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Here is a recap of the stories that appeared last recently at Science-Based Medicine, a multi-author skeptical blog that separates the science from the woo in medicine.
Does peer review need fixing? (David Gorski) Peer review, whereby a scientific article must be scrutinized and approved by the authors’ peers prior to publication, is a flawed system with many defects; but it is still better than the absence of peer review. The peer review process should not be abandoned or radically changed, but it can be improved.
High Fructose Corn Syrup: Tasty Toxin or Slandered Sweetener? (Jim Laidler) HFCS has only a slightly higher percentage of fructose than table sugar (55% vs. 50%) and a lower percentage than some fruits and natural sweeteners. It is sweeter, so using it can reduce the total sugar content of a processed food. A high fructose diet increases the risk of certain diseases, but switching to other sweeteners is not likely to prevent those diseases. Reducing total intake of sweeteners makes more sense than worrying about the evils of HFCS.
Antioxidant Supplements for Macular Degeneration (Harriet Hall) There is limited evidence (from one trial, the AREDS study) that a combination of antioxidant vitamins and zinc can slow the progression of moderate to advanced macular degeneration, a common cause of blindness. Some are recommending it for prevention (without any supporting evidence), and the manufacturer is unwisely hyping a new formula that has not been tested.
Peer Review and the Internet (Steven Novella) Thanks to the speed and interactivity of the Internet, experiments are underway that may improve the traditional peer-review process or offer some new hybrid of peer review and open publication. Dr. Novella discusses the implications.
Tai chi and fibromyalgia in the New England Journal of Medicine: An “alternative” frame succeeds (David Gorski) A new study showing that tai chi benefits patients with fibromyalgia is being touted as a success of “alternative” medicine, but when examined closely it appears that there is nothing “alternative” about any of their findings. Exercise, stretching, relaxation and other components of tai chi can be studied within conventional scientific medicine without invoking any “alternative” concepts like qi or energy medicine.
Why bother? (Peter Lipson) Criticism of alternative medicine can be counterproductive, especially if critics act like dicks. On the other hand, basic errors (like “it can’t be studied by Western reductionist scientific methods”) must be confronted without pulling any punches.
A pox on your bank account: failure to vaccinate and its legal consequences (Jann Bellamy) A lawyer discusses the legal liabilities involved when a child catches a vaccine-preventable disease from an unvaccinated child.
“Integrative” oncology: Trojan horse, quackademic medicine, or both? (David Gorski) Pseudoscience is infiltrating academia; “integrative” oncology all too often serves to integrate science-based medicine with quackery. It promotes nonsense like “energy medicine” and homeopathy and tries to claim ownership of adjunctive treatments like diet and exercise that rightfully belong to scientific medicine.
Testosterone: Not an Anti-Aging Panacea (Harriet Hall) Testosterone replacement therapy is being promoted as a general pick-me-up and anti-aging treatment. Several new studies support the consensus of mainstream medicine that testosterone replacement is only useful for patients with specific problems attributable to low testosterone levels.
Pertussis Epidemic 2010 (Steven Novella) We are in the midst of an epidemic of pertussis that is likely to result in the highest incidence in 50 years. Several factors are probably contributing; the solution is to support herd immunity with boosters for adults.
Medical Science and Public Opinion: The Avandia Story (James Dougherty) The anti-diabetes drug Avandia is effective, but concerns have been raised about its safety. Dr. Dougherty describes how the FDA review process works to evaluate confusing evidence and how science and public opinion interact to determine the approval of a medical treatment.
How to make a difference – Responsible vaccine advocacy (Joseph Albietz) Dr. Albietz recently lost a patient, an infant too young to have been vaccinated, to pertussis after a month of cutting edge medical treatment proved insufficient to save his life. The only way to prevent such deaths is to support herd immunity with vaccination; recent innovative efforts to educate the public are praiseworthy.
Germ theory denialism: A major strain in “alt-med” thought (David Gorski) Just as some people continue to deny evolution, there are still many people who deny the germ theory of disease and employ spurious reasoning and misconceptions about “terrain” and “toxins.” Bill Maher, anti-vaccine activists, naturopaths, and other alternative medicine proponents have failed to understand the strong evidence for germ theory and how it forms the basis of much of modern medicine.
Alchemy Is Back (Harriet Hall) Modern alchemists claim to have found the philosopher’s stone that can change lead to gold and that acts as a elixir of life to cure every disease. You can make it yourself out of dew and Celtic sea salt; it will completely eliminate the pharmaceutical industries.
Venous Insufficiency in Multiple Sclerosis (Steven Novella) Dr. Paolo Zamboni believes that multiple sclerosis patients have chronic cerebrospinal venous insufficiency and he claims to cure it with vascular surgery. Hopeful patients are requesting the surgery, but their enthusiasm is premature. Early research reports are not promising: only one of four replications agreed with Zamboni’s findings.
Homeoprophylaxis: An idea whose time has come – and gone (Peter Lipson) Researchers in Cuba tried to show that homeopathy could prevent an infection called leptospirosis. They conducted a study of questionable ethics and questionable methodology, and came up with questionable conclusions. They didn’t use a control group or consider possible alternative explanations for their data.
NEJM and Acupuncture: Even the best can publish nonsense (Mark Crislip) Dr. Crislip adds his comments to those of previous SBM posts by Drs Novella and Gorski: all three have roundly criticized the recent acupuncture article in the New England Journal of Medicine. The editors have destroyed the credibility of their journal by publishing language and reasoning reminiscent of Animal Farm: saying that even though acupuncture doesn’t work, and isn’t first line therapy for pain, it should be used for first line therapy.
“Hard science” and medical school (David Gorski) Medical school education emphasizes practical applications rather than a deep understanding of the scientific method. A recent program that de-emphasizes pre-med science courses in favor of the humanities is probably misguided; the pre-med curriculum is essential to the development of science-based doctors.
Home Birth Safety (Harriet Hall) A new study reviews all the published evidence on the safety of home birth. While home birth is associated with fewer interventions and fewer maternal infections, it is associated with a tripling of the neonatal mortality rate.
Credulity about acupuncture infiltrates the New England Journal of Medicine (David Gorski) A credulous article by proponents of integrative medicine constitutes an intrusion of quackademic medicine into our most respected medical journal. After showing that acupuncture is no more effective than sham acupuncture (placebo) for low back pain, the authors recommend using it, and even specify the number of treatments! It doesn’t work, but we should use it anyway (!?).
Acupuncture Pseudoscience in the New England Journal of Medicine (Steven Novella) The article on acupuncture for low back pain (see above) contains recommendations that contradict the authors’ own conclusions and amount to an elaborate and misleading plea to use acupuncture for its placebo effects. Dr. Novella calls their tactics “a bait and switch con game.”
Supplement Regulation: Be Careful What You Wish For (Scott Gavura) A discussion of the Diet Supplement Health and Education Act (DSHEA) and how American regulations compare to those of Canada. Canada requires evidence of efficacy, but lowers the standards to where they are practically meaningless, giving bogus remedies a prestige they do not deserve. We need a system that properly informs consumers about product effectiveness and safety: neither country achieves that goal.
Can it get any worse?: industrial bleach as cancer and HIV cure (David Kroll) The FDA has issued a warning about Miracle Mineral Solution ( MMS), an “egregious and obscene” product that produces an industrial bleach that can cause serious harm to health. Its promoters claim it can treat everything from AIDS to warts; they not only encourage patients to use a harmful substance and even inject it IV, but they encourage them to stop taking life-saving prescription drugs.
Apparently, Uri Geller is sticking by his decision that no matter what people say about him, it's all good publicity, just as I'm sure that mentalist Kreskin probably celebrates the existence of the movie The Great Buck Howard, even though it's a devastating and hilarious exposé of him and his methods. Geller delights in quoting Oscar Wilde: "The only thing worse than being talked about, is not being talked about." Take a look here at the latest major comment on the professional spoon-bender, this time by Stephen Colbert, and decide whether Geller will celebrate this event or summon his lawyers – one of his very favorite pastimes – to bleat and moan once again. Colbert being Colbert, he could not possibly have passed up an opportunity to show just how ridiculous the latest from Geller really is. Even Geller’s devoted teenyboppers might gag at this claim.
Of course, we're still waiting for Geller to announce that he has succeeded in bringing back one of the cameras that the lunar astronauts left on our satellite 39 years ago; an intention he announced long ago, but which has so far not been achieved, for some strange reason.
In an effort to make our extensive video library available online free of charge, The James Randi Educational Foundation is posting high quality digital video lectures and sessions from previous Amaz!ng Meetings and other events on randi.org. Check back often to see the latest video content.
Science writer and psychiatrist Ben Goldacre takes a historical look at homeopathy and its critics while reviewing the often misrepresented results of over 200 scientific trials. His talk gives an, at times, humorous explanation of what homeopathy is and why its principles are implausible and even “childish”.
Jeff Wagg’s article about the extreme lack of casualties on board the AIRES 737 in Columbia brought to mind a similar story from 2009. The Insurance Institute for Highway Safety was instituted in 1959 to test and promote auto safety. To celebrate their 50th anniversary they decided to throw a big bash, or rather, a big crash. They slammed two cars together, which is what they do fairly often. What made this crash different was that they weren’t testing crash worthyness. While Mythbusters has shown us that breaking things is fun, that wasn’t the purpose either. In this case they were doing it to show off.
In an effort to demonstrate the improvements brought about by 50 years of engineering knowledge, they crashed a 1959 Chevy Bel Air into a 2009 Chevy Malibu. It was a 40mph head on offset driver side crash; which was probably chosen because it allowed the cars to go head to head and see who came out standing. The cars were both 4-door sedans of roughly the same weight so it wasn’t a David vs. Goliath at least where momentum was concerned. The video to the right shows the crash from several angles, including from inside the cabin. Watch it, then we’ll continue talking.
Pretty cool huh? Even cooler are the still images found here of the two cars before and after. Looking at just the crash test dummies we see the Malibu driver sitting in a generally intact cabin while the Bel Air driver is folded in a way that I suspect even yoga masters would avoid.
However, this isn’t the point of my story. You see, this is old news. It happened last year after all. The point is the discussions that appeared after the video was made public. I went to view the video on Youtube and saw the different copies have hundreds of comments claiming everything from the Bel Air had the engine removed to the frame of the older car was rusted and simply broke. Others say that something was done to the Malibu because the new plastic car wouldn’t have a chance against one made of sheet metal.
These conspiracies spread because of what “everyone knows.” The list of things everyone knows is long and includes things like: Toilets swirl one way in the northern hemisphere and the other way in the southern; Silencers turn the loudest gunshot into a quiet “fffffttt”; that Bogey said “Play it again, Sam”; and, of course, older cars are stronger than newer ones. But, in all these cases, what “everyone knows” is actually wrong.
The sources of these legends are varied, Hollywood encourages the silencer myth, and some text books mention the toilet swirl. But the idea that older cars are stronger is one that people can experience first hand. A gentle press on the side of most modern cars will cause the panel to bend while a good kick to the side of a classic car often leads to little more than a broken toe. The problem in the case of the cars is the often counter-intuitive nature of engineering. The fact that the newer car bends more easily is actually what makes it safer. Lighter cars have less kinetic energy and stop more easily while having the metal bend where the people aren’t makes it less likely to bend where the people are.
I suspect that this conspiracy will fade rather quickly while the JFK, moon hoax, 9/11 truthers will be around for a while. But the root of all of them is the same and that’s a lack of critical thinking. I’m of the opinion that the hard core conspiracy theorists are a lost cause, but educating children, not on conspiracies, but on basic critical thinking will cause belief in these stories to die a slow death. It’s hard to fix our world, but maybe we can keep our children from screwing up theirs quite as badly.
This is a follow up to my article The Media Miracle.
Immediately after posting that article, I was contacted by Patrick Smith, who asked if his article influenced my article. What happened next was very interesting, so I'm going to tell the story in some detail.
As soon as Patrick sent that e-mail, I immediately looked at his article, and I thought... Wow, there's a lot of similarity here. But I hadn't read his article before I wrote mine, so how could that be? And then I remembered.
On the morning of August 18, 2010, I sleepily grabbed my iPad and browsed through two periodicals: USAToday and Slate, using their respective iPad apps. One of the featured articles in Slate was indeed Patrick's article. With horror, I thought "Holy cow, I've stolen his article."
And then I remembered what happened to George Harrison. There's a detailed account of the story here on Wikipedia, but the short of it is this: his 1970 song My Sweet Lord is a copy of the Chiffon's 1962 He's So Fine. The courts awarded damages to Ronnie Mack, the writer of He's So Fine, and the plagiarism was attributed to cryptonesia, wherein a memory presents itself as an original idea. If you listen to the video embedded above, you can see how very similar the two songs are, and why a compelling argument can be made that Harrison plagiarized.
But did he do so consciously? We can't ever know, but I think it's quite possible that he didn't, because a similar thing happened to me before. I used to run a website called Odd New England. It was a travel directory of unusual places to visit throughout the six northeastern states. While I was working on the Vermont section, I noticed a number of strange things relating to animals. For example, on Interstate 89, two giant whale tails rise out of a hill near the highway. As you near the waterfront, the buildings are festooned with life-size flying monkeys. And a few blocks from there, a rhino is bursting through the wall of a lamp shop. Given that these sites were in proximity and nice path could be drawn between them, I created a "strange animal" tour that people could follow.
Except that I didn't. Joe Citro did.
I read a lot of books to compile information for my site, and one of the best was Joe Citro's "Curious New England." In fact it's the best book for this type of thing. About a month after I wrote about "my" tour, I was dismayed to discover that nearly the same tour was in his book. My tour included more sites, but the concept of an animal tour was clearly in his book. I had certainly read that section, but when the idea for the tour occurred to me for my site, it seemed as though it was my own. This was a humbling and disappointing moment for me. After all, if I can't trust myself, who can I trust? I absolutely did not "plagiarize" Joe's work by sitting down with his book and copying his material and calling it my own. But I DID get the idea from him, forget its source, and then later re-attribute it to myself. It's very disconcerting that this type of thing can happen, but it does.
Can I prove that this was the course of events? No, not at all. In fact, it's only because this happened to me that I give credence to the idea that George Harrison may have developed the melody and chord progressions of My Sweet Lord thinking they were a completely original work. Had I not experienced this phenomenon myself, I'd be much more doubtful.
Now back to my article about "miracles." Did the same thing happen again? At first, I was convinced it had. I immediately wrote Patrick and apologized for not at least mentioning his article, and then I promised him I'd write this one explaining what happened. And after several day's of thought, I realize that I did not subconsciously copy his work and call it my own, though his article did influence me.
Here's what happened: When I read his article that sleepy morning, I didn't actually read it. I had literally just woken up, and I only skimmed through the first couple of paragraphs to get the main point, which is: "It's not a miracle that people survived, it's the result of people working hard." I briefly thought "I should mention this in an article" and then decided not to as I had something else I was working on. The following day, I noticed people tweeting what I thought was Patrick's article quite and bit, and I decided that it was worthy of mention. Except that it wasn't Patrick's, it was Alan Levin's USAToday article. My purpose was not to retell the story, but to praise the author for saying what so desperately needed to be said. And my first draft of the article was simply that – a brief retelling of the story followed by praise of Alan Levin for writing it.
While look for a YouTube'd newscast of the crash, I found the Nightline video, which made the same basic points that were in the Levin article, but with commentary that was really great to see. That rather messed up my story, so I changed it to be more inclusive and changed the title to "The Media Miracle." It was originally "The USAToday Miracle." And in fact, it was in the changes that my article began to look more like Patrick Smith's article.
So am I guilty of plagiarism? I don't think so, and Patrick certainly isn't claiming that I am. I didn't read his work completely, and I didn't look at it at all while I was writing my article. My original hypothesis of cryptonesia doesn't look accurate for many reasons, including the simplest one that the two article aren't really all that similar.
But I am guilty of changing the thrust my article and not doing the further research required to support this new thrust. If I had, I would have re-discovered Patrick's piece and included it. So, I apologize to Patrick Smith for not doing that and I thank him for bringing his article to my attention.
There is a post script to this story that bears mentioning. Patrick Smith and I exchanged a few more e-mails in which he asked where I went to high school. I told him St. John's Prep, in Danvers, MA. His reply: "I thought that was you."
It turns out that we were friends in high school, both graduating from the class of 1984. I didn't recognize his name because he changed it many years ago. He's the creator of the site AskThePilot.com, so we both have a connection to the travel industry even though this wasn't something we talked about in high school, and... we were both listening to the same obscure band (Human Sexual Response) last week.
Recently I was driving from Edmonton to Calgary and just outside of Edmonton I came across a sign on the highway that read, “Need a Healing?” and then touted the name of an evangelical preacher (Thurman Scrivner) who was appearing at a hotel in Leduc to ostensibly heal the infirm. Being a skeptic and a former hard-core Christian, I thought I might just go find out what this gentleman was offering those who felt they needed to be ‘healed’ by his words or deeds.
So, off I went with a good friend to one of the evenings that this gentleman was going to be ‘healing’ at the hotel. Upon our arrival we were greeted with friendship and warmth, and the environment was pleasant. There was a band that warmed up the crowd with a series of religious musical numbers and then a local preacher did some talking to the room of about 120 folks before the guest of honor arrived.
A couple of years back a book, movie, DVD, audio-book combination was released called The Secret. The basic premise of the The Secret was that everything in your life can be altered by you simply ‘wanting it’ bad enough. The dangers of this kind of thinking are fairly self evident, and it’s in this kind of thinking where my trip to the faith healer got me a little riled up.
As I said, the evening was much like a church service, but as it wore on the speaker began to hint that the reason people got cancer, got sick, had problems in their lives was because of their sins. Indeed, this gentleman actually suggested that a woman’s teenage son, who was shot and was clinging to life in ICU, had been shot specifically because his mother was pregnant and the baby was conceived out of wedlock.
Now, I don’t pretend to know that what this guy was saying wasn’t true. Maybe some god somewhere is cruel enough to punish a child for something his mother did that has nothing to do with him, but the thing about faith is that we can’t know for sure if that’s true or not, so one has to be careful about how one places blame on someone. Didn’t this preacher think that the mother of the shot boy would be suffering enough with her child clinging to life without him telling her that it’s all HER fault?
After several similar stories where the sins of parents make children suffer or die, the talk moved to the scourge of oral sex, and how many of our most common diseases such as cancers are caused because someone in a family is involved in oral sex.
I say again, my point here isn’t to deride any religion, but rather it’s to point out that silly superstition lies just beneath the surface of many belief systems, and we need to be on guard with critical thinking tools to avoid getting into situations where we’re blaming innocents for the perceived sins of others. After all, what I think is a sin might not be a sin to 99% of the rest of the population. We need cooler heads, not craziness.
A few months back Brandon at the JREF showed me a video taken last may in Africa where some so-called ‘witches’ were burned alive (right on camera) all because some folks in the village decided that they were witches. What a horrible thing, and before you say “well, that’s Africa, that’s crazy” remember that I just attended a ‘healing’ where everyone attending was told that if they engaged in oral sex it’s entirely possible that a child close to them would die. Yuck. Who thinks up this stuff? Let’s let cooler heads prevail and keep religion as faith, and reality as reality. It’ll be better for everyone concerned.
In an effort to make our vast video library increasingly accessible, free of charge, The James Randi Educational Foundation will regularly be posting high quality digital video to randi.org. Check back often to see the latest video content.
This installment features a fun discussion with South Park creators Trey Parker and Matt Stone from The Amazing Meeting 5. They take questions from the audience and recognize James Randi as the inspiration behind the John Edward episode.The introduction is by Penn Jillette.
UPDATE at the bottom.
We've seen the headlines: "Church Burns, Miracle Baby Survives" followed by quotes like "Jesus was watching little Jessica that day." And then there's no mention of the 200 people inside who suffered a horrific death. The baby's survival is attributed to a higher force, and the victims were just statistics.
It seems to me, and I'm sure many of you, that if a higher power was involved, she/he/it deserves credit for the tragedy as well as the remarkable survival. Unfortunately, people don't want to focus on the tragedy, and that's why today's article in USA Today entitled "Engineers: Passengers' survival was miracle by design" and the linked ABC Nightline video are so interesting.
Writer Alan Levin reports that the reason so few people died in the catastrophic crash of an AIRES 737 is the conscious effort of engineers, designers, and regulatory agencies to make planes safer. To recap, the plane landed just short of the runway in bad weather and broke into several pieces. There was only one fatality, and that was attributed to a heart attack and not directly caused by the wreck.
Since 2005, there have been seven similar incidents in which planes have crashed, but there has been little or no loss of life. A miracle? Have we been blessed?
There is no need for divine intervention to explain this. We did it.
So my hat's off to Nightline, Alan Levin and USA Today for the article, and to all the people involved in making air travel safer. Thank you.
Alas, that's not my only point here.
I think there is a benefit to focussing on the good fortune of survivors over the tragedy of victims. We do this all the time... you get in a wreck, and you're upset for many reasons – your car is trashed, you're going to miss the appointment you were driving to, your insurance will be going up, etc. Your first reactions are sadness and anger. But eventually someone will point out "At least you're alive." And then you have to consider how lucky you are to be living in a time where cars are designed with safety in mind. That airbag and those crush cans under the hood may very well have saved your life.
And I think that's a healthier outlook than wallowing in the personal loss that you've just experienced. It's also accurate. You DO have something to celebrate in a tragedy, almost any tragedy, because it most certainly could have been worse. It's a fine time to recognize the efforts of those who've made it so. But it's also a time to recognize the responsibility you have.
If a tragedy occurs, it's the responsibility of the individuals involved and society as a whole to examine the tragedy, and determine what, if anything, should be done to try to prevent or ameliorate such events in the future. In the car crash example, maybe you were driving while texting – or maybe you were hit by a drunk driver on the wrong side of the road. In the first case, STOP THAT. (I have). In the second, you probably couldn't have avoided the accident, so society must find a solution. (We haven't yet.)
While both "Thank you God!" and "Thank you engineers!" might produce the same palliative effect, "Thank you engineers!" is a much more honest and accurate sentiment. It empowers us to make things better, where "Thank you God" just makes some of us feel better. It also absolves us of responsibility, and that's a problem. If you're a religious person, by all means thank whatever form of god you're worshipping, but don't let that blind you to the fact that you have an opportunity and even an obligation to be a part of a solution to help prevent these tragedies in the first place.
Even if there is a higher power up there who dictated the actions of engineers or moved the tree slightly to the left so it wouldn't crush your skull, the engineers in the AIRES 737 example deserve credit. They rarely get it, and that's why the media approach to this incident is a "miracle."
Ok, it's not a miracle, but it sure is nice to see competent journalism. I'd like to see more.
UPDATE: I was just contacted by Patrick Smith who wrote a similar article for Salon on August 18th. (I wrote my article on August 19th.) There's an interesting story about the similarities between the two articles that I will relate in a follow up article this weekend. In the mean time, please read his excellent article.
As part of my responsibility as a good parent, I try to be informed about the television shows and movies my son is watching. I often sit and watch them with Atom and we discuss the content. I certainly don’t think kids shows should have to demonstrate a skeptical perspective. It is pleasing though, to occasionally find shows that take on a problem with the tools of science and critical thinking.
I have seen excellent examples of this on Arthur, which has an episode debunking an urban legend and another taking on UFO claims. We enjoy several PBS Kids programs such as Curious George, Cyberchase, and Sid the Science Kid, all of which regularly use scientific thinking to solve problems. The Nick Jr. series Backyardigans (pictured) has a great episode about the Yeti that challenges both extreme credulity as well as knee-jerk skepticism as it lets the evidence lead viewers to the answer. Of course there’s also good old Scooby-Doo, the prototypical skeptical cartoon.
Cartoons get it very wrong sometimes too. The above-mentioned Curious George, a program funded in part by the National Science Foundation, featured and episode with a naturopath and a bunch of ridiculous claims. Even the beloved Scooby-Doo has a number of later episodes with supernatural solutions to the mysteries and there are always the elaborate conspiracies to blame when the supernatural won’t do.
Nothing gets it more wrong than the Robert Zemeckis directed animated feature, The Polar Express. I won’t go into too much detail here, as I intend to write an entire post on The Polar Express but it isn’t just a credulous fantasy film. I have no problem with that. Kids do a great job of navigating the line between fantasy and reality. The Polar Express is an outright attack on skepticism. The film takes an intelligent kid with actual evidence that Santa doesn’t exist and bullies him into believing by making him look like a bad person for having doubts. Let me stress that I don’t think kids films should have to be skeptical. They are often intended only to entertain. I just find the core message in The Polar Express to be anti-skeptical and that is a little troubling.
I would be very interested in hearing from others about skepticism and woo in children’s TV and films that they have stumbled across. Perhaps I will compile a list of shows and movies that get it right as well as those that get it wrong.