It’s getting colder outside, and if you go into any pharmacy, grocery store, chemist, or superstore, you will find literally a dozen or more homeopathic, herbal, or other unproven lotions and potions to prevent or treat the common cold, or rhinovirus. These supplements are a significant part of the annual US$108 billion dollar supplement/nutraceutical industry.
These alternative medicine (so named because there is no scientific evidence supporting their efficacy, let alone safety) products make claims that are so wonderful, many people take them. Then they themselves tell their friends how fast they got rid of their cold. Or that their cold wasn’t as bad after taking the supplement.
The problem is that determine the length and severity of the course of the common cold is entirely subjective. Since the disease is rather mild with few serious complications, it’s hard to determine when it exactly stopped and started, and how bad it was. The common cold tends to resolve itself without external help, but there really isn’t much you can do to make your immune system attack that cold faster.
There is an American group called Homeopaths without Borders (HWB), who claims that it provides humanitarian aid, in the form of homeopathic “medicine”, to devastated areas of the world. The more famous group that does real lifesaving work across the world, Doctors without Borders, are probably too busy, utilizing real evidence-based medicine with real medications, risking their own lives, and performing great service humanity, to be worried that a bunch of pseudoscientific homeopaths stole their noble trademark to push quackery.
HWB is sending their water magicians to Haiti, Guatemala, Dominican Republic, Sri Lanka, and El Salvador, all countries that have suffered so much during the past few years. During their time in Haiti, “the team will be in Port-au-Prince to complete the final session of the Fundamentals Program—a foundational curriculum in homeopathic therapeutics incorporating theoretical and clinical training.” So not only are they providing nonsense, useless, unscientific healthcare to Haiti, they are training new homeopaths there. Haiti needs to train real doctors who use science based medicine, not quack medicine.
I always get suspicious when someone makes an argument with the statement of “it’s been proven to work”, “the link is proven”, or, alternatively, they state some negative about scientifically supported therapies. Typically, I hear these kinds of statements from the pseudoscience pushing crowd. For example, real science has debunked the “there is a proven link between vaccines and autism,” a common and popular pseudoscientific belief. Or that most alternative medicine (CAM) therapies work based on numerous logical fallacies that suspends reason, and accepts “belief” in the therapy, something that evidence-based medicine just doesn’t do.
So, I decided to put together a rather substantial treatise on science vs. pseudoscience. We’ll explore what exactly makes an idea scientific (and spoiler alert, it isn’t magic), and contrary to real science, what makes an idea “pseudoscientific.” So sit down, grab your favorite reading beverage, because this isn’t going to be a quick internet meme. I intend to show you exactly how pseudoscience, whether it’s creationism, vaccine denialism, alternative medicine, or whatever you want to debunk, lies. Yes, lies.
(more…) «How pseudoscience tries to fool…»
Unless you were hiking in the Amazon River jungles, with no access to the internet or American TV, you probably have heard that CNN’s chief medical correspondent, Dr. Sanjay Gupta, changed his mind about marijuana (or “weed” as he keeps saying). Of course, this has become big news, because he’s such a “respected doctor” (why is that? Because he’s on TV?), and because a few years ago he was vociferously anti-cannabis.
I have no doubt that Dr. Gupta’s “conversion” to being pro-weed is genuine (and that his previous stance of anti-weed was similarly authentic), but we need to weed out what is real and what’s just smoke about his comments. His first major point about cannabis* was that the United States Drug Enforcement Agency (DEA) considers marijuana to be a Schedule 1 drug, which is defined as “drugs with no currently accepted medical use and a high potential for abuse.”
Dr. Gupta thinks this classification is ridiculous, and on the surface, many people, even those who are not devoted pot smokers, would probably agree. However, this is a political discussion, at least in the USA, and it is hardly a medical/scientific one. The chances of any political party having the fortitude to correct this classification is about as close to 0 as you can get, without actually stating that there is a 0 chance. But if Gupta wants to make a big deal of this, or that he’s so self-centered that he thinks he’ll change the mind of politicians, more power to him. But for me as a skeptic, it is not the most important thing he says.
In his article, he mentions a young girl who ”started having seizures soon after birth. By age 3, she was having 300 a week, despite being on seven different medications. Medical marijuana has calmed her brain, limiting her seizures to 2 or 3 per month.” This is simply an anecdote of no quality whatsoever. Did he thoroughly investigate her case to determine if the number of seizures actually went down? Do we know that cannabis has anything to do with the change? Is this nothing more than a Post hoc ergo propter hoc fallacy, that just because she consumed cannabis and the seizures decreased does not mean anything about cannabis’ causative properties with regards to this type of seizure. And then, Dr. Gupta continues with the anecdotes by stating, “I have seen more patients like Charlotte first hand, spent time with them and come to the realization that it is irresponsible not to provide the best care we can as a medical community, care that could involve marijuana.” Why do these TV doctors (like Dr. Oz) think that their anecdotes are better than anyone else’s.
Anecdotes are useless because they aren’t controlled, because they are subject to all levels of bias, and because these stories aren’t peer-reviewed. In other words, anecdotes have no value in science-based medicine. Anecdotes do have value in formulating testable scientific hypotheses, but assuming that anecdote=data, and more anecdotes=more data is simply pseudoscientific. I don’t care what Sanjay Gupta writes or says publicly, but providing these stories as “evidence” that marijuana has a medical benefit is essential like telling me that he observed homeopathy (which is just water) working. It’s laughable.
Last year, I wrote an article about how to critically analyze pseudoscience and misinformation to get at the scientific evidence which may help you accept or reject something you might read on the internet, even if it appeared to be accurate. On Facebook, Twitter and many internet sites (including Wikipedia), there is an amazing tendency of individuals to accept what is written as “the truth” without spending the effort to determine if what is written is based on accurate science. Twitter, of course, limits itself to 140 characters, which means you either have to click on a link to get more information, or just accept that the 140 characters are factual. And if you can make a complex scientific argument in 140 characters, I’m impressed.
Facebook is filled with false memes on just about everything from politics to medicine. The anti-vaccination crowd fills Facebook with their amusing and highly inaccurate memes. For more than a year, there have been dozens of photos of bananas with a few words that some Japanese scientists claim that ripe bananas have high levels of “tumor necrosis factor“, so eat bananas to cure cancer and maintain a healthy immune system. Facebook is famous for these things, little pictures with a few words, no sources of the information, and broad conclusions. Eat bananas. Cure cancer. And people share them with a click of the button and move on to the next cute cat picture. It’s really the lazy person’s way of learning. Although who doesn’t enjoy the cute cat pictures?
(more…) «Despite the meme on Facebook,…»
If you spend any time in the “debate” (actually, one side has scientific evidence and the antivaccination side denies all science, so to avoid falling for a false equivalency, debate gets scare quotes), you’ll hear every dumb argument to deny science. But one thing that you’ll see repeatedly from the vaccine deniers is that they would support vaccinations if there were better clinical trials.
The problem with the vaccine denier’s clinical trial proposals is that they are a moving target, relying on a form of the Argument from ignorance, claiming that if we can’t absolutely “prove” that vaccines are safe, then it must be absolutely unsafe. For example, there are dozens of articles, including one of the latest (published here and discussed here).
My good friend Allison Hagood, co-author of Your Baby’s Best Shot: Why Vaccines Are Safe and Save Lives, wrote a commentary about the antivaccine community’s perfect clinical trial. Follow along! (Allison’s commentary is presented in whole, but I’ve edited the formatting and added links where necessary).
(more…) «The one study to rule…»
In a strange decision, the United States 2nd Circuit Court of Appeals, which has jurisdiction over Connecticut, New York, and Vermont, ruled that a drug sales representative who promotes “off-label” uses of a particular drug is exercising their “freedom of speech.” The Court decided in a 2-1 vote, in United States v. Caronia (pdf), that the criminal conviction of Alfred Caronia, a former sales representative for a pharmaceutical company, be vacated. The case was an appeal of the sales representative’s conviction for promoting an off-label use of the drug Xyrem, which is approved for treatment of narcolepsy. The Court stated that “we construe the FDCA as not criminalizing the simple promotion of a drug’s off-label use because such a construction would raise First Amendment concerns.”
The Court also found that the FDA allows off-label use by physicians, but “prohibits the free flow of information that would inform that outcome,” while “the government’s prohibition of off-label promotion by pharmaceutical manufacturers provides only ineffective or remote support for the government’s purpose.” The Court also ruled that it construes “the misbranding provisions of the FDCA as not prohibiting and criminalizing the truthful off-label promotion of FDA-approved prescription drugs.” It also stated “that the government cannot prosecute pharmaceutical manufacturers and their representatives under the FDCA for speech promoting the lawful, off-label use of an FDA-approved drug.”
(more…) «Court says Freedom of Speech…»
Lyme disease is an infectious disease caused by at least three species of bacteria belonging to the genus Borrelia. Of the three species, Borrelia burgdorferi is the main cause of Lyme disease in North America, whereas Borrelia afzelii and Borrelia garinii are more prevalent in Europe. The disease is named after the towns of Lyme and Old Lyme, Connecticut, where a number of cases were initially identified in 1975.
Borrelia is transmitted to humans when bitten by infected ticks belonging to a few species of the genus Ixodes, called “hard bodied” ticks. Although deer ticks, Ixodes scapularis, Ixodes pacificus, or Ixodes ricinus, are commonly considered to be the vectors for Borrelia infection, some of the other Ixodes species can transmit the disease.
The initial symptoms of Lyme disease include fever, headache, fatigue, depression, and a circular skin rash called erythema migrans (EM). If the Borrelia infection is not treated quickly, later symptoms may involve the joints, heart, and central nervous system. In general, the infection and its symptoms can be treated, if started early, by antibiotics. Lyme disease is the most common tick-borne disease in the United States.
I have updated this website with a new science-based vaccine search engine powered by Google™. It basically searches about 200 websites that are science oriented (usually providing peer-reviewed articles, or links to those articles) and focused on vaccines. You can find it by clicking on the menu bar, and going to Vaccine FAQ’s.
By the way. Vaccines Save Lives.
Yes, there is a group called Homeopaths without Borders. Apparently, the group that does lifesaving work across the world, Doctors without Borders, are too busy, utilizing real evidence-based medicine with real medications, risking their own lives, and doing great works, to be worried about homeopathy, a pseudoscientific concept, even if this group steals their imprimatur without shame.
Homeopaths without Borders are sending their water magicians to Haiti, a country that has had to suffer so much during the past few years. During their time their, “the team will be in Port-au-Prince to complete the final session of the Fundamentals Program—a foundational curriculum in homeopathic therapeutics incorporating theoretical and clinical training.” Clinical training on the poor residents of Haiti? Have they not suffered enough?
(more…) «“Homeopaths without Borders” going to…»
There has been a large uptick in interest about the so-called placebo effect, mostly from the complementary and alternative junk medicine (CAM) crowd. Evidently, they feel that being equivalent to doing nothing is good enough to be real. A recent article in the Wall Street Journal, Why Placebos Work Wonders, is indicative of this recent pro-placebo point-of-view.
What exactly is the placebo effect? The definition is often misused, implying some beneficial effect from a sugar pill or sham treatment. But in medicine, a placebo is actually a failure. If a new pharmaceutical, procedure or medical device shows no difference in efficacy compared to a placebo, then it is rejected. But the CAM-pushing herd thinks that proves its a success when one of its potions and lotions is equivalent to a placebo. What? A failure of a modality in evidence-based medicine is somehow converted into a successful product in the CAM world?
Science denialists, whether they are creationists, global warming deniers, or anti-vaccinationists, are pseudoskeptics, who reject or ignore vast amounts of real evidence, just to maintain their point of view. Discussions with these individuals are generally frustrating because the denialists base their arguments on a very limited amount of education or background. As I’ve said before, at least with respect to vaccine denialism, they have spent no more than a few hours of research on the internet. Then using logical fallacies, whether it’s ad hominems, or appeals to nature, or cherry picking data, they attempt to discredit the vast scientific and medical body of work, patting themselves on the back for their incredible skills in winning a scientific argument. Of course, most of the science against which they’ve been arguing has been performed by individuals with years of scientific education, training and professional research.
Is this research perfect? No, it isn’t. Nature has reported that a Japanese anesthesiologist, who authored over 200 “peer-reviewed” papers, is suspected of fraud on an epic scale. Over half of his papers are being retracted, and he has been dismissed from his faculty position in Japan. How he got away with this level of fraud is subject to a long discussion in the Nature article, but suffice it to say, there was a massive breakdown of the peer-review system at the level of his own university (which may be cultural in Japan) and by the way he published in a wide variety of journals, some of lower quality. I constantly point out that there are differences in journals, based on their impact factor (which is one way of measuring the amount of influence a journal has within the scientific community). However, and this is important, science is self-correcting, and in this case, it has corrected itself. Based on this one story, it would be insane to assume that ALL science is fraudulent. Even assuming a significant minority of science is fraudulent would be improper and not supported by any amount of evidence.
(more…) «Science does not require faith»
Circumcision is one topic that certainly brings up more emotion than just about any medical procedure. In fact, the same level of rhetoric is used for and against circumcision that one hears with regards to vaccines, or even abortion. Recently, the city of San Francisco attempted to ban the practice, but a judge ruled that only the state could regulate medical procedures. During the summer, a German court banned circumcision for religious purposes, though a German court banning a Jewish practice must have blown up irony meters across the world.
In any discussion about circumcision, there is general consensus that female circumcision, or female genital mutilation, is an abhorrent non-medical procedure that is simply an anti-female procedure in many male-dominated societies. We’re not talking about that, and any comparison between male and female circumcision is a strawman argument. It is also clear that part of the anti-circumcision argument centers around secularism and atheism, because male circumcision is integral to both the practice ofJudaism and Islam. That is a valid argument, and there could even be a concern that unskilled individuals performing ritual circumcisions could cause serious complications. I personally could care less about religious rituals as long as they don’t harm anyone, so this is where we need to determine what the evidence tell us.
(more…) «Circumcision–separating science from opinion»
The Cochrane Collaboration is a critically important source in evidence-based medicine, and a useful tool in providing analytical evidence that can debunk pseudoscientific beliefs. Cochrane’s goal is to organize research data and publications in an logical way that helps physicians and researchers make appropriate decisions about a proposed new therapy, medication or clinical idea. Cochrane Reviews are:
…are systematic reviews of primary research in human health care and health policy, and are internationally recognised as the highest standard in evidence-based health care. They investigate the effects of interventions for prevention, treatment and rehabilitation. They also assess the accuracy of a diagnostic test for a given condition in a specific patient group and setting.
Each systematic review addresses a clearly formulated question; for example: Can antibiotics help in alleviating the symptoms of a sore throat? All the existing primary research on a topic that meets certain criteria is searched for and collated, and then assessed using stringent guidelines, to establish whether or not there is conclusive evidence about a specific treatment. The reviews are updated regularly, ensuring that treatment decisions can be based on the most up-to-date and reliable evidence.
(more…) «The importance of Cochrane Reviews…»
Let’s be blunt. Naturopathy is pure, unmitigated, undiluted junk medicine (or what many call “woo”). What is naturopathy? It is a form of alternative medicine based on a belief in vitalism, which posits that life has a quality independent of physical and chemical laws. In other words, it is no different than homeopathy (one of the core competencies of naturopathy), both of which rely upon denying the basic laws of physics and chemistry. Life may have some quality independent of physical or chemical laws and theories, but treating anything from a viral infection to a fractured femur to any of the 200 or so types of cancer requires medicines and techniques that depend upon real science, whether physics, chemistry or biology.
(more…) «Naturopathy and diabetes–pure pseudoscience»
I find interesting stuff in the most unusual places. I have an iPhone App called ID Compendium: A Persiflager’s Guide (Infectious Disease Compendium: A Persiflager’s Guide – iPhone, Infectious Disease Compendium: A Persiflager’s Guide – iPad), a great medical tool for finding different infectious diseases and the medications useful for treating it. The App was written by Mark Crislip, MD, one of the top 10 healthcare skeptics (in the true sense of the word, none of that quack-based pseudoskepticism), and it’s been very useful to me. It’s a really nice app (and for $5.99, there’s no way to go wrong here), and it’s practical, unless you’re a hypochondriac.
I was scanning through the Drugs section, and I saw an entry for “Alternative Medicine.” What? Dr. Crislip went to the dark side? Did he actually think homeopathy worked? Was he a mole for alternative medicine crowd? But, that section had a nicely worded (note: It’s an R-rated section, maybe PG-13) commentary on complementary and alternative medicine (aka CAM). I’m not sure the letter was actually sent to the Annals of Medicine, but from reading his blog, I wouldn’t bet against it.
(more…) «Alternative medicine according to Mark…»
One of the larger problems of the internet (OK, there are a lot) is how science is discussed out in the world. Google any science topic, and you’ll get thousand or millions of hits on any idea in science or medicine. The information is derived from other websites, news reports, rumors, or, to be cynical, from outright fabrication. In the fields of science and medicine, critical thinking is absolutely necessary to understanding it. Because it’s hard work, pseudoscience and anti-science have become quite prevalent lately.
(more…) «Checking for pseudoscience in real…»
This week must be whooping cough news week, which means it’s not a good week. The Wausau (Wisconsin) Daily Herald reports that a whooping cough outbreak has hit the Wausau area. According to the report, more than 100 cases have been seen in the area since the beginning of 2012. And as we have discussed, although the disease is not usually dangerous, it has significant consequences for a number of people including children and those who are immune compromised.
(more…) «More whooping cough outbreaks, now…»
According to the CBC, the whooping cough outbreak is still growing in Fraser Valley, British Columbia in Canada. Fifty cases have been reported recently, bringing the total to around 250 cases in one small area. And now there are cases in Vancouver, a large city, where the highly contagious whooping cough infection will spread quickly to those who are unvaccinated, or whose immunity from vaccination has worn off.
(more…) «Whooping cough outbreak in British…»
Pat Summitt, probably one of the greatest basketball coaches ever, has stepped down as the coach of the University of Tennessee’s women’s basketball team. She announced that she had early-onset Alzheimer’s disease (AD) in August 2011, and she had coached the 2011-12 season, but today, as a result of the disease, she resigned. During her career, she won 8 NCAA Division 1 Women’s Basketball Championships, a record that is almost impossible to comprehend. Her reputation and success is the envy of college sports.
Early onset AD is usually defined as a diagnosis before the age of 65. Early onset AD may occur in individuals as young as their 30′s (very rare), but with most diagnoses in patients in their 50′s. Summitt was diagnosed at the age of 58 (and without knowing everything, she might have had symptoms earlier), so the age of onset is not unusual.
(more…) «Early onset Alzheimer’s disease ends…»