How Do Doctors Learn to Diagnose, and Can Machines Learn to Do It, Too?

Siddhartha Mukherjee weighs in on how doctors arrive at a diagnosis and how computers can assist but not replace them. Is this the doctor of the future? Probably not. I am a big fan of Dr. Siddhartha Mukherjee, a cancer physician, researcher, and stem cell biologist who is also a phenomenally gifted writer and an unequaled

Re-thinking Antioxidant Supplementation for Macular Degeneration

After the AREDS trial, people with moderate to severe age-related macular degeneration were advised to take dietary supplements to slow the progression of the disease. But some experts say the trial actually showed supplements don’t work, and might even make some patients worse. Age-related macular degeneration (AMD) is a leading cause of blindness. Known risk

Misinterpreting TACT: No, Chelation Does Not Outperform Statins for Heart Disease

Chelation with intravenous EDTA (disodium ethylene diamine tetra-acetic acid) has long been used for heavy metal poisoning. It binds the metal ions and facilitates their excretion from the body. In recent years it has been used for many other indications that are not evidence-based, such as autism and coronary heart disease. The Trial to Assess

American Academy of Family Physicians Home Study Course Recommends Non-Science-Based Treatments

Strong medicine…along with a little nonsense Since passing my board exams in family practice in 1979 I have relied heavily on the American Academy of Family Physicians for continuing medical education via the American Family Physician and the AAFP home study programs. The AAFP prides itself on its evidence-based approach to medicine. In general, it delivers. But

Homeopathy and the UK’s National Health Service

Homeopathy is arguably the silliest form of alternative medicine: the published studies show no evidence of anything beyond nonspecific contextual effects, and the underlying premise is incompatible with the existing body of scientific knowledge. Homeopathy has increasingly been questioned or denounced by organizations in several countries, most recently in FDA hearings in the US. I recently spoke

Psychology and Psychotherapy: How Much Is Evidence-Based?

Despite all those Polish jokes, Poland has its share of good scientists and critical thinkers. A superb new book illustrates that fact in spades: Psychology Gone Wrong: The Dark Side of Science and Therapy, by Tomasz Witkowski and Maciej Zatonski, http://www.amazon.com/Psychology-Gone-Wrong-Science-Therapy/dp/1627345280  Witkowski is a psychologist, science writer, and founder of the  Polish Skeptics Club; Zatonski

IOM Recommends Replacing CFS with SEID

Exertion intolerance Chronic fatigue syndrome (CFS) is a controversial diagnosis that has also been called myalgic encephalomyelitis (ME or ME/CFS), post-viral fatigue syndrome (PVS), chronic fatigue immune dysfunction syndrome (CFIDS), Iceland disease, “yuppie flu,” and many other names. A new report from the Institute of Medicine (IOM) says that none of those names really fit the disease

Placebo, Are You There?

Note: This was originally published as “Placebo, es-tu là?” in Science et pseudo-sciences 294, p. 38-48. January 2011. It came to my attention in the course of an e-mail correspondence with the editors of that magazine, where one of my own articles was published in French translation in January 2015. I thought this was the best explanation of placebo

Is the Ebola Crisis a Reason to Skip RCTs?

Colorized transmission electron micrograph of the Ebola virus viron. In a recent “Perspective” article in The New England Journal of Medicine, three physicians (Drs. Cox, Borio, and Temple) make a strong case for not letting the rush to save Ebola patients tempt us to deviate from good science and skip the randomized controlled trial (RCT). Their arguments cut

Smokey the Bear Medicine and Prevention

When I was an intern, we used to joke that we were practicing “Smokey the Bear” medicine: stamping out forest fires. Patients would wait until a spark of disease had developed into a dangerous flame, and then they’d expect us to deal with it. We were mostly doing disaster control, and we wished we could