And this has been covered over and over again. Most of us agree with this as do the doctors and many other people who practice acupuncture. Nobody cares about the old theory except those who want to use it to discredit the current practice. Hence the discussion about a name change.
Not true. As discussed over and over again. This is a lie promoted by a bunch of pseudoskeptics using outdated information to prove their assertion that acupuncture is quackery.
For example, the National Council Against Health Fraud has an acupunture position paper. (Musicat referenced this group earlier.) Look, it’s only 27 years old! And who are these folks? A private group with their own “Manifesto.” The webmaster is Stephen Barrett and they’re affiliated with Quackwatch. This is a group whose position is that “acupuncture is quackery.” Not exactly objective or scientific in their material. Anybody who is getting their info from a group like this does not know anything about the* current * practice/evidence of acupuncture.
That’s why I said “most of us.” I know some people believe in chi and the meridians. I think that’s okay, too.
The point I was making is that nobody (here) is trying to provide evidence that the meridian theory is correct. The evidence discussed is about the efficacy of acupuncture treatments, not how acupuncture works. Continually pointing out that meridians are bunk is irrelevant and is just a tactic used to discredit the practice.
Oh my lord. How about not assuming I have zero respect for modern scientific method? How about that? Jeeez. You entirely missed the point of my post. Allow me to try agian.
I provided cites of medical treatments that at one time were considered valid and healthy. I wasn’t trying to make a logical statement that somehow proved that because some techniques failed, I was saying that other techniques were less valuable. What an odd interpretation to make.
I’m surprised no one has taken up my point that acupuncture may not be any worse, scientifically, than more standard treatments. I firmly believe that one ought always choose the best treatment available, where “best” is defined by a function of evidence and probable effectiveness weighed against risk and cost. In some cases, doing nothing may be the best treatment–it has zero risk and cost, and is very certain to be at least as effective as, say, psychic surgery. In other cases, acupuncture may be the best treatment available, even if the evidence for it is weak compared to the evidence, say, for asprin.
Lots of treatments, including most surgeries, lack rigorous double-blind studies proving effectiveness, and in many cases, such proof is either impossible or cost prohibitive to obtain. Any amount of reading about the evidence-based medicine movement will reveal just how lacking the evidence is for a lot of standard, common treatments. But some evidence, even anecdotal, is better than no evidence, and those standard treatments–or some alternative treatments–may still be the best available, based on the definition above.
Musicat and others, do you disagree with anything I’ve typed here? If so, why?
Any measure of risk has to be relative to a baseline. I would say that doing nothing has no risk by definition. It also has no benefit for something like a burst appendix. But it won’t be an overdose of “nothing” that killed you–it’ll be the burst appendix. Surely you could understand that from what i wrote?
The only way that doing nothing would be the best treatment is if the alternatives have their own additional risks or cost and little benefit. For example, when my back pain is mild, the best treatment is nothing. Taking an Advil is more effective, but not significantly (Mild pain tends to go away on its own in about the same amount of time it takes ibuprofin to kick in) and there is a cost in time, effort, and expense (admittedly all very small) to taking an Advil, as well as a slight risk of stomach irritation. Severe back pain may also be best “treated” by doing nothing, if the risks of surgery outweigh the expected benefit, I don’t want opiates, and NSAIDs/APAP aren’t effective. If the cost and risks are low enough, though, doing nothing may be edged out by acupuncture, which may (or may not) have some actual benefit.
Even in the case of malignant cancer, if the cancer is inoperable the risks/side effects of treatment may outweigh the benefits. Some people choose to forgo chemotherapy if the expected benefit is slight. In such a case, doing nothing or taking a safe but unproven treatment with little likelihood of success may be the best course of action.
I disagree with some of it. If you have any examples of “standard”, mainstream medical treatment that needs more double-blind tests, let’s have them. We certainly don’t need to cut off someone’s arm, then reattach it to see if that works. Is there anything which you feel needs more evidence, and should not yet be accepted?
With respect to Alan Smithee’s comment with which I disagree, “Some evidence, even anecdotal, is better than no evidence,” I would like to call your attention to How medical facts are developed, Why Some Are More Potent Than Others, by Rodger Pirnie Doyle . Since I can’t post HTML table code here, I will extract the data, but the original is far down on that linked page where it says, “Figure 1: Relative Evidentiary Value of Study Type for Hypothesis testing (Value of data (degree of acceptance by the medical community)).” Follows is a list, in sequence, from 100% down to 0%:[ul][li]Clinical trials[/li][]Cohort studies[]Retrospective cohort studies (if based on reliable historical records, including good information regarding exposure of individuals to the suspected disease-causing agent)[]Case-control studies[]Cross-sectional studies (some)[]Short-term human experiments[] Cross-sectional studies (most) []Ecological studies[]Animal experiments[]In vitro experiments[]Anecdotal evidence[/ul]Note the position of anecdotal evidence at the 0% position. If that is all you have, it’s worthless.
Those aren’t weasel words to make my statements seem plausible when they aren’t, they are acknowledgments that situations vary. If you want me to spell it out, fine: when other available treatments carry unacceptable risks and the condition untreated will necessarily deteriorate and cause great harm, a treatment that has no cost and no risk (compared to doing nothing) and even one hazy and unreliable anecdote is always and unquestionably better than doing nothing. Since every action in the real world carries some cost and risk and acceptability of risk and significance of harm are always subjective, this may (or may not) be relevant to any particular real-life situation. I already gave an example of on where I think it is applicable. Why wouldn’t it be?
I’ll respond to the rest of your arguments later–the risk of being on the Dope at work is getting unacceptably high, and this magic amulet for keeping bosses away doesn’t seem to do anything!
Alan Smithee, the only weight I can give to an anecdote is to suggest or point to where some effect might exist. Anecdotes do not help to prove anything, but might make someone say, “Hmmmm.” The next step is to gather what facts are available, make observations, create a hypothesis, and test it. Anecdotes cannot be a part of that test for reasons given earlier.
If you felt better after an acupuncture treatment, that might suggest that more study is needed, but it does not serve as proof the treatment performed as expected or validated any theory. Variables need to be reduced and controlled.
From your source: “Finally, it should be noted that testimonials are often used in many areas of life, including medical science, and that giving due consideration to such testimonials is considered wise, not foolish. A physician will use the testimonies of his or her patients to draw conclusions about certain medications or procedures. For example, a physician will take anecdotal evidence from a patient about a reaction to a new medication and use that information in deciding to adjust the prescribed dosage or to change the medication. This is quite reasonable. But the physician cannot be selective in listening to testimony, listening only to those claims that fit his or her own prejudices. To do so is to risk harming one’s patients.”
You are ignoring everything in this thread that doesn’t fit with your preconceptions. You are being unreasonable to the point where it’s quite obvious that there’s no point in discussing this topic with you.
Nothing I’ve said contradicts this! I am aware of the scientific method and thelimits of anecdotal evidence. Pleas show where I have claimed that anecdotes provide proof of anything. They don’t.
But you yourself admit that they do have evidentiary value: they suggest that “some effect might exist.”
When the options for treatment are all unproven but might have some effect, or the choice is between a treatment that might have some effect and nothing, or between a safe treatment that might have some effect and one that almost certainly does but could also kill you, which one would you choose? It simply doesn’t make sense to dismiss every unproven treatment regardless of the circumstances or the alternatives.
If you had terminal cancer, and a doctor you rust said to you, “I don’t think we can do anything to save you. I have these pills that might help. We don’t really have any evidence that they work, but there are some anecdotes that suggest they could prolong life and reduce suffering. There’s a study planned in a few years to see if they actually do anything. Based on the anecdotes, though, they have no side effects, and I’ll give them to you for free. Want to try it?” what would you say? What if instead of pills, the treatment was acupuncture?
Yes. But they are insufficient, without coorborating, stronger evidence, to prove anything, especially if the claim is otherwise doubtful. Note the list I supplied of evidence “strength”. Anecdotes are at the bottom of the list, very close to 0% in value.
So at what point do you discard evidence as worthless? Never? Do you cling to hope when other evidence is pointing to a different conclusion? “A wise man proportions his belief to the evidence.”
To reiterate, all they offer is hope. If hope is all you have, go for it.
I agree. Due consideration should be given. Questionable evidence should be given very little weight if better evidence is available. To continue your quote of my quote, “a physician will take anecdotal evidence from a patient about a reaction to a new medication and use that information in deciding to adjust the prescribed dosage or to change the medication. This is quite reasonable. But the physician cannot be selective in listening to testimony, listening only to those claims that fit his or her own prejudices. To do so is to risk harming one’s patients.” Absolutely. A physician may not have much more available than a patient’s (biased) observations.
"A wise man proportions his belief to the evidence."
Note that the anecdotal evidence referred to above is building on a clinically tested new medication.
Insisisting on using the scientific method is not a preconception. Believing in something without evidence is a preconception. “It must work - we’ve used it for ages!”
