Adjuvant therapy after surgery, such as chemotherapy, hormonal therapy, and radiation therapy, has contributed to a 39% decrease in breast cancer mortality since 1989. Unfortunately, a significant number of women decline evidence-based adjuvant therapy. A recent study suggests that distrust of the medical system plays a significant role in such refusal.
Dr. David Brownstein is a “holistic” family practice physician in my area. Consistent with being “holistic,” he is antivaccine to the core. That’s why he’s unhappy with the recent CDC recommendation that adults over 50 receive the new shingles vaccine. He thinks he’s found a clever argument to show it doesn’t work. Unfortunately, his argument only reveals his bias and misunderstanding.
Many are the antivaxers who claim they aren’t antivaccine. Few are the antivaxers who are honest enough to openly proclaim they are antivaccine.
Two years ago, I took note of an “energy healer” named Charlie Goldsmith and an incredibly poor “clinical trial” being touted as evidence of his healing abilities. It now turns out that Goldsmith is following a trail blazed by celebrity psychic Tyler Henry and has his own TV show on TLC. His claims are no more plausible or supported by evidence now than they were then.
Last week, the results of ORBITA were published. This clinical trial tested coronary angioplasty and stenting versus optimal medical management in patients with single-vessel coronary artery disease. It was a resoundingly negative trial, meaning that adding stenting to drug management didn’t result in detectable clinical improvement. What was distinctive about this trial is that it used a sham procedure (i.e., placebo) control, which few trials testing surgery or a procedure use. The results of ORBITA emphasize how important sham procedure controls are, whenever they can be ethically used, and how resistant physicians can be to change.
