Honor Spock's Logic - Follow the Science

Like many I was saddened to hear the loss of one of my heroes growing up - Leonard Nimoy was Spock to me as he was to many others. He epitomized the value of science and logic in the resolution of problems

As my good Friend Jane Sarasohn-Kahn highlighted in her tribute on Healthpopuli: Learning from Mr. Spock and Leonard Nimoy about living long and prospering. Her selection of this iconic moment with Spock were right on target - from one of the great movies from the franchise - Wrath of Khan

Spock: “Do not grieve, Admiral. It is logical: the needs of the many outweigh…”
Kirk: “The needs of the few…”
Spock: “Or the one.”

He spoke out on smoking - something that in the end killed him before his time in this tweet from January 2014:

I quit smoking 30 yrs ago. Not soon enough. I have COPD. Grandpa says, quit now!! LLAP

I quit smoking 30 yrs ago. Not soon enough. I have COPD. Grandpa says, quit now!! LLAP
— Leonard Nimoy (@TheRealNimoy) January 30, 2014

30% of people will suffer serious Chronic Obstructive Airways Disease (COPD) as a result of smoking - and that's just one of a slew of diseases inextricable linked to smoking. Smoking while in decline in some countries is on the rise in others and this major health risk remains one a negative impact on personal health

You can explore WHO data in this interactive chart from who here

But don't limit the application of science to health and smoking - you can put Vaccines in the same category of Science and Logic. Jimmy Kimmel captured the sentiments aptly in this segment featuring real doctors




So much of your health boils down to Lifestyle choices that was so elegantly captured by Brigitte Piniewski, MD in this chart




Where would you rather be - fun or no fun


Spock the Hero with Super Powers
We may wish for the seriously cool vulcan Nerve Pinch



But we don’t need the vulcan nerve pinch. He and his character have taught us that science while not infallible has been working for us for millennium. We have started to tap into the power of science and the opportunity offered to our health and well being.

When it comes to science and healthcare Doctors are your trusted advisor - the relationship may be changing from the paternalistic role to a collaborative role as Eric Topol so eloquently describes in his latest book - The Patient will See you Now. But as captured in this piece by this Trauma Surgeon (@DocBastard) on the Daily Beast: Why You Trust the Internet More Than Your Doctor

...for god’s sake don’t think that you know as much as a doctor because you Googled something. Medical training takes up to a decade or longer (depending on the specialty), so a 0.452 second Google search does not substitute for consulting with an actual physician whose only interest is your health.

We are only at the beginning - what comes next and in our future is unimaginable. Our innovation, inventiveness and abilities continue to expand our universe and our understanding. Science wins- every time. Be logical with that splash of human emotion and honor his legacy - open your mind, analyze the facts and apply the science. As Jesse: Yeah, Mr. White! Yeah, science!

Live Long and Prosper (LLAP)

or perhaps

Live Long, Logically and Prosper (L3AP)

On a side note - if you are interested in the history of the Spock Vulcan Salute - Live Long and Prosper you can watch his explanation of his Jewish Origins here (derived from the Hebrew letter shin  and the first letter of several hebrew words Shaddai (god), Shalom (hello/goodbye/peace) and Shekhinah (feminine word for god) - How Fascinating!

Vaccines Don't Cause Autism - Vaccinate your Kids

It can be frustrating to be a clinician in the era of the internet and instantaneous availability of data especially when the reliability and accuracy is variable. But this is the world we live in and there is plenty of data showing that patients are accessing information in ever increasing numbers. The challenge has been helping patients filter the data for both relevance and accuracy.

Vaccination has been at the epicenter of a these challenges for some years - in fact long before the wide spread use of the internet thanks to a piece published in The Lancet in 1998  and unusually retracted. In fact the BMJ published a paper in 2011 declaring the paper fraudulent - as they noted in the discussion the lead author (now stripped of his medical degree and academic credentials) was clearly actively perpetrating the fraud

Who perpetrated this fraud? There is no doubt that it was Wakefield. Is it possible that he was wrong, but not dishonest: that he was so incompetent that he was unable to fairly describe the project, or to report even one of the 12 children’s cases accurately? No. A great deal of thought and effort must have gone into drafting the paper to achieve the results he wanted: the discrepancies all led in one direction; misreporting was gross. Moreover, although the scale of the GMC’s 217 day hearing precluded additional charges focused directly on the fraud, the panel found him guilty of dishonesty concerning the study’s admissions criteria, its funding by the Legal Aid Board, and his statements about it afterwards

Sadly despite repeated studies and investigations. Despite the retraction of the original article by the Lancet. Despite the other authors personally retracting the paper we still hear about a “link”. Sadly some high profile individuals continue to perpetrate the fraud (notably the model Jenny McCarthy and most recently the “reporter” Katie Couric).

I saw the posting by Aaron Carroll MD, MS is a Professor of Pediatrics and Assistant Dean for Research Mentoring at Indiana University School of Medicine (the Incidental Economist) last week when he posted this map of the real effects of this in Vaccine Preventable Outbreaks (click on the map button on the left if necessary)

In fact Dan Munro posted his own take on this piece: Big Data Crushes Anti-Vaccination Movement. As he sadly notes

Add a well known celebrity (or two) and the effects can be powerful, long term and hard to refute.

 And ss Dr Carroll notes the impact can be seen in the chart above:

• All of that red, which seems to dominate? It’s measles. It’s even peeking through in the United States, and it’s smothering the United Kingdom.
• If you get rid of the measles, you can start to see mumps. Again, crushing the UK and popping up in the US.
• Both measles and mumps are part of the MMR vaccine.
• Almost all the whooping cough is in the United States.

But the best part of this post is his accompanying video - included below - well worth watching the full 8 minutes

Expertly and accurately put.

Vaccinate your kids….please.

Social Network Sways Vaccine Compliance

via medpagetoday.com

Excellent article that demonstrates the challenges facing scientists and data. Despite the data clearly showing the benefits far outweighing the risks parents opinion and decision is swayed by "social norms"

As a society, we respect the privacy of healthcare decisions; however, if we are to sustain adherence to the recommended immunization schedule as a social norm, we need to learn how to empower immunizing parents to become vocal and talk with other parents, including prospective parents, about why they chose to immunize their children

Quite!

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Science at Work - Number Of Early Childhood Vaccines Not Linked To Autism

A new study from the Centers for Disease Control and Prevention finds no link between the number of vaccinations a young child receives and the risk of developing autism spectrum disorders.

Jeff J. Mitchell/Getty Images

A large new government study should reassure parents who are afraid that kids are getting autism because they receive too many vaccines too early in life.

The study, by researchers at the Center for Disease Control and Prevention, found no connection between the number of vaccines a child received and his or her risk of autism spectrum disorder. It also found that even though kids are getting more vaccines these days, those vaccines contain many fewer of the substances that provoke an immune response.

The study offers a response to vaccine skeptics who have suggested that getting too many vaccines on one day or in the first two years of life may lead to autism, says Frank DeStefano, director of the Immunization Safety Office of the CDC.

To find out if that was happening, DeStefano led a team that compared the vaccine histories of about 250 children who had autism spectrum disorder with those of 750 typical kids. Specifically, the researchers looked at what scientists call antigens. An antigen is a substance in a vaccine that causes the body to produce antibodies, proteins that help fight off infections.

The team looked at medical records to see how many antigens each child received and whether that affected the risk of autism. The results, published in The Journal of Pediatrics, were unequivocal.

"The amount of antigens from vaccines received on one day of vaccination or in total during the first two years of life is not related to the development of autism spectrum disorder in children," DeStefano says.

The finding came as no surprise to researchers who study the immune system, DeStefano says. After all, he says, kids are exposed to antigens all the time in the form of bacteria and viruses. "It's not really clear why a few more antigens from vaccines would be something that the immune system could not handle," he says.

The study also found that even though the number of vaccines has gone up, the number of antigens in vaccines has gone down markedly. In the late-1990s, the vaccination schedule exposed children to several thousand antigens, the study says. But by 2012, that number had fallen to 315.

That dramatic reduction occurred because vaccines have become much more precise in the way they stimulate the immune system, DeStefano says.

“ The sad part is, by focusing on the question of whether vaccines cause autism spectrum disorders, [researchers are] missing the opportunity to look at what the real causes are. It's not vaccines.

- Ellen Wright Clayton, professor of pediatrics, Vanderbilt University

Hardcore vaccine skeptics are unlikely to be swayed by the new research. But many worried parents should be, says Ellen Wright Clayton, a professor at Vanderbilt University who helped write a report on vaccine safety for the Institute of Medicine.

"I certainly hope that a carefully conducted study like this will get a lot of play, and that some people will find this convincing," Clayton says. That would let researchers pursue more important questions, she says.

"The sad part is, by focusing on the question of whether vaccines cause autism spectrum disorders, they're missing the opportunity to look at what the real causes are," she says. "It's not vaccines."

Autism Speaks, a major advocacy and research group, seems ready to move beyond the vaccine issue. Geraldine Dawson, the group's top scientist, praised the new study and says the result should clear the way for research on other potential causes of autism.

These include factors like nutrition, which can affect a baby's brain development in the womb, Dawson says. Other factors could include medications and infections during pregnancy, she says, or an infant's exposure to pesticides or pollution.

"As we home in on what is causing autism, I think we are going to have fewer and fewer questions about some of these things that don't appear to be causing autism," Dawson says.

via npr.org

More coverage and science referring to a recent study showing no link between vaccines and autism. This was covered in the SBM Site
The Final Nail in the Coffin - sorry if some of yo have trouble getting to the site as it appears to be having problems

As one commentator articulated

"The sad part is, by focusing on the question of whether vaccines cause autism spectrum disorders, they're missing the opportunity to look at what the real causes are, It's not vaccines."

If you are interested in a detailed analysis of the science and statistical analysis the SBM article is excellent. The analysis

They sliced and diced the data in a variety of ways looking for correlations and didn’t find any

And does an in depth debunking of the lack of science in the broadside from antivaccinationists who's fear mongering seems to date back to the widely and roundly debunked falsification of data by Andrew Wakefield that was described as the most damaging medical hoax of the last 100 years. He was struck of the GMC register and barred from ever practicing medicine in the UK.

As David Gorski in his title the study had not intended to disprove the relationship between the "toxins" used as part of vaccine make up. This study came as close as one can to disproving that relationship:

Which brings us to “too many too soon.” It appeared to be a “hypothesis” that was impossible to falsify, but DeStefano et al came about as close as it’s ethically possible to do to falsifying the hypothesis. No wonder that all that antivaccinationists are left with are calls for “vaxed versus unvaxed” studies and pharma shill ranting.

Science at work!

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