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There’s an app for that ?!?

There is no shortage of technology in my household: computers, smart phones and tablets of one kind or another. The nice thing about being a blogger and an app developer is I can justify it all. Well, mostly. The “It’s probably tax deductible” gambit can only be used so many times. It is remarkable how much of my life is filtered through the digital lens. I think if google glasses ever become a reality, my kids and I will be the first up to be permanently wired into the world. To my way of thinking, the Daemon haunted world looks like hog heaven.

There is an app for just about anything, many of which feed into my OCD. I keep track of my daily walk and I have walked over 1500 miles since July 1, 2011. When I developed my middle aged bloat I had the option of medications to control the metabolic results or lose some damn weight. Losing weight is simple in concept, hard in execution. Take in fewer calories than you expend and the weight will slowly, ever so maple bar free slowly, come off. It took 9 months to drop the 45 pounds needed, and I must say I feel just as old and creaky as I did before, but my labs are better. The opposite of the placebo effect: I am subjectively the same but am objectively better. I’ll take it.  One of the cool features of the app I used, and still use, for calorie management is that it will take a picture of the bar code of food and give you the nutritional information for entry in the program. Amazing.

A fellow bugdoc sent me a link to story about Chinese Tongue diagnosis. The journal article has been accepted for publication as Automated Tongue Feature Extraction for ZHENG Classification in Traditional Chinese Medicine 

It is as fine a piece of tooth fairy science and tooth fairy engineering as I have ever encountered.What is ZHENG? The paper starts with the usual blather: ancient, blah blah, holistic blah blah enhances body resistance yada yada. The standard logical fallacy filled introduction to justify the study nonsense. Been there, done that. Is ZHENG based on any known anatomy, physiology, biochemistry or validated in prior well done clinical trials. Of course not. At least no that I can find on the Pubmeds or the Interwebs.

They proceed with

For thousands of years, Chinese medical practitioners have diagnosed the health status of a patients’ internal organs by inspecting the tongue, especially the patterns on the tongue’s surface. The tongue mirrors the viscera. The changes of tongue can objectively manifest the states of a disease, which can help differentiate syndromes, establish treatment methods, prescribe herbs and determine prognosis of disease.

Nope. Wrong. Another nonsensical mapping system. While a few diseases can manifest on the tongue (my personal favorite being disseminated histoplasmosis) the tongue does not mirror the viscera any more that the ear, the head, the hand, the foot or the iris. As I have mentioned before, damn is the body crowded when all these mapping systems are applied to one person. They then describe ZHENG:

It is a characteristic profile of all clinical manifestations that can be identified by a TCM practitioner. ZHENG is an outcome after analyzing all symptoms and signs (tongue appearance and pulse feeling included). All diagnostic and therapeutic methods in TCM are based on the differentiation of ZHENG, and this concept is as ancient as TCM in China ZHENG is not simply an assemblage of disease symptoms but rather can be viewed as the TCM theoretical abstraction of the symptom profiles of individual patients. As noted in the abstract, ZHENG is also used as a guideline in TCM disease classification. For example, patients suffering from the same disease may be grouped into different ZHENGs, whereas different diseases may be grouped as the same ZHENG. The Cold ZHENG (Cold syndrome) and the Hot ZHENG (Cot syndrome)are the two key statuses of ZHENG[3]. Other ZHENGs include Shen-Yang-Xu ZHENG (Kidney-Yang deficiency syndrome), Shen-Xu ZHENG (Kidney deficiency syndrome), and Xue-Yu ZHENG (Blood Stasis syndrome).

I have read and re-read the paragraph and searched the web and the Pubmeds to better understand the concept of “patients suffering from the same disease may be grouped into different ZHENGs, whereas different diseases may be grouped as the same ZHENG.” Reminds be of trying to understand the classification of Streptococci, only less helpful. ZHENG seems to lack the useful clinical ability to classify and discriminate, but I am not certain. My summary of ZHENG: it is anything they want it to be.

‘When I use ZHENG,’ Humpty Dumpty said, in rather a scornful tone, ‘it means just what I choose it to mean — neither more nor less.’
‘The question is,’ said Alice, ‘whether you can make ZHENG mean so many different things.’
‘The question is,’ said Humpty Dumpty, ‘which is to be master — that’s all.’

As T. Jefferson noted in a different context,

Ridicule is the only weapon which can be used against unintelligible propositions. Ideas must be distinct before reason can act upon them…

I am not so sanguine that reason can act upon ZHENG.

Still, they came up with a way to use computerized pattern recognition and applied it to the tongue to identify the ZHENG state, and then compared it to patients with ‘known’ Hot ZHENG, Cold ZHENG, Gastris and H. pylori in the mother of all multiple comparisons and came up with…. well, I really don’t know. Nothing really. If you judge from Why Most Published Research Findings Are False, the authors hit 5 of 6 reasons why any positive result is probably bunk.

Mostly they concluded that, after what looks to be a huge amount of coding and clinical effort, they have a computer program that can analyze a part of a tongue and it somewhat correlates with the patients ZHENG status.  The effort was more to calibrate the system than to validate it as a diagnostic tool, but still generating useless results none the less. All sound and fury, signifying nothing. It saddens me that so much time, effort and money was expended on nothing of value. It is like getting a degree in homeopathy or naturopathy.

If you  think if we have problems with the money spent by NCCAM, this study was funded in part by The National Science Foundation of China, who has a subsection for Chinese medicine. Can you imagine the politics and cultural background of funding in China for their traditional forms of SCAM?  We have it so easy.

The depressing aspect of the paper is the authors intention to continue to apply what appears to be sophisticated and complex computer programming to fiction, and then bring out a smart phone app. Take a picture of your tongue, it will let you know if your ZHENG is hot or cold, and then you can seek appropriate care.

“As we continue to work on the software we hope to improve its ability. Eventually everyone will be able to use this tool at home using webcams or smartphone applications. That will allow them to monitor their zheng and get an early warning about possible ailments,” Duan said.

This will not be the only app available covering some form of SCAM. Looking at the iTunes store and the Android store all the standard SCAMs are well represented with multiple apps, fewer in the iTunes store than the Android marketplace. There are few apps on Blackberry and Windows phone, but then virtually no ones uses Windows phones. You can diagnose and treat yourself (of course they all have the appropriate disclaimer) and others with apps that assist in homeopathy, naturopathy, chiropractic and herbology.

The Android marketplace has a lot more ‘fun’ apps, probably as it is easier to develop and deploy on the Android app store.

The Pocket Naturopath, only a dollar, will help save you money:

No more paying huge sums of money and waiting in line to speak to a Naturopath or Holistic healer.

Why do I think the app is saving people from an alternative  Lucy?  Only charging more than a nickle. From my perspective, a dollar is a huge sum for naturopathic advice. Or, courtesy of the Healing Frequency 528htz app:

DNA Repairing perfect 528hz tones, in long pulses. Heal yourself with the scientifically proven frequency that repairs cells and is said to be the tone of Unconditional Love.”

or

iResist which

accesses vast levels of knowledge along with tools that pierce the veil. The iResist Hyper Portal Application keeps you “In the Know” with the most expansive knowledge and tools related to ascension and spiritual enhancement sourced from The Resistance Community.

Few SCAMs are not represented by at least one app; applied kinesiology and craniosacral therapy the main exceptions I could find, although they were found as subset of chiropractic apps. Entering “the amazing meeting” into iTunes did lead to Bible apps. LOL.

There is a smart phone app for almost anything.  Skeptic related apps are in very short supply. There are Logical Fallacy apps, but they only pop if you search especially for them and evidently not used by ZHENG researchers.   Except, it seems, Science Based Medicine. There is no shortage of medical woo and nonsense in the app stores, but little in the way of medical science and skepticism. For SBM, there is no app for that.

Posted in: Energy Medicine, Science and Medicine, Traditional Chinese Medicine

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27 thoughts on “There’s an app for that ?!?

  1. nybgrus says:

    In my undergrad days, through the course of my medical anthropology degree, I took a number of classes on TCM. I remember learning that the tongue mapped to various disease states. Mind you, this was not taught from a historical or informative perspective – it was taught as absolutely true. In fact, the common canard was “This is true and “Western BioMedicine” refuses to believe it because it violates their reductionist dogma.” I am not even remotely exaggerating here and yes, “Western BioMedicine” was the term used to describe what I am currently studying.

    I learned to speak the language of Moerman and Kaptchuk quite well – I graduated magna cum laude – I just didn’t know at the time that the language was total BS. Now imagine all those poor souls finishing their undergrad and not having the benefit of a rigorous science education to allow them to finally see the light, as it were, and you can begin to understand why such studies are still printed, lauded, and “integrative medicine” programs exist.

  2. rork says:

    My new app for getting in shape: Have a tornado go over your place and then cut and move a quarter million pounds of oak just for starters. I know it’s anecdotal, but I testify to it working. Side effects may include bigger muscles, bulging veins, hernia, white finger, smashed finger, lost finger, and deafness to chainsaw noises.

    45 is most impressive. My compliments. Love your writing as usual.

  3. Janet Camp says:

    @nybgrus

    What you describe (thankfully) was not my experience when I got my Anthropology degree (circa 1982)–thank the universe! Other cultures were studied with respect and relativity, but not as “truth”. Yikes–how awful to hear this. Your experience does go a ways to explain some of the current situation, alas. I had one course–Myth, Magic, and Ritual–in which the Prof gave some nod to validating people’s belief systems, but never in a real-life way such as promoting the transfer of cultural/religious practices to one’s own culture, nor did the course content ever try to pass off the “ours is just another cultural interpretation” gambit. We got a huge dose of science, in Physical Anthropology, Human Biology and in all the “methods” courses. Darwin, and the history of evolution and scientific thought were strongly represented in the overall curriculum. Where the heck did you go to school?

    I understand the human propensity for belief, but I don’t understand why Anthropology Professors, of all people, would “go native”–something that in my day was definitely trained out of us.

    ——
    Mark, get busy on that SkeptiApp!

    I’ve always wondered that people who think TCM is so great don’t take up foot-binding? Surely it cures bunions, in the same way that eating garlic cures onion breath. And now that “cupping” has taken off, can bloodletting be far behind?

    Also, I actually know someone who has a Windows phone–he’s an accountant and he likes to always have his little tiny spreadsheets with him–“just in case”.

  4. DWATC says:

    CAM has more time to spend on developing apps and other marketing ploys. They are the marketing giants afterall. We’re too busy doing things they’re not used to like research, proving our claims, and treating a noncompliant patient population.

  5. agitato says:

    I know this comment is off topic but…..You lost 45 pounds in nine months! Five pounds a month! You really are inspirational. Since everyone I know seems to be trying unsuccessfully to lose weight, I’m interested in the exact specifics of how you managed this.

    Also what is the name of the calorie app?

  6. mousethatroared says:

    I really want to be able to scan my tongue and get a calorie app that will organize, document, shop for and prepare nutritious and emotionally fulfilling meals(TM) that not only allow me to lose weight, but also are specifically tailored to my evolutionary satiety requirements.

    Or you could just post the name of your calorie app… And I’ll have to cope with reality.

  7. Josie says:

    Your food has a barcode? :)

  8. Mark Crislip says:

    My Fitness Pal

    I compulsively stuck/stick to my calorie goal, eating anything I damn well pleased until I hit the limit.

  9. krelnik says:

    > Skeptic related apps are in very short supply.

    Comparatively so, yes. However there are a few:

    Creationist Claims Index For debating Creationists.

    Skeptical Science For debating AGW deniers.

    Today in Skeptic History JREF’s free historical trivia app, I wrote the data.

    Skeptic’s Dictionary Good general purpose reference.

    There are some other skeptic-adjacent ones like Consumer Reports, Politifact and so on.

    You guys should do an SBM app that has handy bullet-points on each form of alt-med and links back here.

  10. Chris says:

    Josie:

    Your food has a barcode?

    I wondered about that too!

    When I cook for my family I usually make enough for four, with some leftovers. And I don’t really want to scan the pasta Alfredo with peas and ham I made last night! And I have been asked to make cheese biscuits for the rest of the ham dinner leftovers.

    Though I have heard there are recipe apps with nutrition/Calorie data.

  11. nybgrus says:

    @janet:

    I should clarify that it wasn’t all of my anthro classes that were like that. I received my degree in 2005 from the University of California at Irvine (which, btw, currently has the Sameuli Center of “Integrative Medicine” as well as the Samueli School of Engineering).

    Many of my general anthro classes were very much as you describe. Physical anthro was, of course, very science based. My cultural classes were also very much respectful, but realistic as well. I was not taught that the voodoo practiced in my “Peoples of the South Pacific” were actually legitimate or that the human sacrifices of the Mayans in my “Latino and South American Cultures” classes were the best way to ensure a good growing season. I also took courses like “Post-Soviet Eurasia” (which I really like, being born a Soviet citizen myself) and “Comparative Religions of South Asia” which I found extremely informative (and further solified my stance as an atheist) but also not taught from a “this is real” perspective.

    However, there was this exciting and pretty new field called “medical anthropology” which was just starting to catch on and become popular. It wasn’t yet a completely separate degree (kind of like how physical anthro was not a separate degree from cultural anthro) but you could take a bunch of classes in it to make that your “focus” which was basically like a minor but in the degree you are working in, instead of a separate degree (i.e. if you do bio, but take enough math classes you can be a math minor, but if you do bio but with enough neuro classes you can be a neuro “focus”). I decided to pursue this since I figured that since my intent was to go into medicine, it would be useful to learn medical anthro! It was a ‘No duh” thing at the time.

    It was in those classes that my professors told us all this stuff was legit. I had courses on the utility of tongue reading, ayurveda, hot/cold medicine, TCM, acupuncture, and yes, even homeopathy. And none of it was taught from the “this is what other pre-scientific people did/do” it was definitively a “this is totally legit and if only those closed-minded Western BioMedicine people would accept it we could have such a better health system!” I kid you not, those same canards we ridicule here was standard for med anthro types. They truly do believe that internal consistency is enough to make a system valid and work. It need not be tied to reality as long as it was consistent within its own framework. And the terms “evil reductionist” and “closed-minded” were liberally bandied about.

  12. What is hot/cold medicine?

  13. nybgrus says:

    essentially the Vietnamese version of Traditional Chinese Medicine. It revolves around the concept of chi (or qi if you prefer) and basically says that “hot” conditions needs “cold” cures and vice versa.

    http://ethnomed.org/clinical/traditional-medicine/traditional-vietnamese-medicine-historical-perspective-and-current-usage

    BTW, I looked through the Sameuli Center for Integrative Medicine (I wonder why the Samueli School of Engineering isn’t also “integrative”???) and looked at their research interests and publications. Basically it is a crock of crap and they are calling electroacupuncture the same thing as acupuncture and looking at the effects of qi on blood pressure. Interestingly enough, the only publications they have are some basic science stuff that is in no way alternative, a bunch of papers looking at the usage of CAM, and a few looking at the validity and evidence for CAM in use for legitimate medical complaints… each one with a conclusion saying “More rigorous evidence is needed.” Basically a whole lot of nothing held together with a bunch of wishful thinking and a smattering of mis-labeled “alternative” studies.

  14. mousethatroared says:

    Chris, allrecipes.com has calories, nutrition info, so does their app. Cooking Light also has a recipe app with calories, you can also build a meal (see total cals for different combo main, side, etc) but the recipes aren’t really extensive. if you are not compulsive, MC’s app has a search that allows you to add a dish like lean cuisine pasta Alfredo or pizza hut pasta alfredo* but it would be a guesstimate on calories.

    Personally, I’m torn between the simplicity of just writing calories down in my note book and adding it up after each meal or going high tech.

    *I’m guessing your pasta Alfredo is better than those. :)

  15. Chris says:

    Mousethatroared,

    I just loaded an old version of MasterCook (bought it from Half Price Books five years ago), so I am putting in my own recipes to see how bad they are.

    My fluffy tapioca pudding that I started tweaking years ago does quite well, since the first thing I did was reduce the sugar (the recipe on the box is too sweet). I recently made it more heart health by using egg substitute (essentially colored egg whites), and egg whites.

    That makes up for my evil pasta Alfredo and cheese biscuits.

  16. Ken Hamer says:

    Every time I see the acronym “TCM” I think of a line spoken by Michael Douglas in a movie called Black Rain:

    “This is America and it’s two hundred years old so you better get your clocks fixed.”

  17. PJLandis says:

    This reminds me of a funny story. Recently I was having dinner at my mother-in-laws’ house. I always look forward to this because she is a very good cook. She is also very “open-minded.” Anyway, during dinner I’m nodding my head as she explains why Revolver (2005) is a really deep film, and you have to watch it three or four times to understand it because it’s based on the kabballah or something. I’m enjoying dinner, but I lie about not seeing the movie because the film is pretty bad and I’m afraid she’ll want to watch it after we eat. So, I’m enjoying dinner, although a little less than usual, but it’s still pretty good so I wasn’t complaining. Then for dessert, she brings out banana bread which I love. I’m pretty sure she made it just because I enjoy it so much, or at least it influenced here choice because she mentions it. I cut a big slice and after I take my first bite the look on my face must have telegraphed my displeasure. I’m trying to smile, but I don’t want anymore of this bread. She seems genuinely surprised and starts telling me how she can’t understand what’s wrong because she followed the ancient Chinese wisdom of the five flavors. I tried to convince her that was the problem, however I don’t believe I succeeded.

    So, my point is that ancient Chinese wisdom is about as effective in the kitchen as it is in the doctor’s office; although it may be an effective weight loss method.

  18. BillyJoe says:

    Mark: “eating anything I damn well pleased until I hit the limit.”

    I can eat anything I damn well please – without limit!

    Seriously, since I switched from walking for an hour most mornings to running for an hour every morning, I actually struggle to keep my weight from slipping below the middle of the healthy weight range.

  19. Chris says:

    PJLandis:

    She seems genuinely surprised and starts telling me how she can’t understand what’s wrong because she followed the ancient Chinese wisdom of the five flavors.

    Um, banana bread mostly consists of banana, flour, sugar, salt, leavening, egg, oil (or butter) and often nuts. What five flavors could she have tossed in to ruin a simple quick bread? Did she throw in Chinese five spice? Or did she do what I did as a kid and mix up the salt and sugar which were both stored in identical unmarked plastic containers when I made brownies (like my dad I also buy Costco quantities, but I actually label the containers).

  20. PJLandis says:

    The Five Flavors thing, as far as I can tell, is not a spice mix but some kind of metaphysical system of health and well being through food; balanced food balances our life-force, thereby causing health, wealth, and happiness. The “spices” are more like Earth, Water, and Fire, but because her references were in Polish I didn’t get a clear understanding of it all.
    (I think this is it, or similar: http://chinesefood.about.com/library/weekly/aa041900a.htm)

    Maybe it was some kind of unintended error. It did contain some kind of non-white flour and more than one kind of nut and fruit but those weren’t new ingredients compared to previous incarnations I’d eaten. Bannana bread might be mislabeling it, but bananas were a key ingredient and it was shaped like bread. I suspect the addition of some kind of actual spices are what spoiled it, but I’m very adept at describing tastes or flavors so I can only say it wasn’t good.

    Based on her previous outings, I highly doubt she mistook sugar for salt if only because I know her sugar is brown . And I think she would have caught a mistake like that because she puts a lot of effort, has a lot of experience, and takes a lot of pride in her cooking.

    What most surprised me was that she assumed it was an error in combining these five elements, and didn’t seem to be considering that everything she knew about cooking and baking might be more relevant than some half-baked psuedo-Chinese wisdom. While I remain hopeful that my next meal with them will improve, I suspect it will be in spite of these Five Flavors/Elements rather than because of them.

  21. mousethatroared says:

    regarding simple banana bread. I once used baking powder instead of baking soda in a lemon cake…no amount of Chinese wisdom OR science is going to overcome that mistake.

    Actually, I’m all for ancient wisdom in baking, I have a zucchini bread recipe passed down from my mother, grandmother, great-grandmother, etc. I’ve never needed to validate it with clinical trials. :) It did take me a little experimentation to figure out what a “scant cup” is.

    @BillyJoe- okay, I was going to be all skeptical and point out that running only uses so many calories and it’s all a calories in calories out equation…but then I looked up the calories expended running for an hour, over 1100…Yeah, I think I could actually eat (and drink) almost anything I wanted with an extra 1100 calories. Unfortunately, at this point I’m not even at my target 30 minute 3 times a week running. But once I get my breathing back under control that’s a worthy goal to shoot for.

  22. PJLandis says:

    “regarding simple banana bread. I once used baking powder instead of baking soda in a lemon cake”

    A better example might be if your family recipe called for baking powder and you used baking soda on purpose because some received wisdom decreed it good for the mind, body, and soul. It’s not quite science that tells you that baking powder was the right ingredient in the first place, its more like simple reasoning.

  23. mousethatroared says:

    Except well…my mom’s zucchini bread IS good for the mind, body and soul.

    Just having a hard time with five element baking analogy. The same thing could have happened if she had tried a new recipe from a book or friend (or Martha Stewart, I’ve had several of her recipes fail me). That’s what bakers and cooks do, try new recipes from different sources.

    Do we really need to approach our baking with the same intense critical thinking that we would our health care. What a drag.

    I mean, unless she’s including poached* rhino horns to make the bread rise, or topping things off with unpaturized whipped cream, that would be misguided.

    *poached as illegally hunted not boiled.

  24. PJLandis says:

    “The same thing could have happened if she had tried a new recipe from a book or friend (or Martha Stewart, I’ve had several of her recipes fail me)”

    But then wouldn’t you assume it was the ‘new recipe’ that was the problem, rather than defending the recipe?

  25. mousethatroared says:

    @PJLandis – Ahhhh! Now I get it. I didn’t get that she was defending the recipe because of it’s ancient wisdom origin.

    I have seen people defend bad recipes because they are “healthy”, but I usually just throw the recipe under the bus if it’s not good, don’t care about the source.

    Sorry about the misinterpretation.

  26. anthony28 says:

    How wonderful to see the noble scientists in dispassionate search of the truth! Having played extensively with Chinese medicine in primary care over many years, I think it’s far too subtle for you guys to appreciate. It’s not a replacement for antibiotics or safe surgery, but it’s an awful lot better than blunderbus statins; BTW what is the latest NNT?
    best,
    Anthony

  27. higgy says:

    As a working acupuncturist for 29 years, I can tell you all that the tongue, sometimes,can be a very helpful diagnostic tool. Othertimes it may not be relevant at all. Those of you who feel acupuncture is quackery will care less. Others, who have seen it work, like Anthony above, will understand. And by the way, there is a lot of intriguing research on acupuncture. That app-related article- didn’t make much sense or have usefullness to me either.
    higgy

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