"Acupuncture has gradually increased its acceptability over the last 20 years [because] it has good, double-blind, scientific proof that it is of assistance for pain and other disorders." As long as you think placebo is effective and ethical. And look at the picture. Again with the bare hands.
Regulating Homeopathy "In July 1951, news spread that certain manufacturers of homeopathic remedies in the Stockholm area had skipped part of the potentization process and had sold pure sugar pills under the false claim that they were homeopathic medicines." As if it made a difference. An interesting review of some Swedish history.
Chiropractic spinal manipulation warning: "Professor Wand and colleagues concluded: “The potential for catastrophic events and the clear absence of unique benefit lead to the inevitable conclusion that manipulation of the cervical spine should be abandoned as part of conservative care for neck pain."
I have been writing a lot about acupuncture in the last few weeks. Perhaps it is because there are just more papers to evaluate about acupuncture, it being the pseudo-medicine with the most active presence on the Pubmeds.
Sham acupuncture is no better than real acupuncture for the relief of pain. The usual interpretation is that if an intervention is no different that a placebo, the intervention does not work. But there is always the issue that sham and real acupuncture (as if there is a difference) are better at relieving pain than doing nothing.
The Australians are so far ahead of us: Order of Australia to Ms Loretta Josephine Marron. For service to community health. "Inaugural Chief Executive Officer and Secretary, Friends of Science in Medicine, since 2011; Founding Member, 2011; formed to support evidence-based medicine and to raise concerns about 'complementary and alternative' interventions for health conditions." Congratulations.
Conflict of Interest Statement: I am a paid Infectious Disease blogger for Medscape.
There was a recent survey of 31, 399 Doctors by Medscape that was published as the Physician Lifestyle Report. The survey covers weight, vacation time, marriage status and other lifestyle issues including complementary and alternative pseudo-medicine use .
Several observations about the report.
Of course they had a picture of acupuncture on the cover and it was usual heebie jeebie inducing ungloved hands needling with bare fingers poking around the insertions. Even Medscape can’t find a photo with good infection control technique, probably because such photos are as rare those of Nessie.
Harriet Hall coined the term “tooth fairy science” which is
to doing research on a phenomenon before establishing that the phenomenon exists….You could measure how much money the Tooth Fairy leaves under the pillow, whether she leaves more cash for the first or last tooth, whether the payoff is greater if you leave the tooth in a plastic baggie versus wrapped in Kleenex. You can get all kinds of good data that is reproducible and statistically significant. Yes, you have learned something. But you haven’t learned what you think you’ve learned, because you haven’t bothered to establish whether the Tooth Fairy really exists.
The concept encompasses most of pseudo-medicine and usually studies look for results based on interventions not based on reality. Much of traditional Chinese medicine is based on concepts divorced from anatomy and physiology and are perfect grist for tooth fairy science mill.
An example comes from the introduction of The Association between Yang-Deficient Constitution and Clinical Outcome of Highly Active Antiretroviral Therapy on People Living with HIV
Before you read further, a warning. If you are drinking, swallow now, so liquid does not squirt out your nose and onto the computer.
Guest Post by Eugenie V. Mielczarek
Science-Based Medicine continually informs about the scientific knowledge and controls required to provide successful medical protocols. The need for a joint effort with major scientific societies is crucial. Neither the the American Physical Society nor the American Chemical Society have lent their expertise communicating ‘science for the general public’ to dispel claims for homeopathy and ‘energy healing’ obvious violations of the laws of science. The founding of Society for Science Based Medicine came as I was reviewing my failed four year effort to have the American Physical Society, APS, recognize this healing protocol as a medical misconception.Some background:learning that healing claims for an undefined field emitted by certain human practitioners, was being taught in nursing schools medical schools, used as a source of revenue by hospitals, and had been funded by NIH’ s NCCAM, I with Derek Araujo and Brian Engler, exposed the claim, practices and NIH’s funding, with articles in the Skeptical Inquirer. The ‘healing’ protocol appears under several pseudonyms: Therapeutic Touch, Reiki, Jorei, and Qigong. NCCAM grants for these protocols total about 11 million dollars. A popular Reiki center close to my home is located at the Winchester Medical Center, Winchester Virginia.
Pseudo-Medicines combine and recombine in a continual fantastical dance. Pick any two alternative medicines and someone, somewhere, has combined them into a unique treatment modality. My favorite is Tong Ren, a form of voodoo acupuncture.
I had thought, perhaps incorrectly, that no one could come up with a more ludicrous combination. Perhaps it would be dark energy homeopathy or dark matter acupuncture. I suppose it is just a matter of time before someone combines some pseudo-medical modality with the time cube and their nonsense will reign supreme.
Photographic representations are worth on the order of 103 words, or so the old chestnut would have us believe.
I have been in charge on infection control at my hospital system for 23 years and in that time we have slowly driven down the rates of hospital acquired infections. There have been many initiatives that have helped with the decline, but I would wager that none have been as important getting out hand hygiene rates to almost 100%.
Hands are a wonderful vector for germs and it you want to have an entertaining, if somewhat nausea inducing time, spend a few hours focusing on what people to with their hands. Euw.
I have no idea why people use pseudo-medicines. Well, I can understand why a particular person may use a given pseudo-medicine, but I find the surveys unsatisfying. There are probably as many motivations for using pseudo-medicines as they are people using them.
I empathize. To be human is to be susceptible to all the cognitive biases that make pseudo-medicine attractive.
I am sure those reading this have, at some time in their past, succumbed to the allure of one unsubstantiated or unfounded idea or another. Mine was Chariots of the Gods by Erich von Daniken back in high school. I was quite enamored of the concept that we were once visited by aliens, not a surprise for a sci-fi addict. It was discovering critical information in the Zetetic all those many years ago that sent me down the critical thinking path.
I like to reason from first principles and move down the chain of reasoning.
One of the characteristics of physiology I remember from medical school is that most of the structural molecules are made on-site from primitive precursors. The food we eat is broken down to its smallest components which are transferred to where they are needed and then these building blocks are altered or strung together with other chemicals to form more complex structures.
Simplistic, I know, but a reasonable rule of thumb.
That is one of the issues about glucosamine and chondroitin for osteoarthritis that bother me. Both products are made on site by cartilage, not imported complete into the joint. So why would taking them help joint disease? Unless you are eating a diet rich in pig snout and cows ears, most peoples diets have little of either glucosamine or chondroitin.
Death probably has more inevitability than taxes. Everyone dies. The question is not are you going to die. You are. The question is are you going to die before you should. Is your death preventable?
There are a lot of reasons why people die prematurely. I spend 95% of my time in in-patient medicine and my sense is a major reason people die is lack of health care insurance. They have illnesses like HIV or high blood pressure and they do not seek care until it is too late to halt or reverse the course of their disease. It is sad.