Science-based medicine versus the Flint water crisis
One aspect of science-based medicine that is not covered frequently on this blog, aside from vaccines and antivaccine pseudoscience, but perhaps should be, is the intersection of SBM and public health. Unfortunately, living as I do in southeast Michigan right now, I’ve been on the receiving end of an inescapable lesson in what happens when the government fails in its mission to...
The cost of repealing mandatory motorcycle helmet laws
It’s a seldom mentioned aspect of my professional history that I used to do a lot of trauma surgery in my youth. I did my residency at a program that included a county hospital with a busy trauma program where I saw quite a bit of vehicular carnage and an urban hospital (which has since closed) where I saw a fair amount...
Is “harnessing the power of placebo” worthwhile to treat anything?
We frequently write about placebo effects here on Science-Based Medicine. The reason is simple. They are an important topic in medicine and, at least as importantly, understanding placebo effects is critical to understanding the exaggerated claims of advocates of “complementary and alternative medicine” (CAM), now more frequently called “integrative medicine” (i.e., integrating pseudoscience with science). Over the years, I (and, of course,...
You’ve been diagnosed with breast cancer. How soon do you need treatment?
Timely surgery for breast cancer is obviously better than delaying surgery, but how long can a patient safely wait for surgery once diagnosed. Because a randomized controlled clinical trial to answer this question would be unethical, this has been a difficult question to answer. Fortunately, a new study provides an estimate of how much of a delay it takes before outcomes start...
The fine line between quality improvement and medical research
As I’ve mentioned before, the single biggest difference between science-based medicine (SBM) and what I like to call pseudoscience-based medicine, namely the vast majority of what passes for “complementary and alternative medicine” (CAM) or “integrative medicine” is that SBM makes an active effort to improve. It seeks to improve efficacy of care by doing basic and clinical research. Then it seeks to...
Is scientific peer review a “sacred cow” ready to be slaughtered?
I’ve frequently noted that one of the things most detested by quacks and promoters of pseudoscience is peer review. Creationists hate peer review. HIV/AIDS denialists hate it. Anti-vaccine cranks like those at Age of Autism hate it. Indeed, as a friend of mine, Mark Hoofnagle, pointed out several years ago, pseudoscientists and cranks of all stripes hate it. There’s a reason for...
Michigan HB 5126: Who thought it was a good idea to make it easier for parents to obtain nonmedical exemptions to school vaccine mandates and harder for local county health officials to do their jobs?
The Michigan Department of Community Health recently passed a regulation that requires parents seeking personal belief exemptions to school vaccine requirements to receive counseling at a local state or county health office, and the regulation has worked. Personal belief exemptions are down. No wonder the Michigan legislature is trying to reverse the rule and ban the MDCH from enforcing similar rules in...
Worshiping at the altar of the Cult of the Brave Maverick Doctor
One of my favorite television shows right now is The Knick, as I described before in a post about medical history. To give you an idea of how much I’m into The Knick, I’ll tell you that I signed up for Cinemax for three months just for that one show. (After its second season finale airs next Friday, I’ll drop Cinemax until...
“Electromagnetic hypersensitivity” and “wifi allergies”: Bogus diagnoses with tragic real world consequences
"Electromagnetic hypersensitivity" and "wifi allergies" are two names given to a nonexistent medical condition in low energy electromagnetic fields like wifi are blamed for a variety of health conditions. This is a story in which the parents' insistence that their teenage daughter, who had posted threats to commit suicide on social media, had this condition appears to have interfered with seeking mental...
How not to debate a “pro-vaxer”
To say that the relationship that antivaccine activists have with science and fact is a tenuous, twisted one is a major understatement. Despite mountains of science that says otherwise, antivaccinationists still cling to the three core tenets of their faith, namely that (1) vaccines are ineffective (or at least nowhere near as effective as health officials claim); (2) vaccines are dangerous, causing...