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Trick or Treatment 713

Posted by samzenpus
from the read-all-about-it dept.
brothke writes "The recent collapse of financial companies occurred in part because their operations were run like a black box. For many years, alternative medicine has similarly operated in the shadows with its own set of black boxes. In Trick or Treatment: The Undeniable Facts about Alternative Medicine, Simon Singh and Edzard Ernst, MD, break open that box, and show with devastating clarity and accuracy, that the box is for the most part empty." Keep reading for the rest of Ben's review.
Trick or Treatment: The Undeniable Facts about Alternative Medicine
author Simon Singh and Edzard Ernst
pages 352
publisher W. W. Norton
rating 9
reviewer Ben Rothke
ISBN 978-0393066616
summary Peels away the fallacies of acupuncture, homeopathy, chiropractic and herbal medicine
I first encountered co-author Simon Singh at the 2005 RSA Conference. In his presentation, he included a demonstration of the human brains unique capability for pattern matching when specific patterns are expected, and used Led Zeppelins Stairway to Heaven as an example. Stairway has long been rumored to have subliminal satanic messages. When played backwards, it is impossible to decipher any message. But when the message is known in advance, one can then hear the message imploring the listener to go to Satans tool shed. Once Singh put the subliminal lyrics on the overhead, the subliminal message was now clear, not due to a subliminal message, rather via pattern matching.

While no reasonable person can believe in Stairways subliminal lyrics, far too many people do believe in equally implausible things in the realm of alternative medicine. In the book, the authors tackle four main areas: acupuncture, homeopathy, chiropractic and herbal medicine. The books conclusion is that acupuncture, homeopathy, chiropractic are essentially worthless, while herbal medicine has limited value.

Chapter 1 starts with an overview of evidence-based medicine (EBM), of which the authors are staunch believers. EBM applies evidence gained via the scientific method and assesses the quality of the evidence relevant to the risks and benefits of the treatments. The foundation of EBM is the systematic review of evidence for particular treatments via mainly randomized controlled trials. In the chapter, the authors reiterate the concept that the plural of anecdote is not data. Acupuncture, homeopathy, chiropractic have plenty of first-person anecdotes, but a lack of controlled studies with real data to back up their spurious claims.

EBM shows that homeopathy and other bogus cures are of no value, yet the public is oblivious to those facts. In a piece I wrote on this topic, New York News Radio" The voice of bad science, its shows that cheap radio advertising (with its mishmash of pseudo-scientific claims) combined with a public that is ignorant of basic scientific facts, creates a perfect storm for the continuation of homeopathy and other bogus cures.

A recurring theme the book stresses is that acupuncture, homeopathy, chiropractic and other alternative therapies are scientifically impossible, and often will violate fundamental scientific principles. A perfect example of this implausibility is with homeopathy. Contrary to what common sense and basic science, in homeopathy, a solution that is more diluted is considered stronger and as having a higher potency. The issue is that the end result is a product that is so diluted, that its contents when in solid form is pure sugar, and when in liquid form; 100% H20. When a homeopathic liquid is in its most diluted state, there is not a single molecule of the active ingredient. Therein lays the scientific implausibility of homeopathy.

Chapter 1 also asks one of the books fundamental questions: how do you determine the truth? The authors answer that it is via the scientific method. This is determined only after strict and careful analysis of a clinical study, of which the most effective is double-blind and randomized.

In chapter 3, the book jokingly notes that since homeopathic liquid remedies are so diluted that they contain only water; their only use would be for dehydration. And since homeopathy is based on the fact that the strength of a remedy is based on its dilution, one could conceivably overdose on a homeopathic remedy by forgetting to take a dose.

The chapter concludes with perhaps the strongest indictment against homeopathy; namely its content. If one looks at the content of oscillococcinum, a homeopathic alternative marketed to relieve influenza-like symptoms, the packaging states that each gram of medication contains 0.85 grams of sucrose and 0.15 grams of lactose. Sucrose and lactose are simply forms of sugar, of which oscillococcinum is nothing more than am expensive sugar pill.

In chapter 4, the authors write that while homeopathy is nothing more than a placebo, the added danger with it is that patients will often forgo real medications to take a homeopathic one. It reports of a study in Britain, which demonstrated that the most benign alternative medicine can become dangerous if the therapist who administers it advises a patient not to follow an effective conventional medical treatment. The study demonstrated that alternative medical practitioners often recommend homeopathic remedies for malaria, and ignore proven conventional medicines. Such an approach can often mean a death sentence for the person taking the homeopathic remedy.

Chapter 5 deals with herbal medicine. The chapter is somewhat different in that the previous chapters about acupuncture, homeopathy and chiropractic showed them to be useless, herbal medicine does have value. The book notes that herbal medicine has been embraced by science to a far greater extent than acupuncture, homeopathy and chiropractics. The chapter lists over 30 herbal medicines and their levels of efficacy. An irony of herbal medicine is that some exotic ones, such as those with tiger bone or rhino horn are pushing the species to the brink of extinction, due to their level of popularity in certain parts of the world.

Chapter 5 concludes with on why smart people believe such odd things? Alternative medicine has failed to deliver the health benefits that it claims, so why are millions of patients wasting their money and risking their lives by turning towards a snake-oil industry? The authors provide numerous reasons for this, from the concepts such as natural, traditional and holistic, to attacks on the scientific method by the alternative medical community and more.

The appendix is a rapid guide to alternative therapies and lists over 30 new treatments with their benefits and potential dangers. The appendix gives single page summaries of the plethora other alternative therapies, from ear candles, colonic irrigation, reiki, to leech therapy and more. The authors write that most of these are bogus, many violate fundamental laws of sciences, and but a few have real, but limited value.

Alternative medicine operates in the shadows, blithely touting that their products have not been evaluated by the Food and Drug Administration, and that they are not intended to diagnose, treat, cure or prevent any disease. While these products are not intended to diagnose, treat, cure or prevent any disease; consumers nonetheless spends billions of dollars per year on unproven supplements. Consumers can be quite fickle. On one side they are furious at the SEC for their lack of oversight around Madoff Investments Securities. Yet when the FDA requires products use their disclaimer of how ineffective the item is, consumers will throw billions of dollars on ineffective products.

Trick or Treatment: The Undeniable Facts about Alternative Medicine is an incredibly important and eye-opening book. While Singh is a physicist and Ernst a medical doctor, the book is written in a clear and compelling style, avoids technical jargon, and sticks to the facts. In the spirit of the scientific method, the authors scrutinize alternative and complementary cures and the results show that the snake oil is still selling.

Ben Rothke is the author of Computer Security: 20 Things Every Employee Should Know.

You can purchase Trick or Treatment: The Undeniable Facts about Alternative Medicine from amazon.com. Slashdot welcomes readers' book reviews — to see your own review here, read the book review guidelines, then visit the submission page.

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Trick or Treatment

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  • by elrous0 (869638) * on Friday December 19, 2008 @12:34PM (#26174463)
    ...My psychic told me so!
  • by Sobrique (543255) on Friday December 19, 2008 @12:40PM (#26174547) Homepage
    So alternative medicine exploits placebo effect and gullibility.

    Essentially taking money from people who want to believe.

    I find it ironic that this book seeks to take money from people who _don't_ want to believe.

    • Re: (Score:3, Insightful)

      by EVil Lawyer (947367)
      The difference is that no one is going to forgo some other important service because they buy the book. While people DO forgo proven and effective medical treatments because a homeopath tells them to...
      • Re: (Score:3, Insightful)

        by Kokuyo (549451)

        Which is equally stupid as foregoing proven alternative treatment and getting out the antibiotics for simple stuff.

        Frankly, with all the quacks I have met that had an actual doctor title...

        The only thing I'll have doctors treat nowadays is the heavy stuff. Broken bones, cancers... you know, the stuff that makes you either move funnily or die rather quickly and painfully. I'm not the type to treat blood poisoning with a herb or two.

        But I will state this: I am going to treat simple infections by means of pers

        • by multipartmixed (163409) on Friday December 19, 2008 @01:32PM (#26175239) Homepage

          > Remember, guys, for doctors, your symptoms are a matter of trial and error.
          > The usual way to treat people is to go through every medication until you find
          > one that helps

          Um, no.

          First you insult the black guy. Then you belittle the white guy and make crude remarks toward the hot chick. If you're in season 4, you also insult the brown guy whilst proclaiming his genius.

          Then you hold a "differential diagnosis" and write stuff on the white board.

          Finally, you pop some pills, call the patient a liar, piss off your boss, annoy your only friend, and only THEN do you start trial-and-error treatment.

          Geez. Don't you people know ANYTHING about medicine?

        • Re: (Score:3, Informative)

          by Haeleth (414428)

          I[f] you've got one of the many bad ones, they're going to start with the most expensive concoction.

          Maybe that's the case in a profit-oriented system like in the USA. Other countries have evil socialist healthcare systems that mean that doctors have no incentive whatsoever to prescribe the most expensive treatment or to prolong your treatment unnecessarily, so they concentrate on doing their job properly instead.

        • Re: (Score:3, Insightful)

          by TeXMaster (593524)

          Remember, guys, for doctors, your symptoms are a matter of trial and error. The usual way to treat people is to go through every medication until you find one that helps.

          Which is why when traditional medicine fails, people say "it was the wrong cure", but when an alternative method fail people say "it's the method which is ineffective". And there is such a strong bias against alternative medicine it's dismissed as either placebo effect or wrong diagnosis. (Which is kind of grotesque when you consider that with traditional medicine wrong diagnosis is usually the cause of problems, not the solution.)

    • Re:Exploitations? (Score:4, Insightful)

      by rgviza (1303161) on Friday December 19, 2008 @01:43PM (#26175429)

      Not to mention that half the medical procedures we think of as "legit" for a given condition today won't be tomorrow.

      Frontal Lobotomy comes to mind...
      As does the medical establishments continual flip flopping on what's healthy and what's not.

      I'm not sayin that herbal medicine is better, just that "scientific" medicine has it's own issues with quackery, bad research, and disinformation, intentional or not.

      This book is the proverbial pot calling the kettle black.

      If scientific medicine was so great we'd be seeing a lot less doctoring and more curing.

      If "legit" pharmaceuticals were so great, They'd learn what "standard deviation" means and stop using stats that fall within standard deviation as "proof" of efficacy.

      Sure most "herbal" doctors are quacks that are FOS. But are medical doctors really that much different?

      All of them, (medical and herbal) without exception, operate on incomplete and often unproven information.

      -Viz

      • Re:Exploitations? (Score:5, Interesting)

        by vtcodger (957785) on Friday December 19, 2008 @02:11PM (#26175847)

        ***If "legit" pharmaceuticals were so great, They'd learn what "standard deviation" means and stop using stats that fall within standard deviation as "proof" of efficacy.***

        They don't actually do that -- at least not that I've encountered. But they approach it by using an absurdly low standard of proof (p=0.05) then designing seriously flawed experiments that increase the chances of meeting that low standard. And then repeating the flawed experiments with minor variations until they get the answer they want. There are people seriously studying all this. Google John P. A. Ioannidis, a Greek researcher who has published several widely distributed papers on the low quality of research.

  • Minor correction (Score:5, Informative)

    by Zironic (1112127) on Friday December 19, 2008 @12:41PM (#26174549)

    "the plural of data is not anecdote"
    should be
    "the plural of anecdote is not data"

  • by swschrad (312009) on Friday December 19, 2008 @12:41PM (#26174559) Homepage Journal

    it was our good ol' boy Hatch who called in chits to get a law passed that puts the not-medicine hawkers beyond the reach of scientific proof and tests for safety and efficacy of their nostrums.

  • by Anonymous Coward on Friday December 19, 2008 @12:42PM (#26174571)

    So what? Anybody with half a brain already knew that alternative medicine is a scam. I'd be much more interested in some of the evidence-based medicine exposes of mainstream medicine. Menopause replacement hormones? Oops, turns out they give women breast cancer. Low-fat diets? Gary Taubes says they may be making us fat. 3rd-generation anti-depressants? They may work for a week but also seem to cause dependence, long-term depression, and make people more suicidal than before.

    Doctors aren't scientists (not very good ones anyway), even if they do plan them on TV.

    • Re: (Score:3, Insightful)

      by liquidpele (663430)

      Doctors aren't scientists (not very good ones anyway)

      Hell, most doctors aren't even good doctors, or are overworked to where they simply don't have to time to give things the attention they should. I think the real reason for the push towards alternative medicine is mistrust of the medical industry these days. After seeing 20 ads for different pill on TV, you just have to wonder if they have your interests are heart or not.

    • by GRW (63655) on Friday December 19, 2008 @01:11PM (#26174931) Homepage Journal

      I'd be much more interested in some of the evidence-based medicine exposes of mainstream medicine.

      Then you might be interested in reading the article The Wholesale Sedation of America's Youth [csicop.org] in the Nov/Dec '08 issue of Skeptical Inquirer [csicop.org].

  • by maynard (3337) <`j.maynard.gelinas' `at' `gmail.com'> on Friday December 19, 2008 @12:44PM (#26174589) Journal

    And likely many of his other claims as well. Here's what PubMed says:

    http://www.ncbi.nlm.nih.gov/pubmed/17568299?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum [nih.gov]

    "Accupuncture may be an efficacious and acceptable nonexposure treatment option for PTSD. Larger trials with additional controls and methods are warranted to replicate and extend these findings."

    http://www.ncbi.nlm.nih.gov/pubmed/6289567?ordinalpos=3&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum [nih.gov]

    "A brief characterisation is maccccde of the working principles underlying neural therapy under local anaesthesia or accupuncture. Common approaches to therapy are offered by disorders of autonomous regulation, including inflammatory processes, and by purely functional disorders.--There are many applications in gynaecology and obstetrics. A brief statistical information on lumbosacral pain is quoted as an example. Optimum performance can be expected from them, when used in combination with proven therapeutic methods. They provide a low-cost approach to reducing both the consumption of antibiotics and other pharmaceuticals as well as time of morbidity."

    There are many others outside of PubMed. And that is but one of the author's claims that actual published studies in the medical literature refute. This side-swipe skepticism is not science, it is marketing in order to sell a bullshit book. Ignore idiots like him and read peer reviewed journals and abstracts before basing your own judgment.

    • by jandrese (485) <kensama@vt.edu> on Friday December 19, 2008 @01:03PM (#26174831) Homepage Journal
      The problem with Acupuncture is that the practitioners still prescribe to the theory that the needles redirect a person's Chi and whatnot. To modern medicine this is about as useful as describing a treatment that restores balance to the four bodily humors.
      • Now you're arguing that an ancient Chinese model for how acupuncture works is flawed because it doesn't conform to modern medical terminology, nor does it conform to the scientific method of making predictions based on prior results.

        I fully agree.

        But that doesn't discount findings, it only calls into question an understanding of the underlying mechanisms behind the technique. Which ultimately means, let's do more research and find out that answer. But having a broken model is not confirmation that one's fin

        • by Haeleth (414428) on Friday December 19, 2008 @01:55PM (#26175613) Journal

          IOW: Skepticism as a business has far outstripped anti-science nuttiness from new-age and other so-called 'alternative' medical and science quacks.

          Ah, right, that's why skeptics are literally raking in billions of dollars selling their books and skeptic products, and their faces are familiar to all of us from their constant appearances on prime-time TV.

          Oh, no, wait a minute, that's the alternative practitioners, while skepticism remains largely unprofitable.

        • Re: (Score:3, Interesting)

          by DerekLyons (302214)

          But that doesn't discount findings

          Then why can't you actually provide any links to any findings? Your first link isn't a finding - it's a suggestion that further study may be warranted. Your second is to an abstract study which indicates that the alternative treatment *may* produce results - but only when combined with existing (non alternative) treatments.

          Hardly ringing endorsements. More like damming with faint praise.

      • by zooblethorpe (686757) on Friday December 19, 2008 @02:44PM (#26176223)

        The problem with Acupuncture is that the practitioners still prescribe to the theory that the needles redirect a person's Chi and whatnot. To modern Western medicine this is about as useful as describing a treatment that restores balance to the four bodily humors.

        Without adding that key word "Western" in there, you're missing an important point -- the whole concept of Chi is based on a complete medical theory independent of Western medical thought. So basically yes, describing Chi flows to someone trained only in Western medicine would be about as productive as talking in Chinese to someone who only understands English. Both languages deal with information, but in radically different ways. Both may be perfectly valid, but analyzing the one from the perspective of the other is going to be an arduous affair.

        The main problem I see with the book, based just on the review here, is that it lumps many different things together. What exactly do they mean by "herbal medicine"? (And what the heck is "herbal" about tiger bone or rhino horn? Those are animal products, not herbs.) "Herbal medicine" is an exceedingly broad category, and could potentially include Native American shamanistic practices, experimental hippie salad recipes, strictly controlled German and Swiss herbal pharmacopoeia, doobie brownies, and Chinese apothecary traditions all in one big indiscriminate mess.

        Likewise, what is "alternative medicine" as the authors intend? It sounds from the review like they mean everything that doesn't normally happen in a Western hospital, which again is an obscenely broad over-generalization. Some things are probably completely la-la -- "oh sure, my neighbor ate nothing but oranges while standing on his head for two days and it cured his sinus cold!" -- while other things are backed by many centuries of refinement (Chi theory, yoga, etc.).

        The reviewer also notes, ...alternative therapies are scientifically impossible, and often will violate fundamental scientific principles. "Scientifically impossible" suggests a misunderstanding of science -- science is about looking into things as objectively and quantifiably as possible, and deriving theories that best fit the observed phenomena. "Theoretically impossible" would certainly make sense -- but it would also imply the need for more study, and if XYZ "alternative" treatment were shown to be effective, then perhaps existing theories need modification. But that is a matter for further research, and thus lies outside the scope of this book.

        Frankly, although the reviewer mentions a disdain for garbage science, such indiscriminate verbiage in the book sounds to me like a big factor in producing garbage science. Clearly defined terminology is a must for any productive hypotheses or research.

        Just my two bits as a professional translator. Sloppy terminology just bugs the bejeezus out of me.

        Cheers,

        • by DerekLyons (302214) <(fairwater) (at) (gmail.com)> on Friday December 19, 2008 @03:31PM (#26176787) Homepage

          The problem with Acupuncture is that the practitioners still prescribe to the theory that the needles redirect a person's Chi and whatnot. To modern Western medicine this is about as useful as describing a treatment that restores balance to the four bodily humors.

          Without adding that key word "Western" in there, you're missing an important point -- the whole concept of Chi is based on a complete medical theory independent of Western medical thought. So basically yes, describing Chi flows to someone trained only in Western medicine would be about as productive as talking in Chinese to someone who only understands English.

          Horseshit. Either Chi flows are susceptible to the scientific method - or they are not. Period.
           
           

          Both languages deal with information, but in radically different ways. Both may be perfectly valid, but analyzing the one from the perspective of the other is going to be an arduous affair.

          Again, horseshit. The language of science is independent of spoken language. Either Chi theory is susceptible to analysis using 'Western' methods (controlled studies, statistics, etc...) or it isn't.

    • Re: (Score:3, Interesting)

      by drfireman (101623)

      On the whole I think you're right about acupuncture. But bear in mind that PubMed doesn't say anything. PubMed indexes articles published in many journals, many of which are decidedly shoddy. Many more people do medical research than actually know how to do it properly. Also, trying to adjudicate any dispute about efficacy with a cursory look at PubMed is dangerous, not least due to publication bias, but also due to the aforementioned shoddiness of the indexed journals.

      I have a question for anyone who's

    • Re: (Score:3, Informative)

      by ZombieWomble (893157)
      As a first point, "Pubmed" says nothing about these things. Pubmed is a search engine which indexes various medical journals. The appearance of something on Pubmed is by itself in no way an indication of quality.

      But the main point about researching any medical articles is that picking out limited data points is a terrible, terrible way to draw conclusions. Holding up a couple of papers as proof is a rather dubious method of calling "bullshit" on a position. Appraoching things that way, we have to assume th

    • Re: (Score:3, Insightful)

      by Colonel Korn (1258968)

      Most studies of acupuncture have been either statistically insignificant or haven't sufficiently distinguished between acupuncture's efficacy and that of a placebo. The deal with acupuncture is that 1) it's nonsense and 2) it works really well a lot of the time, because it's a placebo that almost forces you to really believe in it. Those studies which have used similarly convincing placebos instead of just, say, a sugar pill, show similar (and very positive) effects between acupuncture and the fake treatm

  • by ^Case^ (135042) on Friday December 19, 2008 @12:45PM (#26174599)

    I had a serious fall when skiing in february. A muscle in my back was so sore that I could not tie my own shoelaces or sit down without severe pain.

    After having consulted three different medical doctors who all told me to just go home and lie down and just wait for the pain to go away I consulted a chiropractic. He was able to make some of the pain disappear immediately.

    So I have to say that for me at least it worked. YMMV.

    • by Angostura (703910) on Friday December 19, 2008 @12:52PM (#26174687)

      Not all "alternatives" are created equal. I think it is reasonable to surmise that manipulation of joints and stretch and massage of muscles can help alleviate muscular and joint pain. It is less reasonable to assume that massaging a particular spot on my foot will help kidney function.

      • by RobertB-DC (622190) * on Friday December 19, 2008 @01:11PM (#26174925) Homepage Journal

        Not all "alternatives" are created equal. I think it is reasonable to surmise that manipulation of joints and stretch and massage of muscles can help alleviate muscular and joint pain. It is less reasonable to assume that massaging a particular spot on my foot will help kidney function.

        I was hoping that the reviewer would go into more detail on what parts of Chiropractic treatments are "snake oil". I know "common sense" and "baseless anecdote" are close buddies, but if your vertebra is pinching a nerve, something somewhere is going to hurt! If rubbing it and popping it works, it's a heck of a lot better than addictive painkillers or dangerous surgery.

        But yeah, claiming that a chiropractic adjustment will prevent asthma or allergies is just silly. My chiropractor has a standard chart on the wall that includes some of those claims -- but when I mentioned it in passing, he seemed very uncomfortable with the idea.

        If doctors and chiropractors would mutually respect each other's actual accomplishments and abilities, patients would be much better off. But as long as you have chiros saying they can cure *everything*, and MDs saying *they* are the only valid practitioners of the healing arts, we're stuck in the middle.

    • Re: (Score:3, Insightful)

      Chiro works for pinched nerves in my neck usually in one treatment. A 'mainstream' MD would probably prescribe a weeks' worth of muscle relaxants.

    • by Samschnooks (1415697) on Friday December 19, 2008 @01:04PM (#26174843)

      I had a serious fall when skiing in february. A muscle in my back was so sore that I could not tie my own shoelaces or sit down without severe pain.

      After having consulted three different medical doctors who all told me to just go home and lie down and just wait for the pain to go away I consulted a chiropractic. He was able to make some of the pain disappear immediately.

      So I have to say that for me at least it worked. YMMV.

      My doctor, Johnny Walker, MD, can do better than that. His assistant, Jack Daniels, does a pretty good job too of relaxing muscles. Dr. Jim Beam, on the other hand, I never got along with him. And when times are hard, like now, I get it on with the Blue Nun - yeah, I'm a perv. Now, I heard of this Russian guy, Smirnoff, I think, who can do a good job too. Some folks prefer to go with a laymen with some military training. They like Captain Morgan. I don't know about the Captain. Too each his own.

      Now, I have to go to my Canadian Club to relax.

    • Re: (Score:3, Insightful)

      by raddan (519638)
      The reason, I suspect, is that some parts of chiropractic, e.g., massage, have actual therapeutic value. One of the reasons why people are so unhappy with traditional doctors is that a doctor will look at them, maybe touch a spot here and there, take a photograph, and then conclude: "there is nothing wrong with you". But this phrase means something quite different to a doctor than a layperson.

      A layperson _knows_ there's something wrong. It hurts! What they do not know, and what the doctor is telling
    • by Strange Ranger (454494) on Friday December 19, 2008 @01:12PM (#26174941)
      That's thing with Chiropractic... it's 85% bunk because it claims by "aligning your spine" it can heal all sorts of things.

      Straight snag from Wikipedia: [ emphasis mine]
      Chiropractic... emphasizes diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system, especially the spine, under the hypothesis that these disorders affect general health via the nervous system.[1]... Chiropractic treatment focuses on manual therapy including spinal manipulation and other joint and soft tissue manipulation, and includes exercises and health and lifestyle counseling.[4] Traditionally, it assumes that a vertebral subluxation or spinal joint dysfunction can interfere with the body's function and its innate ability to heal itself.
      [5]

      The bold stuff is the bunk. Complete garbage. But if they just said.. "Chiropractic.. we fix back problems." I think it would be a solid medical practice. Even evidence based. There is no doubt that electro-therapy applied to muscles relaxes spasms and reduces inflammation, that manipulating a sacroiliac joint for instance, back into alignment, definitely works.

      I have recurring problems with my sacroiliac joints. I walk into a chiropractor so crooked and bent I look like I have severe scoliosis, with one leg longer than the other, in severe pain. I walk out straight and tall, with soreness instead of debilitating pain. Every time.

      So yeah, mostly Chiropractic is bunk. But it can fix your back, "kinks" and spasms in your neck, a "thrown out" lower back, etc.

      My anecdote isn't evidence. But a physical therapist will do the same thing: http://www.sportsinjuryclinic.net/cybertherapist/back/buttocks/sacroiliac.htm [sportsinjuryclinic.net]
      They just charge a lot more and don't call it Chiropractic.
      • Re: (Score:3, Insightful)

        by Shikaku (1129753)

        This is the most insightful post about chiropractic in this topic.

        But it can fix your back, "kinks" and spasms in your neck, a "thrown out" lower back, etc.

        But I would like to add that basically they fix lots of things involving the spine. They can help with carpal tunnel syndrome a bit and if your shoulders are really bad they can teach you some ways to not mess up your shoulders typing on Slashdot I mean the computer all day.

  • by howlatthemoon (718490) on Friday December 19, 2008 @12:47PM (#26174619)
    In general, if you are sick or injured you get better or die. If you die you can't say anything about the failure of your medical care. If you have received care, more than likely likely you will improve. The question is whether the care altered the healing. Since humans like to find patterns, which help us predict future events, we tend to associate an action with an outcome. So, if we tend to get better, and we receive care, unless we are careful we will assume the care was positively associated with getting better. I really wish we were better able to teach that correlation does not imply causation.
    Remember, your chiropractor is little more than a highly paid masseur/se.
  • Dear Ben (Rothke) (Score:3, Insightful)

    by Slartibartfast (3395) <[gro.stoj] [ta] [nek]> on Friday December 19, 2008 @12:49PM (#26174641) Homepage Journal

    For the love of God, please: learn to use punctuation and better sentence structure. I tried making it through your review -- I really did. But this review, as well as your "New York News Radio: The voice of bad science" are so rife with incorrect usage that the message becomes blurred and incoherent. Just one example of many:

    "Contrary to what common sense and basic science, in homeopathy, a solution that is more diluted is considered stronger and as having a higher potency."

    What? Oh! I just realized: if I remove "what", the sentence suddenly makes sense. (No, I'm not being sarcastic or ironic.) Perhaps a careful proofreading is what you require, though your utter lack of possessive apostrophes implies that is probably not the case.

    Bottom line: you've got good stuff to say. Please learn how to better say it.

    Thanks.

    • Re: (Score:3, Insightful)

      Strongly agree. I had to re-read and consciously parse way too many sentences. The two missing possessive apostrophes right in the second sentence really kick things off with a bang, and it doesn't get better. There are several sentences where it is clear that you wrote one thing, changed your mind, and then didn't re-read the result, but left a word dangling from the first version. Poor grammar and sentence structure in a run-of-the-mill /. post is one thing, but this is supposed to be a finished (professi

  • although I agree (Score:5, Informative)

    by Trepidity (597) <delirium-slashdotNO@SPAMhackish.org> on Friday December 19, 2008 @12:50PM (#26174659)

    A lot of standard medicine doesn't really pass the test of evidence-based medicine either, in the sense that specific advocated treatments have been validated experimentally when applied to specific, observable conditions. That's one reason EBM is still relatively controversial: many standard surgical and medical practices are based on rational inferences from facts we're pretty sure of, but have never themselves been validated.

    To take a really simple example, look at how dermatologists treat moles. There isn't very good experimental data on mole prognosis. An EBM approach would say something like: given specific observed features of this mole, data tells us it has an x% chance of turning into a melanoma within Y years. You would probably need computer models to aggregate the various features that could contribute to or against it being at risk. Dermatologists don't generally have this information at hand (if it exists at all), but instead make more subjective judgment calls, based on some high-level knowledge of risk factors (which may or may not have ever been validated experimentally themselves).

    • Especially in areas where there's some specific push to use evidence-based medicine, its adoption is increasing and leading slowly to changes in clinical practice, as long-established assumptions have turned out not to be supportable by evidence.

      One of the more notable examples is the significant decrease in use of antibiotics for many bacterial maladies, which has been driven by an initiative to experimentally validate allegedly positive uses of antibiotics, and stop prescribing them if evidence of positiv

    • Re: (Score:3, Insightful)

      by Goldsmith (561202)

      It's very easy to find blind spots in any science.

      Simply ask a doctor to explain why inflammation happens or ask a physicist where G comes from.

      Any scientific person who is unwilling to say "I don't know" once in a while is not as scientific as they should be.

      As for determining whether moles will turn into cancer... there are particular chemicals given off by cancerous cells, and melanoma's "scent" has been mapped (after years of looking at moles and the chemicals which are present in the ones that do and d

      • It's that the entire premise this book's authors are coming from---that standard medicine is about evidence-based medicine---is not really universally accepted in standard medicine. Its acceptance is growing, but EBM as an explicit aim was only introduced in the early 1990s, and was initially seen as basically a crusade by a bunch of ivory-tower lab scientists who didn't understand the subjective complexity of real-world clinical practice. It's only from the late 1990s or so seen increasing acceptance in af

    • Re: (Score:3, Insightful)

      by MobyDisk (75490)

      A lot of standard medicine doesn't really pass the test of evidence-based medicine either

      I suspect that this is part of why people are turning to homeopathy, chiropractic, etc. If the medical community ignores their own scientific evidence, then people don't see alternative medicine as being much different.

      I think that in some cases, the scientific evidence seems counter intuitive, so it is ignored. And in some cases doctors have been doing something one way for years and convincing them to change is difficult. (Can you imagine being told that some procedure you have been doing for 20 years

  • oscillococcinum (Score:3, Informative)

    by EVil Lawyer (947367) on Friday December 19, 2008 @12:50PM (#26174667)
    FTFR: "If one looks at the content of oscillococcinum, a homeopathic alternative marketed to relieve influenza-like symptoms, the packaging states that each gram of medication contains 0.85 grams of sucrose and 0.15 grams of lactose. Sucrose and lactose are simply forms of sugar, of which oscillococcinum is nothing more than am expensive sugar pill."

    Um, it does contain both .85 grams of sucrose and .15 grams of lactose, but those are only the "inactive" ingredients. The supposedly active ingredients are "200CK Anas barbariae hepatis," or heart and liver of the Muscovy duck. Whatever that is. I'm not saying I think it works (though they do have clinical data showing some benefit over placebo), but that the reviewer is wrong that it's ONLY a sugar pill.

    • Re: (Score:3, Informative)

      by FroBugg (24957)

      Except that there is none of this ingredient physically present in the medicine. At some point (supposedly), some small quantity of this ingredient was mixed with greater and greater and greater quantities of inactive dilutants until you'd be lucky to find a single molecule of it in a swimming pool full of the stuff.

      That's how homeopathy is supposed to work. By the memory of the water or whatever was in contact with the "active" ingredient.

    • Re:oscillococcinum (Score:4, Insightful)

      by Amazing Quantum Man (458715) on Friday December 19, 2008 @01:09PM (#26174905) Homepage

      The point is that 1 gram contains .85g sucrose and .15g lactose. In base 10, .85 + .15 = 1.0, therefore the entire 1g contains nothing but sugar. Where is the "Anas barbaria hepatis" to fit?

    • Re:oscillococcinum (Score:5, Informative)

      by mcg1969 (237263) on Friday December 19, 2008 @01:15PM (#26175007)

      The key point you've glossed over is the measurement "200CK". How much is 200CK? It means that the substance has undergone 200 100-to-1 dilutions. That means that the concentration has been reduced from full strength by a factor of 100^200. Yes, that's right---10^400. According to this article [wikipedia.org] in Wikipedia, the number of observable atoms in the observable universe is approximately 10^80. Clearly, you will be the luckiest person alive, 10^40 or so times over, if even one atom of the active ingredient is left in your sugar pill.

  • by aepervius (535155) on Friday December 19, 2008 @12:51PM (#26174675)
    From the example of my family (all have at least a master in education, albeit I am the only one with a natural science [physic] PhD), the main problem is that people do not know how long an usual illness can take to naturally cure (without intervention) and also suffer for confirmation bias. This is enough to explain fully why people even intelligent one buy into it. I keep telling them the old doctor joke : "with medicine you will cure your average banal cold in 14 days. Without it will take 2 weeks". I keep telling them to try blinding as an experiment, to try reading scientific result, I indicated them why it could only be placebo, but after a while, I decided to simply stay silent. Their usual answer was only "it works for me". From that position of belief, sympathic magic, nothing can be done. you can as well try to convince a christian with logic that Jesus was an oridnary man and not the son of god or something similar. The worst is that when they get "complication" they ascribe it to having forgotten or not properly taken their "homeopatic" globule... But when they are cured after the average "14 days" they ascribe it to their beloved oscillocoxnium. The usual confirmation bias, the same which works with other scam like dead talking and what not : forget the negative remember the positive.

    In the mean time, I simply have utterly given up, I think we would need 3 or 4 generation of basic scientific education from the 1st grade onward to change the trend. The way it is now, people as a whole will never be able to recognize homeopathy for the pathetic scam it is. Even if you rub their nose in it.
  • Scientific Method (Score:5, Insightful)

    by Andr T. (1006215) <andretaff&gmail,com> on Friday December 19, 2008 @12:52PM (#26174693)

    The authors provide numerous reasons for this, from the concepts such as natural, traditional and holistic, to attacks on the scientific method by the alternative medical community and more.

    This _really_ makes me angry. When I talk to someone about homeopathy, they always tell me about how "alopathy" doesn't work on prevention and how all those "chemicals" do bad things for your health.

    I think they don't relate the studies saying "don't eat too much fat, it's bad for your heart" and "don't smoke, you bastard, or your lungs will collapse" with prevention. I don't know why.

    I don't have a problem with people getting cured by placebos. But I do want them to notice that, if they have TB, it's the "oh-my-god-they're-so-bad" antibiotics that will probably save them.

  • by Vidar Leathershod (41663) on Friday December 19, 2008 @01:00PM (#26174777)

    While some Chiropractors are trying to sell people on "Blue Light Therapy" and other stuff, others do help patients who are in great pain. Ask anyone who has been helped with Sciatica that occurred after a lumbar disc problem whether they would prefer to go back and have surgery, rather than the solution they got from the chiropractor. Or maybe the person who had a pinched nerve in their neck causing total numbness to shoot down their arm and pain in their shoulder. When the Chiropractor fixes this issue, do we disregard the results because we believe Chiropractic to be quackery?

    Meanwhile, we'll have all the kooks out here proclaiming that Vitamin C or Zinc don't help with colds, and whatever you do, don't drink cranberry juice to help you with a UTI.

    I've seen plenty of quackery. Many people in the Alternative medicine field are insane. But that doesn't mean that every treatment that is not released by a pharmaceutical or approved by a certified M.D. is useless.

  • by Ichoran (106539) on Friday December 19, 2008 @01:06PM (#26174869)

    I looked into these things at various points when I was feeling bored. My recollection is that

    - The placebo effect is a real effect, and can make you feel better, especially if you are more invested in the outcome (either financially (spend $$$$) or socially (there are doubters but you *know* it works); simply wanting to be better for health reasons is less useful).

    - Homeopathy is useless except as a placebo (but one could argue that generating belief in homeopathy is the best way to deliver the placebo effect because you don't have to give the person anything but water).

    - Chiropractors on average do not generate an improved outcome for their patients (possibly beyond a short initial time when the patient feels worked on) on *average*, but there exist some chiropractors who perform at well above chance on helping people with certain types of problem. It was unclear to me at the time whether this was due to the mechanical manipulations or to the placebo effect.

    - Acupuncture has mixed success, but can have reliable if small-on-average effects on certain types of problem. I am pretty sure that there was a control group here, so this is above and beyond what one gets from the placebo effect.

    - Herbal medicine runs the entire spectrum from harmful through better than established commercial drugs for some things. Knowing which is which is difficult if you listen to the people who like herbal medicine.

    - Commercial drugs usually (but not always) work well on average, but insufficient attention is paid to whether they give small benefits to everyone or large benefits to only a small subgroup, and they very often have long-term side effects that are insufficiently characterized. Using older products it therefore more safe than using new exciting ones.

    But I'm afraid I don't have references for any of these vague recollections. Perhaps someone knows of studies to the contrary (or which support these tentative beliefs)?

    • Re: (Score:3, Interesting)

      by raddan (519638)
      My own vague recollection matches yours. On the commercial drug front, tailored drugs are currently the subject of intense research. We now have the ability to quickly sequence a person's entire genome within a reasonable timeframe. What is not well understood, however, is how those genes get expressed, and how that expression interacts with various drugs. The discovery of [what is now being called] the epigenome essentially adds at least an order of magnitude more complexity into biochemical processes
  • From my experience (Score:3, Interesting)

    by aztektum (170569) on Friday December 19, 2008 @01:42PM (#26175407)

    As someone who has dealt with depression and anxiety: 9-10 of meditation, exercise and healthy eating have helped far more than my doctors singular advice to take 3 different medications for over a year.

    I've dealt with more than a few doctors who seem more interested in, to borrow a phrase, treating the illness and not the patient. I really do think that our drugs are over prescribed. In emergencies, no doubt would I want the latest and greatest; but for every day living your average person probably doesn't need a medicine cabinet full of prescriptions.

    I'm as skeptical as the next guy when it comes to "alternative" medicine and down right dismissive of religious quackery from which of it stems. Conversely I can't help but feel there is a disconnect between modern medicine and patient care. There is more to being a doctor than telling people "Take two of these and call me in the morning.". A school of thought I immediately align authors of books like this to.

    I haven't started it yet, but I am looking forward to cracking open this book [amazon.com] as well as digging deeper into Zen & the Brain [amazon.com]. Both also written by MD's.

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