Month: October 2012

A PANDAS Story

One of the skills I try to teach medical students on their journey to becoming experience clinicians is to consider and address the patient’s “narrative.” Patients have a certain understanding of their illness, its cause, and its role in their life. They make sense of their situation as best as they can, resulting in a story they tell themselves. This is how...

/ October 17, 2012

Sports Physicals, Sudden Death, and Chiropractors

Sports physicals could prevent cases of sudden cardiac death in children, but could be improved even more. What won't improve things is letting a chiropractor do it.

/ October 16, 2012

Mortality and lack of health insurance

The 2012 election campaign is in full swing, and, for better or worse, health care is one of the major defining issues of the election. How can it not be, given the passage of the Patient Protection and Affordable Care Act (PPACA), also colloquially known as “Obamacare,” was one of the Obama administration’s major accomplishments and arguably the largest remaking of the...

/ October 15, 2012

Chinese Systematic Reviews of Acupuncture

I’ll begin with the possibly shocking admission that I’m a strong supporter of the collection of ideas and techniques known as evidence-based medicine (EBM). I’m even the current President of the Evidence-Based Veterinary Medicine Association (EBVMA). This may seem a bit heretical in this context, since EBM  takes a lot of heat in this blog. But as Dr. Atwood has said, “we...

/ October 12, 2012

Don’t call CAM “cost-effective” unless it’s actually effective

Before deciding CAM is cost-effective, it is important to determine if is just effective. That low bar has not been surmounted.

/ October 11, 2012

More HIV Nonsense in Africa

It is estimated that 5% of people living in Sub-Saharan Africa are infected with HIV – that’s 22.5 million people. Infection rates vary wildly from country to country, with Swaziland having the highest rate at 25.9%. Gambia is below average, at 2% or 18 thousand people, but still has a serious HIV problem, and now finds themselves at the center of the...

/ October 10, 2012

Clinical Practice Guidelines: Cholesterol Tests for Children?

The American Academy of Family Physicians journal American Family Physician (AFP) has a feature called Journal Club that I’ve mentioned before.  Three physicians examine a published article, critique it, discuss whether to believe it or not, and put it into perspective. In the September 15 issue  the journal club analyzed an article that critiqued the process for developing clinical practice guidelines. It discussed...

/ October 9, 2012

The antivaccine lie that just won’t die: The claim that shaken baby syndrome is really due to “vaccine injury”

One of the vilest ideas that antivaxers promote is the claim that shaken baby syndrome is in reality a "misdiagnosis" for vaccine injury. Come down the rabbit hole with me and see just how low antivaxers will go to promote this idea and use it to try to exonerate child abusers.

/ October 8, 2012

I Never Meta Analysis I Really Like

David Gorski recently pointed out that Science Based Medicine is going on five years. Amazing. That there would be so much to write about day after day comes as a surprise to me. Somehow I vaguely thought that ‘controversies’ would be resolved. Pick a SCAM, contrast the SCAM with reality as best we understand it, and, once the SCAM was found wanting,...

/ October 5, 2012

Obamacare and CAM II: Discrimination (or not) against CAM

Supporters of science-based medicine have expressed concern over this provision in the Patient Protection and Affordable Care Act (“Obamacare,” or the “ACA.”): SEC. 2706. NON-DISCRIMINATION IN HEALTH CARE. (a) PROVIDERS.—A group health plan and a health insurance issuer offering group or individual health insurance coverage shall not discriminate with respect to participation under the plan or coverage against any health care provider...

/ October 4, 2012