Saturday 28 April 2012

Stem cell therapy: still science fiction

I will stay on the thread of things that you inject or implant, before getting stuck into some meatier surgical operations. But there are so many targets, I was wondering which one to shoot first.

Then I got the email, with a link to this. Stem cells: is there anything that invokes a feeling of hope for the future and the wonders of modern technology and medicine more than this?  This isn’t a drug we found in some mouldy bread by mistake, this is something that is so high-tech that it is literally what was considered science fiction in the recent past. If you scan any links related to stem cells you will see that scientists are growing all sorts of tissues from stem cells. Does this hold promise? You bet. Is the technology amazing? Again: yes. Does it actually work now? For anything? Well, considering people are selling the technology to use in patients, we had better find out.

Thursday 26 April 2012

PRP: Platelet Rich Plasma, or just Profit Rich Placebo?

Platelet Rich Plasma is another example of a product that sounds so good, it must work. You would think that if doctors were scientific, they would not be influenced by the name of a product, but you only have to talk to anyone employed in marketing for about 5 minutes before you understand that the name of a product can be as important as its performance. Results are important of course, but so is the presentation (name, packaging, advertising, etc.), and we know that doctors are definitely influenced by advertising (another topic, but click here for a good starting point).

Monday 23 April 2012

BMPs are not BHPs

BMP stands for Bone Morphogenetic Protein. The name suggests that it makes bone, and that is what it does. To be precise, it turns the tissues around it into bone. However, people think that because it makes bone, it heals fractures, but those are two separate things, and the evidence for it healing fractures is much less than the evidence for it making bone. That is why it is called Bone Morphogenetic Protein, and not Bone Healing Protein.

Sunday 22 April 2012

Meet the Greek

While I am gathering information for my first posting, on Platelet Rich Plasma, here is a link to an article by John Ioannidis, who I have never met, but would dearly like to. His skeptical view of medicine has opened the eyes of many doctors, but unfortunately not enough. For those of you wondering what my angle is going to be, it will be along these lines, but mainly exploring the surgical side of medical practice.


There is an inherent bias in medicine whereby doctors tend to overestimate the benefits, and underestimate the harms, of their craft. I do not aim to correct this bias, as attempts to do this in the past have failed. This is because it is human nature to believe in what you do, to the extent that we tend to overestimate our own value.
My aim is to make the readers aware of this bias, so that next time they are sitting in a doctor's office and are asked to decide on whether or not to have surgery or some other procedure, they will think twice, and consider the possibility that the particular intervention on offer might not be as beneficial as advertised, and might have more risks than advertised.
Rather than have a general discussion about the problem, I will put the spotlight on areas where this bias occurs to provide specific examples. This is not because I do not wish to have the discussion, but because the format of blogs is more suited to a collection of examples, rather than a running commentary.