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Why We Need Science: “I saw it with my own eyes” Is Not Enough

I recently wrote an article for a community newspaper attempting to explain to scientifically naive readers why testimonial “evidence” is unreliable; unfortunately, they decided not to print it. I considered using it here, but I thought it was too elementary for this audience. I have changed my mind and I am offering it below (with apologies to the majority of our readers), because it seems a few of our readers still don’t “get” why we have to use rigorous science to evaluate claims. People can be fooled, folks. All people. That includes me and it includes you. Richard Feynman said

The first principle is that you must not fool yourself–and you are the easiest person to fool.

Science is the only way to correct for our errors of perception and of attribution. It is the only way to make sure we are not fooling ourselves. Either Science-Based Medicine has not done a good job of explaining these vital facts, or some of our readers are unable or unwilling to understand our explanations.

Our commenters still frequently offer testimonials about how some CAM method “really worked for me.” They fail to understand that they have no basis for claiming that it “worked.” All they can really claim is that they observed an improvement following the treatment. That could indicate a real effect or it could indicate an inaccurate observation or it could indicate a post hoc ergo propter hoc error, a false assumption that temporal correlation meant causation. Such observations are only a starting point: we need to do science to find out what the observations mean.

Last week one of our commenters wrote the worst testimonial yet:

I have witnessed first hand the life that begins to flow through the body upon the removal of a subluxation.

What does this even mean? Does he expect anyone to believe this just because he says it? Would he believe me if I said I had witnessed first hand the invisible dragon in Carl Sagan’s garage?

Another commenter wrote

Those pro SBM commenters here seem to think that even if they see something with their own eyes that they can’t believe it if there are no double blinded officially published studies to prove that what they saw actually happened.

Well, yes, that’s pretty much what we do think; and we are appalled that you don’t understand it yet, since it’s the whole reason we have to do science. I would phrase it a bit differently: “Seeing something with my own eyes doesn’t prove it’s true and it doesn’t preclude the necessity for scientific testing.”

We can’t believe our own eyes. The very process of vision itself is an interpretive construct by the brain. There are two blind spots in our field of vision and we aren’t even aware of them. I saw a magician cut a woman in half on stage – that was an illusion, a false perception. I saw a patient get better after a treatment – my interpretation that the treatment caused the improvement may have been a mistake, a false attribution.

So for those who still don’t get it, here’s my simplistic article:
—————————————

Sometimes We Get It Wrong

How can you know whether a medical treatment really works? If everybody says it works, and it worked for your Aunt Sally, and you try it and your symptoms go away, you can pretty well assume it really works. Right?

No, you can’t make that assumption, because sometimes we get it wrong. For many centuries doctors used leeches and lancets to relieve patients of their blood. They KNEW bloodletting worked. Everybody said it did. When you had a fever and the doctor bled you, you got better. Everyone knew of a friend or relative who had been at death’s door until bloodletting cured him. Doctors could recount thousands of successful cases.

All those people got it wrong. When George Washington got a bad throat infection, his doctors removed so much of his blood that his weakened body couldn’t recover, and he died. We finally got around to testing bloodletting and found out it did much more harm than good. Patients who got well had been getting well IN SPITE of bloodletting, not because of it. And some patients had died unnecessarily, like George Washington.

Even modern doctors sometimes get it wrong. Not long ago, doctors used to do an operation for heart disease where they opened the chest and tied off chest wall arteries to divert more blood flow to the heart. They had an impressive 90% success rate. A smart doctor named Leonard Cobb wanted to make sure, so he did an experiment where he just made the incision in the chest and closed it back up without actually doing anything. He discovered that just as many patients improved after the fake surgery! Doctors stopped doing that operation.

How could so many people be so wrong? How could they believe something had helped them when it actually had done them more harm than good? There are a whole lot of reasons people can come to believe an ineffective treatment works.

  1. The disease may have run its natural course. A lot of diseases are self-limiting; the body’s natural healing processes restore people to health after a time. A cold usually goes away in a week or so. To find out if a cold remedy works, you have to keep records of successes and failures for a large enough number of patients to find out if they really get well faster with the remedy than without it.
  2. Many diseases are cyclical. The symptoms of any disease fluctuate over time. We all know people with arthritis have bad days and good days. The pain gets worse for a while, then it gets better for a while. If you use a remedy when the pain is bad, it was probably about to start getting better anyway, so the remedy gets credit it doesn’t deserve.
  3. We are all suggestible. If we’re told something is going to hurt, it’s more likely to hurt. If we’re told something is going to make it better, it probably will. We all know this: that’s why we kiss our children’s scrapes and bruises. Anything that distracts us from thinking about our symptoms is likely to help. In scientific studies that compare a real treatment to a placebo sugar pill, an average of 35% of people say they feel better after taking the sugar pill. The real treatment has to do better than that if we’re going to believe it’s really effective.
  4. There may have been two treatments and the wrong one got the credit. If your doctor gave you a pill and you also took a home remedy, you may give the credit to the home remedy. Or maybe something else changed in your life at the same time that helped treat the illness and that was the real reason you got better.
  5. The original diagnosis or prognosis may have been incorrect. Lots of people have supposedly been cured of cancer who never actually had cancer. Doctors who tell a patient he only has 6 months to live are only guessing and can guess wrong. The best they can do is say the average patient with that condition lives 6 months – but average means half of people live longer than that.
  6. Temporary mood improvement can be confused with cure. If a practitioner makes you feel optimistic and hopeful, you may think you feel better when the disease is really unchanged.
  7. Psychological needs can affect our behavior and our perceptions. When someone wants to believe badly enough, he can convince himself he has been helped. People have been known to deny the facts – to refuse to see that the tumor is still getting bigger. If they have invested time and money, they don’t want to admit it was wasted. We see what we want to see; we remember things the way we wish they had happened. When a doctor is sincerely trying to help a patient, the patient feels a sort of social obligation to please the doctor by improving.
  8. We confuse correlation with causation. Just because an effect follows an action, that doesn’t necessarily mean the action caused the effect. When the rooster crows and then the sun comes up, we realize it’s not the crowing that made the sun come up. But when we take a pill and then we feel better, we assume it was the pill that made us feel better. We don’t stop to think that we might have felt better for some other reason. We jump to conclusions like the man who trained a flea to dance when it heard music, then cut the flea’s legs off one by one until it could no longer dance and concluded that the flea’s organ of hearing must be in its legs!

So there are lots of ways we can get it wrong. Luckily, there’s a way we can eventually get it right: by scientific testing. There’s nothing mysterious or complicated about science: it’s just a toolkit of common sense ways to test things. If you believe you’ve lost weight and you step on the scale to test your belief, that’s science. If you think you have a better way to grow carrots and you test your idea by planting two rows side by side, one with the old method and one with the new method, and see which row produces better carrots, that’s science. To test medicines, we can sort a large number of patients into two equal groups and give one group the treatment we’re testing and give the other group an inert placebo, like a sugar pill. If the group that got the active treatment does significantly better, the treatment probably really works.

Jacqueline Jones was a 50 year old woman who had suffered from asthma since the age of 2. She read about a miraculous herbal treatment that cured a host of ailments including asthma. She assumed the information was true, because it included lots of testimonials of people who had used it and were able to stop taking their asthma medications. They KNEW it worked. They had SEEN it work. Sick of the side-effects of conventional drugs, Jacqueline stopped using her three inhalers, steroids and nebulizer, and took the herbal supplement instead. Within two days she was in the hospital.

I had a massive asthma attack. I was seriously ill in hospital for six weeks, during which I developed pleurisy. I couldn’t breathe and my lungs were so sensitive that even touching the area on the outside felt like someone was kicking me.

All those people who said that herbal remedy had cured their asthma got it wrong. Asthma symptoms fluctuate. Maybe their symptoms would have improved anyway. Whatever the reason, the remedy had not been tested scientifically and it was not effective for treating asthma, and believing those testimonials almost cost Jacqueline her life.

The next time a friend enthusiastically recommends a new treatment, stop and remember that they could be wrong. Remember Jacqueline Jones. Remember George Washington. Sometimes we get it wrong.

Posted in: Science and Medicine

Leave a Comment (87) ↓

87 thoughts on “Why We Need Science: “I saw it with my own eyes” Is Not Enough

  1. Michelle B says:

    Excellent explanation, clear and concise. And we all can do with a refresher course.

    As far as the readers who really do not get it, I am afraid–though this article may plant some seeds of doubts regarding their gullibility–it is often necessary for them to experience what Jacqueline Jones went through before they wake up to the merits of science-based medicine and understand that it is the only way to determine effective treatments.

  2. anoopbal says:

    Science is evidence- based, not belief- based.

    If indeed science was based on testimonials and beliefs, the earth would be still flat and at the center of the universe!

  3. nicolaennio says:

    proposition 5 (The original diagnosis or prognosis may have been incorrect) should say “median” instead of “average”, otherwise it would be uncorrect to say that half people live more than 6 months.

  4. Adam_Y says:

    You know it might be a good idea to go into detail about experiment design. It is an extremely bad generalization to say that you just split the people into two groups because you can fall into a trap in that you don’t have equal representation between the two groups.

  5. David Gorski says:

    proposition 5 (The original diagnosis or prognosis may have been incorrect) should say “median” instead of “average”, otherwise it would be uncorrect to say that half people live more than 6 months.

    Actually, this proposition is incredibly common in cancer cure testimonials. The stereotypical bit is the famous “my doctors sent me home to die” claim. Also, as I’ve pointed out, certain cancers have an incredibly variable prognosis. Some, like certain prostate and, to a lesser extent, breast cancers may not even progress at all. We end up treating them all because we do not know how to differentiate anywhere near reliably between the ones that will endanger a patient’s life and the ones that won’t.

    It’s not just because breast and prostate cancer are so common that they are among the most frequent cancers in cancer cure testimonials.

  6. There are several interesting subcategories of #7, “psychological needs.” Here’s one I’ve often noticed:

    Humans have a strong desire to be “in the know,” to be members of an exclusive club. It’s a primate thing, and quacks know it, so they sell their wares by claiming that their treatment is special and different. Patient satisfaction with the belief that they’ve acquired special knowledge can be so potent that it is pretty much indistinguishable from treatment satisfaction. Such patients often give a hearty thumbs up to a treatment that didn’t actually solve their problem. Patients look me right in the eye and earnestly tell me, without irony, that such a treatment “worked” … even though they are asking for my help with unabated chronic pain! What it worked on was their ego alone.

  7. JRD_2 says:

    “Actually, this proposition is incredibly common in cancer cure testimonials.”

    I think you’re missing nicolaennio’s point, which is that the post confuses average with median. It is not the case (or is the case only in exceptional circumstances) that exactly half of cancer patients live longer than the average life expectancy. The post is therefore incorrect to say that “average means half of people live longer than that,” because that isn’t the definition of average.

  8. Skeptic says:

    It is a good article about a fundamental concept that can’t be emphasized enough. If you can only get one point across, this is the one, that we can’t trust what we see and that the scientific method is the best way to compensate for our inbuilt cognitive biases. Nor do I think it is talking down to your audience to post an article that uses less jargon than usual to make the point.

    However, I do have on question. The article, in part, notes that we shouldn’t trust anecdotes, but then uses a vivid anecdote to prove its point. While I realize the use of an a vivid anecdote is likely a conscious choice based on the fact that people find anecdotes, stories, more persuasive than data and statistics, the article failed to tell us why that anecdote can be trusted, but others cannot–and I think it is important to talk about that distinction, so that people can know how and why to question the validity of anecdotes.

  9. Harriet Hall says:

    In defense of the anecdote: I used it as an illustrative example to get the point across. It wasn’t a testimonial for a treatment, but an example of how choosing a treatment based on testimonials can have bad results.

  10. Skeptic says:

    I don’t think the use of the anecdote was wrong, per se, but by using one as what seems like the foundation of your conclusion there is an implicit endorsement of anecdotes as evidence and the article does not why your anecdote is valid while others are not.

    I can see why you didn’t bother with a digression about how your anecdote is different from “their” anecdotes, as it would affect the pacing and flow of the article, and make it longer and more complicated. But, I think one of the biggest challenges in teaching about the differences between scientific medicine is teaching people not to trust their eyes, not to trust their personal experience and countering the natural attraction to anecdotes as evidence for causality. We are telling people not to trust their intuition and to replace their intuition with an acceptance of the scientific method as being superior. That is a tough sell, and it is a tricky one when you conclude by appealing to their intuition with an appeal to their intuition in the form of an anecdote.

    I like the fact that you are using scientifically proven persuasive techniques, vivid anecdotes, to make a case for scientific medicine. But, I also think including an anecdote to prove the scientific side is potentially problematic if you don’t back it up with note of why your anecdote is different, which I think that it is to some degree since it refers to an instance illustrating already proven causal relationships between evidence based asthma medication and a relapse. But, even so, it is tough to teach that anecdotes are not evidence with an anecdote. This might seem like a trivial point, but I don’t think that it is. I think it is fundamental.

  11. daedalus2u says:

    Anecdotes (if properly recorded and documented) are perfectly acceptable proof of some things (or more usually disproof). The hypothesis that all swans are white is disproved by an anecdote of a single black swan.

    I consider anecdotes (when honest) to be data with very low statistical power. When all you need is a single example to disprove a hypothesis, then an anecdote (if accurately reported) is sufficient.

    In this case, Dr Hall was using the anecdote to illustrate that some “natural” cures of asthma are not 100% effective and can have serious and life threatening results. We don’t know if the incidence of those adverse reactions is one per ten, one per hundred, one per thousand or one in a million. This adverse effect is sufficiently severe that it would have to be extremely rare and the treatment otherwise extremely effective for the treatment to be worth the risk. Without good data statistically demonstrating that the adverse effect is extremely rare, the default is to reject the procedure until there is good data.

  12. Skeptic says:

    “# daedalus2uon 18 Aug 2009 at 12:04 pm
    Anecdotes (if properly recorded and documented)

    Indeed, a verifiable anecdote can be a perfectly valid proof by contradiction in an argument over absolute claims, where a single contradictory instance is all that is needed to disprove an expansive claim. Anecdotes are less useful in the realm of medicine where claims are generally less absolute, though I concede that Dr. Hall is attempting to disprove the presumed natural cures are 100% safe assumption, but none of that is my point.

    My point is that one should be careful in using anecdotes in an article which is trying to tell people not to trust anecdotes. It sends a mixed message in an instance where the message needs to be 100% clear: Anecdotes are not [sufficient] evidence.

    But by using an anecdote oneself, without any mention of if or why it is different from woo-woo anecdotes, one risks muddling message to the point that people won’t remember the take away, which should be “don’t trust anecdotes.”

  13. qetzal says:

    Dr. Hall,

    I really, really liked your letter. It’s a shame it wasn’t published.

    In fact, I’d love to see a prominent link to the letter itself right at the top of the SBM home page. (Just the letter itself; not this post & its associated comments.) I think the letter perfectly exemplifies why science based medicine is so important. It would be a great intro to those new to the topic, and a great reminder for the rest of us.

    As an aside, I’d like to comment on the point that ‘we can’t believe what we see.’ That’s sometimes true, of course, but I don’t think that’s usually the problem. I also don’t think most lay people will be persuaded if they percieve the take home message to be “You can’t believe what you see.”

    Most lay people already understand that their eyes can sometimes be fooled. Consider this passage from the post (but not the letter):

    I saw a magician cut a woman in half on stage – that was an illusion, a false perception. I saw a patient get better after a treatment – my interpretation that the treatment caused the improvement may have been a mistake, a false attribution.

    Everybody knows that the magician doesn’t really cut the woman in half. In that case, they know they can’t ‘believe their eyes.’ But with the patient, it’s a different situation. It’s very likely that the patient really did get better after the treatment. We can believe what we saw in that case. What we can’t believe is our conclusion – that the treatment caused the improvement.

    That’s a part of what I liked about your letter. It doesn’t make a point of telling people that they can’t believe what they see. It touch on that in point 7, but mostly it emphasizes that what they see doesn’t necessarily mean what they think it does. That’s the critical issue that more people need to understand, IMO.

  14. Jim says:

    I’m going to keep a link to this on-hand at all times, so I can show it to anyone trying to using anecdotal evidence to establish dumb claims.

  15. David Gorski says:

    I think you’re missing nicolaennio’s point, which is that the post confuses average with median. It is not the case (or is the case only in exceptional circumstances) that exactly half of cancer patients live longer than the average life expectancy. The post is therefore incorrect to say that “average means half of people live longer than that,” because that isn’t the definition of average.

    No. I did not miss the point. I am quite aware of the difference between median and mean (or average). I simply used the post as a jumping off point to reinforce the point that the prognosis in these stories is often wrong.

  16. Skeptic says:

    “Everybody knows that the magician doesn’t really cut the woman in half. In that case, they know they can’t ‘believe their eyes.’ But with the patient, it’s a different situation. It’s very likely that the patient really did get better after the treatment. We can believe what we saw in that case. What we can’t believe is our conclusion – that the treatment caused the improvement.”

    You make an excellent point, one so obvious I over looked it, which is that much of what we “see” is *interpretation* that we think we are seeing but is actually our intuition being imposed on the perceptual cues before us, automatically filling in the blanks, an automatic process that magicians use to fool us because we automatically fill in the blanks with what we expect, not necessarily with what actually happened. Little kids make fewer assumptions, fill in fewer blanks automatically and are often much harder for magicians to fool.

    So, teaching people “that what they see doesn’t necessarily mean what they think it does” seems like a good approach. But whatever tack you take, it is an uphill battle because you are trying to talk people out of unconscious processes, out of their natural intuition.

    I’d love to see some data on what methods, if any, are most effective at teaching people “that what they see doesn’t necessarily mean what they think it does” since it is such a deep rooted cognitive issue concerning the psychology of judgement and their should be some psychology of judgement studies that could be leveraged for this topic.

  17. Scott says:

    proposition 5 (The original diagnosis or prognosis may have been incorrect) should say “median” instead of “average”, otherwise it would be uncorrect to say that half people live more than 6 months.

    While strictly true, the intended audience for the piece cannot be expected to know what the median is. And in common conversation, mean/median/mode are all often called “average.” So I think the imprecision is reasonable here.

    If it were intended for a scientific audience, I’d agree with you. But not for a lay audience.

  18. Ed Whitney says:

    There is a temptation to think that there are lies, damned lies, and anecdotes. But anecdotes persuade in powerful ways that numbers do not.

    Anecdotes have human faces; statistics do not.

    To make statistics powerful, one must somehow make the point that there are real human beings in both tails of the statistical distribution. When a treatment is harmful or futile, there are more human beings whose hopes were dashed or who spent their last dollar on worthless treatments, or who experienced unforeseen adverse effects that made their suffering worse and traumatized their loved ones.

    Evidence-based medicine may stand or fall depending on its ability to put human faces on the numbers it uses to judge effectiveness of treatments.

  19. Skeptic says:

    “# Ed Whitneyon 18 Aug 2009 at 1:32 pm
    There is a temptation to think that there are lies, damned lies, and anecdotes. But anecdotes persuade in powerful ways that numbers do not.

    Evidence-based medicine may stand or fall depending on its ability to put human faces on the numbers it uses to judge effectiveness of treatments.

    All of that misses my point. I’ve already praised Dr. Hall for using a proven, effective technique: a pertinent vivid anecdote. The problem is that we are also trying to teach that people shouldn’t trust anecdotes because they are so disproportionally persuasive that they can and do often give us a false sense of veracity, proportion and causality. Which is not to say that we can’t use anecdotes, but that if we do we need to use them in a way that is substantially differentiable from the way woo advocates do, and clearly point out why our anecdotes are ok and the woo-woo anecdotes are not. You have not addressed that point.

  20. Joe says:

    I quite liked this post.

    @Scott on 18 Aug 2009 at 1:01 pm, You and David beat me to it; but then, Harriet described what she meant by average (half the people live longer) so the initial complaint was doubly misguided.

    As for anecdotes, I agree they can sometimes be instructive. There is one I like to bring up when someone gets “immediate relief” from some quack (placebo) treatment. On the NPR show “Car Talk,” Ray described having tinnitus that became so annoying that he went to a doctor. When the tests came back, the doctor said the best thing would be to wait a little while longer. Ray asked what it might be and the doctor shrugged and nonchalantly said “It could be a brain tumor …” Ray was stunned. On the drive home, he realized the tinnitus was gone, and it has not returned in many years.

  21. Ed Whitney says:

    What makes our anecdotes OK (in the case of futile treatments) is that there are more of them than there are of successes for the same intervention.

    Trying to persuade people that they shouldn’t trust anecdotes, like other attempts to reform human nature, requires considerable inputs of energy.

    Utilizing human nature as it is, and telling people how Jacqueline suffered, is more likely to persuade. When an intervention is harmful or futile, there are more Jacquelines than there are Melissas (the patient’s cousin’s friends’ hairdresser) for whom the story had a happy ending.

  22. daedalus2u says:

    skeptic, I understand where you are coming from, but there are legitimate uses of anecdotes in medicine. It is unfortunate when those legitimate uses are rejected because of the “anecdotes are worse than useless” mindset which many people have; a mindset which is incorrect.

    My own experience is that anecdotes are given negative weight; that is a hypothetical treatment modality based on physiology (i.e. a reasonable prior plausibility due to known physiology) is given less credibility if there is an anecdote supporting it in addition to the argument from physiology. The presence of a positive anecdote negates some of the plausibility from physiology. I think this is an instance of “hypercorrection”, that is a correction that goes too far and introduces its own error. I think that people treat anecdotes this way because they have an anecdote of an anecdote being wrong and are unjustifiably extrapolating from that one anecdote to all anecdotes.

    One shouldn’t “trust” anecdotes, or “distrust” anecdotes. One should give them the proper weight that they deserve which is small but non-zero for positive anecdotes and negative for negative anecdotes.

  23. Skeptic says:

    # Ed Whitneyon 18 Aug 2009 at 2:05 pm
    What makes our anecdotes OK (in the case of futile treatments) is that there are more of them than there are of successes for the same intervention.

    Uhm, to the lay reader that isn’t really substantially differentiable from the way woo advocates claim to use anecdotes. You are claiming that Dr. Hall’s anecdote is true and representative. The woomeisters claim their anecdotes are true and representative. In both cases, the argument comes down to “trust us” our anecdote is the real deal. Dr. Hall did not provide an obvious demonstrable, functional differentiation to her lay audience in how she used a vivid anecdote and how woomeisters use anecdotes. I think it is important to do so since it is important to teach people not to trust anecdotes as being sufficient evidence.

    Trying to persuade people that they shouldn’t trust anecdotes, like other attempts to reform human nature, requires considerable inputs of energy.

    No more so than trying to teach them that science based medicine is better than unproven alt medicine. Teaching science is always an uphill battle, and it should begin in the schools. Teaching people not to trust anecdotes is teaching basic critical thinking skills. Suggesting that we skip the basics because they are hard is counter productive because only by teaching the **process** of critical thinking can you arm people to protect themselves. Debunking individual claims is playing Whack-a-Mole with alt medicine, and that is guaranteed to be an endless game of “catch up.”

    Utilizing human nature as it is, and telling people how Jacqueline suffered, is more likely to persuade. When an intervention is harmful or futile, there are more Jacquelines than there are Melissas (the patient’s cousin’s friends’ hairdresser) for whom the story had a happy ending.

    Yes, we should leverage the psychology of influence in our arguments, and utilize people’s built in hooks, such as their preference for vivid anecdotes. But we also have to arm them against being manipulated, which is why one must be careful in using anecdotes to prove a point when part of the point must be “don’t trust anecdotes.”

  24. weing says:

    Humans learn by and remember anecdotes much better than studies. That is just our nature. The CAM artists use anecdotes in pushing their woo as the studies aren’t there. It is working quite effectively. I see no reason for SBM to forego the use of such an effective medium of communication. If we have the studies demonstrating effectiveness, we can make our point using anecdotes.

  25. Versus says:

    I’ve noticed that chiropractors dress up their anecdotes as “case studies” and then cite those “studies” as “research” in support of their claims.

  26. daedalus2u says:

    I think Ed is actually wrong. It isn’t that there are more anecdotes of harm than there are anecdotes of success. Even if there were 100 anecdotes of a great asthma response and only one of a near death experience for a particular treatment that would be an unacceptably risky treatment.

    The problem with anecdotes is that they are uncontrolled and we don’t know the statistics and circumstances surrounding them (if we did, they wouldn’t be anecdotes, they would be data). They just don’t give enough information as to what is really going on. The problem isn’t the anecdote, the problem is that the conclusion that the treatment is worth doing doesn’t follow from the anecdotes.

  27. dlstone says:

    Good job Dr. Hall! I will link my nutrition students to this article.

    One tiny quibble: In this paragraph, “How can you know whether a medical treatment really works? If everybody says it works, and it worked for your Aunt Sally, and you try it and your symptoms go away, you can pretty well assume it really works. ”

    the “it worked for your Aunt Sally” might be better worded “it seemed to work for your Aunt Sally”, because we don’t know whether it worked or not. The preceding “If everybody says it works” is OK because it is merely a report of what people are saying.

  28. pmoran says:

    “One shouldn’t “trust” anecdotes, or “distrust” anecdotes. One should give them the proper weight that they deserve which is small but non-zero for positive anecdotes and negative for negative anecdotes.”

    I agree with Daedalus2. Our extremely negative reaction to CAM anecdote may have a lot to do with the extremely unlikelkhood of the associated claims, also considerable negative past experience which may or may not apply to the present instance.

    I also observe different meanings to the term. Doctors often use it to refer to any uncontrolled clinical observation, whereas others have in mind the lower quality, highly subjective and uncheckable, sometimes second or third hand tales, that help sustain belief in CAM.

  29. Skeptic says:

    # daedalus2uon 18 Aug 2009 at 2:30 pm
    “One shouldn’t “trust” anecdotes, or “distrust” anecdotes. One should give them the proper weight that they deserve which is small but non-zero for positive anecdotes and negative for negative anecdotes.”

    I have to say that position is just as arbitrary and unfounded as the one it seeks to correct.

    I’d say that the null hypothesis should be distrust for anecdotes. There is no reason to presume they are true. You almost compensate for that in your argument, saying ” One should give them the proper weight that they deserve” but then you falter by assigning equal and arbitrary weight to positive and negative anecdotes respectively, as if they are all equal. That is not giving them the weight they “deserve” since such a value can only be determined based on the individual facts, on the context of the anecdote and the hypothesis the anecdote is used to support.

  30. pmoran says:

    Skeptic: “I’d say that the null hypothesis should be distrust for anecdotes. There is no reason to presume they are true. ”

    “True”? Who is talking about truth. That is rarely if ever absolute within science. We are talking about varying strengths of evidence.

    Daedalus2 has allowed that anecdotes can be extremely weak evidence of treatment activity but he is right to imply that it is unsafe to dismiss them altogether.

    Even some of those dramatic and highly improbable CAM ones may be evidence of spectacularly enhanced placebo responses, enabled by peculiar aspects of the clinical setting or the people skills of the practitioner.

    In “truth”, we do not have sufficient evidence to pronounce otherwise. We may think it highly probable that there are elements of exaggeration, misinterpretation and illusion going on but we have little data to guide us as to how much is this and how much is that.

  31. The Blind Watchmaker says:

    Anecdotes are deceptive when an arguer finds an ‘outlier’ who, by definition, is not a typical case, and then presents this outlier dishonestly as a typical case. A string of anecdotes does not represent the sum of the data.

    Anecdotes can be found to support a treatment that generally doesn’t work, or to condemn a treatment that generally does work.

    Human medicine is complex. In trials, there will be outliers. To ignore the vast majority of typical cases,collect the outliers, interview them, and then publish this small but moving collection of testimonials, is disingenuous. Yet, this happens all the time in infomercials and other places.

    I agree, anecdotes are not to be ignored. However, these stories need to be presented in an honest way. For instance, if a treatment is generally effective and tolerated well by most patients, outlier’s represent those in which treatment was ineffective or not tolerated well. Their stories should be considered when informing patients about the limitations of treatment. However, these stories should be presented in proper context. If a treatment has an overall favorable risk/benefit ratio, then the outliers stories should be given the proper weight.

    Gut wrenching, emotional stories can be found among outliers from many things. Car accidents, industrial accidents, investment losses. However, most people benefit from transportation, construction and investing if done with proper guidance and precautions. The outlier’s stories should be used to guide caution and to make realistic expectations.

    Using anecdotes to persuade against something that may have the best chance at providing benefit, or to promote something that is generally useless is intellectually dishonest and deceptive. That concept is what most are referring to when they say that anecdotes are useless.

  32. It seems to me that the correct thing to say about the anecdote that our author uses is something like: “well, here’s an anecdote that says the nostrum is worthless or harmful, why should yours be believed rather than this one. We use science to find out which, if either, is typical, etc.”

    I also have a minor quibble – it is, IMO, bad form to portray science as too much of an extension of common sense. I used to think this way until I met more and more people – some brilliant in their own ways – for whom it wasn’t common sense at all. I think scientists and those who are fortunate enough to have (for whatever reason) a scientific cast of mind find their way of approaching the world so “obvious” that this is never put in question. That said, I agree that the casual person, in every day life, can apply basic evidence gathering principles, etc.

    I finally wonder how common an answer I get is … the “but the effects don’t show up at the level of a study, they are too personal” … is. Sadly I know someone in the aforementioned “brilliant but seemingly doesn’t get it” category who has stepped into *that* unfortunate morass.

  33. mtarnowski says:

    The reason some anecdotes are ok and others are not is a matter of their derivation. The article first establishes a broad principle – that science is best – by applying common sense, logic, and references to repeatable conditions. The good anecdote simply illustrates the broad principle; it is a product of the principle. It is representative of the broader idea.

    In contrast, the inappropriate anecdote is an individual observation, or a collection of observations, that cannot be used (for any number of reasons) to “derive” a larger principle, although this is exactly what a non-scientific thinker tries to do. In general terms, the OK anecdote is derived; the not OK anecdote is inductive. At least, that’s how the English major sees it.

  34. mtarnowski says:

    The reason some anecdotes are ok and others are not is a matter of their derivation. The article first establishes a broad principle – that science is best – by applying common sense, logic, and references to repeatable conditions. The good anecdote simply illustrates the broad principle; it is a product of the principle. It is representative of the broader idea.

    In contrast, the inappropriate anecdote is an individual observation, or a collection of observations, that cannot be used (for any number of reasons) to “derive” a larger principle, although this is exactly what the non-scientific thinker tries to do. In general terms, the OK anecdote is derived; the not OK anecdote is inductive. At least, that’s how the English major sees it.

  35. rbnigh says:

    Of course we are not talking about ‘gut wrenching emotional stories’ but carefully documented accounts of actual events. As an anthropologist I am used to using this kind of data–we call it ‘ethnography’. It clearly has its limitations and careful, transparent methodology is crucial.

    The real problem is, with this whole blog really, is that science and scientific understanding are one thing (which as a scientist, I fervently pursue) and curing people is something else–something I leave to the curers, most of whom are not scientists.

    In the end, an individual life is but a gut wrenching, emotional anecdote.

  36. Diane Jacobs says:

    “My Faith in Sweet Science Is Double-Blind”, article in the Montreal Gazette from a few days ago.

    Diane Jacobs

  37. nwtk2007 says:

    You are pretty much correct about anecdotal “evidence” if that is what one would call it, but here is my observation:

    1. For the SBM’ers here, it seems that they feel that an average person can’t see something over and over and at least draw a reasonable conclusion about what it was they saw.

    2. For the SBM’ers here, it seems that the anecdote is good if it supports their point of view; case in point your anecdote about the woman with asthma.

    In your previous article about chiropractic and stroke, you cited an anecdotal account of a person who died of a stroke after a cervical manipulation. Your words were that it was a “typical” example. Yes, a typical example of something anecdotal and even if true, as rare, if not rarer (for want of a better word while waking up) than one in 5 million or even less. Yet to you, the SBM’er, it represents a “smoking gun”, if not clear evidence to you. Once again the anecdote is good enough to be used if it supports your position. The use of the word “typical” is the twister I think.

    Science is great stuff and can clarify a great many things, no doubt. But it is not the end all to end all in the interpretation of life events or the universe for that matter.

  38. alison says:

    To add to what Philosopher-Animal says, just as science-based thinkers don’t question their way of looking at the world, neither do belief-based thinkers and this seems to me to be why so many of them just don’t ‘get it’ whatever you say to them. They think that science is just another belief. In the last few days I’ve had a CAM-believer tell me that I’ve been brainwashed by western medicine (didn’t know you could get brainwashing on the British NHS but maybe I’m wrong); and my reply that science is neither a system of brainwashing nor a belief system, but simply the best method we have to stop us fooling ourselves had, predictably, no effect. Like most other CAM-questioners I’ve also been told that scientific proof is unnecessary to those who already know the truth: i.e. that their belief system doesn’t need to be endorsed by another belief system in order for them to be convinced. Which leads me to think, as several other people said on this site last week, that perhaps the only way forward is to reduce the demand for CAM (educate the public) rather than hoping to reduce the supply by converting the believers.

  39. Scott says:

    1. For the SBM’ers here, it seems that they feel that an average person can’t see something over and over and at least draw a reasonable conclusion about what it was they saw.

    A position well-proven by centuries of average (and even distinctly non-average) being completely wrong in their “reasonable” conclusions about what it was they saw.

    2. For the SBM’ers here, it seems that the anecdote is good if it supports their point of view; case in point your anecdote about the woman with asthma.

    Did you read the comments at all? Lots of debate on that point…

  40. nwtk2007 says:

    Scott, yes many observations made by the average person have been proven wrong and yet many have been proven correct. It goes both ways. To play down the average person’s ability to observe and decide is a bit elitest.

    Even science has a tendency to jump to conclusions. I saw a show about six gilled sharks and when a juvenile was spotted in a bay of shallow water, the instant conclusion was that the six gills raised their young in the bay. A conclusion totally with out basis.

    As to the comments, I have not read all of them but I felt I had special previlage to comment on the article as I just read it last night and was quoted in it.

    And I would add that just because I don’t take your absolute line on science and scientific evidence, it should not be implied that I do not understand it’s importance.

  41. Scott says:

    Scott, yes many observations made by the average person have been proven wrong and yet many have been proven correct. It goes both ways. To play down the average person’s ability to observe and decide is a bit elitest.

    That’s just wrong. You might notice that there’s no downplaying of the AVERAGE person’s observational ability, but rather of ALL people’s observational ability. Your conclusion that “it goes both ways” is not even wrong – you’ve just conceded that non-rigorous observations are often wrong, therefore they CANNOT be relied upon.

    Even science has a tendency to jump to conclusions. I saw a show about six gilled sharks and when a juvenile was spotted in a bay of shallow water, the instant conclusion was that the six gills raised their young in the bay. A conclusion totally with out basis.

    Ah, you “saw a show.” Care to justify comparing that to actual science?

    As to the comments, I have not read all of them but I felt I had special previlage to comment on the article as I just read it last night and was quoted in it.

    When you’re claiming that a particular thing is said in the comments (which is the clear implication of your statement) it is incumbent upon you to read them first.

    And I would add that just because I don’t take your absolute line on science and scientific evidence, it should not be implied that I do not understand it’s importance.

    You’re right, it’s not implied. It’s conclusively proven that you have precisely zero understanding of the importance of the scientific method.

  42. nwtk2007 says:

    Why are you so defensive and in this case, insulting?

    This a bit of my point about the SBM line, that they sound a bit like religious zealot’s when there is even the slightest slant against them, which my position is; a very slight slant against that fervor and hard line, unyielding, “SBM is always right and you are wrong” attitude. It comes thru along with the bias which is always denied.

    Yes I saw a show on the Discover channel, I believe, about six gilled sharks. The “scientists” were marine biologists. They make observations in nature, a significant part of the scientific process. In this case, the scientists, to me, jumped to the erroneous conclusion that the six gills raised their young in the bay since they observed a small one in the bay. My point is that all of science has dificculty in distinguishing between what is true or not based upon observation, not just the average guy. In a way I was agreeing with Dr Hall as she had pointed out the same thing of some modern day doctors.

    Zero understanding of the scientific method? You truly are delusional in this opinion. I am objective in that I can see that there are times when the scientific method is not the only road to knowlegde.

    Don’t be so pissy.

  43. Rich says:

    Thank you Dr Hall.

    Despite your stated reservations, I, for one, really appreciate the clarity and level of pitch of your article. As a non-scientist with a hunger for reading about science, I find it essential to regularly refresh my knowledge of the basic principles. If only I had had a lesson like this at the beginning of my high school years to provide me with a context for my learning.

  44. Joe says:

    @ nwtk2007 on 19 Aug 2009 at 12:23 pm “Zero understanding of the scientific method? You truly are delusional in this opinion. I am objective in that I can see that there are times when the scientific method is not the only road to knowlegde.”

    Lotteries are for people who didn’tget arithmetic, chiro school is for people who didn’t get science. Although you say you do not work on subluxations, you still believe in them- education fail.

    What other “roads to knowledge” do you recommend? The eminent professor of physics, Bob Park, has written a book “Superstition” (Princeton U. Press, 2008) about that topic. The final sentence in the book: “Science is the only way of knowing – everything else is just superstition.” He is right.

    People who resort to “other ways of knowing” do so because they lack rigorous evidence and wish to proceed as if comparably reliable data existed. It does not.

  45. nwtk2007 says:

    Joe, pardon my frankness but you are a liar.

    I have never said I “believe” in subluxations nor have I said they cause disease. Your hard line once again illustrates my point. Please feel free to quote anything I might have said as showing that I believe, to the exclusion of all else, in subluxations. Or that I have said I “believe” anything.

    Education fail? Not likely. I have a masters degree in molecular biology, I teach anatomy and physiology to both pre-allied health and pre-med students and I treat a lot of injured patients with both chirpractic and non-chiropractic therapies.

    Your “we get science” and you don’t attitude, is again illustrative of my points.

    Once again you sound like one of the anti-chiros on the Topix forums. You don’t need to lie or make up things to make your “scientific” point Joe. The ends do NOT justify the means.

    Mr Park might be right Joe, but how do you know for a fact that your hard line on scientific evidence is not a superstition unto it’s self? To be so defensive about the slightest opposition to your “all knowing” position speaks volumes to your “beliefs” and science is not about beliefs, right Joe?

  46. Joe says:

    @ nwtk2007 on 19 Aug 2009 at 1:20 pm “Joe, pardon my frankness but you are a liar. I have never said I “believe” in subluxations …”

    So, despite what one infers from your previous posts, if you realize “chiropractic subluxations” are ridiculous nonsense, I apologize (do you repudiate subluxations?). But, how did you stay in a school that pushed that model http://www.chirocolleges.org/paradigm_scope.html It is the organizing feature that you studied.

    As for your MS in molecular bio (if you have it), that’s a technician’s degree; there are many people with a BS whose opinions I value; but the bottom line for an MS only means you have a limited ability to follow directions. I am not impressed.

    @ nwtk2007 on 19 Aug 2009 at 1:20 pm “Mr Park might be right Joe, but how do you know for a fact that your hard line on scientific evidence is not a superstition unto it’s self?”

    Once again- I challenge you to show facts, not argument, about reliable other ways of knowing.

  47. Skeptic says:

    “I have never said I “believe” in subluxations nor have I said they cause disease. Your hard line once again illustrates my point. Please feel free to quote anything I might have said as showing that I believe, to the exclusion of all else, in subluxations. Or that I have said I “believe” anything”

    My, my, that is the careful wording isn’t. You don’t deny you believe in subluxations, either, only that you haven’t **said** you believe in them, specifically “to the exclusion of all else” which is to say that you are leaving your self a huge hole where you may have actually said that you believe in subluxations, just not that they are the exclusive cause of disease.

    So, it seems, your haughty and intemperate claim that Joe is a liar is one that you heave at joe while while you stand precariously balanced on a swaying tightrope of dissembling caveats, unless, of course, you are you willing to admit that subluxations are non-falsifiable, pseudo-scientific BS?

  48. nobs says:

    Joe posts:
    “So, despite what one infers from your previous posts, if you realize “chiropractic subluxations” are ridiculous nonsense, ….”

    Really Joe?- Please provide the indexed cites that support your declaration.

    I won’t hold my breath- you still have not provided your cites I requested from you on another thread.

  49. nobs says:

    Joe:

    “>> But, how did you stay in a school that pushed that model http://www.chirocolleges.org/paradigm_scope.html It is the organizing feature that you studied. “<<

    Your link does work.

  50. nwtk2007 says:

    Joe, technition’s degree? Right. Too funny.

    Do I have it? Studied with guys who worked with Delbruck, considered the father of molecualr biology. They also worked with Watson and Crick. Ones claim to fame was that he was one of the few who Delbruck fired and tried to rehire after he did his work with RNA polymerase. One isolated teh first DNA repair enzyme ever, which was actully mathematically predicted to be present by another. Both were on my graduate committee. Another was the first to clone a gene onto a plasmid, another has a whole host of plasmids named for him (although that might have changed); pBR322.

    I was reading an x-ray report from Baylor Hospital in Dallas this morning where the radiologist stated that there was no frank evidence of subluxation seen. I have indicated that what chiropractors refer to as subluxations are, to most these days, joint segments with restricted or abnormal motion, not mis-alignments. NUUCA’s see them as mis-alignments as far as I know.

    Your position that one must accept totally or deny totally the subluxation hypothesis again illustrates my point.

  51. Scott says:

    Why are you so defensive and in this case, insulting?

    Not defensive in the least. Brutally frank because you deserve it.

    This a bit of my point about the SBM line, that they sound a bit like religious zealot’s when there is even the slightest slant against them, which my position is; a very slight slant against that fervor and hard line, unyielding, “SBM is always right and you are wrong” attitude. It comes thru along with the bias which is always denied.

    Science is not always right. You are, however, quite wrong. That’s not bias, it’s conclusive.

    Yes I saw a show on the Discover channel, I believe, about six gilled sharks. The “scientists” were marine biologists. They make observations in nature, a significant part of the scientific process. In this case, the scientists, to me, jumped to the erroneous conclusion that the six gills raised their young in the bay since they observed a small one in the bay. My point is that all of science has dificculty in distinguishing between what is true or not based upon observation, not just the average guy. In a way I was agreeing with Dr Hall as she had pointed out the same thing of some modern day doctors.

    Gee, do ya think that maybe nuances don’t come through on TV?

    Zero understanding of the scientific method? You truly are delusional in this opinion. I am objective in that I can see that there are times when the scientific method is not the only road to knowlegde.

    There are such times, certainly. However, you have asserted that science is wrong in sufficient cases where it most emphatically IS the only way to reliably answer the question, and your only argument to the contrary is uncontrolled observation (which is absolutely trumped by the scientific method under any situation where they disagree – any question which may be answered by uncontrolled observation may be answered more reliably by the scientific method) that there is no question that you have no understanding of science.

    If someone asserts that 1+1 never equals two but is instead a cow, it is not delusional to conclude that they don’t understand arithmetic.

  52. Harriet Hall says:

    nwtk2007,
    You said, “For the SBM’ers here, it seems that they feel that an average person can’t see something over and over and at least draw a reasonable conclusion about what it was they saw.”

    People certainly can draw a reasonable conclusion, but they still need to test it, because that is the only way to know whether their reasonable conclusion conforms to reality. I gave the example of bloodletting, and here’s another: People see dowsing apparently work over and over and they draw what they think is a reasonable conclusion, but dowsing has consistently failed testing and is explained by the ideomotor effect. Even if everyone in the world, not just the average person but the geniuses and the Nobel prize winning scientists, saw something over and over and drew a reasonable conclusion, they could still be wrong, and scientific testing would still be needed.

    Sorry, but you still don’t get it.

  53. nwtk2007 says:

    I am right Scott. Sorry. Your conclusion is not founded on your objective observation of the facts. So, not conclusive and certainly not scientific. Vaguely biased however, and still, I guess, denied; the bias that is.

    Which particular nuances would you be referring to?

    What exactly have I asserted. It is difficult to address your comment with out specific references. I am also at a loss to what argument I have made with the solution being uncontrolled observation.

    I think you are reading things into my comments which are not there. Should I conclude that you cannot read based upon this, as 2 + 2 does not equal a cow and thus it would not be delusional to conclude that .. you cannot read .. based upon your example.

  54. Danio says:

    In my graduate program, nobody got a Master’s degree on purpose. It was considered the ‘consolation prize’ for someone who either couldn’t pass their competency exams (writing and orally defending a research proposal to a purposefully antagonistic faculty committee) or who were unable/unwilling to complete their thesis research. Just sayin’.

    Credentials are ultimately beside the point, however, as it’s been demonstrated ad nauseum that an advanced degree is no guarantee of critical thinking skills. More’s the pity.

    I also note that nwtk continues to dodge the question of his/her opinion of subluxations, but I suppose that may be due in part to the shifting definition of ‘subluxation’–If chiropractors can vary the meaning of the word in different circumstances, it would seem to be a rather useless term, at least from the standpoint of communicating medically relevant information.

  55. Joe says:

    @ nwtk2007on 19 Aug 2009 at 4:29 pm “Joe, technition’s degree? Right. Too funny.

    Do I have it? Studied with guys who worked with Delbruck, considered the father of molecualr biology.”

    Max Delbruck got a Nobel prize for work in virology (1969), you didn’t study with him. You got a consolation prize (MS) from some anonymous person (and others with whom you claim to be associated) who did not do as well. I remain unimpressed especially because it is so easy, in our time, to go for the full PhD. But, even if you had, you would join the ranks of the initialled ignorant.

    Still, we await (with bated breath) what other “ways of knowing” exist. Claimed “education” fail.

    We also await your demonstration that the “chiropractic” subluxation exists. Claimed “education” fail. By the way, it seems selfish of you to refuse treatment to someone who has one. Just saying. …

  56. Skeptic says:

    “# nwtk2007on 19 Aug 2009 at 5:14 pm

    Which particular nuances would you be referring to?
    What exactly have I asserted. It is difficult to address your comment with out specific references. I am also at a loss to what argument I have made with the solution being uncontrolled observation.”

    Yes, what exactly have you asserted? For someone who claims that their are other ways of knowing equal to the scientific method, it is especially telling that you take great pains to avoid stating what you believe, even going so far as to lash out in apparent false indignation for suggesting that your posts imply that you believe in subluxations, which, IMO, they do, in spite of your slippery attempts at weasel semantics.

    If you are, in fact, a chiropractor then the issue of whether subluxions exist is fundamental to your practice and you should have no problem stating your beliefs on them. For you to avoid stating your beliefs on the issue of subluxions is like a infectious disease specialist dodging the issue of whether he believes in the Germ Theory of disease–except, of course, that pathogenic germs actually exist, actually cause disease and the Germ Theory of disease is a scientifically proven fact.

    You need to say what you believe on these fundamental issues at the core of your practice:

    a) specifically what a subluxion is and is not

    b) whether subluxions exist and what objective (non-subjective) falsifiable evidence proves that they exist both in general and in individual patients, which standard would also entail that findings be independently verifiable and repeatable, meaning, for instance, that different chiropractors would all come to the same specific conclusions about a patient having subluxions and where without consulting one another.

    c) whether they and are a factor in and/or a cause of of disease, including
    1) back pain
    2) ear infections
    3) infant colic
    4) hearing loss
    5) other infectious and/or organic disease

    d) if the adjustment of said subluxions can treat and/or cure the above diseases and what sound double blind clinical tests prove that to be the case.

    Put up or shut up. If you can’t answer the above you shouldn’t be a chiropractor or even talking to patients.

  57. nwtk2007 says:

    As I said Joe, the instructors at UTD in the late 70′s and early 80′s were contemporaries of Delbrucks. They were the instructors in the school. Your criticism falls once again on deaf ears. If you don’t appreciate that level of significance then you couldn’t understand any of the history of molecular biology, or it’s significance in modern biology and essentially bio-physics.

    As to getting a masters, well that was my plan. I was a teacher who went for the masters because the MS paid about 4000 more per year than the BS and this was a local school, public and low cost. I didn’t care for a graduate degree in education. I was invited into the PhD program, by the way, and did well on the qualifying exams. It just wasn’t in the plan. I should have done the doctorate though because in the end I was only 28 hours and 1 year short of completing the program and my masters research was a good 80% of what I needed for the dissertation.

    I only tell you this because it suits me to do so. Your lack of appreciation of this field in that era, literally working with the founding fathers of the field, is indicative of what you lack in venom that could possibly effect me in any way what so ever.

    I find your attempt at insult to be both weak and ineffective.

    As to the “subluxation”, as I have repeatedly attempted to clarify, is that the majority of chiropractors these days see it as an altered mobility of a joint segment. I know it is difficult to open your little mind to the idea of joint segments which have altered/abnormal biomechanics, but you can try. I don’t know, it might be beyond you with such ingrained bias.

    How do they effect the human body? Who knows for sure? Maybe not at all but there are indications that freeing up these fixated or partially fixated joint segments can have a great deal of effect on, at the very least, those structures associated with that segment or joint. When a joint is immobilized, the associated tissues atrophy and degenerate. This is an observation I have made without the benefit of science, by the way, an observation made with my eyes. Oops, another observation that I could not possibly know was real with out some double blinded study to provide the science to back up these uncontrolled observations.

    I could go on but I have probably provided enough fodder for you to puke out some ignorant response demonstrating even further your inability to look beyond those you parrot on a science forum where you so want to be considered a part of the group.

    And Joe, it is not the education that fails, it is the student.

  58. nwtk2007 says:

    And sorry skeptic, my comments do NOT imply in any shape, form or fashion that I “believe” in subluxations. In fact, it is forum’ers such as yourself who obsess over the term. There are no weasel semantics involved other than your attempt to put your own meaning into my words.

    If you knew of the chiropractic profession, then you would know there are a great many who do not practice “subluxation” based treatment. For the nth time, I and most of my contemporaries, treat injuries through the application of physical modalities, both passive and active. I tire of having to expand on that concept.

    I would ask why critics like yourself and Oe seem to require chiro’s to essentially take an oath of anti-subluxation celebacy? What is the nature of your obsession?

    Put up or shut up? Get real. Who are you to decide what a chiropractor should and shouldn’t do? What is it that you seem to think you know about treating patients that makes you think I should have to answer your questions?

    I’ll go one step further, please try to listen. Do “subluxations”, as fixated or biomechanically challenged segments, cause disease? I don’t know but they possibly contribute to the bodies ability to fight diseases. Do they cause the conditions you specified? Probably not, but my patients, blind as they must be when compared to the all knowing elite here, sure seem to think that the treatment they receive helps them get well. By the way, I don’t discuss subluxations with them. Sorry skeptic, but I have real conditions I have to deal with and talking about subluxations does nothing for the injures they have or their treatments. If you wish to say that manipulation is “removing” subluxations then so be it. You are more of a chiropractor than I am, based upon what you obviously think a chiropractor is.

    I know this has nothing to do with the topic of this forum so that is all the subluxation talk you will get out of me.

    And one more thing, it is not my belief that makes things real or unreal, they simply are or they are not; sometimes proven and sometimes not.

  59. Skeptic says:

    “# nwtk2007on 19 Aug 2009 at 10:18 pm

    As to the “subluxation”, as I have repeatedly attempted to clarify, is that the majority of chiropractors these days see it as an altered mobility of a joint segment.”

    Fail.

    I asked you what **you** believe. Since your practice is based on what **you** believe not what you claim “the majority of chiropractors believe,” it is important for you to state your belief on the core principle of Chiropractic. Also of note is that you have not given an objective definition of subluxtions such that a diagnosis can be independently replicated. On its own, “altered mobility of a joint segment” is a completely subjective claim, just as wishy washy as dowsing for auras, but with the false implication of physical proof based on the undefined assertion of a “altered” physical structure.

    One more time:

    What do **you** believe a subluxation is?

    ” I know it is difficult to open your little mind to the idea of joint segments which have altered/abnormal biomechanics, but you can try. I don’t know, it might be beyond you with such ingrained bias.
    How do they effect the human body? Who knows for sure?”

    Wow, so you base your practice on such ways of knowing as “who knows for sure?” While it is true that scientific medicine doesn’t have all the answers just yet, it does at least require a treatment to be proven to be effective even if the exact mechanism of the drug or treatment is not completely known–and you don’t have sound proof for chiropractic when it comes to any chiropractic treatment other than for back pain.

    “This is an observation I have made without the benefit of science, by the way, an observation made with my eyes. Oops, another observation that I could not possibly know was real with out some double blinded study to provide the science to back up these uncontrolled observations.”

    And phrenologists knew they were right based on their clinical observations, too. And today, iridologists know their therapies are efficacious by their clinical experience. And urine therapists. And Voo Doo practitioners.

    So tell us, since you claim that clinical experience is valid proof of effecacy, does that mean you admit that iridology, urine therapy and swine flue curing enemas are just as 100% true as chiropractic?

    (Well, actually, you **have to**, based on your claim that a practitioners clinical experience is a valid “way of knowing” so you are estopped from disbelieving other practitioners claims, no matter how implausible…)

    “I could go on but I have probably provided enough fodder for you to puke out some ignorant response demonstrating even further your inability to look beyond those you parrot on a science forum where you so want to be considered a part of the group.

    Hmm…pathognomonic projection…

    “And Joe, it is not the education that fails, it is the student.”

    Oh, good, now you are finally taking some personal responsibility: Student fail.

  60. nwtk2007 says:

    My daughter has used that term, “fail” and “epic fail” for years now. She’s 15.

    “Your mind games won’t work on me boy”

    Belief. zzzzzzzzzzzzzzzzzzzzzzzzzz … heavy sigh ….

    All of your questions have been asked and answered.

    Good night young sachewon.

  61. Skeptic says:

    “# nwtk2007on 19 Aug 2009 at 10:38 pm
    And sorry skeptic, my comments do NOT imply in any shape, form or fashion that I “believe” in subluxations. In fact, it is forum’ers such as yourself who obsess over the term. There are no weasel semantics involved other than your attempt to put your own meaning into my words.”

    That there is the “intentional” fallacy. You are trying to claim that because you didn’t mean to admit that you believe in subluxions that your statments can’t possibly imply that you believe in subluxions. That is false. Implications can and do go beyond what you may or may not have meant to reveal in your posts. If you’d like to put this issue to rest, you can merely categorically state that you do not believe subluxations are real. Your repeated avoidance of denying the existance subluxions most certainly does imply that you believe in them–whether you like that implication or not.

    “If you knew of the chiropractic profession, then you would know there are a great many who do not practice “subluxation” based treatment.”

    Dodge. Dodge. Dodge.

    What do **you** believe? Do **you** believe in subluxations?

    Put up or shut up.

    “For the nth time, I and most of my contemporaries, treat injuries through the application of physical modalities, both passive and active. I tire of having to expand on that concept.
    I would ask why critics like yourself and Oe seem to require chiro’s to essentially take an oath of anti-subluxation celebacy? What is the nature of your obsession?”

    Dodge. Dodge. Dodge.

    What do **you** believe? Do **you** believe in subluxations?

    Why are you unwilling to state the beliefs your “medical” practice is based on?

    “physical modalites, both passive and active.” Snicker.

    “Put up or shut up? Get real. Who are you to decide what a chiropractor should and shouldn’t do? What is it that you seem to think you know about treating patients that makes you think I should have to answer your questions?”

    Dodge. Dodge. Dodge.

    What do **you** believe? Do **you** believe in subluxations?

    I didn’t tell you what you should do (other than my opinion that you get out of the business if you can’t answer basic questions about your belief in fundamental aspects of Chiropractic). I asked you to say what **you** believe vis-a-vis subluxions.

    “I’ll go one step further, please try to listen. Do “subluxations”, as fixated or biomechanically challenged segments, cause disease? I don’t know but they possibly contribute to the bodies ability to fight diseases.”

    So, do you treat patients on the basis of “possibly contribute to”? Is that the standard of evidence that Chiropractors base their practice on?

    Note that you still give no objective definition of subluxations. But you do attempt to give the illusion of an objective definition by use of undefined jargon.

    Do they cause the conditions you specified? Probably not, but my patients, blind as they must be when compared to the all knowing elite here, sure seem to think that the treatment they receive helps them get well.[emphasis added]

    So, since you now admit that subluxions probably do not cause disease, will you also admit that Chriporactors should not base their practice on a theory that probably doesn’t treat disease?

    And, of course, your patients are not “blind” since they know they are getting “chiropractic” treatment–regardless of what specific manipulation you attempt. That is a classic set up that re-enforces perceptual and cognitive biases, both in the patient **and** in the practitioner. That’s where the scientific method comes in. Science is good at separating what is true from what merely seems to be true, using methodology that a takes into account and controls for inbuilt human cognitive biases. Just as people who take up dowsing often falsely come to believe they actually can magically detect water or other substances through their art, so do can CAM practitioners come to honestly, yet falsely, believe they, too, have genuine knowledge. The only question is whether you are honestly deluded or mendaciously cynical. Given your tap dancing on subluxations, it is hard to know.

    “By the way, I don’t discuss subluxations with them. Sorry skeptic, but I have real conditions I have to deal with and talking about subluxations does nothing for the injures they have or their treatments.”
    Nor may many or most of the treatments you provide based on the dubious “science” of laying on the hands invented by a phrenologist who claimed in 1895 to have cured deafness through spinal manipulation.

    “If you wish to say that manipulation is “removing” subluxations then so be it. “

    No, that is what many, probably most, chiropractors claim. And an issue you like to dodge around.

    “You are more of a chiropractor than I am, based upon what you obviously think a chiropractor is.”

    Hmm…let’s see…you manipulate vertebrae on what theory, exactly?

    “I know this has nothing to do with the topic of this forum so that is all the subluxation talk you will get out of me.”

    Au contrarie, subluxions are classic woo, based on subjective evidence, the very kind the OP is warning people to be wary of. Let’s think of responding to your posts as a case study in Defense Against the Dark Arts.

    “And one more thing, it is not my belief that makes things real or unreal, they simply are or they are not; sometimes proven and sometimes not.”

    Indeed, on that we can agree. The difference is that science is an objective methodology to separate what we merely believe is real from what is real. Chiropractic, and all CAM, are the opposite, practices which claim to be real based solely on belief and demand special pleading from sound objective testing and claim immunity from falsification.

    But you completely avoided the issue of the validity of knowledge based on “clinical experience.” As I asked before:

    So tell us, since you claim that clinical experience is valid proof of effecacy, does that mean you admit that iridology, urine therapy and swine flue curing enemas are just as 100% true as chiropractic?

    (And the answer is that you have to, or you have to admit that clinical experience is not a reliable “way of knowing.”)

  62. Skeptic says:

    Errata: there are some missing quote marks and formatting errors in my above post, but the quotes should be clear enough to make out by context. (Oh, for a “preview” button…)

  63. Skeptic says:

    Oh, one more thing…

    “# nwtk2007on 19 Aug 2009 at 1:20 pm
    Joe, pardon my frankness but you are a liar.
    I have never said I “believe” in subluxations nor have I said they cause disease. “

    Reality tells a different story:

    “nwtk2007
    Rowlett, TX
    Reply »|Report Abuse|#139May 21, 2008

    May 21, 2008

    Wisdom said -Hey balto, prove to me that the chiropractic subluxation exists.-

    He shouldn’t have to. You know absolutely that it exists in some form or another. Specifically which form are you referring to? In chiropractic, as you well know, a fixated joint, usually a facet joint in the spine, is a subluxated joint. Prove that one doesn’t exist or prove it can’t effect the physiology of the human body.

    Are chiro’s the only ones who can find’em? No way. Just anyone who has the patients and sensitivity to “feel” for it through palpation.

    On the other hand, I x-rayed a patient today who had a forward shift of nearly 1/3 of an inch at C3 on C4 on forward flexion. Is this also a subluxation? Could it be suggested that it is subluxated when it shifts that far forward? The shift reduced to about 1/8th inch on neutral position. Would you call that a subluxation? I would. The segments above and below that one had very little motion at all on flexion and extension. Would you say those were fixated? Can we call those subluxations? Do they count as abnormally functioning segments? This patient has numbness and tingling over the traps and into the anterior deltoid on the right side. Her face is flush on the right as well.

    There is a lot going on but I would definitely say there are some subluxated segments there.

    As to the technique I will use to treat this, I would feel fairly comfortable with any technique which can apply motion to the fixated segments specifically enough to prevent adding motion to the obviously hypermobile segment.

    Now Wisdom, prove the subluxation doesn’t exist and suggest the chiropractic technique that would be the most effective. You should be able to do that since you are more familiar with chiropractic than anyone, as you have said countless times.”

    http://www.topix.com/forum/source/myrtle-beach-online/TGS3UDVLO0BMLH2K2/p6

    You owe Joe an apology. A big one.

    Your post at topix doesn’t just imply that subluxations exist, it specifically and vociferously argues that they do.

    You were apparently projecting when you tried to claim that Joe was what the above post demonstrates you specifically are. The hypocrisy is palpable.

    (And, yes, I’d say the person posting at Topix is definitely you since that nwtk2007
    http://www.topix.com/forum/source/myrtle-beach-online/TGS3UDVLO0BMLH2K2/post359
    who just also happens to be advocating for chiropractic in debate about the same also used the same “young sachewon” phrase you used earlier in this thread, and that use on Topix is the **sole** instance of that phrase as indexed by the entirety of Google as of this posting.)

  64. zoechurchill says:

    I’ve been waiting for the opportunity to bring this up – sorry if it’s pretty gross. I have read here and elsewhere how bogus homeopathy is and that it’s basically water.

    My mother started going to a homeopath after her two bouts with colon cancer. They had taken a large part of her intestine the second time which had “turned to cement” from the radiation treatments they had (over)given her after the first bout. Not to get too detailed about it, she has on-going issues every day. As long as she’s not going anywhere unusual, she just makes sure she has bathroom access timed well but…on the days she can’t, the doctor told her to take Immodium-D. That blocked her up for too long and made her uncomfortable so, instead, she started doing a dilution of arsinicum. It would also block her up for longer than she liked but she needed something and it was better. Okay – maybe you’ll say placebo effect. Maybe but the intestinal action (I’m trying to be delicate here) is pretty involuntary – happening in her sleep, without her knowing, etc. But, maybe….

    Because she seemed to like the results, I thought whattheh@ll, and went for depression. I was moving to a new city, someone I loved had died, etc. I got the “remedy” and took it and couldn’t tell if it was helping and didn’t pay much attention, either – I was trying a lot of things – healthier eating habits, exercise, etc., and whatever was doing it, seemed to be helping. Placebo was fine with me. But, then, I got a period when I wasn’t supposed to. It was very heavy and wouldn’t stop after eight days so I tried to stop taking the remedy wondering if that was affecting me. My period stopped in a short time (I don’t remember, 1/2 day, a day – no more than two). I thought fine so I started taking the remedy again and in a short time (maybe 1 1/2 days) the period started again. I went through another few days – maybe five or six and went off the remedy again. Same thing. Period stopped. Again, I waited a few days. Could see it really stopped and went back on the remedy (as I said, I couldn’t tell what was helping my depression but I was doing well and wanted to keep everything the same.) Again, less than two days later, a menstrual period started and this time I didn’t stop taking the remedy. I had three weeks of a heavy period and became very worried so I went to a gyno and she checked everything out – blood, urine, exam, etc. Then, she sent me for an ultrasound to see if there were fibroids or something – no problems. Everything seemed fine so I just stopped taking the remedy (by the way – diluted remedy), and I never had the problem again. I never went back to a homeopath because I was mad what had happened but….on the other hand, I do think it was more than just drinking water.

    These are my two examples and, for me, the jury is still out on homeopathy.

  65. Jurjen S. says:

    Quoth nwtk2007:

    Yes I saw a show on the Discover channel, I believe, about six gilled sharks. The “scientists” were marine biologists. They make observations in nature, a significant part of the scientific process. In this case, the scientists, to me, jumped to the erroneous conclusion that the six gills raised their young in the bay since they observed a small one in the bay.

    Did they actually jump to that conclusion, or did they formulate a hypothesis to that effect, set out to investigate it, and ultimately discover that the hypothesis was incorrect? Because if the latter, well, that’s perfectly sound science.

    But even if not the latter, how do you know, simply from watching the show, that the “conclusion” was in fact erroneous? I would hazard a guess that the “conclusion” was shown to be erroneous through subsequent observation–whether by the initial team of biologists or by other persons–which produced contrary evidence. Which, again, would be application of the scientific method.

    See, what you don’t seem to get, your claims of an MS in molecular biology notwithstanding, is that science is not a system whereby the claims of a person with a lab coat and the letters “Ph.D.” after his name are accorded more weight than those of the “average” person. Science doesn’t accept anything merely on someone’s say-so, whoever that person is; there has to be corroborating evidence, with controls for possible confounding factors.

    That’s what sets the “anecdote” of Jacqueline Jones apart from the testimonials that the “remedy” in question did cure asthma; there was no corroborating evidence for the testimonials, whereas there was strong corroborating evidence that taking the remedy had not helped Ms. Jones’ asthma, namely that she had to be admitted to hospital.

  66. Sil says:

    The german translation is online:
    http://blog.esowatch.com/index.php?itemid=275

    (Warum wir Wissenschaft brauchen: “Ich habs mit eigenen Augen gesehen” Ist Nicht Genug)

  67. nwtk2007 says:

    Skeptic, What about my comment on Topix don’t you understand? Are you another of those “I know all about chiropractic” guys who is out to rid the world of it and thus twist the truth to your liking? Did you also fail at chiropractic and have a huge chip on your shoulder because you blame others and chiropractic for your failure and not yourself?

    As to the mystery of the six gilled sharks, it was presented as an unknown, whether six gills raised their young and where. The narrator stated very clearly that the sighting of the small juvenile six gill in the shallow water of the bay was proof that the six gills raised their young there. Nothing else was presented.

    There might be more to the story but it was not presented. I merely cited it as an example of what appears to be an unsupported and erroneous conclusion drawn by, in this case, marine biologists. It was actually supportive of Dr Hall’s comment that even doctors can be wrong about what they observe. Her comment, not mine.

  68. Skeptic says:

    “# nwtk2007on 20 Aug 2009 at 9:01 am
    Skeptic, What about my comment on Topix don’t you understand? Are you another of those “I know all about chiropractic” guys who is out to rid the world of it and thus twist the truth to your liking? Did you also fail at chiropractic and have a huge chip on your shoulder because you blame others and chiropractic for your failure and not yourself?”

    Interesting attempt at a distraction. Note the lack of any actual rebuttal. It is clear that you are someone who has no interest in facts or honest debate, and can’t admit fault even when caught red handed.

    Once again, you claimed:

    “Oh, one more thing…
    “# nwtk2007on 19 Aug 2009 at 1:20 pm
    Joe, pardon my frankness but you are a liar.
    I have never said I “believe” in subluxations nor have I said they cause disease. “

    But your claim was a false one. In fact, you had posted this, where you excoriated another poster for doubting that subluxations exist, your attempts to dodge the fact that the burden of proof is on the positive claimant (“subluxations exist”) not withstanding. Not only that, but you also admitted how you **treat** subluxations:

    “nwtk2007
    Rowlett, TX
    Reply »|Report Abuse|#139May 21, 2008
    May 21, 2008
    Wisdom said -Hey balto, prove to me that the chiropractic subluxation exists.-
    He shouldn’t have to. You know absolutely that it exists in some form or another. Specifically which form are you referring to? In chiropractic, as you well know, a fixated joint, usually a facet joint in the spine, is a subluxated joint. Prove that one doesn’t exist or prove it can’t effect the physiology of the human body.
    Are chiro’s the only ones who can find’em? No way. Just anyone who has the patients and sensitivity to “feel” for it through palpation.
    On the other hand, I x-rayed a patient today who had a forward shift of nearly 1/3 of an inch at C3 on C4 on forward flexion. Is this also a subluxation? Could it be suggested that it is subluxated when it shifts that far forward? The shift reduced to about 1/8th inch on neutral position. Would you call that a subluxation? I would. The segments above and below that one had very little motion at all on flexion and extension. Would you say those were fixated? Can we call those subluxations? Do they count as abnormally functioning segments? This patient has numbness and tingling over the traps and into the anterior deltoid on the right side. Her face is flush on the right as well.
    There is a lot going on but I would definitely say there are some subluxated segments there.
    As to the technique I will use to treat this, I would feel fairly comfortable with any technique which can apply motion to the fixated segments specifically enough to prevent adding motion to the obviously hypermobile segment.
    Now Wisdom, prove the subluxation doesn’t exist and suggest the chiropractic technique that would be the most effective. You should be able to do that since you are more familiar with chiropractic than anyone, as you have said countless times.”

    It it pretty obvious that you know that Chiropractic is based on shaky ground, which is why you go to such great lengths to try and avoid being caught stating your belief vis-a-via the existence of the mythical subluxations that form the very foundation of Chiropractic, the latter being a fact you also try avoid to no avail. Your own alma matter clearly states that subluxations are the foundation of Chiropractic. From the “What is Chiropractic” page at Parker Chiropractic College

    The chiropractic adjustment is intended to remove any disruptions or distortions of this energy flow that may be caused by slight vertebral misalignments called subluxations. Chiropractors are trained to locate these subluxations and then to remove them to restore the normal flow of nerve energy, in terms of both quality and quantity.

    The idea is that if the master system (the nervous system) is healthy and functioning well, then other systems under its control will also function in a more optimal fashion. Chiropractic is based on the belief that the same innate intelligence that can grow a single cell into a complex human being, made of billions of cells, can also heal the body if it is free of disturbances to the nervous system.

    For example, if the spinal area that supplies nerve flow to the stomach is subluxated, then information going to the brain regarding that organ and its function, digestion, will be distorted and the brain will not receive accurate data on its condition. Likewise, decisions made in the brain and conveyed along the nervous pathways will be disrupted and the correct responses cannot be made. It is essentially the same scenario for all other organs, muscles and blood vessels. When a chiropractor removes this interference, then the nervous system functions more optimally and the body is able to heal itself via the two-way communication system.”

    http://www.parkercc.edu/Chiropractic_defined_by_Parker_College_of_Chiropractic.aspx

    nwtk, do you deny the fundamental tenets of Chiropractic asserted as the core definition of Chiropractic by the very college of Chiropractic you graduated from and have praised?

    I expect you to try to use more attempts at distraction and more slippery weasel semantics to try to avoid saying that your college is wrong without saying what you believe is right–something you wouldn’t have to do if the facts were on your side. By your repeated dissembling tactics, I find that your posts are antithetical to honest inquiry and debate and don’t even rise to being meretricious, having not even the appearance of sound argument.

  69. nwtk2007 says:

    What is this need for absolutism? Are you some sort of religious nut as well?

    In my topix post I clearly described one example of a subluxation. It is clear and without question a true entity.

    The problem you have, which you won’t admit to, is that you wish to equate the “chiropractic” philosophy of subluxation with the word subluxation as all encompassing. Again, my point is illustrated in your argument here. Blind bias.

    Obviously I don’t buy into the philosophy as described in your Parker College definition of chiropractic. I also went to a christian university where they believe that you must be baptized to go to heaven. I don’t buy into that either. Are you saying I have to have the same beliefs as the founders of a school if I am to go there? Am I to live my life by their philosophy, no matter what it is, just because I received a degree there?

    Give it up skeptic, it’s an argument down a blind alley. Chiropractic is changing just as medicine is , and christianity as well (witness the sheer number of bible based churches having church services on Saturday rather than Sunday, being tolerant of other beliefs and life styles, etc.).

    You attack chiropractic like a religious zealot unwilling to progress to the next level, again, making my point.

  70. Skeptic says:

    “# nwtk2007on 20 Aug 2009 at 10:19 am
    What is this need for absolutism? Are you some sort of religious nut as well?”

    Another attempt at distraction. This time you use an ad hominem attack hedged as rhetorical question for deniability. While your rhetorical devices are obviously well practiced, they are not those of honest debate.

    “In my topix post I clearly described one example of a subluxation. It is clear and without question a true entity.”

    Here is where you get to play the equivocation game, where you try and define “subluxations” as suits your particular argument, never denying the existence of the mythical subluxation that is the core philosophy of your alma matter.

    “The problem you have, which you won’t admit to, is that you wish to equate the “chiropractic” philosophy of subluxation with the word subluxation as all encompassing. Again, my point is illustrated in your argument here. Blind bias.”

    Do, tell us, on what basis do you “adjust” vertebrae? And on what basis do you reject the **core** principles of Chiropractic as defined by your alma matter?

    Obviously I don’t buy into the philosophy as described in your Parker College definition of chiropractic. I also went to a christian university where they believe that you must be baptized to go to heaven. I don’t buy into that either. Are you saying I have to have the same beliefs as the founders of a school if I am to go there? Am I to live my life by their philosophy, no matter what it is, just because I received a degree there?

    Invalid analogy. The Christian philosophy at the Christian college you attended were an adjunct to the classes you took their rather than the core of the degree you earned–unless you were a divinity student. Since Chiropractic is a philosophy based rather than scientifically based, the philosophy of Parker Chiropractic **is** what they teach. Saying you don’t have to buy into the philosophy of Parker is like a priest who goes to Catholic seminary school, becomes a Catholic priest and says that doesn’t mean he has to buy into Catholic doctrine or the existence of god–teaching those things is the reason for the existence of the school.

    This issue of Chiropractic being philosophically based rather than scientifically based leads back to your claimed alternate ways of knowing , such as your vaunted clinical experience. The problem being that unlike science such ways of knowing do not have reliable truth discerning qualities, which is why you consistently avoid answering this question:

    You claim that clinical experience is valid proof of efficacy. Does that mean you admit that iridology, urine therapy and swine flue curing enemas are just as 100% true as chiropractic?

    And the answer is that you have to, or you have to admit that clinical experience is not a reliable “way of knowing–which is why you’ve avoided this issue each and every time I’ve brought it up.

  71. airshowfan says:

    Long-time reader, first-time commenter.

    Great post!

    I think we need more articles that take this approach, but especially in places where they will be read by people who don’t appreciate the importance of scientific testing. (I was surprised to learn that this blog is such a place. But that’s good. I commend the people who don’t fully get the difference between anecdotal “evidence” and scientific test,s and who come here to find out, and who even engage in the conversation).

    We can say “Well chiropractic and homeopathy are clearly nonsense” all we want, but without making it clear why anecdotal evidence is no match for scientific testing… without making it clear what it is that scientific testing reveals and why it cannot be reliably revealed any other way… a person who disagrees can still simply believe that scientific testing is over-rated. It’s not.

    And while making this point, it’s important to point out that science is just common sense. Any comparative study where you try to “make sure” of the impact of some factor is science. Well said.

    One thing I would add is the importance of double-blind tests. It’s a very small and easy step from the place where this post goes. And it shows just how hard science fights against the biases and desires of people, because even while running comparative studies it’s easy for our psychology to get in the way of gathering accurate observations of what happened.

    But that’s just my opinion. I tend to err on the side of writing too much. As you can see.

    Anyways, keep up the good work!

  72. Harriet Hall says:

    Spanish translation:
    My article has been translated into Spanish by Mexican pediatrician Giordano Perez-Gaxiola and is posted at:
    http://www.pediatrica.org/index.php?option=com_content&view=article&id=151:ciencia&catid=49:mitos&Itemid=77

  73. weing says:

    Those marine biologists erred if they strayed from the scientific method. I don’t know of any other self-correcting method. You indicated other ways of knowing besides the scientific method. Care to elucidate?

  74. yeahsurewhatever says:

    Dr. Hall, it sound a bit like you’re starting to burn out on the fact that the comments don’t appreciably get smarter as you (or anyone) explain more. They’re not going to. The people that already get it still get it and the people who are philosophically committed to not getting it are still philosophically committed to not getting it, and the people who are truly so stupid that they can’t get it never find this website in the first place.

    I know well the intellectual torture of never seeing anyone meaningfully improve in understanding over the internet, and yes it can drive you mad. I don’t know your situation, but maybe a short vacation is in order. The tard posse will still be here when you get back, and the dike will surely hold.

    Also, to be competely fair about the Jacqueline Jones story, even if that herbal supplement had been effective against asthma, the fact that she had been on glucocorticoids for so long and then suddenly discontinued them is enough to account for her hospitalization. She was probably suffering from severe adrenal insufficiency. I have no doubt that the herbal treatment was crap, but let’s analyze the story as objectively as posssible. All we can really infer from those details is that the herbal product was no substitute for fully-functional adrenal glands.

  75. dugmaze says:

    “We finally got around to testing bloodletting and found out it did much more harm than good”

    But up until that point, everything else was suedoscience? Right?

    If you was a doctor before the testing for bloodletting, would you have performed the same procedure?

    Is this one of those “self correcting” features of science?

  76. weing says:

    I have a couple patients that I send for regular bloodletting. They have hemochromatosis. In George Washington’s time what they practiced is what would now be considered alternative medicine. There was very little in terms of science then.

  77. Harriet Hall says:

    weing,
    In George Washington’s time they practiced bloodletting – they removed blood to balance the humours and to treat fevers. It was based on a myth. What you are doing is fundamentally different: you are removing blood from hemochromatosis patients to reduce the body burden of iron. It is based on scientific evidence.

    Bloodletting was prescientific medicine. Alternative medicine today is not “pre” scientific because it has the advantage of being in a scientific era and being able to use good science, but it chooses not to. It is more like “para” scientific.

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