Archive for the ‘Teachable Moments’ category

The 116th Meeting of the Skeptics’ Circle:The Wooful ER

July 30, 2009

It’s time for your favorite blog carnival and mine, the Skeptics’ Circle!

 I had the most horrible dream the other day. After watching a Mitchell and Webb Sketch about a homeopathic ER, I had nightmares of being trapped in an ER just chock full of Woo, and other nonskeptical gibberish.

Walk with me, through the valley of woo, in the nightmare that is the wooful ER.

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What does “Treatment of Neck Pain: Noninvasive Interventions” tell us about chiropractic

June 30, 2009

ResearchBlogging.org
 Those following our Spot the Mistake posts (here, and here) will notice someone has claimed we’ve gone “…on a chiropractic witch hunt”. As it happens, I disagree. Those who haven’t been following along, this post is an overview of the evidence for or against manipulative therapies (which includes chiropractic) in neck pain, as covered by this particular article from spine. It’s framed as a response to a specific commentors post here.

Let’s give Nick alot of credit for walking into potentially hostile territory though. Let’s give him even more credit for defending his ideas with a citation. He cited the article mentioned in the title, “Treatment of Neck Pain: Noninvasive Interventions, Results of the Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders.” Full citation at the bottom of the page.

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Spot the Mistake (Chiropractic Edition)(updatedX2)

June 25, 2009

Let’s play a game! After my little blurb, I’ve posted something seen in a presentation made by a medical student, on chiropractic. In the comments post all the ways in which the student’s comment is wrong.

Some background: At my med school, there is a senior elective class where one can independently study and research an area of health care that isn’t covered in detail in our curriculum. This student chose chiropractic. Specifically he chose “Evidence based medicine applied to chiropractic.”

Disappointingly the presenter was not up on how to read or understand evidence based medicine.  It’s disappointing because the student in question is an “honors” level student, and will be going on to do his residency at Mayo clinic, in a very competitive speciality.

Among other things, he took Cochrane reviews, and called them biased. He didn’t identify any particular bias. He just picked the author of the Cochrane review and said that this author was against chiropractic. Throughout the presentation he had scattered statistics that “proved” the usefulness of chiropractic.

The worst part of all this, is that his presentation was supposedly reviewed by a clinical professor BEFORE the presentation. I’m hoping that the doctor in question was just busy, because if not, some attending at my school has some ‘splainin to do.

At any rate, I’ve presented the text of the worst slide below. In the comments, post why you think he’s wrong. If possible pop a reference on, but there are multiple right answers that don’t require any research at all!

Chiropractic is, hands down, safer than conventional therapy!

  • The rate of the worst complication (vertebrobasilar artery dissection) is at best 1 in 10000.
  • Compare this to a 0.4% mortality rate with chronic NSAID use.

There are lots of ways in which this is wrong, pick your favorite.

Hint: More than one of the reasons this is wrong are completely independent of the accuracy of the statistics he provides.  That is, the rate of vertebral artery dissection really could be 1 in 10000 (which I doubt, but research to follow with my answers tomorrow) and he’d still be wrong.

 

Answer to follow tomorrow, with a little bit of research blogging thrown in for good measure.

 

UPDATE:

Totally slipped my mind when I initially posted this. There is also a highly entertaining post over at Science Based Medicine on Chiropractic.

If you end up reading through the comments you’ll see that not all doctors understand anything at all about science.

UPDATE 2:

This is probably going to be hard to pick out without the context of the presentation around it. I’m looking for problems with the actual comparison of the rates given. This is not an apples to apples comparison, and he should have known better.

Cervical Cancer Alt-Med Tragedy (an anecdote)

June 9, 2009

In tragically ironic timing with the AP finally doing decent work on any alt-med, yesterday I saw another victim of alt-med.  Our patient was a woman with cervical cancer who opted against conventional therapies. She’s now paying the price.

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What Operation Rescue Doesn’t Understand About Abortion.

June 5, 2009

This is not a political blog. This is a medical, and sometimes a science blog. Mostly it’s a blog about combating willful ignorance. So as I write the rest of this post, set aside your party affiliation, your rhetoric, and just be a human being for a few minutes.

I’ve been pondering George Tiller’s murder over the past few days, it’s left a bitter taste in my mouth. Abortion is a complicated issue, everyone carries their own baggage of beliefs to the conversation.

 What is indisputable is that someone murdered George Tiller, for practicing medicine. Yet people are primarily discussing his death in terms of how it helps or hurts their movement. Worse, they caricature Tiller as a villain, and then characterize abortion as “Murder”.

The decision to abort is never a simple one. It’s even more complicated in the case of late term abortions. Characterizing a doctor who decides to do this procedure as a “murderer” is beyond ridiculous. It’s disingenuous. And like all things I discuss here, it’s all about ignorance.

 Lets have a little respect for a man whose job involved more difficult decisions, and more heart-breaking stories in a day than most of us have to make in a life time.

It’s never easy to make the decision to abort. This is especially true for late term abortions. How do I know?

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Daniel Hauser, Child Neglect, and Freedom

May 21, 2009

We recently discussed informed consnt as it applies to the Daniel Hauser situation. Since then, Jane Doe left a comment on that post which I felt justified me explaining my full thoughts on the subject.

Jane Doe appears to be exactly the kind of person who I fear.  As far as I can tell she’s a well spoken, polite, intelligent woman, who cares about her children. Despite this, she this is about freedom.

It’s not.

It’s about child neglect, and informed consent. (more…)