My latest Forbes piece is now out: “The Positive Value of Negative Drug Trials“.

I discuss the unfortunate bias against publishing “negative” scientific results that show a drug doesn’t have much clinical benefit, and why it’s in the self-interest of drug companies to still report these.

In particular, I highlighted two interesting facts:

1) Most drug trial results are still not being reported to a central registry.

2) Negative results funded by private industry (e.g., pharmaceutical companies) are more likely to be reported than from government-funded research.

Fortunately, free market incentives are driving more drug companies towards full disclosure of both positive and negative study results — which will benefit patients.

For more details, read the full text of “The Positive Value of Negative Drug Trials“.

 

My latest Forbes column is now up: “UK To Experiment on Cardiac Arrest Patients Without Their Consent“.

Here is the opening:

Soon, thousands of UK cardiac arrest patients may find themselves enrolled in a major medical experiment, without their consent. This may be legal. But is it ethical?

As described by the Telegraph:

“Paramedics will give patients whose heart has stopped a dummy drug as part of an ‘ethically questionable’ study into whether adrenalin works in resuscitation or not… Patients in cardiac arrest will receive either a shot of adrenalin, which is the current practice, or a salt water placebo but the patient, their relatives nor the paramedic administering it will know which. The trial is seen to be controversial because patients will not be able to consent to taking part and could receive a totally useless placebo injection…”

First, I want to emphasize that this is a legitimate scientific question. Adrenaline (also known as epinephrine) has been a standard part of the resuscitation protocol for sudden cardiac arrest, along with chest compressions and electrical shocks. (Think of paramedics shouting “clear” on television medical dramas.) But more recent evidence suggests that adrenaline might cause more harm than good in this situation, helping start the heart but possibly also causing some neurological damage. There is a valid and important scientific question. My concern is not over the science behind the experiment, but rather the ethics…

(For more details and discussion, read the full text of “UK To Experiment on Cardiac Arrest Patients Without Their Consent“.)

There are two parts of the study that disturb me the most: (1) The drug trial itself, and (2) the decision to not actively inform relatives that any patient who died had been an involuntary participant.  I cover both aspects in more detail in the piece.

Note: I’m not fully settled on what (if any) experimentation should be allowed on incapacitated patients in an emergency setting without informed consent.  But I do think this should be an issue of active discussion, especially for the people whose lives are on the line.

And for a discussion of prior US medical experiments that have been alleged to be unethical, non-consensual, or illegal, see this Wikipedia list.

 

 

Monica Hughes recently gave an excellent talk on, “The Transformation of American Healthcare: Lessons from the Veterans Administration and Existing FDA Standards of Care” to Liberty On The Rocks at Flatirons.

 

Her talk is now available on YouTube (3 parts).

Part 1

Part 2

Part 3

Disclaimer and synopsis:

DISCLAIMER: The speaker is not a medical doctor or health care practitioner. The ideas in this video are not intended as a substitute for the advice of a trained health professional. All matters regarding your health require medical supervision. Consult your physician and/or health care professional before adopting any nutritional, exercise, or medical protocol, as well as about any condition that may require diagnosis or medical attention. In addition, statements regarding certain products and services represent the views of the speaker alone and do not constitute a recommendation or endorsement or any product or service.

Synopsis: In January 2014, Robb was diagnosed with glioblastoma multiforme (GBM), one of the deadliest brain cancers in existence. Nicknamed “The Terminator” the median survival time is around 11 months. Robb had brain surgery on January 16, which was performed by a team of surgeons while Robb was awake. The surgery was a success.

Monica’s research into the post-surgery treatments that worked best for other survivors showed that they were not approved by the Food and Drug Administration, so they’d have to go to a cancer center that sprouted up in Tijuana, Mexico for treatment which included a 100 year-old immune system booster called Coley’s Vaccine.

Bio: Monica Hughes has bachelor’s, master’s, and PhD degrees in biology and has taught college biology since 2006. Previously, Monica served as a medical writer for National Jewish Health, a premier research hospital for respiratory and immune disorders, and is now a patient advocate specializing in literature research.

Robb LeChevalier has served in the Air Force and has a bachelor’s degree in electrical engineering. He designed his own home situated in the foothills outside of Denver, and currently develops high speed electronics for his own company, Astronix Research. He has been an Objectivist for 40 years.

More: Robb was given 2 months to live without surgery, a maximum of 6 months to live with surgery only, and an unspecified amount of time with additional therapy due to the unusually aggressive nature of his particular tumor. He and his wife Monica faced seemingly insurmountable hurdles by the Veterans Administration along the way, including timely care from the VA and a delay of emergency surgery that could have cost Robb his life had they not pushed for a special dispensation from a panel of VA doctors within the 48 hours leading up to his scheduled surgery. They are currently contesting 58 claims denials by the VA totaling nearly $250,000 in unpaid medical bills.

In the days following Robb’s surgery, they discovered that immunotherapy held the best chance of long-term and quality survival for this cancer. Historical 3 year survival with FDA-approved standard of care for GBM is around 7%. 3-5 year survival for some GBM patients in clinical trials using cancer vaccines is between 20%-50%, depending on the vaccine. Yet they discovered that due to FDA regulations, it is impossible to enter these clinical trials without first or concurrently undergoing FDA-approved standard of care, and that such care would greatly reduce his likelihood of responding to immunotherapy, if he was lucky enough to meet the criteria for the study and be placed in the treatment arm of such a trial.

Given these poor odds, Robb chose to forego all standard of care therapy after surgery, and opted for an immunotherapy protocol abroad that, according to current MRI results, has left him without evidence of disease. As of June 10, 2014, their new low deductible PPO health insurance policy, purchased on the Obamacare exchange, has not paid out a single penny of reimbursement for Robb’s cancer treatment.

(Note: I also discussed their case in my 5/28/2014 Forbes piece, “VA Denies Coverage For US Air Force Veteran With Malignant Brain Tumor“.)

Did Facebook Betray Our Trust?

 Posted by on 3 July 2014 at 10:00 am  Business, Internet, Rights, Science
Jul 032014
 

I’ve seen lots of people upset — on Facebook, of course — about Facebook’s social science experiment with people’s newsfeeds. However, I’ve yet to find an argument that’s compelling. Consider this one from Stephen Green:

Facebook has been described as an internet-within-the-internet, and the secret to making that work is it’s an internet curated for you by people you trust. To see something on your Facebook TL, it has to come from someone with a mutually-defined relationship, or from someone you trust enough to follow. Untrustworthy acts — like when somebody tags your name on something that has nothing to do with you, in order do win unearned trust and attention — are easily reported and corrected. The fact that Facebook uses this web of relationships, clicks, and behaviors to do some seriously creepy data-mining and ad sales behind the scenes doesn’t affect the strengths of the service it provides in public.

But for this to work, Facebook must remain neutral. What you see must be what your trusted friends have curated and presented to you. There can’t be any monkeying around with the Facebook timeline, any more than AT&T or Verizon can decide which phone calls you may receive, or when you may receive them.

Facebook is now essentially corrupt, and it did it to itself. First, they performed this “experiment” of altering timelines in order to assess possible mood changes they could affect on their users. Then, after the fact, they slipped new language into their Terms of Service allowing them to do more of the same in the future.

I agree with the point about the Facebook’s late change to its terms of service. That sucks. Yet the fact remains that Facebook has monkeyed around with the timeline for years in various mysterious ways. I don’t have access to the raw feed of just what my friends post; no one does. (That’s what Twitter displays, which is both refreshing and annoying.) For many years now, Facebook’s display has been extremely selective, only showing me a portion of what my friends post, based on some hocus-pocus algorithm, partly designed to increase my “engagement.”

Then, for this study, Facebook tweaked their hocus-pocus algorithm in a slightly different way… and then published the results. What’s supposed to be so new or so horrible about that?

Or, as Tom said: “I don’t get it. We’ve known all along that Facebook were manipulating the timeline for commercial purposes. They decide to do it once FOR SCIENCE! and suddenly everyone throws a hissy fit? Color me so not caring.”

Am I wrong? If so, tell me what’s so darn horrible about what Facebook did here!

The Value of Philosophy

 Posted by on 1 July 2014 at 11:00 am  Academia, Philosophy, Science
Jul 012014
 

Bob Pasnau — University of Colorado at Boulder Philosophy Professor — writes in the NY Times on the value of philosophy: Why Not Just Weigh the Fish?

The essence of philosophy is abstract reasoning – not because the philosopher is too lazy to attempt a more hands-on approach, but because the subjects at issue do not readily submit to it. If we could simply weigh the fish, we gladly would. In recent centuries, philosophers in fact have discovered how to weigh that allegorical fish, in various fields, and on each occasion a new discipline has been born: physics in the 17th century; chemistry in the 18th; biology in the 19th and psychology in the 20th. The scientists, short on history but flush with their government grants and Nobel Prizes, cast an eye back on what remains of philosophy and skeptically ask: Why don’t you stop wasting your time and just weigh that fish?

It’s a question philosophers ask themselves all the time, and sometimes they despair. The remaining problems of philosophy today concern issues like justice, morality, free will, knowledge and the origins of the universe. In dismissing philosophy as an antiquated relic of our prescientific past, the scientist is making a very large and dubious assumption: that the abstract methods of philosophy, despite the discipline’s string of successes over recent centuries, have nothing more to contribute to our developing understanding of the world. Perhaps scientists think they already have the answers to all these philosophical questions. Maybe, but if so they certainly keep them well hidden. Or perhaps they judge these remaining questions to be simply unanswerable. Possibly they are, but it seems wildly premature to give up hope.

Bob Pasnau was my medieval philosophy professor. He was also the graduate advisor and department chair for periods during my tenure as a graduate student. He was part of what made my experience in the department so good. Go Bob!

 

My latest Forbes piece is a change of pace from the usual health policy discussion. Instead, I decided to have a bit of fun and write about, “8 Star Trek Technologies Moving From Science Fiction To Science Fact“.

Some of the 8+ technologies (or story elements) of Star Trek that I discuss include:

1) Warp Drive

2) Universal Translator

3) Handheld Computers

4) Medical Tricorder

5) Energy Weapons

6) Androids

7) Teleportation

8) Intelligent Aliens

9) Other Technologies

Although some Star Trek technologies are still clearly in the realm of science fiction (e.g., the warp drive), others like the medical tricorder are coming close to reality.  And some design elements (like the flip-style communicators of Star Trek: TOS) have already come and gone as consumer products in the real world.

For more details, read the full text of “8 Star Trek Technologies Moving From Science Fiction To Science Fact“.

I had a lot of fun working on this latest Forbes piece.  I hope you enjoy reading it as much as I enjoyed writing it!

(And I’d like to thank Ari Armstrong for his blog post on Microsoft and Skype Translator that inspired this article.)

The Truth about Science Projects

 Posted by on 17 March 2014 at 2:00 pm  Education, Funny, Science
Mar 172014
 

Heh.

The Natural World Through Christian Eyes

 Posted by on 20 August 2013 at 10:00 am  Christianity, Religion, Science
Aug 202013
 

I just finished listening to the classic allegorical novel of protestantism, The Pilgrim’s Progress by John Bunyan. It was truly atrocious, even aside from the Christianity. I cannot imagine Christians finding any value in it… and yet it is a classic.

The worst — and hence, the best — bit was the following passage on the proper Christian interpretations of natural phenomena:

It was told you before, that Prudence bid the boys, that if at any time they would, they should ask her some questions that might be profitable and she would say something to them.

Then Matthew, who had been sick, asked her, why for the most part physic should be bitter to our palates.

Prudence: To show how unwelcome the word of God and the effects thereof are to a carnal heart.

Matthew: Why does physic, if it does good, purge, and cause to vomit?

Prudence: To show that the word, when it works effectually, cleanseth the heart and mind. For look, what the one doth to the body, the other doth to the soul.

Matthew: What should we learn by seeing the flame of our fire go upwards, and by seeing the beams and sweet influences of the sun strike downwards?

Prudence: By the going up of the fire, we are taught to ascend to heaven by fervent and hot desires. And by the sun sending his heat, beams, and sweet influences downwards, we are taught the Saviour of the world, though high, reaches down with his grace and love to us below.

Matthew: Whence have the clouds their water?

Prudence: Out of the sea.

Matthew: What may we learn from that?

Prudence: That ministers should fetch their doctrine from God.

Matthew: Why do they empty themselves upon the earth?

Prudence: To show that ministers should give out what they know of God to the world.

Matthew: Why is the rainbow caused by the sun?

Prudence: To show that the covenant of God’s grace is confirmed to us in Christ.

Matthew: Why do the springs come from the sea to us through the earth?

Prudence: To show that the grace of God comes to us through the body of Christ.

Matthew: Why do some of the springs rise out of the tops of high hills?

Prudence: To show that the Spirit of grace shall spring up in some that are great and mighty, as well as in many that are poor and low.

Matthew: Why doth the fire fasten upon the candle-wick?

Prudence: To show that unless grace doth kindle upon the heart, there will be no true light of life in us.

Matthew: Why are the wick, and tallow and all, spent to maintain the light of the candle?

Prudence: To show that body and soul, and all, should be at the service of, and spend themselves to maintain in good condition that grace of God that is in us.

Matthew: Why doth the pelican pierce her own breast with her bill?

Prudence: To nourish her young ones with her blood, and thereby to show that Christ the blessed so loved his young, (his people,) as to save them from death by his blood.

Matthew: What may one learn by hearing the cock to crow?

Prudence: Learn to remember Peter’s sin, and Peter’s repentance. The cock’s crowing shows also, that day is coming on: let, then, the crowing of the cock put thee in mind of that last and terrible day of judgment.

What can anyone say to that?!? Except perhaps… LORDY!

Craziest Chemical Reaction

 Posted by on 20 May 2013 at 2:00 pm  Cool, Science
May 202013
 

Heat turns powder into creepy alien creature. No, really.

The first minute and twenty seconds is just a person scooping out the powder into a line, which is rather boring, so you might wish to skip that. You want to watch from the moment that heat is added.

Apr 172013
 

Tonight, I’ll interview Eric Barnhill about Cognition, Movement, and Music. The topic is a bit obscure, but I’ve always been fascinated to hear Eric talk about his work. For me, this interview an excellent opportunity to have yet another interesting conversation… and you get to listen in!

Eric began his career as a Julliard-trained concert pianist, but now he’s a graduate student in medical physics in Scotland. Yes, that’s a bit of a strange path. Oddly, it’s been a path with a mostly steady trajectory, as you can see from his recent write-up for his alma matter. Here’s a bit:

During my time at Juilliard, I was introduced to an obscure field called Dalcroze Eurhythmics, which was developed by the Swiss composer and music theorist Emile Jaques-Dalcroze at the turn of the 20th century. In Dalcroze, movement is combined with vocal work and improvisation to create an alternative approach to teaching music. However, musical subjects are intermediate goals, used to develop attention, focus, coordination and physical performance via movement.

In Dalcroze I saw a methodology of unexplored potential that brought all my varied interests together. However, Dalcroze as a profession, to the extent that it exists at all, mostly consists of young children’s music and movement classes. To many colleagues, I had abandoned interpreting Schubert sonatas for sitting on a floor with 3-year-olds rolling balls around.

Early in my Dalcroze career I was reverse-commuting to a children’s music school in the suburbs (a rite of passage for many a Juilliard grad, in one form or another), where I frequently taught Dalcroze and piano to special-needs and learning-disabled children. I took them on as students because I had a blast teaching them.

However, I began to notice something interesting: The struggles they had executing musical patterns in movement seemed deeply connected to their core special-needs deficits. Similarly, to the extent that these students’ ability to execute rhythmic tasks improved, their core deficits seemed to temporarily recede. If I found a way to help a low-functioning girl keep a beat, she would then become just as present as anyone else. If I could tune up a boy’s ability to track measure, suddenly he would sit up and listen to an entire sentence. Stepping and skipping the rhythms of a nursery rhyme with these children would result in an afterglow of clear and expressive speech from them where none previously existed. This observation was the most exciting one I ever made. It has been the cornerstone on which I have built everything I have done professionally since.

You can read the rest here. Also, Eric gave a talk at TEDxBermuda — Empowering Through Rhythm — that’s an excellent teaser for tonight’s interview:

Fascinating, no? I hope that you join us for the interview!

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