Other blog comments on Patriot Nurse

I didn’t realize how many bloggers about vaccines posted on this woman.  It makes me a bit concerned that we’ve given her more credit than she deserves, but it’s important to stamp out the vaccine denialism quickly.  So when someone googles “Patriot Nurse”, they find the evidence-based discussions, not the ranting of a woo-meister.

Responsible Nurses, and Then There’s This–Canadian Nurse

Vaccines are safe and effective. Scientific study has shown this to be true, beyond a shadow of a doubt. No vaccine – or any medication – is without risks, and I would encourage people to speak to their physician if they are having doubts or questions. Remember that anyone can post anything they wish on the internet – be it true or not. And simply because something SOUNDS authoritative does not make it correct.

Vaccination Ethics Come to Question as The Patriot Nurse Strikes Again–Canadian Nurse

Good morning angry supporters of The Patriot Nurse (TPN).

No one is debating your RIGHT to choose whether or not to vaccinate. But if you have the right to NOT vaccinate, then a patient – especially parents who …will be giving birth to a vulnerable neonate under your care – should have the right to choose whether or not you act as their nurse.

NO one is after The Patriot Nurse’s job. A science writer for a legitimate science zine contacted her work to verify her identity. Which is exactly what a responsible writer does before publication – verifies a source.

Non-vaccinating nurses at other hospitals have to take isolation per-cautions(gloves, gown, mask). This is to protect them and protect the patients. Regardless of whether YOU think vaccines work – science sure thinks that they do, and the employers have a right and a duty to protect those under its care.

The Patriot Nurse is a sham. She states in her video that saying this comes as a great cost to her as a nurse. If she so firmly believes in her anti-vaccination rhetoric – so much so that she would post it online AND STATE THAT SHE WAS A NURSE – then she should be well aware of the potential consequences.

All of you crying “free speech” are being deceived. The Patriot Nurse has deleted EVERY SINGLE comment that was not entirely supportive of her. You can’t claim that her free speech is in jeopardy while she refuses that right to others.

The Patriot Nurse made a video. A stupid video. In which she makes very very basic scientific errors. She was called to answer to those errors on her page, on this blog, on Orac’s blog and elsewhere. She refused to do so. She is not interested in having a dialogue. She had her little diatribe and that was that. NO ONE is so special that they can make sweeping, erroneous statements without recourse.

I know that you anti-vaccination activists have a lot of other anti-vaccination friends online. But the fact of the matter is that 94% of people are still vaccinating. You’re a blip on the radar. You’re the new “trendy” thing to be against. But when it comes down to it, all but a handful of people are intelligent enough to realize that:

1) there is NOT a global conspiracy of scientists and doctors trying to poison your children

2) a few bad nurses or doctors do not discount the whole of the scientific method; nor are the opinions of a few more valid than the opinions of millions

3) researching vaccines on Google is NOT equal to going to post-secondary education for 10+ years to be a physician, pediatrician, immunologist or what have you.

The Patriot Nurse is not a martyr. She is a nurse who is expected to uphold the ideals and principles of her nursing organization and employer. And seeing as those things adhere to evidence-based medicine – and she doesn’t – she now has a problem. She brought it on herself. It was her choice not to vaccinate, and it their choice (and DUTY to the public) to deal with her how they see fit.

A black hole of anti vaccine misinformation–Respectful Insolence (Orac)

Every so often, I come across a bit of antivaccine idiocy that’s so amazingly idiotic, such a–shall we say?–target-rich environment that it’s catnip to a cat. I just can’t resist it, even when there are other topics and subjects out there that have backed up over the last few days and I want to cover. You’ll see why in a minute. In this particular case the antivaccine lunacy comes in the form of a video that’s been making the rounds amazingly quickly the anti-vaccine crankosphere since it was released yesterday.

The Patriot Nurse–Autismum

Of course, whose advice you follow on such matters is your call. You can put your faith in the paranoid rantings of the Patriot Nurse, PlayBoy models and inconsequential actresses or base your opinions on the overwhelming body of scientific evidence that shows, though not perfect, for the vast majority of human beings that receive them, vaccines are safe and the best protection against potentially disabling and deadly diseases that infect us.

Study: Vaccine against bacterial meningitis shows promise

Study: Vaccine against bacterial meningitis shows promise – USATODAY.com.

The study is published in the Lancet (how ironic), and the conclusions (from the original study) state that 91-100% of participants (who received the vaccine) had high titers of antibodies for each strain of meningococcal B.  By the way, the placebo group were in the 29-50% range for the placebo group.

Just in case you might wonder if there’s a placebo effect that causes an immune response to the bacteria, it’s probably not.  There is usually a background seropositive individuals in a population, since individuals may be exposed to the bacteria on a usual basis.  Even at 50%, the risk is so high that the vaccine (which is nearly 100% effective) is still necessary.

One more conclusion from the authors of the Lancet article:

No vaccine-related serious adverse events were reported and no significant safety signals were identified.

Just in case anyone was wondering.

BBC News – La Nina ‘linked’ to flu pandemics

BBC News – La Nina ‘linked’ to flu pandemics.

An interesting article published in the Proceedings of the National Academy of Sciences correlates the La Niña conditions in the equatorial area of the Pacific with flu pandemics.  The authors propose that the La Niña conditions (which upwell colder water to the surface, changes migration patterns of migratory birds.  Since birds are one host for the influenza virus, these changed migration patterns may change how the birds interact with other species moving new influenza subtypes into different parts of the world.

We are, however, a long way from predicting a pandemic based upon a La Niña event.  Right now, the authors can only correlate pandemics and the Pacific circulation patterns in just four cases:  the Spanish Flu of 1918, the Asian Flu of 1957, The Hong Kong Flu of 1958, and the Swine Flu of 2009.  It’s hard to make a case for causality based on these four data points, but the authors do lay out a compelling argument.

Whenever I critique a correlation vs. causation argument, I first determine if the causality is even possible.   I often make the argument that MMR vaccinations cause broken arms in 12-16 year old girls, because a small, but significant proportion of kids being vaccinated get broken arms (or car wrecks, gastroenteritis, an itchy nose, and angry comments to their parents).  However, there is no physiological, biological, or scientific reason why a broken arm might result from a vaccination.

In this article, the authors do make a scientifically plausible case that avian migration patterns do change in La Niña events, so they are on the path to providing outstanding evidence to support this hypothesis.

How pseudoscience makes its case. Part 4.

This is my continuing multi-part discussion about how pseudoscience uses logical fallacies, strawman arguments, and other rhetoric to make its case, rather than real science.  Just click on the links to read Part 1, Part 2, and Part 3.

The other day I engaged in a discussion with a well-meaning pharmacist who claimed that vitamin C could treat colds and prevent other diseases like  “cancer” (I always get annoyed  by people who lump all cancers together, when there are over 200 different cancers, all of which have different histologies, genetics, and causes).  Of course, there are a number of well-controlled clinical trials that show that vitamin C has no effect on the common cold and has no effect on cancers so far studied (see this, this, this and this).

During our discussion, she said “science should be neutral,” with the implication that I wasn’t neutral.  I happen to agree, science should be neutral and it should balanced.  But science should be based upon the scientific method not rhetoric and not using science-y words, at which the writers of Star Trek were well-versed.

So, when I say that I am (or any evidence-based real scientist), “scientifically neutral”, that means I’m willing to weigh the evidence and publications on real scientific issues.  I am not a geologist nor a paleontologist, but I was studying biochemistry when the earliest theories on what caused the Cretaceous-Tertiary extinction event 65.5 million years ago, where all the dinosaurs (well, not all, since technically modern birds are surviving dinosaurs from a cladistic point of view) and some 75% of all extant genera died out or were killed.  In 1980, Luis Alvarez, a brilliant theoretical physicist whose career was extraordinary, along with his son, Walter Alvarez (a geologist), and Frank Asaro, published an article that describe a sedimentary layer across the world that included a rare element, iridium, usually found in extraterrestrial objects like meteors and comets.  The layer fell right at the geological boundary layer that defines the extinction event, so they proposed that the dinosaurs were wiped out by a huge comet or asteroid.

Today, this accepted as a scientific theory with tons of confirming evidence (although some scientists aren’t fully convinced, though they still propose some natural event).  But at the time, it was ridiculed, and scientific meetings were quite energetic in discussions.  The point is that the impact theory displaced the prevailing scientific theory of the extinction event (well, there were several).  One theory replaced another not by rhetoric or appeals to antiquity (that one theory was around forever) or anything else.  In fact, one scientific hypothesis was replaced by another and eventually developed into a solid theory.

We should be neutral in science, reviewing the evidence, then coming to conclusions.  The Alvarez father-son team provided that, and eventually there was overwhelming evidence with the finding and dating of the Chicxulub impact crater in the Yucatan Peninsula of Mexico.

Using scientific neutrality, vitamin C doesn’t work, not because I have an opinion, but because there is no science supporting its efficacy.  There are some articles that support its use in preventing or treating colds, or megadoses for curing cancer, but those articles are in low-impact (meaning obscure) journals or with poorly designed, or non-blinded trials.  My friendly neighborhood pharmacist was stating that I should be neutral between real science and well, nothing at all.  That’s not balance, that’s a close-mindedness to science and the scientific method.  That’s using opinion as the balance to scientific knowledge.  The only thing that should balance scientific knowledge is more scientific knowledge.

Don’t fall for the trap that you should be “open-minded” or neutral to anti-science or pseudoscience.  Open-mindedness and neutrality are expectations that you will balance real scientific evidence, not treat the rhetoric as if it has equal weight to scientific method.

Totally Drug-Resistant Tuberculosis in India

Totally Drug-Resistant Tuberculosis in India.

Along with HIV and malaria, tuberculosis (TB) is one of the most dangerous diseases in the world.  According to the World Health Organization, there were 8.8 million new worldwide cases of TB, along with 1.4 million deaths in 2010.  TB is difficult to treat, usually taking over six months with antibiotics that sometimes have difficult side effects.

Also, because of low patient compliance, misdiagnosis, and other issues, multi-drug resistant (MDR) and extensively drug-resistant (XDR) versions of TB can arise in a population. MDR is resistant to the first-choice drugs, requiring treatment with a larger cocktail of  one or more of the nine different “second-line” antibiotics, which are less effective, have more adverse effects, and can take much longer to effect a cure, up to 2 years or more. XDR TB is resistant to the three first-line drugs and several of the nine antibiotics usually considered as second line choices.

As the article states:

The vast majority of these unfortunate patients seek care from private physicians in a desperate attempt to find a cure for their tuberculosis. This sector of private-sector physicians in India is among the largest in the world and these physicians are unregulated both in terms of prescribing practice and qualifications. A study that we conducted in Mumbai showed that only 5 of 106 private practitioners practicing in a crowded area called Dharavi could prescribe a correct prescription for a hypothetical patient with MDR tuberculosis. The majority of prescriptions were inappropriate and would only have served to further amplify resistance, converting MDR tuberculosis to XDR tuberculosis and TDR tuberculosis.

The spread of this disease could be quicker than some other infectious disease (like HIV), because of how easily it’s spread (one patient can infect up to 15 others before diagnosis and treatment), and, of course, the lack of viable antibiotics for XDR TB.

Right now, the infection seems to be in a small subgroup of TB patients in India (and Iran) in a border region that has poor medical care.  However, given the lack of effective antibiotics means that we’re all in this together.

The interesting fact about the title of the article–the authors seem to have invented a new subset of TB, Totally Drug Resistant.

Duesberg Strikes a blow for HIV/AIDS denialism : denialism blog

Duesberg Strikes a blow for HIV/AIDS denialism : denialism blog.

Laymen summary:  Duesberg has no clue.  None.

I spend a lot of time criticizing the vaccine denialists who have taken a fraudulent study, Andrew Wakefield’s Lancet publication claiming a link between MMR vaccinations and autism, to causing families to stop vaccinating children.  This has lead to increased measles, whooping cough and other disease rates.  All of which are preventable.

But of course, Duesberg, an HIV/AIDS denialist hits a whole new level of harm to others.  He claims HIV does not cause AIDS.  Actually, there is a ton of evidence that it does.  He claims that AZT is ineffective.  The evidence says otherwise, and in fact, HAART has decreased AIDS mortality significantly.

And what has this AIDS denialism done?  Uganda and South Africa have rising AIDS rates because of this denialism (and a government’s complicity to that denialism).

I wish that Peter Duesberg would go away.  But unfortunately, science allows for the gadflies and cranks, which, in this case, cause harm.

Chiropractic: Concussion Craziness – Skeptical Health : Skeptical Health

Chiropractic: Concussion Craziness – Skeptical Health : Skeptical Health.

Let me summarize what the article says:

  1. A concussion is serious, which usually, and I repeat usually, resolves itself.
  2. A real doctor (a DO or MD who actually has a degree and has trained in emergency medicine) should see the patient to rule out anything more serious.
  3. A chiropractor cannot do #2 by law, by training, or by knowledge.

If you want more information about “Chiropractic Neurology” (and if that’s not quack medicine trying to sound real by throwing in scientific terms, I don’t know what is), read what Steven Novella said about it at Science Based Medicine.

How pseudoscience makes its case. Part 3.

This is part of my ongoing discussion on how quacks use pseudoscience to push their myths and potions on the world.  Part 1 discussed the scientific method, which allows us to objectively analyze the natural world.  Part 2 discussed the best way for us to examine the difference between science and pseudoscience.

I just read an outstanding analysis, by Steven Novella, MD, a clinical neurologist at Yale University, of how pseudoscience (those who pretend to praise the scientific method, yet do it in a way that is not actually science) and anti-science (those who repudiate science outright, or even undermine science, with subjective analysis and untestable spirituality) to reject evidence-based medicine.

Dr. Novella clearly states how science in medicine works:

This leads us to the final continuum – the consensus of expert opinion based upon systematic reviews can either result in a solid and confident unanimous opinion, a reliable opinion with serious minority objections, a genuine controversy with no objective resolution, or simply the conclusion that we currently lack sufficient evidence and do not know the answer. It can also lead, of course, to a solid consensus of expert opinion combined with a fake controversy manufactured by a group driven by ideology or greed and not science. The tobacco industry’s campaign of doubt against the conclusion that smoking is a risk factor for lung cancer is one example. The anti-vaccine movement’s fear-mongering about vaccines and autism is another.

Basically, science evolves over time.  A conclusion that lacks sufficient evidence may eventually be supported by better analysis or groundbreaking research.  You’ll notice that anti-science and pseudoscience pushers do not allow themselves to participate in the this continuum of research–they state emphatically that they are right.

Science, by its very nature, must be falsifiable, meaning that any hypothesis or theory has the logical possibility that it can be contradicted by an observation or the outcome of a physical experiment. Just because a hypothesis or theory is “falsifiable,” we do not conclude that it is false.   To the contrary, we understand that if it is false, then some observation or experiment will provide a reproducible result that is in conflict with it.  Simply put, science assumes that it has it all wrong, and attempts to determine why a particular theory or hypothesis is wrong.  Of course, in these attempts, usually more evidence is found to support the original theory.  Just because science requires falsifiability, that does not mean that it will ever be falsified, but science is open to the possibility.  In other words, science evolves.

Pseudoscience, by its very nature, is not falsifiable.  It is mostly based on assertion rather than scientific observation, so it cannot be tested by experiment or observation.  Creationism is a perfect example.  It is based on a human text (the bible), so there is no experiment that could be designed to test the text, since it non-responsive in a natural sense.  It would be like trying to scientifically show that the muppets existed.

Two of the most misused and misunderstood terms in evaluating scientific evidence are correlation and causation, two powerful analytical tools that are critical to evidence based medicine.  Correlation is the grouping of variables that may occur together.  For example, smoking correlates with lung cancer in that those who smoke tend to develop lung cancer at a statistically significant rate.  It’s important to note that correlation does not prove causation.  However, once you have numerous well-designed studies that correlate lung cancer to smoking, along with adding in biological and physiological models that support the correlation, then we can arrive at a consensus that not only is smoking correlated with lung cancer, it causes it.

We observe correlations every day.  But they are subjective observations for which we cannot state a causal relationship without substantial research.  The anti-vaccination movement is rife with these observations which they use to “prove” a cause.  An anti-vaccine conspiracy website claims that pregnant women are miscarrying babies after getting the shot.  The fact is that there is a statistical chance that women will miscarry during any pregnancy.  This is random variability not a cause.  In fact, based on the rate of miscarriage, we could expect that thousands of women would miscarry within 24 hours of getting the H1N1 flu shot.  But it’s not correlation, unless significant studies show a causal relationship.  For example, I’m also sure that thousands of people broke a bone or had a desire to eat a burger after getting the shot, but that’s because in a large enough population of individuals, you can find literally millions of different actions after getting a shot.

So, the miscarriage rate after receiving the swine flu shot is not correlated.  It’s just a random observation.  And there is no biological cause that could be described.  Nevertheless, the “flu vaccine causes miscarriage” conspiracy has been thoroughly debunked by research, but still the internet meme continues.  Pseudoscience sometimes uses the same methodology (or lack of methodology) to make positive assertions.  Homeopaths will claim that their dilutions will cure whatever disease, yet they do not have scientific evidence supporting them, but there plenty of evidence that debunks what they practice.

As part of my analysis of medical claims of causation or “cures”, I often use this logic to test the possibility of the usefulness of any alternative medicine–is there any physical, chemical or biological mechanism that will allow the quack procedure to work?  If you cannot imagine it without violating some of the basic laws of science, then we should stand by Occam’s razor, which states often times the simplest solution is the best.  So, if there is no evidence of vaccinations being correlated, let alone causal, to autism, then that remains the simplest solution.  To explain a possible tie without any evidence would require us to suspend what we know of most biological processes.

As I’ve said in other posts, the internet gives us so much information, we tend to value it equally, as if every website provides accurate and logical data points.  Maybe you have a friend who had a miscarriage 24 hours after receiving the swine flu vaccine.  Maybe you’ve heard that many people have.  But that’s not science, that’s just a subjective observation.  Or even confirmation bias.

Once again, Dr. Novella says it perfectly:

In conclusion, correlation is an extremely valuable type of scientific evidence in medicine. But first correlations must be confirmed as real, and then every possible causational relationship must be systematically explored. In the end correlation can be used as powerful evidence for a cause and effect relationship between a treatment and benefit, or a risk factor and a disease. But it is also one of the most abused types of evidence, because it is easy and even tempting to come to premature conclusions based upon the preliminary appearance of a correlation.