The Role of Liquid Biopsies in Oncology

Liquid biopsies can be used to reduce the amount of chemotherapy used for patients with stage II colon cancer. When a patient has cancer, cell-free tumor DNA circulates in the blood and can be detected in a peripheral blood sample. This is known as a “liquid biopsy,” and it has become a routine practice in

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

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

The Screening Test that Caused an Epidemic

There is a worldwide epidemic of thyroid cancer. South Korea has been hit the hardest; in 2011, the rate of thyroid cancer diagnoses was fifteen times what it was in 1993. There have also been dramatic increases in other countries including the United States, France, Italy, the UK, and Japan, and lesser increases in Scandinavia

The “Art” of Clinical Decision-Making

Much nonsense has been written about the “art” of medicine. All too often, it amounts to a rationalization for doctors doing what they want to do instead of following the evidence. Medicine is not an art like painting. Neither is it a science like physics. It’s an applied science. Since patients are not all identical,

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