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Antivaccine nonsense Medicine

The Atlantic, “methodolatry,” and pandemic swine flu

I’d like to thank revere right now publicly. He’s taught me a new word:

Methodolatry: The profane worship of the randomized clinical trial as the only valid method of investigation.

Many of my readers have e-mailed me about a recent article in The Atlantic by Shannon Brownlee and Jeanne Lenzer, two reporters whose particular bias is that we as a nation are “over treated.” That may be true, although not to the extent that Brownlee, at least, seems to think, and her article on swine flu was truly execrable. Moreover, “methodalatry” perfectly describes one of my complaints about the “evidence-based medicine” paradigm. So I’m really glad that revere took it on and demolished it.

I had actually planned on blogging about this article. However, it’s a long article, with many, many shortcomings. The whole Suzanne Somers thing seemed to take on a life of its own and crowd out my chance at blogging the Brownlee article. I may have to rectify that situation for Monday. revere covered a lot, but he didn’t cover one aspect of the article that bothered me even more in as much detail as I want to. On the other hand, he made my task easier by covering a lot of the issues of vaccine efficacy. Stay tuned.

In the meantime, you might also want to read Mark Crislip’s article on flu vaccine efficacy, which, although not directly written in response to Brownlee’s article, does address many of the shortcomings in its analysis of H1N1 vaccine efficacy.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

12 replies on “The Atlantic, “methodolatry,” and pandemic swine flu”

Obama declares swine flu national emergency
Order could speed up treatments by waiving certain medical standards

The insanity escalates

Yeah Sid I’m really worried about them bypassing the rules for setting up alternative medical sites in places like schools or the hospital parking lot.

Dear Sid:

Hospitals can’t open additional emergency rooms if they wish to treat the spike in flu patients off-site (the very real spike, Sid, just talk to our local ambulance drivers)without this declaration. They also can’t increase the number of beds available for the increased number of people requiring hospitalization (we now have in our mostly rural area six people on ventilators due to H1N1. That’s one-third of the ventilators in the county).

Can you provide us your address, Sid? I’d like to mail you a dollar so you can go buy yourself a clue.

Lest anyone conclude that the august Atlantic has lost it completely, what with hiring McArdle and running the Brownlee / Lenzer piece, let me point out that you can also go to theatlantic.com and find this.

Today I went to my primary care physician for a regular checkup. There is no H1N1 vaccine available. I inquired about getting the pneumonia vaccine and was told that I didn’t fit the recommended target population. I explained that I would like to at least be protected against some complications of the flu if the H1N1 vaccine was not available. Still, no go on the pneumonia vaccine, just a recital of the recommended targets for pneumovax.

I’m a bit taken aback by the refusal to vaccinate me against pneumonia. I’m well sold on vaccination in general. Now I’m just shaking my head and wondering if vaccinating against polio is still reasonable, how in the heck is it not reasonable to give a vaccine for pneumonia?

If anyone has any thoughts on the matter and is willing to share, I’d appreciate it. I’m still considering trying to get the pneumonia vaccine at the local pharmacy but wonder if I’m missing some major error in my thought process here.

Jane, I’m not an expert, but I do have some thoughts on the matter. I don’t believe it’s possible to vaccinate against pneumonia-the-condition – it’s only possible to prepare the immune system with antibodies against one specific bacterium that causes pneumonia. So if you got vaccinated against that bacterium but then got the H1N1 flu, that vaccination wouldn’t prevent you from getting pneumonia as a side-effect of the flu.

That’s my understanding, anyways, and I hope someone will speak up if I’m dreadfully wrong.

Thanks so much for your reply Antaeus. While I recognize that influenza virus can cause pneumonia, as I understand it, there is also an increased (perhaps higher) risk of developing secondary pneumonia, which can be caused by Streptococcus pneumoniae.

I’m not an expert either, just trying to get a better understanding of this and whether or not the pneumovax is a reasonable precaution without access to the H1N1 vaccine.

I believe I’m using good sources for basic info (some of it quite technical though), but putting the risks into perspective is quite a puzzle at the moment.

http://www.virology.ws/2009/06/05/interferons-secondary-pneumonia-after-influenza/

http://www.rxlist.com/pneumovax-drug.htm

http://www.ncbi.nlm.nih.gov/pubmed/19586418

http://www.ncbi.nlm.nih.gov/pubmed/19520922

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