Part 5. Marijuana and pregnancy – assessing the science

marijuana and pregnancy

This is Part 5  of a series of six articles discussing various medical uses for cannabis or marijuana. In this article, I review and summarize some of the evidence that marijuana supporters have used to claim that smoking weed during pregnancy is safe. And I look at data from high quality reviews that shows it isn’t. So let’s assess the science regarding marijuana and pregnancy.

As I have written previously, consumption of and growing marijuana should be completely decriminalized. And the laws need to be rewritten, not in the haphazard way it is now, but with protection and respect of rights of people to consume or grow (for personal use) cannabis. The criminal prosecution of marijuana use and distribution is a ridiculous waste of public resources.

There are numerous health claims made about marijuana, including its use for cancer, neurological disorders, and other medical uses. There’s even a whole area of belief that claims smoking cannabis is perfectly safe during pregnancy. Let’s look at this. Continue reading “Part 5. Marijuana and pregnancy – assessing the science”

Hierarchy of scientific evidence – keys to scientific skepticism

hierarchy of scientific evidence

I am  a scientific skeptic. It means that I pursue published scientific evidence to support or refute a scientific or medical principle. I am not a cynic, often conflated with skepticism. I don’t have an opinion about these ideas. Scientific skepticism depends on the quality and quantity of evidence that supports a scientific idea. And examining the hierarchy of scientific evidence can be helpful in deciding what is good data and what is bad. What can be used to form a conclusion, and what is useless.

That’s how science is done. And I use the hierarchy of scientific evidence to weigh the quality along with the quantity of evidence in reaching a conclusion. I am generally offended by those who push pseudoscience – they generally try to find evidence that supports their predetermined beliefs. That’s not science, that’s the opposite of good science.

Unfortunately, today’s world of instant news, with memes and 140 character analyses flying across social media, can be overwhelming. Sometimes we create an internal false balance,  assuming that headlines (often written to be clickbait) on one side are somehow equivalent to another side. So, we think there’s a scientific debate, when there isn’t one.

I attempt to write detailed, thoughtful and nuanced articles about scientific ideas. I know they can be complex and long-winded, but I know science is hard. It’s difficult. Sorry about that, but if it were so easy, everyone on the internet would be doing science. Unfortunately, there are too many people writing on the internet who think they are talking science, but they fail to differentiate between good and bad evidence.

But there is a way to make this easier. Not easy, just easier. This is my guide to amateur (and if I do a good job, professional) method to evaluating scientific research quality across the internet.

Continue reading “Hierarchy of scientific evidence – keys to scientific skepticism”

Acupuncture research – evidence is overwhelming that it is not medicine

acupuncture research

Recently, I read an article in the Medical Journal of Australia that lists “156 health care practices identified and flagged through the search platform as potentially unsafe, ineffective or inappropriate in certain circumstances (pdf).” They cover procedures from prostatectomies to arterial stenting that lack evidence to support their continued use in many circumstances. Unsurprisingly, the list examined acupuncture research and found it lacking – it’s not medicine.

I know, people will get all upset. They’ll throw out anecdotes, like people do with chiropractic, or cherry pick poorly designed studies to “prove” that acupuncture works. They’ll try to convince everyone who will listen that it’s some sort of racism of Western based “mainstream” medicine that dismisses acupuncture. Because if it worked for your cousin’s daughter’s hairdresser’s uncle, it must be real medicine.

However, the overwhelming opinion of evidence based medicine is that acupuncture does not work. In the article, “An industry of worthless acupuncture studies,” Steven Novella concludes,

There are now thousands of acupuncture studies looking at every indication you can imagine (which stretches credulity that there is any common underlying mechanism). We are well past the time for preliminary studies. Despite thousands of studies, there isn’t a single indication for which real acupuncture has been shown to work to a high degree of confidence. At this point I would say that acupuncture should be abandoned as a scientific concept. It is a failed hypothesis that has added no real knowledge to our understanding of health and disease.

If, however, you are going to spend the resources to do an acupuncture study, make sure it is rigorous enough to add new information, and isn’t just another preliminary study to throw on the pile and get another round of misleading headlines about how “acupuncture” works. Of course a cynical person might suspect that this is the real goal of these studies.

I’m not going to review all 150 plus medical procedures that fail to meet the standards of evidence based medicine. That would be a book! But let’s focus on what they say about acupuncture research. Spoiler alert – it doesn’t work. Continue reading “Acupuncture research – evidence is overwhelming that it is not medicine”

Developing and supporting a scientific consensus

In my writing, I often refer to the scientific consensus, which is the collective opinion and judgement of scientists in a particular field of study. This consensus implies general agreement, though disagreement is limited and generally insignificant.

The major difference between a scientific theory and a scientific consensus is that the theory is essentially fact. It is so predictive, it is supported by so much evidence, and it is so well accepted, it takes an almost ridiculous amount of data to refute it, though it is possible.

In the hierarchy of scientific principles, we often mention scientific theories which “are large bodies of work that are a culmination or a composite of the products of many contributors over time and are substantiated by vast bodies of converging evidence. They unify and synchronize the scientific community’s view and approach to a particular scientific field.” A scientific theory is not a wild and arbitrary guess, but it is built upon a foundation of scientific knowledge that itself is based on evidence accumulated from data that resulted from scientific experimentation.

We want to focus on the scientific consensus, describing what it is. Take a deep breath, because this is a complicated one.

Continue reading “Developing and supporting a scientific consensus”

It’s difficult to be a real scientific skeptic – let’s make it easier

scientific skeptic

Since I started this website, nearly four years ago (that’s 50 internet years), I’ve noticed a serious problem – some skeptics, even scientific skeptics, are lazy, trying to take the easiest way to accept or refute a claim. It is difficult to be a real scientific skeptic (see Note 1). It’s not impossible, but it takes more than using some intentional or unintentional bias or fallacy.

This lack of real skepticism has manifested itself in some incredible meta memes: “vaccines are dangerous,” “gluten is dangerous,” and “GMOs are dangerous,” even in groups who are ostensibly “pro-science.” However, if I replied to them, “wow, you must be a creationist too,” generally, their indignant reply would make a sailor blush.

Scientific skepticism is hard, not because of the complex science (even though, that is part of the issue), it’s because searching for the evidence that supports or refutes some claim is often nuanced, and contradictory. And researching it isn’t easy.

Thus, as a self-proclaimed scientific skeptic, I thought I’d write an article to help anyone learn more about what interests them, how to discriminate between bad and good research, and where to find good information. Sit down with your favorite internet consuming device, grab your favorite snack and drink, and enjoy.

Continue reading “It’s difficult to be a real scientific skeptic – let’s make it easier”

Big Pharma and development of drugs – debunking myths

As I’ve written more times than I can imagine, in the hierarchy of scientific evidence, the best primary evidence for the usefulness of any therapeutic method (including medications) are clinical trials, with double-blind, randomized ones considered the gold standard.

Despite the fact that clinical trials form the foundation of all medical evidence, I sometimes get the impression that many people think it is easy. And that any claims for a new drug or medical device flies through this process, with Big Pharma’s desires taking precedence over science.

Big Pharma and development of drugs are a bone of contention, even to those who don’t jump on board the various conspiracies about the pharmaceutical industry. There is a myth that there really isn’t any regulation – Big Pharma owns the FDA (and other regulatory agencies), and does whatever it wants.

But let’s look at it carefully, including how most drugs are developed and brought to the market. Let’s try to separate the myths of Big Pharma and development of drugs from the facts.

Continue reading “Big Pharma and development of drugs – debunking myths”

“Homeopaths without Borders” are not humanitarians

There is an American group called Homeopaths without Borders (HWB), who claims that it provides humanitarian aid, in the form of homeopathic “medicine” or just plain water, 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.

Continue reading ““Homeopaths without Borders” are not humanitarians”

Relevance of Nobel Prize and Traditional Chinese Medicine

Last week, the Nobel Prize Committee gave out the 2015 Nobel Prize for Medicine to three researchers, including Youyou Tu (see note 1), for her novel work in developing a medicine to treat malaria. Dr. Tu was the first Nobel Prize winner in the natural sciences from China, so she is a groundbreaking scientists in many ways.

Because Dr. Tu found the potential cure through research into Chinese herbs, many people have proclaimed that traditional Chinese medicine has now been “proven.” But not so fast.

What is the relevance of the Nobel Prize and Traditional Chinese Medicine – is there any importance at all?

Let’s take a look at Traditional Chinese Medicine, in general, and Dr. Tu’s work itself. The story is quite a bit more complicated, nuanced, and scientific than you might have read. Continue reading “Relevance of Nobel Prize and Traditional Chinese Medicine”

Pseudoscience and science – alternative medicine is bullshit

Editor’s note: This article combines elements of several articles about pseudoscience published in 2012 and 2013. It’s been revised to include some newer information and split into several parts to improve readability. See Part 1 here.

This is part 2 of the Pseudoscience and science series.

Pseudoscience and science – the former is bullshit. And the latter is fact based on robust, unbiased evidence. Mostly pseudoscience can be ignored, even if it smells bad.

Pseudoscience is enticing because it’s easy to understand. It’s not nuanced, and it general speaks in black and white terms, often false dichotomies. That view is most prevalent in medicine.

Real doctors will say “this treatment for XYZ cancer is going to be difficult. You’ll lose your hair. You’ll feel sick all the time. You might be in pain. But it gives a 73% chance of putting the cancer into remission, and you have a reasonable chance of living at least five years.”

The pseudo-medicine pusher will say, “drink this juice and have a coffee enema. No side effects. And I guarantee that the cancer will disappear.”

The second choice is so enticing. So easy. But most of us know that treating most cancers is hard. We try to find another way, and hope for the best. Maybe you can choose the junk medicine approach, and get lucky with a spontaneous remission. Or maybe the real medicine worked well enough to cause the remission.

 

Of course, pseudoscience can make broad claims without the rigorous research required to make those claims. The charlatans who push junk medicine get to say whatever they want, with no consequences usually.

Alternative medicine is bullshit – it is firmly grounded in pseudoscience.

Continue reading “Pseudoscience and science – alternative medicine is bullshit”

Pseudoscience and science – bullshit vs. rational thought

Editor’s note: This article has been rewritten and updated. Please visit that article

Let’s start with a quote (edited for clarity and because some points aren’t germane to this article) from the just-retired Jon Stewart, in his final rant ever on the Daily Show:

[infobox icon=”quote-left”]Bullshit Is everywhere. There is very little that you will encounter in life that has not been, in some ways, infused with bullshit.

Not all of it bad. Your general, day-to-day, organic free-range bullshit is often necessary. That kind of bullshit in many ways provides important social-contract fertilizer. It keeps people from making people each other cry all day.

But then there’s the more pernicious bullshit–your premeditated, institutional bullshit, designed to obscure and distract. Designed by whom? The bashitocracy.

It comes in three basic flavors. One, making bad things sound like good things. “Organic, all-natural.” Because factory-made sugar oatmeal balls doesn’t sell. Patriot Act, because the “are you scared enough to let me look at all your phone records” Act doesn’t sell. So whenever something’s been titled Freedom Family Fairness Health America, take a good long sniff. Chances are it’s been manufactured in a facility that may contain traces of bullshit

Number two. Hiding the bad things under mountains of bullshit Complexity. You know, I would love to download Drizzy’s latest Meek Mill diss. But I’m not really interested right now in reading Tolstoy’s iTunes agreement. So I’ll just click agree, even if it grants Apple prima note with my spouse.

And finally, finally, it’s the bullshit of infinite possibility. These bullshitters cover their unwillingness to act under the guise of unending inquiry. We can’t do anything because we don’t yet Imow everything. We cannot take action on climate change, until everyone in the world agrees gay-marriage vaccines won’t cause our children to marry goats, who are going to come for our guns. Until then, I say it leads to controversy.

Now, the good news is this. Bullshitters have gotten pretty lazy. And their work is easily detected. And looking for it is kind of a pleasant way to pass the time.

The best defense against bullshit is vigilance. So if you smell something, say something. [/infobox]

Continue reading “Pseudoscience and science – bullshit vs. rational thought”