Well, this is depressing to learn. I'd be even more depressed if I were Canadian. All I can say to my neighbors to the north is that I feel your pain, albeit belatedly. I just learned that the recently appointed Minister of State for Science and Technology within Prime Minister Stephen Harper's Cabinet is Gary Goodyear. So what's the big deal?
Gary Goodyear is an chiropractor. Not only that, but he's an acupuncturist, too. Nothing like putting someone who believes in pseudoscience in charge of science and technology. I wonder how that will work out.
Now, for Harper's next appointment, let's have an astrologer in charge of aerospace policy!
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That's just fucking great.
I'd say I pity you, Canada, but we can't be sure that ours won't be just as bad.
Harper is depressing all on his own. He also took "equality" out of his play book.
Awesome guy. Just wasted 300M of our money on a pointless election too. Can we trade now that you're getting a normal one? Please?
That sucks, but it's not quite as bad as you think. In our system a "Minister of State" is a junior cabinet minister. If you want someone to get depressed about, check out Tony Clement.
http://en.wikipedia.org/wiki/Tony_Clement
The Tories have a generally pitiful record on science.
http://www.nationalpost.com/news/canada/story.html?id=324923
He also funded a national campaign to provide Gardasil for all school age girls purely as an election ploy (~ 400M) to get votes from women. The worst part is that he did it Against the recommendation of most of the Canadian health agencies at the time.
He studied at the Bush environmental school of science. His current finance minister was a disaster as a finance minister of Ontario.
Harper also subscribes to the Bush school of international diplomacy.
Harper eliminated the scientific committee that used to advise the PMO (Prime Ministers Office) and I believe he replaced it with an appointed position.
I don't know how or why you dug up this little tidbit, but it's completely irrelevant in the grand scheme of things.
"Harper also subscribes to the Bush school of international diplomacy. "
Uhh, I hope he reconsiders given the state of Canadian military power. If it didn't work for America and something similar failed the Soviets, the Canadians are going to get slapped about.
My, but the view from the rodent's posterior is severely constricted. What arrogance! I am a practicing naturopathic physician. No doubt, you would consider me a pseudoscientist, but I must tell you that I have advanced degrees in organic chemistry, drug design and molecular immunology, have worked in basic and clinical cancer research for over 10 years and became a naturopath after both professional and personal experience with the Western medical world. I must also tell you that you should review the history and record of both chiropractic and acupuncture. Has the allopathic world a 5000 year clinical history to draw on? Does either acupuncture or chiropractic medicine have as many adverse effects or as great mortality and morbidity statistics as does "conventional" medicine, where sloppy handwriting alone is estimated to have caused 7000 deaths annually (http://www.time.com/time/health/article/0,8599,1578074,00.html )? Do not the many countries where chiropractors, accupuncturists and naturopaths practice have higher life expectancies than does the US (ranked 46th)? (including Canada, Australia, Japan and Okinawa: https://www.cia.gov/library/publications/the-world-factbook/rankorder/2…)
Where, sir, does this arrogance come from if not directly from ignorance? You should also take some time to review the actual history of science and medicine and how often, that which was termed "pseudoscience" was actually proven to be valid. Would you have joined the "scientific" doctors who literally drove Semmelweis out of town because he had the audacity to suggest that puerperal fever was caused by poor hygiene and dirty hands? Would you have joined the Inquisition to threaten Galileo and Copernicus for their "heresy"? Was the use of thalidomide, DES, COX-2 inhibitors and multiple other supported by "real science"? The estimated number of procedures and modalities currently used in "real" medicine is less than 20%. People, even surgeons, who live in rather shaky glass houses should not throw stones before they arm themselves with some facts, not just bias. It never ceases to amaze me how those purporting to defend science often know very little about the actual process, much less the history of science.
Thankfully, health issues are largely provincial issues in Canada. The qualifications of this minister speak to the "bench strength" of the entire conservative caucus.
Re DrZed
My, but the view from the rodent's posterior is severely constricted. What arrogance! I am a practicing naturopathic physician. No doubt, you would consider me a pseudoscientist, but I must tell you that I have advanced degrees in organic chemistry, drug design and molecular immunology, have worked in basic and clinical cancer research for over 10 years and became a naturopath after both professio
The good doctor may best be described as a vast emptiness surrounded by an education.
Hopefully it won't be too bad.
SLC:
Interesting description of a good doctor, SLC, particularly if you mean emptiness in the Zen tradition...
One of my hopes is that I have had -and still have- the advantage of straddling both worlds. I know drugs from starting material to the product because I've synthesized them. I know the good they can do and the limitations. I know herbal medicines because I grow them, dry them and extract them. While they do less harm, they are hardly harmless. I know that if I have a patient with appendicitis, while there is a chance that I can treat it with natural medicines, prudence indicates surgery more often than not.
The "trick" is to be open-minded, as I think you might be saying, and knowing when to use diet, lifestyle,herbal medicines, homeopathy etc and when to use drugs and surgery. Surely, after all this education, we should be willing to consider all the possibilities without bias and help the patient choose the best approach.
I just get particularly tired of self-important conceit and ego parading itself around as Truth and Science, whether it is in the political, the medical or the scientific world. Skepticism is grand, yet its not a one way street. I wonder at the hearts and minds of those who refuse to respect and actively belittle and demean other philosophies. In other arenas, its called fanaticism.
Does either acupuncture or chiropractic medicine have as many adverse effects or as great mortality and morbidity statistics
That's because real medicine has a real physiological effect. Acupuncture and chiropractic medicine have an imaginary effect. Typically, imaginary physiological effects are quite less severe than real ones. Shocking!
Seriously, you naturopaths need to get over yourselves. You treat self-limited subjective conditions with unproven (read: placebo) remedies, and pat yourselves on the back because you have such a stellar safety record? Treat a few MIs or cases of measles with your spice rack and we can talk about which treatment has a better risk:benefit ratio.
while there is a chance that I can treat [appendicitis] with natural medicines
What's your evidence for this?
Exactly.
It's also a huge straw man argument that we "arrogant, self-impressed" skeptics are saying that natural products are not of value. Clearly they are. A large part of our medical armamentarium comes from drugs derived from plants and other natural products. The problem with naturopathy is the apparent overriding belief that crude, impure extracts somehow "synergize" and are better than purified pharmaceuticals. There is no good evidence to support this view.
As for the "chemistry, pharmacology, etc." that naturopaths brag about having studied, all I can say is: I wonder what they teach in those classes, because the use to which the knowledge is put is about as unscientific as I can imagine. Harriet Hall has a term for such studies: tooth fairy science, in which all sorts of aspects of the tooth fairy are studied, but no one ever bothers to ask if the tooth fairy actually exists. Naturopathy is a lot like that in that none of them ever question the underlying assumptions behind naturopathy, while they do use all sorts of "science-y" sounding terms. In other words, there is a patina of seeming science, but the very heart of science, namely skeptical questioning and hypothesis testing and falsification, do not exist to any appreciable extent.
Finally, the whole "treating" appendicitis with natural medicines can only work if the natural medicine is as powerful an antibiotic as some of our second and third generation cephalosporins. In fact, you can treat appendicitis with antibiotics and no surgery, as long as the appendix hasn't ruptured and formed an abscess. In fact, that is how a lot of appendicitis is treated in Europe these days. Indeed, even if the appendix has formed an abscess, sometimes it's possible to drain the abscess and treat with antibiotics successfully. Appendicitis no longer always requires an appendectomy. Often it does, but not always. In any case, is there a "natural medicine" that is as powerful and predictably effective an antibiotic that can treat the mixed bag of organisms found in appendicitis as our pharmaceutical antibiotics? That, I'd like to see.
TJ:
Acupuncture and chiropractic have no physiological effects? Share that rock you have been hiding under with anyone? I'll just suggest you hit PubMed with some keywords and do your own searches...I've spent way too many years teaching students who wouldn't do the leg work themselves to spend more time doing it for them. You might also spend some time at the NCCAM site and read the latest research.
As for placebos, one often sees an equal or greater physiological effect with placebos than with the tested agents. A 15% response rate is considered significant for Drug X yet is dismissed when it occurs with a placebo. That's called psychoneuroimmunology. Try that as a keyword search as well.
We do treat MIs and appendicitis. Generally, we work to prevent them as well. But, if you re-read my post, I suggest that it is more prudent to send those patients in for surgery or ER treatment. And, I might mention that unless you get an MI patient in within the first hour, the ER's record isn't so stellar either. And why do you think they are "subjective" conditions? I know how to read and interpret a lab report, thank you, as well as take a patient history. I know how to do a full PE and a DDx. My hunch is that there is a bit of unnecessary defensiveness here...perhaps that "spice rack" from which you seem to believe I get my medicines from would benefit you....unless, of course you prefer the medicines that come with the black box warnings.
Which methods do you claim have no evidence? I'd suggest that you once again turn to PubMed and pick....oh, let see....digitalis? Perhaps Salix (the starting material for aspirin which lacks the anti-platelet activity yet retains the anti-pyretic and anti-inflammatory properties and is quantifiably safer). Actually, you could go to any number of international resources (e.g German Commission E) to find clinical trials. You might also consider the fact that we've been running research with little funding and lots of bias and have had to rely on case studies, clinical history and yes, anecdotal evidence...rather similar to off-label drug use.
Finally, it is debatable as to which professional group needs to "get over" themselves. Ego is not considered a common descriptor for natural health care providers...
Ego is not considered a common descriptor for natural health care providers...
Sorry, but I have some experience using those kinds of providers, and they most certainly do have egos. Thought they knew everything, and helped me with nothing. And dismissed the time I had "wasted" with western medicine.
I find this the scariest thing I've seen on this thread.
Got a citation from the peer-reviewed scientific literature for that one? After all, it's rare for an MI patient to get clot busting drugs or to make it to the cath lab within an hour of symptoms. In fact, many patients don't make it to the emergency room within an hour of the onset of symptoms. Moreover, there are two parts to your claim, namely that medicine does "as bad as naturopathy" for MIs if it's been more than an hour. That latter claim is patently ridiculous--unless, of course, you can show us some scientific literature on the naturopathic treatment of acute MI that shows naturopaths do as well as standard medical therapy.
Orac:
You have a few points I'd like to comment on:
I have not seen any good evidence (yet?)either of synergetic activity of the "crude" extracts. But, how many studies have been done for ANY pharmacological interactions? Do we know very much about the interactions of OTC and prescription meds? How much do we really understand how the combinations of drugs in chemotherapy work. We don't, because the fact is, we pick the MOA that seems the most important to emphasize for any drug and tend to ignore the other effects and don't even get around to examining synergistic or antagonistic effects. So, while I agree there is no powerful evidence for the synergetic effects of "crude" (they aren't really all that crude, actually) extracts, its a hypothesis purporting to explain the differences in activities between the purified and the less purified products. How does one control for the various parameters?
I'd invite you to attend a lecture at a naturopathic school, if you are curious. As I have the advanced degrees, all I can tell you was that it was the same texts, the same information as I had in graduate school.
Now, I have to admit that there are times when I would personally have liked to "speak to" some students (both allopathic and naturopathic) about the inaccuracies and inadequacies of their language when it comes to explaining the modalities. This is unfortunate...and I had a number of revelatory discussions with homeopathy professors....particularly concerning Avogadro's number. The point remains, however, that there does exist evidence of the utility and rationale for non-drug treatments and while some members of any profession should not be held up as exemplars, that does not negate the value of the profession.
Again, my goal is to provide the best care for my patients and I am happy that my armamentarium includes anything human intelligence can derive. But, just because it comes from a lab does not make it inherently better than what comes from the field...just more useful under specific conditions. And, the problem with, for example, cephalosporins is not they they are effective in dealing with the appendicitis (much to be desired). Its not even that they are effective as well in killing off the normal gut flora...its that until relatively recently, medicine did not recognize the importance of either gut flora or the GALT system in maintaining overall homeostasis and therefore considered NDs as "crazy" for giving probiotics. Well, its getting less crazy, thankfully.
I too, would like to see better research for herbal medicines, vitamins and supplements. Most of the research I've seen uses dosages and protocols that are unlike anything that I would use, and that hardly makes for a valid argument.
As I have the advanced degrees, all I can tell you was that it was the same texts, the same information as I had in graduate school.
You studied a homeopathic materia medica in organic chemistry? Or a textbook of herbal remedies? Must be an interesting MSc program you had, there.
In any case, is there a "natural medicine" that is as powerful and predictably effective an antibiotic that can treat the mixed bag of organisms found in appendicitis as our pharmaceutical antibiotics? That, I'd like to see.
I'd like to see that too, but DrZed doesn't seem to be forthcoming with any evidence for that. Typically, he responds by wordily attacking the evidence for conventional interventions instead.
It's not like it's hard - I'm sure the REB would be quite happy approving a blinded adjuvant study, given how "safe" naturopathic treatment is. Primary outcome: resolution without surgical intervention. If that shows a significant effect, argue for a study on naturopathic intervention alone. There you go, DrZed - I won't even ask for a co-authorship.
Frankly, DrZed, it's ironic that you complain about how condescending and arrogant the medical community is, and then essentially tell me to Google it when I ask for some citations.
It could be worse. Stockwell Day, current Minister of International Trade and former Minister of Public Safety, is a Young Earth Creationist. His YECism probably helped cost him the chance to be Prime Minister, as when it was revealed the response of many Canadians was comments along the lines of Day mistaking the Flintstones for a documentary. Imagine him in a role involving science policy.
DrZed are you for real? Yes, you get more fuck ups in real medicine because you are using chemicals with powerful effects. Certainly zero treatment would have a lower rate of accidental deaths (zero in fact), but certainly not a lower rate of actual deaths if you take into account the cancer/infection/ whatever the problem is. Like the guy recently who died of gangrene because he was diabetic and tried to treat a leg infection with natropathy.
If you really have science degrees, the whole science bit must have flowed off you like water off a duck's back. For a recent overview of the science of most CAM try "Trick or Treatment" by a doctor, ex homeopath and the very first professor of alternative medicine.
It could be so much worse, but it's not like there's not plenty of educated, trained scientists who could better fill that spot, rather than a chiropractor, which is just ridiculous.
This is disappointing. I didn't vote for Harper, because his judgement is dubious at best.
And I grew up where Stockwell Day got his start. I'm well familiar with his flavor of crazy.
By contrast, our Liberal party appointed an astronaut as their Science and Technology critic. Westmount -- Ville-Marie MP, Marc Garneau.
Prime Minister Harper is a part of the Xtian right (Alberta division), and as such, hates science as much as any right-wing Republican. Under his leadership the gov't has suppressed scientific environmental findings, just as the Bush administration has. Harper believes in magic, so acupuncture and chiropractic should seem completely reasonable to him.
Do not the many countries where chiropractors, accupuncturists and naturopaths practice have higher life expectancies than does the US (ranked 46th)? (including Canada, Australia, Japan and Okinawa:
Dr Zed, first, what you are trying to link, the practice of accupuncture, chiropractice and naturopathy with higher life expectancy is a complete fallacy. It might be possible to design a study in order to verify this claim, but basing it strictly from the source you cite is ignorant. (Cia facts website, really?) Not to say that for basic, raw data, the site is not fine, but using it to draw the conclusion you have, is, well, boneheaded.
Not to mention the fact that the US (ranked 46th as you point out) allows the practice of these alternative methods as well. So I could, using your logic, attribute the US' poor standing to the fact that it allows said pseudoscience. Right?
I suggest you rethink that... well, I hate to call it an argument, but in the sense that the word "argument" doesn't contain any inherent definition of quality, why not.
Sounds like the Canadian conservatives. Ontario had an education minister once who had dropped out of high school. Oh Canada indeed.
TJ:
You studied a homeopathic materia medica in organic chemistry? Or a textbook of herbal remedies? Must be an interesting MSc program you had, there.
So sorry, in my admittedly "wordy" manner, I didn't really make it clear that I was referring to classes concerning pharmacology, physiology, pathology etc. Those were the classes where we used the same textbooks, same basic information, same data. Also, I don't believe I actually ever "attacked" any of the evidence for conventional medicine. I merely pointed out some of the shortcomings. So sorry, TJ, I appear to have pushed some sensitive buttons on you. I still suggest you find your own references, for if you still have any degree of open-mindedness, you will have to convince yourself or remain unconvinced...its not arrogance on my part, its simply that I've done my research and simply don't believe that I should do yours.
IR: My "argument" at that point was not well phrased, I will agree...but boneheaded is a bit harsh. I was trying to point out that the US with all its conventional medical resources, still has a rather poor ranking for life expectancy, so it seems that Western medicine is not the whole answer.
Mike: Yes, there are definitely those in the field of natural medicine with their own over-inflated egos and defensive stances. I'm sorry you were unable to get any real help.
General remarks:
While I could have toned down some of my own phrasing and will reflect on my own time on why I didn't, I must say that the overall tone of many of these posts is hardly respectful, is small-minded and clearly biased for the status quo. That is unfortunate and does not reflect a true spirit of inquiry and the true spirit of science, which is not a competition but a quest for knowledge, examining the evidence with an unjaundiced eye. You don't want to convince me--you want to figuratively smack me down and show me I'm stupid. I can take a good discussion as well as take any number of "hits" as in a good, old-fashioned thesis defense...but this is taking too much time with too little useful information in return.
Actually, no... Nobody can do a better job than you in this regard. ;^}
I learned of this fellow at this very blog. And I am ever grateful!
http://www.youtube.com/watch?v=RFO6ZhUW38w
MK; Make you feel real powerful, that juvenile remark? I win my bet...it took less than 30 minutes for a "witty" comeback! Get a life...
"get a life." Damn... I wish I thought of that one! Brilliant!
Life expectancies for most of the developed countries vary by only a few years. A number of factors drive this and the quality of medical care is but one of them.
When you consider the relatively high violent crime rate, sedentary lifestyles, and poor dietary habits in the US, it's downright impressive that we do fare well enough in life expectancy.
You seem to imply that having a strong background in science validates everything you do from there on. Linus Pauling did more for science than everyone who has ever posted on scienceblogs.com combined. Yet, he died a through and through woo. Andrew Wakefield was an an excellent researcher before he turned to the dark side. Or what about John Lilly? He was a legitimate neuroscientist in the 1950s before he started doing massive amounts of ketamine in his attempts to communicate with dolphins.
Joseph C said about Zed:
This is a pretty common tactic from Woomeisters. Which is weird, really. They have utter disdain for science (and medicine) and yet happily use it when necessary to try burnish their woo arguments. Craziness, I tell ya!
DrZed: "Ego is not considered a common descriptor for natural health care providers..."
DrZed: "Yes, there are definitely those in the field of natural medicine with their own over-inflated egos and defensive stances."
Well, so much for that bit of self-congratulatory preening.
What gets me is not so much the smugness of the Dr. Zeds, but the revelation that on the one hand they trained using "the same textbooks, same basic information, same data" as scientists and medical practitioners who practice in in evidence-based fields of endeavor (DrZed tells us he has various advanced degrees in such fields), yet fail to understand and/or respect the most basic principles of acquiring and evaluating scientific knowledge.
DrZed: "I just get particularly tired of self-important conceit and ego parading itself around as Truth and Science".
Very true. It's a major reason why sticking it to quacks is so rewarding.
Joseph C., you listed lots of good scientists who spent their last years involved in questionable research. For anyone who has their computer plugged into an alternating current outlet, thank Tesla... but also remember he had some flaky ideas (some worked, but were not practical, I have a vivid visual memory of my daughter at a science center field trip where a fluorescent tube she held was lit using a Tesla inspired remote power supply)... he still had a weird relationship with pigeons in his older years.
"Uhh, I hope he reconsiders given the state of Canadian military power. If it didn't work for America and something similar failed the Soviets, the Canadians are going to get slapped about."
LOL. He subscribes to the piss everyone off part. The military, now he gives that a lot of lip service.
"Sounds like the Canadian conservatives. Ontario had an education minister once who had dropped out of high school. Oh Canada indeed."
Yes, the crew from that same government is in Federal power now. The way things have been going, one might think that Snoblen was in charge of diplomancy.
Prime Minister Harper is a part of the Xtian right (Alberta division), and as such, hates science as much as any right-wing Republican.
Yeah, which is why he tried so hard to restrict abortion and ban gay marriage. Oh, wait...
Re DrZed
The good doctor I was referring to in my comment was DrZed who is, indeed, a total whackjob. I was certainly not referring to Dr. Orac for whom I have the highest regard.
I am totally unimpressed with DrZeds' alleged academic credentials. Off the top of my head, I can name others with equal or better such credentials who were also total nutcases. Consider Linus Pauling, Peter Duesberg, William Shockley, J. Allen Hynek, and Brian Josephson as examples.
Like all such people, Dr Zed argues that acupuncture, choropractice et all has ben used for "thousands" of years, therefore it's superior to that nasty new allopathy stuff.
First of all, can he produce evidence that acupuncture etc has really been used, in it's present form, for that long?
Once he's done that, can he explain why, if his form of medicine worked so well for millennia, people felt it nesessary to look for new ways of treating illness?
Why invent a new term instead of just saying "theology"? :-)
DrZed, concerning the difference in life expectancy and whatnot between the USA and the rest of the First World, has it never occurred to you that tens of millions of Americans have no health insurance whatsoever, and the rest is insured by private corporations who try very hard to not pay for any treatment, to the point of lawsuits, because they want to make a profit?
Possible adverse effects of acupuncture : tendosinovitis, pneumothorax, infection
Possible adverse effect of chiropractice : stroke
Unfortunately, we have no accurate statistics for these.
Oh, and I forgot the sometimes serious adverse effect of wasting time by going for a useless modality, of course...
I was trying to point out that the US with all its conventional medical resources, still has a rather poor ranking for life expectancy, so it seems that Western medicine is not the whole answer.
Sigh. And then you go and cite other countries (I believe Canada and Australia were two of your examples) that also use an overwhelmingly Western based medical system.
My point is that your assertion has absolutely no basis in fact. The assertion was that it is the inclusion of chiropractic, naturopathy, & accupunture therapy that makes those other countries superior to the US in concrete health statistics--life expectancy being your citation.
What I am saying is that you cannot conclude that it is the inclusion of these things in the system that lead to the differences in life expectancy, especially because those very same practices are allowed in the US health care system as well, and, as you note, the US doesn't fare too well.
As others point out, you make a start by looking at those details which are different across the subjects, such as lack of health care insurance, violent crime rates, diet, etc. You don't find something which is the same and say, "Ah HA! This is why the results are so different from one another! Because they use the same methods of care!" Huh?
And as to your claim that:
While I could have toned down some of my own phrasing and will reflect on my own time on why I didn't, I must say that the overall tone of many of these posts is hardly respectful, is small-minded and clearly biased for the status quo. That is unfortunate and does not reflect a true spirit of inquiry and the true spirit of science, which is not a competition but a quest for knowledge, examining the evidence with an unjaundiced eye.
I believe you began this "spirit of inquiry" with the comment "the view from the rodent's posterior is severely constricted. What arrogance!" as well as "It never ceases to amaze me how those purporting to defend science often know very little about the actual process, much less the history of science." neither of which do exhibit a true spirit of inquiry or show of respect if I may point out. Hey, no problem, but now you don't get to cry foul when you have been engaging in the very same behavior you now find so dastardly.
Of course, you will reflect on your own shortcomings in your own time, but the rest of us, we're just a bunch of assholes?
many of these posts[are]...clearly biased for the status quo.
Look, two things about this. I wouldn't accept right off the bat your claim that the Western view is "status quo", especially here in the States where an incredible amount of money is spent each year on an unregulated, unsupervised industry of woo.
Second, even if we do accept this definition, we're all "biased" one way or the other. Most of us here are "biased" toward evidence based, controlled and repeatable experiments, while you are "biased" toward... other things. Woo as we like to call it. You don't think it's woo, but have yet to offer the same proofs we require of those other methods when considering if they do indeed work.
"R: My "argument" at that point was not well phrased, I will agree...but boneheaded is a bit harsh. I was trying to point out that the US with all its conventional medical resources, still has a rather poor ranking for life expectancy, so it seems that Western medicine is not the whole answer."
Good grief, the US is for all practical purposes a third world country, certainly in its access to conventional western medicine. If one third of your population cannot access it then that will be reflected in lifespan figures, which it is. Dr Zed, claims to be a 'scientist' and a naturopath and can't figure a confound? So much for the science background - if any.
Learning a trick or two on the science blogs. When the alties claim conventional knowledge and seemingly prefer the naturopath/homeopath, just wait until they make some really basic error of scientific reasoning, demonstrating that their background isn't as robust as claimed. We sure didn't have to wait long here.
"Possible adverse effect of chiropractic : stroke"
The most common adverse effect of chiro treatments is pain, generally short-term but occasionally more serious, secondary to soft tissue damage and/or broken bones from forceful manipulation (I've personally seen the latter in the emergency room). Of course, the most serious and common adverse effects of chiropractic relate to treatable conditions including malignancies that are missed by chiropractors or felt (deludedly) to be conditions that manipulation will help.
I did start this off on a negative note, for which I more explicitly apologize. I did not intend to do the searches, but I think some of the criticism in that regard was justified, so here are some...the list is not extensive, but then neither is the funding for the research nor is my free time. Here is a link from NCCAM on naturopathy (http://nccam.nih.gov/health/naturopathy/)giving a reasonable description of the profession for those interested.
I was aware of antipathy towards natural medicine before, as many patients, when I encourage them to tell their MDs of their seeing me and to encourage a collegial approach, tell me that they will not, for fear of ridicule and shame. I certainly understand their stand better. Here, my point is that this stance benefits no one. I expect that this post will do little to change that attitude.
Dhond RP, Yeh C, Park K, et al. Acupuncture modulates resting state connectivity in default and sensorimotor brain networks. Pain. 2008;136(3):407-418.
Berman BM, Lao L, Langenberg P, Lee WL, Gilpin AMK, Hochberg MC. Effectiveness of Acupuncture as Adjunctive Therapy in Osteoarthritis of the Knee: A Randomized, Controlled Trial. Annals of Internal Medicine. 2004; 141(12):901-910.
Iyer C, Kosters A, Sethi G, et al. Probiotic Lactobacillus reuteri promotes TNF-induced apoptosis in human myeloid leukemia-derived cells by modulation of NF-kB and MAPK signaling. Cellular Microbiology. 2008;10(7):1442-1452.
Zhang W, Azevedo MSP, Wen K, et al. Probiotic Lactobacillus acidophilus enhances the immunogenicity of an oral rotavirus vaccine in gnotobiotic pigs. Vaccine. 2008;26(29-30):3655-3661.
Ornish D, Magbanua MJ, Weidner G, et al. Changes in prostate gene expression in men undergoing an intensive nutrition and lifestyle intervention. Proceedings of the National Academy of Sciences of the United States of America. 2008;105(24):8369-8374.
Onken JE, Greer PK, Calingaert B, et al. Bromelain treatment decreases secretion of pro-inflammatory cytokines and chemokines by colon biopsies in vitro. Clinical Immunology (2008) 126, 345-352.
Wang J, Ho L, Zhao W, et al. Grape-Derived Polyphenolics Prevent AÃ Oligomerization and Attenuate Cognitive Deterioration in a Mouse Model of Alzheimer's Disease. The Journal of Neuroscience. June 18, 2008. 28(25);6388-6392.
Herman PM, Szczurko O, Cooley K, et al. Cost-effectiveness of naturopathic care for chronic low back pain. Alternative Therapies in Health and Medicine. 2008;14(2):32-39.
Bloedon L, Balikai S, Chittams J, et al. Flaxseed and Cardiovascular Risk Factors: Results from a Double Blind, Randomized, Controlled Clinical Trial. Journal of the American College of Nutrition, February 2008.
Manheimer E, Zhang G, Udoff L, et al. Effect of acupuncture on rates of pregnancy and live birth among women undergoing in vitro fertilization: systematic review and meta-analysis. British Medical Journal. Published online February 2008.
Michael Hollifield, Nityamo Sinclair-Lian, Teddy D. Warner, and Richard Hammerschlag, "Acupuncture for Posttraumatic Stress Disorder: A Randomized Controlled Pilot Trial." The Journal of Nervous and Mental Disease, June 2007.
Marlene P. Freeman, Joseph R. Hibbeln, David Mischoulon, et al. Omega-3 Fatty Acids: Evidence for Treatment and Future Research in Psychiatry. Journal of Clinical Psychiatry, December 2006
Dagenais S, Haldeman S. Chiropractic. Primary Care. 2002;29(2):419-437.
Senstad O, Leboeuf-Yde C, Borchgrevink C. Frequency and characteristics of side effects of spinal manipulative therapy. Spine. 1997;22(4):435-440.
DrZed:
What does that have to do with anything? It's an argument from antiquity. By your reasoning, astrology would be superior to modern astronomy.
And how many people survive otherwise fatal conditions due to conventional medicine?
Ridiculous. I hope this isn't the quite of thinking you use when evaluating treatment options.
Guess where countries like India and China - countries where the use of CAM is quite high - are on that list. I could also make the argument that Canada, Australia and Japan have publicly-funded healthcare systems which is why they have higher life expectancies than the United States. Of course, it could be an entirely different reason or bunch of reasons, which is why your speculative reasoning is meaningless.
So I count two animal studies, a few in vitro studies, a couple ostenstibly decent but small preliminary RCTs, a couple wholly irrelevant papers (does something being cost-effective now make it effacious?) and only one meta-analysis that looks incredibly familiar? I'm not completely sure what this laundry list is supposed to demonstrate.
But more to the point: I still don't see anything related to appendicitis, so I'll ask again: you said there was a chance that you could treat appendicitis, so where is your evidence for that specific claim? Orac also asked you to back up your claim that naturopaths perform as good as conventional treatment after the first hour of an MI. Where is your evidence for that?
Do you consider it ethical to pronounce that you think you could treat life-threatening diseases without ANY reasonable evidence to substantiate that?
@MrZed,
The problem with data dumps, such as yours, is that you ask us to sort through the papers and determine if there is anything useful.
Quickly:
Dhond is not a clinical study, thus it does not support clinical claims.
Berman lost far too many subjects for the study to be conclusive. Maybe you should read R. Barker Bausell's book (Snake Oil Science) to learn about this.
Iyer- not clinical.
Zhang studied pigs, not humans.
Ornish I dunno.
Onken in vitro means it is not a clinical study.
Can't you cite clinical studies, of some technique, that you think are definitive? Try to understand that one study of one indication for a treatment is rarely convincing. Also, basic research does not go directly into the clinic. If you study medicinal chemistry, you will learn that we know tens of thousands (if not hundreds of thousands) of antibacterial compounds that are not suitable for use as drugs. That's why you need clinical studies to support your claims.
In addition, research that seems to support an intervention (such as acupuncture, homeopathy, herbs, chiropracty, etc.) for one indication does not support all the thousands of claims made by proponents. For example, if you ever study pharmacology you will learn that penicillin kills some bacteria, and not others.
Don't waste your time, our ours, citing articles at random.
Dr. Zed,
speaking just for myself, that last post was definitely better, though, not having any background in methodology, I can't comment on the validity of (most of)the studies you provide to back up some of your claims. My first assumption, and it is just an assumption, would be that there are some that might have merit, and some that are downright dubious.
One of the papers you cite is in regards to the claim that acupuncture increases the rates of pregnancy and live births among women undergoing IVF. It's a meta-analysis of research that has been done regarding this question. I am providing a link to a review of the exact paper you cite(1st link), as well as a separate link(2nd) for another study which was not a meta-analysis but rather an actual study on whether acupuncture does indeed increase the likelihood of conception in women undergoing IVF. In both instances, the point is made that in both cases the evidence was not showing what it was the authors thought it was showing. And he methodically points out why this is so.
http://www.sciencebasedmedicine.org/?p=43
http://www.sciencebasedmedicine.org/?p=162
Hopefully you will take the time to read the links, they aren't particularly lengthy though they are thorough.
I see I've been too slow with a response and a few others have made some valid points regarding your citations. But rather than quibble over that I would also just point out that regarding a few of the other studies, I'm not sure they qualify as being a debate point. The prostate gene expression being changed through intensive nutritional and lifestyle changes is just one that I can mention.
I've been involved in direct patient care my entire life, obviously to begin with(1972), as a patient, and also as a member of a health care team. I have never in my entire life heard of a Western trained MD discounting intensive nutritional and lifestyle changes in order to achieve direct, observable results. Think of our current problems with diabetes, obesity, heart disease, etc and what most doctors are saying is a remedy: drastic lifestyle and eating changes. Do you honestly believe this isn't the case?
You are right Joe, to quote a few studies that might show something positive is useless, especially if cherry picked. The meta analysis would seem to show there is very little most cam that is not placebo effect.
I wonder what Gary Goodyear will do about Philip LaPierre, the Canadian chiropractor who uses "matrix repatterning" as an excuse to molest his female patients? http://www.sciencebasedmedicine.org/?p=286
It seems that some Canadian politicians have become so open-minded their brains have fallen out. Living in DC - I don't think we're far behind. :(
More bankrupt altie debate techniques courtesy of DrZed.
First off, the laundry list of impressive-sounding papers, intended to drown out doubters by sheer mass. Never mind that when they're looked at more closely they turn out to be animal research, small pilot studies, irrelevant in terms of the efficacy of a particular therapy or refuted elsewhere (for more on acupuncture and fertility, check out the paper recently reviewed on this blog which found that placebo acupuncture actually had a more positive effect on fertility following in vitro fertilization than did "real" acupuncture:
http://scienceblogs.com/insolence/2008/11/thatll_teach_em_for_using_an_…
Also, gotta love the excuse (anticipating no doubt responses about the flimsiness of the evidence provided) about how poor DrZed's "time is limited". This is a typical rejoinder from an altie whose claims have been blasted in a forum such as this, particularly inane after a series of lengthy posts from said altie. Apparently we are supposed to feel guilty about responding to his gibberish when he is taking time away from healing appendicitis victims.
If you read this blog further, Zed (stick around, you might learn something, if only humility), you'll find it's not the patients who face "ridicule and shame" - it's the quacks exploiting them who get that treatment.
I voted against Harper for exactly this reason. Too many religious right and anti-science types in his party for my liking.
I even read that the main reason he called an early election was to avoid being sucked down in the aftermath of the Republicans' predicted sinking. With all the enthusiasm here for the Democrats' win, there might well have been some truth in that rumour.
I hear echoes of the creationists' cries for 'fair and balanced' treatment of all the ideas when I read DrZed's posturing here.
I find it curious that Zed, in some dozen posts in which he says he is defending the honor of chiropractic, never mentions subluxations.
There has been a well publicized death by stroke following chiropractic neck manipulation in Canada, and several similar cases of death/paralysis reported in the US. This is due to carotid arthery dissection following neck manipulation. It's very difficult to know how often this happens since stroke may occur days after the injury, and rarely in these instances the patients and doctors will make the link between neck manipulation and stroke. In the canadian case, the patient had the stroke inside the chiropractor's office. Stroke is a really really bad complication for an elaborate placebo, methinks.
Neck manipulation-related stroke would fall under the heading of serious and _un_common adverse effects of chiropractic.
It's an unconscionable risk given the extremely limited evidence that neck manipulation does any good, but it is a low risk compared to the frequency of misdiagnosis/mistreatment in general by chiropractors.
Okay, for those keeping score:
1) Woo-meister arrives with:
a) Appeals to authority
b) Ad hominems out the wazoo (including what smells to me like a big fat 'tu quoque')
c) Cites of bogus studies
d) Cites of information that may or may not be legit but which has nothing to do with his argument, but which he waves around hoping to sound all scientificky
2) Orac and the regulars:
a) Shoot down the classical fallacies like they were ducks in a millpond
b) Shoot down the bogus studies
c) Tease apart the legit-but-irrelevant stuff from the purely bogus
d) Ask woo-meister to offer up actual, legit cites that are pertinent to his argument
3) Woo-meister, stubbornly refusing to admit defeat, continues to dig his hole deeper by abandoning all efforts at looking scientificky and all that in favor of sitting in the corner and wibbling about how meeeeeaaaan Orac and the regulars are.
In other words, the typical experience of a woo-meister who ventures over here.
Have I missed anything?
Eeep! Sorry about that. I hit the "Back" button and for some reason it took me to the preview page instead of to the main page.
Well, so much for that bit of self-congratulatory preening.
What gets me is not so much the smugness of the Dr. Zeds, but the revelation that on the one hand they trained using "the same textbooks, same basic information, same data" as scientists and medical practitioners who practice in in evidence-based fields of endeavor (DrZed tells us he has various advanced degrees in such fields), yet fail to understand and/or respect the most basic principles of acquiring and evaluating scientific knowledge.
MrZed, Do you know what happens to alternative medicine that works? It becomes real medicine. Evidence based medicine. TCM has thousands of years of failure to show for. I'll take evidence based medicine, which has made extraordinary advances over the last century.
Great. It has some demonstrable pain relief. Thats it. Nothing else has been demonstrated. Never mind that far too many infections occur because acupuncturists don't use sterile procedures. Or that where you poke someone has does not affect the effects. Or that it is based on a concept of the body that was developed when dissection was illegal, and assumed that air, not blood, flowed through blood vessels.
Herbal meds? Unless you know and are isolating the active compound and delivering it in standardized doses, your ability to give reproducible results are limited. Add to that, poisons from plants, from which many drugs are produced, may require chemical modification before you get something where the positive effects outweigh the negatives. Camptotheca accuminata yields camptothecin, which is extremely toxic, but add a hydroxyl here or methyl there and you get something that has real use in cancer chemotherapy, with an improved side effect profile.
The difference between evidence based medicine and alt medicine is that evidence based medicine is progressive. We add to preexisting knowledge, and do this through rigorous experimentation. What new concepts have been added to acupuncture? electrical current? Heating? Twirling the needles? Anything? Verification of the existence of chi?
At least some chiropractors have admitted that bacteria and viruses exist, and cause disease. Not many, but they have accepted some features of reality.
Forgive me, regulars, if I'm just beating a dead horse, but I wanted to provide some more information regarding Dr. Zed and his repeated claim that,
"...the US with all its conventional medical resources, still has a rather poor ranking for life expectancy, so it seems that Western medicine is not the whole answer. --Dr.Zed"
A quote from Dr. Kimball C. Atwood IV in his special article Naturopathy:A Critical Appraisal
naturopaths have achieved legal and political recognition, including licensure in 13 states and appointments to the US Medicare Coverage Advisory Committee.[my emphasis]
This was published 12/30/2003 and can be found here:
http://www.medscape.com/viewarticle/465994