Year: 2009
Screening Tests – Cumulative Incidence of False Positives
It’s easy to think of medical tests as black and white. If the test is positive, you have the disease; if it’s negative, you don’t. Even good clinicians sometimes fall into that trap. Based on the pre-test probability of the disease, a positive test result only increases the probability by a variable amount. An example: if the probability that a patient has...
Cancer research: Going for the bunt versus swinging for the fences
A couple of weeks ago, our resident skeptical medical student Tim Kreider wrote an excellent article about an op-ed in NEWSWEEK by science correspondent Sharon Begley, in which he pointed out many misconceptions she had regarding basic science versus translational research, journal impact factors, and how journals actually determine what they will publish. Basically, her thesis rested on little more than a...
“Acupuncture Anesthesia”: a Proclamation from Chairman Mao (Part IV)
The Cultural Revolution After investigating ‘acupuncture anesthesia’ in the People’s Republic of China in 1973, John Bonica wrote: From the guarded comments made by several anesthesiologists, I concluded that this disuse [of ‘acupuncture anesthesia,’ after its introduction in 1958 until the Great Proletarian Cultural Revolution began in 1966] was the result of disappointing failures in a significant proportion of patients. During the...
An Original: Richard de Mille, Carlos Castaneda, Literary Quackery
An Original: Richard De Mille, Carlos Castaneda, and Literary Quackery I was away in Nature – with a real capital N, and decided to insert an allegory this week instead of a medical subject. The genesis here was a sweeping of the mind and brushing away of cobwebs and detritus called worries and other preoccupations. The application to this here blog is...
The death and rebirth of vitalism
Vitalism was once central to the prescientific ideas about biology but was later abandoned to the enormous benefit of the discipline. These days, many CAM approaches want to bring it back.
Chiropractic – A Brief Overview, Part I
When patients ask me if a chiropractor can help them with their problem, I often think to myself, “OK, do I give them the short answer or the long answer?” The difficulty is often in the fact that chiropractic is a diverse profession and it is difficult to even characterize what a “typical” chiropractor is likely to do. As a chiropractor once...
Cranks, quacks, and peer review
Last week, I wrote one of my characteristically logorrheic meandering posts about what turns a scientist into a crank or a doctor into a quack. In a sort of continuation of this line of thinking, this week I’ll turn my attention to one of the other most common characteristics of a crank, be he scientific crank (i.e., a creationist), a quack, or...
Naturopathic Prescribing: The Dark Side Beckons
I am a terrible Oregon chauvinist. I think there is no better place to live on the planet. Period. Great natural beauty, not a lot of people, best beer ever and no pro football team. Oregon is both casual and tolerant. It is safe to say that dressing up in the Pacific NW means tucking your t shirt into your jeans. And...
Barriers To Adoption of Science-Based Medicine
I have a confession to make – it’s not easy keeping up with the other “Joneses” on this blog. My colleagues do a terrific job with thoroughly referenced analyses of key issues in medicine – and I sometimes struggle to think of topics that they haven’t already covered in more depth than I can. So today I asked my friends on Twitter...