People are sometimes surprised to learn that all the heavy hitters of alternative medicine, such as acupuncture, chiropractic, homeopathy, etc., are inflicted on animals as well as humans. I’ve written about veterinary homeopathy, and the associated manufactroversy, in a previous post, and today I thought I’d take a look at veterinary chiropractic.In most states, chiropractic is defined in terms of treatment of humans and chiropractors are thereby licensed only to treat humans. However, there are a variety of ways around this for people who want to subject their animals to this therapy. Some chiropractors will simply treat animals and ignore the fact that it isn’t technically legal for them to do so. And some veterinarians will take one of the many training courses available in animal chiropractic and then employ it as part of their practice of veterinary medicine. A previous SBM article has discussed the lack of consistency or legitimate scientific content in most of these courses.If there’s a characteristic that’s common among proponents of alternative medicine, it’s tenacity. The willingness to stick with an idea, no matter the evidence, must give one a certain clarity. The naturalistic fallacy is often the foundation. Natural is good, synthetic is bad, no matter the evidence. In some cases, in spite of the evidence. How one deals with contradictory evidence is an effective tool to differentiate between medicine and alternative medicine – given sufficient convincing evidence, medicine changes its practices. The same can’t be said for alternative medicine, where few treatments are ever discarded. Otherwise practices like homeopathy, acupuncture, reiki, and chiropractic would have disappeared long ago. It’s also why disproven products continue to have occasional resurgences in interest. Cranberry is one. It has been touted as a treatment and a preventative for urinary tract infections for years. And it doesn’t seem to work not well, and not reliably, if you look at all the trials. And that’s being generous, considering the work.
I know a dead parrot when I see one. Yet its advocates, mainly manufacturers keep insisting it’s alive, supported by the occasional positive report that appears. With a new systematic review and meta-analysis that declares it’s effective, it’s time to update our review. Continue Reading The integrity of the scientific basis of medicine is under attack from numerous fronts. It is not only the intrusion of pseudoscience and mysticism into mainstream institutions of medicine, but also attempts to distort or game the scientific process for ideological and financial reasons.Ideological groups such as the anti-vaccine movement, or grassroots organizations promoting pseudodiseases such as chronic Lyme, electromagnetic sensitivity, or Morgellon’s often misrepresent the scientific evidence while they lobby for special privilege to avoid the science-based standard of care within medicine.Pharmaceutical companies, with billions on the line, have been very creative in figuring out ways to optimize their chances of getting FDA approval for their drugs, and then promoting their drugs to the medical community. Ghost-writing white papers, hiding negative trials, and designing trials to maximize positive outcomes have all beendocumentedAs usual, I was impressed with Mark Crislip’s post on Friday in which he discussed the boundaries between science-based medicine and what we sometimes refer to as woo or what Mark often refers to as sCAM. It got me to thinking a bit, which is always a dangerous thing, particularly when such thinking leads to my writing something for my not-so-super-secret other blog. Of course, this is not my but that doesn’t make it that much less dangerous. Be that as it may, I started thinking about a gambit I started noticing a few years ago being directed at me by the targets of my logorrheic deconstructions. Actually, I noticed it from the very beginning, when I first started blogging about versus quackery way back and even before, back when I was one of a doughty band of pro-science types who waded into the Wild West of online forums known as Usenet, in particular the misc.health.alternative newsgroup.I happen to be in Washington, DC as I write this. In fact, as I write this I’m here to attend the annual meeting of the American Association for Cancer Research the better to soak in all that cancer science goodness andbe pumped up to go back and keep trying to do good science and, hopefully, manage to get my lab funded. Of course, the latter task is a really daunting these days, a truly depressing thing to contemplate, given that the current payline for the National Cancer Institute is around the 7th percentile, which makes me worry about how much longer my lab will be open. My self pity aside, Mark got me to thinking about the characteristics of purveyors of non-science-based medicine compared to. More precisely, I started thinking about a difference that what Mark calls sCAMmers try to pin on those of us who try to defend against the forces of pseudoscience. To introduce this concept, I think it’s worth going back a few years to a comment I got a long, long time ago on a blog far, far awayVacation then taxes have consumed my focus the last two weeks, and I have had little time to devote to issues of infectious diseases, much less SBM, so I will instead meander around a more philosophical terrain. I feel guilty when I do not have a substantive, data driven post evaluating a paper or essay in detail, but some weeks there just is not the time.Being involved with SBM has been, like all intellectual endeavors, a process rather than result. I keep experimenting with conceptual frameworks with which I can understand the differences between a SBM approach and a SCAM (supplements, complementary and alternative medicine) approach. Nothing clarifies thoughts quite like writing them down. Or maybe not.The motto of the blog is “exploring the relationships between science and medicine” but it is often more about non-overlapping boundaries* than relationships. We are often separated more by Berlin walls than Venn diagrams.There are perhaps four boundaries that separate science-based medicine from those check.
At work I am an Occam kind of guy. Continue Reading »who practiced homeopathy. He managed to include all articles monographed in the Homeopathic Pharmacopeia of the United States in the definition of drugs within the although why he did so remains in dispute. The HPUS is a source for monographs, identity, methods of manufacture, standards and controls and potency levels of homeopathic products, both prescription and product , it’s legal. interested in knowing if one of their passwords was one of the less secure may use this tool to check their email address. No matter the result with that tool, the only way to be secure is to change your password on other sites if you also used it here.ScienceBasedMedicine.org was recently hacked, and user account information may have been stolen: usernames, passwords, and email addresses. Most of the potentially stolen passwords were strongly encrypted that is, extremely difficult to read. About random accounts, roughly of the total, were not protected as effectively and may be at greater risk.If your SBM password was used for any other service, website, or account, you should change that duplicate password as soon as possible. (For example: if your SBM password is the same as your password for Gmail, you should immediately go to When hackers get your password from one place, they often try to use the same password with other services and websites. Unfortunately, this is a fairly effective strategy, because many people use the same password for many of their logins. This is why all security experts strongly recommend using unique passwords for all critical services.On Sunday, March 10, hackers successfully gained access to the SBM server, and attempted to use it to attack other servers. Eventually it gave itself away by using too much computing power.On Monday, April 1, our hijacked server was shut down by the service provider. We remained offline for a full day as we repaired the damage and strengthened our protections against hackers. SBM is now back online but all users will have to reset their passwords before commenting again.There is no way to know if the attacker actually took any data from ScienceBasedMedicine.org itself, but the safest course is to act on the assumption that they did. However, most of that data was strongly protected by encryption standard practice for user account information on WordPress blogs for exactly this reason. You can find details on this encryption hereNevertheless, we know that some of the passwords again, only aboutwere less protected. pecifically, they used an older-based encryption.) Therefore, we strongly urge all users to make sure they are not using their password anywhere else.For many years I have been using Continuing Medical Education programs offered by the American Academy of Family Physicians . The FP Essentials program consists of a monthly monograph with a post-test that can be submitted electronically for 5 hours of redit. Overhj-year cycle, a complete family medicine curriculum is covered to prepare participants for the re-certification board exams. Some examples of typical subjects are skin cancer, hand and wrist injuries, valvular heart disease, and care of the newborn. I rely on these programs to learn, review, and keep up-to-date in my specialty. Imagine my dismay when I opened the latest package to find a monograph on Integrative Medicine.First it was called various names like folk medicine, quackery, and unproven/untested treatments, then all of those (the less rational right along with the more rational were lumped together under the umbrella term “Alternative Medicine,” then it became “Complementary and Alternative Medicine” and now it has been re-branded as “Integrative Medicine.” The term is designed to make unscientific treatments seem more acceptable to science-based doctors. “Integrative Medicine” is a marketing term, not a meaningful scientific category. It is a euphemism for combining Complementary and Alternative Medicine with mainstream medical practice, unproven with proven, magic with science. It has been critiqued many times on this blog. We have stressed that there is only one medicine, and that when a treatment is proven to work by good evidence, it is just “medicine.” When the evidence for a CAM treatment is not good, it essentially amounts to experimental treatments and/or comfort measures. Worse, sometimes CAM even persists in using treatments that have been proven not to work or that are totally .
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