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Clinical trials of integrative medicine: testing whether magic works?

 

I just thought that I’d take the editor’s (and, speaking for Steve, the founder’s) prerogative to promote our own efforts. Regular readers of SBM are familiar with our message with respect to randomized clinical trials of highly implausible “complementary and alternative medicine” treatments, such as homeopathy or reiki. Well, believe it or not, Steve and I managed to get a commentary published in a very good journal in which we present the SBM viewpoint with respect to these trials. Even better, at least for now, you can read it too, because it doesn’t appear to be behind a paywall. (I’m at home as I write this, and I can read the whole thing on my wifi, no VPN needed.)

The article is entitled “Clinical trials of integrative medicine: testing whether magic works?” There’s also been a fair amount of news coverage on the article, and I’ve been frantically doing interviews over the last couple of days, including:

There are likely to be at least a couple more, given the interviews I’ve done; that is, unless editors reject the ideas.

In any case, Steve and I are interested in your comments. Trends in Molecular Medicine is good in that it published our article and it’s a pretty high impact review journal, but it doesn’t have a section for comments. So consider this your section for comments on our article.

Posted in: Basic Science, Clinical Trials, Homeopathy

Leave a Comment (139) ↓

139 thoughts on “Clinical trials of integrative medicine: testing whether magic works?

  1. Neil J says:

    I thought that was great, Drs. Gorski and Novella. Succinct and to the point, touched all the most important bases (homeopathy, reiki, TACT), and drew a well-defined line between SBM and EBM.

    I couldn’t help but notice the choice to exclude chiropractic in this paper, though. My guess is that you didn’t want to open that can of worms because there is some legitimacy to the more physiotherapy-aligned aspect of the practice, and not everyone buys into the subluxation nonsense. Also, there’s probably a word limit. Am I close in my thinking?

    Also, FYI all of the reference hyperlinks go nowhere.

    1. Chris says:

      They all worked for me. I am using Mozilla FireFox on a Comcast cable account in the USA through a home WiFi router. What are you using?

    2. Chris says:

      By the way, for a very long time I could not access http://doubtfulnews.com/ from my home. I actually accessed it from other hotspots like local coffee shops and the hospital guest wifi where my son was getting therapy.

      1. Neil J says:

        I’m referring to the numerical reference hyperlinks in the HTML version of the JMM paper. They should redirect the reader to the proper entry in the bibliography but instead they go nowhere. It’s fine in the PDF (and the entries are numbered in the PDF). I’d assume it’s just a problem with JMM’s HTML setup.

        1. Nick J. says:

          The hyperlinks aren’t hyperlinks. they’re javascript. (the link is to javascript:void(0) ). hover over the number, and the reference info pops up.

          the original doc is actually over at ScienceDirect. my guess is Cell pulled the paper from there, and then had its own script for converting from their wonderful interface. They puked javascript all over their interface a couple years ago, so that it doesn’t load the full doc until you scroll down, clicking links make info pop into the right frame (which is what clicking refs do there) etc. used to get really annoying trying to quick scan papers.

      2. Neil J says:

        I probably could have made that more clear in my original post but I myself have been writing a paper all day and it’s ruined my brain.

        1. Chris says:

          Ah, I see. It was a detailed part of some URL that most of us would not venture to click on. Plus the muddled brain bit after lots of mental exertion.

          Been there, done that.. though not for a long time. Which is why I hang around here. I used to be intelligent, but then I had kids.

          By the way, I tried the links of the references, and you are right… they are screwed up. I did not click on them mostly because the article is more of an editorial, and I was being lazy. Plus, I recognize many of them since I have been reading this blog since it started. Though I doubt Dr. Gorski had anything to do with Cell.com’s web programming.

  2. Badly Shaved Monkey says:

    It’s good to have a publicly available statement in a formal journal to explain why SBM importantly refines the EBM concept.

    I have one minor quibble with some wording in the abstract “Despite low to nonexistent prior probability that testing these treatments in randomized clinical trials (RCTs) will be successful”. Of course, as you go on to explain, the problem is actually that RCTs of SCAM are all too often ‘successful’ because random effects and biases can lead to the appearance of success even where the SCAM itself is incapable of actually being successful. I suppose the sentence from the abstract really means the following “Despite low to nonexistent prior probability that testing these treatments in large, well-run and fair randomized clinical trials (RCTs) will be successful, RCTs of these modalities have proliferated,”. It’s a bit technical and pedantic, but I think it captures your meaning more accurately.

    All that said, the news articles seem to have picked up the underlying message quite well, although we have the usual false balance problem with the amount of space given to the unchallenged assertions of the mother-daughter reiki team who clearly seem to regard the existence of scientific evidence as nothing more than optional window-dressing.

    1. goodnightirene says:

      “…who clearly seem to regard the existence of scientific evidence as nothing more than optional window-dressing.”

      That is the main underlying problem with the woo-inclined, er pseudoscience-inclined (with respect to Dr. Crislip’s initiative). Those who regularly use and support pseudoscience simply do not understand or appreciate the value of the scientific method. They are committed to “other ways of knowing” or “science just can’t explain it, who cares?” types of thinking. No matter how much I bring many points made in this blog to the attention of my wooish acquaintances, I am told that “it works and I don’t care how” and the like.

      We need to spend as much time promoting basic science and critical thinking as debunking. I tried referring a wooish friend to the new version of Cosmos. Not only had she not heard of it, but she had never heard of Carl Sagan. She thought she might have an idea who Neil DeGrasse Tyson is–“isn’t he black”? I then referred her to Sagan’s book The Demon Haunted World, but alas, she “doesn’t read much”. She has “lazy eye” after all. Now, I ask you, why hasn’t her chiropractor taken care of that? She’s been seeing him regularly for twenty years!

      But, I digress, and at least this article by our resident docs points out what should be embarrassing to a lot of other docs and institutions.

    2. rork says:

      I think it should actually be “Despite low to nonexistent prior probability that these treatments actually work better than placebo” or such. The prior probability of getting p<.01 (say that is "successful") in an RCT of pure-junk treatment is .01. In an even larger study, still .01. Statistician review might have helped that.
      (No disagreement with Badly's points intended. Last phrasing, very nice.)

  3. MW says:

    Although reiki and homeopathy strike me as ridiculous subjects for clinical trials and investigations, it would be good to have solid research (beyond population study correlations and generalities) on the role of exercise and diet in the lives, and survival, of cancer patients.

    1. Badly Shaved Monkey says:

      Another unintended consequence of the “integrated medicine” tendency is that perfectly reasonable hypotheses such as these get sucked in under the quacky umbrella. We don’t want to be throwing these babies out with the bath-water, we want to have them rigorously tested by competent people whereas the the IM community shows a singular lack of competence in testing anything, which I suspect is partly deliberate, to shield their quackery from serious trials, and partly actual incompetence.

      A the bloggers here at SBM keep pointing out, good medicine is by its nature holistic. Unfortunately the quacks have hijacked some valid areas of research interest in genuinely holistic care.

    2. WilliamLawrenceUtridge says:

      on the role of exercise and diet in the lives, and survival, of cancer patients.

      I can see absolutely no link between this quite mainstream hypothesis and alternative medicine. Why do you bring it up?

      Also, I think the research has been done:

      Exercise and breast cancer.

      Diet and breast cancer.

      Of course, that’s only breast cancer, you’d have to test it with all the different types and stages of cancer to really know.

  4. rork says:

    “In RCTs testing modalities with low pre-test probability (i.e., low plausibility), confounding effects are vastly magnified, easily producing false-positives [15].”
    Someone explain what they think that is attempting to say. The reference is to PMID: 10383350, “Toward evidence-based medical statistics. 2: The Bayes factor.”

    1. whoa says:

      I can explain: it means that “skeptical” materialists are free to discount any positive evidence that they don’t agree wiith.

      1. WilliamLawrenceUtridge says:

        Are you sure you can’t explain it because you can’t understand it?

        And why do you keep bringing up materialism as if it were relevant to all conversations? Do you really think God or the supernatural is so omnipresent as to influence all things, but so undetectable as to never leave unambiguous evidence?

        I’ll just point out that your claim is both untestable by nature and indistinguishable from a reality where God doesn’t exist.

      2. Windriven says:

        ““skeptical” materialists are free to discount any positive evidence that they don’t agree wiith.”

        Wrong. As usual. I have to hand it to you whoa, you are, if nothing else, consistent.

        Evidence speaks for itself and is only subject to discount if it is anecdote or error masquerading as evidence. Why don’t you link us your evidence that water has memory. We’ll use that as an object lesson for you.

    2. MadisonMD says:

      Agree the wording is unclear. What I understand it to mean is that: (a) given FPR of 5% of a highly implausible therapy, a positive is more likely to be false than real. (b) Publication bias will select for positive studies. (c) The need to publish for academic promotion and/or to promote ones ideas will additionally favor trials with a higher likelihood of false-positive rate achieved through multiple endpoints or confounders. Perhaps Ioannidis would have provided a better cite but I didn’t have time to look in PMID 10383350 to see if it is supportive.

      1. rork says:

        Yea, perhaps those things, oft discussed here. Brevity was probably an issue. I could make a joke about that, but it would be unfair, since blogging and manuscripts are different.
        I worried it was edging near heresy of p=.05 gives smaller false discovery rates for more plausible hypotheses, which, out in the wild of what actually gets published, is likely true, though in math theory it isn’t. Maybe there is a better cite (the why half of it is false one perhaps – the one you might mean).

  5. whoa says:

    “the mechanism should not violate laws and theories in science that rest on far sturdier and longer-established foundations ”

    What you really mean is “the mechanism should be compatible with philosophical materialism.”

    “homeopathy violates multiple laws of physics with its claims that dilution can make a homeopathic remedy stronger and that water can retain the ‘memory’ of substances with which it has been in contact before”

    There is scientific evidence that water can store information. More research is needed and it is not yet well understood, but water memory has been demonstrated. Of course, that makes “skeptical” materialists very angry.

    1. David Drummond says:

      “There is scientific evidence that water can store information.”
      Citation needed. and a good citation not some bs article from a news site a real scientific paper.
      “More research is needed and it is not yet well understood, but water memory has been demonstrated. ” i agree more, more research would be a good thing, BUT that would be irrelevant as your second notion that water has “memory” violates many laws of physics and, more importantly, the laws of chemistry. Avogadro’s number much? Of course that makes “magical thinking” loonies like yourself very angry.

      1. Harriet Hall says:

        Before anyone tries to explain “how” homeopathy works, the burden is on homeopaths to show “that” it works. They have failed to provide any convincing high quality evidence that it works any better than water.

        Those attempting to show the “memory of water” fail to realize that even if water could hold a memory, that would not begin to explain a therapeutic effect in the human body opposite to the effect of the substance being remembered.

        1. WilliamLawrenceUtridge says:

          I would even venture that this is an inverting of things – in most cases you must show that a drug or treatment works in some sort of prior-probability-reinforcing model (usually cells and animals) before people. Jumping straight to people means you have to start accounting for a host of placebo issues.

          They’ve invented research protocols where specific rat behaviors are models for human addictive behaviors; surely if homeopathy is as powerful as proponents say it is – they can demonstrate it in rats.

    2. Badly Shaved Monkey says:

      Even if water had usable memory, you then need to explain how this is transferred to sugar pills from which that water has been evaporated.

      You then need to explain how one such pill can transfer this to a whole pot of blank pills (grafting).

      You then need to explain how writing the name of the remedy on a piece of paper and sitting a pot of sugar pills on top transfers these hypothetical water-based memories to the pills (paper remedies).

      [Hint: you can't]

    3. Cervantes says:

      Water has not only been in contact with whatever homeopaths put in in it before dilution — it has been in contact with human and animal urine and feces, sea salt, and the lungs of Julius Caesar, among everything else on the planet since 4.5 billion years ago. How does it decide which of those memories to retain?

      1. Nick J. says:

        it’s all in the wrist. or shaking. or ‘striking’. or whatever.

        water is to medicine what The Clapper is to bedroom lights.

        1. WilliamLawrenceUtridge says:

          Don’t you know? You’re actually supposed to hit them against a Bible. That’s what Hahnemann did.

    4. MadisonMD says:

      There is scientific evidence that water can store information.

      Hey, whoa, for only $100 you can purchase this all-natural 500,000-terabit data storage unit to attach to your computer. Act now, and you will get free shipping. But wait, there is more. We will also send you a bag of organic deionized water to maximize performance of your storage. This special offer (the water) ends today so act now.

      Skeptical materialists will think you a “sucker” but, no matter, you ignore them already.

    5. Neil J says:

      @whoa #5
      “There is scientific evidence that water can store information.”

      No. No there is not. Unless a whole mess of thermal energy is removed (i.e. the water is frozen), the molecules in water will completely rearrange themselves in a fraction of a second.

      http://www.nature.com/nature/journal/v434/n7030/full/nature03383.html

      Note the end of the abstract. “…liquid water essentially loses the memory of persistent correlations in its structure within 50 fs.”

      Also, it’s kind of funny to me that you accuse others of “materialism” before trying to make a materialistic case for homeopathy yourself. Why not just say “it’s magic” and avoid having to scientifically justify your claims at all?

      1. Calli Arcale says:

        Well, technically you *can* get water to store information, but I doubt <a href="http://www.amazon.com/Silicone-Alphabet-Letter-Bake-Tray/dp/B001CJGM1E"this is what they had in mind…..

    6. weing says:

      “There is scientific evidence that water can store information.”
      Maybe pseudo-scientific evidence? Didn’t you say pseudo-science was fine with you? So why not continue to flaunt it?

    7. WilliamLawrenceUtridge says:

      What you really mean is “the mechanism should be compatible with philosophical materialism.”

      Actually, what he really means is “if you’re going to claim that something works but fundamentally violates the principles that have survived centuries of scientific testing, you better have really, really good evidence.” Philosophical materialism itself can expand to include hitherto-unrecognized concepts, provided they are repeatable. If they’re not, then you basically have no way of proving they exist, and you’re resting on faith. That’s fine if you want to do that – but don’t expect it to be convincing or useful.

      There is scientific evidence that water can store information. More research is needed and it is not yet well understood, but water memory has been demonstrated. Of course, that makes “skeptical” materialists very angry.

      Really? Where? Could you link to a source please? And if this is true, then why does homeopathy consistently fail scientific testing?

      What makes most skeptics angry is people making assertions without substantiating them with sources. And it’s really more irked than angry.

    8. Chris says:

      “There is scientific evidence that water can store information. More research is needed and it is not yet well understood, but water memory has been demonstrated”

      How old were you when you completed your last year of formal education? Twelve years old?

      You seem to be a bit fuzzy on the basics of chemistry and physics. Specifically the concepts known as the conservation of energy and the conservation of mass. Do you have a clue what the difference is between potential energy and kinetic energy?

    9. Peter S says:

      Water not only has a memory, it can store colloidal minerals that have been encoded with information, or something like that.

      How Does NES Work?

      The NES scanning method uses a highly advanced process based on biophysics science in the form of a QED scan, to read the HBF map.

      A NES scan is quick, easy, safe, and non-invasive. Simply place your hand on an input device that looks like a computer mouse and in seconds, the assessment is complete.

      Natick Chiropractor | Natick chiropractic Nutri-Energetic Systems | MA |

      Your healthcare practitioner can then recommend the correct protocol using a month-by-month dose of InfoceuticalsTM. These, infoceuticals contain mostly water, micro-quantities of alcohol (preservative), and plant derived minerals, whose subatomic structure has been encoded with information that corrects the Body-Field. This encoding is analogous to the way a DVD is encoded with audio and video info read only by a DVD player (your body in this case).

      Because they have no direct effect on your body’s biochemistry, infoceuticals do not interfere with pharmaceuticals, herbal or vitamin/mineral supplements, or other therapies you may be using. They can be taken at any time of the day, before, during, or after a meal.

      By re-scanning your HBF on a monthly basis, your NES practitioner can monitor your progress over time as finer levels of distortion detail uncover issues that are then dealt with at that time – until some 4 to 12 months later – when you reach your optimal wellness – quite possibly well beyond the end of all the symptoms that brought you in to the office in the first place.

      Give it a try and experience a whole new level of wellness!

    10. CuriousSci says:

      As much as I dislike arguing about fundamentally flawed comment (as it appears to lend the idiocy credence) I couldn’t let the point “There is scientific evidence that water can store information.” pass.

      Others may have stated or put this thought forward previously, so I ask for your indulgence if this is repetitive. Asides from the fact that the comment violates all currently known chemistry and physics of water molecules, there would seem to be a simple way to disprove this notion.

      A layout of a simple experiment:
      1) Take distilled water and measure its radioactivity on an instrument of your choice.
      2) Choose a radioactive isotope, whichever molecule/compound you wish that will dissolve in water.
      3) Prepare a solution that will provide for a statistically & significantly higher reading on the instrument of choice. Record the reading of the initial solution.
      4) Using this prepared solution, complete a 6C serial dilution.
      5) Measure the radioactivity of the final 6C solution.

      If the 6C solution radioactive readings are no different than water, water memory is disproved.

      Disclaimer: Don’t try this at home. I assume anyone who would do this would be capable of doing dilutions accurately, be capable / trained on whatever instruments is used, understand safe lab practices, be appropriately certified in order to source the compound needed and understand statistics to complete the appropriate sample numbers to be have any validity. ;>)

  6. Cervantes says:

    If anything, I think you pulled your punches. This is a fraud upon the public treasury.

  7. superdave says:

    I read some of the comments on the news articles. It was depressing. People just did not grasp the main point of the article. A lot of comments were along the lines of, “well why don’t we conduct a trial”. Which is what the entire article is trying to address.

  8. Kiiri says:

    Great article. I didn’t read the press articles (yet) I am sure they are full of false balance and I am basking in the glow of having a great article appear in a journal debunking woo. I am enjoying all of the warm fuzzies I also get from watching whoa get his/her comeuppance up thread. Keep up the fight fellow shills and minions!

  9. Nick J. says:

    I read it and enjoyed it. I just had one question: it seems one of the main points ‘we need SBM not EBM’, comes across as if there’s something wrong with EBM. Correct me if I’m wrong, but there doesn’t seem to be anything wrong with EBM. It seems the biggest issue discussed is that people are going into RCTs minus the evidence that EBM would demand you have, in addition to not having a scientific basis to begin with.

    Or is the premise that just enough really bad evidence is being gathered as evidence to justify RCTs, and because there’s no science based requirement this is subverting the intent of EBM?

    I read it a few days ago, so maybe my memories fuzzy.

    1. Nick J. says:

      also, some of your citations are missing their little [brackets]. but i guess elsevier’s editing should pick that up

    2. Badly Shaved Monkey says:

      The contention of the advocates of SBM is that the EBM project involved an implicit assumption in creating its hierarchy of evidence with lab science at the bottom and meta-analyses of RCTs at the top. EBM is implicitly Bayesian but it assumes prior probability >>0. No one expected people to be testing fairy dust.

      SCAMsters exploit EBM by jumping straight to the top of the pyramid and doing that clinical research badly so as to give the appearance of doing EBM merely by showing they’ve done RCTs and then doing meta-analyses on them as if that “top level” clinical data can trump overwhelmingly negative basic science evidence.

      The architects of EBM clearly did not envisage their principles being applied to fields where there is not merely an absence of basic science but the basic science tells us that prior probability is effectively zero.

  10. Auf says:

    Great editorial, thank you. Speaking of press coverage, it is also featured on the front page of the Romanian weekly newspaper Viata Medicala (for medical professionals).

  11. Frederick says:

    I finally got to time to read it. Really well written and as pertinent as always. I hope this editorial can have a at least a small influence! Congratulations to both Dr. Gorski And Dr Novella

  12. CuriousSci says:

    Terrific article laying out the errors of CAM. This should be a good reference source to present as the logic retort to the bureaucracies that make the idiotic funding decisions for CAM/Homeopathy and institutes to “train” practitioners.

    Well done.

  13. Josh Nankivel says:

    FANTASTIC!

    Only two points:

    “That is science-based, rather than evidence-based, medicine.”

    Might this rub some the wrong way? Isn’t SBM really just a more rigorous form of EBM? I think this phrasing may be a false dichotomy, when I don’t think it’s really and either-or situation. Maybe something like “This is evidence AND science-based medicine.” would convince better.

    Also, I had been looking forward to a discussion of Bayesian probability, in that SBM to me seems to be arguing for a Bayesian approach to not only interpreting the results of a trial, but also in assessing it’s validity for progressing through the stages to RCT in the first place. I think establishing the plausibility of a hypothesis and updating it’s probability throughout the whole lifecycle from phase I/II/III trials leading up to RCT is a kind of Bayesian approach.

    1. Badly Shaved Monkey says:

      Also, I had been looking forward to a discussion of Bayesian probability, in that SBM to me seems to be arguing for a Bayesian approach

      It does. If you look at the range of blogs on this site you will find various posts and discussions that show that Bayesian approach both implicitly and explicitly. As always with a project such as this, unless you were there at its inception, you are joining a conversation part way through and there is always that irritating sensation of having missed something.

  14. Avijit says:

    Dr. Gorski

    It is good to write such persuasive papers on Science Based medicine.

    Could you name some medicines (not drugs- I am aware of many drugs) available in the allopathic medical system for doctors to cure patients.

    I have never understood why the outlets supposedly selling medicines write themselves as “Chemists and Druggists”.

    1. Badly Shaved Monkey says:

      You will need to explain what you mean by a medicine that is not a drug. I think it’s up to you to provide the example since you are patently using some obscure unconventional definition. You will no friends here by use of the word allopathic, which was coined solely by homeopaths as an insult to be used against the sixties of 200 years ago.

    2. Badly Shaved Monkey says:

      Avijit

      I am fairly sure we have met before

      http://www.quackometer.net/blog/2012/03/boiron-settles-for-12m-to-stop-homeopathy-lawsuits.html

      and, unless you show some willingness and ability to engage meaningfully with discussion I shall make no further replies to you.

    3. weing says:

      “It is good to write such persuasive papers on Science Based medicine.”
      So tell us. What about the paper persuaded you?

    4. WilliamLawrenceUtridge says:

      Could you name some medicines (not drugs- I am aware of many drugs) available in the allopathic medical system for doctors to cure patients.

      How about something better – vaccines prevent diseases in the first place.

      But antibiotics cure infections, steroids cure temporary deadly autoimmune reactions (what actually kills children with West Nile Virus), and accutane cures pimples.

      Expanding beyond drugs, surgery can cure congenital heart defects, replace valves, replace a failing liver with a new liver, re-attach severed limbs, give you a new face, remove cataracts, correct defects in the lens of the eye, and implant metal plates in broken bones that allow them to heal in a way that restores function. Oh, and remove solid tumors, which is often 100% curative for some cancers.

      Electrical defibrillators will cure cardiac dysrhythmias, ventricular fibrillation and pulseless ventricular tachycardia in the sense that the heart will begin beating with a normal rhythm. Atropien and epinephrine can work similarly to restart a heart.

      Steroids will speed the development of lungs in a premature infant.

      A doctor in an emergency room can re-locate a dislocated hip, shoulder, ankle, wrist, finger, etc.

      If patients would follow the advice of their primary care physicians, they would exercise, quit smoking and eat better, that would cure millions of people who are, or would become, obese or die of lung cancer.

      I have never understood why the outlets supposedly selling medicines write themselves as “Chemists and Druggists”.

      In Europe, history. In North America, they don’t.

      But you don’t really want to know, do you? You’re JAQing off, hoping that you can pretend that medicine is nothing but statins and meglitinides. And if medicine were nothing but chronic lifestyle conditions and the accompanying medications, the results of patients ignoring the advice of their doctors, then you could pretend that alternative medicine offered something meaningful – you’re trying to use the fallacy of the false dilemma and hoping nobody notices.

      1. Avijit says:

        WilliamLawrenceUtridge

        ……….How about something better – vaccines prevent diseases in the first place.
        But antibiotics cure infections, steroids cure temporary deadly autoimmune reactions (what actually kills children with West Nile Virus), and accutane cures pimples………

        The article was about medicines. It would be good if you stay on medicines.

        Can you from the above, list out drugs that have continued to be used for over 20 years.

        1. KayMarie says:

          Since we are playing JAQ’s

          And what is the difference between a medicine and a drug?

          What is the deal with if a drug has been in use for more than 20 years or less than 20 years? Does that matter?

          1. Bruce says:

            Kay,

            I suspect a medicine is Scottish, a drug is not.

            At least not a true one.

            1. KayMarie says:

              So now I need to quiz my medications and get them to talk long enough that I can judge their accents?

              How many pharma companies are based in Scotland anyway?

              :-)

          2. Avijit says:

            KayMarie

            …What is the deal with if a drug has been in use for more than 20 years or less than 20 years? Does that matter?…

            Anything that one eats, has either a beneficial or unfavorable effect on health. A drug that is taken off the market, always because its adverse affects far outweigh the supposed benefits.

            A medicine, I would expect will always behave in the same manner: to be taken for a particular disease. After the symptoms of disease are removed, the medicine is stopped. This cannot be taken off the market.

            Like rice: this is a chemical combination being used for over 8000 years (?) that continues to provide the same benefits. Or for that matter, many herbal medicines.

            If a drug is taken off the market because of adverse effects, at times fatal, what happens to patients exposed to the drug? Many times the consequences appear after 20 years- quinine taken for malaria in any form always leads hearing impairment at a later date.

            1. KayMarie says:

              You say that like almost all drugs are removed from the market.

              From http://www.ncbi.nlm.nih.gov/pubmed/11980521

              548 drugs approved from 1975 – 1999 (so not all at the 20 year mark in 2002, but a good number of them will be.

              “16 (2.9%) were withdrawn from the market.”

              Now a lot more have warnings added to them, but that is not the same as saying it is very rare for a drug to make it to the 20 year mark without being shown to be so dangerous it must be pulled from the market place.

              And sometimes they are withdrawn because something has helps better, or has lower risk so it make sense to replace the old with the new, but usually the old stays on because for some people it works better for them than the newer one.

            2. WilliamLawrenceUtridge says:

              Anything that one eats, has either a beneficial or unfavorable effect on health. A drug that is taken off the market, always because its adverse affects far outweigh the supposed benefits.

              You are describing drugs, yes, but also food, beverages, indigestible fiber, certain gasses. Fava beans would be considered a drug under your definition, look up favism.

              A medicine, I would expect will always behave in the same manner: to be taken for a particular disease. After the symptoms of disease are removed, the medicine is stopped. This cannot be taken off the market

              If that is your definition, you are rather naive about the body – different people react differently, and even individuals can react differently at different times. Also, antibiotics would fit your description. Accutane would not because its effects are permanent (for acne).

              But overall you are simply being irrational.

              Like rice: this is a chemical combination being used for over 8000 years (?) that continues to provide the same benefits. Or for that matter, many herbal medicines.

              Rice is food, not medicine, unless you are talking about red yeast rice extract, which is chemically identical to a type of statin, but the dosing and concentrations are variable and uncertain. Also, rice has been selected through farming for thousands of years and is not even close to the rice first cultivated by hunter-gatherers. Oryza sativa bears little resemblance to primordial rice, Oryza rufipogon.

              If a drug is taken off the market because of adverse effects, at times fatal, what happens to patients exposed to the drug? Many times the consequences appear after 20 years- quinine taken for malaria in any form always leads hearing impairment at a later date.

              That’s one example. Do you have others? Do you have other examples even from, say, drugs used to treat malaria? Quinine causes hearing problems, chloroquine does not, nor does amodiaquine, pyrimethamine or proguanil. Further, there is evidence the hearing loss is reversible, not permanent.

              Are you lying or ignorant?

              1. Avijit says:

                WilliamLawrenceUtridge

                ….”If that is your definition, you are rather naive about the body – different people react differently, and even individuals can react differently at different times. Also, antibiotics would fit your description. Accutane would not because its effects are permanent (for acne).”

                Differently people react differently and require different medicines. Not one drug. Therefore antibiotics do not fit the medicine description. With time body parameters change. So should medicine. Does it? Why should the drug for blood pressure taken indefinitely?

                …”But overall you are simply being irrational.”…

                Flying metal birds with tail on fire can be an irrational idea for some.

                “..Rice is food, not medicine, unless you are talking about red yeast rice extract, which is chemically identical to a type of statin, but the dosing and concentrations are variable and uncertain..”…..

                Chemicals that prevent diseases are not medicines?

                ….”.That’s one example. Do you have others? Do you have other examples even from, say, drugs used to treat malaria? Quinine causes hearing problems, chloroquine does not, nor does amodiaquine, pyrimethamine or proguanil. Further, there is evidence the hearing loss is reversible, not permanent..”..

                All drugs create issues because “different people react differently, and even individuals can react differently at different times” and this cannot be validated for one drug as it is already known to come with adverse effects. The extent of effects are evaluated only when serious issues arise.

                In the article “Antibiotics vs. the Microbiome” Dr. Blaser comments of “100 trillion microbes that live on and in each of us, and the possibility that antibiotics may have a causal role in several of the so-called diseases of civilization. ”
                (may have casual- He is pulling punches. His next paper could be scathing)

                These microbes are not there for no reason. Will there be a drug that does nothing to the good microbes and goes after only the abnormal? If a billion microbes are wiped out?

                Quinine in ANY form taken as a drug causes hearing impairment and this is irreversible.

                You take human body rather simply.

              2. KayMarie says:

                http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1380185/

                I thought reversible and resolved completely did not mean the same thing as irreversible

                I mean I didn’t think these words were like regardless and irregardless or flammable and inflammable

        2. Windriven says:

          @Avijit

          Penicillin.

          Who gives a crap how long a drug has been used? Medical science marches on. New and better drugs supplant older, less effective, less safe drugs. Only the idiotic quackeries of chiropractic, homeopathy, and their kin cling to practices that were useless then and continue to be useless today.

          Further, what is your weird hangup about medicines and drugs. ALL medicines are drugs, not all drugs are medicines. Medicines are drugs taken for a specific therapeutic effect.

          1. Iqbal says:

            Windriven

            “Penicillin.”

            You are not serious. This is what a doctor was writing in 2009.

            “One common germ, the streptococcus, was the most sensitive germ to be killed by penicillin. While 95% of these germs could be easily killed by penicillin to begin with, today 95% of the same is resistant to penicillin.”

            What is it used for now?

            “”Who gives a crap how long a drug has been used? Medical science marches on. New and better drugs supplant older, less effective, less safe drugs. Only the idiotic quackeries of chiropractic, homeopathy, and their kin cling to practices that were useless then and continue to be useless today.”"

            I agree with you. First we create conditions with older less effective drugs and then with new and better drugs correct the conditions. This is a never ending cycle. Only the march is is becoming deadly:

            “The gravity of the situation is such that the Royal College of Physicians of London organized a meet to discuss the Clinical Implications of Anti-microbial Resistance on the 28th February 2001. It has been estimated that around 15,000 people die in that small country (UK) every year from infections against which no antibiotic is effective. Some of those germs that are resistant to most antibiotics are called the super bugs and, as of now, we have no defense against them. One of the biggest hospitals in that country, Portsmouth Hospitals NHS Trust, has been forced to shut down most of its operating theatres last summer because of super bugs there.At the Queen Alexandra Hospital the orthopaedic surgeons could not perform any operation around that time. Another leading authority in the field, Professor Hugh Pennington of Aberdeen University, feels that the next big problem would be that of drug resistant tuberculosis.” (http://bmhegde.com/bmh/useartdetail1.php?aid=27)

            Please understand, the drugs were cleared through RCT and prescribed by doctors following Evidence based process.

            1. Chris says:

              Showing that there are problems with real medicine does not prove homeopathy works. You need actually prove homeopathy is better that actual medicine by showing it does prevent/treat real diseases.

              Where is that real evidence to support Andre Saine’s contention that homeopathy works better for rabies than the modern vaccine?

              What evidence shows homeopathy is effective at preventing or curing malaria?

            2. Windriven says:

              lowball, you really need some education. Sadly, I doubt it would ‘take.’

              “What is [penicillin] used for now?”
              Pneumococcal pneumonia
              Tonsillitis
              Scarlet fever
              Bacterial endocarditis
              Syphilis (have you been checked? untreated it can lead to cognitive impairment. Think about it …)

              to name just a few. Moreover, penicillin is just one of a broad range of beta lactam antibiotics.

              “First we create conditions with older less effective drugs and then with new and better drugs correct the conditions. … The gravity of the situation is such that the Royal College of Physicians of London organized a meet to discuss the Clinical Implications of Anti-microbial Resistance on the 28th February 2001.”

              You can’t possibly be that simple minded, can you? Well yes, based on your history of chattering here, you obviously can. Bacteria, both “good” and “bad” have existed for hundreds of millions of years. They evolve just as other organisms evolve. When a doctor prescribes a 10 day course of penicillin to a patient and that patient stops after 6 days because he feels better, some of those bacteria that best resisted the penicillin survive and breed and pass on the alleles that helped it resist. Carry this on over a few decades and you have a resistant species.

              Penicillin didn’t create this new species, stupidity created it. The stupidity of the patient who failed to follow the full course of therapy – or the idiot doctor who prescribed it inappropriately to shut some whining parent the hell up.

              “the drugs were cleared through RCT”

              And more people than your tiny mind can imagine have lived longer and better lives as a result.

              “and prescribed by doctors following Evidence based process.”

              If that were completely accurate we would have had a much longer window before resistance emerged.

              1. Iqbal says:

                Windriven
                ” When a doctor prescribes a 10 day course of penicillin to a patient and that patient stops after 6 days because he feels better, some of those bacteria that best resisted the penicillin survive and breed and pass on the alleles that helped it resist”

                How does a doctor decide that the antibiotic course for the patient will be 10 days or 6 days or 12 days? What evidence does he go by? Dr. David Eddy says: he does not have enough information to make the right decision.

                You did not spend time on the reference. The problem is DOCTORS, (who are evidence based and have studied science?)

                “In a well researched book, Betrayal of Trust: The Collapse of Global Public Health, Laurie Garrett from the USA, shows how the threat is not confined to the poor countries but, is greater in the West, basically because doctors there over-prescribe antibiotics so that bacterial infections are becoming increasingly resistant to the most widely used antibiotics. She writes that “doctors who over-prescribe antibiotics undermine the health care system by encouraging germs to become resistant.” She is dead right there.”

              2. Chris says:

                Showing that there are problems with real medicine does not prove homeopathy works. You need actually prove homeopathy is better that actual medicine by showing it does prevent/treat real diseases.

                Explain how well homeopathy works for actual bacterial diseases like strep and syphilis. Provide verifiable proof it actually gets rid of the bacteria.

                Where is that real evidence to support Andre Saine’s contention that homeopathy works better for rabies than the modern vaccine?

                What evidence shows homeopathy is effective at preventing or curing malaria?

              3. Windriven says:

                lowball, I tire of your silliness. Physicians prescribe a course of antibiotics based on best evidence. You would like there to be perfect evidence. There isn’t. There likely never will be. Have you never heard Votaire’s observation that the perfect is the enemy of the good?

                There is no perfect course for every infection in every individual. You seem to want to live in a childish wonderland of silver bullets and cut-in-stone certainties. Grow the hell up.

                And then you have the nerve to go on about physician overprescribing. If you’d read my comment you’d have seen that I specifically noted that and taken appropriate umbrage.

                ” Dr. David Eddy says: he does not have enough information to make the right decision.”

                So does Dr. David Eddy, lacking enough information to make a perfectly informed decision, quiver in a puddle of his own piss, or does he make the best clinical judgment he can based on available evidence and experience? Just wondering.

              4. Andrey Pavlov says:

                @iqbal:

                How does a doctor decide that the antibiotic course for the patient will be 10 days or 6 days or 12 days? What evidence does he go by?

                Seriously?

                How about from all the trials on the topic which are updated over time like this trial comparing outcomes for different durations of antibiotic therapy in appendicitis from this year.

                We actually do trials to determine length of therapy. And compare new antibiotics to old. And for different indications. Which is how we know that certain antibiotics have better lung penetration so to use those for pneumonia. We talk about the evidence for treatment every day.

                Do you really think we just make this up? LOL

              5. Sawyer says:

                iqbal,

                I would literally stake my life savings on Laurie Garrett’s books NOT supporting your bogus notions of science, public health, or alternative medicine. I heard an interview with her on the radio several weeks ago, and surprise surprise, she wasn’t promoting homeopathy for fighting ebola.

                How stupid do you think we are? You cite sources that you surmise are recognized by many of us here in an attempt to gain credibility. But if we recognize and respect your sources, don’t you think we may actually go read them to find out you’re distorting their work? How can this tactic possibly work out for you?

                Is this self-parody? I’ve seen SSR make the same mistake here before, so maybe you guys all need to lay off on the comments for a while and go take a simple reading comprehension course.

              6. Iqbal says:

                Windriven

                ” Physicians prescribe a course of antibiotics based on best evidence. You would like there to be perfect evidence. There isn’t. There likely never will be. Have you never heard Votaire’s observation that the perfect is the enemy of the good?”

                Please describe “best evidence”. Remember there is a life at the other end and the family may have a very good lawyer.

                ..”There is no perfect course for every infection in every individual…

                A climb down?

                ..And then you have the nerve to go on about physician over prescribing…

                That was Lauri Garret. You will find details on the net that would improve your knowledge about drugs. You may also refer Lucien Leape of the Harvard Medical School. You will end up with a new set of eyes.

                …..If you’d read my comment you’d have seen that I specifically noted that and taken appropriate umbrage….

                For what? This is what you wrote: “When a doctor prescribes a 10 day course of penicillin to a patient and that patient stops after 6 days because he feels better, some of those bacteria that best resisted the penicillin survive and breed and pass on the alleles that helped it resist. Carry this on over a few decades and you have a resistant species.

                Penicillin didn’t create this new species, stupidity created it. The stupidity of the patient who failed to follow the full course of therapy – or the idiot doctor who prescribed it inappropriately to shut some whining parent the hell up.”

                It is seldom the patient-it is always the doctor.

                …”So does Dr. David Eddy, lacking enough information to make a perfectly informed decision, quiver in a puddle of his own piss, or does he make the best clinical judgment he can based on available evidence and experience? Just wondering…”

                Dr. Eddy is an outstanding doctor, so fed up of the crap being pushed around under the guise of scientific medicine, that he did a PhD in mathematics. He set up “Archimedes”. (Please read details on the net) and was able to demonstrate that all the evidence supposedly used by doctors to make decisions was a baseless. (Steve Novella when faced with this information calmed up. From evidence base he now plans to shift to Science based ?)

                “ Think of Archimedes as an intelligent physician with an infinite memory and an almost infinite ability to process data. It’s like Hippocrates meets Einstein. We’re trying to build a representation of what a terribly, terribly smart doctor would know if he or she could remember everything he or she was taught about basic physiology, epidemiology, clinical trials, and so forth..”

                A little too much for a regular doctor?

              7. Chris says:

                Iqbal, answer my questions. You need to provide evidence not side tracks.

                Explain how well homeopathy works for actual bacterial diseases like strep and syphilis. Provide verifiable proof it actually gets rid of the bacteria.

                Where is that real evidence to support Andre Saine’s contention that homeopathy works better for rabies than the modern vaccine?

                What evidence shows homeopathy is effective at preventing or curing malaria?

              8. Windriven says:

                “Please describe “best evidence”.”

                Did you read Dr. Pavlov’s response at (4)? Did you follow the links?

                “A climb down?”

                How is that a climb down? You are pretending that there are certainties where there aren’t any. The best evidence is very, very good. But there will be outliers. Sorry, life isn’t always fair.

                “It is seldom the patient-it is always the doctor.”

                Do you have some factual basis for this or shall I just accept your statement as received wisdom?

                “Dr. Eddy is an outstanding doctor,”

                Maybe, maybe not. But that doesn’t answer the root question: does Dr. David Eddy, lacking enough information to make a perfectly informed decision, quiver in a puddle of his own piss, or does he make the best clinical judgment he can based on available evidence and experience? If he is working as a mathematician the answer doesn’t mean anything. If he is working as a physician it certainly does.

                You claim that Dr. Eddy is an “outstanding doctor.” You also claim that Dr. Eddy “was able to demonstrate that all the evidence supposedly used by doctors to make decisions was a baseless.” Well if all the evidence is baseless – and it most certainly is not – then on what does the “outstanding” Dr. Eddy base his practice?

              9. Windriven says:

                @lqbal

                I’ve just had a look at David Eddy and his work. You have mischaracterized everything from his academic pursuit (engineering, not mathematics) to the thrust of his work which is entirely focused on best evidence. Where are you getting your information? Have you done any independent reading on Dr. Eddy?

                Again, I think you believe science in general and medical science in particular, to be at an end state; that everything that needs to be known is or ought to be known already. In another thread Angora Rabbit gave a wonderful example of science as a series of successive approximations.

                In short, you need to develop a more mature view of the world around you. There are very few certainties. But in medical science alone there are countless dedicated scientists, doctors, and technicians working to make each day a little better than the day before. If that isn’t good enough for you, I suggest that you take full advantage of the alternatives. You will find more certainty in the quackosphere than you will find in science.

              10. Lacri says:

                “When a doctor prescribes a 10 day course of penicillin to a patient and that patient stops after 6 days because he feels better, some of those bacteria that best resisted the penicillin survive and breed and pass on the alleles that helped it resist. Carry this on over a few decades and you have a resistant species.”

                What is it about the inappropriate prescription of antibiotics (eg prescribing antibiotics for a cold) that causes resistance? I don’t understand how resistance develops in bacteria that aren’t present.

              11. Windriven says:

                ” I don’t understand how resistance develops in bacteria that aren’t present.”

                They are present, just not in great enough numbers to make you ill. And with each exposure to antibiotics, those organisms susceptible to that antibiotic die and those with some resistance don’t and these survivors go on to breed and pass that resistance on.

            3. WilliamLawrenceUtridge says:

              You are not serious. This is what a doctor was writing in 2009.

              “One common germ, the streptococcus, was the most sensitive germ to be killed by penicillin. While 95% of these germs could be easily killed by penicillin to begin with, today 95% of the same is resistant to penicillin.”

              What is it used for now?

              Bacillus cereus, Bacillus pumilus, Escherichia coli, Micrococcus kristinae, Proteus vulgaris, Pseudomonas aeruginosa, Salmonella spp., Shigella flexneri, Staphylococcus aureus.

              I agree with you. First we create conditions with older less effective drugs and then with new and better drugs correct the conditions. This is a never ending cycle. Only the march is is becoming deadly:

              I’ll merely point out that you are cherry-picking one type of medications, antibiotics. There are others, which remain effective against a multitude of diseases and conditions.

              Please understand, the drugs were cleared through RCT and prescribed by doctors following Evidence based process.

              What’s your point? The RCTs showed that they worked, then the bacteria developed resistance for many reasons. Are you saying that because antibiotics now don’t work against resistant bacteria, therefore all medicine doesn’t work? Are you stupid?

              1. Iqbal says:

                Windriven

                “Did you read Dr. Pavlov’s response at (4)? Did you follow the links?”

                Did you read the link?

                Read this: “Why do physicians vary so much in the way they practice medicine?

                At first view, there should be no problem. There are diseases–neatly named and categorized by textbooks, journal articles, and medical specialty societies. There are various procedures physicians can use to diagnose and treat these diseases. It should be possible to determine the value of any particular procedure by applying it to patients who have a disease and observing the outcome. And the rest should be easy–if the outcome is good, the procedure should be used for patients with that disease; if the outcome is bad, it should not. Some variation in practice patterns can be expected due to differences in the incidence of various diseases, patients’ preferences, and the available resources, but these variations should be small and explainable.

                The problem of course is that nothing is this simple. Uncertainty, biases, errors, and differences of opinions, motives, and values weaken every link in the chain that connects a patient’s actual condition to the selection of a diagnostic test or treatment.

                Uncertainty creeps into medical practice through every pore. Whether a physician is defining a disease, making a diagnosis, selecting a procedure, observing outcomes, assessing probabilities, assigning preferences, or putting it all together, he is walking on very slippery terrain. It is difficult for non physicians, and for many physicians, to appreciate how complex these tasks are, how poorly we understand them, and how easy it is for honest people to come to different conclusions. (Professional Judgment: A Reader in Clinical Decision Making By Jack Dowie}

                And, then YOU go on to say:

                “You are pretending that there are certainties where there aren’t any. The best evidence is very, very good. But there will be outliers. Sorry, life isn’t always fair.”

                ” does Dr. David Eddy, lacking enough information to make a perfectly informed decision, …. If he is working as a mathematician the answer doesn’t mean anything. If he is working as a physician it certainly does.”

                He did much better: As a physician he provided data to the mathematician who put a computer to work and found out that the “claim of evidence” in medical practice was a big hoax. Most processes were done with the motive of earning money.

                ““But Eddy’s longstanding disdain for the healthcare system remains his key motivator. Despite spending an average of $5,000 for healthcare for every person in the U.S., he says, the system continues to keep many from receiving quality care, such as the 40 million uninsured Americans—while at the same time pushing others toward needlessly expensive, sometimes harmful treatments. “We’ve got a $1.5 trillion tank rolling down the road with its windshield fogged over,” Eddy says.”

                ” Well if all the evidence is baseless – and it most certainly is not – then on what does the “outstanding” Dr. Eddy base his practice?”
                Dr. Eddy is a consultant to hospitals telling them to stop wasting good money on bad expensive drugs. “Kaiser was prescribing to its patients what was then a relatively new cholesterol-lowering drug, Mevacor, from Merck . “We were treating everyone who walked in the door,” recalls Dr. James Dudl, diabetes expert at the Kaiser Permanente Care Management Institute. “We thought the drug would do spectacular things.”

              2. Windriven says:

                One at a time please, lowball.

                Dr. Eddy does not argue that evidence based medicine is a big hoax. Dr. Eddy works to improve clinical adherence to best evidence.

                Why is it that you feel the need to twist his work into an attack on medicine. Eddy is one of tens of thousands of scientists and physicians working to improve health care.

                If you’d like to restate your other points one at a time, I’ll be happy to answer them. But I am not going to wade through a Gish Gallop of nonsense and invective.

              3. Chris says:

                Iqbal, you should not pontificate on medicine until you provide evidence that homeopathy works.

                Explain how well homeopathy works for actual bacterial diseases like strep and syphilis. Provide verifiable proof it actually gets rid of the bacteria.

                Where is that real evidence to support Andre Saine’s contention that homeopathy works better for rabies than the modern vaccine?

                What evidence shows homeopathy is effective at preventing or curing malaria?

              4. WilliamLawrenceUtridge says:

                At first view, there should be no problem. There are diseases–neatly named and categorized by textbooks, journal articles, and medical specialty societies. There are various procedures physicians can use to diagnose and treat these diseases. It should be possible to determine the value of any particular procedure by applying it to patients who have a disease and observing the outcome. And the rest should be easy–if the outcome is good, the procedure should be used for patients with that disease; if the outcome is bad, it should not. Some variation in practice patterns can be expected due to differences in the incidence of various diseases, patients’ preferences, and the available resources, but these variations should be small and explainable.

                Your statement is simplistic, if nothing else humans do vary genetically, not to mention epigenetically, not to mention nongenetic accumulations of history (i.e. identical twins who differ on their alcohol intake will have very different livers). Medicine isn’t as simple as your cartoon statements make it out to be. Following the recommended guidelines is a best practice, not a straight jacket.

        3. WilliamLawrenceUtridge says:

          The article was about medicines. It would be good if you stay on medicines.

          Can you from the above, list out drugs that have continued to be used for over 20 years.

          I’m pretty sure antibiotics, steroids and accutane are all medicines. What would you classify them as if not “medicines”? Also, all of these are more than 20 years old. Accutane is the newest, it was approved in the early 80s.

          1. Avijit says:

            WilliamLawrenceUtridge

            ….I’m pretty sure antibiotics, steroids and accutane are all medicines. What would you classify them as if not “medicines”? ..

            Drugs. The companies that produce these drugs do not name them as medicine.

            …Also, all of these are more than 20 years old. Accutane is the newest, it was approved in the early 80s…

            Be specific. Provide names. All companies define a drug by a name. Antibiotic is a generic name, as is steroid.

            1. Windriven says:

              “Drugs. The companies that produce these drugs do not name them as medicine.”

              It doesn’t matter if the companies that produce them name them Billy. Drugs taken for therapeutic effect are medicines by definition.

              What is you fixation on 20 years? Nitroglycerin is a drug that has been used for many years. Vedolizumab was approved a couple of months ago. So effing what?

            2. KayMarie says:

              Prednisone and prednisolone the usual steroids for inflammatory conditions were approved in 1955.

              Is that old enough for you?

              Many antibiotics were approved more than 20 years ago, a few are newer, you can check the FDA website for all the data you want on there approval dates.

              1. Avijit says:

                KayMarie

                …Prednisone and prednisolone the usual steroids for inflammatory conditions were approved in 1955…

                I checked on the Wikipedia and the time information is correct. I am surprised how a ” corticosteroid drug with predominant glucocorticoid and low mineralocorticoid activity, making it useful for the treatment of a wide range of inflammatory and auto-immune conditions such as asthma, uveitis, pyoderma gangrenosum, rheumatoid arthritis, ulcerative colitis, pericarditis, temporal arteritis and Crohn’s disease, Bell’s palsy, multiple sclerosis, cluster headaches, vasculitis, acute lymphoblastic leukemia and autoimmune hepatitis, systemic lupus erythematosus, Kawasaki disease and dermatomyositis.” continues to be used. “Corticosteroids inhibit the inflammatory response to a variety of inciting agents and, it is presumed, delay or slow healing.

                There is no doubt that the drug suppresses symptoms and when stopped, the disease comes back.

              2. WilliamLawrenceUtridge says:

                There is no doubt that the drug suppresses symptoms and when stopped, the disease comes back.

                Yes, but what’s your point? There is no cure for these conditions, so what should be done instead, just let people suffer?

                You’re kind of a bastard then, aren’t you?

      2. Avijit says:

        WilliamLawrenceUtridge

        ……..In Europe, history. In North America, they don’t……

        All companies in America, as in Europe manufacturer only drugs. So how can anyone sell medicine?

        Check websites for Pfizer, Glaxo, Merck etc.

        1. Chris says:

          Just a random question: Do keyboards in India not have a quotes key, ” ?

          Why do you show a quotation with “…..” and not “quote”?

        2. Windriven says:

          Avijit, you are an idiot. You endow words with your own special meanings. You talk in big looping circles, vague and imprecise. Are we supposed to imagine you to be deep? Is this the zen of woo? The tao of self-delusion? Because buddy, all I can see is the pile of bullcrap you’re shoveling. Now that is plenty deep.

          Do you……….have an actual………point or ………… question …………or do you………..just like……………to read your vapidities………….on the internet?

          1. Iqbal says:

            Windriven

            “Dr. Eddy does not argue that evidence based medicine is a big hoax. Dr. Eddy works to improve clinical adherence to best evidence.”
            “If you’d like to restate your other points one at a time, I’ll be happy to answer them. But I am not going to wade through a Gish Gallop of nonsense and invective.”

            Let us look at evidence(science) based medical practise as demolished by Dr. David Eddy:

            “With a groundbreaking computer simulation, Eddy showed that the conventional approach to treating diabetes, cholesterol, high blood pressure etc. did little to prevent the heart attacks and strokes that are the predicted complications.

            (Kaiser Permanente, the largest HMO in the US, is trying to follow Eddy’s advice in a million patients.)

            Even today, with a high-tech medical-care system that costs the nation $2 trillion a year (in the US alone), “there is little or no evidence that many widely used treatments and procedures actually work better than various cheaper alternatives”, feels David. This judgment pertains to a shocking number of conditions or diseases, from cardiovascular woes to back pain to prostate cancer.

            During his long and controversial career proving that the practice of medicine is more guesswork than science, Eddy has repeatedly punctured cherished physician myths.

            He showed, for instance, that the annual chest X-ray screening was worthless, over the objections of doctors who made money off the regular visit.

            He proved that doctors had little clue about the success rate of procedures such as surgery for enlarged prostates.

            He traced one common practice — preventing women from giving birth vaginally if they had previously had a cesarean — to the recommendation of one lone doctor.

            Eddy liked to cite a figure that only 15% of what doctors did was backed by hard evidence. (Steve Novella’s figure 80%)

            David Eddy feels that the limitation is the human mind. Without extensive information on the outcomes of treatments, it’s fiendishly difficult to know the best approach for care. The human brain, Eddy explains, needs help to make sense of patients who have combinations of diseases, and of the complex probabilities involved in each.

            The predictions of success invariably ranged from 0% to 100%, with no clear pattern. “All the doctors were trying to estimate the same thing — and they all gave different numbers,” he says.

            “I’ve spent 25 years proving that what we lovingly call clinical judgment is woefully outmatched by the complexities of medicine. Go to one doctor, and get one answer. Go to another, and get a different one.

            Or think about expert testimony. You don’t have to hire an expert to lie. You can just find one who truly believes the number you want, adds Eddy.

            Medicine is doing somewhat better in recognizing the problem, but in solving it, unfortunately, no.

            Adding to the problem: Medical literature today is like a thick jungle, what with 7.5 % new information pouring into biology through, well over forty thousand bio-medical journals all over the world, every month, and the novice would find it difficult to separate the wheat from the chaff.

            Not only there is no evidence for procedures followed, it is impossible to follow evidence because of the amount of junk floating around in the name of science based medicine.

            1. Windriven says:

              I see lots of your thoughts and those of others about Eddy’s work. Do you ever bother to read Eddy himself?

              Your comment claims that the bias against vaginal delivery after Caesarian traces back to one doctor. But then don’t quite a few medical achievements trace back to a single doctor or a small group? Do you know who Semmelweis was? Further, the bias has been tested and supported a number of times. See for instance here.

              What is it with your ilk that you so desperately want to find controversy, fraud, and greed where there is only effort to improve care or to advance science? You really should pull your head out of your ass and look at things in the bright light of day.

            2. Chris says:

              To prove homeopathy works, you need to provide real verifiable test data, not whines about other medications. Now provide data:

              Prove Andre Saine’s contention that homeopathy is better for rabies than the modern vaccine.

              Also provide evidence that homeopathy is effective for either preventing or curing malaria.

            3. WilliamLawrenceUtridge says:

              Iqbal, you are citing efforts in America (there are other countries by the way, and most have national health care schemes) to improve medical practice. I laud and applaud such efforts, they are evidence of the self-critical nature of medical research and efforts to improve patient care and savings overall. What’s your point, that medicine keeps trying to get better? That’s great.

              Homeopathy hasn’t changed in two centuries, and never, ever accepts and reacts to the criticisms ventured by mainstream medicine – things like figure out if homeopathy works before how it might work.

              Put another way – what you are quoting at length is science and evidence based medicine, and it’s a thing of beauty.

        3. WilliamLawrenceUtridge says:

          Avijit, your argument only holds if you use an idiosyncratic definition of terms. Zechariah Sitchin used a similar solution to ‘prove’ the Akkadians had access to a spaceship and were from a planet orbiting past Pluto. While this does allow you a hermeneutically sealed and unfalsifiable argument, it doesn’t mean Niburu exists and the Akkadians had rockets.

        4. Iqbal says:

          Avijit says:

          “”I checked on the Wikipedia and the time information is correct. I am surprised how a ” corticosteroid drug with predominant glucocorticoid and low mineralocorticoid activity, making it useful for the treatment of a wide range of inflammatory and auto-immune conditions such as asthma..”

          Wikipedia has a lot of good information and not so good information.
          Let me state an anecdote (term from allopathy)

          Male patient, 33 years old, worked as farm hand. Felt extremely weak, little physical work led to shortness of breath(Asthma?). He was helped on a bicycle for 5 kms. of village road, 30 kms. of bus ride followed by 2 kms. of motor transport to the doctor. Cough and fever at night would not allow him proper sleep. Ring worm on his face.

          The doctor prescribed Thuja 200 and Bacillinum 1m. He was to report back after 30 days.

          He was back in 10 days – the first patient of the day, extremely upset. His complete body was covered with ringworm and it itched horribly. He had in the past some years applied ointment for ringworm that appeared many times, healed himself and now all his hard work had come to naught.

          The good part, in his hurry to meet the doctor he had walked for 5 kms, and 2 kms.(with out waiting for help) with no shortness of breath.(Asthma ?) He had no cough at night. He was asked to continue with the same medicine. 2 months later he came back as a new person. No ringworm, no shortness of breath, no cough, no medicine to continue.

          Some idea what simple problems suppressed with drug can result in.

          1. KayMarie says:

            I got the date by going to the FDA website. The accurately report the dates they approved drugs. And you don’t have to worry about troll edits at the time you access the page. I recommend the FDA site over Wikipedia if you try to confirm some fact about a drug.

          2. Chris says:

            To prove homeopathy works, you need to provide real verifiable test data, not whines about other medications. Now provide data:

            Prove Andre Saine’s contention that homeopathy is better for rabies than the modern vaccine.

            Also provide evidence that homeopathy is effective for either preventing or curing malaria.

  15. Lisa R. says:

    Nice article on the paper last week in MinnPost (I’ve been out of the loop!) – and the comments are good so far too:

    http://www.minnpost.com/second-opinion/2014/08/clinical-trials-unscientific-alternative-medical-treatments-should-end-say-ph

    So great that you’re exposing the emperor’s lack of clothes here.

  16. Jesse says:

    CBC’s medical show did a story on this:
    http://www.cbc.ca/whitecoat/blog/2014/08/25/research-on-alternative-medicine-just-say-no/
    While the show is often good, I think this is an area where he gives far too much credibility to CAM. He also seems to have completely misunderstood the argument about why RCT’s without prior plausibility is important, and misunderstood what naturopathy is.

  17. Darlene says:

    I wonder if any of the comments are made by any individuals who have ever experienced a real live situation that involved suffering that was not explained by any diagnostic tool nor able to be treated by so called conventional methods. I was. I am a practicing PA trained in cardiovascular surgery. I practiced for 15 years in surgery in a hospital based practice. Until I had an unexplained event that caused me to nearly go on disability for the rest of my life. My diagnosis changed weekly. my medications were adjusted weekly. I was completely gorked out. I could not function or take care of my 4 children. I was near full institutionalism. guess what. I saw a shaman. I did dream work and rituals with her. I saw an energy healer who provided weekly treatments for free. I started practicing mindfulness that I learned at a training through work on integrative health.

    I am now off all medications except for vitamins. I have a full time job in the federal government. I manage my home life with increasingly improved balance. I would not be a part of productive society had I continued taking the drugs, followed the advice of the physicians who were not helping me and if I had accepted their diagnoses that were based on “evidence”

    I have a feeling this comment will be deleted. So be it.

    1. KayMarie says:

      And if you’d done what I did in a not quite as bad a situation (I still could work but I have fatigue and pain issues that strangely don’t even match any diagnosis any purveyor of woo came up with and which absolutely none of their attempts did anything for me, either).

      Funny thing I’ve looked over some of the diagnosis I had with a woo-guy and even the stuff we had the scientific knowledge about was interpreted completely wrong. He completely misinterpreted the results of my sleep study, so even if the treatments could have worked, he didn’t even try to treat me for the right thing. Probably because my issue with that was relatively rare so he just had to wing it (and the science based treatments for that worked just fine and actually cured me so I need no further treatment).

      I finally got clear on the description of the symptoms and dug into pubmed and with the doctor determined which rare diagnosis fit. We dug into the best of the scientific evidence (woeful as it is) and altered a prescription medication based on prior probability and a small study that it could help, altered my diet according to the scientific studies and I do take two supplements which have prior plausibility as to why they would work and scientific studies to determine the dose needed for effective treatment. I also adjusted my exercising to fit with the known issues with exercise with this disease.

      I love mindfulness for stress reduction, but no amount of meditating or random supplements for random reasons did me any good at all. Mind-body work did help for some other conditions where there is scientific evidence to show it works (I was part of a fairly large clinical trial for one) but they did nothing for the pain and fatigue that shows up on no medical tests.

      Although there is a test that could show my syndrome, but since the treatments are relatively benign and the test is painful and may require days out of work, we did some shared-decision making and opted not to do the test.

      I’m much better now, not perfect, but also not either begging for pro bono treatment (which I’ve not found one person around here that provides anything like that) and out a minimal amount of out-of-pocket expenses for the woo.

      But no one believe that I exist on most websites either, no one is allowed to feel better because of the science. :-)

    2. Windriven says:

      “I have a feeling this comment will be deleted. So be it.”

      1. Ihave a feeling you’re a liar.

      2. I have more than a feeling that you’re wrong about your comment being deleted. If you were a regular here you would already know that comments like yours are left indefinitely – perhaps as cautionary tales.

  18. I have been promoting this editorial in the veterinary community, and I have seen a tremendously negative reaction from folks who claim to be genuinely committed to scientific medicine and not sympathetic to specific implausible therapies. The main objections seem to be vaguely libertarian in nature:
    1. What right does anyone have to “play God” and tell others they cannot pursue hypotheses that interest them?
    2. Doesn’t ruling out some research stifle competition and innovation?

    Others are more postmodernist:

    3. “Implausible” is just an opinion based on current knowledge and biases. Science has been wrong so often, there is no point in trying to determine what is or is not likely to work without testing it.

    And of course in vet med money and regulatory oversight are orders of magnitude less that in human clinical research, so many argue that from a practical point of view there isn’t any way to prohibit such trials anyway so why talk about it?

    The discussion has been mostly on the Veterinary Information Network (VIN), which is a private forum, so only vets who are members can join. However, I have paraphrased some of the main objections to the editorial and reproduced my own defenses of it in the comments section of my blog post about it:
    http://skeptvet.com/Blog/2014/08/is-enough-ever-enough-wasting-resources-on-clinical-trials-for-magic-and-pseudoscience/

  19. Magic is in the eye of the beholder and unfortunately considered the standard of care by many in the scientific communities.
    My definition of magic:
    When a surgeon amputates a god given knee and replaces it with a metallic object proven to treat knee pain. NO, tragically no!
    When a surgeon places metal rods in someone spine to fix back pain. (which fails) Then the same surgeon tries again with a different product, then again to removes all of the hardware. This is a medieval torture and is a travesty!
    When a surgeon rearranges the ligaments in a shoulder to treat ankylosis. Misguided and flawed!
    When a MD inject chicken extract which is proven to supports articular cartilage shock absorption into a knee to treat DJD. This is classic snake oil!
    When a Migraineur is given a half dozen combination of pills to cure their headache. Flawed logic leading to deadly mishaps.
    When a RA patient is given tnf inhibitors to treat pain. Poisonous killer. Malpractice in my book but the standard of care so no one gets sued.

    Thank goodness for you guys or no one would be making money selling oils, potions or manufacturing doohickies.

    Do you all believe in Mother Nature or natural healing? — NO?? She is why these schemes usually do not kill many more unsuspecting people.

    1. Windriven says:

      Hey Steve –

      MY definition of magic is you graduating from medical school.

      Let’s take the case of a 70. Year old with arthritic knees. I walk my dog with a guy like that. Had ‘em both replaced. Now the guy walks, plays golf, even dances with his wife. Just goes to show you how terrible medicine is. He should have just let you poke a few needles in him.

      1. Stephen S. Rodrigues, MD says:

        “guy like that. ” Amputated under false pretenses, he’s happy (lucky), you are OK with that great!

        I’m not!

        Here are a few who are not happy or lucky: https://www.dropbox.com/sh/37d0wokyh4mbgj5/AADOE8CuuXlMP9k2INzwVPIFa?dl=0

        Jealous — ha ha, don’t be. all you have to do is jump thru the hoops. I certain engineers have to be more exact and accurate than MDs. That is because inanimate object and self repair like living creatures.

        1. Windriven says:

          Steve, you have to have seen radiology from people with badly eroded arthritic knees. Are you going to tell me with a straight face that you can fix that with needles?

        2. Windriven says:

          “Amputated under false pretenses”

          No. The joints were replaced under quite clear conditions.

          “Jealous — ha ha, don’t be.”

          Not a bit. The idea of clinical medicine never appealed to me. The science and technology do, the patients with all their ick … not so much.

          1. Stephen S. Rodrigues, MD says:

            “Amputated under false pretenses” No. The joints were replaced under quite clear conditions.

            Hell no! Don’t you see that this is body part snatching!!?? You really think that a hunk of metal is a valid replacement. Who on earth told you to say that?? pavlov?

            “The idea of clinical medicine never appealed to me.”
            apparently to a lot of people in power cash and influence (who you must represent) … clinical medicine is most of medicine! You don’t understand the concept? Wow … your ideas are lost in space.

            I guess if you go all SBM and betray people you have to betray yourself too.

            1. Windriven says:

              “Don’t you see that this is body part snatching!!?? ”

              Steve, you’re losing whatever grip you ever had. Replacing knees that were eroded to nubs is good medicine. In my dog walking friend’s case, those “hunks of metal” changed his life.

              “Who on earth told you to say that?? pavlov?”

              Andrey is an internist not an orthopod. And Steve, I don’t need anyone to tell me what to say.

              “clinical medicine is most of medicine! You don’t understand the concept?”

              Your reading comprehension skills are horrible. Did you suffer a brain injury after med school? I simply made the point that clinical medicine as a career choice was never attractive to me.

              “I guess if you go all SBM and betray people you have to betray yourself too.”

              Do you really want to talk about betrayal, Steve? There are a limited number of seats in medical school. I’m sure a lot of fine people applied at Howard. For reasons that I will never understand, you were awarded one of those seats. That means that someone else didn’t. That someone might have used is medical degree to save lives, to change the human condition. But ole Steve is too good for that. Or maybe too incompetent. I don’t know. Instead you’ve squandered that precious resource on a fantasy that would be barely acceptable for a 15 year old. You betrayed your profession. You betrayed your alma mater. You betrayed every taxpayer who helped fund the residency you pissed away. That Steve, is betrayal.

            2. WilliamLawrenceUtridge says:

              No. The joints were replaced under quite clear conditions.

              Hell no! Don’t you see that this is body part snatching!!?? You really think that a hunk of metal is a valid replacement. Who on earth told you to say that?? pavlov?

              I believe what Windriven is saying is that the patient presented with a complaint and set of findings, which fit the parameters of a joint replacement surgery, which was conducted with full informed consent by the patient, who was quite happy with the results. As for a hunk of metal being a valid replacement – well, it’s certainly not as good as having the knees of a healthy 18-year-old, but for a man pushing 60 that’s not yet a valid option. A metal knee, which allows you to walk with no, or even merely less pain, is certainly an option worth considering for someone crippled by knee pain due to arthritis and wear-and-tear. The fact that you don’t believe it, but can’t support your alternative position, says more about you than the operation.

              apparently to a lot of people in power cash and influence (who you must represent)

              I must ask – why do you assume Windriven represents the wealthy and influential? The fact that you can’t refute his points or support your own with anything but bare assertions merely means you cannot grasp, articulate or support the issues, it says nothing about Windriven. Stop blaming other people for your own failings.

              I guess if you go all SBM and betray people you have to betray yourself too.

              This makes no sense whatsoever. Could you express it clearly if you want a coherent response?

        3. WilliamLawrenceUtridge says:

          I’m running out of things to say to Steve “Douchecanoe” Rodrigues. Not because he’s repeating himself (which he is), but because he’s becoming less and less coherent. His last sentence, what idea is it conveying? That engineering is inferior to biology because the products can’t self-repair, or that it’s superior because it must design objects that can’t self-repair?

          Then there’s the first incoherent sentence, which as far as I can tell carries no semantic information.

          And of course, the collection of HIPAA violations he keeps posting, here and on youtube, which do nothing to support his points beyond him not understanding research methodologies and ethics.

          1. Stephen S. Rodrigues, MD says:

            “That engineering is inferior to biology because the products can’t self-repair, or that it’s superior because it must design objects that can’t self-repair?”

            Did you just say that human engineering is better than nature in this case. That is a delusion of epic proportions and you are too proud to confess your ignorance because that mean you will have to deal with the truth.

            Attach a person’s weaknesses disregard the science and evidence — that does not work! You lose the argument!

            1. simba says:

              No, he didn’t, he was offering two ideas which *you* appeared to be trying to convey.

              Read it again. Those are two ideas “engineering is superior to biology because the products can’t self repair” or “it’s superior because it must design objects that can’t self-repair” which are mutually contradictory, He reckoned you were trying to convey one, based on the sentences you had written. Were you? Which one?

              “I certain engineers have to be more exact and accurate than MDs. That is because inanimate object and self repair like living creatures.”- this is your quote, which he interpreted as having one of the two meanings above.

              It’s kind of weird that you don’t understand that he wasn’t making an argument, he was asking you to clarify yours. It seemed very very clear.

              1. n brownlee says:

                Rodrigues never understands anything.

            2. Windriven says:

              “Attach a person’s weaknesses disregard the science and evidence — that does not work! You lose the argument!”

              Steve, are you sane? What do those words mean? Blibbity-blah-de-bloodah-blif. You lose!!!

            3. WilliamLawrenceUtridge says:

              Did you just say that human engineering is better than nature in this case. That is a delusion of epic proportions and you are too proud to confess your ignorance because that mean you will have to deal with the truth.

              Actually, if humans were to design the human body, they would do a much better job. Separate the GI tract from the lungs for instance, and bam – risk of choking drops to almost zero. Put the photon-sensing layer in front of the nerve layer in the eye and bam – no more blind spot. Alter the angle, supports and structure of the lower back and pelvis and bam – no more back pain. Scientific American had an article on this.

              Mother nature, whom doesn’t exist let’s not forget, designed humans to live just long enough to produce the next generation, then becomes indifferent to our suffering, happiness and capabilities. That’s all mother nature does – shuffle us into coitus and child birth, then abandons us to the wolves. Literally.

              Attach a person’s weaknesses disregard the science and evidence — that does not work! You lose the argument!

              You haven’t ventured an argument, merely a series of assertions unsupported by facts or logic. It’s one long “NUH-UH” and little else.

        4. MadisonMD says:

          It just blows my mind that SSR could post photos of knees with scars and actually think that demonstrates something. What it demonstrates is that some people have scars on their knees.

          1. Andrey Pavlov says:

            It just blows my mind that SSR could post photos of knees with scars and actually think that demonstrates something. What it demonstrates is that some people have scars on their knees.

            It also demonstrates a high likelihood on non-compliance with HIPAA, which the HHS may have something to say about.

    2. WilliamLawrenceUtridge says:

      Do you all believe in Mother Nature or natural healing? — NO?? She is why these schemes usually do not kill many more unsuspecting people.

      You can’t get much closer to mother nature than hunter-gatherers. Turns out they get arthritis:

      http://www.ncbi.nlm.nih.gov/pubmed/17063463
      http://www.ncbi.nlm.nih.gov/pubmed/10225809
      http://www.ncbi.nlm.nih.gov/pubmed/1928312

      I really don’t think that mother nature exists, and I also don’t think that evolution selected for immortality and perfect health. You’d have to be kind narcissistic to believe that we alone among all the species on the planet somehow have the genes to survive forever if only we would figure out the right diet.

      The rest of your statement is your usual nonsense – disbelief at the effectiveness of surgical interventions that are in large part no longer used.

      1. Stephen S. Rodrigues, MD says:

        “I really don’t think that mother nature exists,”
        Your choice! What’s keeping you alive … spit and gum or duct tape?

        “I also don’t think that evolution selected for immortality and perfect health.”
        Neither do I, so why did you bring it up?

        “narcissistic to believe that we alone among all the species on the planet somehow have the genes to survive forever”
        ?? survive forever ??? Where did you get this idea from?

        IMO, we have evolved with the ability to survive in our present environment. Yes we do live for a life time.

        1. WilliamLawrenceUtridge says:

          Your choice! What’s keeping you alive … spit and gum or duct tape?

          The ongoing conversion of energy from chemical into heat, employing enzymatic systems that evolved through a blind mechanism whose sole “purpose” is to keep me alive just long enough to breed.

          “I also don’t think that evolution selected for immortality and perfect health.”
          Neither do I, so why did you bring it up?

          Because of your ongoing and tedious claims, implied or stated outright, that there are means to heal every ailment that afflicts humans. Generally by sticking silicone-coated filiform needles in the body. Truly a “natural” form of medicine as designed by Mother Nature. You can tell because of the existence of needle trees.

          IMO, we have evolved with the ability to survive in our present environment. Yes we do live for a life time.

          Wow, really? I think we evolved to survive in a totally different environment – one much dirtier, with much scarcer food, for a much shorter lifetime, in small groups with an inborn urge to hate, attack and kill other groups.

          One must also note that a “lifetime” can be longer or shorter, and more or less comfortable. Much like Steven Wright’s comment about room temperature, of course we live for a lifetime, but “living for a lifetime” is not the important part for me – quality and quantity is. And to maximize both, one must turn to medicine and science. Acupuncture doesn’t seem to help.

          1. Stephen S. Rodrigues, MD says:

            You totally did not say much that made any logical or scientific sense

            “Acupuncture doesn’t seem to help.”
            Where did this come from??? “doesn’t seem to work” to “doesn’t work” are ballparks away from the other?? Was that a slip of the fingers??

            1. AdamG says:

              “doesn’t seem to work” to “doesn’t work” are ballparks away from the other??

              What do you perceive to be the difference between these two statements, as it pertains to acupuncture?

            2. WilliamLawrenceUtridge says:

              “acupuncture doesn’t seem to help” comes from the scientific literature. I bring it up because you continually yammer on about it with barely-discernable meaning. So if you find my comments confusing, consider lessons in elocution, logic and rhetoric. An idea expressed poorly can only be mocked.

    3. KayMarie says:

      Do you all believe in Mother Nature or natural healing? — NO?? She is why these schemes usually do not kill many more unsuspecting people.

      If you mean what happens that allows the vast majority of illnesses and injuries to be self-limiting and how we shouldn’t delude ourselves into thinking we did anything when that patient would have gotten better without us? Yes.

      If you mean doing something artificial and thinking that is more natural than the artificial things those people over there do? No.

      Who gets to decide which approaches are natural or not. Because if you really want to just let Mother Nature heal all things (remember she who created all the organisms that cause death and disease) then just leave people alone to live or die as nature decrees.

      For some reason reminded of the Beverly Hillbillies episode where Granny’s Cold cure would fix you right up in ten days to two weeks.

      1. KayMarie says:

        Coding failure *facepalm*

      2. Stephen S. Rodrigues, MD says:

        Mother Nature is why these concepts and flawed idea and medications do not kill many more unsuspecting people.

        Mess with Mother Nature and she will notify you sooner or later.

        “the vast majority of illnesses and injuries to be self-limiting”
        Yes! So if you are crafty just place yourself in the right position and sugar can seem to heal everything. The game is deception.

        “patient would have gotten better without us? Yes.” YES!!

        If you mean doing something artificial and thinking that is more natural than the artificial things those people over there do? No.

        ” organisms that cause death and disease)”
        This is how life is, so it is up to our experiences to figure out how to overcome these illness. Humans knew thousands of years ago how to cure illness, they were not neanderthals.

        “just leave people alone to live or die as nature decrees.” This would be stupid when human beings can logically survive on earth with the help from prior generations collect experiences.

        “Granny’s Cold cure would fix you right up in ten days to two weeks.” Yes moonshine!

        1. WilliamLawrenceUtridge says:

          Dude, mother nature doesn’t exist, it’s an anthropomorphism for an obselete idea of some sort of grand plan to the living world. The reality is things fight, kill and eat each other for survival in reciprocal loops of sex and death. There’s no plan, and there’s no Sky-Daddy or Mommy-Planet looking out for us all.

          Mess with Mother Nature and she will notify you sooner or later.

          Really? Does she phone you or something? Do you speak to her every weekend? Do you have to pay long distance charges?

          Yes! So if you are crafty just place yourself in the right position and sugar can seem to heal everything. The game is deception.

          Yes, and that’s why we’ve been criticizing you for claiming acupuncture is effective. Because all you’re doing is taking money and waiting for the patient to get better on their own.

          If you mean doing something artificial and thinking that is more natural than the artificial things those people over there do? No

          For me, artificial or natural is immaterial. What I want to know is what evidence supports doing something, not doing something, or the specific intervention proposed. I don’t care if it’s natural for me to live for more than 80 years in good health or not – I just want to achieve that goal. Ideally over 100 years actually, hopefully I can still read for most of it. If not, I will do my best to get an unnatural amount of concentrated heroin so I can die painlessly.

          This is how life is, so it is up to our experiences to figure out how to overcome these illness. Humans knew thousands of years ago how to cure illness, they were not neanderthals.

          Then how come smallpox and polio both existed in Ancient Egypt but they weren’t cured until the 20th century? It’s almost as if human experiences in the past were less reliable guides to reality than empirical research…you know, the research that shows your needles are useless?

          This would be stupid when human beings can logically survive on earth with the help from prior generations collect experiences.

          If that were true, we would still be using lancets and leeches rather than antibiotics and vaccines. People would still pray to the god Thoth for a cure, rather than seeking a doctor. The earth would still be considered flat, the solar system geocentric.

          By far, the vast majority of human history has been spent in profound ignorance with simply incorrect ideas about fundamental reality. You can’t rely on past experiences when they are collected unsystematically and impressionistically. That leads to early death and high child mortality. More than 100,000 years of humanity’s existence has been based on the experience of past generations, it’s only when we started testing and abandoning it that human progress accelerated to the point where death at 60 is considered tragically young.

  20. aada says:

    “Neither of the authors have any competing financial interest in the topic of this commentary. D.H.G. is the managing editor and S.P.N. is the founding editor of Science-Based Medicine (http://www.sciencebasedmedicine.org/), a weblog devoted to the analysis of the scientific basis of medical practice and to winnowing out bad science and outright pseudoscience from medicine.”

    Yeah, but you loose industry quack pseudoskeptiks:

    http://www.centerforinquiry.net/news/safe_and_secular/

  21. 4ensic says:

    I’ve just discovered the SBM site, and I am compelled to congratulate site and all the critical thinking contributors.

    I like most of the skeptics here have a healthy science based disdain for the likes of homeopathy. This disdain reached a new height recently when an acquaintance (a so-called “qualified” homeopath) tried argue that it’s not just a placebo effect because he has “treated and cured” animals and children. When I queried him, after he also spruiked that hom can cure cancer, HIV, and ebola, as to when he would be publishing his paper on same and collecting his Nobel prize his quick retort was “It’s really not up to me to do that proof”. After I suggested that he should do some training in critical thinking the discussion, rather heated on his side, was terminated abruptly by him hanging up.

    Question: Has anyone else noted that these homeopathy and alternative medicine types are generally rather cranky folk?

    This acquaintance then carried on after a recent airing on television of an interesting documentary on “The Power of the Placebo”

    http://www.dailymotion.com/video/x1dpxba_bbc-horizon-2014-the-power-of-the-placebo-720p-hdtv-x264-aac-mvgroup-org_shortfilms

    …and protested that the documentary proved that homeopathy really worked.

    And just to lighten the mood up a touch, for all those skeptics out there who don’t understand the “true” principles of homeopathy, nor believe that water has a memory, please view this reliable youtube infomercial on same….the “memory” effect occurs after you say “clear clear clear, with both hands around the mixing jar”, and after you “meditate, pray, whatever…”. If this amazing demonstration doesn’t make your head explode, you may get a chuckle! :-)

    http://www.youtube.com/watch?v=nJDF2czu3CU

    1. WilliamLawrenceUtridge says:

      Question: Has anyone else noted that these homeopathy and alternative medicine types are generally rather cranky folk?

      They’re not used to calm challenge and probing questions. Normally the people they deal with are happy with a cute story and some vague “natural” handwaving. To actually have to justify their interventions is foreign to them, and to do so in the face of someone who has actually studied homeopathy and the arguments against it, is probably unprecedented. In my case, I will actually go out of my way to avoid having to interact with people who promote this sort of nonsense, because unlike over the internet, in real life I can get punched in the face by a defensive loon.

      1. Windriven says:

        Most of them wouldn’t have the stones.

  22. Edward says:

    Actually we are lucky that homeopathy doesn’t work. Otherwise the less concentrated air pollution is the more toxic the atmosphere would be! Have a look at the “Jesus and Mo” comic strip if you haven’t already:
    http://www.jesusandmo.net/2007/11/06/toxic/

    I’m going through the archives and it is unbelievably spot on.

  23. TM says:

    It’s a shame you didn’t carry over the writing style of this blog to the paper. That first paragraph will shut most lay people (and probably most professionals) down immediately.

    “Complementary and alternative medicine
    (CAM) or integrative medicine (IM) modalities based on
    principles that bespeak infinitesimally low prior probability
    of success or that even violate well-established laws of
    physics and chemistry are being tested in randomized
    clinical trials (RCTs).”

    Really? I’ve never seen any writing this obtuse on this blog. Why change styles just because you are going into a journal?

    1. David Gorski says:

      Funny, but you’re the first one who’s complained about the writing style of the paper. Seriously. True, a fair number of people have complained about the content of the article. That’s not surprising, as believers in alt-med don’t like the criticism of criticism of integrative oncology.

      However, no one’s really complained about the prose, not even the editors. And, yes, unlike a lot of medical journals, the editor is heavily involved in actually editing the prose, and the article was stronger for it.

Comments are closed.