The Best Science from The New England Journal of Medicine

The editor-in-chief of The New England Journal of Medicine has selected a dozen articles published during his tenure that epitomize the best of science-based medicine. This is the Science-Based Medicine blog, but all too often we talk about things that are not science-based medicine. Examining what is not science-based medicine is a good way to better understand what science-based

Chronic Fatigue Syndrome and Rituximab

IV rituximab has been used to treat chronic fatigue syndrome. A large, well-designed new study shows it doesn’t work. Chronic fatigue syndrome (CFS), also known as myalgic encephalomyelitis (ME or ME/CFS), is a poorly-understood condition characterized by profound fatigue and a constellation of other symptoms. The diagnostic criteria, cause, pathophysiology, and treatment have been embroiled

Medical Apartheid

Harriet Washington’s book tells the dark history of medical experimentation on black Americans. It also reveals broader problems of inequality, poor science, and human failures. Harriet Washington In a recent post, Clay Jones reminded us that “the unconscious need to avoid cognitive dissonance serves as a powerful motivation to rationalize even the most horrific beliefs

The “Evidence” for Prodovite Is Junk Science

Prodovite is a liquid nutritional supplement marketed as “nutrition you can feel.” The claims are pseudoscientific nonsense and the single unblinded clinical study is junk science that relies on a bogus test: live cell microscopy. I recently got an email asking: What are your thoughts on this supplement? It seems to be a very good

The Tuskegee Syphilis Experiment: A Fiasco with a Silver Lining

The Tuskegee syphilis experiment studied black men with advanced syphilis for 40 years. Patients were lied to and prevented from getting treatment. A black mark in the history of American medicine, it led to important reforms. The Tuskegee experiment was one of the most regrettable incidents in the history of medicine in the U.S. Conducted

The Magic Feather Effect: Placebos and the Power of Belief in Alternative Medicine

In her book The Magic Feather Effect, journalist Melanie Warner covers placebo research, shows that alternative medicine is placebo medicine, takes a “try it yourself” approach, and gives belief and anecdotes more credit than they deserve. In the movie Dumbo, a little elephant with large ears can fly by flapping them like wings, but he refuses to

Osteopenia: When Does Decreased Bone Density Become a Disease Requiring Treatment?

Osteoporosis is routinely treated with bisphosphonates to prevent fractures. A new study suggests that osteopenia should be treated too. But questions remain.  Bisphosphonate drugs have been shown to increase bone density and prevent fractures in postmenopausal women with osteoporosis (remember Sally Field in those ads for Boniva?) but what about women with milder decreases in

Vertigo Voodoo: A Crazy-Sounding Cure That Actually Works

A sequence of positional changes sounds like voodoo, but is actually an effective way to cure benign paroxysmal positional vertigo (BPPV). This will not be my typical Science-Based Medicine post. What it is not This will not be: About vaccines, diet, pseudoscience, quackery, or alternative medicine A critique of a questionable treatment, claim, or practice

The Debate Is Over: Antidepressants DO Work Better Than Placebo

  Depression can kill. Antidepressants can help. A meme that continues to appear regularly in the media and in the comments section of this blog is “antidepressants are no better than placebo.” It is a false belief based on a faulty interpretation of the evidence. A new study has just come out that should put

Another Acupuncture Study – On Heartburn

Patients with heartburn are often diagnosed with GERD (gastroesophageal reflux disease) and treated with a drug called a proton pump inhibitor (PPI) to reduce stomach acid production. It is pretty effective, but it doesn’t always work. When it doesn’t, standard practice has been to double the dose of PPI. Doubling the dose only improves symptoms