Archive for December 15th, 2009

The One True Cause of All Disease

Note: This is a slightly modified version of an article that was published in the magazine Skeptical Inquirer, Volume 34, No. 1, January/Februrary 2010. It is reprinted here with the kind permission of the Committee for Skeptical Inquiry.


Chiropractors, homeopaths, naturopaths, acupuncturists, and other alternative medicine practitioners constantly criticize mainstream medicine for “only treating the symptoms,” while alternative medicine allegedly treats “the underlying causes” of disease.

Nope. Not true. Exactly backwards. Think about it. When you go to a doctor with a fever, does he just treat the symptom? No, he tries to figure out what’s causing the fever and if it’s pneumonia, he identifies which microbe is responsible and gives you the right drugs to treat that particular infection. If you have abdominal pain, does the doctor just give you narcotics to treat the symptom of pain? No, he tries to figure out what’s causing the pain and if he determines you have acute appendicitis he operates to remove your appendix.

I guess what they’re trying to say is that something must have been wrong in the first place to allow the disease to develop. But they don’t have any better insight into what that something might be than scientific medicine does. All they have is wild, imaginative guesses. And they all disagree with one another. The chiropractor says if your spine is in proper alignment you can’t get sick. Acupuncturists talk about the proper flow of qi through the meridians. Energy medicine practitioners talk about disturbances in energy fields. Nutrition faddists claim that people who eat right won’t get sick. None of them can produce any evidence to support those claims. No alternative medicine has been scientifically shown to prevent disease or to cure it. If it had, it would have been incorporated into conventional medicine and would no longer be “alternative.”

Are these practitioners treating the underlying cause, or are they simply applying their one chosen tool to treat everything? Chiropractors treat every patient with chiropractic adjustments. What if a doctor used one treatment for everything? You have pneumonia? Here’s some penicillin. You have a broken leg? Here’s some penicillin. You have diabetes? Here’s some penicillin. Acupuncturists only know to stick needles in people. Homeopaths only know to give out ridiculously high dilutions that amount to nothing but water. Therapeutic touch practitioners only know to smooth out the wrinkles in imaginary energy fields. They are not trying to determine any underlying cause: they are just using one treatment indiscriminately. (more…)

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Acupuncture, the P-Value Fallacy, and Honesty

Credibility alert: the following post contains assertions and speculations by yours truly that are subject to, er, different interpretations by those who actually know what the hell they’re talking about when it comes to statistics. With hat in hand, I thank reader BKsea for calling attention to some of them. I have changed some of the wording—competently, I hope—so as not to poison the minds of less wary readers, but my original faux pas are immortalized in BKsea’s comment.

Lies, Damned Lies, and…

A few days ago my colleague, Dr. Harriet Hall, posted an article about acupuncture treatment for chronic prostatitis/chronic pelvic pain syndrome. She discussed a study that had been performed in Malaysia and reported in the American Journal of Medicine. According to the investigators,

After 10 weeks of treatment, acupuncture proved almost twice as likely as sham treatment to improve CP/CPPS symptoms. Participants receiving acupuncture were 2.4-fold more likely to experience long-term benefit than were participants receiving sham acupuncture.

The primary endpoint was to be “a 6-point decrease in NIH-CSPI total score from baseline to week 10.” At week 10, 32 of 44 subjects (73%) in the acupuncture group had experienced such a decrease, compared to 21 of 45 subjects (47%) in the sham acupuncture group. Although the authors didn’t report these statistics per se, a simple “two-proportion Z-test” (Minitab) yields the following:

Sample X   N   Sample p

1            32  44   0.727273

2           21  45   0.466667

Difference = p (1) – p (2)

Estimate for difference: 0.260606

95% CI for difference: (0.0642303, 0.456982)

Test for difference = 0 (vs not = 0): Z = 2.60 P-Value = 0.009

Fisher’s exact test: P-Value = 0.017

Wow! A P-value of 0.009! That’s some serious statistical significance. Even Fisher’s more conservative “exact test” is substantially less than the 0.05 that we’ve come to associate with “rejecting the null hypothesis,” which in this case is that there was no difference in the proportion of subjects who had experienced a 6-point decrease in NIH-CSPI scores at 10 weeks. Surely there is a big difference between getting “real” acupuncture and getting sham acupuncture if you’ve got chronic prostatitis/chronic pelvic pain syndrome, and this study proves it!


Posted in: Acupuncture, Clinical Trials, Science and Medicine

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