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MS surgery? More studies are definitely needed.

June 13, 2010

I’m currently reading Hyping Health Risks:  Environmental Hazards in Daily Life and the Science of Epidemiology by Geoffrey C. Kabat.  As with most non-fiction books, I’m reading this book slowly while marking in the text and trying to absorb all of it.  The author has confirmed many of my concerns about the conduct and use of epidemiological research while affirming my belief in the power of research when it is done correctly.

While reading the following section in the chapter “Does the environment cause breast cancer?”*, I immediately thought about the current controversy surrounding multiple sclerosis and Dr. Zamboni’s assertions that MS can be cured via angioplasty.

Of course, it is only human to want to come up with positive findings and to have them be meaningful.  But for this reason, it is important to be aware that it is only too common for a small, early study of a new question to show an intriguing result.  When the initial study is followed by larger and more carefully executed studies, it is often the case that the initial finding is not borne out.  This has happened in an early study indicating that coffee drinking was associated with pancreatic cancer, in a study suggesting that consuming beverages containing caffeine could lead to benign breast disease, and in early studies linking fat intake with increased breast cancer risks — to cite but a few instances of this pattern.  When the stakes are high — both in terms of the public’s desire for knowledge and of researchers’ drive to obtain meaningful findings — the danger of getting carried away and committing the cardinal sin of “believing one’s hypothesis” is at its greatest.

I added the emphasis.  In the case of Dr. Zamboni and his CCVSI theory, one could add the personal stakes involved because his wife has MS and the desire to find a cure must be strong.  The MS treatment studies are even further complicated by the possibility of a placebo effect; patients think that the treatment will work and therefore they feel better.

Many MS patients are quite vocal in their demands that the government both allow and pay for this treatment.  Instead of waiting, some are travelling to other countries to obtain the testing and treatment.  An, at practically the same time, patients are demanding that the theory be tested.  Dr. Zamboni even stated that his theories should be tested AND that patients should be treated.

I believe that the MS societies are proceeding in the most prudent manner by first funding studies of whether MS patients actually have blocked cranial veins.  I know that patients are in a hurry but you can’t rush the science.

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