Mark Crislip aka sbmsdictator.  The 'nym is an attempt at ironic humor. Not everyone sees it as such.


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Points of Interest: 1/29/2014

If that is the reason, shouldn't they all be suspended? Snohomish County naturopathic physician suspended for misleading patients.  "Snohomish County naturopathic physician was immediately suspended for allegedly duping cancer patients into treatment with an unapproved experimental vaccine." Conflict of Interests at the General Chiropractic Council Outcomes of Usual Chiropractic; Harm (OUCH). A randomised controlled trial.  An interesting example of placebo causing adverse reactions. Liberals Finally Cleared of Anti-Vaccine Madness Director of ‘ALLIANCE OF HOMEOPATHS’ recommends homeopathy for measles
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JAN
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Points of Interest: 1/28/2014

"Acupuncture has gradually increased its acceptability over the last 20 years [because] it has good, double-blind, scientific proof that it is of assistance for pain and other disorders."  As long as you think placebo is effective and ethical.  And look at the picture.  Again with the bare hands.

Regulating Homeopathy "In July 1951, news spread that certain manufacturers of homeopathic remedies in the Stockholm area had skipped part of the potentization process and had sold pure sugar pills under the false claim that they were homeopathic medicines."  As if it made a difference.  An interesting review of some Swedish history.

Chiropractic spinal manipulation warning: "Professor Wand and colleagues concluded: “The potential for catastrophic events and the clear absence of unique benefit lead to the inevitable conclusion that manipulation of the cervical spine should be abandoned as part of conservative care for neck pain."

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JAN
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Acupuncture Beer Goggles

I have been writing a lot about acupuncture in the last few weeks. Perhaps it is because there are just more papers to evaluate about acupuncture, it being the pseudo-medicine with the most active presence on the Pubmeds.

Sham acupuncture is no better than real acupuncture for the relief of pain. The usual interpretation is that if an intervention is no different that a placebo, the intervention does not work. But there is always the issue that sham and real acupuncture (as if there is a difference) are better at relieving pain than doing nothing.

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JAN
27
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Points of Interest: 1/26/2014

The Australians are so far ahead of us: Order of Australia to Ms Loretta Josephine Marron. For service to community health. "Inaugural Chief Executive Officer and Secretary, Friends of Science in Medicine, since 2011; Founding Member, 2011; formed to support evidence-based medicine and to raise concerns about 'complementary and alternative' interventions for health conditions." Congratulations.

 

 

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JAN
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Doctors Are Just These Guys, You Know?

Conflict of Interest Statement: I am a paid Infectious Disease blogger for Medscape.

There was a recent survey of 31, 399 Doctors by Medscape that was published as the Physician Lifestyle Report. The survey covers weight, vacation time, marriage status and other lifestyle issues including complementary and alternative pseudo-medicine use .

Several observations about the report.

Of course they had a picture of acupuncture on the cover and it was usual heebie jeebie inducing ungloved hands needling with bare fingers poking around the insertions. Even Medscape can’t find a photo with good infection control technique, probably because such photos are as rare those of Nessie.

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JAN
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Points of Interest: 1/25/2014

Is Going For Acupuncture Treatments For Infertility Problems a Good Idea? I'll answer that.  No.  Acupuncture does not and cannot do anything. The American Board of Integrative Holistic Medicine (ABIHM) Announces Its Expansion to Larger International Academy Driven By Six Major Shifts in Healthcare.  Bold added. "In addition to medical and osteopathic physicians, the academy will support licensed and credentialed healthcare providers such as naturopathic physicians, chiropractors, acupuncturists, registered nurses, nurse practitioners, physician assistants, dentists, pharmacists, psychologists, nutritionists, and dieticians." This is an example of why the Society for Science-Based Medicine is needed.  Expandind the role of pseudo-medical providers.
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JAN
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Tooth Fairy Science and the Constitution

Harriet Hall coined the term “tooth fairy science” which is

to doing research on a phenomenon before establishing that the phenomenon exists….You could measure how much money the Tooth Fairy leaves under the pillow, whether she leaves more cash for the first or last tooth, whether the payoff is greater if you leave the tooth in a plastic baggie versus wrapped in Kleenex. You can get all kinds of good data that is reproducible and statistically significant. Yes, you have learned something. But you haven’t learned what you think you’ve learned, because you haven’t bothered to establish whether the Tooth Fairy really exists.

The concept encompasses most of pseudo-medicine and usually studies look for results based on interventions not based on reality. Much of traditional Chinese medicine is based on concepts divorced from anatomy and physiology and are perfect grist for tooth fairy science mill. 

An example comes from the introduction of The Association between Yang-Deficient Constitution and Clinical Outcome of Highly Active Antiretroviral Therapy on People Living with HIV

Before you read further, a warning. If you are drinking, swallow now, so liquid does not squirt out your nose and onto the computer.

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JAN
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Points of Interest: 1/24/2014

HOMEOPATHY, does it really work in animals? ...The short answer to this question is NO. Despite the above, reality not a priority for vets: Judging merits of veterinary homeopathy not an AVMA objective. "Delegates quietly and overwhelming rejected a resolution that called on the AVMA to publicly discourage and identify homeopathy as an “ineffective practice.”  What creationists and anti-vaxxers have in common: "They are, though, different manifestations of the same thing: people’s misplaced and misinformed insistence that their personal beliefs exempt them from the scientific evidence to the contrary, even if that means consequences for people who don’t share their beliefs."
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JAN
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Science For Science Based Medicine

Guest Post by Eugenie V. Mielczarek

Science-Based Medicine continually informs about the scientific  knowledge and  controls  required to provide successful medical protocols.  The need for a joint effort  with major scientific  societies  is crucial.  Neither the the American Physical Society  nor the American Chemical Society   have  lent their expertise  communicating ‘science for the general public’ to dispel  claims for   homeopathy and  ‘energy  healing’  obvious violations of the laws of science.  The founding of  Society for Science Based Medicine came as I was reviewing  my failed four year  effort to have the American Physical Society, APS, recognize this  healing  protocol as a medical misconception.Some background:learning that healing claims for an undefined  field  emitted by certain human practitioners, was being taught in nursing schools  medical schools, used as a source of revenue by hospitals, and had  been funded by NIH’ s NCCAM,  I with Derek Araujo  and Brian Engler, exposed the claim, practices  and NIH’s funding,  with articles in  the Skeptical Inquirer. The ‘healing’ protocol appears under several  pseudonyms: Therapeutic Touch, Reiki, Jorei, and Qigong.  NCCAM  grants for these protocols total  about  11 million dollars.  A popular Reiki center close to my home  is located at the Winchester Medical Center,  Winchester Virginia.

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Points of Interest: 1/23/2014

Influenza kills pregnant women, leads to miscarriage, smaller babies, less intelligent babies  and is spread from mother to newborn.  The vaccine can prevent all of that with no risks to the baby or mom.  This shouldn't happen: More misinformation on flu shots, more tragedy. Big Data Crushes Anti-Vaccination Movement More on the unsavory history of the vaccine-autism 'link' Despite the above, people still want to spread infection. Miss. parents rally for vaccine rights bill. Medical Child Abuse? "Families of children suffering from pain, anxiety, nausea and vomiting, may take part in the study and choose from alternative medicine  therapies like massage therapy, acupuncture, acupressure and Reiki, a form of energy therapy."  And they are being paid  $750,000 to see if worthless therapies can ease the suffering of children.
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JAN
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Points of Interest: 1/22/2014

Acupuncture: A Natural Treatment For Glaucoma?  "Because of the poor quality of the study and the high risk of bias the authors of the review concluded that, “On the basis of currently available evidence, the benefit and harm of acupuncture as a therapeutic modality for glaucoma cannot be established."  Do not rely on pseudo-medicine when failure could lead to blindness. An under-recognized effect of using Chinese Medicine, contributing to animal extinction.  "Poaching is primarily done to satisfy the alternative and complementary medicine markets, which are a quirky shadow business in America (the U.S. government's $120 million annual National Center for Complementary and Alternative Medicine - NCCAM - boondoggle aside) but in Asia, alternative medicine is popular...A long-term strategy is not to demonize hunting, even the illegal kind, or even goofy pseudo-medical practices, but rather to tackle the growing wealth gap between African areas of supply and Asian centers of demand, which remains a central dynamic to the problem. "   It is nice to see this outside the SBM site. Stanislaw Burzynski’s counteroffensive against FDA, Texas Medical Board continues

 

 

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JAN
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Combinations

Pseudo-Medicines combine and recombine in a continual fantastical dance. Pick any two alternative medicines and someone, somewhere, has combined them into a unique treatment modality. My favorite is Tong Ren, a form of voodoo acupuncture.

I had thought, perhaps incorrectly, that no one could come up with a more ludicrous combination. Perhaps it would be dark energy homeopathy or dark matter acupuncture. I suppose it is just a matter of time before someone combines some pseudo-medical modality with the time cube and their nonsense will reign supreme.

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JAN
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Points of Interest: 1/21/2014

Here are 15 home remedies taken from the Ayurvedic tradition that you can try the next time you have the opportunity. Of course if these don’t work for you, or your symptoms get worse, make sure to consult with your health practitioner of choice (whether that’s a medical doctor or a shaman). And for the skeptics who think these types of treatments aren’t real I have to ask, why wouldn’t you try them when there’s no real downside? Er, because I do not to waste time and money of pseudo-medical treatments that have no basis in reality? Fevers are usually good. Treating fevers usually bad. I have discussed the fact that you should let the fever burn. More fuel for the fire: Fighting flu fever with pills making death toll worse, study says The toll of the anti-vaccination movement, in one devastating graphic. I like the way the graphic looks like a infectious rash on the world.
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JAN
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Googlewhack?

Photographic representations are worth on the order of 103 words, or so the old chestnut would have us believe.

I have been in charge on infection control at my hospital system for 23 years and in that time we have slowly driven down the rates of hospital acquired infections. There have been many initiatives that have helped with the decline, but I would wager that none have been as important getting out hand hygiene rates to almost 100%.

Hands are a wonderful vector for germs and it you want to have an entertaining, if somewhat nausea inducing time, spend a few hours focusing on what people to with their hands. Euw.

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JAN
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Points of Interest: 1/20/2014

  • When the facts do not support you, go for misogyny: Life as a Female Journalist: Hot or Not? "J. B. Handley, a critic of childhood vaccination and the founder of the autism group Generation Rescue, affiliated with the actress Jenny McCarthy, sent me an essay titled, “Paul Offit Rapes (intellectually) Amy Wallace and Wired Magazine.” In it, he implied that my subject had slipped me a date-rape drug. Later, an anti-vaccine website Photoshopped my head onto the body of a woman in a strapless dress who sat next to Dr. Offit at a festive dinner table. The main course? A human baby...This kind of vitriol is not designed to hold reporters accountable for the fairness and accuracy of their work. Instead, it seeks to intimidate and, ultimately, to silence female journalists who write about controversial topics. "
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JAN
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Hanlon's Razor

I have no idea why people use pseudo-medicines. Well, I can understand why a particular person may use a given pseudo-medicine, but I find the surveys unsatisfying. There are probably as many motivations for using pseudo-medicines as they are people using them.

I empathize. To be human is to be susceptible to all the cognitive biases that make pseudo-medicine attractive.

I am sure those reading this have, at some time in their past, succumbed to the allure of one unsubstantiated or unfounded idea or another. Mine was Chariots of the Gods by Erich von Daniken back in high school. I was quite enamored of the concept that we were once visited by aliens, not a surprise for a sci-fi addict. It was discovering critical information in the Zetetic all those many years ago that sent me down the critical thinking path.

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JAN
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First Principles

I like to reason from first principles and move down the chain of reasoning. 

One of the characteristics of physiology I remember from medical school is that most of the structural molecules are made on-site from primitive precursors.  The food we eat is broken down to its smallest components which are transferred  to where they are needed and then these building blocks are altered or strung together with other chemicals to form more complex structures.

Simplistic, I know, but a reasonable rule of thumb.  

That is one of the issues about glucosamine and chondroitin for osteoarthritis that bother me.  Both products are made on site by cartilage, not imported complete into the joint. So why would taking them help joint disease?  Unless you are eating a diet rich in pig snout and cows ears, most peoples diets have little of either glucosamine or chondroitin.

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JAN
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Points of Interest: 1/19/2014

I wonder how this would work since no acupuncture chart shows meridians in the genitals. Acupuncture Assists Penile Surgery - New Finding . Looks like they are putting the needles elsewhere. Prince Charles wants “evidence-based complementary treatments taking a proper integrated approach that gives people choice and where regulation would build confidence in making choices”.  Problem is, if it is based on evidence, then it will not offered. Indian Medical Association not happy with the decision to allow homeopaths practice allopathy.  As they should be.  Next: India Airlines to be piloted by transendental medication practitioners who can levitate.
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JAN
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Points of Interest: 1/18/2014

Worthless acupuncture study.  Studies without sham acupuncture show efficacy.  Studies with sham acupuncture always show acupuncture is placebo and placebo is nothing. "Acupuncture was as effective as NSAID therapy for patients with primary dysmenorrhea.” Group 1 received NSAIDs and group 2 received acupuncture care. Both groups received treatment for one month. The NSAID group showed a 52.2% decrease in dysmenorrhea related pain. The acupuncture group demonstrated a 69.5% decrease in dysmenorrhea related pain." You are correct about chiropractic. Creepy Chiropractic Thoughts: "So I asked Mrs. Jones what was troubling her about coming to my office for the correct or proper care of her health, her spinal column. And she replied “Doc., I don’t really like all this foolishness with my bones.”  "Zhang tries to alarm the public about the “dangers” of TCM."  Yet they always show an acupuncture photograph with the worst technique possible. Bare hands holding the needle in the scalp.  Eeuw.  If you are an Infectious Disease doctor these photos give you the heebie-jeebies. "In Pakistan, Taliban commanders have forbidden vaccination teams access in some areas. A handful of religious leaders have also denounced the campaign as a plot to sterilize Muslim children."  And polio thrives. Is fish oil a “miracle” brain healer? CNN does irresponsible story.
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JAN
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People Die. Homeopathy Can Help.

Death probably has more inevitability than taxes. Everyone dies. The question is not are you going to die. You are. The question is are you going to die before you should. Is your death preventable?

There are a lot of reasons why people die prematurely. I spend 95% of my time in in-patient medicine and my sense is a major reason people die is lack of health care insurance. They have illnesses like HIV or high blood pressure and they do not seek care until it is too late to halt or reverse the course of their disease. It is sad.

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