TAM is fast approaching, and I’ve been frantically trying to get my talks together. The theme this year is “Fighting the Fakers,” and one of my talks will be for the Science-Based Medicine Workshop on Thursday, in which I will attempt in a mere 15 minutes to explain what Science-Based Medicine is and how it can be used to combat the infiltration of quackademic medicine into medical academia. Then, the second talk will be a tag-team spectacular with Bob Blaskiewicz about Stanislaw Burzynski as an example of how some cranks skirt the edges of science-based medicine. That doesn’t make them any less dangerous (if anything, it makes them more dangerous), but it does make them not as easy to identify as someone like, say, Hulda Clark.
Unfortunately, between working on these talks, revising some papers, and having an unusually busy weekend on call, I wasn’t sure what I was going to come up with for the edification of you, our readers. Fortunately, right on the 4th of July holiday, there was an article that gave me my idea, particularly given that I had noticed a couple of studies on the very subject of the article in the week leading up to the long holiday in the US (at least for people not on call). As a result, I’m half tempted to refer to this article as a trilogy of acupuncture terror.
Oh, wait. I just did. (more…)
It’s now officially summertime, but people have been hitting the pools and beaches for weeks in many parts of the nation. In fact it has been well into the 90’s for over two month here in Baton Rouge, which is what I blame for the early exit of LSU from the College World Series. Our boys just weren’t used to that cold and dry northern weather.
Not surprisingly, the media has already been busy reporting on some of the many tragic drowning incidents that have occurred thus far, and Facebook profiles have been full of commentary from worried parents. And, as usual, there are businesses offering infant and toddler swimming lessons costing hundreds and even thousands of dollars per course, some of which come with claims of decreasing the risk of drowning in the young participants.
At what age can a child begin swimming lessons? According to Jan Emler of Emler Swim School, teaching a child to swim can start “As soon as the umbilical cord falls off.” Emler, like more reputable proponents of infant and toddler swimming programs, doesn’t actually put newborns into swimming pools for lessons (I’ll leave water birthing enthusiasts out of this discussion). For the most part these programs only cover bath time activities to help younger babies grow comfortable being in the water. Truly teaching infants and toddlers behaviors aimed at reducing the likelihood of drowning in the event of falling into a body of water doesn’t usually start until 6 months of age. There are exceptions.
But when should these lessons start, are they safe and do they work? Or do they actually put children at risk of injury and the parent at risk of having a false sense of security? Until their updated 2010 policy statement on the prevention of drowning, the American Academy of Pediatrics came down firmly against initiating swimming lessons in children less than 4 years of age for a number of very good reasons. Why did they soften their stance and does their change of opinion support the claims that are being made by infant and toddler swimming programs? First some background information.
It’s summertime, and the living is easy. Forget the solstice. For most of North America, this week is the real start of summer – July 1 in Canada, and July 4 in the USA. Vacation time means breaking out of that those usual routines of work and school. I’m amazed after a few weeks of vacation how much sleep my body will accept if given the opportunity, where it will climb from six to nine hours a night within a week. I try not to change my kids’ habits too much, and one area I’m fairly disciplined with is maintaining a predictable sleep/wake cycle, even when they’re on vacation. I’ve learned, mainly through trial and error, that I suffer the consequences when my own kids don’t get enough sleep, or when their sleep cycle is thrown off. It wasn’t always like this. I remember a period of what felt like years when I had to crawl out of my child’s bedroom on my hands and knees so as to not disturb a child who simply would not fall asleep. And when it finally, mercifully, occurred, it would be a brief respite before the cycle began again. The sleepless nights left us all cranky and exhausted. Admittedly I was fortunate, either due to my successful parenting (but more likely mean reversion) and my kids are pretty good sleepers now. I’m reminded of my good fortune when I speak with exhausted and frustrated parents who have children that cannot sleep and are worried about the causes and consequences of persistent insomnia. As a pharmacist I’m regularly asked about insomnia for both kids and adults as there are a number of over-the-counter products available, and many consumers are understandably apprehensive about seeking out prescription products. Tell someone there’s “natural supplement” for sleep and there’s usually a lot of interest. That’s what I’ve seen with melatonin, a hormone that is sold without a prescription in Canada, the United States, and other countries. It is widely perceived as safe and alternative health purveyors like naturopaths, and even some health professionals, may recommend it for treating sleeping problems in both adults and children. Beyond sleeping, some believe melatonin is a wonder drug with efficacy for diseases ranging from chronic fatigue to cancer to irritable bowel. (more…)
It is always gratifying to see regulatory agencies actually do their job. If those regulatory agencies whose job it is to protect the public from false or harmful medical advertising, products, or services thoroughly did their job, so-called “alternative medicine” would cease to exist.
Recently the Advertising Standards Authority (ASA) in the UK issued a judgment about advertising for homeopathy, specifically by the Society of Homeopaths. They had been receiving a number of complaints. After thorough investigation, and considering the response from the homeopaths, they came to two basic conclusions: homeopaths are engaging in false advertising by claiming that homeopathy is a proven treatment for specific indications when the evidence does not support those claims, and homeopaths sometimes “discourage essential medical treatment for conditions for which medical supervision should be sought.”
The ASA specifically investigated the following advertising and claims: (more…)
Ever heard of George Augustus Scott? Probably not. Although he was once touted as “Man of the Century,” he was actually a charlatan who sold electric hairbrushes. (No, an electric hairbrush isn’t a device that will brush your hair for you; it’s a hairbrush that supposedly produces a “permanent electric current” to cure everything from baldness to headaches.) He went on to sell magnetic corsets, electric rings for rheumatism, and sarsaparilla, advertised as the “GREATEST MEDICAL DISCOVERY of the AGE.” (You probably haven’t heard about that greatest discovery either.)
He and his many comrades in crime are profiled in a new book, The Medical Electricians: Dr. Scott and his Victorian Cohorts in Quackery by Robert K. Waits. You will find more quacks in this book than in any duck pond. It provides historical insights and reminds us that there is nothing new under the sun; similar charlatans continue to sell similar quack devices today, facilitated by the Internet and other media.
Electricity and magnetism sounded exciting to Victorian ears, but their properties were poorly understood. Great hopes were raised for medical applications. The opinions of experts varied. Priestly reported experiments from Italy and Germany in 1747-8 showing that a patient who held a vial of medicine while being electrified would get the same benefit as if he took the medicine by mouth. Benjamin Franklin, on the other hand, was persuaded that these reports were not true. (more…)
Well, the latest round of grant applications and pre-applications is finally over, which gave me time this weekend to peruse the stack of journals that’s been accumulating on my desk. Oddly enough, despite my being about as plugged in as you can be at my age, I’m still old-fashioned enough to enjoy the physical sensation and the overall experience of picking up the most recent issue of a journal and randomly flipping through it. There’s something about the feel of the paper, the smell of the coating and print, as well as the sheer undirectedness of it all. It’s how I find articles that I probably would never find if I relied just on perusing the table of contents of an electronic edition.
Sadly, that’s not how I found this week’s topic. The study that I’m going to discuss this week is an E-pub ahead of print that I became aware of through a Reuters story, late last week when I still didn’t have time to deal with it. As is my usual practice, I saved the link for later in Safari’s Reading List, and this time I actually managed to come back to it. The story is entitled “Many cancer patients expect palliative care to cure“, and it’s about a recent publication out of the Dana-Farber Cancer Institute published online in the Journal of Clinical Oncology (JCO) entitled “Expectations About the Effectiveness of Radiation Therapy Among Patients With Incurable Lung Cancer“. It caught my eye, even a week ago, because managing expectations in patients with advanced cancer. It then led me to do a search for related articles, which brought me to a similar study from last fall in the New England Journal of Medicine, entitled “Patients’ Expectations about Effects of Chemotherapy for Advanced Cancer“, also from the same group at the Dana-Farber. This latter study looked at patients’ expectations regarding chemotherapy, and I even remember having encountered it when it was first published and wanted to blog about it then. I don’t recall why I didn’t, but here’s my chance to revisit it.
There needs to be a SCAM index, some quantitative tool, a formula for ranking the SCAMs, so one SCAM could reign supreme, to be definitely declared the the goofiest of all SCAMs. Perhaps (number of adherents)x(number of Pubmed publications)x(age of SCAM) all divided by a plausibility factor.
Homeopathy would win and any SCAM index that did not rank homeopathy at number one would have to put up a very convincing argument indeed that their formula was not somehow fundamentally flawed.1
For first time readers, homeopathy is based on several fictions, totally divorced from reality, made up in the 1800’s.
The first law,2 with less reality than Joe Abercrombie’s, is, “similia similibus curentur,” or “let like be cured by like”. Substances which cause specific symptoms can be used to cure diseases which cause the same symptoms. If like cures like, I am uncertain what moonlight, one of many fanciful homeopathic nostrums, would cure. Lycanthropy? (more…)
States license “complementary and alternative” (CAM) practitioners (chiropractors, naturopaths, acupuncturists/TCM practitioners and homeopaths) via the magic of “legislative alchemy.” Ironically, licensing statutes are enacted based on the states’ constitutional power to protect the health, safety and welfare of the public. Yet these CAM practice acts actually increase public vulnerability to unsafe and ineffective health care practices. It is, in short, a bad idea. (A point we’ve discussed many times on SBM.) Here are six reasons why. Feel free to add to the list.
1. Practice acts grant CAM practitioners a broad scope of practice, including legalization of scientifically implausible and unproven (or disproven) diagnostic methods, diagnoses and treatments.
Like medical doctors, dentists and nurses, CAM practitioners must practice under licensing legislation, also referred to as a practice act. Otherwise, they risk prosecution for the unlicensed practice of medicine or other licensed profession unless they are exempted by one of the so-called “health freedom” laws, which basically give everyone the right to practice medicine.
Chiropractic practice acts incorporate the absurd notion that patients are suffering from “subluxations” that adversely affect their (or their children’s) health. Acupuncture practice acts are based on the equally absurd notion that the body contains “meridians” which, when blocked, cause ill health, but can be relieved by sticking people with needles. Naturopaths can diagnose and treat conditions they invented out of whole cloth, such as chronic yeast overgrowth, ubiquitous “food sensitivities,” and adrenal fatigue. Homeopaths can treat patients with expensive little bottles of water. (You can find out much more about these CAM practices in the pull-down menu accessed via the “Categories” tab to the right of this post.)
Although there are exceptions, most practice acts grant CAM providers the right to diagnose and treat any patient, no matter what age or physical condition, suffering from any disease or condition, as long as the disease or condition is described in the terms of the practice act and the treatment is within the scope of practice. This is perhaps best illustrated by examples. Suppose a patient sees a chiropractor for vertigo. The chiropractor is legally allowed to diagnose the cause of vertigo as one or more subluxations of the spine and to treat the patient with adjustments. What if the patient sees an acupuncturist? If the acupuncturist diagnoses blockage of “qi” as the cause of vertigo and performs acupuncture to unblock the “qi,” the acupuncturist has done nothing outside his scope of practice. And if the patient sees a naturopath? The naturopath is free to diagnose, for example, “toxins” as the cause of the vertigo and proceed to treat these toxins with colonic irrigation. How about a homeopath? Same result: the patient is treated with what is essentially water. None of this will address the patient’s vertigo but it is all perfectly legal. (more…)
Finding a simple fix for complex problems is highly appealing, which drives a persistent market in simple fixes, whether or not they are actually effective. The growing “brain training” industry is an example of this – the concept being that performing simple tasks, such as playing particular games, can have wide-ranging cognitive benefits. Unfortunately the evidence has not been kind to this notion.
Related to the brain training concept is auditory integration training. One permutation of this, the Tomatis Method, describes it this way:
The sound message is correctly heard but poorly analyzed in an emotional framework. The brain protects itself by constructing barriers that can result in the development of various disorders.
You can do the listening sessions repeatedly by using specially designed devices that stimulate the brain and progressively help it more effectively analyze the sensory message.
Your ear is not used only for hearing. It also stimulates your brain and establishes your balance. Well-tuned listening is therefore an essential component for promoting personal development.
This is a common approach to marketing such therapies – argue that one factor is a dominant cause of a host of problems, describe the method for addressing that one factor, which then leads to a happy, healthy, fulfilling life. This marketing formula appears well established. (more…)
We are not alone. Walt Whitman didn’t know how right he was when he said, “I contain multitudes.” The microbes on and in our bodies outnumber our own cells 10:1. Perhaps that creeps you out. Perhaps that makes you curious to know just who all these billions of creatures are that are using your body for a home and a transportation device.
For just $89 you can learn what’s in your gut, nose, mouth, skin, genitals…or sample anything!
The offer comes from uBiome, a “citizen science startup” that has scientific goals somewhere down the line, but for the moment is happy to just provide a personal service, to sequence your microbiome and tell you how you compare to others. The current utility of this offering is questionable. It’s just not ready for prime time. (more…)