26 April, 2009

Sunday Sensational Science

Doctors in the Blogosphere

So, we have an outbreak of swine influenza in Mexico, a chronic infestation of "healers" who wow with woo, and loads of health misinformation everywhere we turn. It's turning critical. Someone call a doctor-blogger!

In this edition of Sunday Science, we'll be making the medical rounds. And don't forget to refer us to your favorite physician in the comments.

Dr. PalMD, The White Coat Underground

A practicing physician in Detroit, MI, PalMD is many things: a delighted dad, a devoted doctor, and a relentless foe of woo. He's become one of my favorite Science Bloggers. And if I lived in Detroit, he'd be my physician. Like the other bloggers I'm highlighting, he really knows his stuff. He's also got a snarky sense of humor and isn't afraid of the word "fuck." If he's accepting new patients, I think we'll just have to make him the official doctor of En Tequila Es Verdad.

In this recent post, he takes down another woo pusher:

The other day, I wrote about the fake health experts at the Huffington Post. Prominent among them is "Dr" Patricia Fitzgerald. Now, we already talked about how writing a health piece in a major media outlet and using the title of "Dr" can be deceptive; the reader is likely to assume you are a medical doctor. In Fitzgerald's case, she isn't anything resembling a medical doctor, or even a health expert.

Like many of HuffPo's so-called health experts, she's selling something. While I'm all for capitalism, she presents herself as something she is not---a legitimate doctor. Let's examine what she is and is not.

Patricia Fitzgerald is a licensed acupuncturist, certified clinical nutritionist, and a homeopath. She has a Master's Degree in Traditional Chinese Medicine and a Doctorate in Homeopathic Medicine.

There are two types of "real" doctors licensed to practice medicine in the US: Medical Doctors (MDs), and Doctors of Osteopathy (DOs). Anyone else claiming to treat common medical conditions is often practicing unlicensed care, or is licensed in a limited way to provide some health-related services.

None of the qualifications listed make her an expert in immunology, infectious disease, toxicology---all topics she has addressed at HuffPo. I'll have to take her on her word that she is Doctor of Homeopathy---most doctors would give a little more information, like what the hell this doctorate is and what institution and board granted it. This is pretty important given that homeopathy is seen as a fringe cult-like practice by anyone who understands science.

The Doctors Revere, Effect Measure

No bloggers do better work on pandemic disease and the CDC than the Reveres. They know their stuff, being senior public health officials and practitioners. They're currently on top of the swine flu outbreak, so head on over there if you've got questions needing answers. The post I'm highlighting here discusses some of the most recent research on influenza:

Every day, it seems, we find out that what we thought we knew about flu isn't the case. As one noted flu expert said to me once, "I knew much more about flu 20 years ago than I do now." So it's good to remember that we are also finding out a lot about flu that we never knew or even thought we knew. A case in point is an extremely important new paper in PLoS Medicine ( Khurana S, Suguitan AL Jr., Rivera Y, Simmons CP, Lanzavecchia A, et al.(2009) Antigenic Fingerprinting of H5N1 Avian Influenza Using Convalescent Sera and Monoclonal Antibodies Reveals Potential Vaccine and Diagnostic Targets. PLoS Med 6(4): e1000049; online as of last night). This work makes a major advance in the science of antibody response to avian influenza/H5N1 ("bird flu"). The advance has two aspects. One is the information the work generated. Even more important is the second part: opening up specific new questions for further research.

Unlike much H5N1 work, this isn't based on experiments in mice, as important and fruitful as such work is and has been. Instead it examines the antibody response of victims of a 2004 bird flu outbreak in Vietnam. Of 18, 13 died. Blood samples were obtained from the survivors during their recoveries. These patients lived long enough to get a response from the part of their immune system that makes antibodies.
Orac, Respectful Insolence

Orac's a surgeon and equally-gifted writer who's expert in taking down anti-vaccine fanatics. I do believe we're going to have to press-gang him on board the HMS Elitist Bastard one of these days. In the meantime, you can enjoy a break from the anti-vacciners with him, and beat up on the Brassagers instead:

This time around, it's not just any woo. In fact, it's woo that relates to my area of expertise. As you may recall, I do a lot of breast cancer surgery, and I run a lab the focus of whose research is breast cancer. And what woo it is! it's a shame that it may now be off the market. Well, not really, and it's not even clear to me that it is off the market. After all, you can still buy Airborne, even though the company was fined millions for making exaggerated and false advertising claims. I still occasionally see Enzyte "male enhancement" commercials even though the company that makes Enzyte was similarly fined big time and its CEO is facing a prison term. So, I'm not surprised that I'm still seeing the website for the Brassage pushing the same woo. What is the Brassage, you ask?

It's serious, serious woo. Indeed, it claims to be able to "stimulate" lymphatic flow in the breasts and thereby--well, why don't you take a guess what "stimulation" of lymphatic flow in the breasts will do, ignoring for the moment that a bra isn't going to stimulate lymphatic flow in the breasts?

Dr. Steven Novella, Neurologica Blog

He teaches at Yale. That's our first clue that he's good. The proof, however, is in the writing, and Dr. Novella delivers the evidence. His blog covers all things woo, not to mention kneecapping creationists and teaching science. In this post, he sets the record straight on what studies show about homeopathy:

The Cochrane Collaboration, an organization dedicated to evidence-based medicine, has published a review of studies of homeopathic treatments for side effects of radiation therapy and chemotherapy for cancer. The results are unimpressive - consistent with the null-hypothesis that homeopathic remedies have no effect. And yet the review is being distorted to promote a very misleading bottom-line to the press - that homeopathic remedies have a role to play in cancer therapy.

One point has been made clear - the treatments under study are not for cancer itself, but for the side effects of standard cancer therapies: radiation and chemotherapy. However, the results are being presented as if they support the efficacy of homeopathic remedies, when they do not.

Other blogs of note.

Due to the lateness of the hour, the increasing length of this post, and the fact that I want to get back to drooling over Dr. Chase watching House, I'm alas out of time. But that doesn't mean I'm out of medical blogs. All of them are well worth a read.

ERV: What you need to know about the cutting-edge of HIV research, ERV's got, along with some of the best smackdowns in the blogosphere.

Neurotopia: What's better than a neuroscience blog written by a guy called the Evil Monkey? Nothing. Start with this post.

DrugMonkey: Home of both DrugMonkey and PhysioProf. I don't need to say any more, now, do I?

Science-Based Medicine: This site is a veritible cornucopia of doctors writing excellent posts on medicine. It's even got a veternarian contributing. Pseudoscience, beware!

(Sorry, no pics this time - I'll make it up to you next week.)

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