Democratic Senator Tom Harkin is the pol who pushed a major “alternative medicine” proposal through congress that led to the formation of the NCCAM, a hotbed of government-sponsored quackery. He now regrets the effort, but for all the wrong reasons. It’s hard to imagine a more damning statement that reveals an utter ignorance of how science should work than this one:
Sen. Tom Harkin, the proud father of the National Center for Complimentary and Alternative Medicine, told a Senate hearing on Thursday that NCCAM had disappointed him by disproving too many alternative therapies.
“One of the purposes of this center was to investigate and validate alternative approaches. Quite frankly, I must say publicly that it has fallen short,” Harkin said.
The senator went on to lament that, since its inception in 1998, the focus of NCCAM has been “disproving things rather than seeking out and approving things.”
Skeptics have complained all along that Harkin and his allies founded this office to promote alternative therapies at public expense, not to test them scientifically. Harkin’s statement at the hearing explicitly confirms that hypothesis.
He’s unhappy because the research didn’t give him the answer he wanted. Does he think science is a magic wishing well?
Maybe we need to establish a new political party, the Rationalists, to replace both the Democrats and Republicans. It would be a wonderful idea, but I fear it would never get more than 0.001% of the American vote.
The NCCAM seems like a good thing, disproving all of that alternative medicine, but too bad Tom Harkin just wants to manipulate reality to his liking, as do the creationists.
I smell a budget cut.
So, does this mean that the NCCAM is a good thing as it has undermined alternative medicine?
What are people’s view on this, should we have government bodies to research the claims of quakery and bollocks science?
I’m still hoping the Republicans will split into the religious nut party and the economic conservative party. Not that I like either position, but without that 25% voting block of absolute crazy voting with those who are misled into thinking they will one day be rich enough to benefit from those tax cuts so better make sure they stay there, I think the danger of a Palin or Bush being voted into office will be much decreased.
On the bright side, it doesn’t seem like our tax dollars have been used to falsify any data or findings. Its done the totally scientifically predictable and disproved magical medicine.
Ahhh, poor baby. He finds reality isn’t what he that it was. Let’s get him a nice blanky and a cup of cocoa. Maybe a nap will help.
If you run the proper tests, you have to accept the results. Very few of the alternative medicines show any benefit above PlaceboTM the wonder drug. There was nothing there in the first place.
Harkin will be much better after a good bleeding, to get his humours back in balance.
This angers me to the core. This guy is spectacularly wrong … the purpose of science isn’t to validate anything, it’s to find out the effing truth. Gah! What the hell is so hard about this?!
Christ’s balls! You can’t win in the states! You’ve got the Republicans on one side pushing creationism, and you’ve got the Democrats on the other pushing alt-meds.
I think you’re selling America short on this one. Think positive! I’m sure we could get at least 0.002 %, maybe more!
There are more rational people in the US that fundies so I bet that a Rationalist party would no do so bad.
How about we all e-mail Obama to get rid of NCCAM.
Save wasted money and stop stupid research!
Same reason the IDiots hate science.
Glen D
http://tinyurl.com/6mb592
I’m all for a government oversight group tasked with debunking alternative medicine. Let the bull-chips fall where they may.
I’m not in favor of outlawing alternative therapies that are show to be ineffective, however. Homeopathy, for example, which has no benefits greater than the placebo effect and can not cause harm I would allow to remain legal. False claims of medical benefits can be better policed by regulations against false advertising.
However, treatments that can cause actual harm, such as chiropractic treatment for children, I would outlaw.
The gray area are those treatments which are ineffective but which cause harm because people willingly choose the alternative treatment over traditional medicine. If people are willing to take themselves out of the gene pool by choosing alt. meds, more power to them. But, child endangerment charges should be available for those who take this route for their kids.
I would also advocate allowing terminally or seriously ill people to take whatever they want. If you’re going to die anyway, grab whatever straws you wish.
@11
Um, Bob, I think you might be betraying a regional bias in your statement. New England might have more rational people than fundies, but I would not be so sure of the rest of the country. I spent four years living in western Pennsylvania, during which time my junior high had “Jesus Week”. There were only about two other students in my grade who I remember also being utterly horrified.
Actually, I think what you (and I) want here is an empiricist party, not a rationalist party.
PZ Myers is actually a mad-libs algorithm?
I think what we have here is another case of journalism and the media in general doing a dishonest job of ‘telling both sides of the story’. Alternative vs. western medicine has been set up to look like 2 equally valid opinions and this senator probably thought what he was doing was allocating resources to help ‘valid’ alternative therapies become more mainstream. Because he wasn’t educated by the media to realize that what makes alternative medicine alternative is the fact that it can’t prove its therapeutic effect, if it could it would just be an accepted part of the evil western medicine establishment. He got hoodwinked into thinking it is in fact therapeutic, so the research would obviously show that, and he’s genuinely surprised that they’ve found otherwise.
Harkin’s idiocy aside, I actually find this a rather positive development. I admit I know nothing about the NCCAM, but if it is accurate that the agency has been objectively evaluating alt-med treatments and determining whether they are effective, that seems to be a very valuable service. People will still be free to waste their money and jeopardize their health by using disproven treatments, but at least the information will be available. Rather than cutting this agency, I’d like to see its work given more publicity.
Mozglubov @14:
I know some areas are crawling with fundies, like Appalachia and upper mid-west but calif, Oregon, Wash., Minn., the north east and mid-atlantic have many rational people. Even some places in the deep south are oases of reason.
Also many ‘normal’ religious people have had it with the fundamentalists, after deferring to them even when they constitute a minority.
OT, but I think readers here will appreciate this Onion article:
Lovecraftian School Board Member Wants Madness Added To Curriculum
At least he’s not claiming it’s a vast governmental/pharmaceutical conspiracy. Well, at least not publicly . . . yet.
yes, it seems that he does think science is a magic wishing well.
I would vote for the rationalist party. I am curious as to who would run under that ticket, considering most rational people stay as far away from politics as possible.
Ryogam at #13
You might find this site interesting- it’s a bit drama queenish but the sources they cite seem credible ( the ones I’ve checked out anyhow). Everytime one of my friends who believes in woo medicine bullshit starts on about their latest fad thing and how wonderful it is I send them a link.
Of course that would me more helpful if I included the link
http://whatstheharm.net
Yes, I am an idiot.
Maybe – and I’m just throwing this out there – maybe, we might want to know if such alternative and complimentary therapies actually work before rubber stamping their approval. Funny how no matter what woo someone is trying to push that the process always seems to converge to an evidence-based system.
I think the good senator needs a colonic.
NE Bob @19:
Oregon and Washington are up to their pierced nipples in altie med woo. Naturopathic, Homeopathic, Chiro, Accupuncture, Reiki–all are huge out here, for people and pets (I wish I were joking about the pet thing, but alas, I now have to ‘vet’ my DVM as well as my MDs to make sure they’re not sCAM-friendly before booking an appointment). Massive outrage over trampled civil liberties and the corrupt, soulless vampire that is BIG MEDICINE would ensue if anyone tried to take their cozy woo away.
As to the validity of NCCAM itself, yes, it’s a good thing that the experiments conducted through this funding have thus far not supported the CAM claims being tested. However, the fact that the center is in a position to grant millions of dollars for these ‘tests’ in the first place is not a good thing. The burden of proof, as it were, is virtually non-existent when submitting a grant to NCCAM. Nothing is required in the way of preliminary results, or even prior published work to support the hypothesis. Anyone who’s ever applied for an RO1 grant should be weeping hysterically at this news. In short, it’s easy money being thrown at a useless cause. Even if the economy were booming it would be a stupid waste of resources, and in light of our current state of affairs, it’s a travesty.
There are a number of good posts discussing NCCAM on the Science Based Medicine blog if anyone’s interested in learning more.
Thanks, Bride, that looks like a very interesting site, I’ve bookmarked it. I’ve never hear of a lot of the stuff on there. Cranal-Sacral therapy? Escharotics? Alphabiotics? I’ll have to delve deeper into the woo fields. Looks like fun.
I thought I had a receptive audience the other day at a hospital, when delivered to a nurse the following joke:
“What do you call alternative medicine that works? Medicine!”
I frowned very deeply when she replied “oh, I don’t know, there’s room for alternative medicine in some cases.” I was very glad that she wasn’t the one operating on my girlfriend.
We can’t chase every single idiot out of either party. We have a hard enough time chasing them out of the threads at Pharyngula. Still, the only viable party where science gets a fair hearing is the Democratic Party. The wise response is for more science-minded progressive people to get involved in the party. Go into local politics. Climb the ladder if you can stand it.
she replied “oh, I don’t know, there’s room for alternative medicine in some cases.”
It’s the Jello of medicine! Tastes great and does nothing for you.
#21 “At least he’s not claiming it’s a vast governmental/pharmaceutical conspiracy. Well, at least not publicly . . . yet.”
Of course big pharma has a big stake in Alternative medicine. They see the possibility of selling low risk, low cost homeopathic products (water) at drug prices.
They would be likely to support Harkin if he tries to force approvals.
In a country where ideology dominates the political zeitgeist, someone espousing “skeptical rational thought” is going to be ignored. If you’re not supporting or lambasting the right people, you’re a shlub.
Turn rationality into a political ideology, and then you might have something…
Hold on, now … a few of your are saying that alt med can’t hurt you. That’s patently false, as the What’s The Harm website readily shows. (They’re anecdotes, sure, but they’re *verified* anecdotes, so they actually happened.)
Even something genuinely benign like homeopathy can hurt you, albeit indirectly. If you take their magical sugar pills for your cancer rather than receiving chemotherapy, you’re going to die. I’d call that “getting hurt” …
Of course, an institution that is in favor of approving “alternative” medicine is by definition working against itself. Every time an alternative medicine is scientifically proven to work (beyond placebo effect) it becomes “medicine”, the mainstream doctors start to prescribe it, and the ranks of “alternative medicine” thin slightly. The word “alternative” means NOT medicine and if it works and can be proven to work, it ceases to be alternative.
I mean, what’s next? Are we going to start grinding up and making a tea out of willow bark to help with a headache? INSANITY! Maybe I’ll take some of this willow bark “medicine” every day in order to ward off the heart attack spirits?? The madness!
Economics dictates that we should test only hypotheses that are both promising and scientifically sound. Political expediency however dictates that it’s helpful to test hypotheses which excite public passions. Sadly, anecdotal evidence will always excite public passions.
Misunderstanding science can be costly.
Of course we do, politics is far too irrational!
But there could be another good reason for a rationalist party. When atheists in the UK complained about the “There definitely is a God” bus ad because it is unprovable, the ASA claimed it didn’t fall under the same truth in advertising rules because it was a political ad (since it came from the Christian Party). So theoretically we should be able to do the same, right?
P.S. does it scare anybody else that political ads officially don’t require truth in advertising?
The problem Danio is that insurance companies are already falling all over themselves, in many cases, to support the woo treatments, since they tend to be cheaper (and probably, if I was cynical enough to suggest so, due to not having to pay out more insurance to the people that drop dead taking them). Without some sort of agency to combat this BS, we already have, to a lesser extent, the, “arsenic laced miracle cure snake oil!”, type BS making its way into treatment, sans the arsenic. And the only reason that isn’t in there, is the FDA was invented to stop the actively lethal bullshit, but not the less lethal stuff.
Its like arguing that “less than lethal” rounds, should be sold instead of lead bullets for everyone with a machine gun, then you wouldn’t have to deny selling the fully automatic machine guns. Ugh.. No, idiots are still going to kill people with them, because “less than lethal”, doesn’t mean it can’t kill people. By the same token, “the new miracle snake oil, now with no arsenic!”, is still the same crap that the FDA was created to protect against in the first place, its just sliding under the radar, by both a) not having any “active” ingredients at all, in many cases, and b) producing items that are not “covered” by the FDA mandate. So, if you don’t have NCCAM to deal with it, when are we going to expand the over worked FDA to do it (right) instead, given that its likely to end up with such low priority for them, even if they did expand to handle it, that you will be lucky to have 1-2 people checking on the stuff per every 10 states?
Or, more to the point, what happens when you have the same situation with doctors in the future you know have with idiot pharmacists and contraception. You literally can’t find someone who isn’t a total idiot that will prescribe acacia pills, or some BS, instead of heart medication. Or your insurance company tells you, “Well, we don’t think you “need” real medicine, but we would happily pay for X or Y ‘alternative’.” Then what? Because, that is the direction things are trending right now.
I’m going to write a letter to Sen. Harkin.
I am rather amused that the body in question is, apparently, showing some skepticism, at least, however. What, the agency you tasked with investigating these things is actually doing so? Dear me. Poor guy…
The phrase ‘be careful what you wish for’ springs to mind.
*11
‘How about we all e-mail Obama to get rid of NCCAM.’
Hell no dude… they is doing a grand job!
A rational party in the states scoring 0.001% of the national vote…some exaggeration surely ;-)
Ping!
https://harkin.senate.gov/c/index.cfm
Here’s a URL with some instructions on starting a new political party:
http://wiki.answers.com/Q/How_do_you_start_a_new_political_party_in_the_United_States
I would gladly start a local chapter, if someone wants to do the heavy lifting of kicking off the national convention.
I would be pleased if any folk remedy were found safe and effective, so I’m not celebrating the failure to date of the few “alternative” treatments studied.
What I protest is the misleading language surrounding alternative, complimentary, or integrative medicine. I’m worried that a US senator can’t appreciate the self-contradiction in the phrase, “science-based alternative medicine.”
Double-think causes brain damage.
Yabbut PZ, doesn’t this really show that your objection to the NACCM is misguided? As it turns out, they in fact perform a beneficial function. They are subjecting claims to scrutiny, and giving us answers that we need. People take all these herbal potions and nutritional supplements and strap on magnets and what not already, often because of claims based on low quality evidence, but there is often suggestive information that some of the stuff might work, as in the case of Glucosamine-Chondroitin, and St. John’s Wort for example.
We need good quality evidence about this stuff, and now we’re getting it. That isn’t a boondoggle, it’s a win! Yes, some of the earliest grants they made seemed to be to study some of the least plausible treatments, but big deal. They’re doing a public service. What’s wrong with that?
Pretty funny that PZ should mention a “rationalist” party : I’ve been pondering that exact idea for a little while, somewhat disappointed with the available options here (in France).
The key question, however, would be : are the ideas we adhere to really all that rational ?
We’d all love to believe that our political positions are the rational ones but I’d bet a lot of people hold contrary positions with the same believe. So, short of becoming an expert on economy, sociology, politics, etc., how can we say that our positions are any more rational than others ?
What would the opinions of this party be and would we find on consensus amongst those willing to call themselves “rationalists” ?
@37
That is rather disturbing.
@19
Fair enough… although from the evidence of Bush being elected for two terms and how close this past election still was, I’m a little sceptical… I will admit, though, that a lot of that scepticism still probably stems from my days living in Pennsylvania’s little pocket of the Bible Belt colouring my whole picture of your vast country.
Speaking as an Iowa, Harkin is one of two senators that we should replace.
Re: “I’m going to write a letter to Sen. Harkin.”
Good luck getting a response. It is sad that he is the least responsive of the two senators, especially when contacted about impending legislation. I’ve received a reply for every letter sent to Grassley, but just one from Harkin. And even though I don’t agree with Grassley on most things, I do respect the fact that either he–or at least his staff, takes the time to specifically reply to my letters.
YES. The rationalist party, I’ve been saying this to my friends for a while and I don’t care if it only get’s .001% of the vote I am in.
If rationalism can’t stand on its own two feet what good is it? Or, if the truth is really worth knowing then a rationalism movement will flourish naturally.
The problem with studying alternative medicine is the same problem as with studying something like intercessory prayer. You’re trying to use science to persuade someone who didn’t arrive at their conclusion scientifically.
If an alt-med study gives negative results, nothing drastic happens. Homeopathic remedies don’t get pulled from pharmacy shelves, chiropractor’s offices don’t close, reiki classes at the gym don’t get canceled. And, if you ask the alt-med people in academia about said negative results, they’ll obfuscate and give you the “needs to be studied more” line.
On the other hand, imagine if some study showed a tiny effect. Actually, don’t bother imagining; just look around at all the crummy studies and puny effects that the pro-alt-med community props up. Notice the discrepancy?
We’re dealing with people who aren’t honestly playing the game of science. Just something to bear in mind, if you think NCCAM is going good by showing alt-med to be mere placebo.
My understanding is that NCCAM is not doing its job, because it was originally founded to use scientific testing to weed out the alternative medicines and therapies which work, from the ones which don’t work.
So, it’s been around for 10 years, and has funded many studies. Which alt med therapies have been concluded to be ineffective?
(Sound of crickets chirping)
They’ve ruled out nothing. Not the obvious bullshit like homeopathy and reiki. Not crystal healing or ear candling. Studies which fail to confirm any effect are said to “call for more research.” The jury is out. We can’t yet say. We’ve still got all this clinical experience (once defined as “making the same mistake over and over again with increasing frequency”). We need a new study, done some different way, with more targets we can hit. It seems to work for some people.
Use it on the ‘worried well,’ and give it to people with chronic problems which have no cure. So what if it’s placebo? Lie to them, for their own good. Then tell the consumers it’s all about “health freedom” and their right to make choices.
Sastra … get outta my head!!!
re: NCCAM had disappointed (Harkin) by disproving too many alternative therapies.
A former Christian, “apologetics” classes had the same effect on me. I left a committed atheist. Ooops :)
Here’s the sort of high quality science NCCAM funds:
http://scienceblogs.com/insolence/2009/02/the_national_center_for_complementary_an.php
Even by those low standards, custom-made to produce false positive results, positive results from NCCAM trials have been rare. Woo just doesn’t work any better than a placebo, I’m afraid.
Too bad Harkin won’t realize it:
http://scienceblogs.com/insolence/2009/03/maybe_nccam_isnt_so_bad_after_allnahhh.php
I’m not in favor of outlawing alternative therapies that “are show to be ineffective, however. Homeopathy, for example, which has no benefits greater than the placebo effect and can not cause harm I would allow to remain legal. False claims of medical benefits can be better policed by regulations against false advertising.
However, treatments that can cause actual harm, such as chiropractic treatment for children, I would outlaw.”
ALL alternative medicine causes harm. If nothing else it strips money from the stupid, but sadly it also effectively strips money from those not so gulible. As insurance covers the costs, this dilutes the monies available for actual treatment.
This woo is far too close to religious woo, and effective at removing money from real need to pay for its own existence. After all who has ever been harmed by faith?http://www.msnbc.msn.com/id/23882698/
http://pandagon.blogsome.com/2008/03/29/child-dies-because-parents-choose-prayer-over-insulin/
or by taking colloidal silver http://www.kval.com/news/local/12648491.html
how about acupuncture/naturopathy
http://healthfraudoz.blogspot.com/2005/06/death-by-natural-causes.html
I assume there is no need to continue.
Agreed, but why stop there? All advertising causes harm, because it tricks people into buying things they don’t need. Things needed are sought out, without advertising.
http://video.google.com/videoplay?docid=8953172273825999151
Not to mention that it puts an irrational fear of actual medicine into the public leading to things like vaccine scares and mistrust of proven medical techniques and drugs.
I’d be careful about making sweeping statements such as “ALL alternative medicine causes harm.”
I’d imagine the NIH imposes too strict a criteria on some of these treatments. How can you randomize and double-blind a therapy like acupuncture? It’s not as simple as using sugar-needles for placebo.
An anecdotal account of acupuncture not healing an asthmatic child does not mean acupuncture has no medicinal value, or is crack-pot medicine. It is currently used at MD Anderson Cancer Center in Houston with statistically significant therapeutic value, and anecdotal evidence abounds.
Acupuncture eh?
http://scienceblogs.com/insolence/2008/08/the_largest_randomized_acupuncture_study.php
I also remember reciently reading a study where they compaired the results from two groups, one recieved “proper acupuncture”, the other group needles jabed in randomly by someone with no training to make sure they putthe needles in the right places. Result equally effective treatment.
the conclusion Acupucnture is placebo.
And the question “was what’s that harm even if it does nothing?
My point is the harm is at a minimum a waste of money and nasty side effects like turning blue or death.
When people choose ” the alternative” to real medicine we see these results.
As has been stated countless times, there is no such thing as alternative medicine, if it works its medicine, if it doesn’t it’s woo. So far the best acupuncture has rated is a placebo effect.
I would also vote for the Rationalist party, but I already vote Libertarian, so it’s not as if I’d help much in splitting the vote. :( To PZ’s comment regarding the poor returns such a party would have, it feels very appropriate that their percentage of the vote would best be expressed in scientific notation.
“Complimentary” [sic] medicine? That’s where the Dr. tells you that you look great in your new hat, and then you feel a whole lot better.
Turning blue and dying happens with “real” medicine also.
I’ve always assumed there may be an element of placebo in acupuncture. I’ve never had the treatment, so I can’t speak personally. But again, the placebo effect extends to real medicine as well.
Well, it all comes down to whether the voters will want to have a beer with whoever’s the candidate.
Glucagon
“But again, the placebo effect extends to real medicine as well. ”
No, real medicine is shown to have an effect beyond placebo…that is why it is medicine; it works. While there is always a placebo effect, if the medicine/treatment has no statistically greater effect then placebo then it is not concidered an effective medicine/treatment.
I’m not aware of any medical treatment that leaves you permenantly blue, but if it does then it must have had a real benifit to warrent the side effect. Using collodial silver for a skin rash resulting in turning you permanently blue….well I guess it was that much more effective than a zinc creame.
Hmmmm. Rationalist party.
I had a similar idea a while ago, only it was called the “Competence Party.” Campaign promises would be along the lines of “I promise to read every bill I vote on.” and “I promise I won’t bitch and moan about a policy unless I have an idea that will fix it,” and “I will not take recess while our state is the butt of jokes at home and overseas because it’s taken us 6 months to pass a yearly budget.”
Maybe I’m aiming too low?
Maybe the “Competence and Reason Party?”
I’d vote for the CRP.
Lol.
The CaRP.
Gene @ #63 said: “Complimentary” [sic] medicine? That’s where the Dr. tells you that you look great in your new hat, and then you feel a whole lot better.
Is it malpractice if he says this: “Geez that’s an awful hat. A man who buys a hat like that should get a free bowl of soup with it.
“Oh, but it looks great on you, though.”
Glucagon #64 wrote:
Of course; but when it turns out to be more placebo than effect, they get rid of it. There are rules. There was a popular knee operation which is now no longer done, because they actually went to the trouble of double-blinding a study and cutting open some knees only to sew them back up after doing nothing — and there was no noticeable difference between the control group, and the patients who had the real operation.
So-Called Alternative Medicine wants all the perks of being considered “scientific,” but without having to follow the rules. They want a double standard. What’s particularly ironic about that is that this failure to follow rules is one of the things they particularly hate about pharmaceutical companies.
I’d love to try something. I’d like to take some sCAM remedy which fails test after test — like homeopathy, say — and tell an ‘altie’ friend about how it’s still being promoted — but tell them it’s a drug from a pharmaceutical company. Tell them the company puts big bucks into its ads to attract customers, gets a bunch of them with ‘testimonials,’ — and then tries to argue that the failed tests should be ignored. Sell the product anyway! Increase the advertising budget! Have the drug company do their own tests and report their own results, which either can’t be replicated, or are worthless because the studies are poorly done. Imagine! The drug companies policing themselves! Bypassing consumer safeguards! Cheating on tests! And making money off worthless drugs! Men in suits exploiting consumers!
Dollars to donuts they’d be indignant. But it’s exactly what they accept and even admire in homeopathy.
Because it’s “natural,” and it’s rebelling against the Big Bad Evil Drug Companies. Homeopaths are “healers” who don’t wear suits, I guess. They care about you, as an individual.
The Senator is needing
A colonic or a bleeding
Or perhaps a dose of radium to give a healthy glow.
My alt-med guru teaches
That the use of sterile leeches
Would give balance to his humours, and would help his chi to grow.
Hydrotherapy and spinning
Would be only the beginning;
An emetic or a purgative would do his body good
Ground-up rhino horn or penis
And a sacrifice to Venus
Will do more to swell his thinking than viagra ever could!
A double dose of calomel
Would do his tired body well
Or drink colloidal silver till his skin is vivid blue
Elective psychosurgery,
As anyone can plainly see,
Is something that could keep his thinking on the straight and true
We can mix some herbs and spices
Bought at legislators’ prices
With the urine of donkey, for the Senator to drink–
But despite our urgent praying
We recall the ancient saying:
You can vote a man to Senate, but you cannot make him think.
http://digitalcuttlefish.blogspot.com/2009/03/to-senators-health.html
Here’s one way:
http://scienceblogs.com/insolence/2008/04/sham_acupuncture_is_better_than_true_acu.php
http://scienceblogs.com/insolence/2008/11/thatll_teach_em_for_using_an_actual_vali.php
Another way is for the “sham acupuncture” to have the needles inserted away from what are considered the acupuncture “meridians” and the “real acupuncture” to use the meridians.
In any event, when acupuncture is compared to sham acupuncture, be it the fake needles that don’t penetrate the skin or needling patients in the “wrong” location, the two are nearly always indistinguishable from each other. Sometimes, the “sham” acupuncture appears more “effective” than “real” acupuncture, to the discomfiture of the study authors. Of course, this would be expected to happen from time to time by random chance alone if acupuncture is nothing more than placebo.
As an Iowa Democrat, I am perplexed by Senator Harkin as well. And I find myself respecting Senator Grassley (R-IA) in ways I would not have imagined previously. I still remember the day last year when the Des Moines Register had one article in which Harkin was supporting new faith-based initiatives, and in a separate article, Grassley was opening up IRS investigations into large tax-exempt churches to make sure they were following the rules. It was like my expectations were flipped. What a strange state I live in.
Perhaps the first example of sham surgery used in a randomized controlled clinical trial was back in the 1950s. For a nearly two decades before, since the late late 1930s, a surgical treatment for angina pectoris caused by clogged coronary arteries was an operation called poudrage, which literally involved opening the chest, exposing the pericardial sac covering the heart, and sprinkling sterile talcum powder or some other irritant on it. The concept was that the inflammatory response to the powder would cause the ingrowth of more blood vessels (an early experiment on angiogenesis!) and help the patient’s symptoms of chest pain with exertion. Indeed, poudrage was first developed around 1935 by a surgeon named Claude Beck, who tried a variety of forms of poudrage using agents that included anything from sodium morrhuate and sand, talc, phenol, silver nitrate, polyvinyl ether foam (Ivalon), and even asbestos
The results of the operation appeared to be good on the basis of uncontrolled single arm studies. Patients reported decreased levels of angina or even its elimination. Then a science-based group of surgeons decided to do a randomized controlled clinical trial. One group actually had placebo surgery in that patients’ chests were opened but no poudrage was performed. The results? Both groups had an equal alleviation of their symptoms. The poudrage was no better than sham surgery.
Surgery, it turns out, is one of the most powerful placebos of all.
My understanding is that, unfortunately, such studies are extremely rare for surgical procedures. As the Newsweek article “Why Doctors Hate Science” indicates, evidence-based medical practice still has a long way to go.
Oh no! It looks like the Rationalist party has yet another hurdle to overcome, genetics:
Humans may be primed to believe in creation
http://www.newscientist.com/article/dn16687-humans-may-be-primed-to-believe-in-creation.html
John
Orac: “Another way is for the “sham acupuncture” to have the needles inserted away from what are considered the acupuncture “meridians” and the “real acupuncture” to use the meridians.”
The investigators at M.D. Anderson have told me that this is what they try to do. I don’t know if they find it to be an effective means of blinding.
Kagehi @ 38
Trouble is, I’ve seen no evidence to date that NCCAM is doing anything like what you’re giving it credit for. If you have information about some hitherto unmentioned regulatory role, please post it here. As it stands, I see only abundant evidence for the legitimization of both CAM studies and CAM practices. The increasing coverage of CAM by insurance companies is a separate, but no less concerning, phenomenon that I suspect has more to do with effective lobbying. If a seemingly qualified practitioner with a woo doctorate applies to be an in-network provider, who at the insurance company is qualified to make a judgement about this? No one. The existence of NCCAM has no bearing on this at all, most especially, as Sastra points out above, because the complete and abject failure of CAM when subjected to RCT of any kind has not slowed the growth and acceptance of CAM in any discernible way.
The anti-science attitudes on the left like Senator Harkin on alt-med and Jenny McCarthy on anti-vax shows that such attitudes are not restricted to the Rethuglican right.
Orac: “Another way is for the “sham acupuncture” to have the needles inserted away from what are considered the acupuncture “meridians” and the “real acupuncture” to use the meridians.”
The investigators at M.D. Anderson have told me that this is what they try to do. I don’t know if they find it to be an effective means of blinding. – Glucagon
Well, if the “sham acupuncture” needles were inserted in the eyes, it might be a very effective means of blinding!
I think he was hoodwinked by lobbyists even more than the media. Either way, that still makes him the most guilty party here. He is the one in a position of political power, and as such he has a responsibility not to be credulous or gullible.
I realize that last sentence will seem radical to most US politicians.
Glucagon, I know Orac has already handled the lion’s share of your points, but I want to just point out that your posts are lousy with alt-med apologetics.
Why? If the therapy in question is proven to be effective, it becomes real medicine. Science gets to cheat that way.
Glad to see you’re relying on your imagination, rather than actually looking into the issue. As Orac said, there are multiple types of acupuncture “placebo.” I find it strange that, after you were called out, you admitted to being aware of this (but still claim ignorance about its validity as a placebo). Well, here’s its validity: you can’t distinguish between any of them (at meridians, randomly inserted, and not inserted).
You have it backwards. The positive evidence is all anecdotal. The real-deal evidence is negative. Nice try on flipping it around, though.
Great, we have a single data point that you *claim* is significant. Any reference to their published works? What did they do as a control group? Nothing? Sham acupuncture? Random needles? Painkillers? And, to hell with your anecdotal evidence. Do you believe in ghosts? Anecdotal evidence abounds for ghosts, too. And UFOs. And Bigfoot.
Um, yes it does. Difference is, “real” medicine has a “real” chance of preventing it from happening.
Whoop-dee-doo. Again, the difference is that real medicine *works*! Would you rather have actual+placebo or nothing+placebo?
@26, @41 and others:
what good comes from NCCAM and the money it is spending?
Are the disproven alternative therapies then banned from the market?
Does the FDA weed them out? No.
From their website:
Agencies like the FDA who have teeth behind them still have trouble regulating.
There is little benefit to NCCAM, an agency who writes reports and ‘shares’ information.
There is that old chestnut:
Medicine.
—
badahbump.
The tufted titmouse parodies Senator Tom Harken:
Integrative Reporting to Keep News Interesting.
As the What’s the Harm site points out, the most disgusting thing about alternative medicine for me is when the crazies use it on their children instead of real medicine. There are all these anecdotes on the site about 7 month old babies or five year old kids that die because their parents refuse real medicine or never take them to a real doctor. I looked up a few of the cases and the sad thing is even when they are charged with criminal negligence or something they usually end up getting off.
When we accept alt medicine as a viable alternative it just opens the door for this kind of thing.
NCCAM studies stuff with no plausible mechanism of action. Consequently, any positive results will almost certainly be false positives.
Spending billions to get bad info is toopid.
http://www.marginalrevolution.com/marginalrevolution/2005/09/why_most_publis.html
One problem is that “real” medicine doesn’t exploit the placebo effect enough. It leaves the door open for the “alternative” medicines to sell their crap.
It’s the curse of beta error, I think.
You do your study with a small patient population. Chances are your two groups won’t be stone cold identical, there will be some little difference which won’t be statistically significant. But there’s a 50% chance that difference will be in the direction you want. So you do your fancy stats and find out that you’d need a population 10 times bigger to show that your observed difference isn’t due to chance alone, and voila, you can claim that your negative study just means that more research needs to be done.
Cue next grant proposal to NCAM.
On a Discovery Channel show a few months back, they made a statement that an “experiment had failed” because it had given a different result than what the testers were hoping for. I was rather upset by this statement because the experiment had not failed. It had given very definitive results. It was the hypothesis that had failed, not the experiment.
Cuttlefish – don’t knock the leeches!
They used them on my reattachment, and even though it didn’t work out they did their job of sucking out blood that wasn’t flowing back.
You think alt-meds are bad, yet you don’t seem to realise how ineffective traditional medicine is…
http://www.theonion.com/content/node/39236
Dale @93:
You can not use theonion.com in a serious discussion.
Dumb question: What makes a treatment “alternative medicine”? Sure, the name suggests that it’s an alternative to traditional practice but there must be more to it, otherwise every medical innovation would technically be alternative medicine.
Angela, a working definition would be alternative medicine is a new practice that has not undergone double blind studies and peer review. Most new practices will usually undergo the proper testing and be approved/disproved. It will also include old practices that have avoided the proper studies. This includes homeopathy and other practices that scrupulously avoid doing the proper studies because the practitioners know they will fail.
I like Tim Minchin’s take on the term alternative medicine: “Do you know what they call alternative medicine that’s been tested and shown to work… medicine”
OK, I see. Would off-label use of a medicine that is FDA approved for something else be alternative? I’m guessing not, since it has undergone some testing.
Y’all reminded me of good friends who are a little woo. A few years ago they were all into Echinacea and wanted us to try it. Unfortunately they got sick much more often than we did and we politely told them that of anything they did for health, we wanted to do the opposite.
sweet.
Lucky bastard! He’s not coming to Canberra unfortunately so I’m going to miss out.
Technically yes, unless it was part of a clinical study to show efficacy for a second indication. But sometimes the indications of efficacy are present long before a paper can be written and the data submitted to the FDA, and other means of proper scientific communication occur to “spread the word”. Official FDA approval will not occur without the clinical studies.
Please help me out here, folks. Absent any hard evidence supporting that most forms of alternative medicine actually work, I prefer to studiously avoid them. However, I am faced with some ground realities;
First, in a third world country like India, homeopathy enjoys immense popularity primarily because it is cheap. There are even State-sponsored homeopathic medical schools offering bachelor’s degrees in homeopathic medicine. Though there is no research-based evidence that it works, it still remains tremendously popular because it seems to work in a lot of people – in different conditions. Even one of our ex-Presidents had a homeopath as his chief physician.
I admit I am treading in murky anecdotal territory, and that I have no clue exactly what or how serious these “conditions” of illness are, but I have seen even people in my own family (much to my chagrin) take homeopathic medicines for various illnesses, and they are absolutely certain that it works. And whether they will themselves to it or not, I have seen them often get better. I can’t understand how that happens.
Secondly, the major opposition to the Lancet study that demolished the claims of homeopathy seemed to have been that the homeopathic ‘principles’ did not lend themselves to the traditional clinical study design paradigm. Apparently, homeopathy is supposed to “treat a patient” rather than a specific illness. I find this claim very hard to believe. But I could not find a good rebuttal to the comments to the Lancet study that addressed these issues. Could someone (perhaps Orac) point me to a good source? I have access to most medical journals through my School.
Third, India has a form of traditional medicine called Ayurveda, with very ancient roots. Once again, this form of medicine rarely lends itself to properly designed scientific enquiry.
But it does deal with extracting active principles (mostly alkaloids) from medicinal herbs and plants. The purified forms of many of these plant products do have physiological effects, and every so often one finds random studies like ‘medicinal value of this’ and ‘beneficial effect of that’; examples that quickly come to mind are anti-tumor properties of ginger, and anti-microbial properties of the Neem plant (Azadirachta indica), which have been tested. So, my question is: does Ayurveda qualify as potential proper medicine or just alternative woo?
Please help me reconcile these facts and clear my confusion.
I haven’t read the posts yet, I haven’t the time and as I have a feeling that this thread will explode soon enough.
Why is it such a bad thing to be disappointed when an experiment doesn’t go your way? From this article it doesn’t look like he’s trying to fudge the results, he WANTED to believe that alternative medicine was true and worked, but he’s saddened because that isn’t the case through the research done by his cronies.
As an example, were I in the position to be able to fund research into say… … a cure for asthma, no matter what it is. If after a while it’s not found, why would I be disparaged for saying that I’m sad and disappointed that the group that I pushed for and funded didn’t find it, as long as I don’t try to fudge the results and say I found it when I clearly didn’t?
If it’s already been brought up, I apologize.
Kausik Datta,
For non-technical starters on alt med, I’d recommend a number of skeptical medical blogs: PalMD’s and Orac’s here on ScienceBlogs, Steve Novella’s Neurologica, and Science-Based Medicine. They’ll link to more technical information (as well as books, etc) that you can move onto as you see fit.
As for your specific comments, I’m really not seeing the meat here. Alternative medicine is popular? So what? Countless people believe in creationism, and its teaching is often state-sponsored; is that “ground reality” (to use your term) for creationism?
Alt-med “seems to work” and people “often get better” when they use it. Uh, people seem to get better all the damn time! It’s like cold remedies: if you take it you’ll be better in a week, if you don’t you’ll be better in seven days. Most ailments aren’t deadly, so you’re “often” going to “get better” no matter what you do.
The claim that alt-med isn’t subject to study is special pleading. If it heals someone, it should be testable. If the healing isn’t tangible and measurable, then what in the holy hell is it? We’re not talking about religion, so they can’t hide in metaphysics. (We are talking about magic, but they claim it isn’t magic so they should be able to produce results.)
Ayurvedic medicine is herbs loaded with heavy metals. The only reason it’s not amenable to study is because you would get arrested for systematically poisoning your innocent test subjects.
Sorry dude, you really don’t have any facts to reconcile. You have canards, fallacies, and cognitive biases you need to get over before you end up hurting yourself or those you love with ideologically-based bullshit.
Homeopathic treatments are so dilute, there’s nothing there but water, a sugar pill, or some salve made of inert ingredients.
Here are some homeopathic dilutions relating one drop of active substance to the amount of water it’s dissolved in:
6C = 4 Olympic class swimming-pools.
13C = 3/4 of all Earth’s oceans.
16C = Sphere the size of Earth.
19C= 10 Spheres with same diameter as our Solar System
22C = 1 cubic light-year
26C = 1 Sphere with same diameter as the Milky Way
30C = nearly a hundred million galaxy-sized balls of water
Please help me reconcile these facts and clear my confusion.
The key thing to understand is the difference between healing and curing. Modern (Western) medicine is really the first system, ever, that’s consistently able to cure a wide variety of diseases. But healing an “illness” (defined in dry, academic terms usually as something like “the experience of devalued states”), as opposed to curing a disease, is not what traditional systems of healing, like Ayurveda (or any form of exorcism and so on), are trying to accomplish, basically because they’re no good at it.
But what they may acheive through healing is to ease the experience of symptoms through a placebo-type effect, and/or, haphazardly, via one of your ‘medicinal values of this’ and ‘beneficial effects of that.’ More importantly, though (at least, in the natural environment of such systems, which is to say in the absence of modern medical technics) is their understood role in navigating the otherwise taboo-fraught mystery of disease and death. Healing re-integrates the unhealthy into society; various cultures render this favored state as “purity” or “wholeness” or “oneness” with a given ideal or concept, and in many other ways.
Those states, however, have very little to do with whether one will die or be severely impaired or not and for what, biological, reasons. The danger, as I see it, is when such systems are contemporaneous with limited availability to actual, curing, medicine. Inevitably these categories are blurred and claims are made for the pseudo-pharmaceutical elements of the traditional system, almost in cargo-cult fashion, where the emphasis of the traditional practice is properly directed toward its social significance.
Empirically based medical care should always be preferred if you’re looking for a cure, to actually “get well” as we understand that term. If you want to feel better before you die or make sure your neighbors don’t shun you for being possessed by demons, a traditional healer might be the way to go.
Meds get used for off-label indications after studies are done establishing some level of safety and efficacy. Drug makers may not bother to file for additional indications due to the expense associated with the process.
The “healing” vs. “curing” thing is a word game that fools no one.
Anyone given false hope may feel better for a time. But in reality, most patients don’t want false hope. They want to know what’s true.
Gah.
Healing an “illness” is what traditional systems of healing, like Ayurveda, are trying to accomplish, not curing a disease.
Sentence construction fail.
The “healing” vs. “curing” thing is a word game that fools no one. Anyone given false hope may feel better for a time. But in reality, most patients don’t want false hope. They want to know what’s true.
Read my comment more carefully please (or better yet, read some Anthropology). Where “curing” or “knowing what’s true” is impossible, “healing” is all there is, and it does, in fact, tend to “fool” everyone under those conditions, except that’s such a patronizing, exceptionalist way to look at the ways pre-modern people had to (and, tragically, have to) deal with the agony and alienation of experiencing illness and death.
I’m definitely not into stuff like homeopathy or Reiki, but I do choose to take some things like vitamin/mineral supplements and probiotics.
The vitamins/minerals actually contain the active ingredient, and the probiotics contain the beneficial bacteria, which are active if they are kept refrigerated and consumed fresh.
Sometimes I’ve heard that people want to outlaw supplements and make them prescription-only, which I believe would be a very bad idea.
I certainly don’t believe in homeopathy, because the infinitesimal concentrations of whatever make no sense, and I don’t believe in stuff like “past life regression.”
partsRheavy, if you are already healthy, eat a balanced varied diet and get a modicum of exercise, then you need no extra additives such as vitamins, minerals or probiotics. Probiotics have not been found to have any benefits for already healthy people. Though they can help in conditions affecting the normal intestinal microflora. However, at least probiotics are unlikely to harm you. Neither are vitamins or minerals as long as you don’t go over board on quantity.
CJO, I’m not letting the woomeisters appropriate the word “healing” for some vague meaning like “wholeness” or “spiritual growth” or whatever. It has a concrete meaning –e.g., “wound healing.”
Anything that looks like, “You guys cure; we heal” gets a swift kick in shins from me.
NewEnglandBob @94:
I know
Oh sorry. The woos can’t have “illness” either
Well we know that. But the patients who seek out Ayurveda doctors don’t know that.
#98
Posted by: Angela
Re: Echinacea
This is one of those rare cases where (hold on to your butts) I think the alties have a point. Echinacea is one of the few herbal remedies that has a proven effect, reproducible results from clinical trials, etc. But a Consumer Reports article a few years ago reported that in testing echinacea tablets they purchased at multiple locations and under multiple brand names they found that most contained a large amount of the two other species of echinacea that exist but do not have any therapeutic effects. Some of the tablets they tested had none of the one species that does have therapeutic effects. Just to give you some perspective, I am anti-woo and I am also one of the people (maybe the person) who sent PZ the link to the Majikthise post on Harkin. In this particular instance, we have a real matter of unscrupulous snake oil salesmen selling the wrong stuff, and they’re the ones who are frauds this time.
102 Kausik Datta
The only source I can think of is a philosopher of science, not a scientist. His name is Paul Feyerabend, a professor of philosophy at UC Berkeley until his death about 5-6 years ago. He wrote a very interesting book called Against Method. It’s definitely advanced undergraduate reading and easily quote-mined by zealots to attack science, but he really does nothing of the sort. However, he does challenge (intelligently) some of the rigidity he observes in the thinking and approach to science characterized in its most extreme form by Karl Popper in his book The Logic of Scientific Discovery.
Back to the point. My vulgarization of Feyerabend on “non-traditional” medicine is that he raises the possibility that a given remedy works on more than one organ or system in the body, and that existing testing protocols focus on very localized results. That is to say, that if a given “remedy” acts on multiple systems, and the benefits (an assumption of facts not in evidence, I know, but I’m tired of putting everything in quotation marks to fend off the nasties) look like the body doing something on its own, then the test to prove/disprove that action will have to be very complex. Further vulgarization: if homeopathic remedy X acts on three organs, none of which are the affected one, but all three react to the substance and produce whatever they produce, but in larger or smaller amounts, then the combination of these actions does have a therapeutic effect, current testing methods will dismiss the result as the action of the three organs and not remedy X.
Keep in mind I am not a scientist and I also wonder about the idea above myself, only I have no expertise by which to evaluate it. So I throw it to the wolves here to gnaw on and maybe we’ll learn something interesting.
The woos can’t have “illness” either
You’re realy determined to find woo in what I said, somewhere, aren’t you? Different fields use different terminology; sometimes a familiar word in the vernacular or in a given field is used with a specific, technical, definition in another field. Like “illness” in medical anthropology, which I took the trouble of defining, before, as “the experience of devalued states” (as a result of disease).
Well we know that. But the patients who seek out Ayurveda doctors don’t know that.
You’re going one paragraph at a time. I guess that’s fine; maybe in a day or two you’ll understand that what I’ve said involves no endorsement of woo. It was exactly the ignorance of which you speak that I was referring to when I said: “Inevitably these categories are blurred and claims are made for the pseudo-pharmaceutical elements of the traditional system, almost in cargo-cult fashion, where the emphasis of the traditional practice is properly directed toward its social significance.”
As simply as I can put it: “healing” as healing, fine. “Healing” as a substitute for curing, where actual curing may be sought, not fine.
I take it you’re an MD. Well, even with effective methods of curing, illness is still not always coterminous with disease. In the best possible scenario, a patient comes in with a complaint: The diagnosis is clear, the course of treatment is clearly indicated and ultimately leads to a full recovery. Disease cured and illness healed (in the technical, anthropological uses of those terms). But what about uncurable, chronic conditions? What about when the diagnosis is not easy or obvious? What about all of the extra-medical ramifications of disease: for the family, for the patient’s livelihood and social identity, and on and on? The experience of those states is illness, over and above disease, and there’s not a whole lot medicine, per se, can do about it if a speedy cure isn’t available.
Steve,
Feyerabend is a prime example of the sort of fuzzy thinking often used by “academic” types to attack science. As near as I can tell, Feyerabend never really understood science. He never bothered to understand why science is the way it is. What Feyerabend perceived as rigidity is in fact rigor, and there is a reason for it–namely, keeping us from fooling ourselves with those comforting notions we’d all like to believe. Feyerabend did nothing that advanced the understanding or philosophy of science, and the sooner he is forgotten, the better.
Re: the rationalist party
Where do I sign up?
Kind of reminds me of the quote by Adlai Stevenson when a woman told him he had the vote of every intelligent, decent voter in America:
“Thank you, Madam, but unfortunately, I need a majority.”
Dictionary.com for “healing”:
1. curing or curative; prescribed or helping to heal.
2. growing sound; getting well; mending.
3. the act or process of regaining health: a new drug to accelerate healing.
Dictionary.com for “curing”:
1. a means of healing or restoring to health; remedy.
2. a method or course of remedial treatment, as for disease.
3. successful remedial treatment; restoration to health.
4. a means of correcting or relieving anything that is troublesome or detrimental: to seek a cure for inflation.
5. the act or a method of preserving meat, fish, etc., by smoking, salting, or the like.
6. spiritual or religious charge of the people in a certain district.
7. the office or district of a curate or parish priest.
8. to restore to health.
9. to relieve or rid of something detrimental, as an illness or a bad habit.
10. to prepare (meat, fish, etc.) for preservation by salting, drying, etc.
11. to promote hardening of (fresh concrete or mortar), as by keeping it damp.
12. to process (rubber, tobacco, etc.) as by fermentation or aging.
13. to effect a cure.
14. to become cured.
If you’d like to re-define common English words for some technical purpose, best to pick terms that don’t overlap so much in meaning.
Your heal-cure dichotomy was hijacked in the early 1990s by the woos who use it to deceive. They pretend to do “wholism” or “healing” when scrutinized by the scienc-minded. But they shift to “curing” like real docs when no one is looking.
Patients wouldn’t bother with vague alt.med “healing” services if they weren’t bundled with some promise of actual physical benefit. There are counselors, pastors, elders, and others to help with emotional coping and social bonding.
Thank you Bob, Dr. Benway and CJO for responding to my message. I knew I was rather stepping into it when I brought up the issue of homeopathy! For the record, I don’t recognize homeopathy as a valid medical option, or advocate its use.
However (this is to Bob), the “ground reality” that I mentioned refers to a certain situation that I, myself, have faced – the popularity of homeopathy in my country. I did not intend using that term – ground reality – sweepingly. As I already mentioned, I have encountered the use of homeopathy in my own family, and not just fleetingly – but for at least 35 years. When I said that ‘people often get better’, I was not referring to a case of the sniffles, or a cough here and a tooth-ache there. I have seen my near and dear ones undergo full courses of ‘homeopathic therapy’ for ailments as diverse as asthma, allergic reaction, severe abdominal cramps, nausea and vomiting, gastritis, arthritis, focal pain (as a result of, say, an accident), flu-like symptoms, anxiety disorder, just to name a few. And I have indeed seen them get better.
I do not know how it works, because the principle (of dilution) does not make any scientific sense to me. I don’t accept the homeopathic ‘holistic healing’ idea because there is not a single scientific study (that I know of) that has tested that idea in a controlled setting. Hell, all I have to say about homeopathy are just anecdotes from my own family! But the fact (that I needed to reconcile) is that in all these people, it seemed to have been working – and for a long time, too!
I don’t have a control obviously, so I don’t know if in all these ailments, a placebo sugar pill would have had the same effect or not. The Lancet study concluded that it would. The pro-Homeopathy group dissented, bringing in the argument about faulty study design of the meta-analysis. Bob, I don’t think the pro-Homeopathy group did any “special pleading”; they indicated that the number of studies that the Lancet reviewed did not conform to the principles of classical homeopathy, where the medicine is supposedly individualized to each patient based on their detailed clinical and personal history. Before you lambast me (again!) for talking about woo, you may want to check an article in the journal ‘Evidence-based Complementary and Alternative medicine’ where Peter Fisher, Director of Research, Royal London Homeopathic Hospital, published a critique of the study. There are three interesting emailed responses following this article, one of which mentions an article dissing the effects of Arnica (a name I know!). Sadly, that article is in German and I can’t read it!
This is one ‘controversy’ I would really like to know more about. I heartily dislike this magical aura that homeopaths shroud their craft with. I want to know if that just reflects intellectual dishonesty or plain inefficiency, or there is some grain of truth in what they claim to do.
Steven and Kausik: Regarding homeopathy, I would recommend looking into what it *actually* is. It is pure magic. Seriously, it’s magic water. Homeopaths are arguing that water gains magical properties when you mix and shake it. It’s truly the most ludicrous of alt-meds, and neither of you are helping your case by harping on about it. It’s prior probability is vanishingly small; for homeopathy to be real, chemistry would have to be wrong. Period.
Kausik, I hate to disparage the health troubles your family has, but try and take an objective look at the list you gave me.
Those ailments are pretty subjective, wouldn’t you say? And, you’d expect every one of those ailments to be pretty amenable to a placebo, right? You’re out of breath, you’re itchy, you’re achy, your stomach hurts, you have a headache, you’re stressed out … and then someone gives you a magic pill and spends a few minutes treating you nicely. Hey, things are looking up!
Homeopathy is LITERALLY a placebo, since it’s nothing but pure water or sugar pills. No one in your family was cured of a non-subjective ailment by homeopathy, it seems. No cancer cured by homeopathy, for instance.
As for it not being special pleading, err … you’re saying it’s not special pleading because, um, you say it’s not? If the shit works, it ought to be detectable. If you need to “individualize” the treatment, then freaking individualize the non-control group. What’s the problem?
As for that article, I don’t see why you’re excited by it and why I shouldn’t lambaste you about supporting woo. Here’s a nice quote from it: “it is well established that high quality trials are less likely to be positive than those of lower quality.” Fantastic! The more you study it, the worse it gets! Just like all other types of bullshit.
Then he complains that the meta-analysis is dependent on what you put into it (really? you think so, doctor? what the fuck else could it be dependent on, dipshit?), and complains again that they put those damn well-conducted and statistically-valid trials in. This guy’s an effing clown.
Individualized = ritualized = “healing”(at best), not curing.
“Healing” in the technical sense I’ve been using, meaning related to the experience of illness, where in Bob’s (#124) vocabulary “illness” is a “subjective ailment,” only to add the point that every “non-subjective ailment” comes with a subjective ailment attached.
If you’re looking for a medical/physiological/biological cure for a disease, homeopathy is useless. I myself don’t even see how its modern, pseudo-medical form could function as a method of traditional healing either, but I’m more interested in the pre-modern conception of health and illness and what we can know about ancient practices and beliefs. Pre-modern peoples had no reliable means of curing disease, warding off infection, or preventing illness. We do, and it’s evidence-based medicine.
That’s our perspective; not theirs. They felt their interventions helped the body get better, just like patients seeing doctors today.
CJO, I think I understand the differentiation you are making between ‘healing’ and ‘curing’, and I agree with you that as far as the biological cure of any condition goes, homeopathy is useless (though they certainly don’t believe so!).
Bob, Bob, the only reason I seem to be harping about it is because I want to know. Really. I absolutely agree with you that when one looks at the principle of Homeopathic medicines, it is indeed magic water, what with the principle of enormous dilutions and “water memory” – Aaaaargh!!
But… wait, there is a ‘but’. The ailments that I mentioned may be ‘subjective’ to you, but they are pretty real to people who have suffered from them. I did not quite follow that term you used – subjective. What is ‘subjective’ about asthma and airway inflammation, or an allergic reaction to, say, prawns, or pain when someone stubs your toe, or you fall down and hurt yourself?
I admit I don’t know – for want of better evidence – if these conditions are equally manageable by placebo (that is, considering – by willful suspension of disbelief – there is something in the homeopathic medicine). But if so, does it indicate that people are willing themselves to get better – that all these illnesses are psychosomatic in origin?
As for homeopathy curing cancer, heck no! Though they do claim to it sometimes, but I would not put my trust in, nor advice the use of, fairy pixie dust (a.k.a. homeopathy) for cancer treatment.
I agree with you one hundred percent that if homeopathy works it ought to be detectable. But don’t you think that – at least as a matter of argument – their point about the study design has some validity? I mean, the so-called “individualizing” of the medicine would mean that the type and dose of medicine would vary from person to person in the test group! How can you ever find an effective control group for that?
I feel that a better way to do a clinical trial to really ascertain the benefits of homeopathy, if any, would be to do comparison studies, where people presenting with similar symptoms are randomly assigned to the homeopathy or the allopathy (western medicine) group. Then let the homeopathy group be treated with “individualized” medicine, and the allopathy group be treated with regular, well-tested, FDA approved medicines, and find which group fairs better, with respect to not just alleviation of symptoms, but also physiological parameters. What do you think?
As far as Peter Fisher’s article goes, I am not excited about it, but I think you may have got the import slightly wrong. IMO he is saying that this particular meta-analysis considered studies that were well-conducted and statistically-valid; however, those studies (in his opinion) did not adhere to classical homeopathy, and therefore, should not have qualified to be included in that meta-analysis.
Kausik,
Sometime in the 1970s the city of New York upgraded their traffic lights so they’d change sequentially. That meant that all the intersection pedestrian buttons stopped working.
Nobody noticed.
Sort of a simplistic dismissal: “…NCCAM, a hot-bed of government sponsored quackery.” For my RO1s, the study sections were quite rigorous, and as I’m sure you know, these reviewers don’t just come from a single Institute. Scientific rigor is the primary quality that must be evident in the research question, analytic section, and study design. Is homeopathy problematic? Sure – if you spend all your time in GNC stores or hobnob with Orin Hatch. On the other hand, some compounds and interventions stereotypically described as homeopathic (i.e., “magic,” “quackery,” etc.) have definitive analogs in the allopathic medicine. The retail segment is a better position from which to hurl insults at that stripe of alternative medicine, but there are plenty of instances of solid, peer-reviewed research that has come out of NCCAM. I’m certainly not giving back my funding!
I used to be involved in alternative medicine (chinese medicine to be exact). I never believed the traditional theories but in my youthful ignorance, I figured there must be something to the fact that it was the traditional medicine of a highly successful culture. My undergrad studies were in biology and I went into CM with the interest of using scientific methods to separate the wheat from the chaff so to speak. While I had a license to practice acupuncture, I decided early on in my studies that it was a placebo. Pretty much every study ever done that compares “real” acupuncture to “sham” acupuncture has proven this. While some studies have seemed to suggest that it it is more effective than some conventional therapy it is being compared to (say vs. a pain or hypertension drug), arguably that is also a placebo effect. (The patient clearly knows whether they are receiving a drug or getting needled and no one likes drugs, especially those with side effects; but as soon as the patient found out they were receiving a placebo therapy, the benefits would no doubt subside. That is the risk of such studies; their long term benefits depend on suspension of disbelief—sort of like enjoying a Hellboy movie.)
Now, that being said, my review of the literature as an educated layperson suggests that there is some usefulness to a number of vitamins, minerals, and other natural substances. There is a strong case to be made that the reason many such substances have not been researched properly is because they cannot be patented, thus giving little incentive for pharmaceutical companies. It is substances like Vitamin D and saw palmetto, for example, that might justify government funds being spent where the private sector won’t. However, as many have pointed out here, NCCAM has chosen their objects of research based on politics and predilections rather than what actually seemed a promising avenue of study.
For years, in my former profession, I argued that in the long run, our professional organizations should spend their money on research instead of bribes to politicians to get favorable legislation—that sooner or later, this would come back to bite us in the butt. The laws would be rescinded and insurance funds would dry up if we had failed to prove what we did worked. But my pleas fell on deaf ears. People were too scared that what did would be disproven and their careers would be damaged. So, one would hear endless obfuscation about how you can’t study an individualized medicine or that science had to catch up with the mechanisms of CAM first (vital energy and the like). It soon became apparent to me that I was dealing with the left-wing equivalents of fundies. They were completely irrational and based their decisions on belief in age-old ideas enshrined in sacred texts (ever hear of the Yellow Emperor’s Classic of Internal Medicine?). I was willing to let anything fall by the way side to determine if any of it really worked (and research on herbs coming out of China, flawed as it was, suggested there was something worth studying—herbs, after, have pharmacologically active constituents).
Finally, I gave up and moved on to other things. Personally, though, rather than seeing NCCAM go away, I would rather it be purged of the politics and actually look at some of those things that truly bear studying (the role of omega-3 fatty acids in health, for example). Otherwise, we may indeed miss out on much knowledge just because no one can turn a quick profit from it.