Respectful Insolence

Nearly a month ago, I expressed my dismay and displeasure at the infiltration fo quackademic medicine into what is arguably the premier medical journal in the world, The New England Journal of Medicine (NEJM) in the form of a highly credulous review on the use of acupuncture for low back pain that brought eternal shame on the hallowed pages of a once-great journal. As Mark Crislip put it, trust, once damaged or lost, is very hard to restore, and I definitely lost a lot of trust for the NEJM compared to what I had for it a month ago. Since then, I’ve been keeping my eyes out for other examples of quackademic medicine infiltrating various peer-reviewed journals. Unfortunately, I have not lacked for examples.

Fresh in my memory, though, remains the stench of quackademic medicine in the NEJM. Unfortunately, just as the faint odor of urine can be revived by hot and humid weather, the stench of quackademic medicine at the NEJM was restored, at least in my memory, by an article that a reader sent to me. Apparently someone was interested in just who some of the writers of the NEJM article were. At the time, when I wrote about the article, I didn’t really care too much about any of the authros other than the lead author, Dr. Brian Berman. Apparently this reader thought I should check out at least one of the other authors, which I proceeded to do. I happened to pick Dr. Helene M. Langevin of the University of Vermont. (Who knew Vermont had quackademic medicine?) One thing led to another (PubMed, specifically), and suddenly I found this gem of a quackademic medicine article by Dr. Langevin in, of all places PLoS ONE, entitled Electrical Impedance of Acupuncture Meridians: The Relevance of Subcutaneous Collagenous Bands.

Senior author? Dr. Langevin.

Funding source? What do you think? The National Center for Complementary and Alternative Medicine (NCCAM), of course!

I feel a little bit bad about having to slather a bit of the ol’ not-so-Respectful Insolence on this bit of quackademic medicine. The reason is that I know and respect Bora Zikovic, who’s the Online Community Manager at PLoS focusing on PLoS ONE. Unfortunately (or fortunately, depending on your point of view), a man’s got to do what a man’s got to do. (Or, more appropriately, a clear plastic box of blinking multicolored lights has got to do what a clear plastic box of blinking multicolored lights has got to do.) There’s also another reason to take this on, and that’s because of how PLoS ONE bills itelf.

PLoS ONE bills itself as a new model for a scientific journal. The idea is that the peer reviewers don’t evaluate the significance of the work being presented; they leave that to their readers, publishing 69% of all submissions. PLoS ONE does, however, purport to have a system of rigorous quality checks and peer review to verify that the actual science is well done, with the following requirements:

  • The study presents the results of primary scientific research.
  • Results reported have not been published elsewhere.
  • Experiments, statistics, and other analyses are performed to a high technical standard and are described in sufficient detail.
  • Conclusions are presented in an appropriate fashion and are supported by the data.
  • The article is presented in an intelligible fashion and is written in standard English.
  • The research meets all applicable standards for the ethics of experimentation and research integrity.
  • The article adheres to appropriate reporting guidelines (e.g., CONSORT, MIAME, STROBE, EQUATOR) and community standards for data availability.

I submit that this article bit of quackademic medicine represents a rather massive failure of PLoS ONE to live up to its ideals, and I’ll explain why.

Let’s take a look at the study under consideration. I knew right away that there was a serious problem right from the very first sentence of the abstract:

The scientific basis for acupuncture meridians is unknown.

Well, I suppose that’s true enough in a very trivial fashion, you know, the same sort of fashion that the scientific basis for homeopathy is “unknown.”

And then there’s first paragraph of the introduction to the paper:

To this day, the fundamental tenets of acupuncture, the acupuncture point and meridian, remain a mystery. What are they anatomically and how do they function physiologically? Past studies have anatomically linked these Traditional Chinese anatomical structures to neurovascular bundles [1], [2], [3], trigger points [4], [5], [6], and connective tissue fascial planes [7]. Other studies have identified functional correlates including reduced electrical impedance [8], [9], [10] and enhanced migration of nuclear tracers [11], [12], [13], [14], [15], [16]. However, due to multiple study design limitations – including inadequate descriptions of acupuncture point/meridian localization, small sample size, and unexplained statistical analysis – a definitive conclusion regarding the scientific basis of these structures is difficult to establish.

A better way to put it would be that there is no known physiological or anatomic structure that corresponds to acupuncture meridians, which brings up the issue of how it was supposedly possible for practitioners of traditional Chinese medicine to have identified these meridians in the first place. Science can’t tell any difference; they don’t really correspond to any nerves; and there’s no criteria by which a meridian can be distinguished from a non-meridian other than drawings on mannequins. It’s magic. It’s fairy dust. In fact, as I’ve described many times before, meridians are irrelevant to acupunture. It doesn’t matter if you stick the needles in a meridian or not, which meridian, or even if you stick the needles in. Virtually any old place will do. Given that, one wonders why Dr. Langevin even bothered to try to undertake a study. But undertake it she did, trying to use a combination of ultrasound and impedance measurements. It’s a tour de force of what Harriet Hall so famously dubbed Tooth Fairy science and Dr. RW termed quackademic medicine using the following rationale:

Given these two reported associations [allegedly between acupunture meridians and decreased electrical impedance and between decreased impedance and increased intramuscular connective tissue], we hypothesized in a previous study that intermuscular connective tissue was the anatomical basis for the reduced electrical impedance reportedly observed at acupuncture meridians. We tested this hypothesis and found that electrical impedance at Pericardium meridian-associated connective tissue was significantly reduced compared to an adjacent muscle control [22]. The Spleen channel segment, on the other hand, showed no statistical difference. This lack of difference was attributed to unintended placement of Spleen-control needles in an adjacent intermuscular plane.

Whoa. Did Dr. Langevin actually find a physiological basis for acupuncture points, or is she measuring how much money the Tooth Fairy is leaving behind? Has she found an objective way to demonstrate that there is an anatomic difference between the tissue under meridians and the tissue elsewhere that could produce a plausible biological mechanism by which acupuncture “works”? Or is she simply measuring which sorts of teeth bring a larger haul of cash from the Tooth Fairy?

Let Harriet apply the general beat down to Tooth Fairy Science:

You could measure how much money the Tooth Fairy leaves under the pillow, whether she leaves more cash for the first or last tooth, whether the payoff is greater if you leave the tooth in a plastic baggie versus wrapped in Kleenex. You can get all kinds of good data that is reproducible and statistically significant. Yes, you have learned something. But you haven’t learned what you think you’ve learned, because you haven’t bothered to establish whether the Tooth Fairy really exists.*

In other words, carefully applied scientific methodology used to study fairy dust produces results that are still fairy dust. Prove the phenomenon exists and that acupuncture works, before you go to all these contortions to try to relate it to subcutaneous connective tissue and changes in impedance.

Sigh. Let’s see what Langevin and her team did:

To avoid confounding by an adjacent connective tissue plane and to see whether the findings from the Pericardium (PC) channel were generalizable to other body sites, we assessed the electrical impedance of skin and underlying subcutaneous connective tissue at the Large Intestine (upper arm), Liver (thigh), and Bladder meridians (calf). These sites were originally chosen because they represented a good balance of anatomical locations and meridian types (2 Yang and 1 Yin channel), and the meridians were not located close to another meridian or intermuscular tissue plane. Acupuncturists determined the location of meridian sites, and ultrasound images were obtained at each test site to record any potential structural associations with electrical impedance. There were two primary aims for this study: (1) to determine whether the electrical impedances at acupuncture meridians were significantly lower than impedances at adjacent controls, and (2) to assess whether echogenic collagen was significantly associated with electrical impedance obtained at the test sites.

So science-y.

Basically, Langevin’s team signed up 28 subjects (19 male, 8 female). Exclusion criteria included: age under 18 years old; pregancy; anticoagulant usage; history of a bleeding disorder; implanted ventricular defibrillator; chronic skin conditioins; chronic skin inflammation (exczema, psoriasis, for example), or a collagen disorder. They also excluded obese people with a BMI greater than 30. Meridians were identified by two different acupuncturists and in the case of any disagreements the two came to a consensus. According to the methods section, the acupunturists had an average of seven years of experience, and each represented a different acupuncture style, one Chinese, one Japanese.

Now here’s where it gets odd. The acupuncturists originally intended to insert the needles into the intermuscular connective tissue but had a hard time getting the needles in there. That’s some pretty deep insertion, which makes me wonder what relevance this even had for acupuncture, I have no idea. Neither did the acupuncturists, either, it would appear, because there’s a most telling passage in the methods:

Furthermore, the intermuscular trajectory mapped out by imaging did not consistently match the trajectory mapped out by the acupuncturists. This was particularly true for the intermuscular plane near the LV meridian where the Sartorius muscle runs obliquely along the leg and across the LV meridian path. For these reasons, we decided to focus on the skin and underlying subcutaneous connective tissue in all our subjects. In other words, impedance measurements were limited to the subcutaneous fat region above muscle.

So basically, our intrepid team of researchers decided to give up on trying to measure impedance in intramuscular collagen bands and stick to the skin and subcutaneous tissue. They even show in Figure 2 ultrasound images showing muscles with thin bands of connective tissue between them. Of course, any orthopedic surgeon could have told them that they’d have a hell of a time hitting those bands of intramuscular connective tissue. Heck, if they had asked me, I could have told them that they’d have a lot of trouble hitting those bands, even with ultrasound guidance, which, by the way, acupuncturists don’t normally have or use in deciding where to place the needles.

So, as a sloppy second, our intrepid band of acupuncturists decided to look at impedance measurements in the superficial perimuscular fascia; i.e., the band of connective tissue that surrounds each skeletal muscle, comparing impedance measurements for meridian versus control. Then, they in essence went anomaly hunting. What do I mean by that? Basically, the investigators used all sorts of statistical models looking for associations between differences in impedance and meridians and correlations between differences in impedance and ultrasound-measured tissue density. Of course one thing that must be noted is that it would be completely unremarkable to find correlations between ultrasound-measured echogenicity (the ability to reflect sound) and differences in impedance. After all, if there’s one thing ultrasound is good at, it’s measuring differences in water content, which, along with various other mechanical properties of of the tissue, determine differences in echogenicity between tissues. Consequently it would be utterly trivial to find correlations between tissue impedance and echogenicity, not at all surprising. It would also not be particularly surprising if differences were not found, because there could well be too much variation in tissue impedances to produce a statistically significant results. Either finding would not be “evidence” for acupuncture meridians.

It’s also rather remarkable that the investigators felt the need to use such sophisticated statistical methodology to look for differences in impedance between meridian and non-meridian segments and for correlations between ultrasound-measured echogenicity and differences in impedance. Let’s put it this way. if there were a clear-cut difference in impedance between the meridian and non-meridian segments tested, the investigators wouldn’t need to do all those analyses. Doing something as simple as a t-test or one-way ANOVA will usually suffice to show the difference. Even if the statistics were appropriate for the data, again, what we appear to have here is an example of the Texas sharpshooter fallacy. All those mixed model statistical methods are modeling how fast the Tooth Fairy can complete her rounds of harvesting teeth and leaving goodies under the pillows of little boys and girls.

So what did the authors find? Let’s take a look. First, they purport to have found a small difference in impedance between the Large Intestine meridian impedance and the control (345±15 Ω versus 355±15 Ω, p=0.021, at 10 kHz; 432±23 Ω versus 449±23 Ω, p=0.017 at 1 kHz). EVerything else was negative. Does this mean anything? Who knows? Does it validate the existence of the Large Intestine meridian? No, but nice try. All it says is that there might be a difference in impedance between one area on the upper arm and another area. Worse, the observers aren’t blinded at all. Without blinding, there’s the possibility of subtle bias creeping into the measurements and sampling. Would it have been so hard to have the acupuncturists place the needles and then leave the room, after which the technicians doing the measurements come into the room to do the impedance and ultrasound measurements?

Finally, the investigators undertook a multivariate analysis to see if they could identify any factors that explained the differences in impedance other than meridians. They looked at subcutaneous tissue thickness, dermal zone echogenicity, subcutaneous zone echogenicity, and perimuscular zone echogenicity. The result are the graphs in Figure 4, which are what I call star charts. About the best that all these multiple comparisons could come up with was the earth-shattering observation that percent echogenicity in the subcutaneous zone correlated with differences in impedance. Personally, I’m surprised that more measurements didn’t correlate with changes in impedance.

If there’s one thing about complementary and alternative medicine (CAM), it’s that its adherents do more stretching and twisting to try to contort data into proving that there’s something to fairy dust. This is a perfect example. It’s in essence a fishing expedition to find any differences, no matter how small or irrelevant, between acupuncture meridian points and tissue somewhere nearby. Investigators find one difference and use the sharpshooter fallacy to declare it evidence supporting the existence of acupuncture meridians. One thing I always ask myself when I see a study like this is: Why these three acupuncture meridians? Why not others? No real explanation is given. Or maybe the investigators tried other acupuncture meridians and they didn’t work. That certainly wouldn’t surprise me.

Sadly, what doesn’t surprise me either is the funding source of Dr. Langevin’s work: NCCAM. In fact, she has multiple NCCAM grants, two of which are R01s:

  • 2008-2013: National Center for Complementary and Alternative Medicine RO1 (AT 001121) “Connective tissue mechanotransduction”. Principal Investigator: Helene Langevin, MD
  • 2007-2011: National Center for Complementary and Alternative Medicine (RO1) Soft tissue biomechanical behavior during acupuncture in low back pain Principal Investigator: H. Langevin

Here’s the abstract from Dr. Langevin’s acupuncture R01 (5R01AT003479):

The goal of this proposal is to test the overall hypothesis that subjects with chronic or recurrent low back pain (LBP) have an abnormal soft tissue response to acupuncture needling, and that this altered response is associated with abnormal perimuscular connective tissue structure and biomechanics. We will also test whether or not altered needling responses in LBP are generalized, or localized to specific locations as predicted by traditional acupuncture theory. 80 LBP and 80 No-LBP subjects will undergo one testing session using computerized robotic acupuncture needling and ultrasound elastography. Needle torque, force and tissue displacement patterns will be compared in LBP vs. No-LBP at Meridians vs. Non-Meridians and Acupuncture Points vs. Non-Acupuncture Points in the back and leg (Aim 1). We also will evaluate soft tissue structural and biomechanical characteristics in the low back by measuring perimuscular connective tissue thickness, ultrasound signal to noise ratio, structural continuity and biomechanical parameters (stiffness and damping) (Aim 2). Accomplishing the Aims of this study will 1) advance our understanding of acupuncture mechanisms 2) provide a first step toward investigating a new dynamic pathophysiological model for LBP incorporating connective tissue and neuroplasticity and 3) provide objective outcome measures of connective tissue structure and biomechanics that can be used in future clinical trials of acupuncture and other therapies for LBP. Relevance: Despite its widespread use for the treatment low back pain (LBP), the mechanism by which acupuncture may promote healing in this condition remains largerly unknown. This lack of understanding constrains the development of improved treatments and is an obstacle to the integration of acupuncture into the mainstream management of LBP. Moreover, the mechanism of LBP itself is poorly understood, further impairing efforts to investigate treatment mechanisms. This study will provide new, objective measurements of phenomena fundamental to both acupuncture and LBP. Demonstrating that acupuncture needling responses are abnormal in LBP, and understanding why these responses are abnormal will bring us one step closer to understanding 1) why LBP occurs and 2) how acupuncture can promote healing in this common and disabling condition.

Fairy dust indeed. Your tax dollars at work, too, $361,600 combined direct and indirect costs per year, for a grand total of $1.8 million over five years. Too bad that PLoS ONE decided to provide an outlet. Perhaps its readers should head on over to the offending article and provide the sober and evidence-based scientific criticism that the peer reviewers so evidently neglected to do when the manuscript for this paper was submitted.

Comments

  1. #1 Catherina
    September 2, 2010

    So are you submitting a condensed version of your criticism to PLoS ONE? I think you should!

  2. #2 Orac
    September 2, 2010

    They’ll get the trackbacks. PLoS journals are very plugged into the web and blogosphere. They’ll see this.

  3. #3 mikka
    September 2, 2010

    No, Orac, you have to submit this. That’s how PLoS ONE intends to work. That way the authors can respond to your criticisms, and other people can join the fray, etc. Do we want a new model for science publishing or not? I know I do.
    Also, I disagree with your opinion on stat methods. Without reading the paper, I can tell you that what you say about large differences being detectable by t-test or ANOVA isn’t true. The hypothesis testing must adapt to the data, not to the size of the differences. A t-test may give you a significance call for any dataset, but the p will be meaningless (and more importantly so will the confidence intervals for the magnitude of the effect) if the data are not normal, homoscedastic etc. Maybe the data needs a sophisticated analysis to account for covariables, confounding factors, god knows. That doesn’t make it less valid.
    (those differences do look small though)

  4. #4 Orac
    September 2, 2010

    OK, OK, I forgot to mention the nonparametric equivalents of the t-test and ANOVA. like, for example, the Kruskal-Wallis test.

    The way they did the statistics sure does look like anomaly hunting to me still, and there’s little doubt in my mind that we’re looking at an example of the Texas sharpshooter fallacy.

  5. #5 Craig Willoughby
    September 2, 2010

    Orac,
    Completely off topic, but I know your fascination with paradolia. I was wondering if you’ve seen this news article.

    http://www.caller.com/news/2008/jul/17/there-image-jesus-utility-pole/

    Enjoy.

  6. #6 mikka
    September 2, 2010

    I’ve now read the paper (quickly) and I think that, seeing the variability they were up against, the mixed models analysis was justified. They should report a bit more on the success of the modeling, the remaining variability after the fit etc. but simply lumping all the data in two groups and doing a K-W would have been worse.
    I had to look up the “texas sharpshooter fallacy”, and if I interpret it correctly you mean that they attribute the difference they see to the basis of acupuncture. I agree with you. There were no differences on two of the tested meridians (the individual meridians were tested so I am ignoring the overall difference they report, which could be due to the one significant meridian), so if that is what they say it’s completely unjustified. So far the score is 2-1 against this hypothesis (3-2 if you include their previous study.)
    Perhaps the most fatal flaw is what you mention in the beginning, that this has little to do with acupuncture as it’s practiced. Waste of money no matter how you swing it.

  7. #7 Coturnix
    September 2, 2010

    Unfortunately, trackbacks from Sb to PLoS don’t work. The way MT4 here is set up (putting it politely), automated trackbacks were always impossible. Manual trackback (by following instructions) used to work, but about a year ago something got borked in the backside of MT4 here and even manual trackbacks don’t work any more. I complained initially, but seeing how even bigger technical problems were not getting addressed, I gave up.

    So the only way people reading that paper will know about this post is if you post a comment there. You can copy+paste this whole thing, or you can just post a link, or you can do something in-between, e.g., post a one-paragraph summary PLUS the link for people who want to come here to see all the details.

  8. #8 Orac
    September 2, 2010

    but simply lumping all the data in two groups and doing a K-W would have been worse.

    Not exactly what I meant. I didn’t mean lump all the data together from all three meridians and then just do a K-W on the data. What I meant was to look at each acupuncture meridian and compare it to its control individually, as a screening test of sorts.

    In any case, regardless of the validity statistical analysis, all the “modeling” is modeling how the Tooth Fairy goes about her rounds. Hmmm. I like that. I’ll add a sentence or two to say that. :-)

  9. #9 daedalu2u
    September 2, 2010

    I don’t know why they write about structures deep below where they are measuring impedance.

    They don’t discuss the depth to which they inserted the needles except to hide the insertion depth. Not a surprise why they do that because insertion depth is the most important factor in determining impedance. In figure 3 they even show that insertion depth is the most important variable with twice the effect of gender (but they don’t show what the insertion depth is). The insertion depth was only ~ 10 mm. Was there systematic differences in insertion depth between the test and control region? If so, that would dominate any impedance differences. The one place they found a systematic difference is where the anatomy is most variable (in the arm).

    They say that the skin and subcutaneous layer was 40 to 50 mm, and they even state:

    “In other words, impedance measurements were limited to the subcutaneous fat region above muscle.”

    If they didn’t insert needles to the depth of the structures they mention, they can’t be measuring impedance of those structures. The impedance they are measuring is from the whole length of the needle, not from the tip. Virtually all of the impedance derives from the superficial skin.

    I agree this is anomaly hunting with essentially no effort to eliminate anomalies.

  10. #10 mikka
    September 2, 2010

    That would risk increasing the “false positive” error by multiple testing, and would not account for a range of problems derived from the design of the study (repeated individuals etc).
    There is a lot to criticize about the stats of this paper but if I were you I would stick to the main problem: this study does nothing to advance understanding of anything related to acupuncture, and the derivation of its conclusions from the observations is unjustified.
    Ultrasound is fairly non-invasive. Show me a body-wide map of these “Colagenous bands” correlating with the “meridians” and I’ll be more interested than with this limited and mostly negative study.

  11. #11 Denice Walter
    September 2, 2010

    ( OT : but are woo-drenched popularizers of whimsy-based medicine unabashedly masquerading as “scientists” *ever* _truely_ OT @ RI ? / and it will have me laughing all the way to my appointment ) Today, at NaturalNews, Adams presents, ” Evidence-based vaccinations : A scientific look at the missing science behind flu season vaccines. ” ……Mike tells us about his educational background and offers a $10K challenge.

  12. #12 HereWeGoAJen
    September 2, 2010

    I’ve heard a lot about how acupuncture is so amazing, so it was nice to get to read this!

  13. #13 IHC Jay
    September 2, 2010

    @Craig
    I checked out that link and being new to the whole vaccine/anti-vaccine “debate” I was wondering if anyone had input on this quote from the article.
    Mike claims “Before learning about nutrition and holistic health, I was a computer software entrepreneur, and I have a considerable scientific background in areas such as astronomy, physics, human physiology, microbiology, genetics, anthropology and human psychology.”

    How the hell can a computer software entrepreneur claim to have a “considerable scientific background” in all of those areas? Is there actually any reality to it? I can’t seem to find a bio on the page.
    I have a BS in Biology and worked in a Microbiology lab for 4 years but still wouldn’t say I have a considerable background in microbiology.

  14. #14 viggen
    September 2, 2010

    A better way to put it would be that there is no known physiological or anatomic structure that corresponds to acupuncture meridians,

    Minor quibble here: acupuncture points do sometimes correspond to locations of nerves. While I was still doing martial arts, I spent a bit of time comparing an acupuncture point dummy to a neuroanatomy book. This is lifting away the “meridian system” and comparing points. There is a surprising correspondence between how points are located on the dummy to where nerves were located in the anatomy book. I think acupuncture enthusiasts take this correspondence to give their beliefs credibility.

    That said, I think acupuncture is a load of crap–it’s an elaborate web of confusing correlation and causation. If you want to model how the nervous system works, better to use the modern version where MRI and CT scanning are available than a tenth century misunderstanding saturated with religious nonsense. I’ve voiced my other thoughts on this subject before and see no reason to rehash that.

  15. #15 Todd W.
    September 2, 2010

    After learning a little bit about acupuncture (warning: University of Google account to follow), anytime I hear someone talking about meridians, I wonder which system? There are several different ones with varying numbers of points. There are the really old points that line up more with blood vessels than nerves, then there are the newer ones that line up more with nerves than with blood vessels. Neither one matches up completely. Likewise, the total number of point, regardless of system, varies, depending on the source.

  16. #16 Craig Willoughby
    September 2, 2010

    IHC Jay,

    Huh? The article I linked to has nothing at all to do with anything you mentioned. It has to do with people seeing the shape of Jeebus in vines on a telephone pole…

    Orac has an interest in Paradolia, and when he writes about, I genuinely enjoy what he has to say. I didn’t come here for a debate or to argue about anything. I just wanted to show that link to Orac.

  17. #17 Seb30
    September 2, 2010

    @IHC Jay 13

    How the hell can a computer software entrepreneur claim to have a “considerable scientific background” in all of those areas?

    When I started to attend my university (in France), the first two years had a common teaching program for all science students, which includes math’s, computers, biology, physiology, chemistry, and physics, so I suppose one can claim to have received a broad scientific background. I believe it’s the same in other European countries. From what I know of US universities, they specialize faster, so this will not apply to them.

    However, I have no idea if Mike Adams went to a university with broader-than-usual-for-US first years’ teachings. Even to me, his “expertise” is way too scattered. (astronomy and psychology alongside the other hard sciences? Whahh! I would have loved to have these two too)

    But even if he did, the objective of these teachings is more about keeping your further orientation possibilities open and giving you a basic understanding of other fields. This will help communicating with a colleague scientist from a different field, but it’s realistically not enough to consider yourself an expert.
    If I was to say that, 15 years after these teachings, I have a considerable scientific background in that many fields, I would be seriously deluded.

    Actually, I read some of Adams’ ranting and I certainly remember more about immunology than him, even after all of these years.

    In short, my guess is on Dunning-Kruger effect at its best.

  18. #18 JakeS
    September 2, 2010

    I’m going to add “star chart” to my vocabulary – I usually call that sort of plot a “shotgun plot” or a “sneeze plot.”

    – Jake

  19. #19 Denice Walter
    September 2, 2010

    @ IHC Jay :It was *I* who pointed out the NaturalNews article. Mike Adams has a bio @ HealthRanger.com which is rather vague about his actual education. Somehow, I sincerely doubt that Adams’ comments about meds for mental illnesses/ LD and the validity of the CCHR’s information reflect a great deal of knowledge about psychology. He is not the only woo-meister to proclaim himself an expert across several areas of scientific research and social sciences.

  20. #20 IHC Jay
    September 2, 2010

    Sorry Craig, you’re right Denice, I was at work and looking between the articles and doing my work at the same time.
    It’s annoying that people in the actual fields he claims his expertise in have to listen to him spew his nonsense. It could make it look the whole field endorse his bs.

  21. #21 Orange Lantern
    September 2, 2010

    I wish they had a hi-res pic of that telephone pole, Craig. It looks more like a mustachioed soldier with a beret to me!

  22. #22 CanadianChick
    September 2, 2010

    I suspect Mike Adams “extensive” education consists of having watched “Nova” occasionally and reading health food store magazines. That and the Pengiun Dictionaries for Chemistry, Biology and Physics was how you did that before U of Google!

  23. #23 Pareidolius
    September 2, 2010

    Okay, I’m not a doctor, nor do I play one on TV, so I need a bit of schooling on this quote . . .

    ” . . . will bring us one step closer to understanding 1) why LBP occurs . . .”

    We don’t understand why Lower Back Pain occurs? Really? As someone who spends most of my work day doing design in front of a computer, I have spent a lot of time and money on treating and preventing Lower Back Pain.

    Aging. Injury. Osteoarthritis/Osteoporosis. Vertebral disintegration. Disc damage and nerve impingement. Muscle tension due to inactivity and repetitive stress from bad ergonomics. Hell, even carrying your wallet in your back pocket. Are these not settled, science-based causes of LBP? Is she looking for a Tooth Fairy cause to go with her Tooth Fairy cure?

    I am constantly be disabused of my layman’s view of medicine by reading this site daily (both from our transparent, blinky master and his loyal medical minions), so if I’m wrong on this, that’ll be more cool stuff I’ll have learned at R.I.

  24. #24 Kafkaesque
    September 3, 2010

    “How the hell can a computer software entrepreneur claim to have a “considerable scientific background” in all of those areas?”

    I don’t really know what “computer software entrepreneur” means but I know software engineers often become experts in many domains from writing code to model, analyze, or automate domain processes. If you are tasked with writing software to sequence the genome, or front running stock markets, by the end of it, you will likely know more about how it all works than most anyone studying that domain.

  25. #25 Chris
    September 3, 2010

    Though Mike Adam’s expertise seems to be mostly web design and youtube videos. If you have evidence to the contrary, we would love to see it!

  26. #26 Kafkaesque
    September 3, 2010

    I don’t know who Mike Adams is, but no, doing web design and making videos would not meet the definition of software engineer.

  27. #27 Bruce Gorton
    September 3, 2010

    OT, but dealing with quackery I have come across in South Africa.

    What I am looking for is reliable info on Johrei. Are there any good resources I can use as a starting point?

  28. #28 TechSkeptic
    September 3, 2010

    paredolious @23,

    yeah, but what causes “Aging. Injury. Osteoarthritis/Osteoporosis. Vertebral disintegration. Disc damage and nerve impingement”?

    huh? huh? huh? Toxins. yeah. and misalignments.. yeah… and poor flowing chi.

  29. #29 Todd W.
    September 3, 2010

    @TechSkeptic

    yeah, but what causes “Aging. Injury. Osteoarthritis/Osteoporosis. Vertebral disintegration. Disc damage and nerve impingement”?

    huh? huh? huh? Toxins. yeah. and misalignments.. yeah… and poor flowing chi.

    Huh. And all this time I thought aging was caused by cellular mechanisms like programmed cell death, replication errors and so forth, all of which originate in DNA and RNA coding and that injury was caused by, well, impacts, cuts, crushing, heat, etc. The others I don’t know much about.

    Then again, you may have a point. I’m just a lowly non-scientist, non-doctor layperson and not a well-trained homeoacupuncherbalismatist. What do I know?

  30. #30 Pareidolius
    September 3, 2010

    Maybe we should all go into Homeoacupuncherbalismatology after all. You know the money’s good.

  31. #31 Trapper John
    September 3, 2010

    One minor quibble with this paricular post–haven’t you asked for this type of study? From your recent opus on homeopathy:

    “It’s hard to imagine a theory that would make homeopathy a plausible modality. Perhaps such a theory exists. It’s incredibly unlikely, but not completely impossible. However, because such a theory is so incredibly implausible based on what we currently know about physics and chemistry, if Maché’s homeopaths think that that paradigm is wrong, then it is up to them to prove it through science.”

    It seems to me that the acupuncture-believers are (bless their hearts) trying to test a theory that would “prove it through science” and provide a physiological explanation of how it might work.

    As to the other points criticizing the methodology, spot on. And whether or not this is a good use of taxpayer money (it isn’t) is another argument. But we’ve paid $400 for this particular toilet seat, I’m glad to see that you’re getting use out of it–sitting on it and unloading some steaming insolence.

  32. #32 Kristjan Wager
    September 4, 2010

    I don’t really know what “computer software entrepreneur” means but I know software engineers often become experts in many domains from writing code to model, analyze, or automate domain processes. If you are tasked with writing software to sequence the genome, or front running stock markets, by the end of it, you will likely know more about how it all works than most anyone studying that domain.

    Nonsense. I have made big financial systems and public systems. This doesn’t make me qualified on advising people on insurance, investments or buying stocks, nor does it make me qualified to make decisions on applications for public money etc.

    I can implement these things, and through that I gain some understanding of what’s going on, but to claim that I know more about these domains than anyone studying them, is pure nonsense. They are the ones that actually define the requirements, not me.

  33. #33 ScepticsBane
    September 4, 2010

    Upset over the funding for an article you disagree with? Don’t despair, happens all the time … !

    What’s Behind Ben Goldacre?
    http://www.whale.to/vaccine/behind_ben_goldacre.html

    Alternative medicine council ousts critic
    26th August 2010 – Prof. David Colquhoun sacked from the CNHC Conduct & Competence Committee!

    http://www.timeshighereducation.co.uk/story.asp?storycode=413175

    http://www.cnhc.org.uk/pages/index.cfm?page_id=65

    Edzard Ernst Exposed
    He admits no qualifications in homeopathy during interview
    http://www.hmc21.org/edzard-ernst/4543212059

  34. #34 trepto
    September 5, 2010

    TechSkeptic @ 28:

    huh? huh? huh? Toxins. yeah. and misalignments.. yeah… and poor flowing chi.

    I’m catching up on some blogs through the wonder of text-to-speech. Somehow, my computer managed to imbue this statement with an audible sneer.

  35. #35 Chris
    September 5, 2010

    ScepticsBane, now Colquhoun is more free to expose the silliness of Ofquack!

    You have also invoked Scopie’s Law:

    In any discussion involving science or medicine, citing Whale.to as a credible source loses you the argument immediately …and gets you laughed out of the room.

    You really aren’t much of a “bane”, but more of a laughing stock. Kind of like Scudarmore of whale.to fame was when he revealed his bum had been burned by a satanic ley line.

  36. #36 sohbet
    September 5, 2010

    Show me a body-wide map of these “Colagenous bands” correlating with the “meridians” and I’ll be more interested than with this limited and mostly negative study.

  37. #37 Kafkaesque
    September 6, 2010

    “Nonsense. I have made big financial systems and public systems. This doesn’t make me qualified on advising people on insurance, investments or buying stocks, nor does it make me qualified to make decisions on applications for public money etc.”

    It sounds like you were writing software where you were implementing a known solution rather than devising a solution in a domain and then implementing it. That’s what I was referring to. Its one thing to write sofware that retrieves and displays stock quotes, its quite another to write one that figures out the best stock to buy.

  38. #38 Nakliyat
    September 6, 2010

    Actually, I read some of Adams’ ranting and I certainly remember more about immunology than him, even after all of these years.

    In short, my guess is on Dunning-Kruger effect at its best.

  39. #39 Nakliyat
    September 6, 2010

    Actually, I read some of Adams’ ranting and I certainly remember more about immunology than him, even after all of these years.

    In short, my guess is on Dunning-Kruger effect at its best.

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