February 25, 2010
Alternative Medicine Remains Popular, Legal, and Ineffective (or Worse)
Melly Alazraki in Daily Finance:
Britain's House of Commons on Monday dealt a blow to CAM. "Homeopathic products perform no better than placebos," said the Parliamentary committee's report, which concludes: "To maintain patient trust, choice and safety, the Government should not endorse the use of placebo treatments, including homeopathy."
In the face of the looming health-care reform, U.S. Senators have been trying to add various provisions to the bill: Sen. Tom Harkin (D-Iowa) has tried to push insurance coverage for alternative medicines; and Sen. Orrin Hatch (R-Utah) has attached a provision that would cover Christian Science prayer treatments.
It's unclear whether faith-based medicine has ever been clinically tested, but a spotcheck of the NCCAM Health page and its Office of Dietary Supplement fact sheet shows that many remedies have very limited health benefit, if any. WIth an industry whose products offer a greater risk of danger than a promise of benefit, and as the public keeps buying into these remedies, the U.S. should intervene not to support the trend of their growing use, as Harkin and Hatch would seem to support, but reducing our reliance on quackery.
More here.
Posted by Abbas Raza at 04:09 AM | Permalink
Comments
Heres the history of our medicine.
"I have a sore throat."
2000 BC : "eat this root"
1200 AD : "That root is heathen, say this prayer."
1500 AD : "That prayer is superstition, drink this elixir."
1800 AD : "That elixir is snake oil, Take this pill."
1900 AD : "That pill is ineffective, Take this antibiotic."
2000 AD : "That antibiotic is artificial, Here why dont you eat this root."
Posted by: chris | Feb 25, 2010 8:12:37 AM
Curious as to why an article that does little more than spout the sophisms of the pharmaceutical industry would be given airing on such a wonderful and high-minded blog as this?
It is dissapointing and destructive when writers use the authority borrowed from the notion of journalistic text as the acme of unbiased reporting to voice what amounts to an opinion, or worse, a dogma.
The only information producing instrument the modern world seems to trust more than journalism is, of course, western science. This is not without reason. However, just because a journalist is able to drum up a few studies that seem to verify her claim, does not mean that he or she has given a balanced and well-researched report of the phenomenon in question and that, therefore, we as readers get to stop exercising our powers of scrutiny.
Unfortunately, it seems that this is exactly what Abbas Raza has done in posting AOL's financial newspaper's one-off review of "CAM."
With the increasing popularity of traditional medicines and the emergence of a critical attitude towards the pharmaceutical industry and western healthcare, the time has certainly come for intelligent debate over the regulation and implementation of alternative medicine in this country. One would hope that a blog with as much credibility and talent behind it as 3quarksdaily could serve as a forum for this debate and not as a propagator of dogmas and subtle falsities.
Posted by: William Ceurvels | Feb 25, 2010 9:21:00 AM
If homeopathy is useless then this is my kind of useless. Will you have the openness to follow up on these studies at M.D. Andersen? They are as far from fringe as you can get.
"A landmark paper on homeopathy and cancer has appeared in the February 2010 issue of the International Journal of Oncology. Scientists at the University of Texas M.D. Anderson Cancer Center (MDA), led by Moshe Frenkel, MD, have confirmed the ability of four homeopathic remedies to induce apoptosis (programmed cell death) in breast cancer cell lines in the laboratory. The scientists in question were from the Integrative Medicine Program, the Department of Molecular Pathology, and the Department of Melanoma Medical Oncology of MDA. Their two Indian collaborators were from the Banerji Homeopathic Research Foundation, Kolkata, India, where these same remedies are employed clinically with apparent success. The four ultra-dilute remedies in question were Carcinosin, Phytolacca, Conium and Thuja.
"The remedies exerted preferential cytotoxic effects against the two breast cancer cell lines, causing cell cycle delay/arrest and apoptosis" the authors wrote.
Posted by: Gene | Feb 25, 2010 11:37:46 AM
"Homeopathic products perform no better than placebos"
And placebos often perform about as well as medications, with the added benefit of having no side effects.
Posted by: J.Hawkins | Feb 25, 2010 12:13:45 PM
No I will not have the openness to follow up on this sort of quackery. I do not have an infinite amount of time to go around chasing the wild claims of every huckster, much less point out the subtleties of how various studies purporting to show the efficacy of homeopathy are invariably shown to be badly designed/interpreted, etc., when looked at closely. You just keep on hawking and pushing your false cures on vulnerable and sick people.
And if you think I am about to engage you in some sort of debate here, you are mistaken.
I will, however, take this oportunity to recommend an excellent book: Bad Science by Ben Goldacre. I think it should be compulsory reading in High Schools everywhere.
Posted by: Abbas Raza | Feb 25, 2010 12:17:20 PM
I really don't care to debate either. I think you've said it all when you say you are not open. Even when a world-respected research center carries out research that goes against, what would yo call it? Science? No, Opinion. Now I understand what Good Science is.
Posted by: Gene | Feb 25, 2010 12:33:49 PM
I had no idea 3quarksdaily was run by someone with such a narrow and conservative perspective on the issue most dear to me, medicine. I hearby renounce my support of this website.
Posted by: William Ceurvels | Feb 25, 2010 12:44:03 PM
Gene,
That article being what it is, in the context of all credible published material, homeopathy is not a good thing for the public to put their trust in. One paper is simply not enough research to justify a whole field of questionable claims. -especially on a speculative topic not even in clinical trials yet.
So lets not cherry pick the things we want to believe in, or feel is right -especially when in that same month of publication of the International Journal of Oncology, research in other methods to treat breast cancer prove are promising.
Posted by: chris | Feb 25, 2010 1:18:21 PM
Chris,
I have no investment in homeopathy on any level. But, I think that a study from M.D. Andersen should weigh more than column from a financial writer with no research background. All I'm saying is that one cannot make a blanket indictment when there is evidence to the contrary. Here at UCSF Peter Carroll, arguable the best prostate cancer surgeon in America, has led the fight against the overtreatment of prostate cancer. There was once a belief about what is and should be the best treatment but EVIDENCE began to weigh against blanket early intervention. As a clinician and researcher, Dr. Carroll changed his views and has acted upon that change. Certainly many approaches can and should be taken and tailored to any individual patient. And, if M.D. Andersen's tests and clinical trials of homeopathy bear up then why not use it? No physician wants to do harm and neither do they want to be ineffective. When a drug extends life, on average, 4 months but savages quality of life what are the criteria for effectiveness?
Posted by: Gene | Feb 25, 2010 1:52:06 PM
"When a drug extends life, on average, 4 months but savages quality of life what are the criteria for effectiveness?"
To take a stab in the dark here, profitability?
Posted by: J.Hawkins | Feb 25, 2010 2:03:35 PM
Well, call me a sucker for wasting time, but I downloaded (for free) and scanned the study. Now, I am completely outside my expertise here, but some comments:
* In the experiential setup, they mix the various homeopathic remedies (HRs) with 87% "extra-neutral" alcohol. In their tests they compare the HRs, straight 87% alcohol, and a control-line that is not treated. Yet there is no alcohol and pure water combination. This is a huge oversight in experimental design in my opinion, although, once again, I'm a computer scientist, not a oncologist. Homeopathy is, scientifically, water, so not using an alcohol/water control seems to make the whole thing near useless.
* There is absolutely no testing for statistical significance of the results. Additionally, the number of experiments carried out is small (6 per substance/cell line), which is probably not enough even make a valid statistical test.
Scepticsbook has much more on the study than I have time for, and they actually know the specific medical science, whereas I'm just a random guy.
There is no doubt the homeopathic community sees this as a huge vindication. Search for the paper on Google and all you'll see are links to homeopathy sites claiming science has finally vindicated homeopathy.
Posted by: Cyrus Hall | Feb 25, 2010 2:42:14 PM
Thanks for taking the time to actually look at the study, Cyrus, but I am sure you know that once the flaws in this study are pointed out (just as they have convincingly been in the case of every study supposedly vindicating homeopathy), and in a hundred more future studies, someone will come along with a badly done 101st study and ask you to have a look at it.
It is a complete waste of time because if our understanding of basic science is correct, and it almost surely is, then there is no way that homeopathy CAN work. That is why money spent on investigating the claims of homeopathy is an absolute and total waste (unlike, say, investigating whether a given herbal folk-remedy works-which may very well be worthwhile).
You'll never convince the faithful. (And I particularly always enjoy their logic of "Big Pharma is really evil, therefore my crackpot theory is correct." Very nice!)
Posted by: Abbas Raza | Feb 25, 2010 2:54:40 PM
Science should not investigate every crackpot scheme that someone presents. Some things are so incredibly unlikely to be true, as they counter not one, not two, but tens of scientific results, that they really merit very little attention. I think homeopathy is clearly in that camp.
However, I'm not sure studies on homeopathy are a complete waste of time at this point. While there are a core group of people who will never be convinced, a lot of people still value science, particularly when there is a preponderance of evidence. There is no reason to believe homeopathy should work, but much of the science done on the subject is similarly flawed as this study appears to be. There have been some proper studies in the last decade, but they are not as numerous as one might like. I would consider it a benefit to society if some qualified scientists wanted to take some time and do some more studies to settle the matter for those who can still be swayed by reason. But as you say, certainly not a funding priority.
I agree that argueing from current scientific knowledge should be a powerful argument. Sadly, it rarely is in the modern world.
Posted by: Cyrus Hall | Feb 25, 2010 3:28:07 PM
Gene,
Key word: A. A study. One. Singular. Apparently a questionable one at that.
Whatever the iffy credentials of this financial writer, her sources are legitimate, and her attitude toward homeopathy as a field is backed by those sources -not to mention much previous research finding homeopathy as a total approach to medicine to be at best worthless. So when we talk of evidence, lets not point to one study and claim it is the end all be all.
Posted by: chris | Feb 25, 2010 4:27:10 PM
You know, it's kind of funny: an unknown commenter on a blog post (who has presented no credentials of any kind, of his own) belittles a journalist as "a financial writer with no research background." As if, for some reason, a commenter on a blog carries much greater scientific authority. He is not willing to take her word about all the scientific backing she has, but we must accept his word that science has shown that homeopathy works. Great.
Posted by: Abbas Raza | Feb 25, 2010 4:43:03 PM
Chris,
Did I claim or did you claim that it was the end all and be all? You. Science, pure or applied, does not work in an environment where apriori presumptions rule. No doubt I am preaching to the choir here, but you will never get rid of homeopathy by snide or arrogant remarks. Encourage all the research, critique it and let the chips fall where they may. Now, homeopathy aside, M.D. Andersen has also done preliminary research on osteosarcoma with a drug called BMTP-11. It "shows promise" and clinical trials are scheduled. How many things show promise and turn out to be nothing? Most. Why should homeopathy not be tested to the max and allowed to be nothing after the fact. The good thing about UCSF or M.D. Andersen is that they can test things that big pharma won't touch (often with good reason). Some things are effective but not remarkably so. Every now and then something is (pace Abbas on herbs) like turmeric. If homeopathy even shows a little effectiveness then one would want to hypothesize mechanisms which could lead into how to utilize placebo effects or some other unknown but knowable mechanism. If, after testing, it doesn't then you won't have to have verbiage like we're having. But, do the tests.
Posted by: Gene | Feb 25, 2010 5:12:22 PM
The article in question was not purely about homeopathic medicine. If it were, I myself would have no problem acknowledging the legitimacy of the concerns raised. The problem with this article was how the journalist generalized from a few studies on specific treatments to the conclusion that the American people should begin to "reduce their reliance on quackery." Quackery being broadly defined as the complementary and alternative medicines in question.
This is an incidious kind of careless journalism. Look how all the vast diversity of "alternative medicine" is lumped into one category: "Doctors, scientists, and researchers have long warned that most "complementary and alternative medicines," or CAM -- acupuncture, homeopathy, dietary supplements, Ayuverda -- are at best ineffective and at worst dangerous." How can we put the two most monumental traditional medical traditions the world has seen in the same category with an incipient pseudo-science and a health fad?? When this kind of careless generalizing is brought into the realm of journalism it can be called nothing if not irresponsible.
post script: actually Mr. Raza, if you look carefully, I took pains not to make an ad hominem attack, as I find them to be a waste of time and a distraction. Likewise I did not provide any of my own credentials a.) because the argument is what is important here and b.) I know that in blog postings arguments can very quickly descend into ad hominem attacks, which I sought to avoid. That being said I was a pre-medical undergraduate and now study Chinese medicine in Beijing.
Posted by: William Ceurvels | Feb 25, 2010 5:34:13 PM
Science, pure or applied, does not work in an environment where apriori presumptions rule.
This really is poppy-cock, reinforced by many well meaning scientists who say it on TV to sound unbiased. Of course a priori assumptions are made, and a good scientist tracks his assumptions so he can later backtrack and challenge them if he suspects they are wrong. The important thing is to not make large assumptions about the factors that can reasonably be expected to affect outcome.
No one has time to check the entire state-space their experiments involve, and no one acts as if prior knowledge is useless. For that's what most assumptions are based on: prior knowledge of the area. That means that some are more valid than others (indeed, reviewers often critique other work because they feel the assumptions made are misguided), not that assumptions aren't made.
In context, I think most scientists make the assumption that the water can not carry a "resonance" of a substance that is not present in it, largely because there is no physical mechanism to explain how it could do so. That's a fairly reasonable a priori assumption: no known mechanism = probably not possible. The typical rejoinder is that if something works, there must be a mechanism, whether modern physics can explain it or not. This is why most of the research has focused on efficacy, not a search for a mechanism. But it's hard to motivate scientists who don't see any reasonable way for something to work according to known physical laws, and that's quite reasonable on their part.
Posted by: Cyrus Hall | Feb 25, 2010 5:54:49 PM
Cyrus,
It's interesting how you parse statements. I didn't say scientists don't have apriori assumptions. Life would be impossible otherwise. I said, "where apriori presumptions rule." There's a difference. And then you want to change the goal posts by saying it's effectiveness that is what scientists are after. Well, if you test something and it's effective then that's enough? If so that invalidates your talking about water which no one here has brought up to defend homeopathy. And your point about motivating scientists is not a point when you have researchers motivated to do tests and face the music. Face it, you are more than just not interested in finding out whether homeopathy can be refuted. You have an irrational fear, of as they say in sports, "Letting them play the game." Probabilities give odds and favorites and are most often proven right. But sometimes not and for some reason you can't abide that being played out.
Posted by: Gene | Feb 25, 2010 6:43:54 PM
Gene-
My point is that a priori assumptions do rule, or, to put it more mildly, play an important part in shaping research. Maybe we are arguing minor semantics here, but assumptions are what give the form and shape to a line of questioning.
I don't see where I talk about effectiveness (do you mean efficency?). Are you referring to the line that ends "be expected to affect outcome."? The point there is not that assumptions are "effective" (although they certainly can be). Rather, I was just pointing out the obvious, that one must be careful with the particular assumptions made.
Science is about increasing knowledge, not effectiveness. Efficiency can be a by-product. The problems that are pursued are not uniformly selected. Scientists like to tackle big problems, and many have a bias for questions that could have a large payoff. There is an underlying incentive to look for positive results. As such, less scientists are interested in spending time confirming a negative result, particularly if all the theory supports such a negative result. No one spends time confirming that breathing does not contribute to early death. Many scientists feel similarly about homeopathy, as there does not seem to be a mechanism that would allow for it to work.
As to my "irrational fear," please read my response to Abbas where I suggest it could be worth funding more studies to put the subject to rest. Bring on the science - I welcome it. If it proves me wrong, then we'll just get to discover some truely amazing new physics and chemistry. I'm betting strongly against that outcome.
Posted by: Cyrus Hall | Feb 25, 2010 8:10:43 PM
Gene,
The issue isn't the fact that some guy is testing homeopathic stuff. Thats fine. The issue is branding the field of homeopathy itself as legit science based on scant research, and then recommending it to the public.
I'm sure all people here welcome testing the issue, but what people (i.e., me) don't want is a public sentiment of "If homeopathy is useless then this is my kind of useless." because of one study. A similar thing occurred with vaccines: one study convinced a bunch of stupid people despite a whole range of research finding it flawed. Almost immediately, the herd-like public labeled 100 years of science illegitimate , risking the general medical wellbeing.
Posted by: chris | Feb 25, 2010 8:36:05 PM
Popular, legal, ineffective--that's pretty much the medical establishment, both mainstream and alternative. Here in Toronto, one wealthy hospital is flogging ads (in the subways just to rub it in for poor schmoes who don't have cars) for how amazing they are at putting people back together after car crashes. They're right. Crash. Lovely word, with cash built in. It's one of the few things modern medicine can help with. Heroic doctors. But when it comes to disease, the allopaths are about as good as the other paths. It's the dark ages, the world is polluted, and we're dying. We could eliminate cars, which in the city are absolutely frivolous, but then what would doctors do?
Posted by: David Ker Thomson | Feb 26, 2010 9:55:23 AM
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