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Sep 10 2009

Response to Peter Lipson MD of “Science” Based Blogs, My Blog Does Not Suck, Yours Does

I got an extremely lame-o critique from Peter Lipson MD, writing on the “White Coat Underground” blog hosted on science-base blogs. Last time I heard from Dr. Lipson he had “unsubscribed” from my email alerts well over a year ago, but apparently he has kept reading because he had a list of things to throw rocks at. This pattern of getting attacked by someone from the science-based blogs (see my exchange with David Dobbs over PTSD), and then have them all chuckle and pat themselves on the back afterward in the comments section like a bunch of naughty school boys, is something I am getting all too familiar with. In the case of Dobbs, I called a comment he made about PTSD “retarded“, which made him have a major freak out attack. I did not call HIM retarded. In the case of Lipson, he called ME stupid. So I would be justified if I were to call him something like, for instance, a major dickhead, but I won’t, just cuz I am a good guy.

Speaking of which, one of the critiques from the commenters was that I said ‘cuz’, and how could you take anyone seriously who said that. Well this had come up before on this blog, and I reserve the right to say ‘cuz’ and ‘anyhoo’ and ‘lol’ and ‘ROTFL’, cuz, well, I want to. And if you don’t like it go read someone else’s blog. Cuz, well, what do you think this is, customer SERVICE?

He also accused me of being ‘cynical’ but a quick perusal of the lame and snarky comments he made unrelated to anything science based would put him in a fair competition for the title.

For instance he threw out my post ‘Breast cancer screening essentially useless’ (he has provided links to all of my posts so I won’t reproduce them here), saying that yes they may not be needed for everyone, namely me (as I am a male). Well obviously I am not going to get breast cancer screening, I was obviously referring to women, and the fact that screening does not reduce mortality, probably related to the fact that many of the “cancers” would not ever lead to any real disease, so women are getting over diagnosed and put under undue anxiety.

What is wrong with pointing out that breast cancer screening doesn’t save lives, and that the public info messaging is not accurate, so that people can decide for themselves? I don’t have any problem with that, do you?

They also accused me of being a “populist”, and “like Bill O’Reilly”. Well the fact that I write in a way that people can actually UNDERSTAND, I take as a compliment. As for O’Reilly, he is a right winger which I am not. As for their “science based blogs” like “The White Underground”, a quick perusal shows that they spend much of their time talking about their “kiddos”, which doesn’t have anything to do with science, and frankly if I want to read about kiddos I can go to pampers.com. They keep throwing out that I am ignoring evidence or not fact based but give no specific credible examples.

Next, my post on angioplasty being useless, he complains that the title of the blog doesn’t state that angioplasty is useful for people with acute coronary events. Well the body of the blog clearly states that, and I don’t think most people having acute cardiac events will read my blog anyway. But since I already had one other blogger MD go bananas over this (btw there are still billions of dollars of angioplasties performed on people with stable heart disease that are in fact useless) I will change the name of the blog. Stay tuned. Should be interesting.

Next, he throws rocks about taking aspirin to prevent heart disease, and mumbles something about my comprehension of primary and secondary prevention. Well only a rock head would tell you to take aspirin if you don’t have heart disease (which would be primary prevention, my friends. Secondary would be if you already have heart disease, and I never quibbled about that). If he wants to argue, go argue with Mrs. Bremner, who is a cardiovascular epidemiologist and has an article on the topic on F1000.

What else. I guess his main beef was with my blog “Flu shots are for idiots”. My main point was that advocates for the flu shot like the Centers for Disease Mongering (oops, I mean Control) for all population groups are not based on the evidence. So he ignores that main point, and focuses on those over 65, and cites a retrospective assessment of a database of those who did and did not get flu shots. Well that kind of analysis is potentially rife with confounders. The only way to see if something really works is with a randomized controlled trial (RCT), as we have learned from the sorry saga of hormone replacement therapy (HRT), which was touted as great but the RCT showed to increase death. If you actually read the links he provides you see the problems with those studies.

The only real substantive critique he has is of my flippant comment that most people who die from the flu are the elderly who may have compromised immune function and won’t benefit anyway (he presents it like they WILL which is misleading). I still don’t think we know who amongst the elderly actually benefits. The fact is that CDC and public health agencies are telling EVERYONE to get a flu shot. And his comments about swine flu affecting children more therefore they need flu shots are egregious since it wasn’t around when I wrote that post, nor were some of the articles he claims I ignored. And I still don’t think kids should get flu shots since the mortality rate is not higher than the regular flu. And the comment that flu shots target more than one virus is lame since the point that it doesn’t cover all flu (maybe 25-50%) still holds.

So before you go calling names, come up with a substantive critique.

32 Comments

  • By Amy Philo, September 11, 2009 @ 12:20 am

    I love posts like this. Cuz, well I do. Anyhoo. G’day.

  • By Doug Bremner, September 11, 2009 @ 12:39 am

    (snorts of laughter)

  • By Danny Carlat, September 11, 2009 @ 6:57 am

    Doug’s blog is the funniest medical blog I’ve seen and I love his free-for-all style. His headlines are unabashedly sensationalist. He points out the holes in the scientific pronouncements and doesn’t claim to be writing peer-reviewed literature reviews in this setting (though he does do that when he signs out of his blog and does his world famous PTSD research at Emory). So lighten up, Bremner critics, cuz it makes you look sanctimonious.

  • By Stephany, September 11, 2009 @ 7:42 am

    What Danny said.

  • By Aram Sohigian, September 11, 2009 @ 10:36 am

    Thank you for standing up to the sell outs and big pharma.

  • By Lisa Van Syckel, September 11, 2009 @ 11:12 am

    I love this blog, second to Pharmalot of course!

  • By Gina Pera, September 11, 2009 @ 2:28 pm

    “And if you don’t like it go read someone else’s blog. Cuz, well, what do you think this is, customer SERVICE?”

    No one can accuse you of not having a sense of humor, Dr. B. :-)

  • By revere, September 11, 2009 @ 8:27 pm

    The flu vaccine problem is technically difficult for a variety of reasons. You and your readers may find this post and its main cite to be useful:
    http://scienceblogs.com/effectmeasure/2009/07/transmission_pathogenicity_vir_1.php

  • By carolyn, September 11, 2009 @ 11:27 pm

    of course, you’re cynical. how could you not be in a world where the FDA just approved Gardasil for boys! your cynicism is one of the reasons we read (and love!) you

  • By Linus Van Pelt, September 12, 2009 @ 1:29 am

    I read your blog. I’ve never heard of, let alone read, the “White Coat Underground” blog nor the science-base blogs.

    That kinda’ says it all, don’t it?

  • By PalMD, September 12, 2009 @ 5:56 am

    I’ve never heard of, let alone read, the “White Coat Underground” blog nor the science-base blogs.

    That’s because there is no such thing as “science-base blogs”. Reading comprehension fail.

  • By gr8googlymoogly, September 12, 2009 @ 4:31 pm

    The wonderful thing about blogs is that anyone can publish anything at all for any reason. The bad thing is that most people can’t tell the difference between valuable and worthless content.

    I can offer a tip – if the blog contains pithy statements like “My Blog Does Not Suck, Yours Does” and “lame-o”, it probably is not worth the electrons it takes to get it to your screen.

  • By gr8googlymoogly, September 12, 2009 @ 4:33 pm

    Oh, and yes, I feel dirty just for commenting here. Shower time.

    Where can I apply for the refund of the few minutes I spent here?

  • By vexorian, September 12, 2009 @ 4:46 pm

    Thank you for standing up to the sell outs and big pharma.

    Man, I hope that’s sarcasm.

  • By Linus Van Pelt, September 12, 2009 @ 10:22 pm

    Wow, PalMD, no surprise you are that insecure and pathetic.

    The very first line of Bremner’s post:
    “I got an extremely lame-o critique from Peter Lipson MD, writing on the “White Coat Underground” blog hosted on science-base blogs.”

    human being fail.

  • By Doug Bremner, September 12, 2009 @ 10:34 pm

    @PalMD
    You started it.
    Can’t say that I don’t appreciate getting alerted to new literature I hadn’t read previously, and having new discussion, so no hard feelings really.

  • By Orac, September 12, 2009 @ 10:36 pm

    I read your blog. I’ve never heard of, let alone read, the “White Coat Underground” blog nor the science-base blogs.

    That kinda’ says it all, don’t it?

    Ah, yes, a combination of argumentum ad populum and the self-centered apparent belief that if you haven’t heard of it it must not matter or be that good.

    Does that mean that I can say because I’ve never heard of you then “that says it all” about you?

  • By Doug Bremner, September 12, 2009 @ 11:31 pm

    Ah yes, another comment from one of the science-based barfers (oops, I mean bloggers), which adds more evidence that they are a bunch of naughty school boys conspiring as to who is the next person they will push down in the playground.

  • By henry, September 13, 2009 @ 1:49 am

    Carolyn,
    When the first vaccine was being developed against HPV, the women who developed the vaccine hoped that eventually men would take some responsibility for the spread of STD’s too. They deliberately included some strains of HPV which cause venereal warts in men in their plans, hoping that some day, men would also be vaccinated. This makes sense from several different perspectives.
    While I am not exactly enamoured of the way the vaccine has been marketed in the US, I think it is relevant that cervical cancer is one of the leading causes of cancer death in the third world. Preventative measures such as yearly pap smears are not high on the list of priorities in many countries. Even here in the US, many people do not have access to this kind of care.
    All of which is just my way of saying, look beyond the obvious before you criticize.

  • By murci3lag0, September 13, 2009 @ 4:49 am

    Seriously, you are not helping yourself with bad retoric and teenager language. I’m just reading each others posts, but yours is not enlightening, and not even funny.

  • By Linda G., September 13, 2009 @ 10:41 am

    Consistently enlightening AND funny. Also informative and useful (in my humble opinion). Please don’t change a thing, Doug. Love your blog!

  • By gr8googlymoogly, September 13, 2009 @ 10:49 am

    Linda G. said “Consistently enlightening AND funny.”.

    Really? I find this blog quite juvenile – intellectually AND humorously. All we need is some fart jokes.

  • By gr8googlymoogly, September 13, 2009 @ 10:52 am

    “Ah yes, another comment from one of the science-based barfers…”.

    Well, ‘barf’ jokes ALMOST count as much as fart jokes. Touche, ‘Dr.’ Bremner!!

  • By Eddie Vos, September 13, 2009 @ 8:40 pm

    Hello Doug, you still run an excellent blog and please don’t let this fellow PAL get under your skin. Instead of him running a positive and creative blog, he occasionally [often] gets into insulting people, and not pulling excessively rude postings by anonymous others, while not backing up nonsensical statements of his own. Paraphrasing: “the US diet contains an excess of all [the nutrients] you need” and nothing could be done to have him give a single study in support [there are none]. I walked when the insults got too gross – followed by a snarky comment by PAL himself.

    So, keep up the good works and, P.S., my response to Ridker’s JUPITER article is now also on the CircOutcomes site with a brief response by the latter. Cheers, Eddie

  • By Calli Arcale, September 14, 2009 @ 11:02 am

    of course, you’re cynical. how could you not be in a world where the FDA just approved Gardasil for boys! your cynicism is one of the reasons we read (and love!) you

    Gardasil was approved for the prevention of penile cancer. I’m curious — why is this a bad thing?

  • By Angioplasty, September 14, 2009 @ 12:50 pm

    Loved everything you said. Then again if we all stopped being lazy and exercised a bit we’d all be in a better boat.

  • By Stephany, September 14, 2009 @ 5:44 pm

    Gardasil has death and convulsions as a side effect from the vaccine and it is being pushed onto 12-13 yr old girls sometimes as a pre-requisite to entering junior high school, mandatory vaccine with side effects for cervical cancer prevention for girls who are mostly still virgins.

    Now onto the boys and their genital warts, and Cervarix, GSK’s version was just approved. Once again, a marketing pimping happening, approved by the FDA, what a joke.

    Now that was off-topic, but someone brought it up here so why not comment about it. Trust the researchers? or the companies that have pushed this vaccine? I don’t.

    Keep up the great blunt humor here Bremner, some people wear white coats and are so damn arrogant, like Dr. Stroganoff.

  • By henry, September 14, 2009 @ 10:00 pm

    Try and leave aside the criminal nature of the current marketing of Gardasil and concentrate on the merits of the vaccine itself. The whole point of Gardasil is to vaccinate girls while they are still virgins. There isn’t any point in vaccinating them once they have acquired HPV. The vaccine PREVENTS infection, it doesn’t cure it. Also, taking reports from VAERS as meaning causality is contrary to the whole purpose of the system. Any reaction that occurs after a vaccine, no matter how unlikely it is to have been caused by the vaccine, must be reported. These are preliminary reports of events that happened within a time frame that makes it possible they were associated with the vaccine. They have yet to be investigated to see whether they were coincidental or caused by the vaccine.
    The real crime here is not the vaccine, but the outrageous price and the profits that are being made from it. In developing countries which are in greatest need of this vaccine, the cost is prohibitive.
    As for boys getting the vaccine, it is not just about preventing venereal warts, it is about making them equally responsible for preventing the spread of HPV.

  • By henry, September 15, 2009 @ 2:43 am

    http://www.seattlewomanmagazine.com/articles/may07-7.htm
    for a broader look at Gardasil.

  • By Tom, September 17, 2009 @ 5:14 pm

    Dr. Bremner,

    I stumbled upon this post through some other posts and decided to read both Lipson’s post and the posts he is referring to. I read the post on angioplasty and the one on aspirin. Allow me a bit of criticism, because I have to agree with Lipson on these.

    On the angioplasty, nowhere in your own, original post do you make clear that your article only holds for acute, not for stable, coronary disease. This only becomes clear becomes someone in the comments points this out. Sorry, but if you’re going to accuse a whole professional group of doing something because of greed, the onus is upon you, not the commentators on the post, to get the facts right.

    Similarly for your post on aspirin, I thought I’d track down the actual recommendations given. Those are not “just give aspirin to anyone aged 47 – 79, as I was led to believe in your post. Rather it is, give it to those in that age group if their chance on coronary events is above x and their chance of intestinal bleeding is below y. This is a decidedly different recommendation than the one you are criticizing and therefore your criticism is quite misleading.

    You state that you write for a lay audience. But you neglect informing us (the lay audience) about the risk-benefit decision making that underlies the recommendations and research that you write about. This is not something all of us understand and neglecting this knowledge gap does a disservice to your audience.

  • By Doug Bremner, September 18, 2009 @ 10:58 am

    Here let me quote my ‘original angioplasty post’ “angioplasty is not more effective than medication treatment alone in preventing heart attack and death in people with stable heart disease” that looks to me like I said “stable heart disease” but maybe I am seeing things, who knows. As for aspirin recommendations that those with 5 year risk of cardiac event of 3% or more take aspirin are not supported by the evidence.
    http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60503-1/abstract

Other Links to this Post

  1. Why I am Not Getting a Flu Shot This Year | Before You Take That Pill — September 23, 2009 @ 9:42 am

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