Slashdot Mirror
Trick or Treatment
brothke writes "The recent collapse of financial companies occurred in part because their operations were
run like a black box. For
many years, alternative medicine has similarly operated in the shadows with
its own set of black boxes. In Trick or Treatment: The
Undeniable Facts about Alternative Medicine, Simon Singh and
Edzard Ernst, MD, break open that box, and show with devastating clarity and
accuracy, that the box is for the most part empty." Keep reading for the rest of Ben's review.
Trick or Treatment: The Undeniable Facts about Alternative Medicine
author
Simon Singh and Edzard Ernst
pages
352
publisher
W. W. Norton
rating
9
reviewer
Ben Rothke
ISBN
978-0393066616
summary
Peels away the fallacies of acupuncture, homeopathy, chiropractic and herbal medicine
I first encountered co-author Simon Singh at the
2005 RSA
Conference. In his
presentation, he included a demonstration of the human brains unique
capability for pattern matching when specific patterns are expected, and used
Led Zeppelins Stairway to Heaven as an
example. Stairway has long been rumored to have
subliminal satanic messages. When played backwards,
it is impossible to decipher any message. But when
the message is known in advance, one can then hear
the message imploring the listener to go to Satans tool shed.
Once Singh put the subliminal lyrics on the overhead, the
subliminal message was now clear, not due to a subliminal message, rather via
pattern matching.
While no reasonable person can believe in Stairways subliminal lyrics, far too many people do believe in equally implausible things in the realm of alternative medicine. In the book, the authors tackle four main areas: acupuncture, homeopathy, chiropractic and herbal medicine. The books conclusion is that acupuncture, homeopathy, chiropractic are essentially worthless, while herbal medicine has limited value.
Chapter 1 starts with an overview of evidence-based medicine (EBM), of which the authors are staunch believers. EBM applies evidence gained via the scientific method and assesses the quality of the evidence relevant to the risks and benefits of the treatments. The foundation of EBM is the systematic review of evidence for particular treatments via mainly randomized controlled trials. In the chapter, the authors reiterate the concept that the plural of anecdote is not data. Acupuncture, homeopathy, chiropractic have plenty of first-person anecdotes, but a lack of controlled studies with real data to back up their spurious claims.
EBM shows that homeopathy and other bogus cures are of no value, yet the public is oblivious to those facts. In a piece I wrote on this topic, New York News Radio" The voice of bad science, its shows that cheap radio advertising (with its mishmash of pseudo-scientific claims) combined with a public that is ignorant of basic scientific facts, creates a perfect storm for the continuation of homeopathy and other bogus cures.
A recurring theme the book stresses is that acupuncture, homeopathy, chiropractic and other alternative therapies are scientifically impossible, and often will violate fundamental scientific principles. A perfect example of this implausibility is with homeopathy. Contrary to what common sense and basic science, in homeopathy, a solution that is more diluted is considered stronger and as having a higher potency. The issue is that the end result is a product that is so diluted, that its contents when in solid form is pure sugar, and when in liquid form; 100% H20. When a homeopathic liquid is in its most diluted state, there is not a single molecule of the active ingredient. Therein lays the scientific implausibility of homeopathy.
Chapter 1 also asks one of the books fundamental questions: how do you determine the truth? The authors answer that it is via the scientific method. This is determined only after strict and careful analysis of a clinical study, of which the most effective is double-blind and randomized.
In chapter 3, the book jokingly notes that since homeopathic liquid remedies are so diluted that they contain only water; their only use would be for dehydration. And since homeopathy is based on the fact that the strength of a remedy is based on its dilution, one could conceivably overdose on a homeopathic remedy by forgetting to take a dose.
The chapter concludes with perhaps the strongest indictment against homeopathy; namely its content. If one looks at the content of oscillococcinum, a homeopathic alternative marketed to relieve influenza-like symptoms, the packaging states that each gram of medication contains 0.85 grams of sucrose and 0.15 grams of lactose. Sucrose and lactose are simply forms of sugar, of which oscillococcinum is nothing more than am expensive sugar pill.
In chapter 4, the authors write that while homeopathy is nothing more than a placebo, the added danger with it is that patients will often forgo real medications to take a homeopathic one. It reports of a study in Britain, which demonstrated that the most benign alternative medicine can become dangerous if the therapist who administers it advises a patient not to follow an effective conventional medical treatment. The study demonstrated that alternative medical practitioners often recommend homeopathic remedies for malaria, and ignore proven conventional medicines. Such an approach can often mean a death sentence for the person taking the homeopathic remedy.
Chapter 5 deals with herbal medicine. The chapter is somewhat different in that the previous chapters about acupuncture, homeopathy and chiropractic showed them to be useless, herbal medicine does have value. The book notes that herbal medicine has been embraced by science to a far greater extent than acupuncture, homeopathy and chiropractics. The chapter lists over 30 herbal medicines and their levels of efficacy. An irony of herbal medicine is that some exotic ones, such as those with tiger bone or rhino horn are pushing the species to the brink of extinction, due to their level of popularity in certain parts of the world.
Chapter 5 concludes with on why smart people believe such odd things? Alternative medicine has failed to deliver the health benefits that it claims, so why are millions of patients wasting their money and risking their lives by turning towards a snake-oil industry? The authors provide numerous reasons for this, from the concepts such as natural, traditional and holistic, to attacks on the scientific method by the alternative medical community and more.
The appendix is a rapid guide to alternative therapies and lists over 30 new treatments with their benefits and potential dangers. The appendix gives single page summaries of the plethora other alternative therapies, from ear candles, colonic irrigation, reiki, to leech therapy and more. The authors write that most of these are bogus, many violate fundamental laws of sciences, and but a few have real, but limited value.
Alternative medicine operates in the shadows, blithely touting that their products have not been evaluated by the Food and Drug Administration, and that they are not intended to diagnose, treat, cure or prevent any disease. While these products are not intended to diagnose, treat, cure or prevent any disease; consumers nonetheless spends billions of dollars per year on unproven supplements. Consumers can be quite fickle. On one side they are furious at the SEC for their lack of oversight around Madoff Investments Securities. Yet when the FDA requires products use their disclaimer of how ineffective the item is, consumers will throw billions of dollars on ineffective products.
Trick or Treatment: The Undeniable Facts about Alternative Medicine is an incredibly important and eye-opening book. While Singh is a physicist and Ernst a medical doctor, the book is written in a clear and compelling style, avoids technical jargon, and sticks to the facts. In the spirit of the scientific method, the authors scrutinize alternative and complementary cures and the results show that the snake oil is still selling.
Ben Rothke is the author of Computer Security: 20 Things Every Employee Should Know.
You can purchase Trick or Treatment: The Undeniable Facts about Alternative Medicine from amazon.com. Slashdot welcomes readers' book reviews — to see your own review here, read the book review guidelines, then visit the submission page.
While no reasonable person can believe in Stairways subliminal lyrics, far too many people do believe in equally implausible things in the realm of alternative medicine. In the book, the authors tackle four main areas: acupuncture, homeopathy, chiropractic and herbal medicine. The books conclusion is that acupuncture, homeopathy, chiropractic are essentially worthless, while herbal medicine has limited value.
Chapter 1 starts with an overview of evidence-based medicine (EBM), of which the authors are staunch believers. EBM applies evidence gained via the scientific method and assesses the quality of the evidence relevant to the risks and benefits of the treatments. The foundation of EBM is the systematic review of evidence for particular treatments via mainly randomized controlled trials. In the chapter, the authors reiterate the concept that the plural of anecdote is not data. Acupuncture, homeopathy, chiropractic have plenty of first-person anecdotes, but a lack of controlled studies with real data to back up their spurious claims.
EBM shows that homeopathy and other bogus cures are of no value, yet the public is oblivious to those facts. In a piece I wrote on this topic, New York News Radio" The voice of bad science, its shows that cheap radio advertising (with its mishmash of pseudo-scientific claims) combined with a public that is ignorant of basic scientific facts, creates a perfect storm for the continuation of homeopathy and other bogus cures.
A recurring theme the book stresses is that acupuncture, homeopathy, chiropractic and other alternative therapies are scientifically impossible, and often will violate fundamental scientific principles. A perfect example of this implausibility is with homeopathy. Contrary to what common sense and basic science, in homeopathy, a solution that is more diluted is considered stronger and as having a higher potency. The issue is that the end result is a product that is so diluted, that its contents when in solid form is pure sugar, and when in liquid form; 100% H20. When a homeopathic liquid is in its most diluted state, there is not a single molecule of the active ingredient. Therein lays the scientific implausibility of homeopathy.
Chapter 1 also asks one of the books fundamental questions: how do you determine the truth? The authors answer that it is via the scientific method. This is determined only after strict and careful analysis of a clinical study, of which the most effective is double-blind and randomized.
In chapter 3, the book jokingly notes that since homeopathic liquid remedies are so diluted that they contain only water; their only use would be for dehydration. And since homeopathy is based on the fact that the strength of a remedy is based on its dilution, one could conceivably overdose on a homeopathic remedy by forgetting to take a dose.
The chapter concludes with perhaps the strongest indictment against homeopathy; namely its content. If one looks at the content of oscillococcinum, a homeopathic alternative marketed to relieve influenza-like symptoms, the packaging states that each gram of medication contains 0.85 grams of sucrose and 0.15 grams of lactose. Sucrose and lactose are simply forms of sugar, of which oscillococcinum is nothing more than am expensive sugar pill.
In chapter 4, the authors write that while homeopathy is nothing more than a placebo, the added danger with it is that patients will often forgo real medications to take a homeopathic one. It reports of a study in Britain, which demonstrated that the most benign alternative medicine can become dangerous if the therapist who administers it advises a patient not to follow an effective conventional medical treatment. The study demonstrated that alternative medical practitioners often recommend homeopathic remedies for malaria, and ignore proven conventional medicines. Such an approach can often mean a death sentence for the person taking the homeopathic remedy.
Chapter 5 deals with herbal medicine. The chapter is somewhat different in that the previous chapters about acupuncture, homeopathy and chiropractic showed them to be useless, herbal medicine does have value. The book notes that herbal medicine has been embraced by science to a far greater extent than acupuncture, homeopathy and chiropractics. The chapter lists over 30 herbal medicines and their levels of efficacy. An irony of herbal medicine is that some exotic ones, such as those with tiger bone or rhino horn are pushing the species to the brink of extinction, due to their level of popularity in certain parts of the world.
Chapter 5 concludes with on why smart people believe such odd things? Alternative medicine has failed to deliver the health benefits that it claims, so why are millions of patients wasting their money and risking their lives by turning towards a snake-oil industry? The authors provide numerous reasons for this, from the concepts such as natural, traditional and holistic, to attacks on the scientific method by the alternative medical community and more.
The appendix is a rapid guide to alternative therapies and lists over 30 new treatments with their benefits and potential dangers. The appendix gives single page summaries of the plethora other alternative therapies, from ear candles, colonic irrigation, reiki, to leech therapy and more. The authors write that most of these are bogus, many violate fundamental laws of sciences, and but a few have real, but limited value.
Alternative medicine operates in the shadows, blithely touting that their products have not been evaluated by the Food and Drug Administration, and that they are not intended to diagnose, treat, cure or prevent any disease. While these products are not intended to diagnose, treat, cure or prevent any disease; consumers nonetheless spends billions of dollars per year on unproven supplements. Consumers can be quite fickle. On one side they are furious at the SEC for their lack of oversight around Madoff Investments Securities. Yet when the FDA requires products use their disclaimer of how ineffective the item is, consumers will throw billions of dollars on ineffective products.
Trick or Treatment: The Undeniable Facts about Alternative Medicine is an incredibly important and eye-opening book. While Singh is a physicist and Ernst a medical doctor, the book is written in a clear and compelling style, avoids technical jargon, and sticks to the facts. In the spirit of the scientific method, the authors scrutinize alternative and complementary cures and the results show that the snake oil is still selling.
Ben Rothke is the author of Computer Security: 20 Things Every Employee Should Know.
You can purchase Trick or Treatment: The Undeniable Facts about Alternative Medicine from amazon.com. Slashdot welcomes readers' book reviews — to see your own review here, read the book review guidelines, then visit the submission page.
Yup it's obvious to any reasonable scientific person that it's the corporate logo stamped on the pill that confers the magic powers.
"the plural of data is not anecdote"
should be
"the plural of anecdote is not data"
And likely many of his other claims as well. Here's what PubMed says:
http://www.ncbi.nlm.nih.gov/pubmed/17568299?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum
"Accupuncture may be an efficacious and acceptable nonexposure treatment option for PTSD. Larger trials with additional controls and methods are warranted to replicate and extend these findings."
http://www.ncbi.nlm.nih.gov/pubmed/6289567?ordinalpos=3&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum
"A brief characterisation is maccccde of the working principles underlying neural therapy under local anaesthesia or accupuncture. Common approaches to therapy are offered by disorders of autonomous regulation, including inflammatory processes, and by purely functional disorders.--There are many applications in gynaecology and obstetrics. A brief statistical information on lumbosacral pain is quoted as an example. Optimum performance can be expected from them, when used in combination with proven therapeutic methods. They provide a low-cost approach to reducing both the consumption of antibiotics and other pharmaceuticals as well as time of morbidity."
There are many others outside of PubMed. And that is but one of the author's claims that actual published studies in the medical literature refute. This side-swipe skepticism is not science, it is marketing in order to sell a bullshit book. Ignore idiots like him and read peer reviewed journals and abstracts before basing your own judgment.
In general, if you are sick or injured you get better or die. If you die you can't say anything about the failure of your medical care. If you have received care, more than likely likely you will improve. The question is whether the care altered the healing. Since humans like to find patterns, which help us predict future events, we tend to associate an action with an outcome. So, if we tend to get better, and we receive care, unless we are careful we will assume the care was positively associated with getting better. I really wish we were better able to teach that correlation does not imply causation.
Remember, your chiropractor is little more than a highly paid masseur/se.
Not all "alternatives" are created equal. I think it is reasonable to surmise that manipulation of joints and stretch and massage of muscles can help alleviate muscular and joint pain. It is less reasonable to assume that massaging a particular spot on my foot will help kidney function.
The authors provide numerous reasons for this, from the concepts such as natural, traditional and holistic, to attacks on the scientific method by the alternative medical community and more.
This _really_ makes me angry. When I talk to someone about homeopathy, they always tell me about how "alopathy" doesn't work on prevention and how all those "chemicals" do bad things for your health.
I think they don't relate the studies saying "don't eat too much fat, it's bad for your heart" and "don't smoke, you bastard, or your lungs will collapse" with prevention. I don't know why.
I don't have a problem with people getting cured by placebos. But I do want them to notice that, if they have TB, it's the "oh-my-god-they're-so-bad" antibiotics that will probably save them.
Any life is made up of a single moment, the moment in which a man finds out, once and for all, who he is.
I mean, drug companies don't tend to release actively harmful substances with no medicinal value. They also tend to document how to use them safely and control of side effects, and avoiding harmful interactions.
Stuff that comes from plants has no such restrictions.
While some Chiropractors are trying to sell people on "Blue Light Therapy" and other stuff, others do help patients who are in great pain. Ask anyone who has been helped with Sciatica that occurred after a lumbar disc problem whether they would prefer to go back and have surgery, rather than the solution they got from the chiropractor. Or maybe the person who had a pinched nerve in their neck causing total numbness to shoot down their arm and pain in their shoulder. When the Chiropractor fixes this issue, do we disregard the results because we believe Chiropractic to be quackery?
Meanwhile, we'll have all the kooks out here proclaiming that Vitamin C or Zinc don't help with colds, and whatever you do, don't drink cranberry juice to help you with a UTI.
I've seen plenty of quackery. Many people in the Alternative medicine field are insane. But that doesn't mean that every treatment that is not released by a pharmaceutical or approved by a certified M.D. is useless.
The brains of a chicken, coupled with the claws of two eagles, may well hatch the eggs of our destruction.
I had a serious fall when skiing in february. A muscle in my back was so sore that I could not tie my own shoelaces or sit down without severe pain.
After having consulted three different medical doctors who all told me to just go home and lie down and just wait for the pain to go away I consulted a chiropractic. He was able to make some of the pain disappear immediately.
So I have to say that for me at least it worked. YMMV.
My doctor, Johnny Walker, MD, can do better than that. His assistant, Jack Daniels, does a pretty good job too of relaxing muscles. Dr. Jim Beam, on the other hand, I never got along with him. And when times are hard, like now, I get it on with the Blue Nun - yeah, I'm a perv. Now, I heard of this Russian guy, Smirnoff, I think, who can do a good job too. Some folks prefer to go with a laymen with some military training. They like Captain Morgan. I don't know about the Captain. Too each his own.
Now, I have to go to my Canadian Club to relax.
The key point you've glossed over is the measurement "200CK". How much is 200CK? It means that the substance has undergone 200 100-to-1 dilutions. That means that the concentration has been reduced from full strength by a factor of 100^200. Yes, that's right---10^400. According to this article in Wikipedia, the number of observable atoms in the observable universe is approximately 10^80. Clearly, you will be the luckiest person alive, 10^40 or so times over, if even one atom of the active ingredient is left in your sugar pill.
> Remember, guys, for doctors, your symptoms are a matter of trial and error.
> The usual way to treat people is to go through every medication until you find
> one that helps
Um, no.
First you insult the black guy. Then you belittle the white guy and make crude remarks toward the hot chick. If you're in season 4, you also insult the brown guy whilst proclaiming his genius.
Then you hold a "differential diagnosis" and write stuff on the white board.
Finally, you pop some pills, call the patient a liar, piss off your boss, annoy your only friend, and only THEN do you start trial-and-error treatment.
Geez. Don't you people know ANYTHING about medicine?
Do daemons dream of electric sleep()?
As someone who suffers from a related problem called Avoidant Personality Disorder, I can tell you that self medicating with drugs and alcohol doesn't solve the problem at all. Oh, sure, you might become a little more sociable, for a while. Eventually, you get to the point where you need the alcohol to function at all, even in non-social situations. Pretty soon, you find yourself stuck in a cycle at the bottom of a bottle and the drugs and alcohol take control, making it even harder to meet other people because by that point, most people actually won't want to be around you and that reinforces the initial problem. I have a lot of family members who buried their problems with drugs and alcohol and they went from being functional addicts to not caring about themselves or pretty much anyone else anymore - all they want is to stay drunk and high. Anything which threatens that state can force them to become aggressive and violent in ways they never were before. Growing up around that, I avoid alcohol and drugs completely.
Cognitive behavior therapy and gradual exposure to social situations actually helps much more. Finding an environment you can trust, especially a group environment, goes a long way.
I think a lot of psychological "disorders" are BS... but as someone who is 31, stays at home all the time (including blowing off what few friends I do have), refuses to go to stores and whatnot during hours typical people do, still gets so anxious that I shake when talking to an interesting woman, and can't even call up a utility company to make changes to my account because I'm afraid of the rejection that I'm "certain" to face, yeah... all encompassing anxiety is a real issue and I can trace it's development and growing prevalence in my life going back to when I was 7. I spent almost two years in a constant state of suicidal depression and if you think alcohol is going to make that better, you're very mistaken. I refuse to take pills for it because they just seem to delay dealing with the problems rather than actually solve them.
Anyways, I realize you were trying to be glib... but for people with real underlying problems, alcohol isn't the answer. For someone fairly normal with just a bit of stage fright, sure, but not for the person that can't deal with life as it is.