Pharyngula

Posted by: ivy privy | June 12, 2009 9:24 AM

How Reiki is all sciencey

To give reiki a scientific basis, many of the known laws of physics and biology have been demonstrated. A functioning human body is electrical in nature; currents flow through nerves, blood and organs. Tests like the electrocardiogram are used to measure the electrical activity of the heart. "Reiki gets rid of negative energy created by suppressing negative feelings that can manifest," Cady says.

Posted by: JRD | June 12, 2009 9:27 AM

On the glass-half-full side of things, at least the AP article takes an uncharacteristically (for the MSM) skeptical perspective on alternative medicine.

Posted by: M | June 12, 2009 9:27 AM

But it's all real: http://www.elarius.org/

I wonder if I can get this on the NHS.....

Posted by: Cimourdain | June 12, 2009 9:28 AM

Speaking of antiscientific lunacy, I had thought I'd seen it all, but then I noticed this gem:

In 1982, the Institute for Policy Studies in Islamabad, Pakistan, criticized a chemistry textbook by saying: “There is latent poison present in the subheading Energy Causes Changes because it gives the impression that energy is the true cause rather than Allah. Similarly it is unIslamic to teach that mixing hydrogen and oxygen automatically produces water. The Islamic way is this: when atoms of hydrogen approach atoms of oxygen, then by the Will of Allah water is produced.”

Un-be-lievable. Speaking of pikers, this makes creationism look like small potatoes in comparison.

Posted by: Rev. BigDumbChimp | June 12, 2009 9:36 AM

sigh

just as idiotic as

Posted by: Cuttlefish, OM | June 12, 2009 9:42 AM

Congress created it after several powerful members claimed health benefits from their own use of alternative medicine and persuaded others that this enormously popular field needed more study. The new center was given $50 million in 1999 (its budget was $122 million last year) and ordered to research unconventional therapies and nostrums that Americans were using to see which ones had merit.

I know my treatment works, and hence
I have no need of evidence;
It does not matter what the facts is--
This is how I'll spend your taxes.

Posted by: tsg | June 12, 2009 9:44 AM

Three seconds after a friend of mine posted this link on Facebook, someone else responded with "It's not true! Some of it does work. I'm living proof!"

It absolutely amazes me how many people don't understand why double-blind clinical trials are even done, let alone necessary.

Posted by: Russell Miller | June 12, 2009 9:46 AM

Why be afraid? If it does no good, if it's just hand waving, what is there to fear?

Personally, I'm ambivalent about those remedies. If they don't work, they don't work, but there's something to be said for the placebo effect. Maybe just believing they'll work has some benefit in itself.

If they force it on you or the state pays for it, obviously it's not acceptable. Otherwise, why not just leave them to their woo?

Posted by: strangebrew | June 12, 2009 9:55 AM

Unfortunately seems to be a sign of the times...all things to all people and every ones beliefs are as valid as everyone elses...even the out and out kooks can claim protection under the law...and nobody has the cojones to call them on it...(present company accepted).

Posted by: Kausik Datta | June 12, 2009 10:10 AM

@#15: Michelle,

So... any ideas how this worked? The biology buffs on the softball team theorized about it, but we didn't have the resources to test it.

It is not the magnet, or quarter, or foil. It is the pressure of a small hard object applied constantly to a small area under it, that leads to resolution of the edema - simply by pushing the tissue fluid away to surrounding areas.

This alt med nonsense has simply gone on far too long, and has deceived too many innocent people. It is time to put a stop to this, by insisting on hard evidence.

Posted by: mxh | June 12, 2009 10:18 AM

Thanks Kausik... I work with magnetic stimulation (much more powerful magnets targeting the brain) and I am sick and tired of people taking what I do as validation that their woo magnetic therapy (magnetic rings) have scientific validity.

and @15, Michelle, anecdotal evidence doesn't mean anything.

btw... The trend of medical schools and hospitals going through woo is disturbing, but I was pleasantly surprised by the AP article (maybe a backlash is forming against it?).

Posted by: gf | June 12, 2009 10:22 AM

Again though, it's not just the obvious wacky treatments that should be condemned.

The reason homeopathy etc are offered on the NHS is that they perform as well as many 'conventional' treatments. Please don't give quackery that was cooked up in a lab by men in white coats any more respect than that of eastern mystics. That really would be 'scientism', and all the other things opponents accuse rationalists of.

I really wish that Dawkins/ PZ/ etc would take the time to look at the terrible evidence base that underpins so much western medicine, and does so much to discredit science within the eye of the community. For most people, their GP is the closest they come to contact with a 'scientist', and the lies and nonsense spouted by so many of them must play a significant part in people's scepticism towards the claims of science more generally.

Posted by: Orac | June 12, 2009 10:23 AM

Dude, this is old news that I and others have been trying to sound the warning about for the last three or four years now. While I'm glad to see that the mainstream media is finally taking notice, I'm not optimistic that it will change. Indeed, Tom Harkin is trying to hijack any health care reform that Obama may come up with in order to insert provisions to require the government to pay for quackery:

http://scienceblogs.com/insolence/2009/03/maybe_nccam_isnt_so_bad_after_allnahhh.php

http://scienceblogs.com/insolence/2009/03/senator_tom_harkin.php

Posted by: the pro from dover | June 12, 2009 10:25 AM

The issue isn't that alternative medical treatments are demanded despite the fact that there is no scientific evidence to back them up. It is precisely the lack of such evidence that drives their popularity. Medicine is a statistical science like all sciences are, and testimonials carry no weight to those engaged in research. It is the testimonial nature of alternative medicine that drives its popularity through miracles and special endowment. This special nature then is transferred to the recipients increasing their personal worth. Face it, medical facts are dull and statistical presentations promise no guarantees. In a scientifically illiterate population Jonas Salk can't hold a candle to laetrile.

Posted by: John RN | June 12, 2009 10:27 AM

"At one of the nation's top trauma hospitals, a nurse circles a patient's bed, humming and waving her arms as if shooing evil spirits. Another woman rubs a quartz bowl with a wand, making tunes that mix with the beeping monitors and hissing respirator keeping the man alive. They are doing Reiki therapy, which claims to heal through invisible energy fields. "

Meanwhile the real nurses (the ones actually doing actual patient care) are running around like their hair is on fire, trying to stave off complete chaos, and wishing they could get some help in there before someone dies. I know, I've been there.

Posted by: the pro from dover | June 12, 2009 10:30 AM

The issue isn't that alternative medical treatments are demanded despite the fact that there is no scientific evidence to back them up. It is precisely the lack of such evidence that drives their popularity. Medicine is a statistical science like all sciences are, and testimonials carry no weight to those engaged in research. It is the testimonial nature of alternative medicine that drives its popularity through miracles and special endowment. This special nature then is transferred to the recipients increasing their personal worth. Face it, medical facts are dull and statistical presentations promise no guarantees. In a scientifically illiterate population rituxan can't hold a candle to laetrile.

Posted by: Charles | June 12, 2009 10:36 AM

You nuts give anecdotal evidence in favor of "alternative" therapies? Here's a couple of anecdotes on the other side...

My wife's family has a genetic predisposition for low serotonin levels, tending toward depression and addictive behaviors. Every member of the family in recent memory has had fantastic success with SSRIs during depressive periods. Every one. But diet modification? Nothing. Herbals? Nothing. Acupuncture? Nothing. Prayer? Nothing. Zoloft, Lexapro, Paxil? Success.

My wife's sister was trying for eight years on and off to become pregnant. They decided to go for IVF, then wimped out, went for a holistic fertility quack. Acupuncture, diet, chiropractic, herbals, meditation, spiritual un-conceived baby channeling even. $15,000 later, still not pregnant. Then they tried IVF. Success on the second try with an adorable little daughter.

You want to go on about anecdotes, you MUST include all the times your woo-woo didn't work, and all the times scientific medicine did. THEN figure out what works better.

Posted by: raven | June 12, 2009 10:38 AM

gf the crackpot:

I really wish that Dawkins/ PZ/ etc would take the time to look at the terrible evidence base that underpins so much western medicine, and does so much to discredit science within the eye of the community.

You mean like this one. In a century the lifepan of US residents has increased by 30 years. This is all the fault of modern medicine of course.

Contrary to gf's lies, the big problem with modern medicine is not that people don't trust it, don't want it, and are rejecting it. The problem is that demand far exceeds both the supply and the ability to pay for it. People want those extra 3 decades.

Perhaps gf would be happier in a more traditional culture where modern medicine is in short supply. The average lifespan in the USA is 77 years. In Afghanistan it is 44 years and going down. This is one of the few places on earth were you can still catch polio and die.

Posted by: Neil B ♪ | June 12, 2009 10:47 AM

What is the source of so much certainty here that there isn't any evidence for at least some "alternative treatments" to have some effect? Since I'm challenging assurance they don't work, rather than arguing that they do work, it's a legitimate question of principle with no burdens on me.

For example, doesn't acupuncture work, more or less? It was considered questionable in the past. I heard a talk by a NIH rep. in the 90s saying that many homeopathy experiments work, granted statistics makes it hard to be sure. Are many of you assuming for theoretical reasons (which sometimes turn out wrong) instead of referring to warranted, literally empirical grounds? And that leads to wondering, how easy is it to know how good or absent the extant evidence is anyway? Some things we know surely do work or exist, others I presume it is rather clear they don't. But when I hear someone say, "there's no evidence for X", just how do you assure yourself of that? Not maybe a straw-man of absolute certainty; I mean, even reasonable confidence. Do you read over every possible journal, reports, what? And again, no one has to make a case for X to question your assurance of the state of the evidence.

Of course, if the placebo effect is so powerful that makes assessing medical treatments difficult anyway. But I'd rather not see it used as a crutch or universal escape clause every time there are claims or evidence of something working that seems like it shouldn't.

Posted by: stillwaters | June 12, 2009 10:50 AM

Reiki gets rid of negative energy? Then all you're left with is protons.

Are you sure?

I'm positive :)

Posted by: raven | June 12, 2009 10:55 AM

Why be afraid? If it does no good, if it's just hand waving, what is there to fear?

Dying for one thing. Sometimes patients substitute alternative medicine for real medicine. If they have a serious underlying condition this can and often is fatal. Docs see it occasionally.

Woman decided to stop her blood pressure medicine for some natural alternative. A few weeks later, she felt dizzy and an hour later was dead. Hemorrhagic stroke, age mid 40's.

Cancer patients were IV infused with a Mexican sourced treatment. Which turned out to be saline water contaminated with live bacteria. No one died before the cops shut them down but they easily could have. A good way to cause septicemia leading to septic shock and death in a patient population susceptible to this.

No one gets too excited if patients combine alternative treatments with standard medicine. They will anyway and no one can stop them. The real danger is substituting one for the other..

Posted by: stillwaters | June 12, 2009 10:56 AM

Seriously, though, I already have a clause in my living will that I don't want to be kept in a religiously-affilitated hospital since I don't believe in their superstition.

I guess I will have to update it to include Reiki and other magically-based superstition.

Posted by: Matt Penfold | June 12, 2009 11:02 AM

Since I'm challenging assurance they don't work, rather than arguing that they do work, it's a legitimate question of principle with no burdens on me.

Nice try, but a big fail on understanding the concept of scientific Falsifiability.

However, there is evidence they do not work. Many claims for alternative medicine have been tested. The evidence tells us homeopathy, acupuncture, reiki et al do not work beyond the expected placebo effect. Some forms of alternative physical manipulation have limited evidence that they are effective, but then we KNOW physiotherapy can relieve symptoms in a number of conditions. We also know that herbal treatments can be effective, but we also know that dosage is much harder to control in herbal remedies and that many practioners are poorly trained to understand possible interactions. And the idea "natural" means "safer" is just rubbish. The most toxic substances known are mostly organic compounds found in plants.

What we find with alternative medicine is either the claims they are effective are simply wrong, or that when they are effective there are good explanations as to why that do not involve a load of new age mumbo-jumbo.

Posted by: tsg | June 12, 2009 11:13 AM

@38:

Despite your claims to the contrary, you're shifting the burden. The burden of proof is on those claiming they work, not the other way around.

Many of these claims have been around for a long time without the barest thread of evidence to support them despite many years looking for it.

Some of those claims, if true, would require everything we know about the way the world works to be wrong.

"X does not cure Y" is not a positive claim requiring proof. It is the null hypothesis to "X cures Y": the default position, the one that is there before the claim is even made. Asserting that "X does not cure Y" is simply the same as saying "X has not been shown to cure Y". And, no, I don't need to read every medical journal ever written to make that statement because it comes with the implicit condition that I'm willing to be shown I'm wrong, but it is the burden of the claimer to do that.

Posted by: the pro from dover | June 12, 2009 11:18 AM

The issue isn't that alternative medical treatments are demanded despite the fact that there is no scientific evidence to back them up. It is precisely the lack of such evidence that drives their popularity. Medicine is a statistical science like all sciences are, and testimonials carry no weight to those engaged in research. It is the testimonial nature of alternative medicine that drives its popularity through miracles and special endowment. This special nature then is transferred to the recipients increasing their personal worth. Face it, medical facts are dull and statistical presentations promise no guarantees. In a scientifically illiterate population rituxan can't hold a candle to laetrile.

Posted by: Joker | June 12, 2009 11:20 AM

The bit by rogue medic interests me, not because I think it's true but because I am a huge fan of spectacle, so I suppose I might go to one of those hospitals so long as they do the regular stuff as well it's sort of like getting a unique show along with the treatment.

Also makes me think of this old saw

"A SHORT HISTORY OF MEDICINE:
"Doctor, I have an ear ache."
500 A.D. - "Here, eat this root."
1000 A.D. - "That root is heathen, say this prayer."
1850 A.D. - "That prayer is superstition, drink this potion."
1940 A.D. - "That potion is snake oil, swallow this pill."
1985 A.D. - "That pill is ineffective, take this antibiotic."
2000 A.D. - "That antibiotic is artificial. Here, eat this root!"

Posted by: --E | June 12, 2009 11:36 AM

Ya know, I try to think of moderate amounts of woo in the hospital as sort of "bedside manner" to help a patient feel psychologically more comfortable with all the poking and prodding they must undergo. Sometimes my outlook in this regard wars with my idealism that people should face facts, dammit; but in the end I think of hospitals as emergency places, so anything that will make a crisis go more easily is tolerable.

But this... wow. This is pushing the point where I start to think that if people need this much psychological coddling, the merciful thing might be to not give them proper medical care.

Posted by: gf | June 12, 2009 11:39 AM

@49:

I thought acupuncture had been shown to work marginally better than pseudo-acupunture, it's just thought that this was because the 'genuine' acupuncture was performed in a way that inspired more confindence from patients.

Maybe we could see acupuncture as an evolving meme, picking up the traits which best induce a placebo affect? Or maybe it was that those who created the pseudo-acupuncture struggled to instil the level of belief and misplaced confidence that genuine acupuncture managed?

Or maybe the slight difference was just a fluke? I doubt it's an area which has been heavily researched.

Posted by: Rogue Medic | June 12, 2009 11:43 AM

Thank you for the link.

I originally read about this at Respectful Insolence. The infiltration of woo into medical academia continues apace just put my own spin on it.

I have been very critical of the similarly unscientific fly everyone to Shock Trauma approach to prehospital care in Maryland. Things have improved since the fatal crash in September imposed some oversight on their system. However, they still believe that putting a patient in a helicopter creates some magical healing aura around the patient.

The big selling point on both of these unscientific treatments?

It's Free!

There is a surcharge on registrations, or licenses, or both, to pay for the helicopter program. The helicopters are used to fly patients past closer hospitals, even if they are also trauma centers, to get to Shock Trauma. Shock Trauma also rejects any outside oversight. If you go to other states, there is a specific American College of Surgeons designation of Trauma Center. Shock Trauma does not believe that they need to play by the same rules as other hospitals, because Shock Trauma originated the concept.

I am trying to encourage more of an evidence based medicine approach to prehospital patient care. In Maryland, they seem to be going in the other direction.

Posted by: The Other Ian | June 12, 2009 11:54 AM

For example, doesn't acupuncture work, more or less?

No. Trials have shown it works no better than "pseudo-acupuncture" in which the needles are inserted in the "wrong" places.

I think it depends on the indication. The general review at Wikipedia suggests that there is significant evidence of effectiveness for chronic low-back pain, infertility (when combined with conventional treatments), nausea, neck pain, and idiopathic headaches.

Most of the claims commonly made by acupuncturists are totally unsupported, however.

Posted by: Neil B ♪ | June 12, 2009 11:54 AM

Re @ 46 and 48, you are mostly misunderstanding my points. As for falsifiability, that means whether we can test the idea, it's being valid wouldn't assure that your intuitions about the state of the evidence were valid. Two separate issues. And sure there's a burden of proof about claims, but first, I am criticizing the characterizing of the situation as "there is no evidence of ..." without clear support for that. (IOW, the "meta-statement" in logical terms, no pun intended re new age jargon.)

What I meant most directly is, the principle of how do you even know for sure whether there is or not evidence, rather than what you are warrented to think if you are quite sure there isn't any. And I'm not saying you never can be sure, but challenging on how easy, how much in the cases claimed, etc. And let's accept that the BOP is on claimants here, what does that really entitle you to do? First, I deny that there's a *general* default position of likely not working or being real. The legitimate default is, "don't know." And if you weren't sure about whether there was positive evidence or not, the honest characterization would still be, "AFAICT, there is no evidence of X." You don't get to mischaracterize the *state of your knowledge* of the extent of evidence because of what evidence the other side would need to provide if they have it. That's an improper conflation.

You could assume you would have heard more of it, or certain authorities would have approved. So I'm not talking about the consequences of "having no evidence" but what warrants you even saying "we have no evidence" in the first place. Some examples of testing is given, but the challenge was valid IMHO as a matter of principle.

The NIH rep I heard said that some experiments on the effects of highly diluted substances *did* work, and showed tables etc. How about the claimed results of Jacques Benveniste about "water memory." That was challenged, but now you have to think about pitting one claim against others and saying "there's no evidence" is not so simple. The examples from the talk were similar, and most were in vitro studies and hence not subject to PE. I heard it, and the claims at least were there so I won't believe anyone saying there isn't even something resembling evidence. I don't know how good it is, but do you? (Above all I am criticizing assurance and noting the sticky nature of knowledge, not arguing for bending over the other way.)

In any case, what the PE can do is amazing in it's own right. Some of that is hard to explain!

See e.g. http://en.wikipedia.org/wiki/Water_memory

Posted by: Matt Penfold | June 12, 2009 12:07 PM

And sure there's a burden of proof about claims, but first, I am criticizing the characterizing of the situation as "there is no evidence of ..." without clear support for that.

Oh dear.

You do not grasp the concept of the burder of proof do you ?

You cannot claim that ANY treatment for a medical condition is effective until that treatment has undergone rigorous testing, normally involving extensive randomised trials with double blind protocols where appropriate. Until a treatment has gone through such tests, and the data indicates there is a significant difference in outcome compared with the control groups then it cannot be claimed a treatment works.

Whenever alternative medicine has been put through such trials it either fails, or is found to replicate treatment known to be effective. Chiropractory has been shown to have some benefit with regards mild lower back pain, but since physiotherapy also is effective that is no surprise. A good number of drugs are based on organic compounds originally found in plants, and either are still extracted from plants or are now synthesised. We are not surprised therefore when some herbal treatments are shown to be of benefit.

However a good number of alternative remedies would require us to abandon much of what we understand in science. Homeopathy if correct would mean that all we understand about quantum physics is wrong. Given the success of quantum physics, and the lack of evidence that homeopathy works, which do you think it is reasonable to think is correct ?

Posted by: Matt Penfold | June 12, 2009 12:12 PM

"How about the claimed results of Jacques Benveniste about "water memory." "

What about them ?

They are a good example of how even decent scientists can deluded themselves and others. They are not a good example that water has been proven to have "memory".

Why, when the fact the results produced by Benveniste are spurious as best, and more likely involve a degree of dishonesty is well known, do you bother even mentioning it ? It is like you do not want us to take you seriously.

Posted by: Monado | June 12, 2009 12:18 PM

Wasn't the 12.5 billion USD spent to test whether alternative therapies worked? If the government is now able to de-fund those therapies and educate people not to waste money on them, it will be worth it in future savings in health-care costs alone (from patching together people who neglected proven medical care while their problems were easily treated).

And to put it into perspective, I seem to remember similar numbers for the amount spent on cosmetics for women. I never did see a comparison for something men spend their money on, e.g. aftershave scents.

Posted by: raven | June 12, 2009 12:21 PM

I'm slowly realizing I'm surrounded by creationists who think alternative medicine is fantastic.

Fundie xianity, creationism and pseudoscience medicine seem to go together often. I got a brochure in the mail inviting me to a local church to hear about the Endtimes and Rapture from some famous preacher I never heard of. The other half of the brochure was his other business which seemed to be a whole bunch of alternative medicine quackery.

If you believe the earth is 6,000 years old, it apparently isn't any harder to believe some quack is going to cure your potentially fatal medical condition.

Posted by: tsg | June 12, 2009 12:24 PM

@62:

You are merely re-iterating your position from #38 and my reply at #48 still stands.

Posted by: Holbach | June 12, 2009 12:30 PM

That useless total should also include crackers that don't work their insane magic. Never questioned, never doubted, but totally useless, unless of course used solely for food. For food? Blasphemy!

Posted by: Matt Penfold | June 12, 2009 12:40 PM

"Yes I do understand it. Like others, you are getting mixed up about my point. Probably that's because people are so used to certain arguments, but that doesn't justify carelessness. It wastes a lot of everyones' time, mopping that up. I am not challenging the degree to which one should have evidence before claiming such and such, I am not claiming such and such, OK? I was challenging the confidence expressed here that the state of the evidence was such and such. That is a different issue than what it ideally ought to be."

No, you were trying to claim that the burder of proof is not on the affirmative claim.

"@66: As I clearly implied, my point in referncing the claimed results of Jacques Benveniste was to show, you can't just throw out sloppy claims "there is no evidence of ..." Some claimed evidence is there. None of it may have survived challenge, I didn't say JB's evidence was good, it was to reframe how you can rightly talk about the state of the evidence."

No, there was NO evidence. The results were faked, and could not be replicated either in other labs or under supervision in the original lab. In science you do not get to make stuff up and call it evidence.

I can claim the moon is made of blue cheese. Unless I can support that claim it is NOT evidence of anything. Benveniste did not provide any evidence to support his claims. No one, except when he was around could replicate his results, and even he could not do so when he was observed by third parties. A fundamental concept in science is that results obtained in one lab can be replicated in another.

There is no evidence that alternative medicine works. Either it is shown not to work at all, or it just replicates known effective mechanisms. In some cases there may be a lack of research, in which case the default position is that it does not work.

Posted by: tsg | June 12, 2009 12:58 PM

Most of these were proposed long ago by herbalists and alternative practitioners, before they found their way into mainstream medicine.

As my father used to say, "even a blind squirrel finds a nut once in a while".

It's like with psychic predictions: when you make thousands of them, some of them will invariably come true. That doesn't, however, validate the process because you have no idea which ones it will be. Focusing on the hits and ignoring the misses is called "confirmation bias" and is precisely why psychics and alt-med seem to work on the surface.

Getting rid of bad ideas is just as important as finding the good ones. If the process doesn't do both, it isn't a useful means of knowing anything.

Posted by: Stu | June 12, 2009 1:01 PM

sinz, nice try.

Glucosamine for osteoarthritis

http://nccam.nih.gov/research/results/gait/

"GAIT researchers led by rheumatologists Allen D. Sawitzke, M.D., and Daniel O. Clegg, M.D., both of the University of Utah School of Medicine, conducted a 2-year ancillary GAIT study at nine sites with a subset of participants from the original GAIT study. The ancillary study results, published in Arthritis & Rheumatism, October 2008, showed that glucosamine and chondroitin sulfate, together or alone, appeared to fare no better than placebo in slowing loss of cartilage in knee osteoarthritis. However, interpreting the study results is complicated because participants taking placebo had a smaller loss of cartilage, or joint space width, than predicted."

Saw palmetto to treat benign prostatic hyperplasia

http://content.nejm.org/cgi/content/short/354/6/557

"There was no significant difference between the saw palmetto and placebo groups"
"In this study, saw palmetto did not improve symptoms or objective measures of benign prostatic hyperplasia."

I'll look for the others later, I'm not familiar with those.

Posted by: KemaTheAtheist | June 12, 2009 1:04 PM

@56

I thought acupuncture had been shown to work marginally better than pseudo-acupunture, it's just thought that this was because the 'genuine' acupuncture was performed in a way that inspired more confindence from patients.

No.

Maybe we could see acupuncture as an evolving meme, picking up the traits which best induce a placebo affect?

No.

Or maybe it was that those who created the pseudo-acupuncture struggled to instil the level of belief and misplaced confidence that genuine acupuncture managed?

No.

Or maybe the slight difference was just a fluke?

Yeah... I'll remember to go to that fake one as opposed to the other fake one...

I doubt it's an area which has been heavily researched.

Enough we shouldn't be wasting any more money on researching it. It makes me sick to think about how far that would go in REAL medical research for stuff like curing blindness:

http://www.dailymail.co.uk/health/article-415317/Stem-cell-treatment-cure-blindness.html

http://gizmodo.com/5277456/stem-cell-contact-lenses-cure-blindness-in-less-than-a-month

Posted by: Stu | June 12, 2009 1:07 PM

Fish oil to reduce blood triglyceride levels

http://nutrition.stanford.edu/projects/fishOil.html

"Two types of fish oil supplements, differing in the way they are manufactured, are commercially available. However, no research study has evaluated whether these two types of supplements confer similar benefits. The aim of the Fish Oil and Triglycerides Study is to investigate the triglyceride-lowering effect of these two types of supplements in individuals with elevated levels in their blood (>150 mg/dL)."

So far, two "no" and one "maybe". Weak gruel.

Posted by: Stu | June 12, 2009 1:18 PM

Sigh...

Lactobacillus acidophilus for bacterial vaginosis

Can't find a serious study for this at all. Shocker. About as scientific as LadyBalance, right?

N-acetylcysteine (NAC) as a mucolytic and to prevent nephropathy from drug reactions

http://www.bestbets.org/bets/bet.php?id=851

"The current evidence does not support the routine use of IV NAC to prevent contrast nephropathy in patients with renal impairment. Administration also comes with a reasonable risk of anaphylactoid reaction (14.6% in one trial). Simple measures such as IV hydration with isotonic saline and use of non ionic contrast should be utilised. A large double blind PRCT looking at the effect on GFR of high dose IV NAC with normal saline therapy pre and post contrast, in patients with renal impairment, is needed to establish benefit"

So much for your claims, sinz.

Posted by: Neil B ♪ | June 12, 2009 1:43 PM

@ 76: No, that wasn't the relevant claim I made. You also confuse my being skeptical of your confidence about the entire body of evidence, with how good a possible counter-example was. I mean, how well do you know how many results are in this or that category. A lot of you forget, characterizing a set of things is itself a claim needing justification, regardless of whether it's a "yes" or a "no." The body of evidence is something about which one should know things before saying them. It isn't the same thing or issue as the subject matters themselves.

Saying "there isn't X" in the BoE is a logically "positive" claim in saying, things are such and such a way to be. (Positive in logic means an assured claim of the state of affairs, often wrongly confused with "existence" v. "non-existence" claims.) That is not over the rules about what to do, *if given* the presumption of knowing what the evidence really consists of. That's logically different from being skeptical that such and such happens. (You could imagine this as a second-order, "evidence about the evidence" question.) You still don't get to say "there isn't" as a default, the proper bystander's default is "I haven't seen any evidence" or maybe "those who review this say there isn't, and I trust them" etc.

Aside from the BoP, it is careless to presume someone can only make one point, or to mix up criticisms. As for my use of the term "evidence" regarding Benveniste I admit to being careless. I should have called them "claimed results" again like I did @62, to show we have to hash over validity of claims and not just "look for whether there's any evidence." I made that clear in context, no excuse for exaggerating for easier complaint. Also, I always thought that loosely, "evidence" could include claimed evidence at start because you need a simple word for the whole in advance of being sure how good it is. But it's likely better to reserve the plain word for claimed evidence that has been validated.

In any case, maybe I was right to doubt the assurances about the state of the evidence anyway. (By now, you had better be able to get the difference between appreciating that, and the other issues of what constitutes good evidence, etc.) While so many were piling on Benveniste, I actually checked some of the links in that Wikipedia article and found what's below. It's derived from their Ref. 23, but you need the link http://pagesperso-orange.fr/thiacytidine/homeo/ennis_1.pdf.

It's just the sort of thing I heard at the NIH talk. (BTW, it is reckless and close to libel to presume "dishonesty" from unreplicable results per se.) They say that very high dilutions had a significant effect. Well, maybe that isn't really what happened, whatever, but the point is: do you know? (Nor am I'm not insisting it is valid, and shouldn't have to keep explaining that to careless misframers.) But it's glib to just say "there isn't evidence of" ... Why not the below? Are you really qualified to know? Maybe, but why should I take your word for it?

Inflamm. res. 48, Supplement 1 (1999) S17–S18
1023-3830/99/010S17-02 $ 1.50+0.20/0
© Birkhäuser Verlag, Basel, 1999
Inflammation Research
Inhibition of human basophil degranulation by successive histamine
dilutions: Results of a European multi-centre trial
P. Belon1, J. Cumps2,M. Ennis3, P.F. Mannaioni 4, J. Sainte-Laudy5,M. Roberfroid6 and F.A.C.Wiegant 7

1 Boiron, 20 rue de la Libération, F-69110 Sainte-Foy-Les-Lyon, France
2 UCL 7369, 73 avenue Emmanuel Mounier, B-1220 Brussels, Belgium
3 Department of Clinical Biochemistry, Institute of Clinical Science, The Queen’s University of Belfast, Grosvenor Road, Belfast BT12 6BJ, UK,
Fax +44 12 32 23 61 43, e-mail: m.ennis@qub.ac.uk
4 Department of Pharmacology, Viale G. Pieraccini 6, I-50139 Florence, Italy
5 Cerba, F-95066 Val d’Oise cedex 9, France
6 Laboratoire de biotoxicologie, UCL 7369, 73 avenue Emmanuel Mounier, B-1220 Brussels, Belgium
7 University of Utrecht, Department of Molecular Cell Biology, P.O. Box 80.056, NL-3508 TB Utrecht, The Netherlands

Introduction

The biological action of ultra high dilutions is controversial
[1, 2]. Inhibition of anti-IgE induced basophil degranulation
by successive histamine dilutions is of interest, as it studies a
chemically defined compound (histamine) which exerts a
negative feed back effect via the histamine H2 receptor. The
biological activity is measured using the human basophil
degranulation test, which is relatively simple to perform and
does not require specialised equipment. Inhibition of basophil
degranulation was observed with histamine dilutions
ranging between the 15th and 19th centesimal dilutions. Since
most data were originally obtained from only one laboratory,
this study aimed to verify these results in a multi-centre trial.
...
Results and discussion

A total of 3674 datapoints were collected from the 4 laboratories,
of which 840 were invalid at the 0.1% level of risk.
Combining all data in the presence or absence of histamine
dilutions, the overall effect was highly significant
(p the lowest anti-IgE concentration (0.04 mg/ml) was the best
for the observation of inhibition. At this concentration, there
were 772 valid data points.
Using the GLM procedure, the overall effect of all histamine
dilutions (15th–19th centesimal dilutions) was significant
(p = 0.0001, F = 40.07) (Table 1). The normality of the
distribution of the basophil counts was verified using Henri
plots for the control but not for the histamine-dilution treated
cells (data not shown). Non-parametric analyses (Kruskal-
Walis test) confirmed the inhibitory effect of histamine
(p These data confirm previous findings that histamine, at
very high dilutions, inhibits anti-IgE induced basophil degranulation.
In 3/4 of the independent laboratories a statistically
significant inhibition was found and in the fourth
laboratory the results approached significance. Overall there
was a small but statistically significant percentage inhibition of anti-IgE induced basophil degranulation.

The test solutions were made in independent laboratories,
the participants were completely blinded with respect to the
content of the test solutions and data analysis was performed
by a biostatistician, who was not involved in any other part of
the trial. The method to assess basophil degranulation has
been a matter of much controversy, however in this study
we have attempted to remove areas of potential problems [3].
We are further investigating this phenomenon using flow
cytometry [4, 5].

Acknowledgement. Dr. Ennis gratefully acknowledges the financial support from the Royal Society to attend the European Histamine Research Society meeting in Lodz, Poland. [!]

References
[1] Linde K, Clausius N, Ramirez G, Melchart D, Eitel F, Hedges VL,
et al. Are the clinical effects of homeopathy placebo effects?
A meta-analysis of placebo-controlled trials. Lancet 1997; 350:
834–43.
[2] Doutremepuich CH, Aguejouf O, Belon P. Effects of ultra-low dose
aspirin on embolization in a model of laser-induced thrombus
formation. Seminars Thromb Hemostas 1996; 22 Suppl 1: 67–70.
[3] Sainte-Laudy J. Standardization of basophil degranulation for pharmaceutical
studies. J Immunol Meth 1987; 98: 279–82.
[4] Sainte-Laudy J, Belon P. Analysis of immunosuppressive activity of serial dilutions of histamine on human basophil activation by flowcytometry.
Inflamm Res 1996: 45 Suppl 1: S33–4.
[5] Sainte-Laudy J, Belon P. Application of flow cytometry to the analysis..

Posted by: Matt Penfold | June 12, 2009 1:55 PM

Neil B,

Despite your claims to the contrary you do not understand how science works. You cannot just say there is no evidence to show I am wrong in support of a claim. To support a claim you need evidence the claim is correct. If you want to claim water has memory you need to show that it does, and you need to explain your methodology in such a way others can replicate your experiments. If they do so, and they do not get the same results then your claim is in serious trouble. When you are unable to reproduce the same results in your own lab, when placed under scrutiny by people from outside your lab then you have serious
questions to answer.

You mention this NIH talk again. You now need to tell us the following.

1. When and where did the talk place. Precise location and time is needed.

2. Who gave the talk.

3. What study did they cite.

You have been asked for this, but have failed to supply us with the information. Should your next reply not have it, then I will conclude the talk is a figment of your imagination.

Posted by: Knockgoats | June 12, 2009 1:56 PM

Neil B,
The "P. Belon" who is first author on that paper is "research director" of a company supplying homeopathic remedies, Boiron. As I said, the only apparently successful replications of Benveniste's batshittery come from teams including members of his original team. That's after more than 20 years. Please stop inflicting your stupidity on everyone.

Posted by: tsg | June 12, 2009 1:59 PM

Neil B, you're entire argument hinges on a semantic definition of what it means to know something.

All knowledge is conditional. It is you that is putting an undue certainty requirement on the statement "there is no X" and insisting that's what others mean when they say it. It isn't true.

"There is no X" is very easily refutuable: show me X. The rest of your argument is a red-herring and shifting the burden.

Posted by: gf | June 12, 2009 2:03 PM

@81: I KNOW!!

We need to make sure that all doctors know and are honest about this too though.

I am not arguing against the scientific method, I am arguing that too often 'mainstream' doctors and medicine are willing to go beyond what is shown by the evidence, and that this can serve to discredit science generally to many of their patients.

I think many 'rationalists' are too quick to consider any claim made by a mainstream doctor to be a part of 'science', and do too little to attack that quackery that is still a part of western medicine.

I am not saying that the fact doctors did not know what caused stomach ulcers shows western-medicine is a flawed endeavour. But I do think the fact that mainstream medicine was so contented to conclude that as they did not know what caused the ulcers, it was probably psychological and their patients own fault for not relaxing more, shows that there were (and I believe still are) problems in the culture of western medicine that leads to irrational and unsupported claims being made and accepted.

@ 79 cynic:

I don't think that the evidence shows anti-depressants are useless, or should never be used. In talking about mental health, it would be very easy to move slightly off-topic here, or be easily misunderstood talking briefly about a complicated topic, but really, I agree with everything in your post, and don’t see it as conflicting with anything I believe or have said.

Re cfs.etc: indeed, these are still largely mysterious illnesses of which we are ignorant of causes and treatments. But look at the history for them. It is only now we have MORE evidence that the mainstream medical community is being forced to accept its ignorance. For a long time, doctors were telling patients that they knew what was wrong, and all the patient had to do was follow a Graded Exercise program and they’d be better. There is not the embrace of uncertainty and doubt within the medical community that their should be amongst true rationalists. Still now, many doctors treat CFS/etc patients as malingerers who just need to pull themselves together because it’s not yet been proven that this is not the case (although I think there’s now a fairly universal consensus amongst specialists that this is not the case). There is not enough of a culture within the mainstream medical community of condemning doctors whose treatment of their patients is based on their personal beliefs and prejudices rather than simply the available evidence.

Re stress ulcer: Yes, the science was incomplete, but again, the mainstream medical community was content to pretend it knew more than it did, with more certainty than the evidence permitted.

Going beyond the evidence should be seen as unacceptable – it doesn’t matter if it’s being done by crystal healers, atheists, priests or doctors. Some people on here seem to take a more tribalist view of ‘our-side vs. theirs’ in a way that surprises me, and that I’d previously thought had been a stereo-type and straw-man of atheists created by the religious.

Posted by: Stu | June 12, 2009 2:06 PM

(BTW, it is reckless and close to libel to presume "dishonesty" from unreplicable results per se.)

It most certainly is not, especially if you throw in conflict of interest (as in your example). What the fuck is wrong with you?

They say that very high dilutions had a significant effect.

I say your brain dissolved.

Well, maybe that isn't really what happened, whatever, but the point is: do you know?

Do you?

Again, "no evidence" means "no evidence". What is so hard to understand? What on earth are you trying to accomplish here other than making a complete fool of yourself?

Posted by: Neil B ☺ | June 12, 2009 2:09 PM

I wrote " ...versus that person claiming an effect himself." Nor would it be the same issue as the general principle of what justifies belief etc., not just me making the claim. Arguments about bodies of evidence are not to be conflated with arguments over good rules for finding evidence, etc.

Posted by: a_ray_in_dilbert_space | June 12, 2009 2:13 PM

Neil B., If we are to assess claims scientifically, the claims must be phrased in a way that is falsifiable (in this case the claim really is simple enough to fall into the Popperian paradigm). Most likely, it will not be a straight claim of causality-- A causes B--but rather a statistical claim--A increases the likelihood of B.

To assess statistical evidence you have to have a competing hypothesis called the null hypothesis--say B is not significantly less likely in the absence of A. You also have to control for effects like the placebo effect (e.g. by using placebos, controls, etc.), bias by the researcher and/or subjects (e.g. by double-blind trials) and so on.

The basic problem is that we humans like to lie to ourselves--give ourselves comforting reassurances that we've found ways to cheat pain, illness, death, poverty, fear... It allows us to cope, but it makes it very difficult to assess effectiveness of treatments on human subjects.

To date, no "alternative" therapy has been shown to be more effective than a control or placebo--that is why they are still "alternative".

Posted by: Matt Penfold | June 12, 2009 2:15 PM

"Good Lord (so to speak) Matt P, you still don't get the difference between a person questioning other people's confidence in the status of the data about an effect, versus that person claiming an effect himself. *They are not logically the same problem, I am doing the former and not the latter, and please (and others) quit getting mixed up all the time.*"

No, I get it all right. You think that unless one has evidence that water does not have memory one should consider it does. You still do not understand how science works.

"Finally, you last little indulgence about an NIH talk is silly. People forget details about things like that all the time, but I do remember it was in the 90s and definitely given at Jefferson Lab - then CEBAF - by IIRC an NIH rep, who was indeed a female ;-) You forget things, people do, it is stupid to consider something forgotten as a figment of anyone's imagination per se."

I am quite happy to accept you have forgotten the details. I also note your lack of honesty, in that it was you, not us, who made the claims about this talk. In doing so it is expected you could provide the information. That you could not tells us much about your credibility. Do you now withdraw your claims this talk supports anything you have to say ? You see either you need to provide us with the details of this talk we have asked for, or you need to admit it was dishonest of you to mention it.

Posted by: Stu | June 12, 2009 2:20 PM

Finally, you last little indulgence about an NIH talk is silly. People forget details about things like that all the time, but I do remember it was in the 90s and definitely given at Jefferson Lab

And as we have repeatedly told you: nobody gives a shit, because it doesn't mean anything.

The bottom line is, you don't know what happened there and so don't have any basis for considering it anything at all

Okay, everybody out of the pool. Neil, please go look up "science", "evidence", "reproducability" and "reality" up in a dictionary before you say anything more.

Posted by: Marcus Ranum | June 12, 2009 3:39 PM

At $2+ billion, it's now officially "big CAM"

I am willing to serve as a "big CAM shill" - please contact me if you want my rate card. I'm much cheaper than HRH Prince of Wales.

Posted by: Xenithrys | June 12, 2009 4:04 PM

gf @ 43 said: "My grand-father went to his grave been told that the terrible pain he sufferend from stomach ulcers was his own fault, because of stress. Now they've found it's actually a bug easily treatable with a pill."

They? You mean scientists! Not homeopaths, chiropractors, acupuncturists, but scientists. It's because of science that you probably won't go to your grave suffering from ulcers (unless you reject evidence-based medicine that is, which sadly seems to be the case).

Posted by: vt | June 12, 2009 4:16 PM

As a layman, [I have a master’s degree in computer science, but a very limited background in life sciences], how can I differentiate between accepted consensus in the scientific community vs. quackery?
It seems to me that I would need to spend at least tens, if not hundreds of hours researching an issue in order to figure this out. Maybe this is not as hard as I’m imagining it would be, but I’m thinking that if I wanted to evaluate a claim (for example: ‘I can increase my lifespan by eating a restricted calorie diet’, or (just for fun) ‘autism is caused by an inability to digest grains, and can be cured by a Paleolithic diet), I would need to figure out:
1. Where to look for research studies that may have been done on this topic.
2. How to tell the difference between a respected peer-reviewed journal vs. a publication that is propaganda published by a drug company, or some fringe group.
3. I would need a refresher course in statistical methods to be able to understand how compelling (or not) the results of a particular study were.
4. Still, due to my inexperience with the subject matter, I might not recognize whether a study had a flawed methodology.
It sure would be nice if there was a website (like snopes for scientific research) that could help laymen differentiate between claims that have been proven vs. claims that have been debunked, vs. claims that have not yet been researched.

Posted by: Gingerbaker | June 12, 2009 4:32 PM

gf @ 103:

"I really don't know why you think I said that anti-depressants are never more effective than placebo. That's not what I believe or wrote. I certainly think that they can be helpful for many people."

I think it was when you accused the guys in white coats of quackery, and gave as an example the cases when antidepressants are not more effective than placebo. It was easy to misunderstand you, but misunderstand you I did. Sorry.

I used to be a pharmaceutical sales rep. I got to know a lot of physicians, and I can tell you that the vast vast majority took their profession very seriously, were sober in judgment, and never prescribed a treatment that they did not have some pretty good reason to try. the few docs that were different were invariably D.O's or specialized in alternative medicine.

On the other hand, MD's are not required to only write prescriptions for drugs for the specific indications for which they are approved. And many docs keep abreast of the literature, so they are aware of small promising studies where a medicine or treatment is used in new ways.

Medicine is evidence-based, but it is also an art. If no better options are available, many a doc will try an unapproved med or technique because it makes biological sense, or there is some experimental evidence to think that the treatment might work. Not every treatment they use is guaranteed to work in most patients - sometimes the best medicine is hit and miss.

To garner a new indication for an existing drug is often prohibitively expensive for a pharmaceutical company. I knew some docs who tried an approved medicine for an unapproved use based on published research in animals. One doc was using antibiotics to treat stomach ulcers and this was more than twenty years ago. Another doc was getting very good results for his colitis patients with an antidepressant. This sounds very much like the kind of situation you were criticizing? This was a good doc doing good work outside of a clinical study. Not every patient responded, but for those that did, the results transformed their lives.

Have I missed your point again? :D

Posted by: Mike Olson | June 12, 2009 5:14 PM

Rogue Medic's bit is both hilarious and frightening. I suppose my problem is that I've got a really difficult time believing anyone in the 21st century in a supposedly 1st world country is buying into evil spirits, hauntings, energy waves, frequencies or other odd circular mumbo jumbo. It's a joke right? Only an idiot would buy into this, right? I think I'm going back into that basement closet to hide until rational thinking once again has popular support.

Posted by: gf | June 12, 2009 5:31 PM

@ sastra 109:

Hmmm. So if a doctor is promoting nonsense cures because they're biased, inattentive of the evidence, pigheaded, ignorant etc... that's not quackery, so long as they are within the mainstream system? I think that, to me, it is still quackery.

I don't think I see western medicine as being as closely tied to the scientific process as you seem to. It has certainly moved that way, especially with medical research, but historically it has not been and culturally I still do not think it is, certainly not on the front-line where most people come into direct contact with it.

I suppose these are periphery, subjective or semantic matters though.

re a system of checks and balances: these may move on particular instances when new evidence is discovered, but the culture of exaggerated certainty remains. There does not seem to be any in-built check or balance here, and it's been a problem with medicine for a very long time. I think it is a serious problem that anyone concerned about the honest presentation of science should be worried about.

I certainly would not feel comfortable telling an alternative therapist that they should accept that their fake cures and unsupported claims are any worse than the fake cures and unsupported claims of the mainstream medical community because they’re within a more effective self-correcting system. It sounds too much like special pleading. I think it is best to be equally condemning of all claims unsupported by the available evidence.

Re “I think pseudoscience is wrong in a more serious way than sloppy science is wrong.” I think that the sloppy science to be found within medicine, when combined with the exagerated certainty which seems to be an accepted part of mainstream medical culture, is even more dangerous than alternative therapies, as it serves to discredict science and rationalism in the eyes of many of it’s victims. If you go for acupuncture and it turns out to be rubbish, it’s bad, but few people use these therapies as a replacement to mainstream medicine. If your doctor starts making false claims and misleading you, that can be truly terrifying and isolating at a time when people most need someone they can trust. Also, given the power doctors have within our societies (disablity benefits, gatekeepers for expensive treatments, etc) any false beliefs allowed to linger within mainstream medicine could potentially lead to harm in a wide range of areas.

(@ anyone just reading this post: it was replying to a specific post, and if read in isolation could seem instinctively opposed to western-medicine. This is not the case, I just think that there are specific instances where western medicine has and does slip over into faith based nonsense, and that these instances should be treated the same as any other type of nonsense. Of course, taken as a whole western/mainstream medicine is massively preferable to any alternative.)

@110 xenithrys + 111 Marcus Ranum: good points. Maybe I’ll stop hating all science and scientists now. Top marks for reading and comprehension.

This is beginning to piss me off. Do you just assume that anyone who thinks mainstream doctors make mistakes, or there are any systematic problems with western medicine are nutty river worshipers? I know that western medicine has done a lot of good things, that doesn’t mean it’s perfect, doesn’t mean we should not be sceptical of the claims of doctors, and doesn’t mean we should have faith in it.

I’m an atheist who normally spends time on religious sites (I like to talk to people who disagree with me), but some of you guys are nearly as bad. I know that people are psychologically drawn towards misplaced certainty and that acknowledging our ignorance and the uncertainty inherent to much of life can be emotionally unappealing, but I still expected more. You’ve got a bit of a faith based community going on here.

@114 gingerbaker: I never meant to imply that all western doctors were quacks. It’s just that I think some are, and the culture of western medicine still has flaws within it which allow certain false ideas about reality to flourish in an unscientific manner. People here seem used to certain arguments, and seem to be imposing them on my posts. Maybe I'm used to writing posts aimed at the religious, and need to cover myself in a different way than I'm used to? Thanks for taking the time to look back though.

I’m sure that there are many good doctors, but I also think it is a very difficult job to do properly, intellectually and emotionally, and I don’t think many people are able to do it well within the system we’ve created. (‘Well’ could be misinterpreted: ‘Excellently’?)

Where medicine stops being science based, I think doctors have a responsibility to make this clear to their patients. Too often, the art and science of medicine become blurred together, and I do not think this is acceptable. If doctors and patients talk honestly about unproven treatment options, and then decide to give it a go, that would be fine. When doctors allow their beliefs to be guided by their own prejudices, anecdotal evidence, ignorance, etc; but present their claims as being science based, I think that this is quackery.

Posted by: gf | June 12, 2009 5:46 PM

@119: Once again, someone's claiming I've said things I haven't.

Anyway, I think most alternative therapists really believe their therapies work. The fact they decieve themselves as well as their patients doesn't make it acceptable. Incompetence = Incompetence, and it doesn't matter what their job title is.

Posted by: tim gueguen | June 12, 2009 7:56 PM

Ooops, that should have been "Looking through the travel section of a local bookstore...."

Posted by: Jim | June 12, 2009 8:46 PM

Sodium citrate is used as a clear antacid prior to surgery. In a plastic disposable one-ounce medication cup, sodium citrate looks an awful lot like an ounce of "aromatherapy" moon-juice.

There is some evidence that sodium citrate somewhat lessens the risk of acid aspiration pneumonia.

That is not true of the aromatherapy moon-juice which the woo nurse decided to put into the plastic disposable medication cup.

I know, post hoc ergo propter hoc. I'm just sayin'...

Posted by: Zetetic | June 12, 2009 9:20 PM

@ Neil B:
Of all the things in CAM to support...Homeopathy? Really? I mean for herbs there is at least a reason to think that it might work, and there is research that at least some of them are somewhat effective. Homeopathy can't make that claim, at least not honestly.

It's based on nothing but a string of logical fallacies from the days of pre-scientific medicine. This is why the scientific consensus is that it's just a placebo, as has been the conclusion of the vast majority of studies on homeopathy. The few studies that show an effect beyond a placebo, ether had serious flaws, or couldn't repeat the results.

This is why one of the important criteria in science is for a result to be repeatable. It cuts down on human error, confounders, and cheating.

If you really want to support homeopathy though, please start by telling us what part of it makes any sense if you're trying to make something more effective that a placebo.
For example...caffeine diluted to the point were there isn't even a single molecule of it left, makes you sleepy? Water retaining the "memory" of a chemical, but only the chemical that you want it to, not others? Yeah right...

Posted by: Zetetic | June 12, 2009 9:27 PM

damn... #126 should have read "more effective than a placebo.

Posted by: Nerd of Redhead, OM | June 12, 2009 9:36 PM

Neil B still thinking he is the smartest guy posting (false by a long way), and still peddling woo. Wrong blog for that combination.

Posted by: Rorschach | June 12, 2009 9:47 PM

way back @ No 3,

File this one next to the non-hand-washing doctors in the UK (Islamic religious prohibition on alcohol, see?).

Not true,if i remember correctly this was about female interns/students exposing their arms to wash.

Sodium citrate is used as a clear antacid prior to surgery.

Where?

@ 93,

I know anecdotal evidence isn't proof of anything. There was no negative control, the situation was not properly monitored, and it wasn't a proper scientific experiment. It did, however, make me wonder if there was some possibility, however remote, that magnets could improve healing. I would never cite that single example as proof, but it did cause me to raise questions.

This the kind of muddled thinking that makes homeopathy,reiki and all this other altie medicine possible.

Posted by: Neil B ♪ | June 12, 2009 10:17 PM

Zetetic, that's not a bad answer. That says what the right approach is, it doesn't show that it was actually done by those who went around saying "there's no evidence for ..." so much. That was my essential challenge per se. I don't know whether for example homeopathy works or not and wasn't insisting it did, just using it to needle people about their assumptions. I can see it's logically doubtful, but that wouldn't justify assuming and claiming things about the body of evidence - it's the principle of the thing. As for the "talk", I just happened to remember some things I heard and wondered if anyone at least also remembered what research was done.

The bigger issue is how well we can believe claims about evidence itself in general. (Again, not the same issue as claims about the rules of evidence! The first is phrased as, "most studies support the claim X", and the latter as "the right kind of study of X would work such and such a way".) If you have logical reasons for doubt that makes it easier as in the case of homeopathy, but with many medical claims we can't possibly know what to believe on the face of it. It is not easy, to assess the body of evidence for a lot of things so we tend to believe experts who would know. That typically "works" but there are pressures to undermine that. And if e.g. someone can be careless or fake a "positive" claim, they might also fudge a "negative" claim because they don't want it to look good. Forget weird stuff for now, how about products from rivals? Medical research is very corrupted by $$, isn't that true?

Posted by: Zetetic | June 12, 2009 10:46 PM

@ Niel B:
The first problem with homeopathy, as I earlier pointed out is that there is absolutely no reason in anyway to think that it would work. None of it makes any sense at all, from it's fundamentals the same symptoms) through it procedures (that diluting the drug makes it stronger.

If you can cite anything about homeopathic methods that makes a lick of sense, please do so.

As for testing, it's not that hard. Just like in medicine you do a double blind study with controls. You do this to rule out the placebo effect (which all homeopathic treatments have been able to consistently show) and to measure it's effectiveness. As for pressure to get a desired result, that is why one study means very little in science. In science you want multiple studies done by independent parties, coming to the same conclusion. In modern medicine drugs and many procedures are supposed to be tested this way to determine it's effectiveness. When it's not, is when mistakes are made. When this is done with homeopathic treatments (in many, many studies from around the world) it is shown to be no more effective than a placebo.

The important point is that it has been tested over and over around the world, and it's been shown to be no better than a placebo. The few studies that seemed to indicate that it was more effective than a placebo had flaws that didn't properly control the study (and therefore were unreliable) or couldn't repeat the results. As I mentioned earlier, being able to repeat the results is very important in science.

That homeopathic treatments are able to elicit a placebo response is not in dispute, in fact it's the main reason why some people erroneously think that it works. Unfortunately, a placebo response means that it doesn't actually do anything (just as homeopathic methodology would lead us to believe), it means that the patient just thought that they felt better. Now thinking you feel better is all well and good, but it's still just in your own head. Frankly a standard placebo is just as effective, and much cheaper.

As to modern medicine being corrupted by money... you seem to be showing a selective bias on your part. Yes money can be a factor, but that is why independent studies from many countries (some of which have socialized medicine) are important in determining the effectiveness, or lack there of, for a treatment. As for homeopathic treatments, you seem to be leaving out that CAM is big business with lots of money on the line, far less control, far less regulation, far less testing, and far more emotional involvement. If you are looking for a reason to question the integrity of one side or the other, the CAM side is far more questionable.

Posted by: Nerd of Redhead, OM | June 12, 2009 10:57 PM

It's very easy to see if water has memory. Plop it in a NMR and check the spectrum. One peak implies no memory. Multiple peaks that are not spinning side bands imply memory, or changes in relaxation time. Simple experiment. Gee, it has been run. Guess how many peaks were seen? Homeopathy is woo woo woo!

Posted by: Zetetic | June 13, 2009 12:29 AM

damn... "Oh but Nerd, it's a special type of quantum memory"

BTW... I really wish that I haven't actually heard that as an excuse before.

Posted by: astrounit | June 13, 2009 3:27 AM

JThompson #29 says:

"So, the purpose of that trauma hospital is the patient laughing at the two grown human beings shooing spirits and rubbing a bowl while walking in circles, right?I have to admit, seeing that would cheer me right up. I'd probably laugh until they stormed out in a huff.
After all, a positive attitude is supposed to help you get well.So it sort of works. Just not the way they intend it to."

On the other hand, that kind of ridiculous display can send a patient right over the edge. It may NOT be amusing for many patients who just don't feel like laughing when they feel ill (or, in laughter, increases the pain) - especially when they are under the influence of interesting drugs that may heighten the revulsion...

A friend of mine long ago related a story to me about when he was laid up in critical condition after a bad motorcycle accident, and when the doctors decided his chances of recovery were remote, sent in the obligatory hospital clown, appropriately dressed in black-as-death garb - in the form of a minister.

He was so annoyed by the presence of this asshole speaking gibberish and conducting all manner of magic woo over his broken body (spinal problems, broken pelvis, both legs busted, both arms busted to the shoulder, half his ribs broken and some serious internal injuries including a lacerated liver) that he felt physically threatened. The assault by this "man of the cloth" almost made him pass out with rage.

On an ample dose of morphine that would have put most people into a coma, which my friend had a, ahem, certain - let us say an "advanced tolerance" which left him quite conscious - all it did was enhance the unpleasantness he experienced with this joker giving him his "Last Rights".

My friend said it seemed to last "forever", that it was "pure agony", that it was the worst sort of nightmare he'd ever experienced, and that he kept imploring him "go away". He repeated: "Go away!" "Get out!" "Get away from me!"

But the minister, preoccupied as he was with his VERY IMPORTANT RESPONSIBILITY didn't seem to hear him. Each time my friend summoned the fortitude to speak up louder, and each time more pain shot through him.

The minister - the death-clown attired in black - kept on with his spiel, never once noting his pleas. Finally, he screamed at him, "Don't you understand English??? Get the hell out of here!!!" He said that was the last thing he remembered of the episode, because he passed out. He didn't know if the minister ever heard him. But he was never again visited by any minister during the next 3 months in that hospital's trauma section before he was transferred to another facility. Fortunately, he survived...although with considerable chronic problems. (He has only been able to walk with the aid of crutches ever since, and he requires constant visits to clinics to keep him on pain and other medication to ensure that his severely damaged liver isn't cacking out on him).

Who knows how much extra damage that minister caused?

And how many "believer" patients who might otherwise have survived but noticed a minister flitting around them doing the preparatory "death-dance" to ensure the survival of their "soul" slipped away because they figured it was no longer worth putting up a fight to survive, and just let go, because the presence of the minister immediately implied to them that the docs figure they were goners?

If it doesn't explicitly have to do with the physical medical care of the patient, it is a potential HARM. Get RID OF IT.

Either that, or let scientists (not exclusively medical doctors) go into churches and other houses of worship to bring the alternative "good news" that the crap the ministers and priests keep filling the heads of their congregation with is not only unsupported by any evidence, but may actually harm their health...that there really is another and far more effective way to live that appeals to actual evidence rather than to figments of the imagination.

They have just submitted a bill to Obama suggesting the huge burden to the health and economy due to smoking tobacco. It seems a similar effort to stem the potentially even greater hazards to (both physical as well as mental) health and the economy posed by religion and all other forms of superstitious and pseudoscientific nonsense might be arranged. Unfortunately, addiction of any kind is a hard nut to crack.

Posted by: Matt Penfold | June 13, 2009 7:06 AM

"You are still confusing that issue with my actual point: how well do you know if there is such evidence or not. There should be an appreciation of that separate issue, "how well do you know the state of the evidence"- whether for example it is really true, as said elsewhere, that "alternative" therapy has been shown to be more effective than a control or placebo", that "there is no evidence" etc. IOW, what is the process for rightly assuring oneself, what is the extent or lack of evidence for something? Is that too hard for some people to fucking understand?"

Try reading about scientific research sometime. That is HOW we know what works and what doesn't. Do clinical trials, collect the data and then analyse it. Get others to check the methodology and analysis. Publish your results.

In otherwords DO SCIENCE.

Posted by: Neil B ☺ | June 13, 2009 9:03 AM

Matt Penfold, I now think I understand why I have often been misunderstood. When I said, "How do *we* know ..." I didn't mean, "we the community" via it's scientists. I don't have the personal wherewithal to do much experimentation - "to do science" instead of just reading about it. I meant, how does a given individual like you or me know what the status and quality of the extant evidence is.

My bad then. I appreciate your civil response just above, in light of all the snark from me and others above. If people thought I meant "we the community", then their answers were mostly pertinent to that question. So subsequent arguments were mostly a sad misunderstanding. I should have said: "How does a given individual [presumed to be lay, as a contrast to the actual investigators] find out whether there's good evidence for X around" etc. Clearly the task for the latter involves not much in personal research, but looking into journals, reading what experts say, etc. and forming conclusions (not certainties for the most part, I know that.)

That's what I meant, when I asked people if they (as mostly ? "readers" here) were sure about what evidence had or hadn't been amassed. (That issue should still be dealt with directly and candidly, even when there's a theoretical case against something - as a "matter of principle.") I also still think the process is not as simple or reliable as many presume, due to various complications. And yes, various corrupting influence do exist, bias or not in my mind - we know that. That makes learning the truth about medical issues harder than for physics.

As for the placebo effect, @ 147: I realize it's hard to even define the PE when the whole issue is about "doing nothing" versus a "real treatment." It seems hard to distinguish subcategories of "doing nothing" (rather, apparently nothing), but there are distinctions and they make the whole point. Like I said, the PE was observed as the difference in outcomes for patients given sugar pills etc. and told "this will make you better" v. patients not getting *anything at all* - where "anything" includes people telling them something, etc.

If you deny the PE, you are incredibly denying that psychological stimuli can affect people in measurable ways. What's controversial, is just what kind of affects are possible. Some have claimed dramatic cures (statistically of course, like regular cures!), others find that hard to believe. But the sheer existence of the PE is hard to deny.

Posted by: Tsu Dho Nimh | June 13, 2009 9:13 AM

Sounds like voodoo to me. Is the patient aware this is going on, and is the hospital and/or patient paying for this? Do the patients who hear the singing bowl (which by the way is taken from Tibetan Buddhism/Animist worship) have to pay their share? Are they sucking up the good vibes and keeping them from the patient?

The last time I did voodoo on a patient (really, I did!), we were all working pro bono, even the priest and the doctor who called him in.

Posted by: Tsu Dho Nimh | June 13, 2009 11:51 AM

@96

I do think the fact that mainstream medicine was so contented to conclude that as they did not know what caused the ulcers, it was probably psychological and their patients own fault

That's not the way it worked ... Helicobacter pylori (under other names) was under suspicion early in the 20th century because it was seen more often in stomach washings from ulcer patients than controls ... BUT it wasn't always seen in ulcers and was fairly common in patients without ulcers so there was no smoking gun. There was also no way to cultivate it, study it, and a lot of the current arsenal of diagnostic materials weren't available,

A large study in the early 1950s failed to show the bacteria in biopsies of ulcers in 1400 or so patients ... that was enough to squelch the idea for a while, until the Australian guy decided to revisit the issue. H. pylori was still being found as a "fellow traveller".

He figured out how to cultivate it in labs, and also found out that it doesn't hang around when there are ulcers in the mucosa (it moves to undamaged mucosa at the edges), which is why the 1950s biopsies from the ulcer centers were negative.

You will note that he went from idea to acceptance of the idea to Nobel Prize in under a decade, in an area where it takes 6-12 months to show the ulcer is caused or healed. As soon as he published how to grow it, a number of labs jumped on the idea like ducks on a June bug to replicate his studies. And they REPLICATED them, which is what counts. When labs D, E, and F find the same things you do, using only your written instructions, it's probably real. If you have to send staff over to show them the way, you aren't doing science.

Posted by: gf | June 13, 2009 4:20 PM

@sastra 123:

“I don't disagree that you're pointing out a real problem. But it's a different sort of problem. Doctors are in error because they're not following their own standards. With alt med, they're in error because they are following their own standards.”

I think that for me, this makes it even worse though. They profess to be following the standards of good science and are widely believed to do so, yet systematically fall short so that in the eyes of many of their patients it serves to tarnish not just themselves, but the standards they claim to value. Anyway, many alternative therapists will profess the standards of good science – many creationists will too. Words are cheap.

I’m sceptical as to just how commited many members of the medical community are to following the humbling ideologies of science. I have some sympathy for their desire to avoid doing so: when you’re dealing with a patients life, they may not react well to your honest uncertainty. They often have to deal with subjective and difficult to identify complaints. For many conditions it’s very hard to design and run convincing studies, and much is unavoidably left to interpretation. (And so on, and so on.) I think there needs to be greater honesty about the fact that doctors do often move beyond what is supported by the science. Who knows? - maybe introducing homeopathy etc could be a good thing: it reminds people that some mainstream medicine is on a similar level to this nonsense, and helps shake them of their misplaced faith. When your doctor says “Homeopathy is a good option for this condition” it’s a more cheery way of telling you that there’s nothing they can do. It might even help prevent doctors developing their own personal and potentially more damaging superstitions about how to treat patients desperate to try anything.

I think that by your definition, some of the problems within the culture of western medicine that I mentioned earlier would count as pseudo-science and quackery.

There seems to have been a re-occuring and unjustified assumption that when they do not know what causes an illness, it is psychological (or simply imaginary). There’s a general and widespread belief that the treatments available for many conditions are more succesful than they really are (although it’s difficult to know to what extent this is deliberate deception, justified by a desire to keep patient’s hope up). There’s an exagerated sense of certainty and an exagerated faith in their understanding of certain medical conditions. These are more cultural problems within the medical community than specific flawed conclusions, but that is what makes them so pernicious, and allows them to continue despite of the checks and balances which occur within most medical research. (I am primarily concerned here with practices amongst doctors and front-line staff, rather than the pursuit of knowledge by medical researchers, although the direction of research will obviously be affected by the beliefs of the medical community). These cultural biases do not stem from the misinterpretation of specific results, but rather are ingrained and institutionalised prejudices that are then often dressed up or falsely justifed in sceintific terms in a way which impedes the progress of further research and good science. Actually - I may be giving an exagerated impression of the extent to which these distortions are driven by the instituionalised prejudices of mainstream medicine, when many of them will simply result from the peculiarities of our own minds and the difficulties of any sort of medical practice, but regardless, I still think that we could do more to counter-act and pre-empt these problems. It seems quite normal for people to exagerate their own levels of knowledge, their own past success rates, and their likelihood of future successes. I think that science has effective mechanisms for restraining these impulses, but medicine (of all sorts) is lacking here. Some of the same problems can be seen in other professions were individuals have large ammounts of discretionary powers over others (Who watches the watchmen etc).

I’m not sure quite where you’d draw the line for mainstream medicine. A lot of the dietary advice promoted by western governments seems to be presented in a dishonest way, that downplays the level of uncertainty, and exagerates the ammount of control people have over their own future health. There does seem to be a widespread desire amongst people to exagerate the level of natural justice to be found in life, and the behavioural causes of many illnesses. It’s far nicer to believe that those whose poor health is ruining their lives had done something to deserve this fate, rather than acknowledge just how unfair and random these things are.

While many of these psychological distortions are widespread, their impact within the medical community will of course be especially damaging, and where they affect claims about reality which are being presented as science based, this is especially unjust.

When I talk of exagerated certainty, I mean that medical conclusions can be reached on very weak evidence, or even nothing more than tradition or prejudice, and then become an ingrained consensus with doctors pretending it is certainly true, despite the evidence not justifying this confidence. Even when the evidence could be considered to show something is likely to be true, there will often be considerable uncertainty as well, yet doctors often seem all too willing to gloss over our ignorance in a way that seems to me to be deceptive and faith-based.

To me, an awareness of the limits of our knowledge is a vital part of science, and a part not embraced by much of the medical community.

re special pleading: You’re talking as if all alternative therapists quite happily acknowledge that they have no interest in reality or the evidence. This is not the case, and many will claim their treatments are evidence based. You cannot start a discussion with them by saying “When mainstream medicine is shown not to work, that shows how great mainstream medicine is, when alternative therapies are shown not to work, that shows how great mainstream medicine is.” I think alternative medicine’s are a load of rubbish… but that’s not how you’d convince someone who disagrees. Some alternative therapists will claim that they are constantly working on improving their treatments: there are journals commited to doing so. Both systems have checks and balances within, and both have cultural distortions which allow nonsense to slip through. Certainly, the checks and balances within mainstream medicine are massively superior to anything from alternative medicine, but if (for example) a certain acupuncture technique was shown to be actively and dramatically damaging in some way, I think it would be stopped. I do not think alternative therapists would be happy to accept from the start of a discussion that they have no interest in reality.

@ Zetetic 125: You just seem to just be defending the scientific method. I am arguing that mainstream medicine needs to be more commited to this method and complaining about where the it seems to fall short of these standards while continuing to claim otherwise. I’ve never said anywhere that mainstream medicine as a whole should be seen as no more effective than alternative therapies: it’s clearly vastly superiour. But there are still areas where it is useless, and I do not think the faith claims of mainstream medicine should be given any more respect than the faith claims of alternative medicine.

@150: Again, that doesn’t contradict anything I’ve said or believe. The problem was not that western medicine did not know what caused stomach ulcers: there will always be gaps in our knowledge. The problem is that they pretended they did know. My Grandfather spent a lot of time in terrrible pain, made all the worse because he’d been told it was his own fault for stressing too much (what a stressful thing to be told!). If we do not know what causes an illness, we should be honest about that rather than slip into faith-based quackery presented as solid and proven science.

@anyone else: Please only reply to the things I’ve written rather than the things you think I might have meant. I’m afraid this post may be difficult to understand in places without referencing the other posts in this thread. Sorry, but I didn’t want to repeat myself, it took quite long enough to type as it is.

Posted by: Rogue Medic | June 13, 2009 11:04 PM

@gf #118

If your doctor starts making false claims and misleading you, that can be truly terrifying and isolating at a time when people most need someone they can trust.

Do you have any evidence that this is a significant problem?

You keep stating that this is meant to represent only a small portion of the medical community, but you keep making statements that give the impression that this is representative of evidence based medicine. You keep denying this is what you mean, then you follow those denials with similarly extravagant accusations.

The recognition of H. pylori as the cause of gastric ulcers (and further modifications to this theory) are used as examples of failures of science.

This is completely wrong. The ability of those using the scientific method to identify a cause that is different from what had been accepted, study it, present research to peers on these inconsistencies, and not be ridiculed, harassed, thrown out of their professional organization - this is science.

Evidence based medicine was not pretending to know what the cause was. They misunderstood. You keep using these bogus representations of evidence based medicine, then deny that you are criticizing all of medicine. This is nothing but a passive aggressive attack.

What would be the approach of alternative medicine to misunderstanding what works?

Alternative medicine does not make progress.

What treatments did alternative medicine offer as alternatives?

I'm going to take a wild guess and assume that the alternative medicine treatments did not include antibiotics, or anything demonstrably effective.

So evidence based medicine makes progress, but it is more like the frog climbing out of the well. He goes up a few feet, slides back a couple. Occasionally he goes up a couple and slides back a few, but overall the move is toward more accurate, more complete information.

On the other hand, alternative medicine is able to continue to use the same books as when the treatment was dreamed up. Progress is for others, not alternative medicine.

Which one is responsible for improving life span? The one adapting to new knowledge or the one claining that the ancient wisdom, that led to an early grave, should never change? Maybe I should ask a psychic.

Posted by: Rogue Medic | June 14, 2009 9:20 AM

As for the placebo effect, @ 147: I realize it's hard to even define the PE (Placebo Effect) when the whole issue is about "doing nothing" versus a "real treatment."

No.

Doing nothing = baseline or the no treatment group.

Placebo = doing something ineffective.

Real treatment = what has been studied and shown to surpass the placebo treatment.

In this study there was the baseline treatment that everyone received, there were also three groups that received treatment in addition to the baseline treatment. In this study, all three of those treatments turned out to be no more effective than placebo.

In other words, they are all placebos.

Real acupuncture.

Supercharged acupuncture.

Fake acupuncture.

No difference

It seems hard to distinguish subcategories of "doing nothing" (rather, apparently nothing), but there are distinctions and they make the whole point. Like I said, the PE was observed as the difference in outcomes for patients given sugar pills etc. and told "this will make you better" v. patients not getting *anything at all* - where "anything" includes people telling them something, etc.

If you deny the PE, you are incredibly denying that psychological stimuli can affect people in measurable ways. What's controversial, is just what kind of affects are possible. Some have claimed dramatic cures (statistically of course, like regular cures!), others find that hard to believe. But the sheer existence of the PE is hard to deny.

I was not denying the placebo effect. All alternative medicine that produces any kind of positive effect appears to be a placebo effect. There is the possibility that some alternative medicine will eventually be shown to be better than placebo, but there is no reason to believe that anything that has been thoroughly studied so far is any more effective than placebo.

Then there is the problem of what the placebo effect is. The placebo effect is the response of the patient to the expectation of getting better. This is oversimplified, but the placebo can be anything.

That is why alternative medicine does not beat placebo in experiments. There would have to be some effect from alternative medicine for it to do better than placebo in a controlled trial.

Anecdote is where placebo treatments look good.

Anecdote is what fools the brain.

Anecdote convinces us that it has the answer.

Then anecdote pulls the football away, again.

Anecdote is the optical illusion of experience.

Posted by: Nerd of Redhead, OM | June 14, 2009 12:37 PM

If it's thought anything longer than a twitter can be assumed to incoherent, that would explain a lot.

Posted by: Neil B ♪ | June 14, 2009 2:36 PM

"The fact that there are difficulties in assessing conventional medicines gives absolutely no credence whatever to the absurd claims of homeopathy."
You're right, it doesn't. I didn't say it did. "Problems" with credibility means, that it can be hard to know in general whether to believe studies on purely empirical grounds. We don't know how accurate the claims are if there are corrupting influences. If a researcher has a stake, that may corrupt its accuracy - that's a general point, it has nothing to do with the issue of "woo". The fact that I worked off an example where it did, is irrelevant to the overall point.

I may sound sophistical sometimes, but over and over you and many others misrepresent what others are saying or implying. You have little excuse not to understand a new argument, by itself, because you are too buzzed about what we argued about before that. It shows no "intellectual maturity." Nor do you understand the valuable "challenge" technique versus being a "peddler" or promoter of something. Gripe about "sophistical" all you want, you sure as hell aren't sophisticated enough.

This reminds me of what happens if I post liberal proposals on Redstate, LGF, Free Republic etc: the same type of partisans assume the worst possible interpretation, nor can they turn the corner. They can't believe your point can be just be what it appears to be - it always has to feed back into their paranoid fantasy of your "real" subversive purpose, etc. It's part of the classic flaws of the partisan, authoritarian personality type.

@154:
The recognition of H. pylori as the cause of gastric ulcers (and further modifications to this theory) are used as examples of failures of science.

This is completely wrong. The ability of those using the scientific method to identify a cause that is different from what had been accepted, study it, present research to peers on these inconsistencies, and not be ridiculed, harassed, thrown out of their professional organization - this is science.

But it shows that what many experts presume to be true, might not be after all. That implies caution about intuition-based (! how ironic) blanket rejection of all alternative-seeming claims. IOW, killing bacteria to stop ulcers is a sort of AM compared to previous assumptions. And sure, "science" at its best, by definition, will operate that way. But does it always?

Posted by: Nerd of Redhead, OM | June 14, 2009 2:47 PM

It's now paranoid to not think that doctors can be misled and misleading in the same way as the rest of us, or that the current structures of western medicine do not do enough to mitigate this? I need more faith?

Posted by: gf | June 14, 2009 3:14 PM

@162: Were you sceptical of your belief that I was incoherently defending alternative medicine, or had such an extreme distrust of modern medicine that it should be viewed as paranoid? What evidence led you to overcome this scepticism?

Posted by: Rogue Medic | June 14, 2009 5:07 PM

@Neil B 163

@156: You seem to admit the PE is real but then fall into confusion between the very existence of a placebo effect (in the sense I described, about expectations) with how well it compares to various claimed treatments and how it is a (false but pragmatically convenient) "baseline" to judge them against. Just put aside whether there are "real effects" from acupuncture, etc. (I wouldn't know, believe it or not.) The PE, per se, is "real" because it has been shown that people told they're getting something effective do better than those not told that, etc. Period. Don't mix up that idea with other things or arguments, and don't let the base definition get run over by the other contexts.

Read what I wrote again. The placebo effect is the change from baseline.

The placebo effect is the effect produced by the patient's expectation for the treatment. The placebo would be stronger for a truly effective treatment, but is there even with the completely ineffective treatments.

You claim not to know if alternative medicine is just a placebo, then you start making mistaken claims about what a placebo is.

There is not a huge problem in creating placebos to compare against any proposed treatment, whether the treatment is proposed by conventional medical personnel or by alternative medicine personnel. The treatment needs to show that it is better than the placebo, or it is a waste of time and money.

So far, the evidence on alternative medicine is that alternative medicine is just a waste of time and money.

Alternative medicine = No scientific basis.

Posted by: Neil B ♪ | June 16, 2009 8:11 PM

The point, goat-knocker, is that most people here were upholding traditional medicine as a paragon of virtue and trustworthiness. I reminded them much of it too was suspicious, not just "alternative medicine." And you still can't get the difference between defending something directly v. just needling overly confident critics of that something. And I don't enjoy wasting time to mop up puke from lousy arguers, nor does it help my ego much compared to real discussions at the good physics or poli blogs (like Washington Monthly.)