Critical Thinking in Medicine

Rodin’s Thinker is doing his best to think but if he hasn’t learned critical thinking skills, he is likely to make mistakes. The human brain is prone to a multitude of cognitive errors. Critical thinking in medicine is what the Science-Based Medicine (SBM) blog is all about. Jonathan Howard has written a superb book, Cognitive Errors

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.  DEXA Scanner Measures Bone Mineral Density 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

Autism Revisited

131SHARES1272002000 Is the autism epidemic due to more awareness and better diagnosis, or to diagnostic substitution? Is it due to something that has changed in our environment? Is there really an autism epidemic? Gil Eyal et al., the authors of the book The Autism Matrix: The Social Origins of the Autism Epidemic wonder if we have been

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

BladderMax: Fake News and Outrageous Headlines

A newspaper ad for BladderMax is disguised as a news story reporting “the end of bladder leakages.” The information is inaccurate and the headlines are preposterous. There is a half-page article in my newspaper. The headline announces, “Scientists Predict End of Bladder Leakages by 2019.” This is reinforced by accompanying statements: “New developments in scientific

Reader’s Digest Promotes Prevagen

Reader’s Digest is advertising a memory aid, Prevagen, that has been tested and shown not to work. Shame on them! I am a long-time subscriber to Reader’s Digest. I enjoy the jokes and some of the human interest stories, but I have become increasingly disturbed by some of the questionable health information they present. The most recent

Should Evidence-Based Medicine Be Replaced By Interpersonal Medicine?

An opinion piece in the New England Journal of Medicine complains about the limitations of evidence-based medicine (EBM) and recommends a new approach they call “interpersonal medicine.” In my opinion, good clinical medicine is already interpersonal medicine; there is no need for something new. The 22 November 2018 issue of The New England Journal of Medicine carried an opinion

Leaky Brain, Leaky Gut: Are They Real?

First there was leaky gut; now there’s leaky brain. These questionable concepts are being promoted by practitioners of so-called “functional medicine.” First there was leaky gut  Three years ago Mark Crislip wrote about leaky gut syndrome for SBM. He said, “because of an almost complete lack of supporting basic science and few therapeutic clinical trials showing no effect,

Molecular Phylogenetics: A New Way to Tell the Story of Evolution

The new science of molecular phylogenetics tells the story of evolution with no need to consult the fossil record. It has produced some surprises, including a whole new domain of life, the archaea. Darwin’s 1859 book On the Origin of Species was a well-written, well-argued introduction to evolution, to the theory that populations evolve and species differentiate