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10 May, 2009

Sunday Sensational Science

Woo Gets Whacked



In a world full of woo, who do we turn to? There's a small army of bloggers out there whose mission, which they enthusiastically accept, is to seek out new and old forms of woo wherever they flare up, set the phasers on "obliterate," and hit the snake-oil salesmen right between the eyes. They're scientists, doctors, and hard-core skeptics.

They are the bane of all pseudo-scientific mumbo-jumbo artists.

And they are relentless.

They're also delightfully snarky. Only part of the pleasure in a good debunking is the overwhelming onslaught of facts. These authors don't stop there. They employ the devastating weapons of humor, disdain and sarcasm to leave their targets moaning on the ground.

No woo can withstand them.


The White Coat Underground
Reiki: still stupid after all these years

Here's my problem with reiki---it's bullshit, pure and simple.

"But how can you be so dismissive?," a credulous reader might ask. My answer comes in two parts.

Absurdist ridiculousity

OK, so I made up that phrase---which is exactly what I have in common with the founder of reiki. In 1922 Mikao Usui (JSG) fasted on a mountaintop in Japan and "received" the revelation of reiki. In other words, he made it up.

[snip]

Evidence---there isn't any

Really, there isn't. Every once in a while, I skim the literature to see what may be new regarding various cult medicine practices. There are dozens of pilot studies and case reports, which are basically useless, but most of the controlled trials have failed to show any benefit to reiki above that of placebo. (The pilot studies mostly evaluate the safety of reiki, which shouldn't be in doubt given its inert nature.) For example, an article in the Journal of Alternative and Complementary Medicine (not exactly hostile ground for reiki) published a randomized controlled trial of reiki for fibromyalgia pain. The conclusions?

Neither Reiki nor touch improved the symptoms of fibromyalgia. Energy medicine modalities such as Reiki should be rigorously studied before being recommended to patients with chronic pain symptoms. (J Altern Complement Med. 2008 Nov;14(9):1115-22.)

If reiki is so damned promising, it shouldn't be all that hard to measure an effect.


Respectful Insolence
A cancer quackery I had never heard of before?

Perusing the Skepchick blog the other day I saw a wonderful story related by Masala Skeptic about how a group of skeptics in Mississippi attended a talk by a cancer quack named Robert Dowling, who apparently claims that dental pathology is the cause for all cancer and sells a "cure" for breast cancer called Quantum Health Management and triumphed. This is how:

After the steaming piles of pseudoscience flew right and left, the skeptics in attendance asked our questions: what bacteria cause this? Why would doctors cover up a cure for cancer? What studies have you done? Where were they published? How long have you followed your patients? Are you a doctor? We asked far more questions than the rest of the audience combined, even though they outnumbered us six or seven times. I doubt that Randi, Dennis, Brad, Don and I were the only ones skeptical of his claims - but we were the only ones voicing that skepticism.

Dowling did not have our answers. After claiming to have published studies, after claiming a 100% cure rate, after calling himself a doctor, he said that he had the proof. And when we asked for it, we got dodgy answers, evasions, and even the confession that he was not in fact a doctor. Of course, he was only a few semesters away from a medical degree in the Caribbean.

[snip]

After having seen the account of this lovely slapdown on Skepchick and Living Better Skeptically, I headed straight over to Robert Dowling's website, CancerCured.org, which forwarded me to BreastCancerCured.com. The website claims to be something called the North Carolina Institute of Technology, and, boy, oh, boy, is there some pseudoscientific woo there!

[snip]

First, there's the usual claim for curing cancer "without chemotherapy, radiation, or radical surgery." Then there's the claim that "100% of participants" are now cancer-free. Then, of course, there's the fake journal to publish the "results" of these "studies."

Science-Based Medicine
Risks Associated With Complementary And Alternative Medicine (CAM): A Brief Overview

Having grown up on a dairy farm, I am one of the least likely people to object to the deification of yogurt. However, as a critical thinker, I cannot help but resist the idea (promoted by some health sites) that probiotics are a reasonable alternative to chemotherapy in the treatment of colon cancer. And there are many other equally unhelpful claims being made all the time. Fish oil for ALS anyone?

What amazes me about the “cherry yoga” camp (as my friend Bob Stern likes to call it), is that they aggressively market CAM as “harmless” and “natural.” They point to the warning labels and informed consents associated with science-based medicines as evidence that the alternative must be safer. In reality, many alternative practices are less effective, and can carr

y serious risks (usually undisclosed to the patient). For your interest, I’ve gathered some examples of risks associated with common alternative practices that have been described by the CDC and in the medical literature:

Colon cleansing: amebiasis, ruptured colon with pelvic abscesses, Fournier’s gangrene

Herbal supplements: fulminant hepatic failure, bladder cancer, arsenic poisoning, anticholinergic poisoning, lead poisoning, severe hemorrhage, hepatic failure.

Acupuncturebilateral pneumothoraces (collapsed lungs) leading to death, transmission of hepatitis C

Chiropractic Manipulations - Vertebral artery dissection and stroke, pediatric subarachnoid hemorrhage, paralysis, and misdiagnosed meningitis

Homeopathy - offered for malaria prophylaxis. All 5 contracted malaria. Offered in lieu of standard of care treatment for melanoma (patient died), colloidal silver causes permanent skin disfigurement.

All CAM - can result in delay of effective care, thus worsening outcomes for cancer patients and others.


The Quackometer
A quickly bashed out manifesto, if I were to have such a thing

Last night, a friend who I have not seen for a little while, asked me an important question. She was well aware of my blogging activities as my blog rss feed pipes through delicious and then twitter and onto my facebook account, or something. Why my fascination with criticising alternative medicine? A difficult question – and after a few pints and the energy for a one word answer, I responded “sport”.

Fortunately, a journalism student asked me some interview questions that allowed me the indulgence of providing a little more depth to my reasoning. I repost them here for the record after bashing them out whilst also trying to cook a mushroom stroganoff. The strog was a success. I hope these answers are also digestible.

Is there any e

vidence that alternative medicines work?

That depends on which alternative medicine you mean and what condition you want it to work for. It also depends on what you mean by 'work'. A complex question. What we do know is that most alternative medicines are essentially inert - they have no specific effects. Homeopathy uses medicines so dilute that no medicine remains. Reiki is just a form of faith healing. Acupuncture is just sticking pins in your body at arbitrary points. Reflexology is just a foot massage. Bach Remedies are just dilute brandy. Practitioners may claim specific effects due to 'quantum theory' or Chinese Meridians and Qi, but these are just pseudoscientific explanations with no basis of evidence or rationality. Some therapies may have specific effects such as chiropractic, but the evidence suggest that this is only effective for lower back pain and then pain killers may be just as good, and much cheaper. A few herbs have been shown to have specific effects, but patients have no way of telling if their herbs contain the right amount of active ingredient and are not contaminated with other compounds.

Do you think there is any merit in using alternative medicines and
therapies or is it more of a danger to health?

Even though specific effects may be non-existent, or at best unpredictable, alternative medicines may well give non-specific effects and these may indeed have positive effects. The use of alternative medicine may well give a sense of empowerment and control, lift the mood, reduce anxiety and make pain more bearable. Together, these effects tend to be clumped under 'the Placebo Effect'. In itself, this is not harmful and it is clear to see why patients like to take alternative medicines. The dangers are wider though. Firstly, in order to gain a good placebo effect, you have to believe that the therapy will work. The therapist then has to be a liar or deluded about their own powers. Trust in medicine is pretty important and it can be argued that the mild benefits of placebo do not outweigh the loss of integrity in delivering a placebo. Also, placebo effects are not magic. They have effects concerning beliefs but do not generally alter the course of the illness. With serious illnesses, people taking alternative medicine may delay or avoid treatment with proven beneficial and necessary effects. Practitioners too fail to limit their claims to what can be expected from a placebo treatment as they often do not realise this is what they are doing. Therein lies the danger of alternative medicine.


Wandering in the Wilderness
The Seductive Powers of Woo

I’ve read in about a hundred new agey books on clearing out clutter (yes, including some on Feng Shui) that clutter traps us. That we need to let go of things if we are to move on. Obviously I don’t buy into that kind of nonsense, but there is something to be said for the cathartic walk down memory lane that happens when you go through your stuff. I started the culling with the most obvious stuff… the shelves that I filled when I decided to begin making my own soap. Before you decide to send me a snark-o-gram, I decided to make my own soap because the detergent bars that I purchased at the grocery store made me wheeze and dried my skin.

Woo Purrs Into Your Ear: “Natural is Always Better”

The soap making led to a foray into the wonders of Aromatherapy and of course Herbal Medicine. Natural Care is an interesting subject, I read books by Worword about the effects of essential oils, read Rosemary Gladstar and her particular brand of nuttiness, and even picked up a book titled: “Magical Aromatherapy” at the suggestion of an instructor which truth be told was fairly disappointing although there are some very nice recipes for scented cleaning supplies. No magic, but the house smells lovely. One thing that I picked up that will remain on the shelf is “Culpepper’s Complete Herbal and English Physician” which is a great read just for glimpse into the beginnings of medicine, and folk medicine.

The Natural Care led me to look into Detoxing. Detoxing my life, environment and of course body. All nonsense. And nonsense which has not really changed in the years since I looked at this stuff. Blah, Blah, blocked chakras, blah, blah, blocked liver, blah, blah, evil conspiracy by chemical companies which are making us sick. It was interesting to read but didn’t make it past the pre-skeptic Bullshit Detector.

Next. the “Beauty Industry Conspiracies”. Books like “Don’t Go To The Cosmetic Counter Without Me” and “The Truth About Beauty” which “Offers a Blue Print” and is a “Paradigm Shift” and contains things like “Myth: Beauty Requires Will Power and Self-Discipline - Fact: Will Power and Self-Discipline are dead end roads”. Of course there is a conspiracy by cosmetic companies to keep the public ignorant about proven natural alternatives. Blah, Blah, Natural works best.

It is all very seductive, if I didn’t have a strong science background and the passion for reading and learning I could have easily been pulled into the land of the “Natural Cures”. There is something reassuring about the idea that a product can do no harm if it is ‘natural’. That horrible Kevin Trudeau has made several fortunes feeding off of the ignorance and distrust that people have of things that they do not understand. More importantly he has earned a special place in the Hell of Crap Coming Out of Your Mouth For Eternity by feeding off of human misery and fear.

Reality Growls: “If This Crap Worked - It Would Be Common Knowledge. Think of the Grant Money!”



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