Tag Archives: medicine

Labelling Homeopathic Products

Earlier this year the UK’s MHRA opened a consultation to help them decide how homeopathic products should be labelled when sold to the public. As expected, Ben Goldacre — devoted critic of homeopathy, pseudoscience and general quackery — suggested a label of his own and asked his readers for further suggestions.

Some of the suggestions were truly fantastic (and proved that I couldn’t come up with an original joke, no matter how hard I tried), and so Goldacre published some of the best suggestions for homeopathic labelling in his column for The Guardian:

On instructions, we have “take as many as you like”, since there are no ingredients. The proposed belladonna homeopathy pill ingredients label simply reads “no belladonna”, which is a convention the MHRA could adapt for all its different homeopathy labels. Other suggestions include “none”, “belief”, “false hopes”, “shattered dreams”, and “the tears of unicorns”.

For warnings, we have: “not to be taken seriously”, “in case of overdose, consult a lifeguard”, and “contains chemicals, including dihydrogen monoxide“. This, of course, is a scary name for water, which became an internet meme after Nathan Zohner’s school science project: he successfully gathered a petition to ban this chemical on the grounds that it is fatal when inhaled, contributes to the erosion of our natural landscape, may cause electrical failures, and has been found in the excised tumours of terminal cancer patients.

The comments on both articles are real gems for those in need of a laugh today.

via @IrregularShed

Medicine, Specialism, and the Scientific Education

In the commencement speech he delivered to the graduates of Stanford’s School of Medicine earlier this year, Atul Gawande eloquently (as ever) examined the state of modern medicine (in the U.S. specifically, the world generally), the problem with specialism, and the problem of specialists trying to fit into a system not necessarily designed for it.

I particularly like Gawande’s analogy on the experience of a scientific education:

The experience of a medical and scientific education is transformational. It is like moving to a new country. At first, you don’t know the language, let alone the customs and concepts. But then, almost imperceptibly, that changes. Half the words you now routinely use you did not know existed when you started: words like arterial-blood gas, nasogastric tube, microarray, logistic regression, NMDA receptor, velluvial matrix.

O.K., I made that last one up. But the velluvial matrix sounds like something you should know about, doesn’t it? And that’s the problem. I will let you in on a little secret. You never stop wondering if there is a velluvial matrix you should know about.

via Intelligent Life

The Evidence For (and Against) Health Supplements: a Visualisation

After collating the results of over 1,500 studies and meta-studies (only “large, human, randomized placebo-controlled trials” were included), Information is Beautiful’s David McCandless collaborated with Andy Perkins to produce a comprehensive data visualisation mapping the the effectiveness (or not) of a wide range of health supplements (there’s a static image and interactive Flash version available).

Some of the findings:

  • Green tea has been shown to lower cholesterol in a large number of studies, but there’s no sign of cancer prevention properties.
  • There’s strong evidence showing Omega 3‘s cholesterol-lowering abilities and good evidence indicating it can help improve some ADHD behaviour and lower blood pressure. In terms of preventing arthritis and cancer, and in relieving depression, the evidence is conflicting.
  • Fish oil has been shown to help lower blood pressure and the risk of secondary heart disease, but the evidence for it improving general health isn’t strong (but is promising).
  • Vitamin D is fantastic: great for all-round general health and cancer prevention.
  • Vitamins A and E aren’t beneficial for much at all, while Vitamin C studies are somewhat conflicting.
  • Beta carotene‘s position surprised me: there is little-to-no evidence of any health benefits. The same goes for acai and goji berries, ginkgo biloba and copper.

The raw data used to generate the visualisation is available–along with citations–in a Google document that is occasionally being updated.

The Anti-Vaccine Movement and the Rejection of Science

Already covered to death, it’s been on my bookmarks list since I read the following from Wired editor Mark Horowitz on it’s day of publication:

Best/worst day. Story I am proudest of assigning and editing at Wired goes live today. […] But I also lose job. Bummer!

That story is a fantastically well written and researched article looking at the snake oil peddled by the anti-vaccine crowd and why people listen to, and fall for, their pseudo-science (i.e. perceived risk and irrationality).

The rejection of hard-won knowledge is by no means a new phenomenon. In 1905, French mathematician and scientist Henri Poincaré said that the willingness to embrace pseudo-science flourished because people “know how cruel the truth often is, and we wonder whether illusion is not more consoling.” Decades later, the astronomer Carl Sagan reached a similar conclusion: Science loses ground to pseudo-science because the latter seems to offer more comfort. “A great many of these belief systems address real human needs that are not being met by our society,” Sagan wrote of certain Americans’ embrace of reincarnation, channeling, and extraterrestrials. “There are unsatisfied medical needs, spiritual needs, and needs for communion with the rest of the human community.”

Looking back over human history, rationality has been the anomaly. Being rational takes work, education, and a sober determination to avoid making hasty inferences, even when they appear to make perfect sense. Much like infectious diseases themselves — beaten back by decades of effort to vaccinate the populace — the irrational lingers just below the surface, waiting for us to let down our guard.

I post this now as in recent days Andrew Wakefield—the physician who linked the three-in-one MMR vaccine to autism—has had his original article fully retracted by the medical journal The Lancet after the General Medical Council found he acted “dishonestly and irresponsibly” with “callous disregard” and had a conflict of interest in his study.

The Health Care Debate To Date

For the health care debate that has been raging in America of late, I have subscribed to the same philosophy as Ben Casnocha:

I’ve decided I’m just going to read it about once it’s resolved.

You can’t keep up with everything. Rather than lightly follow along and skim articles and pretend to be informed, I’m consciously opting out. I rarely do this when it comes to current affairs — I’m kind of a junkie — but I must say, this time around, it feels liberating.

The debate was also covered widely here in the UK and coverage has, at last, died down. As such I decided it was time to start reading about the progress to date, and came across David Goldhill’s extensive and penetrating piece in The Atlantic that, as Alex J Mann rightly says, contains “everything you need to or should know [about the health care debate]”.

The piece begins with this admission;

I’m a businessman, and in no sense a health-care expert. But the persistence of bad industry practices—from long lines at the doctor’s office to ever-rising prices to astonishing numbers of preventable deaths—seems beyond all normal logic, and must have an underlying cause. There needs to be a business reason why an industry, year in and year out, would be able to get away with poor customer service, unaffordable prices, and uneven results—a reason my father and so many others are unnecessarily killed.

and continues with the following statement that really won me over:

So before exploring alternative policies, let’s reexamine our basic assumptions about health care—what it actually is, how it’s financed, its accountability to patients, and finally its relationship to the eternal laws of supply and demand.