The Danger of Science Denial - "Alternative Medicine"-Split

Homeopathy, Chiropractic and similar "alternative" views

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Re: The Danger of Science Denial - "Alternative Medicine"-Sp

#841  Postby Dr. Nancy Malik » Jun 21, 2010 6:22 am

GenesForLife wrote:
Lack of resolution of diagnostic techniques, because even though the pathways of disease are identical, they often tend to overlap in the symptoms they cause, therefore, treatment is often based on the most likely diagnosis based on observed symptoms, so say, for instance, Dengue and other fevers may still result in fever, and the symptoms look the same, but Dengue can only be identified by specific diagnoses based on reduced platelet counts.

The reason that people keep coming back is that they received treatment based on the diseases indicated by the observed symptoms, which can overlap as the manifestations of the pathological effects of many particular diseases, this automatically does not, in any logically consistent universe, mean that the pathways of disease are heterogenous.

To put it simply, similar symptoms and signs may appear due to different diseases, but each disease has its own pathway of causation and progression,which is common to patients who suffer from the same disease, and "rationalist" medicine is capable of dealing with these diseases once they are diagnosed correctly and the perceived "problem" with heterogeneity is not in the latter, but in the former, which is increasingly being resolved by ever improving diagnostic methods.

Care to make the distinction?


the “rationalist model” is based on collating the symptoms, placing them into a diagnostic category with a specific label, and then using some form of drug, surgery or radiation to eliminate the symptoms. The assumption is made that all patients are homogenous. The “rationalist model” is a “wait for illness” approach.
Evidence-based scientific homeopathy is a modern nano-medicine like Conventional Allopathic Medicine (CAM)
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Re: The Danger of Science Denial - "Alternative Medicine"-Sp

#842  Postby Dr. Nancy Malik » Jun 21, 2010 6:37 am

DST70 wrote:A universal 1:1 set mapping symptoms to disease would surely be the Holy Grail of medicine; albeit utterly unobtainable.

But the problem in any case is that if it's signs and symptoms that show variance from case to case, this needs not only to be accounted for, but accounted for in a way that makes it irrelevant to the treatment of a given disease based on pathological causes and pathological effects. How do you do that?

And what do you do about illness that has no obvious underlying physical pathology, and therefore where you don't have obvious access to any discrete disease entity?


In conventional medicne, if the disease can not be diagnosed, there can be no treatment. That’s why many times patient says he is not feeling well despite of all his laboratory tests indicates he is in perfect health.

Conventional medicine restricts the physician's ability to treat diseases which are not diagnosed or not previously known.
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Re: The Danger of Science Denial - "Alternative Medicine"-Sp

#843  Postby GenesForLife » Jun 21, 2010 6:39 am

CARE TO PROVIDE ANY FUCKING EVIDENCE FOR ALL OF YOUR ASSERTIONS?

And to remind you again, THE TOPIC IS ABOUT THE VALIDITY OF ALTERNATIVE MEDICINE , NOT ABOUT CONVENTIONAL MEDICINE.
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Re: The Danger of Science Denial - "Alternative Medicine"-Sp

#844  Postby orpheus » Jun 21, 2010 6:43 am

GenesForLife wrote:CARE TO PROVIDE ANY FUCKING EVIDENCE FOR ALL OF YOUR ASSERTIONS?

And to remind you again, THE TOPIC IS ABOUT THE VALIDITY OF ALTERNATIVE MEDICINE , NOT ABOUT CONVENTIONAL MEDICINE.


Yes.

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Re: The Danger of Science Denial - "Alternative Medicine"-Sp

#845  Postby DST70 » Jun 21, 2010 10:14 am

Shrunk wrote:
DST70 wrote:Wrong. It is precisely because of the "variation of individual response to disease and treatment" that randomized controlled trials are necessary. If there was uniformity in response, then trials would be unecessary.

To say that homeopathy varies too much in its response to be detected under controlled conditions is just another way of saying that it is no more effective than placebo.


Isn't it true though that as the sample increases in heterogeneity, the more difficult it becomes in RCTs to differentiate between treatment and no treatment? And there are theoretical reasons that limit heterogeneity, as well as the more obvious financial and practical reasons.
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Re: The Danger of Science Denial - "Alternative Medicine"-Sp

#846  Postby DST70 » Jun 21, 2010 10:27 am

Paul wrote:If there is a difference between a sample of a medicine 'properly' prepared according to the rules of homoeopathy and that hasn't been shaken properly, then that difference should be detectable in the laboratory.

Why aren't particle physicists spending as much time and money looking for water's 'memory' as they are for the Higgs boson? Because the idea is complete tosh - that's why.


I think it's got a lot to do with the fact that the Higgs boson has been postulated in a model of physics where there's been enough experimental evidence already to confirm certain predictions. The theoretical framework supports the likely existence of such a particle. There is no such scientific body of theory and evidence currently to support non-physical causation/interaction. If there was - then you'd see more impetus for study into the mechanisms of homeopathy.

AFAIK the memory of water idea is really just a speculative concept being proposed (maybe Nancy can correct me if I'm wrong). Personally I don't think it's going to be very fruitful. To validate any mechanism in homeopathy is going to have to involve contravening physical laws.

GenesForLife wrote:CARE TO PROVIDE ANY FUCKING EVIDENCE FOR ALL OF YOUR ASSERTIONS?

And to remind you again, THE TOPIC IS ABOUT THE VALIDITY OF ALTERNATIVE MEDICINE , NOT ABOUT CONVENTIONAL MEDICINE.


But you can see the problem can't you? This whole issue hinges on the matter of what constitutes evidence. To talk about the validity of alternative medicine is to bring into question the model that dictates what is, and what isn't evidence in medicine.
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Re: The Danger of Science Denial - "Alternative Medicine"-Sp

#847  Postby Shrunk » Jun 21, 2010 10:34 am

DST70 wrote:
But you can see the problem can't you? This whole issue hinges on the issue of what constitutes evidence. To talk about the validity of alternative medicine is to bring into question the model that dictates what is, and what isn't evidence in medicine.


Nancy Malik and the BHA keep quoting double blind studies that (they erroneously believe) support homeopathy, so it seems they have no disagreement with what constitutes evidence. Their disagreement only arises when that evidence doesn't say what they want it to say. I don't think you'll find any proper model in which the definition of evidence is "whatever agrees with my personal preconceptions."
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Re: The Danger of Science Denial - "Alternative Medicine"-Sp

#848  Postby Shrunk » Jun 21, 2010 10:39 am

Dr. Nancy Malik wrote: Conventional medicine restricts the physician's ability to treat diseases which are not diagnosed or not previously known.


So homeopaths charge patients for treating illnesses that don't exist. In conventional medicine that is malpractice.
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Re: The Danger of Science Denial - "Alternative Medicine"-Sp

#849  Postby DST70 » Jun 21, 2010 12:02 pm

Shrunk wrote:Nancy Malik and the BHA keep quoting double blind studies that (they erroneously believe) support homeopathy, so it seems they have no disagreement with what constitutes evidence.


It is a mixed picture. I think this could be a natural result of any field of empirical study needing to achieve some recognition in the scientific community.

Shrunk wrote:I don't think you'll find any proper model in which the definition of evidence is "whatever agrees with my personal preconceptions."


True, but the problem is that there's no way to discriminate between the placebo effect and treatment that shows no statistical significance better than placebo in clinical trials. If you're committed to the scientific method there's no point even differentiating between these - both amount to the same thing. But that's a constraint of clinical trials, and a constraint of scientific investigation.

For me personally, it's not a big problem that the evidence from RCTs is not very supportive. But practicing homeopaths have to face possible closure of hospitals and restricted healthcare for patients.
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Re: The Danger of Science Denial - "Alternative Medicine"-Sp

#850  Postby Paul » Jun 21, 2010 12:03 pm

DST70 wrote:
Paul wrote:If there is a difference between a sample of a medicine 'properly' prepared according to the rules of homoeopathy and that hasn't been shaken properly, then that difference should be detectable in the laboratory.

Why aren't particle physicists spending as much time and money looking for water's 'memory' as they are for the Higgs boson? Because the idea is complete tosh - that's why.


I think it's got a lot to do with the fact that the Higgs boson has been postulated in a model of physics where there's been enough experimental evidence already to confirm certain predictions. The theoretical framework supports the likely existence of such a particle. There is no such scientific body of theory and evidence currently to support non-physical causation/interaction. If there was - then you'd see more impetus for study into the mechanisms of homeopathy.


which was my point precisely. There is no solid, testable theory to back up homoeopaths claims as to how it works. They just make up bullshit for the credulous.

AFAIK the memory of water idea is really just a speculative concept being proposed (maybe Nancy can correct me if I'm wrong). Personally I don't think it's going to be very fruitful. To validate any mechanism in homeopathy is going to have to involve contravening physical laws.


(my bold) So in other words homoeopathy can't be validated in any way? We just have to have "faith"?
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Re: The Danger of Science Denial - "Alternative Medicine"-Sp

#851  Postby Dr. Nancy Malik » Jun 21, 2010 12:21 pm

TMB wrote:I would say this arises because they are trying to look deeper than the symptoms, they are looking for causes. By asking about a person dietary habit, bowel habits, reactions to various things, and not just the external symptom, of course they develop better empathy. However, I have worked with iridologists who although personable only take a few minutes and get all they need from the eyes without drawn out discussions. Still they are effective.

Take another personal example in skin reaction. My health causes skin rashes and itching. Conventional medicine will prescribe topical steroid creams, that certainly work. They also damage the skin, and perhaps do internal damage as well, and make the patient reliant and dependent upon them, and do not look for a cause. Most MDs will look no deeper, while alternate practitioners will recognise that the skin is just reflecting a deeper problem. Their topical treatments wont be as effective as steroids, but they have more chance of finding the cause.



A homeopath physician during case taking tries to know the make-up of a patient. Genetic code genome is responsible for what's going to constitute the resulting individual. This code map is responsible for

1. Structure/built/looks of an individual
2. nature.emotions, senstivity, reactions of an individual
3. tolerance to external factors like heat, cold, sun, wind, sound, light
4. desires, aversions, thirst, appetite
5. peculiar symptoms

When a homeopath physician takes all these above for prescribing a medicine, it becomes a genetic constitutional simillimum
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Re: The Danger of Science Denial - "Alternative Medicine"-Sp

#852  Postby Dr. Nancy Malik » Jun 21, 2010 12:25 pm

DST70 wrote:As long as diagnosis and treatment is centered around discrete disease entities with homogeneous causation and progression, it underplays symptomology that greatly varies from case to case and from patient to patient. It underestimates variation in human health and illness, variation in real world cases that clinical trials can not so easily replicate.


The embryology [Bhatnagar`s embryology] text says: “embryology has no explanation for the unfailing uniqueness of each individual ---face / fingerprints, pattern of sulci and gyri on the brain or the veins on the dorsum of the hand. if basically the same processes work to shape all the human beings they should all look alike; but they never are.More forces then are at work in shaping each embyro than can be described.”
and what are these different forces responsible for individualisation they are the genes
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Re: The Danger of Science Denial - "Alternative Medicine"-Sp

#853  Postby Dr. Nancy Malik » Jun 21, 2010 12:30 pm

DST70 wrote:
Homeopathy is said to be ineffective mostly because it gives inconclusive or poor results in clinical trials. Clinical trials are the product of a medical paradigm that assumes a 'normal' level of diversity in human health. It's focussed on diagnosing and grouping common symptoms, and doesn't acknowledge the variation of individual response to disease and treatment. It's not a surprise to me that homeopathy doesn't show a lot of success in clinical trials.

David


Double blind trials are perfect for conventional medicine, because they have specific medicines for a particular diagnostic condition, hence it is apt to see how the chosen medicine fares for that condition in a trial.

In Homeopathy, we do not treat diseases based on their medical diagnosis, but remedies are chosen based on the individualizing features of each case, hence 100 patients of, say, high blood pressure, may probably need 100 different remedies, each patient receiving a remedy to suit him/her best.
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Re: The Danger of Science Denial - "Alternative Medicine"-Sp

#854  Postby Dr. Nancy Malik » Jun 21, 2010 12:37 pm

Dudely wrote:
I seriously doubt that if there was evidence to show that homeopathy works that the mere fact that a clinical trial "doesn't acknowledge the variation of individual response to disease and treatment" would prevent that from coming to light. As I said earlier in this thread- if it does work there is a reason, and you should be able to figure out why and witness this happening.



Let's take an example. Say we are doing a trial for migraine headaches.

First we have to find look at our cured cases for people with migraine headaches. Then we look at what homeopathic remedies were prescribed in these cases. We find in 100 cases we used 20 different remedies in total but 40% of them responded to the remedy Natrum Muriaticum. So we select that remedy for the trial.

Then we do the trial. Don't forget only Nat. Mur. is used for every patient in the trial. Let's say the results show that 35% of subjects reported a significant improvement in symptoms after taking the remedy. The trial concludes that homeopathy has an effect above that of placebo.

But this is less than half the story. What would happen if a skilled homeopath were then allowed to individualize the 65% of cases that reported no improvement and prescribe any remedy he or she felt was indicated? I would expect that around 80% of these remaining cases would report a significant improvement.
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Re: The Danger of Science Denial - "Alternative Medicine"-Sp

#855  Postby Dr. Nancy Malik » Jun 21, 2010 12:41 pm

Shrunk wrote:Relevant:

Save Taxpayer $$$: Eliminate Alternative Medicine Research

Steven Salzberg
Forbes.com
June 16, 2010


This past week, President Obama called on all federal agencies to voluntarily propose budget cuts of 5%. Well, Mr. President, you might be surprised to learn that there's a way for you that cut the National Institutes of Health budget without hurting biomedical research. In fact, it will help.

Here's my proposal: save over $240 million per year in the NIH budget by cutting all funding for the two centers that fund alternative medicine research--the National Center for Complementary and Alternative Medicine (NCCAM) and the Office of Cancer Complementary and Alternative Medicine (OCCAM). Both of them exist primarily to promote pseudoscience. For the current year, NCCAM’s budget is $128.8 million, an amount that has rapidly grown from $2 million in 1992, despite the fact that not a single “alternative” therapy supported by NCCAM has proven beneficial to health. OCCAM’s budget was $121 million in 2008 (the latest I could find) and presumably higher in 2010. That’s over $240M, not counting money these programs got from the stimulus package (and yes, they did get some stimulus funding).

These two organizations use our tax dollars – and take money away from real biomedical research – to support some of the most laughable pseudoscience that you can find. To take just one example, NCCAM has spent $3.1 million supporting studies of Reiki, an “energy healing” method. Energy healing is based on the unsupported claim that the human body is surrounded by an energy field, and that Reiki practitioners can manipulate this field to improve someone's health. Not surprisingly, the $3.1 million has so far failed to produce any evidence that Reiki works. But because there was never any evidence in the first place, we should never have spent precious research dollars looking into it.

(Continued...)


Status of CAM in USA

U.S. Census data reported that in the preceding three years, total spending for alternative care grew by 83%, from $10.3 billion in 1987 to $18.9 billion in 1990, while total expenditures paid to mainstream physicians increased by 56%, from $90 billion to $141 billion. Not since President Nixon brought acupuncture back from China has interest in alternative medicine been so great.

Utilization went up from 33.8% of the American public in 1990 to well over 50% in 1998. There were 427 million CAM visits in 1990, and that number increased to over 629 million in 1997, a 47.3% increase in just seven years! Spending for CAM therapies, including nutritional and botanical/herbal supplements in 1998, totaled $18 billion OUT-OF-POCKET! Overall CAM patient satisfaction rates are greater than 75%. And if that's not enough, perhaps this is the clincher: current CAM visits far outnumber visits to any and all primary care physicians 2.1:1.

A follow-up study published in the November 11, 1998 issue of the Journal of the AMA reported a 47.3% increase in visits to alternative medicine practitioners, from 427 million in 1990 to 629 million in 1997 - a number that exceeded total visits to all US primary care physicians.

A federally funded survey in 2007 found that in the previous year nearly 5 million Americans used homeopathic remedies,

U.S. adults spent $33.9 billion out-of-pocket on visits to complementary and alternative medicine (CAM) practitioners and purchases of CAM products, classes, and materials.
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Re: The Danger of Science Denial - "Alternative Medicine"-Sp

#856  Postby Shrunk » Jun 21, 2010 12:47 pm

Dr. Nancy Malik wrote: Double blind trials are perfect for conventional medicine, because they have specific medicines for a particular diagnostic condition, hence it is apt to see how the chosen medicine fares for that condition in a trial.

In Homeopathy, we do not treat diseases based on their medical diagnosis, but remedies are chosen based on the individualizing features of each case, hence 100 patients of, say, high blood pressure, may probably need 100 different remedies, each patient receiving a remedy to suit him/her best.


So why does the British Homeopathy Association claim that double blind studies support homeopathy? Are they liars?
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Re: The Danger of Science Denial - "Alternative Medicine"-Sp

#857  Postby orpheus » Jun 21, 2010 12:51 pm

Shrunk wrote:
Dr. Nancy Malik wrote: Conventional medicine restricts the physician's ability to treat diseases which are not diagnosed or not previously known.


So homeopaths charge patients for treating illnesses that don't exist. In conventional medicine that is malpractice.


To be fair, "diseases which are not diagnosed or not previously known" may not mean illnesses that don't exist. It could mean 1) a disease which does exist but has not been diagnosed yet because it is difficult to diagnose (for any number of reasons). or 2) a disease which does exist but is heretofore unknown to medical science.

However, just as you said for charging patients for treating illnesses that don't exist, treating in either of these other cases would be malpractice too.
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Re: The Danger of Science Denial - "Alternative Medicine"-Sp

#858  Postby Shrunk » Jun 21, 2010 12:52 pm

Dr. Nancy Malik wrote:
Shrunk wrote:
Save Taxpayer $$$: Eliminate Alternative Medicine Research

Steven Salzberg
Forbes.com
June 16, 2010


This past week, President Obama called on all federal agencies to voluntarily propose budget cuts of 5%. Well, Mr. President, you might be surprised to learn that there's a way for you that cut the National Institutes of Health budget without hurting biomedical research. In fact, it will help..... (SNIP)


Status of CAM in USA

U.S. Census data reported that in the preceding three years, total spending for alternative care grew by 83%, from $10.3 billion in 1987 to $18.9 billion in 1990, while total expenditures paid to mainstream physicians increased by 56%, from $90 billion to $141 billion. Not since President Nixon brought acupuncture back from China has interest in alternative medicine been so great. (SNIP)


1) Quoted without citation. Reported.

2) WTF does this have to do with what I posted?
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Re: The Danger of Science Denial - "Alternative Medicine"-Sp

#859  Postby Dr. Nancy Malik » Jun 21, 2010 12:53 pm

TMB wrote:
My daughter reacted badly to a vaccination, swelling and paralysis down the side of her body with the vaccination. The paediatrician (specialist allopathic doctor) suggested that we should avoid any vaccinations as her reaction was too severe. On what basis could this doctor make this recommendations? Based upon repeatable, confirmed issues around this particular vaccination? In other words did she base her diagnosis and treatment options upon a validated, double blind testing? Actually she used her professional judgement and all the experience gathered in her years practicing, all of it anecdotal. Yet I suggest it was the right choice for my daughter.

Consider another case. After taking a tested drug called Thalidomide in the 1950/60s mothers were giving getting birth defects in their children. This was just anecdotal evidence of course, as the testing required for the drug meant that only when another properly conducted trial that proved conclusively that indeed the drug was harmful and responsible for the birth defects, should it be necessary to stop administering the drug. Of course the gathering weight of anecdotal evidence became a political issue long before the issues were proven in clinical trials. This extreme example shows that many things medical begin with anecdotal evidence. It does not mean that anecdotal evidence is therefore the means to prove effective treatment, and we chuck out all conventional testing. It means that judgement of what works and does not work, regardless of belief, should guide our choices.

Going back to thalidomide, do you think that your argument of

Anecdotal evidence, no matter how extensive and sincerely believed, remains anecdotal evidence


Would have been a good position to take, especially once it was validated. Unless we apply our judgement to medicine, how can you be sure that another more subtle form of thalidomide is happening? Thalidomide simply provides us with an example, it does not mean that we fixed that problem and there are no others, and never will be, therefore we only do what the testing says we should do.

If I recall correctly you are a psychiatrist. How does the practice of this, the medical treatment of mental disorders operate with repeatable, double blind studies on what is efficacious? Is there a whole lot of off the shelf medical treatments that one can apply on a homogenous basis like broad spectrum antibiotics to patients, or is there are requirement to apply your experience, based upon anecdotal case histories in many cases, on what might work for specific patients?


About anecdotal evidence

http://www.dailymail.co.uk/health/artic ... -year.html
http://www.i-sis.org.uk/peerReviewUnderTheSpotlight.php
http://www.electriceditor.com/impossibl ... tories.php
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Re: The Danger of Science Denial - "Alternative Medicine"-Sp

#860  Postby Shrunk » Jun 21, 2010 12:53 pm

orpheus wrote:
Shrunk wrote:
Dr. Nancy Malik wrote: Conventional medicine restricts the physician's ability to treat diseases which are not diagnosed or not previously known.


So homeopaths charge patients for treating illnesses that don't exist. In conventional medicine that is malpractice.


To be fair, "diseases which are not diagnosed or not previously known" may not mean illnesses that don't exist. It could mean 1) a disease which does exist but has not been diagnosed yet because it is difficult to diagnose (for any number of reasons). or 2) a disease which does exist but is heretofore unknown to medical science.

However, just as you said for charging patients for treating illnesses that don't exist, treating in either of these other cases would be malpractice too.


Thanks.
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