Some Encouraging Backlash Against Nonsense

One of the themes of SBM is that modern health care should be based upon solid scientific ground. Interventions should be based on a risk vs benefit analysis using the best available scientific evidence (clinical and basic science).

As an extension of this, the standard of care needs to be a science-based standard. Science is (or at least should be) objective and transparent, and without such standards there is no way to have meaningful quality control. Without the filter of science there is no limit to the nonsense and magical thinking that can flow into the health care system. Increasingly we cannot afford the waste of fanciful and ineffective interventions, and even if limited resources were not an issue – individual patients deserve better.

It is for these reasons that we oppose the attempts by proponents of so-called complementary and alternative medicine (CAM) to erode or eliminate the science-based standard of care in medicine. Proponents differ mostly on how open they are about this goal, but there is no escaping the reality that at the heart of the very concept of CAM is at least a double standard – one in which the science-based bar for inclusion is lowered for some favored modalities.


Posted in: Science and Medicine

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Scientific American Mind Is Not So Scientific

When Scientific American first announced that they would publish Scientific American Mind, I hurried to subscribe, thinking it would keep me informed about new developments in a field I am passionately interested in. I have enjoyed the magazine, particularly the regular columns, the news items about research findings, the reviews that alert me to books I will want to read, the “Ask the Brains” Q and A, the challenging “Head Games” quiz, and the presentation of many intriguing ideas. The board of advisers is impressive, and the columns by Christof Koch, Scott Lilienfeld, Hal Arkowitz, the Ramachandrans and others have been consistently excellent. Unfortunately, some of the other articles have descended into pop psychology, speculation, poor science and even pseudoscience. Contributing editor Robert Epstein’s articles have particularly raised my blood pressure.

Love-Building Exercises

In December 2009 I was annoyed enough to write this letter to the editor:

After reading Robert Epstein’s article in the last issue, I had to go back to the cover and verify that the word “scientific” was indeed part of the title of your magazine. The Love Building Exercises he recommends are more appropriate to a magazine of fantasy and science fiction.

Two as One — feeling that the two of you have merged?
Soul Gazing — looking into the very core of your beings?
A Mind-Reading Game — wordlessly trying to broadcast a thought to another person?
Love Aura — feeling “eerie kinds of sparks” when your palm is close to another’s?

Thought transfer? Auras? Come on! Shame on you for publishing such metaphysical pseudoscientific psychobabble!

They published my letter to the editor with the heading “Hating ‘Love’.” There was no response from the author.


Posted in: Neuroscience/Mental Health, Science and the Media

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Survey says, “Hop on the bandwagon of ‘integrative medicine’!”

A Brief Clinical Vignette

In researching this post, I found an article published nearly two years ago in The Hospitalist entitled Growth Spurt: Complementary and alternative medicine use doubles, which began with this anecdote:

Despite intravenous medication, a young boy in status epilepticus had the pediatric ICU team at the University of Wisconsin School of Medicine and Public Health in Madison stumped. The team called for a consult with the Integrative Medicine Program, which works with licensed acupuncturists and has been affiliated with the department of family medicine since 2001. Acupuncture’s efficacy in this setting has not been validated, but it has been shown to ease chemotherapy-induced nausea and vomiting, as well as radiation-induced xerostomia.

Following several treatments by a licensed acupuncturist and continued conventional care, the boy’s seizures subsided and he was transitioned to the medical floor. Did the acupuncture contribute to bringing the seizures under control? “I can’t say that it was the acupuncture — it was probably a function of all the therapies working together,” says David P. Rakel, MD, assistant professor and director of UW’s Integrative Medicine Program.

The UW case illustrates both current trends and the constant conundrum that surrounds hospital-based complementary medicine: Complementary and alternative medicine’s use is increasing in some U.S. hospitals, yet the existing research evidence for the efficacy of its multiple modalities is decidedly mixed.

My jaw dropped in horror when I read this story. Acupuncture for status epilepticus? There’s no evidence that it works and no scientific plausibility suggesting that it might work. And what does the questionable research suggesting that acupuncture might ease chemotherapy-induced nausea and vomiting or radiation-induced xerostomia (which, if you look more closely at the studies, it almost certainly does not, but that’s a post for another time) have to do with this case, anyway? Nothing. Worse, Dr. Rakel fell for the classic post hoc ergo propter hoc fallacy; i.e., despite his disclaimer, he appears to be implying that, because the child recovered, acupuncture must have contributed to his recovery. He also repeats the classic fallacy that I’ve written about time and time again in the context of cancer therapy, namely that if a patient is using quackery as well as science-based medicine, then either it was the quackery that cured him or the quackery somehow made the conventional medical care work better.

I expect better from an academic medical center like the University of Wisconsin. Unfortunately, increasingly I’m not getting it. Quackademic medicine is infiltrating such medical centers like kudzu.

Posted in: Faith Healing & Spirituality, Medical Academia, Science and the Media

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Dummy Medicine, Dummy Doctors, and a Dummy Degree, Part 2.1: Harvard Medical School and the Curious Case of Ted Kaptchuk, OMD (cont.)

Rave Reviews

In 1983, Ted Kaptchuk, the senior author of the recent “albuterol vs. placebo” article, and soon to become the long-time Second-in-Command of the Harvard Medical School “CAM” program, published The Web that Has No Weaver:

The book received rave reviews:

A major advance toward the synthesis of Western and Eastern theory. It will stimulate all practitioners to expand their understanding of the causes and treatment of disease.

–Paul Epstein, MD, Harvard Medical School

A lucid and penetrating exposition of the theory and practice of Chinese medicine. While the book’s rich detail makes it of great use to practicing healers, it is in its entirety very simply written, enjoyable reading for the layman…it brings a demystifying balance…Instructive, profound, and important!

Professor Martin Schwartz, University of California, Berkeley

…demystifies Oriental medicine in a remarkably rational analysis…

—Science Digest, Nov. 1982

…an encyclopedia of how to tell from the Eastern perspective ‘what is wrong.’

Larry Dossey

Dr. Kaptchuk has become a lyricist for the art of healing…

—Houston Chronicle

Although the book is explicitly detailed, it is readable and does not require previous knowledge of Chinese thought…

—Library Journal

The 2nd edition was published in 2000, to more acclaim:

…opens the great door of understanding to the profoundness of Chinese medicine.

—People’s Daily, Beijing, China

…weaves a picture…that is eminently understandable from a Westerner’s point of view…adds a valuable analysis of the current scientific understanding of how the therapies work and their effectiveness.

Brian Berman

Ted Kaptchuk’s book was inspirational in the development of my acupuncture practice and gave me a deep understanding of traditional Chinese medicine…

Dr. George T. Lewith

…a gift for all who share an interest in deep understanding of healing. This new edition is essential reading…

Michael Lerner, President, Commonweal

Even Edzard Ernst, still in his foggy period, called the 2nd edition “a brilliant synthesis of traditional and scientific knowledge…compulsory reading…”


Posted in: Acupuncture, Book & movie reviews, Health Fraud, Medical Academia, Science and Medicine

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Caffeine for ADHD

Caffeine powder: A better medication for ADHD?

Caffeine powder: A better medication for ADHD?

“I don’t want to give my child any drugs or chemicals for their ADHD,” says a parent. “Instead, I’m thinking about using caffeine. Sound strategy?”

It may be dispensed by a barista and not a pharmacist, and the unit sizes may be small, medium and large, but caffeine is a chemical and also a drug, just as much as methylphenidate (Ritalin) is. Caffeine is even sold as a drug — alone and in combination with other products. But I regularly speak with consumers who are instinctively resistant to what they perceive as drug therapy — they want “natural” options. Caffeinehas been touted as a viable alternative to prescription drugs for ADHD. But is caffeine a science-based treatment option? This question is a good one to illustrate the process of applying science-based thinking to an individual patient question. (more…)

Posted in: Herbs & Supplements, Science and Medicine

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Pseudoscience Sells

It is an unfortunate truth that there is money in pseudoscience, particularly medical pseudoscience. Money both attracts charlatans and also funds their activities, which includes marketing pseudoscience and defending their claims from scientific scrutiny. In this way the game is rigged in favor of pseudoscience.

With0ut effective regulation, sites like ours are forced to play whack-a-mole with the medical pseudoscience du jour. The latest case in point is Titanium Ion Bands – which are just another version of the Power Balance bands that have been previously exposed as nonsense. The idea is that by wearing a small bracelet on one wrist you will experience improved athletic performance. This sounds impossible – because it is. But companies have successfully bamboozled enough of the public to rake in millions.

The marketing strategy is three-fold. First, get naive professional athletes to endorse the product. Second, give live demonstrations (deceptive parlor tricks) that convince the unsuspecting that something must be going on. And third, wow the scientifically illiterate with a confusing barrage of medical techno-babble. The combination is sadly effective.

Power Balance, for example, makes vague references to frequencies and energy as the explanation for how a little piece of rubber (with embedded holograms) can have any effect on human physiology. The company was eventually legally forced to admit: “”We admit that there is no credible scientific evidence that supports our claims.” The admission has not ended their sale, however.


Posted in: Energy Medicine, Herbs & Supplements

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TIME Magazine, Dr. Oz, What to Eat, and Supplements

Here on SBM we have frequently had cause to criticize the media for poor science reporting and for spreading misinformation. Among many other individual offenders, we have criticized Dr. Oz for promoting alternative medicine on his TV show and gullibly promoting guests who pretend to talk to the dead and pretend to heal people with carnival sideshow tricks. We tend to be negative and critical because somebody has to do it, but it’s not pleasant.  For once, I have some good things to say.

The September 12 issue of TIME magazine was a Special Nutrition Issue. The cover featured pictures of food and the title “What to Eat Now: Uncovering the Myths about Food by Dr. Oz.” It devotes 7 pages to an article by him entitled “The Oz Diet: No more myths. No more fads. What you should eat — and why.” This is followed by a 5 page article by John Cloud “Nutrition in a Pill? I took 3000 supplements over five months. Here’s what happened.” Both articles have a rational, science-based perspective without any intrusions of woo-woo. (more…)

Posted in: Nutrition, Science and the Media

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Chemotherapy doesn’t work? Not so fast…




I’ve lost count of how many times I’ve come across statements like the ones above, often in all caps, quite frequently with more than one exclamation point, on the websites of “natural healers,” purveyors of “alternative medicine.” In fact, if you Google “chemotherapy doesn’t work,” “chemotherapy is poison,” or “chemotherapy kills,” you’ll get thousands upon thousands of hits. In the case of “chemotherapy kills,” Google will even start autofilling it to read “chemotherapy kills more than it saves.” The vast majority of the hits from these searches usually come from websites hostile to science-based medicine. Examples include, the website of “alternative medicine entrepreneur” Dr. Joe Mercola and, the website of Mike Adams, where you will find cartoons like this one, which likens the administration of chemotherapy to a Nazi death camp:


Posted in: Cancer, Science and Medicine

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Gullible George: A monkey goes to the naturopath

I get the occasional email.  Very little hate mail, unfortunately, since hate mail is often more amusing.  I read what little email I receive, and usually do not respond, mostly as I do not have the time.  I am a slow writer and a slower typist, and there are just so many hours in the day, and the older you get, the shorter th0se hours become.

Recently, over at the center of the growing Mark Crislip multimedia empire, I had the following in the feedback section:

Just thought you’d like to know:

My kids watch the PBS show “Curious George” which usually does a good job with introductory Physics, Astronomy, scientific method, etc. Interspersed with the cartoons they have scenes with real children that do a real-life parallel investigation of what happened on Curious George.

Today’s episode involved the Man with the Yellow Hat catching a cold, and Curious George going to the pharmacy and picking up various drugs to assist in making the guy feel better, mainly to have him sleep and be comfortable.

The interspersed skit, however, had the children visit a naturopath, where they learned:
* Oregano cures infections
* Various pressure points that correspond to energy lines
* And that taping magnets to these points is really effective.

I sat here simply amazed.

Me, not so much.  Alternative medicine has always been a blind spot for PBS.  While PBS  would not show perpetual motion machines,  suggest that astrology is legitimate, or give credence to a flat earth, alternative medicine, as it is for many otherwise thoughtful people, is exempt from even cursory critical thinking. PBS has broadcast  Drs. Chopra and North, so its track record with science based medicine is not so good. My children are long past the Curious George part of their lives, but I read them the books when they were kids.  Not my favorite (I like the Madeleine books better; 6 weeks in hospital for an acute appendix never failed to amuse me) but they were a quick read when the kids wanted a story at bedtime and I was too tired for a longer exposition. (more…)

Posted in: Naturopathy, Science and the Media

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Quoth the anti-vaccine group SANE Vax: Beware HPV DNA in Gardasil!

Every so often, there’s a bit of misinformation that starts spreading around the Internet that shows up in enough places that our readers take notice and e-mail us about it. What happens is that these in essence become “requests.” We at SBM are, of course, happy to consider all requests and sometimes will actually take them on, particularly when doing so will be educational about the mission of this blog, namely discussing science-based medicine and providing much needed critical analysis to the pseudoscience that is, alas, becoming more and more common in medicine. A frequent topic of this blog is, not surprisingly, the anti-vaccine movement, which is arguably the most dangerous (to public health, at least) pseudoscience movement currently in existence. The misinformation about vaccines that anti-vaccine activists spread through websites, podcasts, radio, TV, and other media is protean, and it’s difficult to keep up with it all.

Which is probably why I hadn’t heard this bit of misinformation about the HPV vaccine from an anti-vaccine group I hadn’t heard of before (or at least didn’t remember) called SANE Vax. (I include the “Inc.” because SAFE Vax, Inc. itself insists on using it frequently in all its press releases.) If you’ve been in the biz a while, as I have, you can tell right away from the very name of this website exactly where its creators are coming from. Here’s a hint. It’s not the mission that the website claims that it is, which is stated thusly:

Posted in: Science and Medicine, Vaccines

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