Heralded as a revolution in mental health care – a cost-effective way to deliver evidence-based psychological help to large numbers – low-intensity Cognitive Behavioural Therapy (CBT) is recommended by NICE, the independent health advisory body in England and Wales, for mild to moderate depression and anxiety.
Prior studies into its effectiveness have been promising. However, little research has looked at whether the benefits last.
This researcher may have discovered the antidote to health bullshit – Vox – by Julia Belluz and Alvin Chang – Jul 17, 2017,
Andy Oxman is obsessed with the study of bullshit health claims and how to prevent them from spreading.
Oxman, now the research director at the Norwegian Institute of Public Health, started to wonder whether the best hope for bullshit prevention lay with children.
The little classroom visit convinced Oxman he had to start schooling people in the ways of bullshit detection early in life.
So he began working with other researchers from around the world to develop curricula — a cartoon-filled textbook, lessons plans — on critical thinking skills aimed at school children. Continue reading
‘What Used to Be Fraud Is Now Alternative Medicine’ | Medpage Today | by F. Perry Wilson MD, MSCEF. Perry Wilson MD, MSCE June 28, 2017
I’m appalled at how the government is pushing unproven “alternative” treatments as substitutes for proven and effective opioid therapy. Here are the most pertinent parts of the interview (you can listen to the podcast of it at the link above).
As a physician, Novella has spoken out against homeopathy, acupuncture, and other alternative medicine modalities, based on a lack of robust evidentiary support or prior plausibility.
I had the chance to speak with Novella in the studios at Yale. We discussed a wide variety of topics ranging from the public’s view of science and scientists to interacting with patients who hold nonscientific beliefs. Continue reading
In the first of this two-part article, I discussed six popular tricks of the quackery trade.
Some readers pointed out that these ploys are not exclusively used in alternative medicine. I agree.
Quacks are everywhere, and unfortunately conventional medicine has its fair share of charlatans as well. Yet I would nevertheless suggest that the ploys mentioned in part one and the eight discussed below are more often used in alternative than in mainstream medicine. Continue reading
In every industry, from education to healthcare to travel, the generation of quantitative data is considered important to maintain quality through competition.
Yet statistics rarely show what they see.
If you look at recent airline statistics, you’ll think that a far higher number of planes are arriving on schedule or early than ever before. But this appearance of improvement is deceptive.
Airlines have become experts at appearance management: by listing flight times as 20-30 percent longer than what the actual flight takes, flights that operate on a normal to slightly delayed schedule are still counted as arriving ‘early’ or ‘on time’. A study funded by the Federal Aviation Administration refers to the airline tactic as schedule buffering. Continue reading
Insufficient Evidence: How Opioid Deniers Spin Studies — Pain News Network – By Roger Chriss – April 2017
Researchers cannot and do not investigate if “opioids” work for “chronic pain.”
Good research is more narrowly focused, such as these clinical studies:
- “Tapentadol extended release for the management of chronic neck pain”
- “Effectiveness and Safety of Once-Daily Extended-Release Hydrocodone in Individuals Previously Receiving Immediate-Release Oxycodone for Chronic Pain”
- “Oxycodone for neuropathic pain in adults”
The results are equally specific. Continue reading
This document, which I found on a hospital website and annotated below, is a leftover from the “good old days” when doctors were actually obliged to provide effective pain care (and even too much in too many cases).
In the 1990’s, a lot of effort and money was spent trying to convince the public that opioids were safe if used responsibly for legitimate pain control – which they truly are, of course. Or they were before 2000, when the pendulum started heading back to the demonization of all opioids.
All the money spent publicizing and advocating for the use of opioids for proper pain control before 2000 is dwarfed by the amounts now being spent to demonize those very same opioids. Compassion for people with chronic pain evaporated. Suddenly we became lazy and self-indulgent addicts, and we were shunned. Continue reading
Hyperalgesia: No Reason to Stop or Reduce Opioids – May 30, 2017 – by Forest Tennant M.D., Dr. P.H.
One of the excuses that some health practitioners are using to stop opioids is to claim a patient has hyperalgesia (HA).
This is a most dishonest, devious, and dangerous ploy.
First, the definition of hyperalgesia is simply that a stimulus such as hitting your thumb with a hammer is more painful than usual.
Second, there is no way to measure or quantify the presence of HA in a chronic pain patient who takes opioids. Continue reading
Want More Trust in Medical Science? Embrace Uncertainty and Cut the Hype – John Mandrola, MD – April 2017
…in this week of righteous celebration of science, certainty will be favored over uncertainty, as will acceptance over skepticism.
This, I believe, is a core reason science has a trust problem. An old mentor warned me of the danger of hubris. Hubris, he said, was the doctor’s greatest enemy.
I see a lot of overconfidence in medical science. Continue reading
This turns out to be a lesson in BS detection: an old article citing decades-old research repurposed as though new.
The association between anxiety disorders and pain may be stronger than the association between depression and pain. Learn more about the most common anxiety disorders seen in pain patients, as well as new DSM-5 diagnostic criteria.
I checked the 62 references supplied at the end of the article and found that half are from the previous century: Continue reading