Saturday, September 5, 2020
Critical review of some of the more extreme claims about “neuroplasticity”
The second book, “The Brain’s Way of Healing,” is by a Canadian, Norman Doidge, M.D. Dr. Doidge is described on his website as a “psychiatrist, psychoanalyst, researcher, author, essayist and poet.” His clinical and research background includes an interesting mix of scientific research and psychoanalytic therapy and he has received some prestigious awards for his contributions. Dr. Tallis discussed how Dr. Doidges’s book describes “how the brain can alter its own structure and function in response not only to environmental stimuli but also to mental activity” and “clinics where miracle cures are seemingly an everyday occurrence, as patients are treated with light, sound or electrical therapy.”
Dr. Tallis clearly is concerned about the claims in the book, writing, “Dr. Doidge’s pen portraits of patients facing neurological adversity with courage and determination, and of their charismatic healers, are disarming. Yet the reliance on anecdotes and testimonials, without much clinically and scientifically relevant detail, is exasperating.” He goes on to eviscerate Dr. Doidge’s references in support of his claims, and he conclude, “ It seemed reasonable to conclude that, while using what we currently know of neuroplasticity may deliver modest therapeutic advances, we need to learn much more about the brain before we can hope to regularly achieve the results that Dr. Doidge reports.”
Medicine’s Fundamentalists
https://www.tabletmag.com/sections/science/articles/randomized-control-tests-doidge
The idea that “only RCTs can decide,” is still the defining attitude, though, of what I shall describe as the RCT fundamentalist. By fundamentalist I here mean someone evincing an unwavering attachment to a set of beliefs and a kind of literal mindedness that lacks nuance—and that, in this case, sees the RCT as the sole source of objective truth in medicine (as fundamentalists often see their own core belief). Like many a fundamentalist, this often involves posing as a purveyor of the authoritative position, but in fact their position may not be. As well, the core belief is repeated, like a catechism, at times ad nauseum, and contrasting beliefs are treated like heresies. What the RCT fundamentalist is peddling is not a scientific attitude, but rather forcing a tool, the RCT, which was designed for a particular kind of problem to become the only tool we use. In this case, RCT is best understood as standing not for Randomized Control Trials, but rather “Rigidly Constrained Thinking” (a phrase coined by the statistician David Streiner in the 1990s).
With such a good technique as RCTs, one might wonder, why do we ever bother with observational studies?
There are a number of situations in medicine in which observational studies are obviously superior to randomized control trials (RCTs), such as when we want to identify the risk factors for an illness. If we suspected that using crack cocaine was bad for the developing brains of children, it would not be acceptable to do an RCT (which would take a large group of kids, and randomly prescribe half of them crack cocaine and the other half a placebo and then see which group did better on tests of brain function). We would instead follow kids who had previously taken crack, and those who never had, in an observational study, and see which group did better. All studies ask questions, and exist in a context, and the moral context is relevant to the choice of the tool you use to answer the question. That is Hippocrates 101: Do no harm.
Similarly, withholding the most promising treatment we have for a lethal illness is also a moral matter. That is precisely the position taken by the French researchers who thought that hydroxychloroquine plus azithromycin was the most promising treatment known for seriously ill COVID-19 patients, and who argued that doing an RCT (which meant withholding the drug from half the patients) was unconscionable. RCT fundamentalists called their study “flawed” and “sloppy,” implying it had a weak methodology. The French researchers responded, in effect saying, we are physicians first; these people are coming to us to help them survive a lethal illness, not to be research subjects. We can’t randomize them and say to half, sorry, this isn’t your lucky day today, you are in the nontreatment group.
Hydroxychloroquine: A Morality Tale
https://www.tabletmag.com/sections/science/articles/hydroxychloroquine-morality-tale
Raoult is the most highly cited microbiologist in Europe, recognized for having identified 468 novel species of bacteria, most in humans, and for his team having discovered the largest virus ever documented at the time (so large it had been mistaken for an intracellular bacterium). He has boldly asserted that viruses—which had been classified as nonliving—are alive. He has published over 2,000 papers, many of them through the IHU, with him as a contributing or lead author. He has been given major awards, the French Legion d’honneur, and perhaps the most important one for a microbiologist, having a bacteria genus, “Raoutella,” named in his honor.
Raoult is a fascinating, eccentric, theatrical figure. He couldn’t be more colorful—a maverick who delights in opposing conventional thinking, his peers, and followership in science. He has hair to his shoulders, a long, pointed beard, and looks like a medieval knight in a lab coat. He loves a fight. At 68 years of age, he rides a Harley to work. He still treats patients. He sees himself as more like a philosopher or anthropologist than a typical French scientist, and teaches epistemology, the study of how we know that we know things, to his lab scientists, He believes an ever-increasing homogeneity is ruining scientific thought. He told Paris Match:
Trump’s political base cheered for HCQ and his opponents booed and accused him of practicing medicine without a license—and began dredging up any evidence, or “experts,” they could find, who might emphasize that HCQ was dangerous, or useless, or both, and thus they responded to his hyperbole with their own, and then some. As Risch observed in Newsweek, for many HCQ became “viewed as a marker of political identity, on both sides of the political spectrum.”
So this story is twofold. It’s about the discussion that unfolded (and is still unfolding) around hydroxychloroquine, but if you’re here for a definitive answer to a narrow question about one specific drug (“does hydroxychloroquine work?”), you will be disappointed. Because what our tale is really concerned with is the perilous state of vulnerability of our scientific discourse, models, and institutions—which is arguably a much bigger, and more urgent problem, since there are other drugs that must be tested for safety and effectiveness (most complex illnesses like COVID-19 often require a group of medications) as well as vaccines, which would be slated to be given to billions of people. “This misbegotten episode regarding hydroxychloroquine will be studied by sociologists of medicine as a classic example of how extra-scientific factors overrode clear-cut medical evidence,” Yale professor of epidemiology Harvey A. Risch recently argued. Why not start studying it now?
The Politics of Science Fraud - nonsense digested from a nonsensical article
https://mishpacha.com/the-politics-of-science-fraud/
THE POLITICALLY CHARGED field of climate science has been beset by data manipulation by leading research centers. And now there is evidence that politics has crept into the search for cures to COVID-19, argues Dr. Norman Doidge in a lengthy article in Tablet, “Hydroxychloroquine: A Morality Tale.”
That VA study, however, proved highly flawed. It had ignored a crucial confounding factor: Those patients receiving HCQ in the study were much sicker than those who did not. At that time, HCQ was only approved for use as a desperation measure for seriously ill patients. Dr. Anthony Fauci was still recommending doing nothing for patients quarantined at home.
On July 1, the Henry Ford Medical Center in Detroit published in the International Journal of Infectious Diseases a study of patients in which the severity of illness was fully taken into account, which showed that HCQ reduced the mortality hazard (mortality over a fixed period of time) by 66 percent. Another study from Italy at the end of July found the same 66 percent reduced mortality rate.
Studies In Italy Offer New Evidence of HCQ Role in Saving Lives
https://yated.com/studies-in-italy-offer-new-evidence-of-hcq-role-in-saving-lives/
A wave of new evidence from studies in Italy, Belgium and the United States showing the effectiveness of hydroxychloroquine (HCQ) in reducing death from Covid-19, is spiking public demand for the drug even as the FDA continues to block its release and Americans die.
The following events bear out Dr. Atlas’ grim assessment. On August 10, ignoring the wealth of new HCQ-supporting data coming out of studies in Italy, Belgium and New Jersey, the FDA denied Henry Ford Hospital’s urgent request for emergency use approval (EUA) for HCQ.
The Hospital made the request after its clinical trials found an impressive 51% reduction in deaths if HCQ was begun within 24 hours of admission to hospital. These findings were supported by studies led by Dr. Peter McCullough’s team from Balyor Cardiac and Vascular Hospital in Dallas. The Baylor data showed prophylactic benefits of HCQ given to hospital workers who were exposed daily to Covid during the course of their work.
Critics Fault Henry Ford Hydroxychloroquine Study Methodology, Conclusion
A recent Henry Ford Health System study finding COVID-19 patients treated with hydroxycloroquine were less likely to die from the virus is drawing skepticism from some medical professionals.
Critics say the research is an “observational study” that did not make use of random control groups. Steven Nissen, chief academic officer of the Heart & Vascular Institute at the Cleveland Clinic, says the study’s methodology preordained its conclusion.
In a randomized study, “you assign people to get one therapy or another and then find out how they do,” Nissen said. This study, however, “was what’s known as an observational study, where you look at people who got the drug compared to people who didn’t.”
Nissen says the Henry Ford patients not given hydroxychloroquine
based on risk of side effects were already more likely to die from the
virus. The Henry Ford researchers counter that they used different
dosing methods than other studies.
Friday, September 4, 2020
Carter affirms safety of mail-in voting after Barr and White House cite him to diminish it
https://edition.cnn.com/2020/09/04/politics/carter-vote-by-mail-safety-barr-white-house/index.html
Jimmy Carter is pushing back on efforts by Attorney General William Barr and the White House to use the former Democratic president's work studying voting by mail to discredit the practice.
Speaking to CNN's Wolf Blitzer on Wednesday, Barr had referenced the "fundamental problem" that "the bipartisan commission chaired by Jimmy Carter and James Baker said ... that mail-in voting is fraught with the risk of fraud and coercion."
Trump’s vote-twice comments outrage media, which amplify his message
https://www.foxnews.com/media/trumps-vote-twice-comments-outrage-media-which-amplify-his-message
Had Trump merely issued his 130th warning about mail ballot fraud, it wouldn’t have made much news, maybe one paragraph in a story. But he knows from long experience that when he crosses the line, goes over the top, the resulting furor can last several days, even a week, getting the media and political world chattering about the very issue he wants to spotlight.
[ And if he shot someone to demonstrate he is above the law that is also acceptable to his supporters]
Trump called American war dead ‘losers’ and ‘suckers’, report alleges
https://www.theguardian.com/us-news/2020/sep/03/trump-american-war-dead-losers-suckers-report
A new report details multiple instances of Donald Trump allegedly making disparaging remarks about members of the US military who have been captured or killed, including referring to the American war dead at the Aisne-Marne American Cemetery in France in 2018 as “losers” and “suckers”.
The allegations were first reported Thursday in the Atlantic. A senior Defense Department official with firsthand knowledge of events confirmed some of the remarks to the Associated Press, including the 2018 cemetery comments.
The defense official said Trump made the comments as he declined to visit the cemetery outside Paris during a meeting following his presidential daily briefing on the morning of 10 November 2018.
Trump himself told reporters on Thursday the story was false. “To think that I would make statements negative to our military and fallen heroes when nobody has done what I’ve done,” for the US armed forces, Trump said. “It’s a total lie ... It’s a disgrace.”
Netanyahu secretly okayed F-35 jet sales to UAE, report claims
https://www.timesofisrael.com/netanyahu-secretly-okayed-f-35-jet-sales-to-uae-report-claims/
Prime Minister Benjamin Netanyahu has privately removed any opposition to the sale of American F-35 fighter jets to the United Arab Emirates, despite repeated assurances that he is against the deal, according to a New York Times report published late Thursday.