Here is a recap of the stories that appeared last week at Science-Based Medicine, a multi-author skeptical blog that separates the science from the woo-woo in medicine.
Correcting the scope of practice of advanced practice nurses will not endanger patients (David Gorski) http://www.sciencebasedmedicine.org/expanding-the-scope-of-practice-of-advanced-practice-nurses-does-not-endanger-patients/ Nurse practitioners receive advanced training in specific areas that prepares them for a limited scope of practice. State and federal laws vary: in some jurisdictions NPs are allowed to practice independently; elsewhere they must be supervised by physicians. Medical societies that oppose legislation to define and increase the scope of NPs are motivated by turf protection, not evidence. Studies show that NPs provide quality care.
Announcing the Society for Science-Based Medicine (Mark Crislip) http://www.sciencebasedmedicine.org/announcing-the-society-for-science-based-medicine/ A new organization aims to create a community of like-minded individuals, both in and out of health care, who support the goals of Science-Based Medicine. You can register and/or join now at http://sfsbm.org/ Goals include education and consumer protection. An SSBM wiki http://sfsbm.org/wiki2/index.php?title=Main_Page will serve as a central source of information, incorporating the content of Quackwatch. Future plans include conferences, podcasts, curricula, a journal, e-books, and advocacy efforts.
Vitamin E for Alzheimer’s (Harriet Hall) http://www.sciencebasedmedicine.org/vitamin-e-for-alzheimers/ A randomized controlled study showed that giving high-dose vitamin E to Alzheimer’s patients slowed functional decline when given alone, but not when given in combination with the drug memantine. The effect was modest, and there was no effect on the disease process itself. In this study Vitamin E appeared to decrease mortality, but earlier studies showed increased mortality. Several unanswered questions remain, and it would be premature to incorporate vitamin E into routine clinical practice.
The Limits of Neuroplasticity (Steven Novella) http://www.sciencebasedmedicine.org/the-limits-of-neuroplasticity/ The headline says “this pill could give your brain the learning powers of a 7-year-old.” But all the study actually showed was that valproic acid slightly improved the ability of a small sample of subjects to learn to identify the pitch of various tones. The drug has serious side effects, and would not be expected to have a net cognitive benefit. The study was a preliminary one and no conclusions can be drawn from it. It should not have been publicized, much less hyped the way it was.
2013 Legislative Review: placenta take out (Jann Bellamy) http://www.sciencebasedmedicine.org/2013-legislative-review-placenta-take-out/ New legislation makes it legal for new mothers to take their placentas home so they can eat them. A review of 2013 legislation shows that chiropractors, naturopaths, acupuncturists and others have made gains in licensure and privileges. Through the new Society for Science-Based Medicine website, Jann Bellamy will keep the public abreast of new pro-CAM legislation to facilitate providing science-based advocacy to our legislators.
Acupuncture Whac-a-Mole (Mark Crislip) http://www.sciencebasedmedicine.org/acupuncture-whac-a-mole-tm/ Pseudo-medicine researchers persist in doing studies with small sample sizes, high dropout rates, bad statistics, inadequate blinding, small effect sizes, underlying biases, and other factors that render a clinical trial suspect. A recent study of ear acupuncture for weight loss is a case in point. Acupuncture only appears effective in flawed studies, and ear acupuncture is even sillier than traditional acupuncture.
Even in 2014, influenza kills (David Gorski) http://www.sciencebasedmedicine.org/even-in-2014-influenza-kills/ The HPV vaccine and the flu vaccine are the most easily demonized by the anti-vaccine movement. The flu vaccine is far from perfect, but the flu is far more serious than most vaccine rejecters realize. In Michigan, 3 previously healthy young adults have died from influenza and a dozen others are on life support. Other deaths are being reported around the country. Most, if not all, had not been vaccinated. It’s not too late: get your flu shot.