Respectful Insolence

ResearchBlogging.orgIf there’s one thing I’ve learned over the last four years of examining the various forms of woo out there, it’s to be very, very skeptical whenever an advocate of a highly dubious-sounding “therapy” points to a study as “proof” that the therapy, whatever it is, works. Usually, what I find is a small pilot study with inadequate controls or even a poorly designed study. For example, the acupuncture literature is rife with these sorts of studies. It’s also rife with larger studies for which the control was inadequate–or for which there was no real control at all. This phenomenon is generalizable to many, if not most, studies of so-called “complementary and alternative medicine” (CAM), as is another feature, namely that the larger and better designed the study, the less likely it is to find a treatment effect greater than placebo due to the treatment. Another principle is that at a statistical significance level of 95%, at least 5% of studies will appear to find a treatment effect through random chance alone. Guess which studies will be cherry picked and held up as “proof” while the preponderance of studies showing no effect are ignored?

There is at least one other form of studies pointed to by CAM advocates to “prove” that their woo “works.” Indeed, this form is perhaps their favorite crutch to fall back on. It’s what I like to call the “non sequitur” study. In other words, it’s a study that is, at best, only tangentially related to the question at hand, or, as I like to put it, a study that is related to the therapy being argued for only by coincidence. This sort of study is a favorite of homeopathy. Just think of studies about the molecular bonds of water homeopaths like to point to as “evidence” for the “memory of water.” It is this latter form of study that I’m going to deal with here.

Remember about three weeks ago, when I had a bit of fun with one of the most hilariously ludicrous bits of woo that I’ve ever seen, Tong Ren? If you’re really new to the blog and didn’t happen to read my post, I encourage you to go back and do so now. If you do, you’ll see, besides my own inimitably insolent prose, YouTube videos of a man named Tom Tam leading a bunch of people tapping on acupuncture dolls with small hammers and concentrating their “intent” to “heal” a person. I’ve seen a lot of woo before. A lot of woo. But Tong Ren was about the most ridiculous things I’ve ever seen. These people really believe that by taking what looks in essence to be a voodoo doll and tapping on it at the correct acupuncture points, they can direct some vague “energy” undetectable by science to cure cancer and all manner of other diseases. One thing you’ll also see is a news report that mentions a study of Tong Ren being done at the Dana Farber Cancer Institute, a very prestigious institution indeed. Naturally, at every opportunity, the connection to Harvard University is played up, so desperate is Tom Tam to wrap himself in the mantle of seeming legitimacy that the attention of Harvard University suggests. When I poked around various Tong Ren websites, I couldn’t find out anything about the study other than that it appeared to be some sort of survey and that the manuscript had been submitted.

It appears that the manuscript has been accepted and was published recently in a journal I’ve never heard of, namely Complementary Health Practice Review. The article, entitled The Tong Ren Healing Method: A Survey Study, by Amy M Sullivan, EdD (Virginia Commonwealth University School of Medicine), Susan Bauer-Wu, PhD, RN (Emory University), and Michael Miovic, MD (Dana Farber Cancer Institute). Of course, that this study appeared in a journal called Complementary Health Practice Review does not bode well for its quality, and this is no exception. More importantly, the hypothesis examined by this study is related only by coincidence to the hypothesis that Tong Ren “heals” anything. Check out the abstract:

Tong Ren (TR) is an untested energy healing modality with anecdotally-reported effectiveness for a variety of disorders. Study objective: To describe participant reports of effectiveness and safety. Design: Cross-sectional, anonymous survey. Setting: Weekly group sessions in the Northeast US. Participants: Adults attending group sessions. Measures: Changes in conditions attributed to TR. Results: Response rate 89% (n = 265). Cancer (30.6%), endocrine/autoimmune (17.5%) and musculoskeletal disorders (17.2%) were the most commonly reported conditions. Among respondents who had attended more than one session (n = 216), 30% used superlatives (e.g., “amazing”) to describe TR’s impact, and one-third noted improved quality of life. No adverse effects were described. Anxiety, depression, cancer, and autoimmune disorders appeared to have the greatest treatment responses, with 63.8%, 61.0%, 60.3%, and 58.1% of participants with these conditions reporting substantial improvements. Conclusion: This first study documenting self-reported effects of TR shows subjective benefits and no adverse effects. Further research on this approach is warranted.

In other words, what Sullivan et al did was to collect anecdotes. That’s it. Other than that, she characterized the characteristics of the people who sought out Tom Tam’s particular brand of woo. The article begins:

The National Institutes of Health National Center for Complementary and Alternative Medicine (IH NCCAM) has described energy medicine as a domain in complementary and alternative medicine (CAM) in need of scientific research (National Institutes of Health [NIH], 2007). Tong Ren (TR) Healing is a relatively new modality of energy medicine developed in 2001 by Tom Tam, a practitioner of acupuncture and other forms of Traditional Chinese Medicine (TCM; http://www.tomtam.com/content/tom-tam).

Ugh. Right from the beginning I can tell I’m dealing with believers, or at least people who are so open-mined that their brains fell out. Don’t believe me? Then get a load of this next section:

The TR method blends TCM with Western biomedical knowledge of neurophysiology, endocrinology, and neuroanatomy. Since 2001, TR has been used to treat symptoms of a variety of diseases and conditions, including cancer, diabetes, AIDS, arthritis, autoimmune diseases, anxiety, and depression, with ongoing classes currently held in 13 countries and 24 states in the United States (http://www.tomtam.com). TR practitioners report that thousands of people have sought treatment and reported benefits from this method. This approach to healing, however, has not yet been subject to systematic empirical study.

[…]

TR is distinguished from other energy healing methods in two ways. First, it posits that the qi follows actual physiological pathways of the endocrine, circulatory, and central and peripheral nervous systems, in contrast (>or some cases in addition) to the hypothesized energy pathways represented by TCM acupuncture meridians (Tam, 2004; Tom Tam Healing System, 2007). This approach thus aims to facilitate healing by identifying and removing blockages in specific physiological systems that relate to the particular organ or disease. For example, treatment for breast cancer would target not only the tumor itself but, more importantly, the supposed cause(s) of the tumor, which for breast cancer would include blockage at the level of the spinal nerves (particularly T4; Tam, 2004) that emerge from the thoracic vertebrae and cross in front of the internal mammary artery and pectoral muscles. Second, although many energy healing modalities involve one-on-one treatments in which the practitioner is thought to use her or his own energy to promote healing in the recipient, TR group sessions are thought to facilitate the release of specific blockages by the collective intention and attention of the participants in the group (Tam, 2008).

The purpose of this study is to obtain information from users regarding their experience with TR Healing in improving symptoms from disease, disease course, or treatment side effects through an anonymous cross-sectional survey of participants of TR Healing group sessions. Prior to the study, we determined that if 50% or more of participants reported improvements with symptoms of their disease or relief from side effects of treatment, we would consider this sufficient preliminary evidence to support future, more rigorous investigation of this healing method. For this report, we address the following specific research questions: (a) What are the conditions for which participants are seeking healing through TR? (b) For participants who have attended more than one TR session, what is the self-reported effectiveness of the treatment? (c) Does self-reported treatment effectiveness vary by group leader, time-in-treatment, or specific condition? (d) What are the self-reported adverse effects, if any, of this treatment modality?

First off, reading this credulous prose cues me in right away that I am not dealing with anyone interested in actual science. The whole routine about qi flowing along actual physiological pathways instead of (or in addition to) meridians is a nice touch, but it’s nothing but the proverbial putting lipstick on a pig. (Oh, wait, should I have used that metaphor? Our recent election shows that particular saying can have unintended consequences.) Of course, Sullivan et al don’t bother to cite any actual evidence from the peer-reviewed literature for Tong Ren. Oh, no. That’s because there isn’t any. Rather, they cite a bunch of URLs from Tom Tam’s various websites and books by him. Unfortunately, peer review for this particular journal isn’t what one would hope.

Moving on, I suppose there are some circumstances where such a study might be useful. It might give information about who uses woo such as Tong Ren. It might be useful as a psychological study of what draws such people to incredibly implausible “treatments” such as Tong Ren. It might even be useful as a measure of user perception of Tong Ren. What it’s not in the least bit useful for is as evidence for any sort of efficacy due to Tong Ren. Indeed, it is nothing more than the formalized collection of anecdotes, and, when it comes to determining the efficacy of a therapy, the pleural of “anecdote” is not “data.”

The results of the study are essentially as described in the abstract. However, the manner in which the results are reported and discussed tells us nothing. To get an idea, I quote a typical paragraph:

To obtain a qualitative measure of which diseases or conditions appeared to have the strongest response to treatment, we sorted the comments coded as “superlatives” (n = 65 cases) by ICD-9 classification and counted the number of superlative ratings in each disease category. Cancer (n = 20) and endocrine, metabolic, and immune disorders (n = 16) received the highest number of superlative ratings, followed by musculoskeletal disorders (n = 11; Table 5). Table 5 shows three examples of individuals within each of these disease categories. For example, one person with non-Hodgkin lymphoma described TR as “revolutionary” and said that the difference noted from TR was “no trace of cancer” and that “remission” was the most important result of TR treatment. Other disease categories that were associated with comments using superlative terms were digestive system disorders (n = 5), nervous system disorders (n = 4), mental health conditions (n = 4), and respiratory disorders (n = 1). Some improvements that were not coded as superlative were still notable, for example, one participant who was in attendance to treat “bone loss in jaws, potentially loss of at least 7 teeth,” described TR as “energizing, revitalizing,” and after 11/2 years of weekly TR treatments reported that “y teeth are no longer mobile, none have had to be removed, am able to use my teeth without problems.”

Note that these are entirely subjective impressions. Not one whit of clinical correlation is provided to determine whether there was anything to these testimonials other than what the patients said. If there’s one bit of wisdom I’ve tried to impart over the last four years, it’s that the vast majority of testimonials are not what they appear. It’s also that the people who make these testimonials are not stupid, by and large. Credulous, yes. Not trained in the scientific method. Almost always. Unable to realize that correlation does not equal causation. Definitely. Attributing effects that are due either to regression to the mean or treatment effect from “conventional” therapy to the woo they’re undergoing. Almost certainly. Generally, they fall prey to the cognitive quirks that all humans share that lead us to make incorrect conclusions regarding causation when faced with small sample sizes (namely us), or, as physicians, our own “clinical experience” (as Dr. Jay Gordon is fond of invoking). It is these cognitive quirks and shortcomings that make the scientific method necessary. Too bad Sullivan et al seem not to realize that, as they write in their Conclusion section:

Equally intriguing were the write-in descriptions citing “amazing” and “remarkable” improvements, with 30% of respondents who had attended more than one session using superlatives such as these to describe the impact of TR. Many of these descriptions did indeed appear remarkable, including reports of cure or remission from cancer, elimination of pain from arthritis, and reversal of bone loss.

None of which were verified by objective measures or correlated with Tong Ren therapy. Yes, the authors do concede that in the Discussion and (weakly) admit that this study does not provide concrete evidence for the efficacy of Tong Ren, but that admission does not keep them from taking all the “superlative” adjectives used by Tong Ren users, adding some dubious scientific studies, and using them to conclude that Tong Ren (a.k.a. the tapping of little voodoo dolls with little hammers to cure disease) is the greatest thing since sliced bread and should be studied further:

Some prior well-designed research does support the possibility of these effects; research and reviews of research on Ki and Qigong energy healing has documented evidence of inhibition of cancer cell growth in both in vitro studies with human carcinoma cells and in vivo animal studies (Chen, 2004; Ohnishi, Ohnishi, & Nishino, 2006; Ohnishi, Ohnishi, Nishino, Tsurusaki, & Yamaguchi, 2005). A systematic review of Qigong for pain reported evidence for its effectiveness as “encouraging” and warranting further study,(Lee, Pittler, & Ernst, 2007) and in vitro research on Ki energy healing has shown it to stimulate osteoblast and inhibit osteoclast cell activity (Ohnishi, Nishino, Uchiyama, Ohnishi, & Yamaguchi, 2007). If, as proponents have suggested (Kimura et al., 2005), balancing and unblocking the flow of qi energy enhances immune, endocrine, and nervous system function, some of these descriptions of healing from TR are plausible and may reflect measurable improvements in these physiological functions. The reports of strongly positive results indicate that future controlled studies of TR are warranted to test hypotheses about the physiological mechanisms that may be involved.

I’ve discussed these sorts of studies before. Suffice it to say, I’m not nearly as impressed as Sullivan et al apparently are, any more than I was impressed by a teenager who claimed that Tong Ren inhibited the growth of cancer cells.

Reading studies like this, I can’t help but alternately marvel and despair at what a waste of time, effort, and money they are. I note from the Acknowledgments section that the work was paid for by an “unrestricted grant from a private donor to the Department of Social and Behavioral Health, Virginia Commonwealth University School of Medicine.” That means it wasn’t funded by a grant, either from the government or a private foundation, won through peer review and competition with other applicants. Most likely, some woo-friendly wealthy contributor who had heard of Tong Ren paid to have this survey done. Nice work if you can get it. I wish I could find a wealthy patron to fund my research without all that nasty groveling (metaphorically speaking) in front of study sections and pounding my head against the wall to demonstrate that my results are worth funding and publishing.

The bottom line is that this study is yet another example of the phenomenon of “quackademic medicine” that has led so many medical schools to embrace pseudoscience. In the “good old days,” oh, say 20 years ago, no self-respecting medical school would have wanted anything to do with such a survey. A medical school might have tolerated it if funded by an outside source, but it would have been an embarrassment. No more. Now, no quackery is beyond the purview of quackademic medicine, and medical schools now seek it out as a means of enhancing their revenue stream, both through grants from NCCAM, donations from wealthy supporters of woo, and the creation of a new billable set of services that are all cash on the barrelhead without all that nasty mucking about with third party payors. Now, even the most elite medical schools have no sense of shame and–even more depressingly–no sense of science.

REFERENCE:

A. M Sullivan, S. Bauer-Wu, M. Miovic (2008). The Tong Ren Healing Method: A Survey Study Complementary Health Practice Review DOI: 10.1177/1533210108329265

Comments

  1. #1 Bob O'H
    January 6, 2009

    Equally intriguing were the write-in descriptions citing “amazing” and “remarkable” improvements, with 30% of respondents who had attended more than one session using superlatives such as these to describe the impact of TR.

    Never mind the complicated mediciny stuff, the authors don’t even understand basic grammar.

    I recall Ben Goldacre being amused when a British homeopathy hospital trumpeted similar results. He pointed out that this sort of thing is just a customer satisfaction survey.

  2. #2 Christophe Thill
    January 6, 2009

    I’m not quite intellectually satisfied with Tong Ren. Something seems to be missing.

    I know!

    Let’s just replace the voodoo doll with vegetables! A carrot, or a turnip, or a cucumber, etc.

    Why?

    Because it’s natural, of course!

  3. #3 MartinB
    January 6, 2009

    Did they even bother to check whether patients did receive other treatments in addition to TR?

  4. #4 Carlo
    January 6, 2009

    Didn’t an independent review recently reccomend that the NCCAM be disbanded (or more rather be incorporated into the NIH). The only reason that there’s a separate outlet for funding of this garbage is because it would never get a dime from respectable medical research – which should be rather telling…

  5. #5 Carlo
    January 6, 2009

    Didn’t an independent review recently recommend that the NCCAM be disbanded (or more rather be incorporated into the NIH). The only reason that there’s a separate outlet for funding of this garbage is because it would never get a dime from respectable medical research – which should be rather telling…

  6. #6 Argon
    January 6, 2009

    …when it comes to determining the efficacy of a therapy, the plural of “anecdote” is not “data.”

    Oh, snap. That is a sweet aphorism. Can you claim that as an “Orac original” or did you pick that up somewhere else? (I want to get the attribution correct when I use it in the future.)

  7. #7 Mu
    January 6, 2009

    I like it how they found no negative side effects – did anyone check for Carpal from repetitive motions? Or damage to the ear from continuous hammering on a wooden block?

  8. #8 DLC
    January 6, 2009

    So Tom Tam managed to scam a trio of (theoretically) educated people into doing a “study” (read : customer survey) and reporting positive results. Where are the other 11% ? the ones who did not reply ? are they dead? were they so disgusted with the woo that they vowed never again to discuss it ? And anyway, do they not realize that anecdotes are not evidence ? Every late-night scammer infomercial includes many testimonials. “it worked for me!” claims the smiling model.

    Well, Tom Tam, put up or shut up: how do I measure this “Qi”? what sort of particles is it made up of ?
    Come on, show me how the Qi particles move, how they cause healing and what happens to them afterward. In short — show me the evidence.
    Oh, right. you can’t because there isn’t any.
    Come back when you get some.

  9. #9 Orac
    January 6, 2009

    I recall Ben Goldacre being amused when a British homeopathy hospital trumpeted similar results. He pointed out that this sort of thing is just a customer satisfaction survey.

    D’oh! I forgot about that. You’re exactly right. This isn’t even a collection of anecdotes. It’s a customer satisfaction survey.

  10. #10 Alan Henness (zeno)
    January 6, 2009

    They never cease to amaze and surprise us, do they?

    Christophe said: “Let’s just replace the voodoo doll with vegetables! A carrot, or a turnip, or a cucumber, etc.

    Why?

    Because it’s natural, of course!”

    They’d have to be organic, of course!

    Argon: that aphorism has been around for a while, so, unfortunately, Orac can’t claim it for his!

  11. #11 HCN
    January 6, 2009

    Argon said “Can you claim that as an “Orac original” or did you pick that up somewhere else?”

    It has been around for years. I read it on Usenet at least ten years ago. Doing a groups.google search, I can see it used back to the early 1990s:
    http://groups.google.com/groups?hl=en&q=plural+anecdote+data&ie=UTF-8&tab=wg&scoring=d&sa=N&start=540

  12. #12 Robster, FCD
    January 6, 2009

    Wow. I feel very bad for my friends and colleagues at Dana Farber and Emory. Don’t those august institutions know that having their names attached to such credulous research drags their names through the mud? Why not have an Oral Roberts trained faith healer as a faculty member?

  13. #13 DrCogSci
    January 6, 2009

    God this is depressing. My general misanthropy seems downright optimistic when I read about this kind of crap.

    Incidentally, I saw a “documentary” called “Phobias” on the BBC today. As well as doing that wonderful reduction of “Phobic fear is different because it involves the hippocampus” they then cut away to Dr. Richard Callahan and “Thought Field Therapy” without a single word about its fringe status, or the fact that, to use the technical terminology, he’s a wackaloon.

    Even after the therapy “didn’t help” for the woman, they cut away and didn’t say a word more on him. Republic of Rationalism anyone?

  14. #14 Chayanov
    January 6, 2009

    Well, Tom Tam, put up or shut up: how do I measure this “Qi”? what sort of particles is it made up of ?
    Come on, show me how the Qi particles move, how they cause healing and what happens to them afterward. In short — show me the evidence.

    Indeed. I’ve seen supposed practitioners of energy work do what they call a cutaway — they use a knife to cut negative energy away from the air around a person. Apparently this energy can’t be seen or measured using any known instruments, but it can be cut with a simple knife. There’s got to be an infomercial in there somewhere.

  15. #15 D. C. Sessions
    January 6, 2009

    The biggest problem TT has is that he failed to observe one of the Cardinal Rules of Woo: “Thou shalt not make expose thyself to proper studies.”

    TR would be trivially easy to do a Real Blinded Study on: thanks to the noncontact protocol, neither the “therapist” nor the “subject” know whether the other even exists. Also, it makes claims that are far too objective. Between the low cost of TR, the ease of blinding, and the unambiguous endpoints it’s just begging for someone to actually shoot it down.

  16. #16 Scote
    January 6, 2009

    Hmm…it seems that the “study” authors are not familiar with this aphorism: The plural of anecdote is not “data.”

  17. #17 Tacroy
    January 6, 2009

    I wish I could find a wealthy patron to fund my research without all that nasty groveling (metaphorically speaking) in front of study sections

    There’s that old joke: when it comes time to cut funding, universities always cut physics first, math second, and philosophy last. Why?

    Physicists need expensive equipment for experiments.
    Mathematicians only need pens, paper, and a trash can.
    Philosophers need pens and paper, but can make do without the trash can.

    Your research needs actual equipment; studies like this only need gullible people.

  18. #18 The Perky Skeptic
    January 6, 2009

    It makes me want to facepalm and hide my face in Orac’s Doctor Doom mask whenever I hear about stuff like this. I was COMPLETELY INTO this stuff for most of my life!!! It’s bloody embarrassing to look back on.

    You cannot argue effectively with a believer in the Collective Unconscious as a healing power. They have unparalleled ability to rationalize all study or survey data to see what they want.

    That high school student, Miles, really seemed to be not too far gone, though. If he keeps studying the scientific method, I really believe that he could snap out of it. It might take him years, as it did for me, but it can happen.

    Tom Tam, I’m afraid, is wwwwwwwwwwwwwwwwway too much of a True Believer to be swayed. This is why he wants Tong Ren studied– he actually believes the woo he is spouting can stand up to rigorous study! Most likely it’ll only be further down the line, when studies have shown negative results and he has made more money off of Tong Ren, that he will slide down the great Chopra Slope and start handwaving reasons that his modality isn’t able to be studied by a placebo-controlled, randomized, double-blind trial.

  19. #19 spor haberleri
    January 6, 2009

    thanks admin very nice blog

  20. #20 flim flam
    January 6, 2009

    TR is so utterly ludicrous, even for woo that i keep expecting tom tam to peel off his face mask revealing james randi underneath saying GOTCHA!.
    Also here in australia we have these really nice biscuits called tim tams, they are most certainly therapeutic in a very chocolatey way, some connection perhaps?

  21. #21 flim flam
    January 6, 2009

    TR is so utterly ludicrous, even for woo that i keep expecting tom tam to peel of his face mask revealing james randi underneath saying gotcha!.also here in australia we have these really nice biscuits called tim tams, they are most certainly therapeutic in a very chocolatey way, some connection perhaps?

  22. #22 Sven
    January 6, 2009

    Equally intriguing were the write-in descriptions citing “amazing” and “remarkable” improvements, with 30% of respondents who had attended more than one session using superlatives such as these to describe the impact of TR.

    Urgh… note how this is written… choosing only those that attended more than once doesn’t make for a more informed population, it just weeds out those that saw it as bullshit straight away and leaves you with positively skewed conclusions. That’s a kind description of this kind of (advertisement) study…. positively skewed.

  23. #23 peaveyd
    January 7, 2009

    hi, new to the site but gaining tons of perspective. i am a very skeptical person and always have been. as ludicrous as it sounds, my mom who has been overweight most her life and dealing with diabetes has tried TR recently and she swears she has felt change in her life as well as with her weight and sugar levels. as much as i don’t want to believe this quack, my mom says it has helped and she has felt more energetic than ever, so, i feel compelled to atleast give it the benefit of the doubt. i was suprised to find out these quack-classes, as i call them, are free to the public and when questioned about interaction with standard medical treatment they say it isn’t meant to replace that treatment. i’m a bit on the fences on this one.

  24. #24 Militant Agnostic
    January 7, 2009

    DrCogSci – I believe the correct term for someone like Dr. Richard Callahan is “Quackaloon” since he not only believes something preposterous, but practices a “therapy” based on his whackalunacy.

  25. #25 Tracy W
    January 7, 2009

    Peaveyd, my brother got a severe head injury from a biking accident and one of our friends recommend we feed him some glyconutrients. My brother had a ridiculously good and fast recovery (he was out of the rehab centre in 8 months, sooner than many people who arrived after him). Wonderful success story for the glyconuturients, except we hadn’t fed him any. If we had, we presumably would now be convinced of the wonders of glyconutrients.
    Sometimes people’s conditions just change for unknown reasons. Attributing this change to anything in particular is very hard and really can’t be done in individual cases.

  26. #26 Robster, FCD
    January 7, 2009

    Hey peaveyd,

    Did your Mom change anything else around the same time as TR? Medication, exercise? It is certainly possible that TR gave her a placebo boost that kicked her into gear to make some changes.

  27. #27 Mojo
    January 7, 2009

    I recall Ben Goldacre being amused when a British homeopathy hospital trumpeted similar results. He pointed out that this sort of thing is just a customer satisfaction survey.

    That would be the 2005 Spence et al paper. Lately another group of researchers have managed to reproduce the results.

    At least this time the coverage is giving an indication that the study doesn’t actually tell us anything about the effectiveness of homoeopathy:

    The current study, published in the journal BMC Public Health, looked only at how homeopathy patients tend to fare in their everyday life. Therefore, it does not settle the question of whether the remedies are actually effective, lead researcher Dr. Claudia Witt told Reuters Health.
    “This observational study design does not allow (us) to determine any causality between the improvement and the given homeopathic remedy, nor does it exclude the placebo effect,” said Witt, of Charite University Medical Center in Berlin.

    It does rather make one wonder why they bothered, though.

  28. #28 Chris
    January 7, 2009

    Janet Holmes said “Let’s see if this makes you angry: Over 8 years ago Dr. Barbara Starfield* wrote in JAMA (the Journal of the American Medical Association) that, conservatively, iatrogenic causes led to 225,000 deaths per year in the US alone;* still others have estimated the death rate is now closer to 800,000.”

    Yawn: http://www.sciencebasedmedicine.org/?p=316

    Fun how you just keep adding zeros to the numbers.

  29. #29 Chris
    January 7, 2009
  30. #30 peaveyd
    January 7, 2009

    She hasn’t had much lifestyle changes other than going to the class. She doesn’t exercise much, let alone drive so we drive her there. She’s been a housewife for 30+ years. I believe it’s very placebo like as well, and I don’t really tell others about what we’ve been doing. The only way I really explain it to myself is that it’s placebo but I haven’t denied that she has some lifestyle change ever since going.
    She tells me that ever she’s been going she feels more energetic around the house and she cleans more vigorously and she says she now gets sleepy later than she has prior to the classes. As much as I don’t believe it, I’m not going to convince my mom, a 63 year old lady, she’s crazy.

  31. #31 Alan Henness (zeno)
    January 7, 2009

    There was an adjudication by the UK’s Advertising Standards Authority today about a wrinkle-reducing cream by Estee Lauder, which also concerned a customer satisfaction survey.

    What’s interesting is that they made several claims about how good their product was, and, as proof, they claimed clinical trials (‘an open, non-randomised trial on 25 women, was not blinded, and did not include a control group’, according to the ASA), and a ‘customer satisfaction survey’. Fortunately the ASA determined that it all did not add up and was insufficient proof of their claims. The lost the adjudication on two counts.

    The adjudication is here: http://www.asa.org.uk/asa/adjudications/Public/TF_ADJ_45542.htm

    and I’ve said a bit more about it (and other adjudications) here: http://www.thinkhumanism.com/phpBB3/viewtopic.php?f=14&t=318&start=80.

  32. #32 peaveyd
    January 7, 2009

    Chris, from your link:

    “Colons are full of poop. Poop is yucky. Therefore, cleaning out a colon is good. Except that it’s not true.”

    LOL!

    (pointless comment)

  33. #33 The Perky Skeptic
    January 7, 2009

    Response to the placebo effect doesn’t make her crazy, peaveyd– placebo is a very real, powerful, documented and highly-studied effect, which produces physiological changes in the subjects.

    I highly recommend Ben Goldacre’s book, Bad Science, for a detailed, entertaining, and well-researched account of the placebo effect and other phenomena that tend to cloud people’s perceptions about the effectiveness of various treatments.

  34. #34 bw wilcox
    January 7, 2009

    There is a lot time spent castigating everything about energy medicine – which is the future of allopathic medicine. Perhaps Tong Ren Therapy didn’t get the “proper” research procedures to prove its credibility. Yet if one investigates further, one will find that anecdotal evidence, (which brings entrepeneurs to the rain forest shamans for healing herbs), will show that people have had success in “healing.” This word is not synonymous with “curing.” When the medical doctors wrap their brains around this simple concept and deal better with their “failures,” i.e. death results, the spirit and the science worlds will merge.

  35. #35 HCN
    January 7, 2009

    wilcox said “Yet if one investigates further, one will find that anecdotal evidence, (which brings entrepeneurs to the rain forest shamans for healing herbs), will show that people have had success in “healing.””

    The plural of anecdote is not data.

  36. #36 Prometheus
    January 7, 2009


    “There is a lot time spent castigating everything about energy medicine – which is the future of allopathic medicine.”

    I wonder how long it will take before someone who is facile with “energy medicine” finally explains where the “energy” comes from, how it is directed and what type of “energy” they are referring to.

    The problem is that – so far as I can discern – “energy medicine” is simply a “Just So” story made up by practitioners who want to put a “sciencey” cover on what is nothing more than “magic”. It is like dressing a wizard in a lab coat.

    As disappointing as this may be to the thousands who “believe” in “energy medicine”, magic does not work outside of fiction novels. Energy cannot be created from nothing, nor can it be sucked up from “the Universe”, “the Force” or “quantum physics”.

    As for “energy medicine” being the future of “allopathic medicine” – that may be so, since “allopathy” has only existed in the minds of homeopaths. Modern medicine is not “allopathic medicine”.


    “Perhaps Tong Ren Therapy didn’t get the “proper” research procedures to prove its credibility.”

    Tong Ren “therapy” didn’t use any research procedures to “prove its credibility”, which is why its “credibility” has not been proven. The “study” cited is nothing more than a poorly done consumer survey of people gullible enough to buy into the Tong Ren nonsense.

    I note that they didn’t survey people who had tried Tong Ren therapy and discontinued it, so it isn’t even a valid consumer survey! I can detect no attempt to make this “study” even an accurate measure of how popular Tong Ren is with the public – it’s more like an “infomercial”.


    “Yet if one investigates further, one will find that anecdotal evidence, (which brings entrepeneurs to the rain forest shamans for healing herbs), will show that people have had success in ‘healing’.”

    If one investigates further, one can find “anecdotal evidence” of zombies, werewolves, vampires, Bigfoot and reptilian aliens replacing the leaders of the European Union. This is why anecdotal “evidence” is not the same as data. And that is why this “study” is nothing but a load of natural fertilizer in a “sciencey” wrapper.


    “This word [healing] is not synonymous with “curing.” When the medical doctors wrap their brains around this simple concept and deal better with their “failures,” i.e. death results, the spirit and the science worlds will merge.”

    It seems that the commentor is saying that if “medical doctors” (i.e. practitioners of modern medicine) can simply see their “failures” – defined by the commentor as “death results” (deaths?) – as a different type of “healing” (in the sense that the person is no longer suffering from their disease), then the woomongers and the scientists will all join hands and sing folk songs around the campfire.

    Certainly, if you view death as just another type of “healing”, then the “alternative” practitioners are way ahead of modern medicine. After all, modern medicine spends an amazing amount of time, effort and money trying to keep desperately ill individuals alive.

    If death is just another – equally valid – means of “healing”, then modern medicine is preventing these people from “healing” by keeping them alive.

    It is all so clear to me now! “Alternative” medical therapies – like energy medicine – make people feel like they’re getting better while not prolonging their lives. The patients feel better – and so suffer less – but are not delayed in reaching the “ultimate healing” that is death.

    Modern medicine, on the other hand, tells people the truth about their illnesses (or “wellness”, if you like) and thus increases their suffering (by increasing their anxiety) while simultaneously doing all it can to prolong their suffering by keeping them from dying.

    Can it really be that simple?

    Prometheus

  37. #37 peaveyd
    January 7, 2009

    I know a lot of people that gets upset about a lot of this stuff and seems like it includes many readers of this site. I realize there are the two extremes, whether for or against TR. I would like to see more research and supporting data. Instead of either strongly defending or strongly bashing on it, I’m going with the let’s wait and see approach.

  38. #38 Robster, FCD
    January 7, 2009

    bw wilcox, I second the request for you to define energy, and how this energy can be quantified.

    There is a reason that scientists would examine herbs that “witch doctors” would use. There is a remote possibility that those herbs have an actual active ingredient. And if not, whether they work or not, they can still be sold to idiots as supplements, who will buy anything natural, especially if it has some kind of special “ancient” knowledge attached to it.

  39. #39 sanjiva
    January 8, 2009

    They should’ve just given this project to a market research agency.

  40. #40 Tracy W
    January 8, 2009

    BW Wilcox: There is a lot time spent castigating everything about energy medicine – which is the future of allopathic medicine.

    Well I’m not sure how you measure “a lot of time”, relative to what amount of time? And I don’t know anything about allopathic medicine. But energy medicine is commonly used in scientific medicine, and has been for a long time. Burns are treated with cool running water (takes away the heat), hypothermia is treated by gentle warming of the body, defibrillators and pacemakers provide electrical impulses directly to the heart, patients suffering from malnutrition are fed up again (chemical energy), and so forth.

    Yet if one investigates further, one will find that anecdotal evidence, (which brings entrepeneurs to the rain forest shamans for healing herbs), will show that people have had success in “healing.”

    Call me crazy, but I prefer my medical treatments to have statistical evidence of success in healing (or alleviating pain, or preventing infection, or so forth), not merely ancedotal evidence of success in “healing”, whatever “healing” actually is. Does “healing” mean you feel like you’re healed, but it actually has no physical effect?

  41. #41 Mojo
    January 8, 2009

    I don’t know anything about allopathic medicine.

    “Allopathy” is a term invented by Samuel Hahnemann to describe medical practices of his day which attempted to treat diseases by inducing an opposite effect to the symptoms of the disease (the term is derived from “opposite suffering”, cf. “homoeopathy” which is derived from “same suffering”). Allopathic treatments tended to included things like blood-letting and large doses of toxic substances, and involved the concept of balancing four “humours”. “Allopathy” and the balancing of opposing humours is no longer practiced, apart from in “alternative” systems such as Ayurveda and TCM. Ironically, these are often practiced alongside homoeopathy.

    I suspect that Wilcox is not using the term “allopathy” in this sense, but is merely using it as a derogatory term for real medicine. This is a common usage among proponents of CAM who don’t realize that medicine, unlike homoeopathy, has moved on over the last couple of centuries.

  42. #42 Dangerous Bacon
    January 8, 2009

    “…if one investigates further, one will find that anecdotal evidence, (which brings entrepeneurs to the rain forest shamans for healing herbs), will show that people have had success in “healing.” This word is not synonymous with “curing.”

    I’m sorry, but this statement violates a key tenet of woo – which is that alternative remedies cure people while mean old allopathic medicine just treats the symptoms. If “energy healers” are just “healing” but not “curing”, they’ve fallen into the same trap.

    I want my shamans to banish “dis-ease” entirely. Out, damned spirit, out!!!

  43. #43 Tracy W
    January 8, 2009

    Mojo – thanks for your explanation of the term allopathic medicine. I’m not quite sure, does gently warming someone suffering from hypothermia count as allophathic or not?

    Peaveyd – the better a hypothesis stands up to a strong bashing, the more likely it is to be right. Strong bashing is an essential part of the process that should be undergone before a theory is accepted. The defenders of Tong Ren are welcome to provide evidence that they have actually detected a new form of energy. The definition of energy is the capacity to do work, eg move stuff, so any Tong Ren defenders could provide instructions on how to use their new energy field to move stuff in a lab test, so other people can replicate their work. They also could provide some evidence that their energy field is not one of the existing known ones. If the people bashing Tong Ren couldn’t poke holes in the evidence that there is a new form of energy field, and it works in the ways that it would be necessary for Tong Ren to work, then Tong Ren would start to become slightly more plausible. But, given the history of physicists fooling themselves, the bashing is a necessary part of the process. Of course it’s easier to do a good job of bashing if you start out not believing in a hypothesis than if you start out believing in it, but the believers of a hypothesis should try to bash it anyway. As should someone like you, who is trying to make up their mind.

    And, at the moment there aren’t two extremes, whether for or against TR. The feeling against TR is not an extreme, it’s based on the failure of this claimed form of energy to be identified by physicists or engineers and used for non-medical purposes over the centuries, and based on centuries of evidence that people often believe things that aren’t true. Failing to believe unsupported claims is not an extreme – there are far more possible claims about reality than can possibly all be true so failing to believe unsupported claims is a necessary tool to get through life.

  44. #44 Chris
    January 8, 2009

    Tracy W said “I’m not quite sure, does gently warming someone suffering from hypothermia count as allophathic or not?”

    No, that is conventional real medicine.

    Allopathy is a made up word and is just an insult term for anything that is not homeopathy. Just like Mojo said. Also see http://skepdic.com/allopathy.html .

    Basically, what we are saying is to use the term “medicine”, “real medicine”, and perhaps science based medicine. Do not use “allopathy” as it is inaccurate and is considered an insult term.

  45. #45 Chris
    January 8, 2009

    Tracy, I just thought of another way to say it:

    Calling medicine “allopathy” is similar to calling all women “bitches.” Do you understand why there is objection to the term?

  46. #46 Tracy W
    January 8, 2009

    Chris – I suggest not using that analogy. When I first read your second comment, for a moment I thought you were accusing me of calling all women bitches, just because I asked about the meaning of a word.

    And I’m not sure why you felt the need to tell me to use “science-based medicine”. I used the word “scientific medicine” in my reply to Wilcox. If you object to using the word “allopathic” at all, may I point out that you used it in your own comment?

    Peaveyd, I just realised another danger of your wait-and-see approach. All the different forms of energy I learnt about in physics class are potentially dangerous, including when used in a medical setting. Heat energy is necessary for treating hypothermia, but too much heat causes a burn. High-frequency radiation is a treatment for some cancers, but can also cause cancer (this killed Marie Curie). Electrical energy is a vital part of pacemakers, but too much can kill by stopping your heart. Chemical energy is necessary to treat malnutrition, but too much causes obesity. Very strong low-frequency electromagnetic fields can kill by sending metal objects flying through the air, this is a serious risk with the use of MRI scans. Burns, electric shocks and flying rubbish bins are very immediate and obvious, but other energy effects are far more subtle and long-term (cancer, obesity). So, *if* there is in fact some sort of energy behind Tong Ren, it is entirely plausible that it does as much or more harm than good, particularly as the advocates of Tong Ren have never investigated what they are doing in terms of physics.

    So either Tong Ren’s effects are entirely due to the placebo effect, or Tong Ren is on to some new energy field, in which case it is entirely possible that they may be doing more harm than good, so we really don’t want people randomly trying it out. I personally think any effect Tong Ren has is entirely due to the placebo effect, but your position implies you should be very worried about your mum trying it.

  47. #47 Chris
    January 8, 2009

    Sorry, but you seemed to have missed the point on how insulting “allopathy” is, since you asked if something that is real medicine in “allopathic”. And if you used “scientific medicine”, why even bother with “allopathy”? But I think you now get the point (also, read more carefully next time, I did use the phrase “similar to”).

  48. #48 Prometheus
    January 8, 2009

    When Sam Hahnemann dreamed up homeopathy in 1810, he needed a word to describe all of the other medical practices of the time – a word that would distinguish his “like cures like” from the rest of medicine.

    The prefix “allo-” is from the Greek “allos”, meaning “other”. If “homeopathy” is “treating a disease (“pathos” – Greek for “suffering”) with something that causes the same effect (but diluted past the point where it actually contains a single molecule of that “something”)”, then “allopathy” means “treating a disease with something that causes different effects.

    Thus, “allopathy” truly means any medical therapy other than homeopathy. Chiropractic, herbal medicine, “energy” medicine, etc. are all forms of “allopathic medicine”.

    This is why I inwardly chuckle whenever a chiropractor or naturopath or other woomonger scornfully refers to “allopathic medicine”. They are allopathic medicine – at least by the definition of the man who invented the word.

    Of course, “allopathy” has become a popular shorthand for woomongers to vent their envy and spite about how real medicine has triumphed over their crafts.

    Real medicine has shown an almost obscene willingness to adopt new practices that work and abandon old practices that have been shown to not work, while chiropractic, naturopathy and even homeopathy continue to diligently follow the outmoded (and disproven) tenets of their founders, barely changing through the decades.

    Tong Ren may seem new, but it is older than the written record of humanity. Crude human figures that appear to have been used in much the same way as Tong Ren are found in archeological digs dating back to at least the Neolithic.

    I can readily picture a Neolithic (and possibly even Upper Paleolithic) shaman holding a stone or unfired clay doll while chanting words of power and making ritual gestures of making and summoning in order to heal an ailing member of the clan.

    How is Tong Ren different from that?

    Prometheus

  49. #49 alison
    January 9, 2009

    Sort of off-topic, I know – but apparently carbs are addictive (/snark): http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=10514948
    Thanks Orac, I remembered reading something you said in an earlier post about Medical Hypotheses, which supported my original ‘what the heck?’ feelings about the story :-) Don’t even get me started on the call for ‘more regulations’ to do with carbohydrate consumption!

  50. #50 Tracy W
    January 9, 2009

    Thanks Prometheus for your explanation.

  51. #51 Leslie
    June 15, 2009

    Desperate people turn to desperate measures and if Tong Ren offers them something, who are we to judge? I am a big skeptic and my sister calls me a “Heathen,” but I do believe that most people participating in the Tong Ren therapy aren’t out to con anyone. A friend of mine is a Tong Ren practicioner and she does many healings for free, or she charges a whopping 10 bucks. And she really wants to help people. What bugs me are the healers and some of them are medical doctors who charge $200, $500 and $1,000 an hour for their so called expertise. And they don’t take insurance.How about writing about that, Orac? I once held a vile of liquid while chanting because a Holistic Doctor who was also an MD swore it would heal me. The fee was $170, and it didn’t help, and I felt so stupid afterwards. but as I said – “desperate people.” Orac, are you my ex husband. You sound just like him. LOL!

  52. #52 Chris
    June 15, 2009

    Leslie:

    What bugs me are the healers and some of them are medical doctors who charge $200, $500 and $1,000 an hour for their so called expertise. And they don’t take insurance.How about writing about that, Orac?

    There are plenty of postings of that sort on this blog. Click on the “quackery” tag by the title of this posting. Then there are posts on specific doctors like Rashid Buttar and the Geiers. Plus check out some of the posts tagged with “cancer”, especially the one about the “Orange Man.”

    You should also check out this blog: How do scientists become cranks and doctors quacks?

  53. #53 Barefoot Dr
    June 3, 2010

    This comment might not make it to public viewing, because it tells too much of the truth:

    Why all these talks about Tong Ren and Tom Tam? This is a complete waste of time even as I am typing in the comment. Tom Tam was a semi-literate peasant in China. He did all kind of odd jobs as short-order cook in restaurants and handy man for years, and then out of the blues he became a healer. A neighbor of his told me, when he heard Tom Tam started the Tong Ren practice, he just could not help laughing out loud and marveling how gullible the Americans are. Well, many people voted for Sarah Palin, also, but that is another story. Statistically, if you can get 1 out of 1000 persons believe somewhat in what you sell, you’ve got it made. Tom Tam’s sister-in-law once told me: “[Tom Tam] knows sh*t about medicine. Back in the village, he used to hike to the city and get his monthly massage, and then he would hold massage classes in the village, teaching what he experienced in the city.” Go figure.

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