I’m always hesitant to write about matters that are more political than scientific or medical, although sometimes the sorts of topics that I blog about inevitably require it (e.g., the 21st Century Cures Act, an act that buys into the myth that to bring “cures” to patients faster we have to neuter the FDA and a retooled version of which is still being considered). This is one of those times. Yesterday, I woke up to the news that President-Elect Donald Trump had chosen Rep. Tom Price (R-GA) as his new Secretary of Health and Human Services. The Department of Health …
Tag: evidence-based medicine
Evidence-based medicine guidelines versus patient wishes
There’s a misconception that I frequently hear about evidence-based medicine (EBM), which can equally apply to science-based medicine (SBM). Actually, there are several, but they are related. These misconceptions include the idea that EBM/SBM guidelines are a straightjacket, that they are “cookbook medicine,” and that EBM/SBM should be the be-all and end-all of how to practice clinical medicine. New readers might not be familiar with the difference between EBM and SBM, and here is not the place to explain the difference in detail because this post isn’t primarily about that difference. The CliffsNote version is that EBM fetishizes the randomized …
Better late than never: Orac comments on the hijacking of evidence-based medicine
It’s no secret that I’m a fan of John Ioannidis. (If you don’t believe me, just type Ioannidis’ name into the blog search box and see how many posts you find.) Over the last couple of decades, Ioannidis has arguably done more to reveal the shortcomings of the medical research enterprise that undergirds our treatments, revealing the weaknesses in the evidence base and how easily clinical trials can mislead, than any other researcher. Indeed, after reading what is Ioannidis’ most famous article, “Why Most Published Research Findings Are False“, back in 2005, I was hooked. I even used it for …
Contrary to antivaccine claims, childhood immunization schedules are evidence-based
I write about vaccines a lot here at Respectful Insolence, and for a very good reason. Of all the medical interventions devised by the brains of humans, arguably vaccines have saved more lives and prevented more disability than any other medical treatment. When it comes to infectious disease, vaccination is the ultimate in preventive medicine, at least for diseases for which vaccines can be developed. We also know that when vaccination rates fall, it opens the door for diseases once controlled to come roaring back. We saw this phenomenon with the measles a year ago in the Disneyland measles outbreak. …
Respect my authoritah on “integrative medicine”!
David Katz doesn’t much like skeptics, particularly those of us who question the value of “integrative medicine.” In fairness, I can’t say that I much blame him. We have been very critical of his writings and talks over the years to my criticism of his statement advocating a “more fluid concept of evidence” more than once, to my pointing out that his arguments frequently boil down to a false dichotomy of either abandoning science or abandoning patients. Last week, my friend Jann Bellamy discussed an unfortunate special supplement of the American Journal of Preventative Medicine (AJPM) entitled Integrative Medicine in …
Choosing Wisely three years on
I like to point out from time to time that arguably the most striking difference between science-based medicine (and the evidence-based medicine from which we distinguish it) and alternative medicine, “complementary and alternative medicine” (CAM), or (as it’s called now) “integrative medicine” is a concerted effort to change practice for the better based on science and evidence. In other words, in SBM, we are continually doing studies to improve practice. These studies take on two general forms: Comparing new treatments with old to determine if the new treatments work better and, as has become an imperative over the last several …
Dr. Oz promises to stop promoting pseudoscience. Should we believe him?
Regular readers of this blog will find it no surprise that I don’t think much of Dr. Mehmet Oz. The reason, of course, is that his daily television show, The Dr. Oz Show, has been a font of misinformation about medicine almost since it began airing six years ago. It’s not for nothing that I long ago labeled him “America’s Quack.” Simply searching for the name Mehmet Oz on this blog will quickly produce examples of the many times when he’s credulously promoted quackery and pseudoscience such as homeopathy (The One Quackery To Rule Them All), faith healing, fear mongering …
Straw men everywhere about evidence-based medicine
NOTE: Orac is on vacation recharging his Tarial cells and interacting with ion channel scientists, as a good computer should. In the meantime, he is rerunning oldies but goodies, classics, even. (OK, let’s not get carried away.) Here’s one from all the way back in 2007. Notice how, the more things change, the more they stay the same. Evidence-based medicine is not perfect. There, I’ve said it. Like anything else humans do in science or any other endeavor, evidence-based medicine (EBM) has its strengths and its weaknesses. On the whole, I consider it to be potentially vastly superior to the …
Science isn’t perfect, but it’s better than the alternative.
It often comes as a surprise to proponents of alternative medicine and critics of big pharma that I’m a big fan of John Ioannidis. Evidence of this can easily be found right here on this very blog just by entering Ioannidis’ name into the search box. Indeed, my first post about an Ioannidis paper is nearly a decade old now. These posts were about one of Ioannidis’ most famous papers, this one published in JAMA and entitled Contradicted and Initially Stronger Effects in Highly Cited Clinical Research. It was a study that suggested that at least 1/3 of highly cited …
Mike Adams defends Dr. Oz. As usual, hilarity ensues.
After I woke up this morning, the haze induced by feasting and hanging out with family only slowly clearing, I debated about whether I wanted to post anything at all today. After all, in much of the English-speaking world, it’s still a holiday, Boxing Day. Although not an official holiday here in the US, when Christmas is on a Thursday, as it was this year, Boxing Day becomes an unofficial holiday that the majority of people not working in the retail sector seem to take off, the better to produce a four or five day weekend, depending upon whether they …