If there are 99 different diagnoses for people with largely similar complaints, it’s likely that a lot of those diagnoses are wrong. And that’s a big problem with anecdotal evidence for a treatment or style of therapy. If you can’t even define what you’re treating with any consistency, how can you possibly tell if the treatment is effective?
The statistics are far from meaningless to others who are considering the treatment, but are worried about the cost or the result of delaying a known effective medical therapy. And as for the “ethics” of double-blind studies, there are situations where they’ve been cut short because of clear-cut indications that the treatment under study worked and it was felt not to be ethical to deny it to anyone by drawing out the study to its planned conclusion.
This is flat-out wrong, though it’s a common justification in the alt med world for lack of proper testing.
Herbs and supplements are a multi-billion dollar industry, and that doesn’t count the vast number of alt practitioners who’ve sprung up in recent years. Lots of research is done on herbs and supplements (PubMed literature searches reveal numerous basic and applied studies on a variety of promising botanical drugs); just this week a study on black cohosh was released to national fanfare (not very favorable, I’m sorry to say). “Big Pharma” is also involved, hoping to find the next Taxol or other big-selling plant-derived drug.
What skeptics continually point out is that, given the income available to supplement dealers and alt med practitioners, it’s a wonder that they plow so little of it back into research to benefit patients.
Why do you say that? All I’m hearing people say is that they don’t believe in things that aren’t proven. Do you believe that unproven remedies should be accepted on blind faith?
I’d settle for mere evidence that a given remedy works at all. A double-blind study on the effectiveness of a particular treatment does not have to concern itself with why? at all. Most treatments that are now accepted as valid were discovered before we figured out why they worked.
You are mistaking a call to determine if something works, with a demand to know why it works. Figure out if it even does anything, then worry about why.
If that’s the case, it would be child’s play for you to silence us. All you have to do is cite a properly controlled study that shows that the remedy you are espousing works. You are misinformed about science dismissing valid results as “placebo effect”. If the study is properly controlled, the two cannot be confused. The only time skepticism regarding placebo effects come into play is when people try to use anecdotal evidence to make claims about a treatment.
Well that’s wildly off-topic, but I very rarely hear any atheists here make an assertion like that. The claim is almost always that they don’t believe in God, and that there is no evidence to support the claim that God exists. That’s not a belief; it’s a lack of belief.
Oh sure. I certainly believe that if someone claims a health benefit for a particular treatment, its effectiveness should be proven before we accept it. My point is that we should allow “alternative” treatments to have a chance to prove or disprove their effectiveness before sneering.
In my first post, I named chiropractic, hypnosis and acupuncture as fields that I believe might have benefits. I’ve read before that chiropractic actually gives positive results in the case of back pain, and I believe I’ve also heard that hypnosis has a positive effect, probably more in the field of psychology though. As for acupuncture, I don’t know much about it, and WhyNot seems to, so I’ll let her (and other more knowledgeable persons) discuss what studies have been done about it. But I must admit that I tend to give it the benefit of the doubt, since as far as I know it is the product of centuries of trial and error, so I can hope that it has at least a certain level of effectiveness. I know it’s not the same as a scientific study.
You’re correct that homeopathy has been tested and never shown to be effective. It is not an example of treatment for which I hold any hope. This might also be because I fail to see how it could possibly work, even though some counter-intuitive things actually do work in some cases.
As I’ve said, the placebo effect is real. But do we really know how it works? Not as far as I know. It’s another example of a real (and even intuitive) effect for which we don’t have a satisfying explanation. I’m holding hope that maybe some claims of acupuncture (or other “alternative” treatments) might be shown to have a certain effectiveness, even though the traditional explanation isn’t satisfying.
I’ll refer you to AHunter3’s argument concerning psychiatric medicine, which I alluded to in my first post. Is “depression” really a disease, or just a set of similar symptoms that may or may not have the same cause from case to case? If the latter, is it really meaningful to refer to it as a single condition?
Now I guess that a lot of research has been done on the causes of migraine headaches. Once we’ve figured them out – and if it turns out that migraines usually have similar causes in many people – it is certainly meaningful to consider migraine to be a single condition. But my point is that what WhyNot describes to be Traditional Chinese Medicine’s diagnosis strategy isn’t so dumb.
What I’m trying to say is that for many people, being a “skeptic” is some kind of badge of honour. Something that distinguishes them from all these regular idiots who believe in religion, astrology and/or all these new-age medicines. I’m trying to remind people that being a skeptic implies giving provable claims a chance to prove themselves. Some parts of traditional Chinese medicine, I believe, have a possibility to be provably beneficial. We shouldn’t reject them out of hand just because they aren’t part of our scientific medicine, or because they claim that “qi” or other unlikely things exist. I feel that’s what, for example, Diogenes does in post 58.
An anecdote: in high school biology, we had to do an oral presentation on a type of alternative medicine. We had to talk about its history, its claims, the criticism that it has received, etc. My teacher mentioned a few, including animal-assisted therapy (it was actually zoothérapie in French, I think it’s the same thing). My reaction was basically “Zoothérapie is an alternative medicine?! But it works!” At the time, I considered that if something was called an alternative medicine, you could pretty much take as proven that it didn’t actually do anything good. That’s an anti-scientific attitude, and one that I’m now trying to discourage.
Great! Then we agree.
I’m not trying to silence anyone, since I’m not making any claims here. I have hopes, but I’m not claiming anything. Actually, if someone has any good studies regarding the effectiveness or lack thereof of traditional Chinese medicine, it could be interesting to look at.
If I’m not mistaken, what we’re looking for is for a treatment to display a level of effectiveness that statistically cannot be attributable to the placebo effect with a large enough level of confidence. Is that correct? It certainly seems like a valid test to me.
What I’m saying is that “placebo effect” has become some kind of buzzword, used in this sense not by scientists but by these “skeptics” I alluded to earlier, to dismiss claims without even considering them. “If that quackery did help someone, then it must be the placebo effect; I mean, can you really imagine that doing any good? :rolleyes:”
Well, this is what I mean when I say I’m an atheist: I lack belief in God, but I don’t assert anything about the existence of the supernatural. But there are a few strong atheists here, and some are rather obnoxious about their beliefs. It may seem off-topic, but I believe there is a correlation between “skeptics” who think you’re an idiot if you entertain the possibility that some alternative treatments may be effective, and “atheists” who think you’re an idiot if you entertain the possibility that some kind of supreme being exists.
I don’t know what you’re driving at. If there’s one demand constantly made by skeptics here, it’s to scientifically test whatever claim is being made. I have never heard a skeptic here say “don’t give that a chance”. We’re practically begging for these things to be tested. Name one skeptic, ever, who has prevented anything from being scientifically tested. It’s the proponents of these “alternative” treatments who don’t want them tested. So I don’t know what you mean by “giving them a chance”. They have the same chance as anything else. You don’t expect us to believe in these things before they’re tested, do you?
We don’t reject them out of hand; we simply withhold belief in them until they are proven to work. And if you claim a thing exists, shouldn’t it be contingent on you to demonstrate that it does in fact exist?
In post 58, Diogenes asks for a definition of “qi” and a cite that it exists. Do you find that to be an unreasonable request? Should we believe in things that you can’t even define, let alone prove?
“Alternative” is a bogus designation. A treatment is either proven or it is not proven. If it’s proven, then it’s a valid treatment. If it’s not proven, it’s nothing, except perhaps a hypothesis.
No, we don’t. You are characterizing the position of the skeptic as wanting to know why something works, and not accepting its validity without the “why” explanation. That’s not our position. All that’s needed to evaluate the effectiveness of a remedy is a trial. If it’s effective, then it’s proven. “Cupping” (or whatever untested thing you want to discuss) has not been scientifically shown to be effective. You’re making it sound like it is effective, but skeptics are rejecting it out-of-hand because they don’t like the explanation of why it works. That’s totally false. If it were proven to work, scientists would then work on explaining why it works. I don’t fully understand what gravity is or how it operates, but I’m not stupid enough to claim it doesn’t exist. I can easily prove its existence; the explanation is more difficult.
No, no, no - what I’m saying is, if the skeptics are dismissing things out of hand, as you accuse us of, you could easily win the argument by simply citing evidence that proves us wrong. But you can’t do that because there isn’t any evidence.
Huh? Yes, that’s correct. The results cannot be “dismissed” as a placebo effect if the experiment was done properly, because the experiment would control for that very thing. That’s what I said.
What do you mean by “consider” them? It has either been proven or it hasn’t. If it hasn’t been proven, then there’s nothing to consider. If a person is charging $1000 a pop to perform some treatment where there’s absolutely no evidence that it is effective in any way, then it is quackery.
Honestly, if you went to your doctor, and he said, “Take these pills. There’s no evidence that they work, but I want you to ‘consider’ them” - would you think that’s o.k.?
Well there are certainly some vocal atheists, and I don’t agree with their style of discourse, but I have encountered very few in my life who ever said, “God doesn’t exist. It’s a fact. You’re an idiot if you don’t agree.”
jebert, “alternative” or “complimentary” medicine is called that for a reason. It means the treatment has not been proven to work. That doesn’t mean it has been proven NOT to work, but either insufficient studies exist to show that it is effective, or the interested parties have not undertaken to perform the studies. If the latter, you might infer that there is good reason to avoid such tests, as an unfavorable outcome might reduce their profit. There is very little reason to NOT conduct tests if the chances are good that they will prove effectiveness, even if the tests are expensive, as the potential profits for known-effective medicine are enormous.
So we have evidence-based medicine and alternative/complimentary medicine. * If any alternative treatment is shown to be effective, it ceases to be alternative and becomes part of standard medical practice.*
No problem, that’s also my demand. I’ll try to explain what it is that I worry about. I’m afraid that there is a significant number of people who call themselves skeptics whose main interest, though they won’t admit it, isn’t really to see the validity of claims being tested. What they want to do is mock, not only those who believe without proof, but also those (like me) who do not believe but are ready to consider the possibility that some pre-scientific claims might be proven true using modern science. For example, if some claims of traditional Chinese medicine are eventually proven correct, I will be happy. Those people will be angry: traditional Chinese medicine is a hoax intended to fleece the gullible, and in any case it was created by Medieval Chinese people and not by modern scientists building upon the European scientific tradition, and so it cannot be any good. (They also wouldn’t be able to scoff at the idiots anymore if it happens.)
From your posts, it’s clear that you’re not one of them. Really, we do agree, lowbrass. The only difference between you and me is that you don’t worry about this. And you’re probably right: traditional Chinese medicine, just to give an example, has a large enough market potential that we can be sure that some scientist, somewhere, will think like me and try to test some of the claims that are made.
You’re right, I don’t think they’re preventing things from being scientifically tested. It’s just that I’ve read a few skeptic websites, and very often their webmasters sound like jerks. And they all seem to worship James Randi, who I don’t know much about but also sounds like a jerk of the highest order. They just don’t seem to want to help scientific knowledge grow, they just seem to want to laugh at others. I really don’t like arrogant jerks. This is where I’m coming from.
Actually, as you yourself said, the “what” is completely independent of the “why”. If some elements of traditional Chinese medicine do work, I don’t care that those who invented them claimed that it worked because of some “qi” bullshit. So yes, it’s an unreasonable request. And in any case, just one or two sentences later he says:
So he completely brushes away the possibility that it might exist (but is obviously as yet unproven). Or the possibility that it might be some metaphysical explanation that obviously is outside of science – so we should try to find an actual scientific explanation – but nevertheless “exists” in some philosophical sense. I’m reminded of the [thread=401175]current Pit thread[/thread] about transubstantiation.
Okay then. I’ve got nothing against hypotheses. Of course, hypotheses have different strengths. As far as I know, traditional Chinese medicine has been around a long time, and has developed itself through trial and error. That makes me think that it might be a good idea to submit it to an actual scientific test. I don’t presume to know what the result would be.
That’s not your position, but what is Dio doing? Laughing at WhyNot because of her use of “qi”, “heat” and “cold”? What do these concepts’ existence or nonexistence have to do with the effectiveness or ineffectiveness of traditional Chinese medicine?
I’d be willing to agree with that. A thousand dollars per month seems way excessive to me, especially for something that’s unproven.
Well, sometimes drug trials work in a somewhat similar way to this. It’s more scientific, of course, since there’s usually another group taking a proven medicine and maybe a third one taking a placebo, and it’s done on a larger scale. But you test new drugs by trying them on patients.
I’ve seen quite a few on this board. Sure, usually they’re not especially popular, but they get more support than I think they deserve.
If you don’t know much about him, how do you know he’s a jerk?
Well isn’t one way of helping reason to prevail to expose that which is based on flawed reasoning? I suppose there is a certain amount of arrogance to it. But then, I suppose Einstein was rather arrogant, too. What’s dangerous is being arrogant and wrong, as are those who espouse untested medical treatments. Laetrile was the ultimate in arrogance, wouldn’t you say?
“Outside of science”? How exactly does one distinguish “outside of science” from fantasy?
Because they are being touted as a supposed explanation for how this process works. But without any explanation of what they’re supposed to be, one might as well say “it works because of fleenbrap”. That means nothing.
Excuse me, but was I talking about trials? We’re not talking about trials, we’re talking about people plunking down hard-earned money for untested treatments that are being touted as effective remedies. We’re talking about the fact that there haven’t been trials for these things.
I’m going a little off-topic here, but has your wife tried Botox treatments? * A week ago, I was assisting a doctor coding a patient visit for a migraine and found she used Botox injections as the treatment. A shock, I tell you, so I asked for details. ** The doctor said it’s effective only in a small number of patients, as alluded to in the linked article. From what I gather, it’s not cheap, but if you’re dropping a grand a month on the current treatment, it may fit into your budget. Of course, that is if a doctor thinks your wife would benefit.
I neither have migraines, am a doctor, nor have any ties, financial or other, to Allergan, Inc., maker of Botox. This is not a for-profit clinic, so the doctor’s pay is not affected by the cost of treatments (i.e. she has no dog in this race, either.)
** I was then totally grossed out because I hate injections. I never learn; DON’T ask for details from a doctor!
The answer to your question is that you are being ripped-off to the tune of $1000/month for a treatment that is painful and futile. With the possible exception of some plant-drugs, TCM is a complete waste of time and resources.
Severus
I take your point about skeptics seeming arrogant. I probably appeared that way in the paragraph above. I do believe that what you see as arrogance is probably more of a lack of patience.
Western science is a way of determining the truth of something and the woo-woo practitioners know this as well as you or I. They (the woo-woo people) have been given endless chances to prove their particular brand of medicine works but refuse to do so. Clinical trials have been run on all kinds of things (by real scientists and doctors) and whenever the acupuncture/homeopathy/crystal healing/prayer is shown to be ineffective, the next thing is a special plead in the form of “The effect is too subtle to measure,” “it doesn’t work in the presence off skeptics,” or some other reason why their own particular brand of wishful thinking is different than everything else in the universe.
After hearing the special pleads for years most scientifically-literate, rational people are just fed up and tend to simply call TCM and the like “a load of crap” and leave it at that.
If someone could run clinical trials on TCM (since that’s what we’re discussing) and show that X percent of it was total crap, and the practitioners would stop pushing that part of it then there would probably be a lot more willingness to experiment. As it is, the believers simply keep on believing regardless of the facts or logic or anyting else.
Depression is not viewed as a single disease similar in all patients. The DSM for psychiatric disorders has specific diagnostic criteria for major and minor forms of depression. There are obviously multiple causes for depression (just as there are multiple causes for heart failure) but the end result of whatever precipitating factor(s) are involved is a specific condition. Clinical trials are performed using specified criteria for depression so that we can judge what treatments are effective. If, as you claim, there are 99 different diagnoses and 99 different treatments in a particular area of TCM, that speaks to a degree of vagueness that casts doubt on the nature of TCM, not the fallibility of scientific testing.
For some people, there’s undoubtedly satisfaction in exposing quackery and fraud. What you should consider is that there’s more involved than getting a kick out of the discomfiture of alt med advocates. When people are given false hopes, it can mean several things - expenditures they can’t afford, pain or disfigurement (some or all of which may apply in the case of the OP), worsening health or even permanent or fatal consequences for bypassing known effective care. There are skeptics who find it disturbing when people are taken advantage of in this way, and their goals are not to jeer but to protect their fellow citizens.
I haven’t seen a particular bias against TCM or Chinese people. There is considerable skepticism about any medicine based on folklore (excuse me, “trial and error”), where vast claims are made using the example of people for whom few records were kept and who tended to die at an early age despite the supposed wonders of their traditional medicine.
I’ll be glad to see scientific validation of any traditional plant-based remedy or technique since the ultimate goal is to lessen human suffering. I’m all too aware that in any case vast amounts of quackery will persist and be restated in novel ways by its practitioners, who in far too many cases are less concerned about alleviating disease than they are about making a buck and expressing their hostility towards mainstream medicine.
I advise everyone to go to www.pubmed.gov ( a service of the National Institutes of Health and National Library of Medicine, and literally as mainstream as it is possible to get) and typed in “acupuncture double blind trials.” Anybody who does that will find that a LOT of properly conducted double blind trials have indeed been done and published for acupuncture in the treatment of many medical conditions. For some conditions, such as fibromyalgia and mild to moderate depression, TMJ pain, nausea, and other types of dental pain, actual acupuncture produces results that are better from a statistically significant point of view than placebo. For some, it just doesn’t. It is not appropriate for everything it is used for. Everything that is claimed about it is not true. There are certainly aspects that can be criticized in an overall sense. There really haven’t been anywhere near enough studies that involved truly large number of subjects. More study is needed on the best possible protocols, as detailed in “Clinical trials of acupuncture: consensus recommendations for optimal treatment, sham controls and blinding” by White AR, Filshie J, and Cummings TM. However, it’s just not accurate to say that double-blind studies have not been done in ANY circumstance. The ones that had fatal errors are most definitely identified as such on PubMed. I really urge everyone to check this out.
That being said, $1000 a month is ridiculous, and it’s questionable whether acupuncture is any better for migraines than placebo is. I have no interest in championing anything just “because it’s alternative medicine.” The facts have to speak for themselves, but in the case of acupuncture, the facts lead to the conclusion that acupuncture as a whole does not merit being tossed on the same trash heap as a lot of dubious alternative treatments. It should not be blindly lumped in with them without checking out the double -blind studies that HAVE been done.
But this is about cupping, not acupuncture. Has cupping been tested? By the way, the nomenclature here is confusing. People are throwing around this acronym TCM, which I assumed was the name for this cupping procedure, but it’s not. I looked it up and it simply stand for Traditional Chinese Medicine, which could be any one of thousands of things, right? Isn’t it non-sensical to refer to “studies on TCM”? Isn’t that pretty much like saying “studies on medicine”? It’s hopelessly vague.
No, not if you’re talking about acupuncture, which I am-- and acupuncture has gotten thrown in with a lot of dubious procedures here, which is my very specific objection. Some of the things we’ve been discussing-- well, God only knows if they do anything positive. There are a lot of aspects to TCM, for example, and I don’t claim to have any information about whether they have any validity, and if so, to what degree and for what illnesses. They may or may not have double-blind studies done on any or all of them. Acupuncture does, though, and some of them have shown that is very helpful for certain medical conditions. I hope there’s a lot more research on the horizon for acupuncture, but there is enough so that it shouldn’t be lumped in and summarily dismissed along with procedures that have not had any of these studies done.
Of course, there’s really no reason for any of this to apply to the specific issues originally brought up by the person who started this thread, which is important to remember. The evidence that acupuncture does anything for migraines is very mixed, and it’s important to look at why. Here’s one article from PubMed about acupuncture and migraines, for example:
Acupuncture versus metoprolol in migraine prophylaxis: a randomized trial of trigger point inactivation.Hesse J, Mogelvang B, Simonsen H.
The acupuncture worked just as well as the medication for reducing frequency and duration of migraines, although not severity. The really interesting thing here, though, is that they were actually studying myofascial trigger points (Travell and Simon’s points), rather than classic TCM qi points. Here’s another interesting study in that vein:
Trigger point acupuncture treatment of chronic low back pain in elderly patients–a blinded RCT.Itoh K, Katsumi Y, Kitakoji H.
Treatment on myofascial trigger points worked quite a bit more effectively than treatment on TCM-derived points.
I have to say, too, that judging from the people I’ve worked with, myofascial therapy does more for migraines than anything else except medication, although migraines are not muscular in nature (as tension headaches are.) There are a lot of possible reasons, but I suspect one is that the occipital nerve can be entrapped by certain muscles (traps and semispinalis are the worst,) and that really can contribute to migraine headaches.
For some conditions, though, acupuncture does very well in double-blind studies. We may not really know why, but then we don’t know exactly why most psychiatric medications work, either. If you look at the insert in a package of Focalin, for instance, you’ll see the results of the double-blind studies they did before it was approved, and then you’ll see the statement that the mechanism by which it works is unknown. We don’t use it because the mechanism is known; we use it because it passed the double-blind study test.
Hey severus - I owe you an apology. Up to now I hadn’t encountered anyone fitting this description, but there’s currently a thread going on in GD where one of the participants fits your desciption to a T.
Sorry for the sidetrack, but I see where you’re coming from now, and I think I was wrong in what I said earlier.
It’s more of a general impression, but there has been a thread that touched the subject recently. [thread=394028]Here it is.[/thread] Basically, the OP claimed that he had applied for Randi’s million-dollar challenge – he didn’t claim supernatural abilities, but disagreed with him on a point of science – but mostly seemed to have a beef with Randi as a person. It was pointed to him, in that thread and the accompanying [thread=394125]pit thread[/thread], that a large number of skeptics very much dislike the man too. [post=7914236]This[/post] is an example.
Even before reading these threads, I already had this impression. I don’t think I can point out where it started. As I said, it’s more of an impression. But maybe Testy is right. Maybe it’s just that after dealing with credulous people for such a long time, some skeptics just lose their patience.
Yeah, I know, it might not have been my best argument. My point was that if “qi”, “heat” or “cold” don’t exist as such, maybe it’s because they’re not intended as a scientific explanation. If they’re not intended as science, mocking them as pseudo-science isn’t really useful. But I don’t actually know if practitioners of traditional Chinese medicine today consider that these terms refer to actual things or processes in the human body, and in any case, it doesn’t really matter.
True. But the point is that in some cases, someone suggesting an untested remedy for something that ails me would be acceptable.
Thanks for the kind comments. I’ve also read these threads. Fortunately I don’t get many people like this in real life, but on this board there are a few.
I didn’t claim that. WhyNot said that practitioners of traditional Chinese medicine are likely to reach many different diagnoses for conditions that seem similar, because they operate on a different philosophical background than the doctors we are used to. I just wanted to point out that lumping similar conditions together isn’t in fact always a good idea. And there is something to be said for a more “holistic” view of human health.
Unfortunately, it’s clear there are some people (like the OP’s wife’s practitioner) who are doing it the way Randi described (with the cutting and blood drawing), and who call it “cupping.”
My point was that if “qi”, “heat” or “cold” don’t exist as such, maybe it’s because they’re not intended as a scientific explanation. If they’re not intended as science, mocking them as pseudo-science isn’t really useful. But I don’t actually know if practitioners of traditional Chinese medicine today consider that these terms refer to actual things or processes in the human body, and in any case, it doesn’t really matter.