Monday, December 23, 2013

Medical Myths, Lies, and Half-Truths: What We Think We Know May Be Hurting Us

I'm not much of a fan of "evidence-based medicine". Yes, there are lots of good advances that have come about out of it. But, there is also plenty of bias that has been built in to the system. It is geared towards finding isolated drugs that have a certain impact on the general population. This may be the "best" that can easily be done today, but it is far from ideal. The "treatments" often distract people from the well known (but harder to follow) "cures" that can be achieved by appropriate lifestyle changes.

The bias towards chemicals also leads to a disregard of ways in which the human body can influence itself. Some people may have better ability to cause changes in their health themselves. However, the studies typically try to remove these "outliers" from the double-blind studies so they can focus only on the specific treatments. Even studies that attempt to be purely objective require a huge amount of interpretation. There are numerous places that bias can creep in. Large meta-studies allow an even greater chance to make the data fit one's own beliefs. (There is always something "horribly wrong" with the methodology or results of the contradictory study.)

With all that being said, I approached these lectures with trepidation. Was this going to be another one of those pandering medical lectures? Was he going to come out and say "the current accepted medical wisdom is 100% correct and everything else (including last decade's accepted wisdom) is all quackery? Luckily, it wasn't so bad. There was actually some good information in here - with only a few contradictions.

First the problems. Other than the general issues with evidence-based medicine, there were some problems with "out-of-domain" coverage. (This was all the more humorous as it followed a criticism of some doctors for attempting to influence policy outside the medical domain.) GMO plants are given as pass as being "just as healthy" as non-GMO plants. You would hope so. However, the problem with GMO is not so much the impact on the food source but on the environment as a whole. How will the GMO plants impact the overall ecosystem? This is a question outside the domain of medicine. Similarly, organic plants were found to have little health differentiation from non-organic plants. Some of the "organic" pesticides were criticized as being "Worse" than the traditional alternatives. Again, this is going outside the domain. While, the organic standards due tend to be somewhat arbitrary, a doctor is not any more qualified than a farm worker to discuss their specific impact.

Discussions of ADHD and Autism were also interesting. They are both on a continuum, so the diagnosis is somewhat subjective. Treatment is seen as something that can help people coping with these to succeed in our society. (Though perhaps we need to ask the question as to why they need to. Aren't we in a society that prides itself on diversity.) The increase in both (especially ADHD) is claimed to be due to better diagnosis. (But you have to wonder what other diseases would be more common with better diagnosis.)

Other areas were a little better. He did a fairly decent job of covering many medical "myths" and providing the studies that backed up the alternatives. Often times popular culture or media influenced false perceptions (like of hypnosis.) There are also many folk remedies that have no basis in the "evidence-based" medicine culture, while others have been shown to be effective. (I wonder about the origins of some of the ineffective ones. Were they always "quackery", or were they previously effective remedies that had been stripped of their "effectiveness" over time. (Perhaps a key ingredient in a concoction was substituted, living the new remedy less effective.)

Overall, the lectures were not bad. Sure, they were biased towards meta-studies, but they did contain plenty of decent information.

No comments:

Post a Comment