I've gone on record as saying more times than I care to remember that there is no such thing as "alternative" medicine. There is only medicine. Indeed, the only reason any medicine is considered "alternative" is (1) it is on a scientific basis incredibly improbable and/or it comes from a pre-scientific "healing" tradition; (2) its efficacy is unproven in scientific studies and clinical trials; (3) its efficacy has been tested in randomized clinical trials and found wanting; or (4) a combination of (1) plus one or more of the other three. Of course, one argument that I have made before is that clinical trials are about more than just science; they are also about medical ethics. In practice, this means that it is usually unethical to test therapies that are highly improbable on a scientific basis in human subjects testing without compelling preclinical data in the form of cell culture and animal experiments. The reason is, absent such evidence, testing such therapies in humans is all risk, with, for all intents and purposes, no potential benefit.
Still, some believers in "complementary and alternative medicine" (CAM) keep trying to come up with the necessary preclinical data, no matter how incredibly improbable on a strictly scientific basis the CAM remedy being tested is. This is particularly true for a modality like homeopathy, which is so incredibly unlikely on a scientific basis, given its postulate that diluting and shaking a compound actually makes it stronger even when there isn't a single molecule of the original substance remaining. It's also true for reiki, the Japanese art of "energy healing," which has inexplicably become popular in academic medical centers and has even been used, for reasons that I haven't been able to figure out, in a major trauma center. Never mind that, for reiki to work, there has to be some sort of human energy field (i.e., qi) that can be manipulated by a master through time and space using the appropriate symbols and gestures. If it worked, it'd be a great thing, especially if I could send the healing energy into the past or the future, it'd be way cool. Too bad reiki is among the woo-iest of woo, and about as improbable as it gets. Indeed, it's nothing more than magic, complete with elaborate gestures, symbols, and incantations. Doctor Strange would be a good reiki master, just as he would be a good homeopath, given that reiki and homeopathy are in essence magic.
Still, I have to give woo-friendly "scientists" credit for one thing: They're so convinced of the magic of homeopathy or "energy healing" like reiki that they keep trying to demonstrate it scientifically. Indeed, I found a study published just a couple of months ago in which Gary Schwartz at that desert bastion of woo, the University of Arizona, tested reiki on rats.
My first thought upon seeing this study was to start to giggle almost uncontrollably. I don't know about you, but conjuring up an image of reiki masters doing all their hand gestures and symbols on laboratory rats strikes me as hysterically hilarious, particularly given all the effort the investigators went to to make this study seem "scientific." Still, Schwartz apparently wanted to test whether the application of reiki could alleviate the increase in heartrate that occurs because of the stress of the application of 90 dB white noise. Get a load of the methodology:
Six (6) male Sprague Dawley rats weighing 375 to 400 g were obtained from Charles River Laboratories (Portage, MI). Three of the rats had been implanted with PhysioTel® C50-PXT telemetry transmitters (Data Sciences International (DSI), St. Paul, MN) at Charles River Laboratories (Fig. 1). After giving the implanted animals 8 days to recover from surgery, all 6 animals were shipped to Tucson, Arizona. Upon arrival, each implanted rat was pair-housed with a nonimplanted rat in wire mesh cages (16 X 12 X 12 inches) with plastic bottoms. No data were collected from the 3 rats that were not implanted with telemetry transmitters; they served only as cage-mates for the implanted rats. Each cage contained a ramp leading to a wire mesh shelf (16 X 4 inches) and a piece of polyvinylchloride tubing (length = 8 inches, diameter 4.5 inches) for enrichment. The rat diet consisted of Harlan Teklad 7001 rat chow (Harlan Teklad, Madison, WI) and water that was deionized and chlorinated to 10 parts per million. Fresh food and water were available ad libitum. The same investigator performed all measurements throughout the whole experimental procedure, and the only other people who entered the room were the animal caretaker, who was instructed to perform his duties gently and quietly, and the 2 Reiki and sham Reiki practitioners. All research procedures and animal care were reviewed and overseen by the University of Arizona's institutional animal care and use committee (IACUC).
Wow. It sounds almost like science, doesn't it? Almost.
I'd have loved to have been on that IACUC. Really. It would have been a hoot. I'd have been asking this: You mean you plan on doing surgery on rats to implant these monitoring devices, and then you plan on doing magic on them to see if you can reduce their heart rate in response to the stress of noise? That's your experimental plan? I guess those reiki masters are really skilled. Not only can they detect and recognize human life forces, but they can detect rodent qi as well and fix it. I don't know how they do it, but those reiki masters are amazing, aren't they?
Here's the meat of the study, where it gets all "science-y":
For each experimental series, the implanted radiotelemetric transmitters were turned on by gently swiping a small bar magnet longitudinally down the chest. Cardiovascular data were recorded from the 3 implanted animals starting at 8:45 AM. At 9:00 AM, the animals were subjected to 30 minutes of 90-dB white noise. Data were recorded during the noise period. This procedure was repeated for the next 2 days. On the fourth day, the Reiki treatment was introduced; after the initial, quiet 15-minute period of data collection, each of the 2 Reiki practitioners performed Reiki for 15 minutes on a pair of rats. Next, they both treated the remaining pair of rats simultaneously for 15 minutes. The rats were then subjected to 30 minutes of white noise. For the first 15 minutes each Reiki practitioner performed Reiki on the same pair of rats they had treated first previously; for the second 15 minutes both practitioners treated the remaining pair of rats. Data were recorded continually during this process. The whole noise and Reiki procedure was repeated for 4 more days, making sure that the same practitioner did not treat the same pair of rats on subsequent days. After a 2-week rest, the whole 8-day procedure was repeated except that the 2 Reiki practitioners were replaced by 2 students who were not trained in Reiki. The students imitated the physical movements of the Reiki practitioners, and this procedure was termed sham Reiki.
This methodology brings up a number of questions. First, why did the third pair of rats get the bonus reiki treatment by both reiki masters at the same time? Were these rats made twice as mellow by the applications of double-strength reiki? If not, why not? One would expect that reiki, if it were real, would have a dose-response curve. Oh, wait. That's the nasty materialist skeptic in my talking. Reiki masters don't need no stinkin' dose-response effects!
The glaring flaw in this experimental methodology should be obvious. For the first treatment round, all three pairs of rats got reiki and all three supposedly showed effects. After the passage of some time, the three pairs of rats were then subjected to the same experiment, except with sham reiki practitioners. Of course, rats react to the presence of humans, and if the reiki masters were sufficiently soothing to the rats, that could have had an effect. Also, rats react differently to people depending upon if they've become acclimated to them through repeated contact or not. It wasn't stated whether the rats were acclimated to the reiki masters or not. Most importantly, though, there's no way of telling whether this is a period effect, or not. The time passage could be even long enough for seasonal effects. Who knows? A better experimental methodology would have been done to test two groups, reiki and sham, in parallel or to a two-period crossover design. As described, this study is well nigh uninterpretable.
Another strange aspect of this paper is in Figure 2, which shows the pulse rate data for one rat in response to reiki on five different days, I see extreme variability. On most days, the decrease in heartrate was in the 1.5% to 5% range, and on only one day was it 33%. Moreover, the data is presented in a most unconventional day. After all, if there were only three rats, there's no reason before-and-after data can't be presented for them all, but that's not the way it was presented. Instead, the authors presented linear regression of initial heartrate versus decrease in heartrate, trying to argue that the higher the initial heartrate, the more the effect of reiki. This is abuse of statistics, pure and simple. There is no reason to assume a linear model for decrease in heartrate as a function of initial resting heartrate. Also, a correlation coefficient of -0.68 is reported. Odd that the r2, the more appropriate metric, wasn't reported. It would have been 0.46, not nearly as impressive.
Of course, the worst flaw of all is the number of experimental animals used. Getting interpretable results from any animal study, particularly rat studies, with N=3 with each animal serving as its own control rather than a parallel control group is also pretty close to impossible unless the treatment effect under study is really, really strong. I guess that reiki's so strong that it don't need no stinkin' control group, either. Another aspect of this experiment is that there's no objective way to way to detect the difference between "real" reiki and sham reiki. What if one of the reiki master's magic wasn't working one day or one of the "sham" practitioners had somehow figured out how to administer a little bit of reiki? There'd be no way to tell. Also, those taking the measurements of heartrate and blood pressure were not blinded to when the rats were receiving reiki or sham reiki, another source of potential bias.
Basically, this study shows nothing. It doesn't even work very well as a pilot study. I will, however, agree with one thing the authors say. This probably is indeed the "among the most rigorous tests of the efficacy of Reiki that has been performed." Of course, if that's true, that shows you just how bad the data supporting reiki is.
Those of you who are regular readers probably wonder: Who funded this study? Those of you who are regular readers can probably already guess. In case you can't, though, here's the Acknowledgments section:
This research was supported by National Institutes of Health (NIH) grants R21 AT 1124 (A.L.B.) and P20 AT00774 (G.E.S.) from the National Center for Complementary and Alternative Medicine (NCCAM) and RR01 RR017358 (A.L.B.) from the National Center for Research Resources, and a grant from the Canyon Ranch Institute (G.E.S.).
Yes, indeed. This study was funded by the NCCAM. It's your tax dollars at work once again. Don't you feel as though you're getting your money's worth from NCCAM as it funds reiki masters focusing their magic on rats? (I still have trouble not giggling that that image brings to mind.) Aren't you glad our precious research dollars are being spent on a study like this instead of that nasty, materialist science?
Don't answer me. Answer your Congressman.
Although I recognise the necessity of animal testing, I feel strongly about the lives of animals being wasted on pointless crap like this :S
Won't help, I'm stuck with Danny Burton.
fusilier, who should be grading lab finals, right now.
James 2:24
Ugh. Rats. and I live in Arizona. fortunately I am separated from Woo-Central at the U of A by the distance between Phoenix and Tucson. Perhaps the Burning Stupid coming out of Schwartz's lab is the real reason Arizona is so hot ?
Woo-meisters. You shall know them by their friends.
DLC, I think you might have a point: There's so much burning stupidity that I think the emissions probably are contributing to global warming.
It is no surprise that Gary "I talk to the Dead" Schwartz would be involved in this. What I can't work out is why Prof Ann Baldwin, who has a long track record of actual proper science published in serious physiology (and related) journals , would be buying into this pile of bulls*!t. She is an animal behavioural physiologist, but that really doesn't explain the bizarre interest in Reiki hand-waving.
Of course, it could just be the money. But I would have thought that a successful lab working on cardiovascular diseases would be well enough funded that you wouldn't need to go chasing NCCAM's woo-dollars.
First, rats make excellent pets. They are clean, and love to be cuddled.
Second, feeding rats ad libitum means you will soon have obese rats.
Third, this is my hard earned tax money being wasted.
"The same investigator performed all measurements throughout the whole experimental procedure, and the only other people who entered the room were the animal caretaker, who was instructed to perform his duties gently and quietly, and the 2 Reiki and sham Reiki practitioners."
What about the janitor? How do we know that he didn't come in to mop, slamming around his bucket and cranking up "Bad To The Bone" on his boombox? Think how that could have skewed test results.
My personal stress level goes up whenever I am working late and the evening cleanup crew makes a racket. I blot out the noise with some good music on headphones - which leads me to wonder if rat stress could be relieved more effectively this way than with reiki. I think I'll apply to NCCAM for a research grant to design some tiny rodent headphones and do a project, measuring rat cortisol levels before and after playing them appropriate music (i.e. "Rats In My Room" by NRBQ and Michael Jackson singing "Ben").
So just how the hell did this get ethical approval?
I know the rules in the US are not as strict as in the UK but this is lunacy.
I suspect that in the UK a Home Office inspector would have written a rather terse reply to the licence application for this...after they'd picked themselves off the floor...and probably followed up with a few more unannounced site inspections than usual just to make sure that nobody is mad enough to actually go ahead with the project.
you have got to be f#%&ing kidding me.
as i was reading that, the first thing i wondered was who funded it. i also asked myself who would have published that garbage, and how the HELL that is justifiable grounds for survival surgery on rats.
disgusting.
As you point out, Orac, their bizarre regression is an abuse of statistics. The approach they used doesn't even address their research question. At all. All they have is a finding that initially panicked rats calmed down more than the others did, and this should be no surprise to anybody. I'd be hard pressed to come up with a statistical approach less germane to their purpose.
Perhaps this is why they published in The Journal of Alternative and Complementary Medicine?
I won't pay to read the article, so perhaps somebody else can tell us. Did they use any other statistical tests to compare the "real" reiki (sic) with the sham?
Has Gary Schwartz ever been involved in a well-designed study? I mean, surely at some point he learned about experimental design. right? RIGHT?
@ Dangerous Bacon,
Playing Michael Jackson singing "Ben" would be cruel, it would never pass the Institutional Review Board.
As if it needed repeating, the JACM is a standing joke. It is basically a house journal for Woo-meisters, with a Woo-friendly editorial board and Woo-friendly reviewers, a phenomenon I discussed for AltMed journals in general here. If JACM have expert peer review, you'd never know - or rather, the secret is in the words "peers". As in "expert" "peer" review.
The following two JACM "advertising tag lines" spring to mind.
"JACM: by Woo-meisters, for Woo-meisters" ....or:
"JACM: we never met a Woo we didn't like"
I am both relieved and gratified that my Univ does NOT have an institutional subscription. At least, not yet.
Can you say regression towards the mean boys and girls? Yes, I knew you could.
I don't quite understand why reiki couldn't be tested in a human clinical trial. I certainly understand that it would be unethical to substitute reiki for proven therapies, but surely it would not be unethical to test it as a supplement to those therapies, right? I mean, there's no risk to "treating" someone with reiki, is there?
[i]"First, why did the third pair of rats get the bonus reiki treatment by both reiki masters at the same time? Were these rats made twice as mellow by the applications of double-strength reiki? If not, why not? One would expect that reiki, if it were real, would have a dose-response curve. Oh, wait. That's the nasty materialist skeptic in my talking. Reiki masters don't need no stinkin' dose-response effects!"[/i]
There's a perfectly sensible explanation. You see, reiki-energy is managed and distributed by a omniscient úbermind. That's why everyone gets just the right amount of healing power.
I'm ashamed that I know all this about reiki.
And I'm not only a taxpayer in Arizona, but have this crap devaluing the degrees from UA held by my mistress and two of my children.
In sanctimoniously claiming that you claim that "there is no medicine but medicine," you apparently ignore (1) the widespread practice of "off label" prescribing, and (2) the also widespread practice of "inventing" new drugs or combinations of drugs that are no more efficacious than the old drugs, but which can be sold at higher profit because they cannot be genericized.
I am paying at least the tax on the high-priced gasoline I burn getting to my Doctor's office through the savings I realize by insisting on the "old" medicament, rather than the new, but not better, "replacement."
IMHO, "off label" prescribing would be a good topic for YFDOW.
"Off-label" prescribing is usually not non-evidence-based. There is almost always, although admittedly not always, a clinical and scientific rationale that makes sense behind such prescribing. It's nothing like reiki or homepathy.
So, here's a question for you. NIH funding is tight. You're grants are running out. Do you take a legitimate research proposal and frame it to submit for a CAM grant from the NIH? Lord knows, it wouldn't be hard to beat the crap out of most of the applications they're funding.
Mike
Speaking of "therapies that don't work", of interest:
http://news.bbc.co.uk/1/hi/uk/7520756.stm
I can see how people would be tempted, Mike. I have no axe to grind with people applying for the money, or doing the studies, provided they do them stringently, to proper standards, with proper experimental design and controls to exclude confounding effects... ...and then publish the findings in journals that will give the work a real, rigorous peer review by real, rigorous, skeptical scientifically-literate reviewers.
So my issue with the professional scientists authoring this work (I'm not including Gary Schwartz, who clearly is not a scientist) wouldn't be that they have taken NCCAM money, or done silly research on Reiki. It would be:
(tiny n numbers , lack of proper controls, iffy statistical analysis)
... and then
Of course, the answer to the second question largely follows automatically from the first.
Now, for Gary Schwartz we already know the answer to both questions. He is a true believer in Woo and long since handed in his critical faculties. But the other participants... where has their scientific skepticism gone?
Perhaps I should pronounce "Dr Aust's Law of Published Woo-science:"
I guess they did not have a chance to read this systematic review of reiki and its exhortation that future research "should adhere to rigorous trial designs which are adequately suited to the research question that is being asked."
None of which addresses the real question - would Master Splinter have rodent ki or human ki?
I see you your reiki-for-rats study, and raise you a study about how rats are soothed by Pyramid Power (includes pictures of rats in pyramids).
I've had an extended shot at the "mellow rats in pyramids" paper Rob Hinkley mentions in my post on Cargo Cult Alt.reality journals that I linked to above (note shameless self-bigging). A proper animal behaviourist wrote in and pointed out that the explanation for any "pyramid anti-stress effects" was most probably the amount of "enclosed cover" provided for the rats by the pyramid shaped-box.
Predictably the authors of the paper did not discuss this plausible but Woo-free explanation. They (and presumably "Evidence-based Complementary and Alternative Medicine"'s referees) preferred to postulate that pyramids might have mystic soothing powers unknown to regular science and medicine.
Like they say, Woo-garbage in, Woo-garbage out.
I'm ashamed to say that I had an opportunity to point out how ridiculous reiki is at a family gathering last year, but I passed on the opportunity in order to avoid arguments.
Also, don't go hatin' on Doctor Strange.
Hatin'? I love Doctor Strange. I have a large pile of old Doctor Strange comics in my basement dating back to the old Strange Tales days in the 1960s.
Those of you with access to the article, have a look at Figure 3.
Looking at the side-by-side graphs, it seems obvious that the variance of starting heart rates is significantly smaller for the sham Reiki treatments than for the Reiki treatments. But since this is the starting heart rate, we would expect the distribution to be the same, unless the rats response to white noise has attenuated during the course of the experiment (which it almost certainly has).
Also, there are 15 data points for the Reiki treatment and only 12 data points for the sham Reiki treatment, but their protocol seems to indicate they should both have 15 data points. What happened to the other 3 sham data points? I can't seem to find an explanation for their exclusion in the paper. Whatever the reason, it is misleading to say that the treatment was statistically significant and the control wasn't when the sample size of the treatment is larger (and thus more likely to be significant) than the control.
Anyone got the PDF? Would appreciate a look-see.
draustblog *at* gmail-dot-com
One thing not even addressed is the fact that their baseline experiments were performed by telemetry activation followed by 15 minutes rest time, then noise. In the reiki portions, there was telemetry activation followed by 15 minutes rest, themn 30 minutes reiki, THEN noise. There's a big difference between 15 and 45 minutes rest time and this aspect is completely ignored in the study.
I know an actual Reiki practitioner, although he has not tried it on me. However, a mutual friend swears he cured her of sore shoulder or something (I've forgotten the details). The sad thing is that my feelings about my friend have changed somewhat since she described this incident to me. She's really a nice person, but I just don't feel the same about her. Does that make me a snob?