy.

Thirty-five years ago the standard was simpler. Same for our knowledge of staging and biological behavior. Genomics was not a word yet. Targeted therapy was not a concept. Tamoxifen was the ony estrogen agonist and had just been introduced.  The standard adjuvant therapy was single agent melphalan or its equivalent. But even then, patients had choices. The surgery had probably cured her, but then… Chemo or none.
(more…)

Posted in: Cancer, Health Fraud, Herbs & Supplements, Nutrition, Pharmaceuticals, Politics and Regulation

Leave a Comment (6) →

Where Does Sanjay Gupta Register On The Quackometer?

Four weeks ago I wrote a blog post about Sanjay Gupta’s nomination by the Obama administration as our potential new Surgeon General. Many of you voiced concerns about Sanjay’s nomination, specifically because of his poor handling of the Raelians’ Clonaid fiasco, his inability to counter Michael Moore’s health statistics as presented in Sicko and his relationship to the pharmaceutical industry.

As I wondered about what Sanjay Gupta might be like as Surgeon General – and specifically how he might assist in “restoring science to its rightful place” – I decided to educate myself about his thought processes by purchasing his recent book “Chasing Life.” The question I sought to answer was, “is Sanjay Gupta a crank?”

The short answer is: I’m not sure.  Although I wouldn’t go so far as to say that he is a crank, I think he’s more likely to be a shruggie. For those of you who haven’t read my post on shruggies, here’s the definition:

Shruggie (noun): a person who doesn’t care about the science versus pseudoscience debate. When presented with descriptions of exaggerated or fraudulent health claims or practices, their response is to shrug. Shruggies are fairly inert, they will not argue the merits (or lack thereof) of complementary and alternative medicine (CAM) or pseudoscience in general. They simply aren’t all that interested in the discussion, and are somewhat puzzled by those who are.

The longer answer involves an exploration of Gupta’s disturbing insistence on flirting with cranks, if it gets him publicity. The back cover of Chasing Life caries an endorsement from Deepak Chopra – and the inside page a favorable review from Andrew Weil. Normally, I would assume that the author of any book endorsed by those two would contain an intolerable blend of science and pseudoscience and refuse to read it. But for the sake of the readers of Science Based Medicine, I stifled my gag reflex and purchased the book. I hope that my sacrifice will benefit you all.
(more…)

Posted in: Book & movie reviews, Public Health, Science and the Media

Leave a Comment (9) →

Some Good News on the Academic Front

There is a recent trend in UK Universities to close programs offering science degrees for various forms of so-called alternative medicine (CAM), such as homeopathy, crystal healing, and traditional Chinese medicine. This occurs amid growing scientific criticism of these programs.

This is a very good thing, and something I would like to see replicated in the US. The scientific community is appropriately concerned about such programs for a number of reasons. We have also been highly critical of them here at SBM – for example take a look as Wallace Sampson’s excellent analysis of academic medicine here and here, and David Gorski’s summary of Medical Academic Woo here.

Academic institutions have an implied contract with society – they are given resources (donations, scholarships), power (the ability to grant recognized degrees), and respect (the institutions and their members are often given the assumption of credibility and knowledge), and in exchange they agree to follow a code of professional ethics.  This contract is similar to many professions, like physicians or lawyers.

(more…)

Posted in: Medical Academia

Leave a Comment (4) →

University of the Sciences in Philadelphia Justification for Scientific Honor of Homeopathic Leader, John A. Borneman, III

To update readers, I posted last week that my alma mater was to offer a Doctor(ate) of Science degree at our Founders’ Day celebration to Mr. John A. Borneman, III, pharmacist graduate (1952),  founder of the Board Member, Homeopathic Pharmacopoeia Convention of the United States, Southeastern, PA, and Chairman, Standard Homeopathic Company, Bryn Mawr, PA

The university, known prior to 1998 as the Philadelphia College of Pharmacy and Science (PCP&S), has been led by Dr. Philip Gerbino, a gentleman whom I hold in highest regard for his leadership and dedication to pharmacy practice. As I increasingly appreciate the time demands on a university administrator, I was grateful to receive a very prompt response from Dr. Gerbino following the public posting here of my letter of objection last week:

Dear Dr. Kroll,

I would like to thank you for e-mailing myself and our provost, Dr. Russell DiGate, on Jan. 26 with your concerns regarding our Founders’ Day honoree. We most certainly respect your opinion and thoughtful correspondence.

We had no intention of eroding the honorific nature of science with our selection of John A. Borneman, III, P’52, RPh. Instead our objective was to honor a man who is a founder, innovator, and successful entrepreneur.  His selection for the Honorary Doctorate of Science degree is not about the rigors of science, nor the appropriate applications of science to homeopathic and alternative medicines, but about a founder who possesses remarkable leadership qualities and who is willing to share some of those with our students.  

Mr. Borneman’s selection as our Founders’ Day degree recipient provided a source of considerable discussion internally. I can say that in the end, it was decided that since one of our missions is to provide our students with academic and personal development through intellectual, cultural, and ethical understanding and awareness, Mr. Borneman’s honor would ultimately benefit them on their own paths to becoming future leaders and innovators. As point of emphasis, and in this context, we honor founding, not the field of homeopathic medicine. We honor a founder with entrepreneurial spirit.

Again, we appreciate your interest and comments and value your opinion. This letter is not intended to change your mind. It is provided to offer a better understanding of our decision. A good criticism is healthy and often inspiring. While it is not always necessary that we all agree, the basis of academia is to provide an environment of inquiry, debate, and critical thought where all opinions are respected.

Sincerely.

Philip P. Gerbino, PharmD

President

Again, readers, please keep in mind that I hold Dr. Gerbino in my highest regard.  He has been a university leader since I conducted my very first research project at PCP&S in 1984. Knowing what I know of him personally, even considering the unrecognized challenges of being a lead university administrator, I am led to register an even stronger objection to this honor of Mr. Borneman.

At first, I thought it might be more appropriate to acknowledge Mr. Borneman with an honorary MBA from the university.  However, even this recognition would honor leadership and entrepreneurship in the absence of ethics by promoting the sale of products with no medicinal value under the guise of health remedies.

Not to be melodramatic, but if I were to collect lawn clippings from my yard and sell them as a cure for cancer with 30% of patients claiming they were helped, would I be worthy of an Honorary Doctorate of Science from my alma mater?

And I also submit that Mr. Borneman’s grandfather, John P. Borneman (1907) was a PCP graduate and promoter of both botanical medicines *and* homeopathics at a time when dose-response pharmacology was first being realized in the United States.

My most serious point is that one cannot, as Dr. Gerbino proposes, separate the business leadership and success of Mr. Borneman from the fact that the business is one of deceptive products marketed in the name of medicine.

Whatever Mr. Borneman offers to my alma mater in terms of business acumen and leadership training, I find his honor highly deficient in ethics and an affront to the principles of authenticity and scientific rigor put forth by the founders of the Philadelphia College of Pharmacy.

Unfortunately, my compatriots are graduates of a small college with a small alumni organization. I was graduate number 17,346 since 1821 and the school has only had between 900 and 2,500 students per year in the last 20 years. I doubt seriously that a significant public objection can be mounted against the honoring of Mr. Borneman.  I’m sure he is a fine gentleman personally, and I hope to meet him at some point to discuss these issues, but I am disgusted by the imprimatur about to be given to him by the same institution whose academic endorsement hangs above my desk.

 

Posted in: Homeopathy

Leave a Comment (15) →

Amish Home Burn Treatment: B&W Salve and Burdock Leaves

People in the Amish community have been using “The New Concept in Treating Burns” and their experience is recounted in a little booklet by that title. It is a compilation of articles, testimonials, and letters to the editor of a monthly newspaper Plain Interests, published in Millersburg PA.

The treatment, involving B&W ointment and dressings of scalded burdock leaves, was developed by John Keim, an Amish farmer and natural healer. The Amish have a tradition of taking care of their own, and they try to avoid hospitals whenever possible. In the booklet, they even recommend treating hip fractures at home without surgery. (Which, after all, is what we did before we had hospitals and surgery).

They claim that with the B&W burn treatment:

  • Painful burns are rendered non-painful.
  • Healing is faster.
  • Painful debridement is not necessary.
  • Skin grafting is not necessary.
  • Scarring seldom occurs.
  • Iatrogenic harm from hospitals is avoided.
  • Patients can be treated at home at much less expense. (more…)

Posted in: Herbs & Supplements

Leave a Comment (18) →

Keeping ‘em alive

ResearchBlogging.orgOne of the frequent complaints I hear about science-based medicine is that it is dangerous.  Of course, it’s true—so is riding in a train, but it sure beats walking.  And that’s the danger of this particular fallacy—yes, medicine is a sharp tool, but it’s also an effective tool, so we must use it properly.  And this is where the tools of evidence- and science-based medicine can give us a hand.

The potential harms of modern medicine must be approached carefully.  If they are ignored or approached in an ineffective way, we’ll miss an opportunity to save lives.  This comment from my other blog is typical:

You asked if so-called traditional Chinese medicine has ever eradicated any diseases. Well, yes. It pretty much eradicated one that is in epidemic numbers in the U.S. and most of the developed world: Iatrogenic disease.

This is wrong is so many ways.  The definition of “iatrogenic” is difficult.  The traditional definition is “adverse effects of medical treatment or advice.”  I suppose one could broaden this to include failure to give proper advice, as inaction by a physician has similar consequences to action, but perhaps that is a discussion for another day.

The way in which this is truly wrong is the false dichotomy. Yes, medical errors would be reduced to zero if we didn’t treat people, but the consequences would be rather dramatic.  Our goal should not be to abandon modern medicine because it sometimes causes harm.  Our goal is to reduce iatrogenic illness in a science-based way.

Strangely enough, this is being done.  A recent study in the New England Journal of Medicine (effectively discussed here) described a study in which surgical checklists reduced errors.  This study was based on earlier work by Peter Provonost of Johns Hopkins, the subject of a terrific piece in the New Yorker.  (Related commentary here.)
(more…)

Posted in: Science and Medicine

Leave a Comment (10) →

Since when did an apologist for the antivaccination movement, Dr. Jay Gordon, become an “expert” in vaccine law?

I am an alumnus of the University of Michigan twice over. I completed a B.S. in Chemistry with Honors there in 1984 and then I stayed on to do obtain my M.D. in 1988. I look back very fondly on those eight years spent in Ann Arbor, as several of my longtime friendships were forged or solidified during those years. Consequently, I still care about the place. Indeed, I even once tried to see if I could get a position in the Department of Surgery there a few years back, but unfortunately the “fit” just wasn’t there at the time. That’s why it distresses me when I see my alma mater suffer from a self-inflicted wound, almost as much as the plight of the Michigan Wolverines bothers me, given that never before in my life (at least not since I was old enough to pay attention), have the Wolverines sucked so badly and so hard. Given that level of football futility, though, I consider it even more important that my alma mater not provide any more ammunition to those who would enjoy making fun of it. It doesn’t matter to me that I never went to law school at Michigan; it’s all part of the same campus to me.

This time, the embarrassment comes in the form of an article in the Michigan Law Review by a person who has previously been a subject of posts by both Dr. Novella and me. I’m referring to Dr. Jay Gordon, whom we have both–correctly, I believe–labeled as being, if not fully anti-vaccine, at least a prominent and major apologist for the anti-vaccine movement. Unfortunately, because he is the pediatrician taking care of Jenny McCarthy’s son Evan, he has gained even greater prominence in the antivaccine movement than ever, to the point where he gave a speech last summer to the antivaccine “Green Our Vaccines” march on Washington and where he is regularly called up by TV producers to give a false “balance” whenever a discussion of vaccines and/or autism comes up. He also wrote the foreword to Jenny McCarthy’s latest paean to autism quackery and attack on vaccines as the cause of autism in which he blithely repeated some of the worst distortions of the antivaccine movement. Unfortunately, Dr. Gordon lacks the intestinal fortitude to stop the piteous denials any time he is called out for his parroting of antivaccine pseudsocience and to embrace his inner antivaccinationist. Then, at least, we wouldn’t be treated to the spectacle of his simultaneously claiming he is “pro-safe vaccine, not anti-vaccine” while at the same time saying he “doesn’t give a lot of vaccines” and admitting that parents have actually had to persuade him to vaccinate “reluctantly.”

So what was the topic of the Michigan Law Review article that Dr. Gordon was apparently asked to pen? It’s actually an interesting question from a legal, political and civil rights standpoint, specifically: Whether or not parents should be held legally liable for refusing to vaccinate their children. Not surprisingly, Dr. Gordon took the “no” position. Unfortunately, as we’ve come to expect of Dr. Gordon, he uses a number of highly dubious arguments. However, more interesting to me, having had a nearly four year history sparring online with him off and on, was the seemingly “kinder and gentler” antivaccine stance that he took in this article.

But first, let’s take a look at the debate. The symposium published in First Impressions (the online companion to the Michigan Law Review) was entitled Liability for Exercising Personal Belief Exemptions from Vaccination, and it contained the following articles:

  1. Choices Should Have Consequences: Failure to Vaccinate, Harm to Others, and Civil Liability by Douglas S. Diekema.
  2. Parents Should Not be Legally Liable for Refusing to Vaccinate their Children by Dr. Jay Gordon.
  3. Unintended Consequences: The Primacy of Public Trust in Vaccination by Jason L. Schwartz.
  4. Challenging Personal Belief Immunization Exemptions: Considering Legal Responses by Alexandra Stewart.
  5. Gambling with the Health of Others by Stephen P. Teret and John S. Vernick.
  6. The Problem of Vaccination Noncompliance: Public Health Goals and the Limitations of Tort Law by Daniel B. Rubin and Sophie Kasimow

There were a number of fascinating issues raised here. Although it’s obvious that universal vaccination is a public health policy good, given that the higher percentage of vaccinated children, the greater the herd immunity, there is always the nagging question of how far the state should go to mandate vaccination in a free society; i.e., how much coercion is acceptable to bring about maximal levels of vaccination? In other words, what is the proper balance between the needs of society as a whole and the rights of the individual? The next interesting legal and moral question is whether parents who refuse to vaccinate should be held liable for injuries to other children if their unvaccinated child passes on an infectious disease. Personally, I tend to believe that it is entirely reasonable to require vaccination as a precondition for school or day care and that exemptions should be primarily medical in nature. I grudgingly allow that the freedom of religion guaranteed in the First Amendment probably requires religious exemptions (although I do not understand why religion should be given such a privileged place in society that it can endanger public health), I am far less convinced that philosophical exemptions should be mandated. I realize many may disagree with this position, but I would hope that our disagreements would be based on (1) the best science regarding the benefits and risks of vaccination and (2) honest beliefs regarding the proper balance between public health concerns and individual liberty. Clearly, this is an area of debate. I also tend to believe that if parents refuse to vaccinate their child and that child passes an infectious disease to another child, then those parents should be potentially legally liable. Indeed, Douglas Diekema argues this position very well.

Unfortunately, Dr. Gordon does not meet at least condition #1 above. He does not base his arguments on the best science.
(more…)

Posted in: Politics and Regulation, Public Health, Vaccines

Leave a Comment (18) →

Just in case anyone’s interested…

…I’m actually on Facebook. So are Val Jones , David Kroll, Peter Lipson, and Steve Novella.

In any case, feel free to check it out and, if you’re interested, leave a note on my wall, that of my co-bloggers, or send us a friend request. Being somewhat new at this whole Facebook thing, I note with some amusement that, in a moment when I was in an unusually perverse mood, I sent Dr. Jay Gordon a friend request, and he actually confirmed it.

Posted in: Announcements

Leave a Comment (15) →
Page 184 of 217 «...160170180182183184185186...»