Tuesday, May 23, 2023

Dr. David Gorski is fighting for science-based medicine and against nonsense

 


 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

There is an article by Matthew Hongoltz-Hetling at The New Republic on February 28, 2023 titled A Doctor’s War Against the Right-Wing Medical-Freedom Movement. It is about Dr. David Gorski, whose long-running blog is titled Respectful Insolence. He also is the Managing Editor of the Science-Based Medicine web site. Dr. Gorski blogged about that magazine article on March 2, 2023 in a post titled The New Republic on a two decade war against medical quackery.

 

I ran across his blog when I was trying to make sense of dubious information about COVID-19. Then I blogged about him in a post on March 24, 2020 titled Phony coronavirus remedies, a post on April 8, 2020 titled Going on a wild goose chase by treating coronavirus with an unproven malaria drug, a post on May 4, 2020 titled Sifting through misinformation, and a post on May 23, 2020 titled Simplified images either can clarify or confuse.

 

Dr. Gorski writes long, detailed posts and articles, which include lots of medical terminology. I admire and often read (or just skim) his writings. He is excellent in explaining why things do or do not make sense. For example, an article on March 20, 2023 titled Ivermectin is now fast becoming the new MMS explains:

 

“As I’ve written many times before, despite its ability to inhibit the replication of SARS-CoV-2, the coronavirus that causes COVID-19, in cell culture, well-designed randomized clinical trials have failed to find any efficacy for the drug. There’s a reason why I’ve referred to ivermectin as the acupuncture of COVID-19 treatments because of its extreme implausibility based on basic science alone. The reason for that implausibility is that the concentration required to inhibit viral growth in vitro is 50- to 100-fold higher than what can be safely achieved in humans, meaning that, from strictly a pharmacokinetics and pharmacodynamics standpoint, ivermectin was always a highly implausible treatment for COVID-19.”

 

Another article on May 22, 2023 titled Evidence-based medicine vs. basic science in medical school discusses randomized controlled trials (RCTs) and homeopathy as follows:

 

“As I like to ask: Which of the following is more likely, that a 30C homeopathic solution of…something…that has been diluted on the order of 1037-fold more than Avogadro’s number and thus is incredibly unlikely to contain even a single molecule of that something has a therapeutic effect or that the RCTs concluding that it does reveal the problems and biases in clinical trials? As I also like to say, given the usual p-value of 0.05 designated for ‘statistically significant’ findings, under ideal circumstances, with perfectly designed and executed RCTs, by random chance alone 5% of these RCTs will be ‘positive.’ Of course, in the real world, RCTs are not perfect, either in design or execution, and the number of ‘false positives’ is therefore likely considerably higher than 5%. Yet, basic science alone tells us that a 30C homeopathic remedy is indistinguishable from the water used to dilute it, which means a placebo-controlled RCT is testing placebo versus placebo and ‘positive’ results show us nothing more than the noise inherent in doing RCTs.”

 

The image of a boxer was modified from this one at the Library of Congress.

 


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