I am editor in chief of a journal called FACT. It has a large editorial board, and I am always on the look-out for people who might be a good, productive and colourful addition to it. On 3 June, I sent an invitation to Mel Koppelman, who is by now well known to regular readers of this blog. Here is a copy:
Hi Mel,
can I ask you a question?
would you consider joining the ed-board of FACT [as you mentioned it in one of your comments, I assume you know this journal – but you are wrong in implying that it has anything to do with the pharmaceutical or any other industry]? if you agree, we would expect you to write 2-3 ‘summaries/commentaries’ per year. in return you get a free subscription and, of course, can submit other articles.
no, this is not a joke or a set-up. I like to have the full spectrum of opinion/expertise on my ed-board, and I do think you understand science quite well. our opinions differ but that’s what I think is good for the journal.
think about it – please.
cheers
edzard
On 6 June, she replied as follows:
Hi Edzard,
Great to hear from you, I hope you enjoyed your weekend.
Thank you very much for the kind offer, it’s something I would consider. I certainly have no problem with, and in fact embrace, people who have different opinions and views from my own, so long as I feel that they have integrity in their approach.
Just a few questions / comments:
1) Regarding FACT’s affiliations, what I said in my comment was that it was a publication of the Royal Pharmaceutical Society. According to Wiley’s website, Focus on Alternative and Complementary Medicine is copyright by Royal Pharmaceutical Society. It’s also listed on the Pharmaceutical Press website.
Are you telling me that’s incorrect? That I’m “wrong” in saying there’s a relationship? I obviously need to understand the nature of the publication whose editorial board I’m considering joining. Very confusing that you as editor say there’s no relationship to the RPS and yet they claim copyright over your publication. Incidentally, is FACT self-sufficient, earning all of its income from subscriptions? Or does any financial support come from the publishers?
2) As enticing as a free subscription to FACT is, I have access to more high quality peer-reviewed reading material than I could enjoy in many lifetimes. Because my skills seem to be in high demand and because I already spend 10-20 hours per week doing unpaid volunteer work, any additional projects that I take on at this time would need to be financially compensated. I understand that this may be a deal-breaker.
3) While I have no issue with you having different views when it comes to medical research, in order to choose to work with your publication, it’s important to me that it’s run by people with a high level of academic integrity and put patient welfare at the forefront of it’s agenda.
In March, you came out in public support of the NICE draft guidelines. You were quoted in the Guardian as saying: “It is good to see that Nice have now caught up with the evidence. Neither spinal manipulation nor acupuncture are supported by good science when it comes to treating low back pain.”
Following this, it was brought to your attention that the recommendations were contrary to best evidence and that the conclusions were unsupportable. While you have the option of following this up to make sure that the record reflects best evidence, you have indicated that you have no interest in evaluating the situation and possibly admitting an error. This behaviour is concerning from the perspective of academic integrity, particularly when it directly leads to increased human suffering (policy in several countries has already been changed based on the draft), and I would be worried that by joining your board I could be associated with such unethical behaviour.
Perhaps if I understood better your position, which seems to be to ignore the situation, not follow up on the concerns raised, and leave your comments uncorrected even though they may be inaccurate and backing guidelines that cause harm to patients, that might allay certain reservations.
Anyways, these are my initial thoughts. I hope you have an opportunity to enjoy the beautiful weather, and I look forward to hearing from you.
Best wishes,
Mel
At that stage, I began to fear that I had made a mistake. But, giving her the benefit of the doubt, I swallowed my pride and replied as politely as I could to her concerns which, in my view, were odd, to say the least. This is what I wrote on 7 June:
Hi Mel,
Thank you for your reply to my invitation. Let me address your points in turn:
- I said that FACT has nothing to do with the pharma industry which is true [when you state that “you as editor say there’s no relationship to the RPS” – it suggests to me that you did not read my email properly]. In their own words, the RPS is “the professional membership body for pharmacists and pharmacy in Great Britain and an internationally renowned publisher of medicines information.” [http://www.rpharms.com/home/about-us.asp] They have a similar status as the Royal Colleges. In the 2 decades that I am running the journal, there has been not a single instance of interference of any kind. We use them simply as an excellent publishing house. And yes, FACT is to the best of my knowledge self-sufficient and survives without funds from 3rd parties.
- I am delighted to hear that your skills are in demand.
- I have stated my position regarding the draft NICE guideline ad nauseam: I prefer to wait until I see their next version of the draft before I make further comments on it. In my view, this is both reasonable and honourable. If you disagree, I can do little about it other than expressing my sincere regrets.
I hope these brief clarifications are helpful for you to arrive at a decision.
Regards
Edzard
On 8 June, I received Mel’s reply:
How interesting! Is he trying to ‘keep his enemies closer’ or am I being too skeptical? He has recognised your talents and dedication and intellect so he is not altogether stupid after all! I eagerly await his response to your reply.
Those who have studied with Ernst say that he’s a genuine chap and misunderstood – which I know is almost unimaginable given his behaviour – but we always have to allow for the possibility that we have misjudged people however remote! Also, people can turn – especially when they get older and near retirement. Alternatively he may just fancy you!…
Mel Koppelman Really enjoying hearing y’all’s thoughts on this. I just want to say that If I had thought that the chances of me being able to create positive change by joining FACT were high, I would have tempered the tone of my reply. But the simple fact that EE can’t even be factual or forthright about whose journal it is suggests an irreparable break with reality. And surely there’s an issue (academic? ethical? legal?) with recruiting someone to your board and denying an industry tie when there is one? Not to mention that if the RSP does fund his journal, he’s been lying about his conflicts of interest. Is that someone I want to spend time adding value to that could be spent with family, patients, time in nature or really making positive change by supporting the ANF? I’ll be interested to read his reply if there is one and especially how he responds regarding the relationship between FACT and RSP. Will keep y’all posted.
Max Forrester keep your friends close; keep your enemies closer…
John McDonald Healthy skepticism! Healthy journal! And it’s 99% fact-free!
I hope that you find these exchanges as amusing as I did – but are they important? Perhaps not exactly, but revealing certainly. They shed some light on the mind-set of acupuncturists and perhaps other alternative practitioners as well. Let me try to explain.
What struck me first was the degree of suspicion, even outright hostility from the acupuncturists. I had made it quite clear that I was asking Mel to join my Editorial-Board because of her views which vastly differ from mine. In science, differences of opinions and backgrounds can be stimulating and often generate progress. That is not something that seems to be wanted by alternative practitioners; they do not seem to tolerate criticism, different perspectives or views. One cannot help asking to what degree this attitude is immature or even dogmatic.
The next thing that baffled me was the speed with which conclusions are jumped upon. Everyone seemed to be instantly convinced that I was via my journal FACT in the pocket of the pharmaceutical industry. Nobody even bothered to look up what the Royal Pharmaceutical Society truly stand for and to verify that they do NOT represent ‘BIG PHARMA’. This blindness to the possibility of being wrong confirms my fear that alternative therapists are guided by strong beliefs which must not be questioned and are hard to influence, even with facts that take less than a minute to research.
And then there are, of course, the personal attacks which came quick, thick and fast. Its authors might think that such attacks get under my skin. If so, they are mistaken: if anything, they amuse me! I have long been of the opinion that they are important victories of reason. When an acupuncturist went as far as diagnosing me as being borderline psychopathic, I almost fell off my chair laughing! To me, this remark (which has emerged several times before) is emblematic, as it suggests several things at once:
- The author is obviously rude
- He/she is incompetent, even stupid
- He/she lacks empathy – after all, one would expect from a healthcare professional to show some understanding, if I were truly ill! And if not, one would expect more respect towards mentally ill patients.
- But, of course, he/she did not mean it like that; he/she merely meant to insult me. And employing mental health issues for this purpose shows a remarkable lack of professionalism, in my view.
Am I making too much of all this? Perhaps – sorry, I am almost done.
But first I need to briefly address Mel’s doubts about my integrity. She can, of course, question what she likes as often as she wants. My point is that repeating nonsensical arguments ad nauseam does not render then sensical.
Finally, there is Mel’s public claim that I have been lying about my conflict of interests. To me, it suggests a degree of desperation, perhaps even fanaticism, that is only surpassed by her inability to apologize after the truth had become undeniable even to her.
I know that there are some people who would have sued for libel.
Not I!
For that I find all this far too hilarious.
510 Responses to An invitation resulting in a rare insight into the acupuncturists’ mind-set
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You might just as well have dodged a bullet. Posting the whole exchange on Facebook reeks of desire for attention and “see how I am fighting those stupid skeptics”, and her audience is grabbing the opportunity.
Being open to and giving space to opposing views is a honourable endeavour, but there’s also that saying about playing chess with a pigeon…
Citing Tim Bolen as a reliable source of information? That’s a paddlin’.
I’m embarrassed for her, and even more maybe for her immature,vindictive friends. Just another example of the futility of trying to argue decently with people who hold extreme views. It’s the same as arguing with people of any religion – I think it’s clear by now that these beliefs are no more than that. They not only will not, but can not, admit defeat on any basic point, because then there’s a danger the whole lot will come tumbling down.
I’ve been watching some Richard Dawkins on Youtube recently, and of course one of his arguments is that ‘The evidence is all in about Evolution’, and that there is no reason to teach in schools that the Earth is flat, or that the Sun revolves around the Earth, just to appease the Creationists and maintain the illusion that there is still a debate to be had.
The argument about Altmed of course is different, since as we know it is still being taught – less so now than a little while ago – it has powerful supporters, or at least one, and it’s still doing great harm. To paraphrase Dawkins, in order to believe in say Homeopathy one would have to be stupid, insane, or-in the original meaning of the word-ignorant.
We laugh now at people who say the Earth is at the centre of the Universe, because they and their beliefs cause little real harm. Whether homeopaths etc should be shunted off to the side and ignored, or whether they should be debated with, thus giving the impression that there is indeed a debate to be had, is something else.
Obviously, most homeopaths and acupuncturists are unlikely to attempt to defend their views in a serious publication, since they’re not likely to expect their arguments to go unanswered. Much the same applies to the as yet unclaimed 1 million dollar prize from James Randi. All of the few attempts to claim it end in tears, on one occasion quite literally.
I could share comments by so called skeptics that cover the spectrum of beating up, multilating, burning, killing, etc alt med practioneers. This doesn’t excuse alt med folks from taking the lower ground but one should consider the environment before passing judgement.
Doc Dale – Share, do. I’ve encountered few of these people. OK, none. But I’m sure that if they really exist, they would be immediately dismissed by most on this site.
However, the fact that you ‘could’ share such comments, but do not, rather places you to my mind in the camp of the countless people who claim they ‘could’ provide evidence that homeopathy works, but never get round to doing so. I’m still waiting, some months later, for a gentleman on the Quackometer site to reveal his promised evidence of an Australian test that proves that homeopathy works.
Even if there were evidence that a handful of fruitcakes and trolls had made threats to the extent you claim, they’d have to go some to match the level of childish, sulking, crowing, vitriolic abuse and whingeing exhibited by the woman Mel’s supporters. Why’s she proud, not embarrassed, about such support? I never encounter such immature weirdness on my side of the argument.
And as to the feller Ernst’s reason for not sueing – I fully understand why, given Britain’s notorious libel laws-Robert Maxwell was well known for misusing them -but as I’ve said before I wish SOMEBODY would sue.
Even I have been accused more than once of holding the views I do because I must be in the pay of drug companies. And I’ m nobody of importance in this particular debate. People like Professor Ernst however have professional reputations which others try to impugn by telling lies or making slimy allegations. It seems to me that people like Mel are playing the Donald Trump game of passing on unworthy allegations and then saying ‘I’m not claiming that there’s any truth to this, just that it’s what some other people are saying and maybe it should be investigated, that’s all’.
Barrie. If you are on Facebook go to the page “things quack chiropractors say” and wait for the topic of infants/children to come up. It tends to spawn hateful and threatening comments from the so called skeptics. Killing, burning chiropractors alive, mutilating body parts, etc… And many of them “like” the comments, including the admins.
The last time I checked, Facebook is not part of the scientific method. It does, of course, play an essential role in the worldwide promulgation of both the pseudoscientific method and the antiscientific method: quackery; charlatanism; science denialism; and any other form of misdirection/exploitation.
The topic is the conversations that take place on social media on both sides of the fence.
Doc Dale -took a half-hour look -football approaches – but couldn’t trace the stuff you say is on there. Maybe you can be specific. The anti-quack/idiot stuff I DID find on there was pretty chortlesome though, so thanks for the pointer.
Barrie: not worth my time to make the case. Believe what you want.
This isn’t surprising me… I’ve never head of an alt practionner wanting to go with science and try to do some ‘real’ research on the subject. This for a simple reason : most (if not all) of their claims are contradictory with science, so they can only be proven wrong in the long run. In fact, if an alt practionner decide to choose the science way for real, they will become like you Edzard : a scientist so not an alt practionner anymore.
I am surprised you offered such an invitation. She has exhibited an ignorance of science beyond any sense.
Am I surprised she refused the Iinvitation in such an obnoxious manner? Not really, being able to argue with facts and logic is hardly her forte.
Apart from exposing such a vacuous individual, what was the purpose?
Dear Edzard,
I find your characterisation of my sharing your letter with colleagues as inelegant perplexing as less than a week ago you began a post on your blog by making unfavourable personal comments about me. You were correct in your assessment that this wouldn’t bother me but then it’s peculiar that you pass judgement on my behaviour, which was much more innocuous. I shared your missive in order to benefit from other perspectives. The negative views of you were to be expected but some people who’ve met you actually had a positive opinion on you, something I wasn’t expecting, which caused me to reflect longer than I might have and actually gave me a more favourable view of you than I had before posting.
Your comments regarding “FACT”‘s relationship to the RPS were directly responsible for the confusion that followed. You responded to my factually correct statement that they’re the journal’s publisher by characterising this as “wrong.” Had you said that my statement was correct but that there was no interference, it would not have led to further speculation about the relationship. Incidentally, the Royal Pharmaceutical Society is a membership organisation that pertains to the pharmaceutical industry. That doesn’t by definition contribute to bias but noting who publishes the journal is relevant when critically assessing its output.
I remain ever hopeful that you will soon fully understand what the term ‘ad hominem’ means given the frequency with which you use it. It does not simply mean a rude comment about an individual but is short for ‘argumentum ad hominem’ and literally refers to making a counter-argument that’s aimed characterising the person rather than responding to the argument. When you said “why do you think acupuncturists defend acupuncture,” that is a clear example of an ad hominem argument, pointing to the motives of the speaker rather than addressing the content of their argument and is considered irrational. Speculation about whether or not you are “on the margins of some kind of personality disorder,” while unpleasant and perhaps unprofessional, is not an ad hominem argument, it’s not any kind of argument, it’s just the author’s opinion.
You do seem to believe that making a characterisation about the evidence base for acupuncture low back pain that you are completely and utterly unable to support with any reference to published research literature ‘reasonable’ and ‘honourable’ (you’re at least thoroughly committed to the role if you can see how untenable that is). But that’s a level of disagreement that seems insurmountable. At least I was able to have an intelligent discussion with the punters over at Science Base Medicine, who are usually correct in their use of research terminology and are able to actually discuss research literature. But obviously it’s not possible to discuss evidence with someone who refuses to do so. Just seems a bit peculiar on the one hand you say how important EBM is and then you seem unable to discuss evidence.
I find your response curious. You appear to have dug yourself a hole, and are now trying to make this Prof. Ernst’s fault because he showed us a picture.
Mel on Thursday 09 June 2016 at 20:41,
The queen of word salad; so many words, so little substance.
I do try to avoid the use of Ad Hominem, however, I am weakened when confronted with fantastical idiots. You say you come from a family of real medical people; do they ever feel the embarrassment you must bring with this Mao-inspired pseudo-scientific bullshit?
When was the last time you cured an illness, or measurably slowed the progression of a disease, or eliminated a cancer, or stopped sciatic pain entirely? You people faff around the edges, and, in reality, do nothing except have some people say, “ooh, I feel better”. If that is the sum total of your efficacy, pull the other one.
I think the prof is too generous; you are a dangerous cultist, albeit with a better command on language than the other dunderheads, such as jm and his puppet master, Sasha.
Tut tut Frank, ‘command on language’ eh?
But yes, I have to admit, you’ve rumbled us after all that work we put in trying to be respectable and pretending we’re treating people for their ills. The truth is out … we are cultists. But little do you know how far and wide our conspiracy spreads. We’ve signed up hundreds of thousands of doctors, physics and practitioners of all kinds plus hundreds of millions of patients from the teeming cities of China, Vietnam, Korea and Japan to tiny little clinics in the Outer Hebrides. Our cunning plan is simple – we’re going to wrest power away from Big Pharma, undermine orthodox medicine with our crazy ideas about treating the whole person and spread our insidiously effective medicine into every corner of the world.
Peter Deadman Arguing-
No you’re not. Stop being silly.
I think you’ll find that we know full well how far and wide your cult – I’ll use that word, rather than ‘conspiracy’ here- has spread. That’s one reason this whole argument is continuing.
It’s noticeable that, like the idiot Kondrot, you’ve had your ‘success’ mostly in the more medically backward countries, plus Japan, where as I understand it they have ‘Microdilution Colleges’ teaching people how to really really dilute things.
You’ve made an impressive start though, if you really have, as you claim, signed up ‘physics’.
Signed up ‘physics’? Nah, it was obviously a typo in “psychics and practitioners of all kinds”.
Close but no cigar Pete. It was a typo (autocorrect) for physios.
Oh and now you’ve cracked the other part of our conspiracy … that we’re taking over the ”more medically backward countries’. Would those be the ones with the slant-eyed devils in?
Peter Deadman –
To quote Ali G – Ain’t that a little bit racist?
Hi Barrie. I’m sure you’re acquainted with irony. What else do you think your suggestion that China, Vietnam, Korea and Japan are all characterised by being medically backwards is?
Peter Deadman-
Medical backwardness at a rough guess.
I don’t see where irony – a very much misused word – is applicable here.
Although I suppose that if one were utterly desperate one might pretend to think I’d omitted the Outer Hebrides from my comment since-as far as I know- the eyes of those people are the type more traditionally favoured in the West, and therefore my ‘racist’ point would be somewhat undermined.
I almost hesitate now to bring up the Indian Army’s adoption of homeopathy, or that country’s often aggressive and murderous belief in Holy men and related charlatans, or the Indian and Nepalese governments’ promulgation of homeopathy, for fear of what I should be accused of.
Implying that to criticise some countries’ continuing belief in witchcraft is ‘racist’ is about as much use as saying that to point out that India shouldn’t consider the rape and murder of women as honourable is ‘patronising’.
I imagine one reason you and your fellow cultists have had the success you claim in places like Vietnam is similar to the fool Kondrot’s ‘success’ in Cambodia. They contain large numbers of uneducated people, they have very little in the way of a health service, and they’re desperate.
The same kind of desperation that drove Steve McQueen to the Gerson criminals in Mexico for a cancer ‘cure’. I don’t see why that’s anything to boast about.
Sure thing. CHOP (Children’s Hospital of Philadelphia – look them up) just announced starting in-house acupuncture program for their patients. TIME just published on Andrew Vicker’s meta analysis of acupuncture, very favorable. He’s a biostatistician at Sloan Kettering. Harvard Medical School’s researcher is also interviewed in the same article.
But who knows? Maybe CHOP, Sloan Kettering, and Harvard are also in one of those “medically backward” places, somewhere between Vietnam and Cambodia…
Sasha-
It would certainly seem like it. Inviting cults to stick needles into children is plain weird.When do they bring in the homeopaths?
I did resolve to keep out of this discussion – especially as the last laggardly comments come in, but I can’t resist. What strikes me is that the ‘acupuncture is witchcraft’ commentators proudly protect their flag against all-comers on an island that is rapidly shrinking. Day by day, all over the world, more and more doctors, hospitals, army medical units, vets etc. are adopting acupuncture because they find it works in real life – offering meaningful relief from suffering to their tens of millions of patients. It seems to be that the deniers will still be shouting about delusion and placebo and criminal CAM practitioners taking money off deluded patients as the last few feet of their island finally sinks beneath the waves. Or perhaps the island image isn’t the right one … sinking ship maybe?
an island with feet? or perhaps you meant ‘square feet’? doesn’t matter you don’t make sense anyway.
Peter, I know right? I haven’t been to this blog for over a year but yesterday read lots of Mel’s interaction with the Inquisition… Mel, if you’re still reading this, great job! I’ve become a bit of epidemiology nerd recently, I think I need to study with you!
Poor Edzard went through all the five stages of grief with her. First he ignored her questions, then he kind of mocked her (while claiming he didn’t), then he gave short, not meaningful answers (claims he is too busy – probably compiling all the ad homs into another post). And finally offered her to write for his magazine because “she understands science”. At one point even thanked her for increasing traffic to his sleepy blog of senior citizens… Who knows, maybe next week he’ll be buying her flowers?
In any event, yeah, CHOP is great news as is the fact that TIME profiled Vickers’ meta-analysis and Harvard chimed in. You’re right, the evidence is getting stronger and stronger and once they design verum properly, it will become overwhelming. But I wouldn’t count on EE & Co accepting it any time soon, though, would create too much cognitive dissonance… Doesn’t matter, in the field of this larger debate they are just a small, insignificant blip…
“Wellness” Thorpe:
They told me they got a homeopathic medicine just for you. But you gotta get off all your psychotropic meds first. Otherwise, too many interactions…
Sasha-
That’s just a lazy stab at comedy.
Since I’m not the one who believes in unproven or magic medicine, I believe I’m in no need of any such medication.
Sasha wrote: “‘Wellness’ Thorpe:
They told me they got a homeopathic medicine just for you. But you gotta get off all your psychotropic meds first. Otherwise, too many interactions…”
Which typifies the abysmal standard of diagnosis and professionalism that is considered to be adequate within the alt-med empire.
No, it simply signifies how I, Sasha, choose to personally respond to dimwits. It says nothing about other acupuncturists, most of whom are too smart to engage on this blog.
I recommend you read up on logic. If tomorrow you develop intractable diarrhea, should I conclude that all pseudo-sceptics suffer from IBS.
Sasha – the faster you dig….
Just as you’re now disavowing what’s said on your own website in relation to homeopathy – hobbies, the craving for salt, the colour blue, bottom movements – are you later going to deny calling people ‘dimwits’ for having the audacity to disagree with you?
As was just said – why allow other people to write stuff about you and your personal beliefs without your knowledge?
Are you even dimmer than you think I am?
You’re not really Sacha Baron Cohen taking the mick are you?
No I am not Sasha Cohen. I called you a dimwit because that is what I think you are, not because you disagree with me. Something tells me I am not the first to do it…
In order to disagree, one needs to have valid arguments. It happens on this site but rarely and you are not one of those people. Keep trying though, we have hope for you…
If Sasha genuinely hasn’t visited the discussion for as long as claimed, then it’s possible that one or two threads may have slid by unnoticed. Among them that so many cultists, when questioned or asked to back up their claims with evidence, quickly descend to anger, childish tantrums, ad hominem attacks, name-calling, claims of impoliteness and aggression, etc.
The immature and hysterical use of the word ‘Inquisition’ here in relation to anyone who questions cultish beliefs and badly argued flim-flam plumbs new and somewhat disturbing depths. Apart perhaps from the recent occasion when somebody claiming to be a professionally trained doctor lost his rag and called the feller Ernst a ‘wanker’.
I believe someone pointed out a while back – Sasha will have missed it – that anyone such as Mel who is happy to have supporters adducing Tim Bolin in their defence has probably lost the plot anyway.
Yeah, sure thing, Thorpe. I think Mel’s left pinkie toe knows more about research than you.
Sasha-
Possible.
But – as Margaret Thatcher, Norman Tebbit, many Nobel Prize scientists, Michael Gove, Boris Johnson, etc etc show, ‘knowledge’ and ‘wisdom’ are not the same thing.
Of course, Barry. You have shown us lots of wisdom here. All we need to do is look at your posts…
@ Peter Deadman on Monday 13 June 2016 at 14:16
“Tut tut Frank, ‘command on language’ eh?”
Is that you best?
“But yes, I have to admit, you’ve rumbled us after all that work we put in trying to be respectable and pretending we’re treating people for their ills. The truth is out … we are cultists. But little do you know how far and wide our conspiracy spreads. We’ve signed up hundreds of thousands of doctors, physics and practitioners of all kinds plus hundreds of millions of patients from the teeming cities of China, Vietnam, Korea and Japan to tiny little clinics in the Outer Hebrides. Our cunning plan is simple – we’re going to wrest power away from Big Pharma, undermine orthodox medicine with our crazy ideas about treating the whole person and spread our insidiously effective medicine into every corner of the world.”
You went to the trouble of responding but did not answer anything I asked. You gave a logical fallacy, followed by nonsense, however, you failed to answer the question I asked; when was the last time you CURED anything, even an itchy arse will do?
@Frank Collins, you could do worse than to watch the interview with Peter Deadman referred to in this thread. Especially around 15 mins in or so, where he talks about expectations to ‘cure’ disease. I have to warn you though, you might find the whole thing disappointingly down-to-earth and pragmatic…
@Tom Kennedy
As I said in a previous comment on that interview, the first two minutes were enough for me to understand that the man is totally missing the goal. You say that there is interesting stuff around 15 mins into the hour long monolog so I watched several minutes around that time point and did not find anything of more value, This is a man rambling on trying to sound knowledgable and humble and warning, as you say for high expectations, promise of cure etc.
The Joker card in this game is the glaring awareness that all you acupuncturists are constantly avoiding, the obvious inference of collected evidence, that needling simply does not have any specific effect.
If you add this constant to the equation it can be solved, everything falls in place and suddenly all the speculations about difficult clinical situations, inconsistent effectiveness (yes, he talks about that in so many words) periods without effect of the intervention, which Deadman is going on about in this unstructured interview… all the oddities and inconsistencies he describes and is trying to explain away, become crystal clear.
The observed improvements and even the occasional happy cure, if you like, can easily be explained by other factors – mechanisms that we have discussed on this blog ad nauseam.
The big problem for you acupuncturists is that you are stuck in a limbo as long as you refuse to apply the only scientific approach applicable to this problem. You have to look at the cumulated evidence from decades of use and thousands of test and apply it to refuting the the null-hypothesis (that acupuncture is worthless). While you cannot verify that the null-hypothesis is wrong, then you have to accept the alternative[sic] hypothesis that acupuncture is not efficacious and any observed effect must be explained by other factors.
Of course you have to filter out and correct the equation for the noise of randomness. If you see an effect sometimes, that is not evidence of efficacy. That is evidence that sometimes things go that way, by chance or from other factors. That is why we use strict methods of trial design and statistical rigour.
We often explain this approach using the example of Santa Claus. You cannot prove that he exists because he does not exist. The only way of finding the truth is to try to refute the null hypothesis i.e. find him. If you fail that, you have to accept the alternative hypothesis, that he does not exist.
Let’s say for arguments sake that the efficacy of acupuncture does not exist… see my point?
Here’s the link again:
https://www.youtube.com/watch?v=TOhe1HdBgho
Could you explain and pinpoint more exactly what you find salient in this monolog Tom, and tell us why you find it important?
Bjorn, don’t you ever weary of your own pompous certainty? You think you embody the scientific mindset but it’s actually the opposite, because that requires an eternally open and questioning mind. You well embody the words of Alexander Pope (1688-1744), “Some people will never learn anything because they understand everything too soon.”
it would be nice, if you could, one day, post something that does not amount to a personal insult!
Bjorn, this is my last message to you as I really can’t be bothered, but can I point out to you that (completely unwarrantedly) you said I was a man who was “totally missing the goal”, that what I said was valueless, that I rambled on “trying to sound knowledgeable” etc. I would call that rude, no?
Oh the irony.
How many acupuncturists have ever investigated needling with a truly open mind? Open, that is, to the possibility that they have invested years of their life learning something that is simply wrong?
Prof. Ernst did a lot of careful and patient work trying to come up with ways of blinding acupuncture experiments. Is science is dogmatic and closed-minded because it wants to objectively test a claim rather than believing it as you do? I would say not. Science open-mindedly tested acupuncture and found a few striking things:
1. It does not matter where you put the needles.
2. It does not matter whether you actually insert them or not.
3. Evidence of any specific effect is elusive.
4. Evidence for the existence of qi or meridians (which are in any case inconsistent between traditions) is notable mainly by its absence.
So the response of the scientific advocacy community is: over to you. You want us to believe your schtick? You need to prove that it matters where you stick the needle. You need to show that actually inserting the needle makes a difference. You need to do this because the burden of proof for all claims, let alone extraordinary ones, lies with the claimant.
Open-mindedness starts with devising a test that could prove you wrong, and abiding by the result if it does. Show me any concrete example of any alt-med “researcher” who has ever done that.
Don’t go around demanding that everybody should be more “open-minded” and accept your dogmatic belief in something. Demanding that people accept claims with no clear basis in reality is not a plea for open-mindedness, it’s blatant special pleading. Demanding that people accept the claims of believers as equivalent to the objective tests of the unconvinced is no different.
Re Guys post: Now that is a response that models nearer to a true skeptic. Refreshing.
It is prudent to point out that I was not addressing Mr. Deadman as I do not engage in discussion with those who have demonstrated their inability to carry a useful dialog. He has given further proof for that in the preceding utterings.
I was simply using the example of the interview to illustrate how purveyors of useless healthcare methods are locked in total blindness for the possibility that they can be wrong. Of course they get all disturbed, angry and haughty, it is part of their psychologic defense mechanisms against defeat.
Tom Kennedy has hitherto shown due respect for the dialog so I gladly discuss with him but I do not dress my words to please anyone.
Bjorn
On another thread, you recently commented:
“Due to our dedication for seeking truth…”
“Now why am I even spending time writing this?… because I CARE!!! – That is my agenda”
Maybe you should find a nice dark room, and quietly contemplate the Pope quote. You certainly present yourself as being only dedicated enough to skim Wikipedia and YouTube, latch onto “confirmation of that which you already believe to be the truth”, and dig your heels in.
Or do you really believe you could get a good working understanding of something like Chinese medicine from a Wikipedia article? Do you really think you understand it well enough to come to definitive conclusions? Do you think you’ve gleaned enough to understand the terms, theories, and principles? Do you think Wikipedia is sufficiently thorough, or do you think there may be more to it than is on their site?
Based on your comments here and elsewhere on this blog, I’m not sure you even understand the difference between acupuncture and Chinese medicine.
I don’t know Peter Deadman, but here’s another guess for you (and it’s only a guess). I would guess that he has spent a good deal of time and effort studying Chinese medicine. I bet he even understands some of those books you say you can’t get through.
Someone dedicated to “seeking truth” would take this opportunity to ask people like Peter (and Tom) questions, clarify some possible misunderstandings, learn some terminology.
Or you could dig your heels in deeper. It’s funnier that way :).
@Björn Geir I felt Peter did a good job of explaining that acupuncture (and surely medicine of all kinds) is often not about complete ‘cure’, but more often about easing suffering and reducing symptoms. There are implications on this thread that only a ‘cure’ constitutes real medicine, which is why I referred to the interview.
I respect your opinion and your standing as a medical professional, but I share Peter’s feeling that you and many others here are too sure in your conclusions. Peter makes a good case I think in his post on June 16th that our collective understanding of how health and disease work are constantly shifting, and that an open mind is required from everyone in order to expand and learn. I try to employ that mindset, which has led me to concentrating on those conditions which, based on my clinical experience, respond best to my skill set. I have been disappointed and frustrated at my lack of success for certain conditions, and I explain that to prospective patients. Whilst you see ways of explaining away acupuncture’s apparent successes, I see many reasons why categorical ‘proof’ is hard to provide. For example, I get particularly good results with migraine headaches, but the active treatments in the trials I see for this condition generally bear very little in common with what I (or many other practitioners) would do in the clinic. And these are often people who have tried multiple alternative and mainstream approaches without success, so I don’t feel the ‘theatrical placebo’ argument accounts for what I regularly see. Anyway, never the twain shall meet I suppose…
All the best.
1) “I get particularly good results with migraine headaches, but the active treatments in the trials I see for this condition generally bear very little in common with what I (or many other practitioners) would do in the clinic”. in this case, it is the acupuncturists’ duty, in my view, to make sure that trials test the sort of approach you do in the clinic.
2) ” I don’t feel the ‘theatrical placebo’ argument accounts for what I regularly see”. how would you in the clinic feel a difference between a placebo response, the natural history of the condition and a specific therapeutic effect?
@ Tom Kennedy
Once, like most physicians at that time, I took acupuncture for granted, believed like most that there must be something to it since it was said to be widely used in China, even as anesthesia in open heart surgery and said to be effective for pain and all kinds of other problems even. I was very curious about what would turn out to be the scientifically proven mechanism of action. Being a surgeon I never found the need to delve into it myself but I worked with anesthesiologists and others who did. All kinds of ideas flourished as to why this invasive intervention worked – most if not all took for granted it did, at that time.
The ‘Gate theory’ was very talked about and sounded like a very likely explanation so few questioned the likelihood of efficacy. But the technique seemed difficult and tricky. Doctors were in those days very open minded towards acupuncture because, believe it or not, we want to have and use tools that work, however proven or likely. If someone gave me a magic wand to wave over someone in pain and it would clearly take away or soothe pain without doubt, I would bl..y well use it daily! Producers of such wands would also profit enormously, patent or no patent.
Most physicians do not mind if what they use is expensive or cheap, simple or complicated, patented or not as long as it can help their patients effectively and safely. Many doctors, especially anesthesiologists and others involved in pain management, laid down time and effort to learn these methods properly and apply them.
But how is the situation today? Only a very small handful of people with MD degree’s still use acupuncture in practice. If you find one it is probably a religiously devout admirer of mystical “oriental” medicine in general and probably not more than marginally involved within the conventional medical system anymore. Acupuncture is for all practical purposes a totally ‘alternative’ medical product.
In my work I come into contact with many senior anesthesiologists and I have asked many of them if they ever use AP. Surprisingly, most say they did before but none of them still do. When asked why, the response is often preceded by an awkward, short silence and you always sense a subtle embarrassment when they explain that they found it difficult and unpredictable and that they simply have better, more reliable and dependable methods.
You said Tom:
I am not sure Tom, if you have a working insight into medicine (the “conventional” kind if you like) Medicine works both with cures and palliation, as the situation demands and allows. Medicine is neither complete nor infallible. We work with what we have and we work hard at eliminating the limitations. We often cure but when we cannot we palliate and we use any means available and effective.
When you say “medicine of all kinds” I take it that you imply there are different kinds of medicine. There is only one kind of medicine, the one that works. If acupuncture really worked, if it was efficacious and effective in practice it would be part of (conventional) medicine by now. The process of adopting methods, means and medications into (conventional) medicine does not always happen through the scientific process, not in the beginning at least. Even methods that have gained acceptance can later be thrown out when found lacking in efficacy, whether from scientific scrutiny or b other critical means. See for example many surgical techniques. This is what we call progress.
Acupuncture has in effect failed this test. In the eighties and nineties it was accepted and applied by many MD’s and it would have continued on that path and become part of the normal, conventional arsenal of medicine had it held up to the test of practice and time.
Later trials have, as we have so often discussed here, not confirmed efficacy and they have failed to demonstrate effectiveness beyond what can be expected from the profound effect of a theatrically impressive, invasive but ineffective methodology.
If you on top of these facts add a scrutiny of its history (try searching for Ben Kavoussi on sciencebasedmedicine.com for example) and the total inconsistency of technique, i.e. the confusion regarding location of meridians and points where tens of different “schools” describe them all over the body (except for the genitalia?).
Taking all these different easily confirmed facts into account, it is impossible to come to any other conclusion than acupuncture must be a grand ‘misunderstanding’ from the beginning.
Do you mean the link I posted of Deadman giving excuses why acupuncture did not work?
Frank, I don’t know what your profession is but most medical practitioners – whatever type of medicine they practise – are deeply realistic about the power of medicine to cure patients, especially for long-term chronic conditions. It’s true that for some conditions, surgery and orthodox medicine achieve high rates of cure but I would say that accounts for a minority of disorders. In the most part, medicine can delay progression, make partial improvements and alleviate symptoms at best. For me to reflect that acupuncture is the same, is not the same as saying that acupuncture doesn’t work, any more than a diabetic patient losing a limb despite orthodox medical treatment suggests that orthodox medicine doesn’t work. It may be reassuring to you to hold to a position that conventional medicine offers shining and proven certainty against the uselessness of every other approach to healing but that’s just a fantasy. Recognising the limits of medicine is a priority in a world facing an epidemic of non-infectious chronic disease. No health service will be able to cope with the expected doubling or trebling of incurable CVD, diabetes, cancer, dementia, depression, strokes etc. expected in the next 2 or 3 decades, and we need to look at broader approaches to wellness and disease. That’s why I’ve spent two years writing a book on the 2500 year old Chinese tradition of disease prevention and health maintenance. I’ve covered many different teachings from this tradition and matched them against several decades of lifestyle research. I suspect that if you and your fellow gold-plated sceptics had the open-mindedness to read and discover the depth of wisdom in this tradition, your certainties might start to waver.
@ Peter Deadman on Saturday 18 June 2016 at 08:30
Before I start, may I ask for you to try to adhere to that most simple of expedients in presenting an argument; the use of paragraphs, please? The mess, above, seems indicative of your thinking.
“Frank, I don’t know what your profession is”
Red herring, and pointless. What if I was a forklift driver (no disrespect intended to forklift drivers, of course.)? Would it matter? In fact, I have described my occupation as such to some people because they were so far up themselves I could not, and would not, be bothered in such a tawdry display of one-upmanship with them, particularly if they were lawyers, for whom (generally) I have so little regard. So, in this regard, you are on equal footing with the tax lawyer across the street, who I regard as attempting to legitimise corporate theft from fellow citizens; both seeming to have equal disregard for morality and ethics.
“but most medical practitioners – whatever type of medicine they practise – are deeply realistic about the power of medicine to cure patients, especially for long-term chronic conditions.”
Red herring and non-sequitur. The point, which you so obviously wish to shroud, is that medicine can and does cure illnesses; you don’t. Here is a list of chronic diseases from this website (chosen at random):
https://www.medicalschemes.com/medical_schemes_pmb/chronic_disease_list.htm
Addison’s disease
Asthma
Bronchiectasis
Cardiac failure
Cardiomyopathy
Chronic obstructive pulmonary disorder
Chronic renal disease
Coronary artery disease
Crohn’s disease
Diabetes insipidus
Diabetes mellitus types 1 & 2
Dysrhythmias
Epilepsy
Glaucoma
Haemophilia
Hyperlipidaemia
Hypertension
Hypothyroidism
Multiple sclerosis
Parkinson’s disease
Rheumatoid arthritis
Schizophrenia
Systemic lupus erythematosus
Ulcerative colitis
Bipolar Mood Disorder
What does acupuncture do for any of these, apart from some short-term placebo? Medicine, however, is making progress in many of them and the recent research in auto-immune diseases looks promising. Does acupuncture restore the eyesight of glaucoma sufferers? I could go on, but the picture is clear.
“It’s true that for some conditions, surgery and orthodox medicine achieve high rates of cure but I would say that accounts for a minority of disorders.”
Hmmm, “a minority of disorders”? What do think of that, Prof?
I suggest those people with those afflictions would have comfort their diseases have been cured, rather than continuing to suffer with needles being pointlessly jabbed in them, in some primitive display of witchcraft. Medicine (not “orthodox medicine”, as you so wrongly describe it) appears, to have a quite reasonable record of prevention, as well as cures. While appreciating the stupidity of the general public of wanting antibiotics for chapped lips in this age of narcissism (fancy you getting another mention), there are no outbreaks of epidemics which wiped out significant proportions of the world’s population. No more plagues or smallpox or many others. Did acupuncture do that?
“In the most part, medicine can delay progression, make partial improvements and alleviate symptoms at best.”
Yes, very true, however, you left out the most important part; medicine continues (if adequately funded) to find answers with the only proven technique available – the application of science.
“For me to reflect that acupuncture is the same, is not the same as saying that acupuncture doesn’t work, any more than a diabetic patient losing a limb despite orthodox medical treatment suggests that orthodox medicine doesn’t work.”
The crucial distinction here, which you have conveniently ignored, is that the person (not a patient) is alive, albeit without a limb with a treatment to control their condition to not lose another limb. The treatment may not be successful but acupuncture will do nothing either.
“It may be reassuring to you to hold to a position that conventional medicine offers shining and proven certainty against the uselessness of every other approach to healing but that’s just a fantasy.”
No, I didn’t say or imply that. When a treatment offers a evidence of being part of the medical arsenal of countering our biological weaknesses, it becomes part of medicine. Acupuncture doesn’t, which addresses the last part of your contention.
“Recognising the limits of medicine is a priority in a world facing an epidemic of non-infectious chronic disease”
You say this as if medicine doesn’t recognise and understand this problem. Trying to address a real medical problem with a non-medical, non-proven application is without reason.
“No health service will be able to cope with the expected doubling or trebling of incurable CVD, diabetes, cancer, dementia, depression, strokes etc. expected in the next 2 or 3 decades, and we need to look at broader approaches to wellness and disease.”
“Broader approaches” does not mean approaching real problems with unreal solutions. As I said, when you can cure any single disease with sticking needles in people is when we can look at finding other diseases to cure with it. Come up with the first cure and then we can proceed to find others. (I really didn’t want to say this, because it should not be necessary but, without a first, there is nothing.)
“That’s why I’ve spent two years writing a book on the 2500 year old Chinese tradition of disease prevention and health maintenance. I’ve covered many different teachings from this tradition and matched them against several decades of lifestyle research. I suspect that if you and your fellow gold-plated sceptics had the open-mindedness to read and discover the depth of wisdom in this tradition, your certainties might start to waver.”
Appeal to Antiquity; and really, really stupid. Then again, you have dedicated your life to stupidity, rather than the scientific method. I do wonder whether your life may have been better lived 100 years earlier when a preventable disease may have ended it. Consider your good fortune that you are, more than likely, alive because of the medicine you rail against. (I might not be debating a silly argument with someone who despises the reason they can.)
The reason I ask, Frank, has got nothing to do with one-upmanship but that I suspect modern modern looks much shinier and more effective from the outside than the inside. In your case, you seem to be badly misinformed. I have great respect for orthodox medicine but of that list you give, very few are curable by modern medicine, and iatrogenesis (preventable harm arising from medical treatment or advice) is estimated to be the third most common cause of death in the United States after heart disease and cancer, with nearly a quarter of a million people a year dying as a result of treatment.
“you seem to be badly misinformed”
?????
http://edzardernst.com/2016/06/acupuncture-a-new-white-paper-turns-out-to-be-a-white-wash-ignorance-or-fraud/
@ Peter Deadman on Sunday 19 June 2016 at 20:59
I repeat:
“Before I start, may I ask for you to try to adhere to that most simple of expedients in presenting an argument; the use of paragraphs, please? The mess, above, seems indicative of your thinking.”
Deadman:
“The reason I ask, Frank, has got nothing to do with one-upmanship but that I suspect modern modern looks much shinier and more effective from the outside than the inside.”
Another false assumption, however, the Argument from Antiquity is an established Logical Fallacy. You may think you are “on the inside” when it couldn’t be further from the truth. What you do has nothing to with medicine or saving lives (well, apart from your own pecuniary life).
Deadman:
” In your case, you seem to be badly misinformed. I have great respect for orthodox medicine but of that list you give, very few are curable by modern medicine,”
Do you not read what I write, or do you suffer badly from cognitive dissonance?
Deadman:
“and iatrogenesis (preventable harm arising from medical treatment or advice) is estimated to be the third most common cause of death in the United States after heart disease and cancer, with nearly a quarter of a million people a year dying as a result of treatment.”
This hoary old nonsense again. The Prof has addressed this many times, but I don’t think you pay attention when you don’t see what you want to see, in the same way, you have avoided addressing the questions I raised.
Frank Collins, our old friend!
ThIs is way too funny, I went on EE site to see if there’s any discussion of latest meta analysis of acupuncture by Andrew Vickers, TIME just had an article on it. Instead, one of the first comments I see is you Frankie! Calling me a dunderhead and jm’s “puppet master”.
I don’t know about jm but I certainly seem to be YOUR puppet master. The last time I commented on this site was AT LEAST a year ago and I am still in your head. Probably because, if I remember correctly, I suggested that you should leave your mother’s basement and see the world. Sorry.
You still seem to have too much free time on your hands. May I suggest meditation? It really helps to clear the head. May even help to get me out of it. Something tells me you won’t go for it, though…
Anyways, would be interesting to get a reaction from others on Vickers’ analysis. Looks like verum is outperforming sham even. Oh no, the last vestige of acupuncture sceptics is slipping away!
Don’t worry Frank, we won’t be expecting input from you. Looks like you’re still learning grammar or how to make a point without cursing…
@ Sasha on Thursday 30 June 2016 at 22:00
“Frank Collins, our old friend!”
Hmm, I didn’t realise this blog was intended as a means of making “friends”; I always thought it was for the Prof to provide comment on the type of nonsense you espouse without evidence.
“ThIs is way too funny, I went on EE site to see if there’s any discussion of latest meta analysis of acupuncture by Andrew Vickers, TIME just had an article on it. Instead, one of the first comments I see is you Frankie! Calling me a dunderhead and jm’s “puppet master”.”
Dunderhead? I must have been feeling particularly charitable that day. I thought of insulting you but, instead, a compliment. What was I thinking?
“I don’t know about jm but I certainly seem to be YOUR puppet master. The last time I commented on this site was AT LEAST a year ago and I am still in your head.”
The reason I remembered you is because of interchange between you and jm about acupuncture; it was nearly as funny as the scene in the Life of Brian about the People’s Front of Judea and the Judean People’s Front. I really laughed out loud at the ridiculous nature of a discussion about which (witch?) part of the witchcraft is right. I will remember it for a while to come. I love good comedy and that was solid gold.
“Probably because, if I remember correctly, I suggested that you should leave your mother’s basement and see the world. Sorry.”
I did point out I haven’t resided with my mother for over forty years but I am expecting too much for something as basic as that to sink in with you. After all, you do believe there is some mystical energy moving around the human body but which is undetectable by modern science. Science has been able to detect gravity waves, the last vestige of relativity undetected, but this mystical energy cannot be found. Maybe those physicists would have been better directed to design and fabricate an instrument to detect this energy. Perhaps it could power the first human journey to Mars given it is so ubiquitous and powerful, or use to to power CERN and find more particles, or even create power plants to power cities. The possibilities are limitless.
Then again, it might be a complete waste of time, money and effort………………………………………….
“You still seem to have too much free time on your hands. May I suggest meditation? It really helps to clear the head. May even help to get me out of it. Something tells me you won’t go for it, though…”
No, I prefer to spend my spare time doing something useful, such as voluntary work at the cancer charity helping with research. I have other interests, like building hifi speakers and associated electronics, music servers, and working my dog. I only think of you when I need a good laugh, and it works every time. Thank you.
“Anyways, would be interesting to get a reaction from others on Vickers’ analysis. Looks like verum is outperforming sham even. Oh no, the last vestige of acupuncture sceptics is slipping away!”
If you are going to hang your hat on that, good luck. Frank Odds has already torn it another anus, to use the crass vernacular. Being mentioned in Time is only recognition that journalists, not unlike lawyers, know nothing about nearly everything. If it is so groundbreaking, why has it not torn the scientific community asunder? Two guesses.
“Don’t worry Frank, we won’t be expecting input from you. Looks like you’re still learning grammar or how to make a point without cursing…”
I’ll do you a deal; you learn science and I’ll learn grammar? While you are at it, also lookup Argument from Antiquity, Tu Quoque and Ad Hominem.
So much self-assurance and so little substance but, at least, you do provide people here with a good laugh.
That remark about Dr. Ernst maybe having a “personality disorder” was quite amusing; it reminded me of what my chiropractor brother said when I disagreed with him about chiropractic being a science which, of course, it is not: He said I was “mentally unstable.” So you have all my sympathy, Dr. Ernst, this seems to be what pseudoscientists resort to when they can’t answer hard questions about the scientific basis of their claims.
You wanker
THANK YOU!!!
http://edzardernst.com/2012/12/ad-hominem-attacks-are-signs-of-victories-of-reason-over-unreason/
IS THAT YOU?
Dr. Keown received a degree in medicine from Manchester University in 1998 and has worked continuously as a registered doctor since. He currently works in the Homerton hospital in Hackney where he is in the process of introducing acupuncture to the Emergency department.
In 2008 he completed a degree in Chinese Medicine and Acupuncture from the College of Integrated Medicine affiliated with Kingston University, and has been a member of the British Acupuncture Council since. In 2010 he studied alongside the renowned Dr. Wang Ju-Yi at the Institute of Channel Diagnosis in Beiing. Currently Dr. Keown uses a form of acupuncture that is based heavily on the work of Dr. Wang Ju-Yi. He has found this to be the most consistent form of acupuncture and has often amazed his medical colleagues with the results this can give.
Dr. Keown is the author of the popular, newly-released book The Spark in the Machine: How the Science of Acupuncture Explains the Mysteries of Western Medicine.
If Dr Daniel Keown is not the person who was abusive, he must immediately make that clear lest he is inadvertently accused and even reported to the GMC.
If the Daniel Keown who expressed himself so eloquently is a registered medical practitioner he has behaved unethically, unprofessionally, and his fitness to practice might have to be questioned.
More on the history and practice of acupuncture in my own book, ‘Real Secrets of Alternative Medicine’!
I have ‘often amazed my colleagues’ with magic! But then, I admit, there are in reality, no magic forces.
Richard
There is a Daniel James Patrick Keown on the GMC’s LRMP whose qualifications are given as ‘MB ChB 1998 University of Manchester’, so it would appear to be him. His current status is ‘Registered without a licence to practise’.
I believe we have recently encountered Mr. Keown here on this blog.
So we have!
Did I read that correctly? That Dr Keown is in the process of introducing acupuncture into the Emergency department of a hospital? Truly, this is the Mitchell and Webb ‘Homeopathy A and E sketch come to life.
I understand that acupuncture is being used in ER care in hospitals in australia and israel and is currently being trialed in the US. The necessary audits have shown good levels of satisfaction for pain relief. FYI the US army , not normally known for their acceptance of whacky stuff, has been using acupuncture for battlefield care for some years. Basically because it is effective and does not cause dangerous sedation. Acupuncture is not the same as homeopathy and it makes no sense to conflate these two entirely different forms of medicine. There are roughly 28,000 research papers in print on acupuncture, including numerous mechanism studies published in lead academic neuprophysiology journals such as Brain Research. Its actually a little absurd to see one rather old physiotherapy professor disagree with hundreds of PhD level scientists around the world, especially when the evidence for physiotherapy itself is not exactly great. When are we going to see Prof Ernst reprint the research showing physio to be scientifically dubious?
Charlie-
If you seriously believe the US Army is not known for its wacky beliefs/ experiments in this area, I suggest you look into it all a little more deeply. It’s a bit disingenuous also to skip past other ‘alternative therapies’ they’re said to be using apart from acupuncture. At this rate they’ll soon catch up with the cutting-edge homeopathic treatment being used by the Indian Army.
@charlie
“FYI the US army , not normally known for their acceptance of whacky stuff…” LOL! For a start try reading Jon Ronson’s The Men Who Stare At Goats.
Veterans’ Administration hospitals are awash with CAM, including homeopathy. Google “Integrative medicine invades the US military” for three articles from science-based medicine giving full details.
” FYI the US army , not normally known for their acceptance of whacky stuff”
HAHAHAHA That’s actually a good one ! You are ridiculous… And then appeal to popularity ‘people use it so it work’ ‘people have done reseach on it so it work’. Maybe you should closer at what those research paper says… You will be surprised.
Five days and no answer…………………..
Too busy wan…………………………………………………….perhaps?
Frank Collins-5 days or 50, makes no difference. It was an astonishing display of vitriolic,stupid, puerile aggression. As I said many times, alt meds are often their own worst enemies. The difference here is that the fellow Keown was touted by them as a prize example of a qualified doctor who had been won over to the Wooside. He as truly urinated on his own fried potatoes here. Who apart from a cultist could possibly take him seriously now.?
It took a while to get an answer, but I finally got a reply from Homertom Hospital NHS Trust. I asked them:
They replied today:
Perhaps Keown needs to update his website?
WELL-DONE ALAN !!!
Alan Henness-
The childishly abusive Dr Keown’s ‘clinic’ in Tunbridge Wells has a name straight out of ‘Thunderbirds’ – ‘Space 21st Century Acupuncture’ indeed. The fact that early on he makes a supportive comment about the absurd Gwyneth Paltrow and her advocacy of ‘cupping’ does not augur well.
Maybe he should as suggested update his details.
My ex-local Indian in North London still has in its window a rave review from the 1980s. Whether it’s still valid now I leave to the public.
He claims that while ‘Western’ medicine is better for emergency and life-threatening situations, ‘Chinese’ medicine is better for general health and ‘wellness’ or whatever.
If I’m correct in my belief that the Colin who raises his homeopathic head on this blog is indeed the one I encountered previously, on ‘Quackometer’, then I think I’m right in saying that he used to be in the Police Force.
He wouldn’t answer my question back then on whether he ever attended a serious road traffic accident in response to the emergency call ‘For pity’s sake, is there a homeopathic policeman available to save lives here?’
But then perhaps Keown has answered that one for us.
@daniel keown,
“No causal relationship is known between masturbation and any form of mental or physical disorder.[3]”:
https://en.wikipedia.org/wiki/Masturbation
I posted two of the comments that Ernst quoted. In one, I commented that the two American editors of FACT are quack busters and one seems to have had an extremely dodgy career. I find it extraordinary to choose editors for a complementary medicine research journal whose perspective is by definition to debunk it. I’m sure no biomedicine journals would employ people of this kind.
I also suggested that Ernst may have a personality disorder. This is based on the numerous times he has demeaned and insulted people who comment on his blog and then denies that his response was rude. The rudeness and arrogance ithemselves are bad enough but then denying it is more worrying. In my personal encounters I find that people who behave like this do have personality disorders.
You are obviously a quack. Only a quack would diagnose a person without meeting them in a clinical setting. Only a quack would discuss their diagnosis of that person in public.
Quack [noun]: a person who dishonestly claims to have special knowledge and skill in some field, typically medicine.
Careful budy, you look like someone with a personality disorder. Only a truely deranged person could do such a rude and non-sensical diagnosis through internet post.
Seems? Only if you believe the word of nutters. Are you familiar with Ernst’s Law? If you are writing about alternative medicine and the quacks do not hate you, then you are doing it wrong. If one has had a long history of effectively challenging the claims of charlatans then one will become the focus of increasingly insane rants from the alternative community.
Stephen Barrett, for example, has attracted almost stalker-level attention. Tim Bolen is one of the more obvious perpetrators. Bolen is a crank and a pathological liar. Barrett is not alone, though – David Gorski of Science Based Medicine is now suffering a spiteful and deranged campaign of harassment and defamation from Mike “Health Danger” Adams, and Prof. Ernst attracted the opprobrium of no less a personage than HRH Prince Charles, the well known homeopathy apologist.
The existence of criticism from the crankosphere does not confer legitimacy on that criticism.
And it seems they hope we will somehow be fooled by their sleight of hand into thinking that the vitriol, ad homs and law suits are replacements for good evidence for whatever quack claims they were making in the first place…
Doc Dale’s reply to my polite request for more information on a claim he made is, sadly, to be expected, and par for the course. I had an even more huffingly puffingly stroppy one from a homeopathy cultist who’d made claims about homeopathy’s magnificence in combating an outbreak of yellow fever in Cuba, and -a popular myth this, as I’m sure you know — a typhoid epidemic in Victorian London.
I could find no evidence to back up said claims, so returned to the cultist for further assistance. At which point he rather angrily instructed me that ‘The evidence is all there. Look it up. I’m not doing your work for you’.
Albeit that a keen intellect will have spotted that he was demanding that I do HIS work for HIM.
LOL, pseudo skeptics are so predictable. You would fit nicely with the TQCS group. Take care.
That your best shot?
By the way – and I’m aware of your disdain for evidence, so I shan’t hold my breath – but is there any chance you could explain what you – and many others – mean by this odd, unnecessarily inflated term ‘pseudo skeptic/sceptic’? The ‘pseudo’ part implies someone who tries to pass him/herself off as something he/she isn’t. But I think it must be readily apparent that I am indeed proud to be a genuine sceptic -I’m not pretending to be one, I AM one. So what then does ‘pseudo sceptic’ mean?
Take care!
Based upon your comments above: I posted with anger, I’m a member of a cult, I have a disdain for evidence, etc, gives indication that you fulfill enough characteristics to be considered a pseudo skeptic. TQCS are full of them, hence, you will fit in nicely with that group.
Marcello Truzzi attributed the following characteristics to pseudoskeptics:
Denying, when only doubt has been established
Double standards in the application of criticism
The tendency to discredit rather than investigate
Presenting insufficient evidence or proof
Assuming criticism requires no burden of proof
Making unsubstantiated counter-claims
Counter-claims based on plausibility rather than empirical evidence
Suggesting that unconvincing evidence provides grounds for completely dismissing a claim
He characterized “true” skepticism as:
Acceptance of doubt when neither assertion nor denial has been established
No burden of proof to take an agnostic position
Agreement that the corpus of established knowledge must be based on what is proved, but recognising its incompleteness
Even-handedness in requirement for proofs, whatever their implication
Accepting that a failure of a proof in itself proves nothing
Continuing examination of the results of experiments even when flaws are found
Doc Dale,
“‘Pseudoskepticism’ is most often used as a loaded term by woo-promoters to dismiss skeptical criticism of their beliefs as unfounded. Some promoters of woo maintain that demanding evidence before accepting an idea is an extreme position, and they feel that we should all be agnostic about, well, everything.”
http://rationalwiki.org/wiki/Pseudoskepticism
Yep, misuse of the term happens as well. If Barrie is a “true” skeptic this will be evident in his posts. I have yet to see that but rather indications of the opposite. The closest I’ve seen to a “true” skeptic here is Guy….the rest, well, your posts speak for where you lie upon the continuum of pseudo skepticism towards “true” skepticism.
Doc Dale, Regarding medicine, I don’t need to be a “true” skeptic. People don’t read this website then start wondering “Who provides the best medical advice, my GP and the Chief Medical Officer for England, or Doc Dale?”
Pete: “Doc Dale, Regarding medicine, I don’t need to be a “true” skeptic. People don’t read this website then start wondering “Who provides the best medical advice, my GP and the Chief Medical Officer for England, or Doc Dale?””
Pseudo skepticism has more to do with the persons mindset.
@ Charlatan Dale on Saturday 11 June 2016 at 12:44
“LOL, pseudo skeptics are so predictable. You would fit nicely with the TQCS group. Take care.”
Start with poor English, fit an insult in the middle, and finish with a false sincerity. Hmm, about par for you.
By-the-way, is this you? http://www.dalefamilychiropractic.com/page/doctorBio.html
Not-a-Doc Dale,
Are you going to answer this simple question;
“is this you? http://www.dalefamilychiropractic.com/page/doctorBio.html“
Frank: Are you going to answer this simple question;
“is this you?
If the answer becomes pertinent to a conversation I may answer the question.
@ Not-a-Doc Dale on Monday 04 July 2016 at 19:07
“Frank: Are you going to answer this simple question;
“is this you?
If the answer becomes pertinent to a conversation I may answer the question.”
It is particularly pertinent because that website makes many claims, about chiropractic, for which there is no evidence and others which have been rejected by chiropractic professional bodies. In light of refusal to deny, a safe assumption it is you.
However, to be fair, I await your denial.
Frank: It is particularly pertinent because that website makes many claims, about chiropractic, for which there is no evidence and others which have been rejected by chiropractic professional bodies.
The claims may be pertinent, but who in particular presented them, at this point, is not.
@ Not-a-Doc Dale on Tuesday 05 July 2016 at 13:33
“Frank: It is particularly pertinent because that website makes many claims, about chiropractic, for which there is no evidence and others which have been rejected by chiropractic professional bodies.
The claims may be pertinent, but who in particular presented them, at this point, is not.”
Too cute, however, as much as you try to deflect it, it is you and the prof can confirm it.
The pertinence relates to you arguing that the science backs chiro when, clearly, you engage in practices with no scientific basis and which have been disowned and discredited by chiro “professional” bodies. As I asked elsewhere;
1. Why do you treat kids when it has been widely condemned and deemed unnecessary?
http://www.dalefamilychiropractic.com/page/1testimonials.html (treating a four day old/)
http://www.dalefamilychiropractic.com/experts/3.html
http://www.dalefamilychiropractic.com/nyk/templates20/shared/kidsnchiro.html
2. Why do subscribe to subluxations?
http://www.dalefamilychiropractic.com/experts/5.html
3. Why do you make claims about treating conditions for there is no evidence?
http://www.dalefamilychiropractic.com/page/articles.html
I’ll leave out your constant references to God which, in itself, is enough to render your views unsustainable.
Frank: Too cute, however, as much as you try to deflect it, it is you and the prof can confirm it.
Are there any claims I have made within EE blogs that you wish to challenge?
If not, I prefer to focus my attention on Guy and Bjorns posts as thus far they are the only two who consistently share anything really worth reading.
@ Not-a-Doc Dale on Wednesday 06 July 2016 at 12:21
“Are there any claims I have made within EE blogs that you wish to challenge?”
Yep, any and all that posit chiro has any reason for existing.
“If not, I prefer to focus my attention on Guy and Bjorns posts as thus far they are the only two who consistently share anything really worth reading.”
Of course you do, because you prefer to attack as a defensive mechanism for your inability to defend the indefensible.
Now, please would you please offer an explanation as to why you engage in the points made below?
“The pertinence relates to you arguing that the science backs chiro when, clearly, you engage in practices with no scientific basis and which have been disowned and discredited by chiro “professional” bodies. As I asked elsewhere;
1. Why do you treat kids when it has been widely condemned and deemed unnecessary?
http://www.dalefamilychiropractic.com/page/1testimonials.html (treating a four day old/)
http://www.dalefamilychiropractic.com/experts/3.html
http://www.dalefamilychiropractic.com/nyk/templates20/shared/kidsnchiro.html
2. Why do subscribe to subluxations?
http://www.dalefamilychiropractic.com/experts/5.html
3. Why do you make claims about treating conditions for there is no evidence?
http://www.dalefamilychiropractic.com/page/articles.html”
You do love the moniker “Doc” and you use it at every opportunity on your website, one which advertises and promotes abject nonsense. If you can’t defend it, why do it?
Doc Dale: “Are there any claims I have made within EE blogs that you wish to challenge?”
Frank: Yep, any and all that posit chiro has any reason for existing.
Doc Dale: I see, you are one of those people.
Doc Dale: “If not, I prefer to focus my attention on Guy and Bjorns posts as thus far they are the only two who consistently share anything really worth reading.”
Frank: Of course you do, because you prefer to attack as a defensive mechanism for your inability to defend the indefensible.
Doc Dale: My impression is that they may have the intellect and enough objectivity to have a civil conversation. Future dialogue will tell me if I’m correct.
Pete Attkins –
Pretty well as I thought then.
Doc Dale did a superficially convincing job of copying some stuff off the Internet. But I think the reality is that most people like sticking ‘pseudo’ in front of ‘sceptic’ the way they like ‘pseudo intellectual’ instead of the often appropriate ‘intellectual’. It’s a way of giving away more than you realise about yourself.
It joins a number of words and phrases like ‘modalities’ ‘awesome modalities” Big Pharma’, and ‘pals’, as in the sneering ‘You and your medical pals’. I normally stop reading whenever I spot one of those looming.
Frank Odds –
Of course, the Ronson book was high on my list of recommendations for Charlie. I figured he’d find it eventually, providing he’s not so caught up in the Web of Daftness that he’s too scared to look around him.
Doc Dale and others – Let’s try to narrow the definition of ‘skeptic’.
I’m not a sceptic in the sense that – say-if someone posits the notion, as homeopaths do, that a substance becomes stronger the more you dilute it, then I’m going to sit there stroking my chin and saying ‘I never thought about it that way. I very strongly doubt it, but I suspect it deserves investigation, even though I think it’s probably nonsense . Let me give you the benefit of doubt though. Leave it with me to think about it for a few days, for this is a difficult notion for modern science. I shall commission tests in order to prove if your idea is scientifically justified’. I’m equally not sceptical about the idea that the Earth is the centre of the Universe either. It just isn’t.
This would not even approach the intellectual rigour of Isaac Asimov’s ‘I cannot prove that God does not exist, but so strongly do I suspect that he does not, I live my life accordingly’.
As to the feller Truzzi – he was a good goalkeeper once, but I think he’s out of his depth viz this one.
Granted, he is one side.. Nonetheless, he lays out his views.
The third approach, which I’ve tried to empower and legitimate, is the zetetic. Zetetic is an old word coming from the Greek followers of the skeptical philosopher, Pyrrho. The main feature of this approach is to emphasize the communal norm of skepticism present in the scientific community. By skepticism I would like to strongly distinguish between doubt and denial. Doubt is the skeptical approach; the debunker’s approach is denial. True skepticism which is a part of science consists of doubt preceeding inquiry, and that essentially takes the position of non-belief rather than of disbelief. The main elements of the zetetic approach are: firstly, ignorance; secondly, some doubt; thirdly, an emphasis upon inquiry. Charles Sanders Peirce required that the first and primary obligation of any philosopher or scientist is to do nothing that would block inquiry. This approach involves a general acceptance of what Mario Bunge calls methodism, on science as method, not science as some established absolute body of knowledge.
http://amasci.com/weird/truzzi.html
How much inquiry do you require before doubt turns into denial? Extraordinary claims require extraordinary evidence, etc. (Old saying: don’t leave your mind so open that your brain falls out.)
Frank: “How much inquiry do you require before doubt turns into denial?”
It’s more a weighing of probability and possibility, not denial.
Dale: when the probability approaches zero, what is the difference between doubt and denial?
Frank: “Dale: when the probability approaches zero, what is the difference between doubt and denial?”
Probability: I doubt this is true but any new evidence can be considered which may or may not change the probability of it being true.
Denial: I know this is not true and any new evidence can only confirm that it’s not true or be dismissed as bad evidence.
Doc Dale has illustrated the fact that alt-med apologists do not begin to understand the fundamental difference between epistemic probability and ontic probability.
@ Pete Attkins on Tuesday 14 June 2016 at 20:25
“Doc Dale has illustrated the fact that alt-med apologists do not begin to understand the fundamental difference between epistemic probability and ontic probability.”
I don’t disagree with what you have written BUT please do not address this flog as doctor. He has a fake degree, premised on woo. Do not feed his insurmountable ego.
Frank Collins-as far as I recall I don’t call him ‘Doctor’, but simply ‘Doc Dale’ as he styles himself. I have never thought of him as a ‘doctor ‘ -not unless the qualification standards are shockingly low. If anything I’d thought it was a joke to do with the great Diick Dale. which it may be.
Frank, I had mistakenly assumed that it was short for doctor (angling): an artificial fishing fly.
All you guys are accomplishing is the affirmation that you are a bunch of pseudo skeptics…which is kind of humorous considering how this started.
And what has Doc (angling) Dale managed to accomplish by fishing in the wrong pond?
Pete Attkins –
Judging by his large family, his ‘qualifications’ and ‘degrees’, ‘Doc’ Dale has managed to ‘achieve’ quite a lot it would seem. Mostly built on sand, but then it seems there enough people out there willing to believe in this type of building practice. Im glad he didn’t build MY house.
I’m just hanging out waiting to see if a true skeptic shows up (but apparently they don’t have an interest in what Ernst has to say…and I am beginning to see why).
@ Doc Dale on Wednesday 15 June 2016 at 18:38
“All you guys are accomplishing is the affirmation that you are a bunch of pseudo skeptics…which is kind of humorous considering how this started.”
I don’t know about being “pseudo skeptics (sic)”, however, it must be better than being a pseudo-doctor.
Frank: I don’t know about being “pseudo skeptics (sic)”, however, it must be better than being a pseudo-doctor.
A “pseudo-doctor” would be one who holds him or herself out to have obtained the educational/legal requirements for that field when they have not done so. So yes, I agree, a “pseudo-doctor” would be worse than the simple annoyance of a pseudo-skeptic.
A first-professional degree is an award that requires completion of a program that meets all of the following criteria: (1) completion of the academic requirements to begin practice in the profession; (2) at least 2 years of college work prior to entering the program; and (3) a total of at least 6 academic years of college work to complete the degree program, including prior required college work plus the length of the professional program itself.
Doctor of Chiropractic (D.C. or D.C.M.)
Doctor of Dental Science (D.D.S.) or Doctor of Dental Medicine (D.M.D.)
Doctor of Jurisprudence or Juris Doctor (J.D.)
Doctor of Medicine (M.D.)
Doctor of Optometry (O.D.)
Doctor of Osteopathic Medicine/Osteopathy (D.O.)
Doctor of Pharmacy (Pharm.D.)
Doctor of Podiatric Medicine/Podiatry (D.P.M., D.P., or Pod.D.)
Doctor of Veterinary Medicine (D.V.M.).
https://www2.ed.gov/about/offices/list/ous/international/usnei/us/professional.doc
Pseudo-doctor [noun]: a person who practises licence without a medicine 🙂
@ Dale on Sunday 19 June 2016 at 13:50
Dale:
“Frank: I don’t know about being “pseudo skeptics (sic)”, however, it must be better than being a pseudo-doctor.
Doctor of Chiropractic (D.C. or D.C.M.)
Doctor of Dental Science (D.D.S.) or Doctor of Dental Medicine (D.M.D.)
Doctor of Jurisprudence or Juris Doctor (J.D.)
Doctor of Medicine (M.D.)
Doctor of Optometry (O.D.)
Doctor of Osteopathic Medicine/Osteopathy (D.O.)
Doctor of Pharmacy (Pharm.D.)
Doctor of Podiatric Medicine/Podiatry (D.P.M., D.P., or Pod.D.)
Doctor of Veterinary Medicine (D.V.M.).”
Bar the first and third (also sixth, if in Australia), all of the others are useful to humankind, having established a body of knowledge that has withstood scrutiny. We all know the political and legal war chiro waged in the US but that does not confer credibility of a crackpot idea.
Please tell me; when, in your view, did chiro transition from Palmer nutbaggery into credible healthcare?
Frank: Bar the first and third (also sixth, if in Australia), all of the others are useful to humankind, having established a body of knowledge that has withstood scrutiny. We all know the political and legal war chiro waged in the US but that does not confer credibility of a crackpot idea.
Regardless, chiropractors are recognized as doctors in the US. Hence, referring to them as “pseudo-doctors” is merely your opinion.
Frank: Please tell me; when, in your view, did chiro transition from Palmer nutbaggery into credible healthcare?
Oh, the profession has a lot of work to do as it moves closer to being seen as “credible healthcare”. Over the course of several years I’ve laid out my views in other forums….from splitting the profession to creating a “new” profession, stripping a few colleges of accreditation, standardization of state regulatory boards, getting the FTC involved in truth in advertising (esp in social media), mandatory funding of research thru licensure, reviewing continuing education requirements and approval, a 5 and 10 year window for “techniques” to demonstrate (via quality research) credibility or be removed from all campuses, I’ve shared hundreds, if not thousands, of research papers with chiropractors in an attempt to improve outcomes and understanding, I’ve debated with many fundamental chiropractors (pointless) as well as many so called skeptics (pointless) in an attempt to give them insight as to the complexities of human function, dysfunction, plausibility, quackery, proper research methodology and interpretation, etc, etc, etc. I’ve been called every name under the book and have been threatened professional and personally…whatever.
So, as I wrote in one of my responses in one of these blogs, I was hoping to find a “true” skeptic. Guy comes close, I see he has (or had) his own blog. I think I’ll check it out.
Take care.
@ Dale on Monday 20 June 2016 at 13:30
“Regardless, chiropractors are recognized as doctors in the US. Hence, referring to them as “pseudo-doctors” is merely your opinion.”
Only my opinion? If there were any evidence for chiro, they would be employed in hospitals around the world. Are you oblivious to the self-obvious?
“Oh, the profession has a lot of work to do as it moves closer to being seen as “credible healthcare”. Over the course of several years I’ve laid out my views in other forums….from splitting the profession to creating a “new” profession, stripping a few colleges of accreditation, standardization of state regulatory boards, getting the FTC involved in truth in advertising (esp in social media), mandatory funding of research thru licensure, reviewing continuing education requirements and approval, a 5 and 10 year window for “techniques” to demonstrate (via quality research) credibility or be removed from all campuses, I’ve shared hundreds, if not thousands, of research papers with chiropractors in an attempt to improve outcomes and understanding, I’ve debated with many fundamental chiropractors (pointless) as well as many so called skeptics (pointless) in an attempt to give them insight as to the complexities of human function, dysfunction, plausibility, quackery, proper research methodology and interpretation, etc, etc, etc. I’ve been called every name under the book and have been threatened professional and personally…whatever.”
Why don’t you just retrain as something useful, such as a physiotherapist? It does mean you would lose the meaningless and undeserved title of “Doctor”, but you love it, don’t you? You can’t even lance a boil, let alone cut skin but you think you deserve the title for faffing about with backs.
If you have any of these “thousands of papers”, please send some links or references to the Prof? He has been searching for decades but it seems this goldmine has clearly eluded him. Perhaps because some are these are those I refer to below, which I wouldn’t use as dunny paper.
“So, as I wrote in one of my responses in one of these blogs, I was hoping to find a “true” skeptic. Guy comes close, I see he has (or had) his own blog. I think I’ll check it out.”
A “true skeptic”, according to you is one who is prepared to believe you, rather than abundant evidence to the contrary. Anyway, it is the use of the No True Scotsman fallacy; no surprises there.
“Take care.”
Faux bon hommie.
I’ve asked before whether this is you (http://www.dalefamilychiropractic.com/page/doctorBio.html) and I assume by the lack of response, it is.
It seems you engage in practices which have been widely condemned, such as;
The claim of the subluxation
http://www.dalefamilychiropractic.com/page/sublux.html
Claims of the ability of chiro to treat autism, ADHD and bipolar disorder, among others
http://www.dalefamilychiropractic.com/articles/ADHD+Autism/
The inclusion of a dodgy study linking higher vaccination rates to higher infant mortality rates. (Partially funded by an ant-vax organisation and with qualifier, “Although most of the nations in this study had 90%–99% of their infants fully vaccinated, without additional data we do not know whether it is the vaccinated or unvaccinated infants who are dying in infancy at higher rates”.)
http://www.dalefamilychiropractic.com/article/2177.html
There is much more but these will do for the time being. Despite this, you claim to be evidence-based. Chortle, chortle, chortle.
I tend to share research like this which I doubt would interest Ernst or most folks here (the folks I hang with aren’t stuck on the subluxation model, unlike some so called skeptics)
https://www.infona.pl/resource/bwmeta1.element.elsevier-d0d4e4e8-2764-3532-a0cb-5933a23ef49b/content/partDownload/8900b0c7-b69c-39dc-8cbd-94217452a25f
http://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-016-1116-6
Take care.
no need to hang yourself or your friends!
I don’t know what that means, but OK.
take care
no need to hang yourself or your friends!
I googledl Peter Deadman in an attempt to learn more about him – ‘Know your enemy’ and all that – and got a link to the ‘Golden Needle’ site. Whereupon I find an advert for a book called ‘Methodologies For Effectively Assessing Complementary And Alternative Medicine’.
The blurb/guff says ‘This book highlights how CAM research must be treated differently to research in conventional medicine’.
Quite a demand, and baldly stated.
I’ve got a list of Surfin’ Instrumental books as long as my arm I need to afford yet, so shall hold off purchase for a while.
But maybe someone out there can tell me whether the authors make a convincing case?
yes, most definitely!
a most convincing case for Mikey Mouse science.
sorry to disappoint but this book has nothing to do with me
Peter Deadman-
I didn’t say the book was anything to do with you, at least in the sense of being written by you. Though I should think, judging by the blurb, that the contents and ‘evidence’ therein wouldn’t be a million miles away from your own beliefs.
Is that how you work … set up a random straw dog … make an assumption that another person has anything to do with it/believes in its propositions … then condemn them for it? In fact I wonder why I bother to respond to someone with such a tenuous grasp of things and will refrain from doing it in the future.
Peter Deadman with all respect, if you don’t want people to jump to conclusions about the relationship that your views might have to other, some might say similar, views, then perhaps you might make more strenuous efforts to distance yourself. ‘By their friends shall ye know them’ might well apply here.
If I google your name -never heard of you before, just wanted to get a handle of some kind on your basic beliefs in relation to the discussions on this site – Google then points me to the ‘Golden Needle’ site.
Blimey! What an Aladdin’s Cave of New Age silliness!
Reflexology, Magnet Therapy,’Balancing Cream’, Moxibustion etc etc.
The most useful thing on there is something that’s claimed to ‘Unblock Plugs’.
That doesn’t make sense really, I think they mean toilets.
Any rate, I find caustic soda usually works. AND it’s probably cheaper.
Seriously though – I’d consider getting in touch with them to sort this one out.
There’s a danger it’ll make all this stuff about chi and prana and meridians look a bit silly.
It might be this Peter Deadman;
https://www.youtube.com/watch?v=TOhe1HdBgho&feature=youtu.be
The first minutes are very illuminating. It seems acupuncture is all cre and no responsibility.
@Frank Collins
The first minutes of that interview (until 2:20) The Deadman describes acupuncture quite accurately, and even the mechanism behind why he does not realize his observations are wrong.
As you point out he puts the blame on anything other than the futility of needling.
I have to admit I stopped watching there. Don’t have time for lengthy narratives of nonsense.
Peter,
“…if you don’t want people to jump to conclusions…”, you’re on the wrong blog.
Or to look at Peter Deadman’s- and other altmed cultists’ – interpretation of the Pope quotation another way – ‘One day Science will catch up with my idiotic beliefs’.
“A health or medical practice is called ‘alternative’ if it is based on untested, untraditional, or unscientific principles, methods, treatments, or knowledge. Most treatments that are called alternative medicine would be more accurately described as alternatives *to* medicine since they are not really medicine at all.
‘Alternative’ medicine is often based on metaphysical beliefs and is frequently anti-scientific.”
http://skepdic.com/althelth.html
Q1: Which diseases does acupuncture cure?
A1: A zero-length list.
Q2: For which diseases do acupuncturists provide treatments?
A2: A long list of diseases.
Q3: For each disease in the long list of diseases in A2, where is the evidence to show that acupuncture is more efficacious than the plethora of other branches of alt-med that claim to treat the same disease, such as aromatherapy, chiropractic, craniosacral therapy, ‘detox’ therapies, dietary supplements, homeopathy, osteopathy, reflexology, Reiki, and urine therapy?
Q4: What is the protocol that acupuncturist must follow in order to ensure that each client receives the most efficacious form of treatment for their disease/illness/condition, i.e., what are their diagnostic and referral procedures?
Q5: What and where are the reporting mechanisms and the review systems that would enable acupuncture to become a self-correcting (therefore a tentatively science- and evidence-based) system of health care?
Q6: Are alt-med practitioners sufficiently open-minded and skeptical to abandon a treatment modality when it has been clearly shown to have either no evidence for efficacy, or volumes of evidence that it is inefficacious: i.e., a benefit:risk ratio that is either unknown or it is close to, or below, unity?
A6: Professor Ernst is a shining example of a former practitioner who was indeed sufficiently open-minded to abandon their beliefs when new evidence comes to light.
I am not the only commentator on this blog who was previously a ‘true believer’ in alt-med, then decided to tread the long, very painful, and deeply humiliating pathway towards properly learning science- and evidence-based critical thinking skills.
Pete: “A health or medical practice is called ‘alternative’ if it is based on untested, untraditional, or unscientific principles, methods, treatments, or knowledge.”
That’s not entirely accurate. The common use of “alternative medicine” is…
“If a non-mainstream practice is used in place of conventional medicine, it’s considered “alternative.””
https://nccih.nih.gov/health/integrative-health
Minchin’s Law:
By definition, alternative medicine either has not been proven to work, or has been proven not to work. The name for alternative medicine that has been proven to work is: medicine.
Categorically, it is only alternative if it lacks solid evidence. That’s because the thing to which it is alternative, is evidence-based medicine.
Guy: “By definition, alternative medicine either has not been proven to work, or has been proven not to work.”
No, here are some examples of definitions of AM:
Alternative medicine definitions
any of various systems of healing or treating disease (as chiropractic, homeopathy, or faith healing) not included in the traditional medical curricula of the United States and Britain (Merriam Webster)
Alternative medicine is the term for medical products and practices that are not part of standard care…..Alternative medicine is used in place of standard medical care. (MedicineNet)
A variety of health care practices, such as homeopathy, naturopathy, and Reiki, whose tenets often differ from those of mainstream medicine and are not generally taught in conventional medical schools. (American Heritage)
Alternative means treatments used in place of conventional medicine. (Mayo Clinic)
a range of treatments for medical conditions that people use instead of or with western medicine (Cambridge)
‘Doc’ Dale
Your definitions agree that alternative medicine involves practices that are not included in conventional medical schools. That prompts the question why are they not included? The answer is that they have not been proven to work, or have been proven not to work. Which was Guy’s definition. His is merely less mealy mouthed than those in the dictionaries.
Frank: The answer is that they have not been proven to work, or have been proven not to work.
That is one possibility. Others may include: the time to teach the therapy, malpractice coverage/limitations, ease of referral, political conflicts, doctors interest, etc.
“That is one possibility. Others may include: the time to teach the therapy, malpractice coverage/limitations, ease of referral, political conflicts, doctors interest, etc.”
You are kidding yourself, again.
Guy: “That’s because the thing to which it is alternative, is evidence-based medicine.”
No, by definition, it is alternative to is what is being taught to, and utilized by, MDs and allied health professionals…conventional medicine:
conventional medicine
A system in which medical doctors and other healthcare professionals (such as nurses, pharmacists, and therapists) treat symptoms and diseases using drugs, radiation, or surgery. Also called allopathic medicine, biomedicine, mainstream medicine, orthodox medicine, and Western medicine. (National cancer institute)
Medicine as practiced by holders of M.D. (medical doctor) or D.O. (doctor of osteopathy) degrees and by their allied health professionals, such as physical therapists, psychologists, and registered nurses. (MedicineNet)
the type of medicine that is generally used in the US and Europe which uses drugs and surgery as a form of treatment (Collins)
the usual methods of healing or treating disease that are taught in Western medical schools (Merriam Webster)
‘Doc’ Dale
This time the dictionaries seem to be struggling to differentiate conventional medicine from the alternatives. e.g. “the type of medicine that is generally used in the US and Europe which uses drugs and surgery as a form of treatment”. No cigar here, Collins: this form of medicine is also used for mainstream care in Canada, Central and South America, China, Japan, Australia, New Zealand — in fact it’s pretty well the global standard. Any dictionary definition that attempts to limit evidence-based medical practice (for that’s what it is) to the US and Europe is just plain wrong.
That also applies to the two definitions that restrict medicine to ‘Western’ geographies.
No cigar to MedicineNet, either, which seems to believe the world consists entirely of the USA. Medical degrees elsewhere are not MD or DO; for example the British MBChB.
Frank: the point was the common theme that runs through the definitions for both conventional and alternative medicine. What was purposed here as definitions do not really fit with accepted definitions.
@Frank Odds. You seem to imply that everything taught in conventional medical schools is proven to work…
@Tom Kennedy
No, you and I both know perfectly well that’s not so. But scientific medicine is able and willing to reject its practices that aren’t supported by evidence. There is nowadays a far higher threshold for tolerance of remedies that can’t be shown to work. Like pure science, real medicine is constantly learning, persistently adjusting its approaches to diagnosis and treatment in the light of evidence. Alternative medicine appears never to move on, in many cases citing its bases in antiquity as a plus point in its favour.
Pete Attkins-
I’m fascinated by the small number of people who admit – often, let’s face it – are brave enough to admit – that they were for a while sucked into some kind of altmed, and were then inquisitive or intelligent enough to see their way out. It’s tempting to say they ‘saw the light’ but that phrase is too loaded with religion and cultism.
It kind of brings us back to the earlier ‘ad hominem’ discussion, in that I never fell for any of it either because I considered those who did to be – at best – well’meaning but gullible, or – at worst – idiot twonks. The ‘ad hominem’ argument is of course that either of these conditions does not preclude the possibility that the people are right- they may have stumbled across the one sensible idea they were ever going to have in their entire life – but everybody has to start somewhere.
I don’t say any of this from superciliousness -like most of us, I’ve believed a few bits of nonsense in my time. But I’m interested in how people arrive where they do. I’d have to say that there enough weird and aggressive altmeds giving vent to their hatred and anger on this blog to make most decent people -surely -question the company they’re keeping.
When I opened a natural food store in the 1970s and advocated the idea that diet played a vital role in the development of diseases such as CVD and cancer, it was ridiculed as fantastical, absurd – even punishable by law – since current scientific opinion knew that this couldn’t be the case. When Jerry Morris demonstrated in the 1950s that bus conductors on London buses had healthier heart profiles than sedentary bus drivers, he was ridiculed because exercise didn’t meet the criteria of specificity and biological plausibility (even though Hippocrates, Sun Simiao, Ibn Sina, Maimonides and many more had known the numerous benefits of exercise for 2500 years). When practitioners of tai chi and qigong claimed extensive health benefits, these weird Oriental mumbo jumbo exercises were dismissed (not aerobic enough) as useless. Now we know the claims to be well proven. The moral? Take care about what you so high-handedly dismiss, especially health practices that traditional cultures have used for centuries. Not all traditional practices are sound of course, but long trans-cultural historical usage renders them worthy of serious appraisal and open minds, and not a priori rejection by people who have made up their minds too early in the process.
‘1) “I get particularly good results with migraine headaches, but the active treatments in the trials I see for this condition generally bear very little in common with what I (or many other practitioners) would do in the clinic”. in this case, it is the acupuncturists’ duty, in my view, to make sure that trials test the sort of approach you do in the clinic.
2) ” I don’t feel the ‘theatrical placebo’ argument accounts for what I regularly see”. how would you in the clinic feel a difference between a placebo response, the natural history of the condition and a specific therapeutic effect?’
@Edzard (sorry, no ‘reply’ button above).
1) I agree to some extent, but there are a few things that stop me personally from doing this. Firstly, I feel I need to dedicate what time I do have into my development as a practitioner, and simply don’t have the time to become an active researcher as well. Secondly, if I did do that, surely you and other like-minded people would simply cry ‘high risk of bias’ if the trial was designed and performed by a practicing acupuncturist?
2) Very hard I agree, but I feel experience and common sense have their place here. As I mentioned above, many people arrive at my door having tried multiple other treatments that are likely to elicit a placebo response, including strong medication, and have had regular crippling migraines for many years. Many of these people now have much less frequent, much milder migraines, and a significant number have none at all any more. Maybe that’s all due to my charming bedside manner but I personally find that implausible 😉
1) I did not mean to say that YOU PERSONALLY must do the research – but the acupuncture community has the duty to do so [or drop the claims]. and a good trial is done in co-operation of methodologists and subject experts [all of ours were done this way].
2) I and most experts think it is impossible to tell them apart. “Maybe that’s all due to my charming bedside manner but I personally find that implausible”; I am afraid you might be mistaken; it’s not just the bedside manners; there are many other phenomena at play.
@Tom Kennedy
From your comments I wonder if you might be at risk of following a path similar to one described in this post from Edzard earlier this year. Substitute ‘acupuncture’ for ‘homeopathy’ and ‘migraine’ for ‘infertility’ and you’ll get the idea.
“I feel experience and common sense have their place here.” Sadly, experience and common sense are very unreliable qualities. They’re subjective, and humans are extremely good at fooling themselves by trusting subjective feelings. You asked me earlier in this thread if I was implying that everything taught in medical schools is proven to work. Much of the presently unreliable stuff in medicine arises from practitioners’ “experience and common sense”.
@Frank Odds, I think @Edzard does a pretty good job in the post you link to of explaining the problem of confirmation bias, and I agree it is something acupuncturists and all healthcare practitioners have to be very wary of. I’ve seen several women for ‘induction’ treatments for example, one today in fact. She told me she’d come to see me because her friend had gone into labour within hours of my treatment. I told her that’s great, but who knows, maybe she was about to into labour anyway? She agreed, but was very happy to give it a go. That’s what I (and I hope most acupuncturists) do – give an honest appraisal based on clinical experience and available knowledge, and give the patient the credit of being able to make up their own mind.
But with migraines and a few other conditions, I feel the situation is very different. As opposed to the story described in @Edzard’s post with fertility, I have had many people spontaneously and dramatically improve after several years of almost constant suffering, and this has happened enough times for me to feel confident In giving a positive prognosis (although always tempered with the caveat that no treatment is guaranteed). Perhaps I’m delusional, but to me the evidence base looks pretty good for headaches when you consider how loosely the trials tend to match up with clinical reality, and when balancing this with my own experience over 10 years, I’m happy to be able to offer a relatively affordable option for people in real strife.
@ Tom Kennedy on Saturday 18 June 2016 at 00:09
Yep, not only Confirmation Bias, but Post Hoc Ergo Propter Hoc, Special Pleading, regression to the mean, and natural progression.
These are why clinicals trials and blinded and placebo controlled, something alt-meds do not ever seem to appreciate. After all, their brand of witchcraft is real while there can be question marks over others; the loony cultist jm is a prime example.
Peter Deadman sums up the altmed position quite succinctly I think when he says ‘No health service will be able to cope with the expected doubling or trebling of incurable diseases in the next two or three decades, therefore we have to look at broader approaches to wellness and disease’.
Like waving sausages at people? Or is that too broad?
No Rotherham United team is likely to be promoted to the Premiership in the next two or three decades either, so maybe they should adopt a broader approach too. Perhaps they could try fielding a team of wildebeest, or cardboard cut-outs of themselves. Sounds mad I know, but ‘conventional’ football hasn’t worked.
An interesting article here : http://www.theguardian.com/healthcare-network/2015/oct/13/acupuncture-used-more-widely-nhs
The times they are a’changing
another interesting article here:
http://edzardernst.com/2016/06/acupuncture-a-new-white-paper-turns-out-to-be-a-white-wash-ignorance-or-fraud/
And a personal story here : https://www.washingtonpost.com/national/health-science/migraines-were-destroying-my-life-heres-what-finally-cured-me/2016/05/02/7007b840-f6b1-11e5-9804-537defcc3cf6_story.html
@ Peter Deadman on Sunday 19 June 2016 at 22:19
Did you actually read the article? Apart from being written by a drama queen who thinks she is a novelist, there are some clues:
“A month into my treatment, after eight sessions, I noticed that my migraines had begun to slow down in frequency and weaken in intensity.”
Natural progression?
“It has now been five years since I discovered acupuncture. I still occasionally get migraines, and if they seem to be amping up, I’ll use acupuncture, even a couple of times a week. But there have been months when I don’t need it at all.”
Post hoc, ergo propter hoc?
“Stress seems to be a big contributing factor, and with acupuncture I know that in addition to healing my body with needles, I also get a whole half-hour when I only think of good things.”
Perhaps the cause, and another factor causing de-stressing?
Alas, clutching at straws is all you have.
Hold on everyone. Perhaps ‘Doc’ Dale is a little more cutting edge than we’ve all given him credit for. Where exactly does he ‘hang’ wid the bros and the hos? In the Acupuncture Projects? Careful with those needles now.
More samples of what I’ve shared in the past week?
http://www.ncbi.nlm.nih.gov/pubmed/27317503
http://www.ncbi.nlm.nih.gov/pubmed/27317975
http://www.ncbi.nlm.nih.gov/pubmed/27317914
http://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-016-0932-z
(I don’t know much about acupuncture)
Take care.
But some of the “bros” I hang with prefer this stuff, which I’ve shared with them in the past few months.
http://www.sciencedirect.com/science/article/pii/S016801021500293X?via=ihub
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3940958/
http://online.liebertpub.com/doi/pdf/10.1089/brain.2014.0309
I could go on but I’m sure most here prefer to keep chiros in a little subluxation box…I suppose it makes for a softer target.
What a gem:
“What kind of man would drop out of the medical profession… ?”
One who is 83 and has been retired for years, maybe?
Probably Colin, Deadman Talking, and others have views on the Canadian couple who have just been sentenced for trying to ‘treat’ their toddler’s bacterial meningitis with horseradish. Whether anybody would be interested in listening to them is something else again.
I see however that among the couple’s deranged supporters are people who claim that only parents should be allowed responsibility for looking after their children – despite the tragedy right in front of them – and the usual anti-vax loons who see this whole case as an attack by Big Government and Big Pharma on the rights of ordinary, stupid people whose only crime is finding more and more daft ways of killing their offspring.
In fact, before phoning the emergency services, the child’s father first of all called his own father, a fellow director of his wingwang company, presumably for extra wingwang advice.
Ok, all of you sceptics, pseudo-sceptics, people with “wellness” in their names and people with photos wearing scrubs in a subconscious attempt to establish authority: Andrew Vickers published a meta-analysis on acupuncture with favorable results. TIME just profiled it, Harvard Medical School also chimes in on the whole acupuncture vs standard of care thing. Now discuss!
@Sasha
You said
It would be a courtesy to readers if you provided a literature reference to the meta-analysis. Or told us at least precisely which issue of TIME “just profiled it”. We don’t all regularly consult the same literature you do.
TIME’s website doesn’t (today) mention acupuncture anywhere, and it provides no search facility for non-subscribers. I searched Medline for publications containing ‘Vickers A’ as author, ‘acupuncture’ in the title and ‘2016’ as publication year. I came up only with this result: Linde K, Allais G, Brinkhaus B, Fei Y, Mehring M, Shin BC, Vickers A, White AR. Acupuncture for the prevention of tension-type headache. Cochrane Database of Systematic Reviews 2016, Issue 4. Art. No.: CD007587. DOI: 10.1002/14651858.CD007587.pub2. Is this the paper you mean? Why do you single out Vickers as the author? Most of us would normally refer to this paper as ‘Linde et al.’
If this is the paper you refer to, I’m unimpressed. To save others the effort, I’ll paste the pertinent portion of the abstract here.
Key results
We reviewed 12 trials with 2349 adults, published up to January 2016. One new trial is included in this updated review.
Acupuncture added to usual care or treatment of headaches only on onset (usually with pain-killers) in two large trials resulted in 48 in 100 participants having headache frequency at least halved, compared to 17 of 100 participants given usual care only.
Acupuncture was compared with ‘fake’ acupuncture, where needles are inserted at incorrect points or do not penetrate the skin, in six trials. Headache frequency halved in 52 of 100 participants receiving true acupuncture compared with 43 of 100 participants receiving ‘fake’ acupuncture. The results were dominated by one large, good quality trial (with about 400 participants), which showed that the effect of true acupuncture was still present after six months. There were no differences in the number of side effects of real and ‘fake’ acupuncture, or the numbers dropping out because of side effects.
Acupuncture was compared with other treatments such as physiotherapy, massage or relaxation in four trials, but these had no useful information.
Quality of the evidence
Overall the quality of the evidence was moderate.
You wrote: “Now discuss!” OK: for a start, that line about ‘overall the quality of the evidence was moderate’ doesn’t inspire confidence that any conclusions will be based on the robust evidential support that the extraordinary claims of acupuncture demand. The publication is an update of an earlier meta-analysis, with a single extra paper included. Two trials were of the A+B vs B type (see paragraph 2 of the abstract above.) I have lost count of the number of times Edzard Ernst has explained the following on this blog: this type of trial design cannot fail to produce a positive outcome for A. This part of the meta-analysis is therefore of no evidential value.
We are left with an analysis of just six publications in which acupuncture was compared with sham treatment. Five of the six are described as having ‘comparably good quality’ — the weasel word ‘comparably’ is the give-away here — the statement is qualified with concerns about patient attrition during long-term follow-up and “some uncertainties regarding the details of randomisation”. The sixth paper, of lower quality, is the only new publication included in the updated meta-analysis. (This publication, for the interested reader, is Kwak et al, Journal of Korean Acupuncture & Moxibustion Society 2008;25:165-77.) Just four of the papers (excluding the new one and one other) provided the data for the main conclusion (para. 3 of the ‘key results’ above) that in nominally double-blind trials, ‘true’ vs ‘sham’ acupuncture halved headache frequency in 50% of the former group vs 43% in the latter. That meagre advantage for ‘true’ acupuncture could be explained by publication bias (trials with negative results remain unpublished) and the uncertain randomization already acknowledged by the authors.
In any case, we know from the comments on several acupuncture posts on this blog that believers in acupuncture regard sham controls as ‘active’ controls and therefore not valid, so this part of the meta-analysis should be unconvincing to these people.
Sasha, is this really the best you can do? Or have I got hold of the wrong publication (your fault, not mine)? Scientists, clinical and otherwise, spend a lot of their time demolishing poor or irrelevant studies as peer reviewers, in journal clubs and, publicly, at scientific meetings. Even though the status of this publication as a Cochrane Review implies some guarantee of quality, it is essentially a reworking of old data, reworded to dodge critiques of its predecessor, and it fails to make a serious case for the contention that sticking fine needles into people’s bodies is a medically significant intervention that can be used to treat a wide range of diseases.
Of course sham control is active. Comparing sham acupuncture to verum isn’t the same as comparing active drug to a sugar pill. Plus, most studies have poorly designed verum arm which also affects final difference between sham and verum.
I’m glad you found the other paper. The results may seem “trivial” to you but they aren’t to Sloan Kettering or Harvard Medical School.
And CHOP is starting in-house acupuncture program. Also, MD Anderson is running acupuncture trials which aren’t even RCTs, just clinical effect trials on their cancer patients. Look MD Anderson and CHOP up, those two are huge.
@Sasha
“The results may seem “trivial” to you but they aren’t to Sloan Kettering or Harvard Medical School.” These hospitals, like a lot of others in the USA, are cynically taking grant money from the National Center for Complementary and Integrative Health. The NCCIH, having spent years undertaking research without success in demonstrating any effects of CAM, is currently handing out huge grants to reputable establishments to add CAM to some of its programs, particularly cancer treatments. Cancer patients have always been prey for Big Snakeoil, so Sloan Kettering and Harvard can justify what they’re doing by saying they’re best placed to subject their patients to needling, water treatment, rubbings of greater or less severity, and other forms of faith-based nonsense.
BTW, the fallacy of argument from authority includes citing institutions as authorities as well as individuals.
This has nothing to do with argument from authority. The reason these centers are beginning to implement it is because, unlike you guys, they are not a bunch of religious fanatics. They can look at evidence and draw conclusions. That is called science. And evidence clearly shows that acupuncture is not placebo, Vicker’s meta analysis is the latest example.
Your arguments are laughable: NIH, Sloan Kettering, Harvard are cynical money grabbers, while you are true scientists, even though you are languishing on this site and no one is paying attention to you!
LOL! You mean the widely criticised Vickers paper that concluded:
Vickers, Andrew J. et al. “Acupuncture for Chronic Pain: Individual Patient Data Meta-Analysis.” Archives of internal medicine 172.19 (2012): 1444–1453. PMC. Web. 1 July 2016.
AHA! I did find the wrong paper. Now we have two examples of evidence for the trivial impacts of needling in one thread. But in future I shall avoid responding to posts without reference citations. I’ve better things to do.
Widely criticized by whom?
Also, please refer to the following line: “significant differences between true and sham acupuncture indicate that acupuncture is more than a placebo”.
And this is even though his meta analysis for sure included studies in which verum arm wasn’t properly designed since in most of them verum isn’t properly designed. Once more studies come out in which pattern differentiation, rong and Wei circulation, etc are taken into account, verum will outperform sham every time.
But even as it is – data clearly shows that the last leg you’ve been standing on is crumbling. Oh no! What are we going to do now?
Sasha said:
Why are you concerned about who criticised it rather than what those criticisms actually are? That’s very telling, isn’t it?
Ah, you want to cherry-pick even from the paper’s own conclusion?
Ah, you have faith. I understand. Say no more.
To steal from John Maynard Keynes: when the facts change, I change my mind. What do you do?
No, it’s not very telling. When a meta-analysis by a Sloan Kettering biostatistician is claimed to be “widely criticized” and
such a claim is made on an obscure blog not known for its intellectual rigour, it is only fitting to ask: criticized by whom? After all it was good enough for Sloan Kettering and Harvard, so once again – criticized by whom. In research they talk about impact factor, what do you think Sloan Kettering’s and Harvard’s impact factor is versus you guys?
And I am not cherry picking conclusions, I am addressing the only criticism you had left: sham vs verum comparisons.
Interestingly, Steven Novella was writing today about this very same matter of acupuncture’s uselessness and mentions the criticism of Vickers & al:
http://theness.com/neurologicablog/index.php/time-gets-it-wrong-on-acupuncture/
Yes, who should we believe: a professional biostatistician who analyzes data for a living and says that the data is sound OR a neurologist writing on his blog and whose piece consists entirely of his own opinions?
A professionally done meta analysis versus an op-ed that got published on the guy’s own blog?
Wow, the choice is real hard on this one!
Nope. It is easy.
Your ‘argumentum ab auctoritate’ falls on the fact that the authors of this meta-analysis have a confirmed agenda to promote their own vested interests.
Further, a senior neurologist’s education, training and experience far overwhelms that of a biostatistician in being able to understand not only the very simple statistical principles involved but also biology, physiology, anatomy, pathology, neurology and pharmacology and to apply this knowledge to assess different treatment modalities for pain and their evaluation for efficacy and effectiveness. On top of that this particular neurologist has an extensive experience in appraising misguided scientific efforts. If that’s not enough, several others, including me, agree in toto with his analysis and conclusion.
The formal education of the authors of the meta-analysis in question does not preclude the possibility of severe mistake-inducing bias.
Many different experts have put forth very plausible critique of this paper and to refute their consensus you need more than a inanely pompous “my guy is smarter than your guy” blurb.
If AP had any clinically useful value in pain management or even other effective medical application, the profound interest and engagement that the medical (the real one) laid into learning and applying this therapy modality clinically after its emergence forty-something years ago, it would have led to it being widely used in modern health care today. Even I would be referring my patients to such treatment if it were any good.
Instead, as I have outlined in a previous comment, it did not survive the test of time and practice and is practically demoted to a high-street parlour trick today.
Bjorn –
Tough one that for Sasha I would think.
Couldn’t you just insult him a bit? Call him a dimwit?
That’s the level he seems comfortable with.
And once again I’d say to Mel, to whom he seems to be somewhat slavishly devoted – ‘By their friends shall ye know them’.
Although it may all be quite academic anyway, since he’s in the habit of having his blogs/web pages written by others, and then saying ‘Hold on a bit, I didn’t say that’.
So who knows who’s writing his stuff now?
Anyway I think I’ll avoid him. He seems rather odd, and I’m not at home to Mr Aggressive.
Another well done post, “Wellness”. The wisdom is just overwhelming.
Barrie: “Couldn’t you just insult him a bit? Call him a dimwit?”
Björn responds with an appreciated higher level of maturity. I enjoy reading his comments as they don’t such contain childish tactics.
Doc Dale-
Unfortunately, Sasha doesn’t choose to adhere to your unconvincing pretence to high standards, having chosen to call me a ‘dimwit’ Hence my reference to the word.
He maybe has the excuse that, having been absent from the blog for some time, he’s missed Edzard’s comments – often expressed – that acupuncturists, homeopaths, altmeds in general, tend to resort to puerility and name-calling when put under the pressure of argument. Sasha’s a prime example.
I realise full well my standing in this whole conversation, and did I not, the level of name-calling would act as a salutary reminder. After all, I’ve simply been called a ‘dimwit’ by a religious cult member, The feller Ernst has been called a ‘wanker’ by a fully qualified doctor.
As the Ronnie Corbett sketch had it – ‘I know my place’.
http://edzardernst.com/2012/12/ad-hominem-attacks-are-signs-of-victories-of-reason-over-unreason/
this is a small consolation, I hope.
“In reality, ad hominem is unrelated to sarcasm or personal abuse. Argumentum ad hominem is the logical fallacy of attempting to undermine a speaker’s argument by attacking the speaker instead of addressing the argument. The mere presence of a personal attack does not indicate ad hominem: the attack must be used for the purpose of undermining the argument, or otherwise the logical fallacy isn’t there. It is not a logical fallacy to attack someone; the fallacy comes from assuming that a personal attack is also necessarily an attack on that person’s arguments.
Therefore, if you can’t demonstrate that your opponent is trying to counter your argument by attacking you, you can’t demonstrate that he is resorting to ad hominem. If your opponent’s sarcasm is not an attempt to counter your argument, but merely an attempt to insult you (or amuse the bystanders), then it is not part of an ad hominem argument.”
http://laurencetennant.com/bonds/adhominem.html
Could not agree more, Doc Dale.
Barrie and others: look up the definition of ad hominem. An ad hominem is when Edzard, for example, instead of answering some of the arguments I present, instead goes and talks about my website. That’s an ad hominem.
Barrie, you haven’t earned an ad hominem. I called you a dimwit based on what you write. That’s not an ad hominem, that’s a statement of fact, as far as I am concerned.
Anyway, I will retype my take on Novella’s arguments when I am in front of computer. Don’t want to loose a bunch of paragraphs on my phone again…
Doc ‘At Least In Your Own Mind’ Dale-
I wonder if- now your mistaken understanding as to my comment has been clarified,-i.e. that I was pointing out Sasha’s resorting to name calling, rather than indulging in such myself – you will apologise to me and and admonish him for said childish tactics, as you admonished me.
If not, why not?
I’m not wondering very HARD you understand.
Jes’ wonderin’.
Ok, here’s a message for Sasha:
When dealing with some folks who call themselves skeptics occassionaly you will come across someone who intentionally uses inflammatory lingo such as “a member of a cult” and “practicing witchcraft”. Often this is done in an attempt to evoke an emotional response from the other party. Once you respond to these attempts with similar labeling they will claim the moral victory.
It’s best to recognize this as a weakness in their position because, typically, they use this approach because they are ignorant on the topic. Any attempts to have an intelligent discussion with them will often be in vain.
Therefore, I advise you not to acknowledge those who continually use childish name calling tactics unless you have some time to waste.
Rather, I suggest you focus your responses towards those skeptics who actually wish to better understand your views and your points…one of the characteristics of a true skeptic. Likewise, take the time to try and understand the true skeptics points…often those points contain some truth.
Doc ‘If Only In Your Own Mind’ Dale-
As I’ve said before. I’ve decided that the word ‘sceptic’ doesn’t adequately define my position, therefore I’d prefer to be called ‘Unbeliever’ or even ‘Infidel’. After all, Religion is what we’re basically talking about here.
In the same way-as I said equally before – I am not a sceptic about the Fact Of Evolution, or the Flat Earth Theory, or the ‘Theory’ that the Earth is the centre of the Universe and that the Sun revolves around it. Or the ridiculous notion that a substance becomes more potent-even dangerous – the more one dilutes it.There’s nothing to be sceptical about. As Richard Dawkins says -the evidence is all in. All that remains is the ‘scientist’s 1%’.
Anyway- you ought to get back to adding more letters after your name. You’ll soon have enough to write a short children’s book. Though Dog knows who’ll publish it. You probably. Or maybe a vanity publisher/degree mill equivalent.
Barrie: “After all, Religion is what we’re basically talking about here.”
I admit I know very little about acupuncture but I doubt it qualifies as a religion. But if that’s how you have to play it in your head….
The Seven Dimensions of Religion (Ninian Smart)
Ritual: Forms and orders of ceremonies (private and/or public) (often regarded as revealed)
Narrative and Mythic: stories (often regarded as revealed) that work on several levels. Sometimes narratives fit together into a fairly complete and systematic interpretation of the universe and human’s place in it.
Experiential and emotional: dread, guilt, awe, mystery, devotion, liberation, ecstasy, inner peace, bliss (private)
Social and Institutional: belief system is shared and attitudes practiced by a group. Often rules for identifying community membership and participation (public)
Ethical and legal: Rules about human behavior (often regarded as revealed from supernatural realm)
Doctrinal and philosophical: systematic formulation of religious teachings in an intellectually coherent form
Material: ordinary objects or places that symbolize or manifest the sacred or supernatural
Doc Dale-
Yep. Just like I said.
Religion.
Barrie: Doc Dale-
Yep. Just like I said.
Religion.
It just makes you look ignorant on two topics, but I’m OK with that. Take care.
‘Doctor’ Dale-
Whereas you of course are vastly learned in the one topic, albeit a silly made-up one.
an expert in nonsense can produce little else but nonsense!
Edzard-
As my favourite singer, the great Little Richard, put it in one of his recordings- I’ll leave you to imagine the uptempo musical accompaniment-
‘A little bit of something
Sure beats a whole lot of nothing’.
THERE you go Sasha! THAT’s how you patronise somebody! And the ‘Doctor’ didn’t even call you a dimwit! He did spell ‘occasionally’ wrongly though, but then many people do.
Doc Dale: you bring up some very important points that I would like to address so sorry in advance for a long post. Overall, I think you are absolutely right, engaging with people like Barrie is a waste of time. I will refrain from it in the future.
Majority of regular contributors on this blog are pseudo-sceptics, not sceptics. They lack the very foundation of a scientific mind: curiosity, openness, and humility. In addition, from what I can deduce from their posts, most of them have zero experience in medical research or medicine (clinical or academic). That’s why they shout or ask silly questions. The latest example is Alan who first asked me to critique Novella and then, rather than respond to my criticism, asked me if I posted this to Novella’s blog. It is much easier to deflect to people whom you consider authorities than to engage your own brain cells.
We also have people like Bjorg, who think that MD education somehow absolves them from making a coherent argument on why a particular medical intervention does or does not work. His kind is easy to deal with. I was pre-med, almost became an MD, 90% of my family are MDs and both of my acupuncture teachers are MDs. If there’s a fake MD argument, I will deconstruct it easily. Bjorgs aren’t common on this blog, they are more likely to be on SBM blogs since the quality of argumentation is (somewhat) better than here.
And then Edzard Ernst. I only read some of his acupuncture posts and comments that come with it. I don’t read other posts: chiro, homeopathy, etc. But from what I read so far in his posts and in his responses to Mel, me, and some others, Edzard’s main talents are claiming numerous ad hominems (many of which aren’t) and sophistry. As in me saying that one doesn’t need to understand pharmacology, etc to evaluate acupuncture and him responding: do you only need to understand stars to build a space ship? Who knows, maybe it does a great job of rallying the troops, many of whom probably don’t know what sophistry is.
I haven’t looked into EE research and what lead him to believe that acupuncture is elaborate placebo. I suspect it has to do with both poor verum design and not realizing that sham isn’t physiologically inert even when skin isn’t penetrated. In ancient China, many acupuncture needles were just held to the skin and didn’t penetrate. The mechanism of action has to do with physics (like everything else) and I can refer you to sources if you’re interested. It is only recently that all acupuncture is done with skin penetration. Sham with actually penetrating non-points is even more problematic. Also, verum design as it’s done in most studies has too many problems to list but I will, if you’re interested.
When these issues are raised with EE, you usually get no response. At least I don’t. Too much invested into a particular cognitive bias, books, blog, faulty studies, etc. Here we have the issue of humility again. Before attempting to study something, learn about what you’re studying and learn how to ask proper questions in research.
Whenever someone with solid understanding of logic and research comes along (like Mel), we can quickly see that EE is a man out of his depth.
– Why did you say what you said about NICE recommendation?
– Ah… Umm… Hmm. Enough! You think you understand research! Thanks for bringing traffic to my blog. Will you contribute to my magazine?
You know, that sort of thing. It’s kind of funny to watch actually.
Now to the most important point of your post: taking time to understand the true sceptics points. I absolutely agree with you, it’s extremely important and this is the reason I initially came on here a year ago and why I came back now. Even if I don’t see much of open minded skepticism, at least on this blog.
What many unfamiliar with acupuncture field don’t realize is that many acupuncturists are very scientifically minded, skeptical people. I know I am and I know lots of others. That’s part of the reason I didn’t become an MD, btw. I just so too many things that don’t work. So, if you go on some of the acupuncture professional forums, you will see debates that are even worse than what’s going on here. People shouting at each other, experimenting, all in attempts to parse out the mechanism of action.
Also, I get the main points of skepticism:
1. What is the mechanism of action that accounts for acupuncture and myriad of its effects: neurological, digestive, cardiac, hormonal, etc? The answer has to do with physics and I can refer you to sources if you are interested. In general, physicists often have no difficulty understanding traditional Chinese medical concepts. That’s probably why Niels Bohr adopted yin yang symbol on his coat of arms.
2. Does acupuncture work? Yes it does for many conditions and often better than standard of care. Even with substandard verum design in studies.
3. If acupuncture is not placebo, how come verum doesn’t outperform sham. First of all, often it does. Second, sham isn’t inactive. Third, if verum is properly designed, it will blow sham out of the water (I believe).
Anyways, these are my thoughts, sorry for a long post.
Sasha: Doc Dale: you bring up some very important points that I would like to address so sorry in advance for a long post.
I know little about acupuncture but this is my impression.
It is a system of personalized patient analysis, interpretation and application (AIA). Just because a group of subjects may share common symptoms the the AIA could very well vary. This type of care is best studied by the pragmatic approach.
Often research on this approach takes just one part of the system and studies it. Which is fine, but the problem so called skeptics have is how to interpret and apply the results in light of the AIA approach.
That’s true. One of the foundations of TCM is that it treats patterns, not diagnosis. 4 patients with asthma could have 4 different patterns and be treated differently. While a patient with asthma and a patient with diarrhea could have the same pattern and be treated the same.
Any verum design that doesn’t take that into account is worthless.
Pseudo sceptics have lots of problems, not just how to interpret and apply AIA. There’s no better place to see it than this blog…
but most trials testing the efficacy of TCM acupuncture do account for that
Can you provide links to these studies which describe verum and sham design? Then I can comment on something concrete.
In addition, acupuncture (vs TCM which is larger umbrella term) has some additional parameters: rong and wei circulation, pulse findings that are unique to acupuncture, etc. No practitioner uses same preset set of points for each treatment which is what lots of verum designs do.
I will look for some links: Mel Koppelman does a nice job of deconstructing some of the studies that SBMers use to make their points.
I thought you had implied that trials do not account for the need to individualize the treatments. so, should it not be you providing the evidence first?
anyway, my very first acupuncture trial of 1993 did account for it http://www.ncbi.nlm.nih.gov/pubmed/8439229
and my very recent meta-analysis included several trials that did that as well http://www.ncbi.nlm.nih.gov/pubmed/24953665
there would be lots more, but I am sure you are clever enough to find them yourself.
Ok, thanks. I will read and get back.
Ok, Edzard, the link you provided for meta analysis of ankle sprains does not say anything about verum vs sham design of the studies you looked at.
What I am looking for is description of methodology: this is how verum group was treated vs how sham group was treated. And results.
Instead, your meta analysis describes studies that:
– compared AP vs no treatment
-compared AP vs AP +standard treatment
– compared AP vs herbal patches and other non-surgical treatments
In addition, it says that studies had no blinding.
I am looking for single blind studies that would have three arms: verum, sham, standard. With clear description of methodology in each arm and results.
Also, your meta analysis says that future rigorous RCTs are needed to establish effectiveness/safety of AP in acute ankle sprains. So, I don’t see how that meta analysis supports the idea that acupuncture is placebo.
I don’t really care what you are looking for!
however, the details of verum and sham are provided in the appended tables. did you not read our paper to the end?
By paper, are you talking about the meta-analysis? If yes, then I did read it to the end. It ends with authors’ conclusions. No appended tables at the end. I am looking at it on my phone, maybe something isn’t showing up. I will look tomorrow on the computer.
Or are you talking about 1993 study? That link is empty. Can you provide another link to it?
Overall, in order for me to evaluate a study, I need verum and sham methodology. And results of them vs whatever it’s being compared to.
Can you provide this kind of data from either your studies or the ones you analyzed? Or links to it? Thanks
next you will ask me to teach you how to suck eggs?
Re sucking eggs, I wouldn’t mind a lesson. I’d like to know why eggs need to be sucked, what evidence is there for example that sucking them is better than any other method of eating them, which end should I suck from (evidence-based only please), chicken eggs versus duck/bantam/goose/ostrich or dinosaur. So many questions needing answers.
you don’t need to try so hard to convince us that your arguments are bogus
Edzard-
Peter Deadman seems not to understand
A. How to suck an egg
and
B. The reason for doing so. Which is not to do with eating the contents.
It’s to be hoped he’s not similarly confused about which end to stick his needles.
Edzard, here is what ankle sprain meta analysis looks like on PubMed:
Abstract
BACKGROUND:
An acute ankle sprain is a sudden-onset injury of one or more of the ankle ligaments. It is one of the most common musculoskeletal injuries in the general population as well as in athletes. In some countries, such as China and Korea, acupuncture is frequently used in the treatment of ankle sprains, either as a single treatment or a secondary intervention accompanied by standard medical treatment.
OBJECTIVES:
To assess the effects (benefits and harms) of acupuncture for the treatment of ankle sprains in adults.
SEARCH METHODS:
We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (May 2013), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2013, Issue 4), MEDLINE (1948 to May week 2 2013), EMBASE (1980 to May week 2 2013), China National Knowledge Infrastructure databases (1994 to August week 4 2013), the Cumulative Index to Nursing and Allied Health Literature (1937 to May 2013), the Allied and Complementary Medicine Database (1985 to May 2013), Science Links Japan (1996 to August week 4 2013), several Korean medical databases (August week 4 2013), the World Health Organization International Clinical Trials Registry Platform (August week 4 2013), the bibliographic references of included trials and conference proceedings.
SELECTION CRITERIA:
We included randomised and quasi-randomised controlled trials involving adults with acute ankle sprains. We included all types of acupuncture practices, such as needle acupuncture, electroacupuncture, laser acupuncture, pharmacoacupuncture, non-penetrating acupuncture point stimulation (e.g. acupressure and magnets) and moxibustion. Acupuncture could be compared with control (no treatment or placebo) or another standard non-surgical intervention.
DATA COLLECTION AND ANALYSIS:
Two review authors independently screened the search results, assessed trial eligibility, assessed risk of bias and extracted data from the included trials. We calculated risk ratios (RRs) for dichotomous outcomes and mean differences for continuous outcomes. We conducted meta-analyses using the fixed-effect method or, where appropriate, the random-effects method, and used 95% confidence intervals (CI) throughout.
MAIN RESULTS:
We included a total of 20 heterogeneous studies (2012 participants with acute ankle sprains); three of which included more than one comparison. Seventeen trials were conducted in China. All of the studies had a high risk of bias due to lack of blinding. The results may also have been affected by selection bias, particularly as five studies were quasi-randomised controlled trials and 12 studies gave no information on their method of randomisation. Of our three prespecified primary outcomes, only cure rate was reported by the majority of studies. No study reported on patient-reported assessment of function and only one reported on adverse events (in which three participants receiving a control intervention experienced skin problems from over-the-counter Chinese herbal patches). The other 19 studies did not record or report on adverse events. We assessed the quality of evidence for cure rates as very low for all comparisons, which means we are very uncertain about the reliability of any of the estimates.The single study comparing acupuncture treatment with no treatment found acupuncture to be more effective with regard to cure rate at five days (31/31 versus 1/30; RR 20.34, 95% CI 4.27 to 96.68). Acupuncture plus another standard treatment versus that standard treatment alone was tested in eight studies; with cure rate data available for seven. Most of these studies reported higher cure rates in the acupuncture plus another standard treatment group than in the standard treatment alone group. However, while the results of an exploratory meta-analysis of cure rate data from eight trials testing acupuncture versus no acupuncture tended to favour acupuncture, the results were very inconsistent across the studies and the estimated effect was very imprecise (383/396 versus 272/355; RR 1.32, 95% CI 0.95 to 1.84; P value = 0.1; I(2) = 98%).Fourteen studies compared acupuncture with a variety of other non-surgical treatments, such as Chinese drug patches, hot and cold water, ice packs, oral Chinese herbal medicine and elastic bandage. Some studies found in favour of acupuncture, some in favour of the other treatment and some found a lack of evidence for a difference between the two interventions under test. The results of an exploratory meta-analysis of cure rate data from 11 trials testing acupuncture versus another non-surgical intervention tended to slightly favour acupuncture, but these were not statistically significant and the data were very heterogeneous (404/509 versus 416/497; RR 1.07, 95% CI 0.94 to 1.22; P value = 0.30; I(2) = 92%).
AUTHORS’ CONCLUSIONS:
The currently available evidence from a very heterogeneous group of randomised and quasi-randomised controlled trials evaluating the effects of acupuncture for the treatment of acute ankle sprains does not provide reliable support for either the effectiveness or safety of acupuncture treatments, alone or in combination with other non-surgical interventions; or in comparison with other non-surgical interventions. Future rigorous randomised clinical trials with larger sample sizes will be necessary to establish robust clinical evidence concerning the effectiveness and safety of acupuncture treatment for acute ankle sprains.
You said “the details of verum and sham are provided in the appended tables”.
Where are they? I don’t see them.
you have to read the full paper [not just in these 2 cases but always – now I AM teaching you to suck eggs after all]
I understand I have to read the full paper. However, the PubMed links you provided contain what they contain. Meta-analysis contains what I cut and pasted and muscular dystrophy study from 1993 link is empty.
Since both of them are yours, do you have the full text for them? And can you provide it so I can read it?
sorry, but I am not your librarian.
the meta-analysis abstract links automatically to the full paper.
the 1993 study’s abstract is not ’empty’ but there is none. the article was published without an abstract. to read the article, you have to find a hard copy which you can get in several ways, e. g. by going to a library.
if you want to discuss science, you need to be able to use the tools of science – and a library is such a tool.
I will read the full meta-analysis. Regarding 1993 study: I live on an island in the middle of the Pacific. It’s quite possible that it would take the library here a long time to get a hard copy for this particular paper. I know it’s from 1993 but does it exist in a digital format somewhere?
not on my files
Sasha: The 1993 study may not be worth your time…
Fialka 1993 compared acupuncture (five times/week for three weeks) to sham (type of sham not reported by Forouzanfar 2002) in 14 patients with RSD. At the end of treatment no significant between-group difference was observed in mean pain reduction (VAS). Forouzanfar 2002 used a 15-item methodological quality checklist that returned a score out of 100. They assessed Korpan 1999 as scoring 41.5, Kho 1995 as scoring 26.5 and Fialka as scoring 38/100. While the spe- cific scoring for each study on each criterion was not presented, all of these scores can be considered to reflect significant method- ological limitations.
Interventions for treating pain and disability in adults with complex regional pain syndrome (Review)
O’Connell NE, Wand BM, McAuley J, Marston L, Moseley GL. The Cochrane Library 2013, Issue 4
Doc Dale, did you read the whole study? And where did you get the full text, if you did?
Thanks
The link to 1993 study is empty page on the site. Can you provide description of the arms of the study and detailed description of treatment methodology for each arm?
no, you need to go to a library
Ok thanks
You provided the link for reflex sympathetic dystrophy as evidence that your trials individualize verum. That link is empty. Now you’re telling me to “go to a library”.
It is your study. I can’t find data on it on PubMed because the page is empty. Can you provide details on what you did in that study?
Here’s my evidence to problems in verum/sham design as well as verum individualization.
http://www.abetterwaytohealth.com/acupuncture-science-based-medicine-ufos/
Scroll down to Spot The Placebo.
This is, of course, one of the common tools used by believers in nonsense to manage the cognitive dissonance caused by reality-based commentary.
When proponents of nonsense call for an “open mind”, what they actually mean is that we must establish parity of esteem between their beliefs and empirical fact, because their “open” minds are not open to the possibility of being wrong.
You could persuade pretty much any skeptic with a single well-constructed experiment that convincingly refutes the null hypothesis. What actually happens is an endless succession of bad experiments most of which cannot, by design, refute anything.
Ask anyone active in this discussion: what would persuade you that you are wrong? I bet you dollars to doughnuts that the proponents of acupuncture, chiropractic, homeopathy and so on will carefully construct something that protects their core beliefs. A typical response to this question from a homeopath was that they would believe the scientific view of homeopathy as and when they stop seeing its miraculous results.
If you are not prepared to state a set of tests that would cause you to change your mind, and guarantee to abide by the results, then you are part of a cult. I have yet to encounter a single skeptic who is unwilling to state the tests that would cause them to change their mind. I have yet to encounter a single proponent of “woo” who is prepared to do so other than in terms which ensure that they will never have to actually do it.
Guy: Ask anyone active in this discussion: what would persuade you that you are wrong?
Properly designed quality studies that represent today’s typical clinical and therapeutic approaches. Many other nuances, but that is the basic requirement.
Guy Chapman-.
You’re just about the only feller that Doc ‘If Only In His Own Mind’ Dale pretends to have any respect for.
To the rest of us, it’s a bit like watching a re-match of the ‘Rumble In The Jumble’ featuring Muhammad Ali and George Formby.
Foolishly, the ‘Doc’ is backed up against the ropes but refuses to give in, resorting to the tactic of shouting ‘gibberish’ at the referee.
I’ve got a few quid riding on this.
I reckon he’ll try to hold out until the year ‘Forever’, hoping-like Hitler’s would-be successors in the ‘Foxley Plot’ assassination story-that the rest of us will give up in exhaustion, and his side will be able to sue for some kind of degenerate and rather creepy peace treaty.
@Dale:
That’s not actually an answer. The question is, what would convince you that you are wrong? You raise the prospect – using some slightly coded language – of “pragmatic” trials, a form of trial that, by design, is almost incapable of delivering a negative result. Many of these trials have been carried out, even on totally bogus therapies like homeopathy, and produced positive results, so it is unclear how many negative results (in a trial that pretty much can’t deliver a negative result) you’re demanding, to offset the positive ones.
So, what test *that is objective and capable of producing a negative result*, would you accept as definitive, if it disproved your beliefs?
Guy: So, what test *that is objective and capable of producing a negative result*, would you accept as definitive, if it disproved your beliefs?
Either I misunderstood your request or you altered it. Doesn’t really matter.
To my knowledge there are no completely objective tests when he comes to evaluating manual therapy outcomes.
Thus, I would be content at this time with using the same tests that are accepted as valid and used in medical research when dealing with like conditions (which tests, of course, are dependent on experimental design). Personally, I would lean toward tests which examine and evaluate the postural control system.
As far as I’m concerned, what chiropractors have to demonstrate is that their usual multimodal approach is as good as the standard medical approach with equal or lesser risk. How that is tested, as you alluded to, is a little more complicated.
Fwiw, Guy I’m leaving this particular blog as its deteriorated to mostly name calling and littering my inbox with junk. I suspect I’ll pop up on another blog sometime.
Sorry to see you go, Doc Dale. What you posted on 1993 study, was there a link to the full text?
Thanks
I’m just leaving this blog on acupuncture.
I’m not sure that any online pdf of the cochrane study was obtained via proper channels so I won’t share any links. But it’s out there if you want to search for it.
Oh, I see… The authors of the meta-analysis analysis have vested interest and confirmed agenda and Steven Novella does not? I looked up his bio, all the guy seems to do is write for sceptics blogs and, curiously enough, adventure gaming books. I know lots of MDs and all of them, who are experienced clinicians, treat patients. They don’t write multiple blogs.
And yes, in a conversation between a biostatistician and a neurologist on interpretation of data, I will take biostatistician.
“Senior neurologist” – please, don’t make me laugh. My first acupuncture teacher is a neurologist, my second is a surgeon. And they would both laugh at Steven Novella.
“Several others INCLUDING YOU agree with him”? Well, it must me be right, then what was I thinking! YOU agree with him.
Ask yourself one simple question: who the hell are you?
would it not be more appropriate to mention the flaws in Novella’s arguments [if you can identify any], rather than attacking the person?
I just typed up a response to Novella’s arguments which got erased because I pressed a wrong phone button. I will retype in a couple of hours…
So here are my thoughts on Novella. The only arguments that are possible to respond to are contained in a couple of the paragraphs in the middle of his piece. The rest are just his personal opinions worth nothing, as far as I am concerned. I’ll focus on statistical arguments because Novella’s opinions are irrelevant.
1. Clinically insignificant difference of 5 points on a pain scale. Difference between what and what? Sham vs verum? Verum vs standard of care (SOC)? Sham vs SOC?
If first option, it raises the same sham/verum issues that have been raised before. If verum vs SOC option, I would have to see verum design of the studies Novella refers to in order to comment further.
2. Publication bias and researcher bias. These are just post hoc theatrics to explain away results which Novella doesn’t like. All meta analyses are subject to publication bias but to claim it here Novella would have to show examples of negative acupuncture trials that were never published and therefore weren’t included in Vickers analysis.
3. P-hacking. This doesn’t even deserve a response because here Novella basically accuses researchers of data mining.
4. Poor blinding. Is he talking about lack of single blinding? Since double blinding doesn’t make sense in acupuncture trials, I assume he talks about poor single blinding. How did this escape Vickers?
5. Rigor and decline effect. Here I can’t comment since I don’t have access to what Novella means by “rigorous” studies. How was verum designed? Did patients have pattern differentiation? Was it preset points for verum or were points changed visit to visit depending on what pulse showed? Were rong and Wei circulations taken into account when needling? And so on… Without all of this answered I don’t know how “well-designed” those studies were.
So, to summarize: the only points worth paying attention to in Novella’s op-ed are numbers 1 and 5. Clinically insignificant difference (according to him) and rigor and decline effect. To comment on them further I would need those questions about the studies answered. Also, it’s worth noting that what Novella alleges in 1 and 5 is in direct contradiction to what Vickers says in the TIME article: “We saw a measurable effect there. If acupuncture were a drug, we’d say the drug works”.
The rest of Novella’s piece consists of two things:
1) Points 2-4 which are basically a bunch of fancy sounding conjectures and post-hocs: publication bias, research bias, p-hacking, etc with nothing to back it up. They sound sciencey but are nothing more than Novella’s opinions and can be disregarded.
2) Novella’s fantasies on what TCM is and isn’t: pulse and tongue diagnosis are meaningless and so forth. Any TCM practitioner can tell you that Novella has no idea what he’s talking about.
All of the above is probably the reason that Vickers analysis got profiled in TIME while Novella’s piece was published on Novella’s own blog. To believe, as he alleges, that Vickers represents minority opinion while Novella is in the majority of scientific consensus is to defy all reason.
“The only arguments that are possible to respond to…” You mean, that you are capable of responding?
Oh wow… Well, I’ve spent enough time on this. Enjoy the rest of your interactions.
@Bjorn: regarding Novella’s understanding of biology, pharmacology, etc.
In order to evaluate acupuncture you don’t need to understand those disciplines. To design a proper RCT evaluating acupuncture one needs to understand one thing – acupuncture. And based on the link you supplied Novella doesn’t understand acupuncture. And I am not even sure if he actually runs RCTs or just evaluates data from other people.
Regarding your parlour trick comment. You do realize that you’re just one guy who doesn’t believe acupuncture works, right? The fact that you are an MD means nothing. I know lots of MDs who not only believe acupuncture works but who also get it themselves, refer patients to it or perform it on their patients. We have MDs referring to our clinic whom we never met nor have we solicited their referrals. They do it solely based on the changes they see in their patients.
Consider that next time you get an urge to make a pompous comment.
“In order to evaluate acupuncture you don’t need to understand those disciplines. To design a proper RCT evaluating acupuncture one needs to understand one thing – acupuncture.” WHY DON’T YOU SHOW US THE RCTs YOU HAVE DONE THEN? [in my view, this is the daftest of your comments yet]
Is this supposed to be an argument? The fact that I didn’t design any RCTs, what does it possibly prove in your mind?
what would it prove to you, if I publicly announced ‘ALL IT NEEDS TO DESIGN A SPACESHIP IS TO KNOW STARS’?
Obviously, that’s not what I meant. It was in response to the assertion that Novella knows physiology, pharmacology etc and is therefore better able to evaluate acupuncture plausibility. It meant that in evaluating a technique you need to observe the rules that make this technique effective and Novella, based on what he wrote, doesn’t understand what those rules are.
I have a feeling you would be able to parse it out from the comment but maybe the urge to catch me in a logical inconsistency was too strong for you…
Sasha said:
Did you spot any errors in that criticism?
Edzard said:
I already asked. Still waiting…
yes, ad hominems are so much easier than real arguments!
Yes there are the odd MD’s who lost their senses. I also know several idiots who have an MD.
There was one fool with an MD who thinks Chinese medicine and acupuncture works was snooping around here recently and throwing about (apparently )drunken obscenities. Can’t recall his name at the moment and really don’t want to.
I so wish we had more balanced characters here to discuss with.
No doubt there are idiots with MD. I can think of a couple right now.
Shows how very little you know about medical education and training vs. biostatistician.
Either you didn’t understand it or simply didn’t read it properly (probably both) or it was a false one. As any good skeptic, Steve Novella has made enemy of many quacks and charlatans. Novella is an academic clinical neurologist and an associate professor. He wouldn’t hold such posts if he didn’t actively keep deserving it. He is a very productive and dedicated man who spends his free time well.
Try looking him up on PubMed. I doubt you will, but people who understand academic and medical matters are impressed, very impressed by his productive work in many fields, not the least academic neurology.
Sasha said:
Which article are these your thoughts on and have you posted them as comments on his blog?
As well as name calling, the fellow Sasha is now trying distraction, as is Doc ‘In His Own Mind At Least’ Dale, with their windy guff and patronising explanations of the phrase ‘ad hominem’.
As far as I recall, I hadn’t accused either of them directly of this. Though I’m willing to.
I’d simply pointed out that this Sasha item had called me a ‘dimwit’, I kind of mind, but kind of don’t, since in the end, as E E has pointed out, it’s the last resort of someone who’s run out of arguments.
In Sasha’s case, round about the 2nd lap.
And by the way, ‘Doc’ Dale still hasn’t apologised for the misunderstanding. Or explained why he’s so happy to associate himself with playground name-callers.
Probably adding more letters to his ‘qualifications’.
Anyway – over and out with Sasha for a while. I expect the rest of you are well capable of dealing with him.
‘Tis’. ‘Tisn’t’. ‘Tis’. ‘You’re a poo face.’ ‘No you are’. ‘I said it first’. ‘Didn’t’. ‘Did’.
Peter Deadman –
Thanks for backing me up.
First intelligent comment you’ve made.
Appreciate it.
On Novella’s article that was linked. What does it matter whether I posted them on his blog or not?
Alan
“Which article are these your thoughts on and have you posted them as comments on his blog?”
Can you link to a post/article/anything that demonstrates Novella understands the basics of acupuncture/Chinese medicine? I’ve been looking, but so far have only found stuff that he must have written before doing any real research into it.
Jm – the question to ask of Alan is this: he asked me to critique Novella’s article and I did. Now he asks me if I posted my comments on Novella’s blog. Why?
Wouldn’t it be more logical for Alan to now respond to my critique of Novella? Provided he can, of course.
jm said:
Are you unable to criticise it either?
Sasha said:
Why would you not want to post your criticism of Dr Novella’s article under that article where he can see it and respond to it?
Why don’t YOU respond to my criticism of Navella? You are one of the people who asked for it.
@ Sasha on Sunday 03 July 2016 at 22:23
“The mechanism of action has to do with physics (like everything else) and I can refer you to sources if you’re interested. It is only recently that all acupuncture is done with skin penetration.”
“What is the mechanism of action that accounts for acupuncture and myriad of its effects: neurological, digestive, cardiac, hormonal, etc? The answer has to do with physics and I can refer you to sources if you are interested.”
Yes, please post the references and/or links?
Ok, give me a bit of time.
Alan
“Are you unable to criticise it either?”
What is “it”? Can you post a link to a post/article/anything that demonstrates Novella understands the basics of acupuncture/Chinese medicine?
Sasha said:
I don’t think I need to be taking lessons in logic from you, but the obvious, sensible, constructive and productive thing to do would be for you to post your criticisms of Dr Novella and what he said on his blog under the article you’re criticising, where he can respond to them, don’t you think? If not, why not?
You asked for critique of Novella and I gave it. What do YOU have to say about the critique? Or do only know how to defer to other people and direct traffic: you post this here, you post this there?
Either learn how to use your own brain cells or stop wasting others’ time.
Jesus Christ, some of these pseudo sceptics can’t even put a paragraph of their own thoughts together ubless it’s copy/paste from someone else.
jm said:
Well, if you’re going to play silly games instead of providing evidence-based arguments against what Dr Novella said…
Alan
The link Sasha posted is Novella talking about a study. Can you post a link to a post/article/anything that demonstrates Novella understands the basics of acupuncture/Chinese medicine?
What is there to understand? Acupuncture is in effect a fictional belief system so there are no basics to understand other than the basics of imaginary health fantasies in general. You can name more than four hundred different varieties of make-believe medicine. What sets AP somewhat apart from most of them is its invasive nature, which makes it more impressive and easier to market to the gullible. The balderdash about mystical energies and pathways etc. not even our most ardent acupuncture advocates have been able to explain consistently.
Bjorn
“What is there to understand?” is a fantastic mantra for an Olympic level conclusion jumper.
Sasha does not seem to be bothered by evidence nor critical thinking; on his website (http://www.peoplesmedicine.us/clinic.html), he writes about acupuncture the following:
Traditional Acupuncture is a healing art and science which teaches us to see the entire human being in body, mind and spirit, how to recognize the process of health and illness, and how to restore the body to health. Chinese medicine believes there is a life force called Qi (energy), and that this life force flows within us in a harmonious, balanced way. This harmony and balance is health. If the life force is not flowing properly, then there is disharmony and imbalance. This is illness.
Usually we know we are ill via a symptom which acts as a signal of distress. We may have a headache, an ulcer, depression, arthritis, insomnia, or other complaints. Chinese medicine believes that these symptoms are caused by stagnation in the flow of Qi (energy). We could say that the symptom is the trouble in itself and try to eliminate it, but from the perspective of traditional acupuncture this would be like covering up a flashing generator light in your car when all it’s doing is indicating trouble.
A comprehensive examination is performed utilizing the diagnostic tools of Chinese medicine to assess the condition of Qi, and to identify the root cause of illness. These tools take into consideration everything about a person; the sound of the voice, complexion, predominant emotion, temperature and texture of the skin, posture, childhood history, favorite tastes, best and worst times of day, dreams, appetite and diet, sleep patterns, bowels, sexual energy, habits & hobbies, level of stress at home and work, etc. This information is important in order to make an accurate diagnosis of a person’s illness. Important tools in this process are pulse and tongue diagnosis. Each organ is associated with a pulse and other facets of life: an emotion, a taste, a color, a time of day, a season, an odor, a sound, a sense organ, a body orifice, a pathway where the Qi flows. This means that a person who has an imbalance in the flow of the Qi that controls the Kidneys may also have symptoms such as a craving for salt, an excess of fear, a preference for or intense dislike of the color blue, a lack of will power, ear troubles, dislike of cold weather, sexual inadequacy, pain in the joints, lower back pain, knee pain. Each organ has its correlations.
Acupuncture restores order and balance to the Qi enabling it to flow without obstruction, so that the body, mind, and spirit can heal itself. Traditional acupuncture treats the person, not the disease.
Edzard: for the record, I wrote none of it.
I am too lazy to maintain my own website! It was written by someone else who worked in the clinic at one point and took care of these matters. Thanks for posting it, upon reading it, there are some things which I would phrase differently. I’ll have to go and revise them. In fact, I think you just motivated me to go in there and scrap the whole thing to reflect only what I think is pertinent.
However, posting passages from a website addresses none of the points regarding Vickers, sham vs verum data, etc. I believe this one is a straw man, since you guys seem up to date on logical fallacies…
but, you know, you are still responsible for it.
You will get no argument from me there. That’s why I said I will go and scrap the whole thing.
Sasha
Wonderful! This remark stands as your own self ad hominem.
I think you just recognized your own horse shit when it was stuck under your nose.
No, I think I just admitted that I am too lazy to maintain my own website. That’s ok, I got lots of failings.
“Acupuncture restores order and balance to the Qi enabling it to flow without obstruction, so that the body, mind, and spirit can heal itself.”
When a client’s body, mind, and spirit fails to heal itself, who is responsible for this outcome: the client; or the practitioner who is too lazy to maintain their own website!
“…a preference for or intense dislike of the color blue…”. That’s a new one to me. What wavelength of blue light, I wonder.
But the same claim comes from practitioners of feng shui, qui gong, taoist energy touch, reiki and acupressure massage, among other forms of snakeoil. Why should a person undergo needling when they can go to all these other pricks and achieve the same results?!
if a panacea is a cure all; what are conditions cured by all treatments?
Edzard –
Same reason as with all the other hundreds of religions in the World -they all claim to be the ONE, which is logically impossible. The only thing – luckily for them -that the various altmed cults have over ‘Religion’ is that they’re not all busy murdering one another to establish supremacy. Yet.
Edzard, you’re a funny guy. You said you have no time to answer Mel’s questions and now you are spending time discussing my website. Without, btw, addressing any of the points raised by Vicker’s analysis. Verum outperforms sham, period. Once better verum studies are designed, I believe it will outperform by even more.
If you are a scientist, as you claim to be, focus on those issues, not my website.
why do you think I might listen to your advice?
[actually, I do find it interesting…in that it might tell me what NOT to do]
Panaches? Pandanuses? Pangs?
Frank, start spelling it “qi gong” or “qigong”. It’ll help with the illusion that you did a touch of research. The first time you added the u, I figured it was a typo. And the second, third, etc. But you’re pretty consistent…which makes it look like you don’t know that the qi in qigong is the same qi in the quote you’re referencing.
Or, it would probably be better to just stick with “witchcraft”…that way people won’t know you’re unfamiliar with the terms. (Well…they would know that you’re unfamiliar with term “witchcraft”…but what are the odds that someone who practices witchcraft would end up reading this blog, eh?)
You should probably also leave out “acupressure massage” from your list. People might look that up, and realize that what is used as “sham acupuncture” in a lot of the studies, would actually be considered acupressure. In which case many would expect it to perform similarly to acupuncture.
Don’t know if it went through, here is one more thing.
Interestingly enough, while I was writing up on Novella, five patients came into the clinic and all of them for pain. I will summarize it here to show how acupuncture compares to standard of care (SOC) and how Novella’s fantasies hold up in real life.
Two of the patients were first visits and while I normally don’t ask in depth questions about pain reduction after one visit, here I did for the purpose of writing this.
Patient #1. First visit. 10 year history of cervicalgia b/o athletics. Managed with ibuprofen. Regular flare ups with occasional torticollis. Presents with acute torticollis of 24 hours following a week old flare up of cervicalgia. Shooting neurological pain into the occiput and ROM of about 10%. Inability to sit up from supine position without severe pain (classical torticollis). Pain is 9-10 and severe enough that the patient isn’t sure if they can get on the plane for a 30 min flight.
After the treatment the patient reports 30-40% reduction in pain and 20% improvement in ROM. Feels “much better” and wants to send their spouse for a treatment.
Patient #2. 2 months old sharp hip pain with restricted ROM. Pain is throughout the day with particular movements. Patient had hip replacement 4 years ago, thus they are at the end of SOC. At this point it’s opiates, NSAIDs and steroids for them. 3rd visit. After 2nd visit patient was pain free for 2 days, then throughout the week pain began to return and yesterday was sharp again. Patient was also given hip opening exercises today in addition to treatment.
Patient #3. Pain in multiple joints of 2 year duration. Sinus congestion with mucus and weak digestive system. Pain flares up with cold, windy weather. First treatment. Here I didn’t ask about pain reduction after the treatment because with this etiology such a question wouldn’t make sense. Based on my experience, though, this type of pain can be either greatly improved or completely resolved with acupuncture and some dietary modifications.
Patient #4. Chronic Achilles tendonitis following tendon rupture 28 years ago. Bursitis of the affected heel. Lumbalgia, cervicalgia, and opposite leg pain in the hamstring b/o impaired walking mechanics. Prior SOC – steroid injections which patient doesn’t want to continue b/o decreased effectiveness and possible side effect of tendon rupture. 3rd treatment today. Before this treatment patient reports 30-40% decrease in pain in the affected heel and improved ROM in opposite hamstring. Says they feel “fantastico” and can’t believe the progress considering how chronic the problem has become.
Patient #5. A month old yoga injury in right shoulder. Decreased ROM because of pain, weakness and pain with abduction. Prior SOC – 2 physio treatments with exercises that were hard to do b/o pain. After two acupuncture treatments patient reports 80% reduction in pain with ROM restored.
So, here are real life clinical results and how they compare to Novella’s theories. What would you think happened if I told these patients that according to some guy who writes lots of blogs the improvement is in their head or maybe they just statistically improved by 5% or regressed to the mean? Do you think it would affect how they see their improvements or what they think of acupuncture or whether they will recommend acupuncture to their friends?
@Sasha: Odd how none of those cases had objectively measurable endpoints. Isn’t it funny how that goes?
What would persuade you that you are wrong? In the following specific areas:
1. What would persuade you that the location of needle placement is irrelevant?
2. What would persuade you that whether or not the needle is inserted is irrelevant?
3. What would persuade you that acupuncture itself is irrelevant, if the first two conditions are fulfilled?
I state this in these terms because my reading of the evidence says that items 1 and 2 are already established, but I am sure you dispute this. Your answer to 3 is more interesting and important of course. I take it you do not believe in “qi”, since that lacks any reality-based foundation at all.
Guy-and others- Sasha announced that he wouldn’t play with me any more. Although since I’d already said a day or so earlier that I was fed up with his childish insults, and had no interest in any further conversation with him-at least directly – his petulant statement after the fact resembled nothing so much as the Enfield/Whitehouse sketch-based of course on the Dave Lee Travis travesty-where the two outdated Radio 1 DJs huff and puff their way down the corridors in an attempt to get their retaliation in first.
But he does seem willing to continue his discourse with everyone else.
I don’t think you can be trying hard enough.
And I bet I can guess what his response will be….
Barrie, since you insist… I won’t call you dimwitted as you object to the idea so much. But I do have a good treatment for bright wittedness. It’s called: Less Mass Media and More Reading.
Here.That should give you enough to play for a week in your little sand box. Try not to hurt yourself.
@Guy: Wow. So many words so little substance…
You pseudo sceptics don’t make it easy, do you? Here I am, trying to do something useful like get links for Frank Collins or read links by EE and instead I will be once again forced to deconstruct your fantasies and not follow Doc Dale’s good advice to temper my sarcasms.
That’s ok, refuting arguments by pseudo sceptics is easier than shooting fish in a barrel. It is 4th of July in US, though, so it will have to wait a day or so.
But do stay tuned and don’t worry, it will only hurt a little bit…
In the meantime, a good Chinese proverb for you: If you get enough patience and sit by a river bank, eventually you will see a body of your enemy floating by.
@Sasha:
And you think ad hominem argument helps your case? You are not going to persuade many people that way.
I haven’t seen any pseudoskeptics here at all. I’m not one: I am open to persuasion. I can detail the evidence I would find compelling enough to cause me to reconsider. I have already changed my position on acupuncture once – I used to think it had merit, but that it was not related to meridians and other mystical nonsense. Now, having experienced it and read more research, I am of the view that it is worthless, but as I say I am open to persuasion by new evidence should it arrive.
You misperceive what you are doing. It is safe to assume that most of us are familiar with the literature; what we are asking for, in the main, is pointers to specific rigorous science that supports your position. Clinical trials are not a particularly rigorous form of science, especially since they are usually founded on P=0.05, a test which is only valid for a therapy with a plausible mechanism.
I agree that refuting pseudoskeptics is easy – I have debated enough GMO and climate change deniers to say this form personal experience. Before you have any success here, though, you will have to learn the difference between the words “refute” and “reupdiate”. Just in case you hadn’t noticed, you have failed to refute anything to date.
Very telling that you frame this in terms of a battle. Science is not a battle. There are no enemies, other than bullshit. In science, a person who has extensively tested an idea and yet been shown to be wrong, has not lost, they have increased the sum of knowledge. It’s only religious and pseudo-religious movements that vest themselves in dogmas to the extent that they cannot be questioned. The only dogma in science is that empirically verified reality is the final arbiter.
You “forgot” to answer, though: what, specifically, would cause you to change your mind and accept that you are wrong?
@Guy: regarding ad hominems.
I don’t know what it is about you guys and Latin phrases but you just LOVE them. And I mean – love ’em, love ’em, love ’em. Maybe it’s Latin itself. Makes you feel kinda smart, doesn’t it?
So… since you’re ready to cry ad hominem at the drop of a hat, let’s talk a bit about logical fallacies, shall we?
Ad hominem (Latin for “to the man” or “to the person”[1]), short for argumentum ad hominem, is a logical fallacy in which an argument is rebutted by attacking the character, motive, or other attribute of the person making the argument, or persons associated with the argument, rather than attacking the substance of the argument itself.
This is from Wiki.
The key word here is Hominem, as in Human. When I say to you: “So many words, so little substance”, I am commenting on what you wrote not attacking you as a person. I do feel that it would be helpful for you and a few others to print out Wiki definition of ad hominem and glance at it every time you get an urge to accuse others of logical fallacies.
Here’s a recent example to help you understand the difference between true ad hominem and an imaginary one:
Let’s say someone (like Ted Kennedy) posts Cochrane review on verum acupuncture outperforming sham – one of the central themes of this thread and the whole debate in general. And let’s say someone else (we are not gonna say who) posts a response like:
Ha! Look at Ted’s website he claims to cure smoking by acupuncture which Cochrane disallows.
Now, that’s an ad hominem. You can accuse Ted of inconsistencies or hypocrisy (sorry, Ted, I don’t think you are a hypocrite) but it does nothing to refute his original argument about Cochrane.
Another example. Let’s say Sasha makes an argument (whatever it was, I don’t remember). And let’s say someone else (we are not going to say who again ) writes a response like:
Look at Sasha’s website! He believes that color blue is good for your kidneys!
Sasha could be a crack whore who lives on Oreos, thinks that he’s been abducted by aliens, and believes that blue color is good for your kidneys. That in itself does nothing to refute his original argument. Therefore… This is a real ad hominem.
DO YOU NOW UNDERSTAND THE DIFFERENCE, GUY?
Well, this was fun… I will address the rest of your post later. As I said before: deconstructing your arguments will be easier than shooting fish in a barrel. (I will stay away from “refuting” for now).
I do need to get back to links for Frank Collins and to EE links, both of whom have been patiently waiting. Sorry, busy day today – a morning run, a swim in the ocean and a yoga class. They keep talking about prana, marma points and all that other stuff in yoga class, though. And I do feel full of energy (ie Qi) after it. But who knows, I may be regressing to the mean…
@Guy: ok, moving on to your other points:
1. “I can detail the evidence I would find compelling enough to cause me to reconsider.” – Please do. What form of evidence do you find compelling enough?
2. “Now, having experienced it and read more research” – Which research? Do you mean clinical trials or some other kind of research?
3. “Clinical trials are not a particularly rigorous form of science, especially since they are usually founded on P=0.05, a test which is only valid for a therapy with a plausible mechanism.” – Here I have a couple of questions/comments:
– You seem to imply that clinical trials aren’t rigorous form of science in evaluating acupuncture but at the same time you are asking me for “specific rigorous science that supports your (my) position”. If not clinical trials, what sort of scientific evidence are you asking for?
– Since clinical trials aren’t applicable to acupuncture, what research have you read?
– As far as “plausible mechanism” – you may not understand it but it doesn’t mean that plausible mechanism doesn’t exist in acupuncture. Here you’re making a classical pseudo-sceptic mistake of thinking your opinion counts as scientific evidence.
– Btw, clinical trials aren’t only about p-value but also ARR and other things.
4. “what, specifically, would cause you to change your mind and accept that you are wrong?” – Show me via trials with properly designed sham and verum arms that:
a) verum doesn’t outperform sham
b) verum doesn’t outperform standard of care
Then I’d be willing to change my mind and accept that I’m wrong.
I eagerly await your answers to these questions as well as your answers to my earlier post about Qi, Yinyang and all other kinds of woo woo.
In the meantime, here is a link to Mel Koppelman’s (yep, her again) conversation with “science based medicine” crowd. It has lots of interesting stuff but I’m interested in your thoughts on the whole verum/sham design and whether you may think it’s problematic.
http://www.abetterwaytohealth.com/acupuncture-science-based-medicine-ufos/
Until we meet again…
@ Guy Chapman:
Before we explore your questions 1-3, let’s get the fundamentals out of the way.
On objectively measurable endpoints, please answer the following questions:
1. What is an objectively measurable endpoint in the treatment of pain?
2. Is ROM an objectively measurable endpoint?
On the question of Qi – I absolutely believe in Qi as a concept that describes a myriad of phenomena observed on the physical level. To understand why I believe in Qi, please answer the following:
1. Who said: “Nothing happens until something moves”?
2. What is that something that causes “something” to move?
As a bonus, I can also tell you that I believe in Yin Yang. To understand why, please answer the following:
1. What is the common mechanism underlying these phenomena :
Electricity
Cell membrane potential
Cell differentiation
Passive heat transfer
Wind
Ocean currents
and so on
Now, regarding your questions 1-3. Your reading of evidence on questions 1-2 is wrong because evidence itself is faulty. Something I keep repeating but you don’t want to hear it.
The truth is:
1. SHAM ISN’T PHYSIOLOGICALLY INACTIVE.
2. SHAM ISN’T PROPERLY DESIGNED IN MANY STUDIES.
3. VERUM ISN’T PROPERLY DESIGNED IN MANY STUDIES.
4. BOTH SHAM AND VERUM OFTEN OUTPERFORM STANDARD OF CARE.
5. VERUM OUTPERFORMS SHAM.
As the latest Cochrane review clearly shows.
We will leave aside question 3 since it doesn’t make sense in view of questions 1-2.
So, I eagerly await your answers to my questions. In the meantime I will get back to links for Frank Collins and to reading EE links. I will also study the difference between refute and repudiate.
@Sasha
Sigh… The plural of ‘anecdote’ is ‘anecdotes’ not ‘evidence’. None of these stories are the least impressive. Any physician, physiotherapist etc. with experience can regularly see such improvements with a reassuring attitude, common sense, patience, ordinary analgesics, NSAID’s, physiotherapy methods and above all, activity, exercise and time.
Pain is a very subjective phenomenon and it is quite easy to achieve temporary[sic] relief with a reassuring and suggestive approach.
We have been through this so often here that it is almost tiresome to repeat but regression to the mean (you said it but obviously do not understand it), normal healing process/self-improvement, cyclical symptoms of arthritis and other chronic conditions, etc. etc. are simple, straightforward explanations for all these “success” stories. You see this with any of the nonsense “alternative” modalities, e.g. acupuncture through cranial osteopathy and homeopathy to shiatsu, reiki, prayer, angel therapy, aromatherapy, chiropractic and many more. You are deceiving yourself, that’s it. Of course your customers think you’re a hero. Simply because you tell them so and they have no way of understanding that the improvement is not due to the needling. What about those that don’t return?
You conveniently omit to count all those who do not return because they felt no improvement and you forget to count all those who never dreamt of paying you to use them as a pin cushion but got better anyway. The crux of the matter is that you can achieve all this and more without the needles and the mumbo-jumbo about Qi and meridians, Yin or Yang and all that jazz that no one has ever seen, felt or measured.
You are fooling yourself using an unnecessary, invasive, occasionally harmful but non-efficient method to entertain your customers while nature takes it’s course.
You are welcome to continue your rants about our pompous attitude, our naysaying, our negativity, our reductionism and so forth and so on till you are blue in your face. You can list all your satisfied customers stories, but you are still not providing credible, controlled evidence for the efficacy of acupuncture, which by the way was “invented” as late as last century as make-believe medicine modeled on old, prescientific blood-letting rituals.
“…mumbo-jumbo about Qi and meridians, Yin or Yang and all that jazz that no one has ever seen, felt or measured.” What is there to understand, eh Bjorn? Olympic level. 🙂
Ok, Bjorn, I will keep this short since I do need to get to more important matters like reading and commenting on EE studies and getting Frank Collins the links.
I won’t go on about our differences on regression to the mean, subjectivity of pain, and how clinicians deceive themselves. As far as Qi and Yin Yang, wait for my post to Guy Chapman. He seems to be another great authority on nonsense and mumbo-jumbo.
As an MD you’re free to treat pain however you wish: NSAIDs, opiates, steroids, physio or even rest and exercise. But do understand one simple thing:
We are not going to let you and a few others who think like you to decide how or with what we treat patients. And neither will the patients themselves or the MDs who refer patients to acupuncture or who practice acupuncture on their patients.
It is really as simple as that. Nothing more to understand or discuss.
SASHA: you do come up with a lot of tosh!!!
“As an MD you’re free to treat pain however you wish: NSAIDs, opiates, steroids, physio or even rest and exercise.”
do you really believe that? I’d say responsible doctors have a duty to treat with whatever treatment is best supported by evidence for efficacy and safety!
“We are not going to let you and a few others who think like you to decide how or with what we treat patients.”
If that is true, you put yourself outside the scrutiny of others, and that is a hallmark of quackery!
Edzard: will you people let me work already! I promised I will read your studies and I promised Frank Collins a response. Instead, you keep coming up with non sequiturs that need a response.
What was so difficult to understand about what I said? Bjorn contrasted what he thinks are science based approaches to pain: analgesics, NSAIDs, etc versus what he thinks is mumbo-jumbo like acupuncture.
That’s why I wrote what I wrote. How you deduced from it that I somehow advocate clinicians acting irresponsibly is something only you can understand.
As far as outside scrutiny, I am all for that regarding acupuncture. As long as studies are designed with proper verum, all the issues with sham are taken into account and acupuncture is evaluated vs standard of care. Then we can realistically compare verum vs sham, verum vs standard of care and sham vs standard of care.
And while we are scrutinizing acupuncture, we should also scrutinize conventional approaches to pain and the havoc they’re wrecking. Then we’ll truly get a full picture on quackery.
Now, in order for me to look at the studies you referenced, I actually need to go and read them. Won’t be today, though, probably within next 48 hours.
are you saying that nobody should interrupt you with critical comments while you have better things to do? SURELY NOT!
“And while we are scrutinizing acupuncture, we should also scrutinize conventional approaches to pain and the havoc they’re wrecking. Then we’ll truly get a full picture on quackery.”
absolutely!
but this is a blog about alt med – simply because that’s my expertise. so, forget about the TU QUOQUE fallacy.
alternatively read the some of the 200 000 Medline listed articles on NSAIDs.
Look, TU QUOQUE or not, the clinical issue is straightforward. We have people with pain, lots and lots of pain. (Acupuncture isn’t only used in pain but let’s leave that aside for a moment ).
It is pain of many etiologies and often of unknown etiology. For some cases surgery is indicated, for many it isn’t. For these conventionally there are: NSAIDs, opiates, steroids, and analgesics. With everything that it entails. And physio.
If sham and verum acupuncture both outperform standard of care, we should look into it further. Now we have to establish whether verum outperforms sham. I believe the data are already there that it does. Once better verum is designed, it will even more.
And the first step would be to remove the bit which, your own statement acknowledges, does nothing: sticking needles in people. Instead we should focus on what is actually causing these subjective improvements.
I think we already have a fair idea, incidentally: the “tea and sympathy” effect. I am a huge fan of this, and think it should be used as a core part of therapy by the NHS. I don’t know if it counts as a low-level CBT intervention or what, but it certainly seems to help.
And I am a fan of “put your money where your mouth is” approach. We should run a trial. You will treat 100 people in pain with tea and sympathy and I will treat them with acupuncture. We can then compare results of two approaches. Of you win, I will give you the $ of those 100 treatments. If I win, you give me the equivalent monetary value.
Are you ready to try?
did you earlier pretend to have some knowledge of trial methodology? if so, you have just wiped out that impression completely.
Chill out Edzard. I don’t claim to know more than I do. I said I will critique your verum vs sham design. I expect to find flaws in it. We’ll see if I am right.
In the mean time, you are welcome to criticize me while avoiding generalities.
You misunderstood my statements. None of them ever “acknowledged” that sticking needles in people “does nothing”. I know that it does a hell of a lot.
Regarding Chinese proverb: science is quite often a battle between people with opposite ideas but respect for one another. Partially why debate between proponents of acupuncture and opposers isn’t really a scientific one. I don’t consider those who oppose me as enemies. It’s safe to say that acupuncture deniers have no effect on my life, other than tying up some of my time. The proverb was just a commentary on where I think the larger debate on acupuncture is heading…
Anyways, the response to your earlier “woo woo” post is coming, once I free up a bit.
Edzard said:
You must be thinking of robust and unbiased methodologies – if only you could open your mind to trial methodologies that are designed to give the ‘right’ answer…
“We should run a trial.” Indeed, you should. I can’t wait to see the results of the efficacy of Sasha versus the efficacy of ‘Doc’ Dale.
As long as you can take money from your “customers”… or maybe I should be straightforward and say ‘marks’ or ‘victims’?
We are all waiting patiently for any information from Sasha, “jm” or anyone, on why we should stop considering acupuncture and other oriental injury-involving services (cupping, gua sha etc.) to be make-believe medicine and the marketing and sale of such services to be fraudulent and harmful.
Please take all the time you need. Until then we continue to present facts and rational conclusions that can easily be found and substantiated.
I prefer the word “patients”.
https://www.jcm.co.uk/news/research-archive/
“I prefer the word ‘patients’.”
Indubitably.
patient: able to accept or tolerate delays, problems, or suffering without becoming annoyed or anxious.
Bjorn,
You posted this on another thread: “Due to our dedication for seeking truth…”. Followed by this: “Now why am I even spending time writing this?… because I CARE!!! – That is my agenda.”
Rather than “…waiting patiently for any information from Sasha, “jm” or anyone…”, care enough to do some research into the Chinese medical model, learn some terms, learn a touch of theory. You’ve said you find the Su Wen too challenging (fair enough) but you can start simpler with something like “The Web That Has No Weaver”. That’ll get you started.
If you want to continue to beat the dead gua sha horse, give me you thoughts on this: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0117146. Gua sha for neck pain/low back pain, effective with no side effects. I’m sure there’s something wrong with the study…and I’m sure you’ll point it out.
I don’t blame him. Chinese medicine scholars have been debating Su Wen for centuries. “The Web” has some issues with it, if I remember correctly. I read it about 20 years ago and that’s the impression I got back then.
To begin to understand acupuncture – good book to read is Nanjing, “The Classic of Difficult Issues”, Unshuld translation.
Our resilient troll “jm” seems to be at the bottle again, hoping to entice me into an argument by fabulating pompously about what I am supposed to have said or thought.
For those who recently bought tickets and entered this circus, the “jm” character, whom I consider unworthy of addressing in first person due to several previous immature and indecent utterings, is a self professed purveyor of “Gua Sha” and “cupping”, the former being prescientific quackery that consists of scraping the skin with a spoon or similar utensil producing bleeding into its superficial layers, the latter is the application of hickeys using suction cups as popularised by dim-witted celebrities like Gwyneth Paltrow. In effect these modern variations on outdated bloodletting rituals produce the same kind of injury. These practices the joker “jm” sells to the worried well and other gullible marks with fraudulent claims of efficacy against various health issues.
The only reason I bother to respond now is because the nitwit has yet again demonstrated its intellectual limitations by waving a link to a paper that I don’t think (s)he was able to understand anything of beyond perhaps the title. It does not show what (s)he seems to hope, it actually shows that TCM, including Gua Sha, cupping and all the rest is useless for neck and back pain.
Here is the abstract conclusion. (emphases are mine) :
What the authors are in effect saying, even if they do not seem to like phrasing it clearly is:
“We found nothing of worth in all these different TCM modalities but because we hope some day something will prove useful then further research is still needed“. In the main conclusion they repeat this vague paraphrasing and add some speculations that clearly confirm their strong bias for TCM.
The uprightness they manage to apply despite this obvious dislike for the results is interesting. Perhaps that is because the academic editor is a wash-proof Norwegian scientist Professor with an impressive reputation.
Reading through this paper and looking at the different forest plots, there are many interesting twists and I do not have time to delve on them any further, but in summary all the different modalities looked at simply show no effect beyond the expected from bias and other obvious confounding effects.
Many of the studies are for example “woo against waiting list” which will always show a slight tendency for the woo as is evident here.
“Gua sha, tai chi, qigong, and Chinese manipulation showed fair effects, but we were unable to draw any definite conclusions, and further research is still needed”
This sounds very definitely as the disheartened mumbling of someone who had hoped for more but lacks the courage to say ” We found nothing”
I am surprised the editor let them get away with this vague wording.
” relatively safe” is their way of saying “we found no evidence for safety”
Another morsel to the ever growing heap of confirmation that TCM is worthless woo.
Thanks Bjorn. Why didn’t you say that on the gua sha thread, when Edzard first posted the comment?
http://edzardernst.com/2013/01/gua-sha-torture-or-treatment/#comment-76394
Since I am just a nitwit again demonstrating my intellectual limitations…perhaps I also misunderstood what you meant by your dedication for seeking truth. Ah well, what’s to understand, eh?
@Sasha – despite the issues wth Web (newer edition, from 2000) it’s a big step above skimming Wikipedia and looking at pictures. Unshuld is an intense read, and I’m sure Bjorn wouldn’t want to break a sweat in his dedicated search for truth.
jm- Well that’s refreshing.
Somebody getting in first and calling himself a nitwit before Sasha does it.
Although it’s a bit like the old joke about a feller complaining to his doctor-proper doctor-that he gets a pain in his eye every time he drinks a cup of tea.
“jm” again failing at being smart.
Bjorn
I really don’t understand why you don’t just learn something about Chinese medicine. Having a basic understanding won’t change the results of the studies you comment on. It would just make you seem less like the equivalent of Dr Oz, writing for the Onion.
As an added benefit, you could then appreciate how funny it is when folks refer to qi as magical blah blah, meridians being imaginary, and (my favorite) yin/yang theory being pre-scientific. Really, you’re missing out on some good belly laughs. It’s a great abdominal workout.
“Jm” is so busy trying to be smart (s)he missed (suppressed by cognitive dissonance) the part about research showing clearly that his/her woo-services are worthless.
Reminder to self: Stop feeding the troll!
“…missed (suppressed by cognitive dissonance) the part about research showing clearly that his/her woo-services are worthless.”
Didn’t miss it at all, Bjorn. You should post your observations on the gua sha thread: http://edzardernst.com/2013/01/gua-sha-torture-or-treatment/#comment-76394
If you actually learn something, you won’t have to use terms like woo-service, or talk about tooth fairies, or Harry Potter. After learning a bit, you’ll actually quit misusing terms like qi, meridian, yin/yang. And you won’t have to make up what practitioners are trying to do. You could deal with the reality of the situation, rather than your fantasy.
Or did you mean something different by “dedication for seeking truth”?
Hot off the press, an updated Cochrane review on acupuncture for migraine. Still work to be done of course, but it seems in this case at least that the trend is not towards the conclusion espoused here so often that acupuncture is useless, and that verum is no better than placebo. Quite the opposite in fact.
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD001218.pub3/full
not that hot! I saw it days ago.
and not very impressive: “After treatment headache frequency at least halved in 50% of participants receiving true acupuncture and 41% receiving sham acupuncture (pooled RR 1.23, 95% CI 1.11 to 1.36; I² = 48%; 14 trials, 1825 participants) and at follow-up in 53% and 42%, respectively (pooled RR 1.25, 95% CI 1.13 to 1.39; I² = 61%; 11 trials, 1683 participants; moderate quality evidence). The corresponding NNTBs are 11 (95% CI 7.00 to 20.00) and 10 (95% CI 6.00 to 18.00), respectively.” I very much doubt that this is clinically relevant.
A bit pedantic about the relative warmth of the press (first published 28th June), but never mind!
You’re obviously not impressed either that acupuncture performed significantly better than prophylactic drugs, with fewer reported adverse events and side effects? Many people (including the review authors) conclude that this, in combination with the statistically significant frequency reduction over sham, is clinically relevant.
no, not nearly as impressed as you seem to be.
You have discredited yourself by using the nonsense term “performed significantly”.
he had discredited himself long before; if you look at his website, you will find that he earns (some of) his money by treating smokers who want to quit with acupuncture and hypnotherapy. both interventions have negative Cochrane reviews. this suggests he likes Cochrane reviews only if they confirm his prejudices. I do pity his patients!
@Pete I think you discredit yourself by being pedantic with my choice of words rather than addressing the findings of the review.
His patients that don’t quit smoking after his ‘treatments’ is entirely the fault of his patients, it is never his fault, nor the fault of the treatment modality. This is the primary tenet of both sCAM and pop-psychology (aka self-help courses and books).
Oh oh. Looks like Mr Attkins just woke up from his meds…
Eh? Where did you get that from please @Edzard?
where did I get what from? the info about your treatment of smokers? that came from your website.
@Tom kennedy
You seem to be very interested in results.
How about you show us the results of an audit of your results. For example your success rate in smoking cessation. You must have accumulated quite a database by now, right?
For how long do you follow your customers and how soon do you contact those who do not show up for their follow-up appointments?
@Björn Geir are you really more interested in my own results than the Cochrane review I was trying to introduce to the discussion? No doubt they would be dismissed as anecdotal anyway, so no point. As I’ve said, I don’t treat smoking cessation – probably best not to trust @Edzard’s research without taking the trouble to check it yourself first in future.
@Bjorn: when you say to Tom Kennedy “you seem to be very interested in results”, what are you referring to?
@Tom Kennedy
Do you or do you not document and follow the results of your work?
@Bjorn – when I did my initial training at the University of Westminster, we used the MYMOP system to record patient-reported outcomes. I have used something similar sporadically since then – here’s the first page of the current version of my intake form:
http://screencast.com/t/GJYbhUpe
But I have to admit I find it hard to fit in the time needed to complete this extra paperwork as well as give a full treatment, discuss progress/advice etc. (especially in the low-cost clinic I run). Because of this, I’ve had advanced discussions with software/app developers about creating a quick and convenient way of doing this, and it’s something I intend to follow up.
So yes, I have collected a fair amount of data over the years (with generally very favorable results), but not as consistently as I’d like (a work in progress). I acknowledge the limitations of this type of outcome measurement, but it’s a start, and I’m looking into the possibility of incorporating various more condition-specific measures in the app, including more objective outcomes like blood pressure where appropriate.
I often follow up with people who only come once, and although I don’t have exact data available, I’d say about 50% say they just wanted to try it out as a one-off, 25% say it wasn’t for them (they found it more uncomfortable than they expected, or didn’t experience any improvement and have moved on to other things), and 25% felt enough improvement not to need to return. Last week in fact, I bumped into a patient who came for a single treatment a year or more ago, for chronic migraines. She said the reason she didn’t come back was that she hasn’t has a recurrence since that day (n=1 of course, but that’s happened several times).
I am far from perfect, but I strive to be completely honest and up-front with people that seek my help, and to consistently improve my skills and methods. When people ask me ‘does acupuncture work for x’, I give them what I consider to be a balanced response based on the available evidence, my clinical experience, and the data I’ve collected. Sometimes that means telling people I don’t think it’s likely I can help, but they want to try anyway, as my treatments start at £15 (I’m not in this to get rich!).
I hope I’ve answered your question.
@Tom Kennedy
Yes you answered and I find your answer very enlightening. And saddening as well since it shows you have no idea how to find out if your work is doing any good. Perhaps you do not want to find out??
In essence you are saying you do not keep consistent records, you do not follow up consistently on the results of your treatment and you name different lame excuses for this.
You say you “…often follow up on people who come once…” That is nowhere good enough. you have to follow up on everyone who can be reached if you want to know if your ministrations are any good.
In my work we are required to enter every case into a national database as soon as they are done and each patient is followed up regularly to evaluate results as well as adverse effects. We cannot rely on bumping into happy patients… we simply are not allowed to cheat. Everythign is checked by a third party.
If chiropractors and acupuncturists etc. were serious professional people they would not be guessing as to the success of their work or the complications. They would make sure they know.
They would stop doing what cannot be shown to work, just like in medicine. It’s called progress. Acupuncture hasn´t progressed since Mao popularised this new invention. It’s only gotten sillier.
Bjorn, it is a real test of patience and goodwill not to respond to your comments with anger. You come out with the trope that acupuncture is a new Maoist invention. This is simply wrong. It betrays the fact that you have read it somewhere and taken it on board without bothering to investigate the truth of it. Acupuncture textbooks have been written consistently from around the 1st century BCE onwards. Many of the acupuncture protocols used today – the selection of points for example – can be found in a whole series of ancient texts. You really excel yourself in arrogance when you assume to lecture people who know what they are talking about with such half-digested ideas.
Secondly you respond to a real attempt to enter into a dialogue with you (by Tom Kennedy) with dismissive rudeness. Please remember that you work within a funded medical system that has the resources to pay for all kinds of background work of the kind you describe. Most acupuncture practitioners have to fund everything from their work with patients, and contrary to assertions made in this thread, the great majority earn relatively low incomes. Incidentally, many also – aware of the demands that private medicine places on low-income patients – work at very reduced rates so as to make their treatments affordable to the greatest number of people. With such limited resources it is thoughtless to assume that such practitioners can match the level of practice that, for example, has a national database as a resource. I also wonder whether all medical practitioners (including GPs), in all European countries, work to such exacting standards (I’m sure my GP doesn’t) and if so for how long this has been going on.
1) “dismissive rudeness” – not something anyone could accuse you of???
2) “contrary to assertions made in this thread, the great majority earn relatively low incomes” – please cite the ‘assertions’ you refer to.
3) “With such limited resources it is thoughtless to assume that such practitioners can match the level of practice that, for example, has a national database as a resource” – keeping complete case notes is an ethical requirement for all clinicians; and the way he describes it, Tom does not seem to do this.
1. Bjorn, there are frequent suggestions that practitioners scan, rip off and enrich themselves at the expense of patients.
2. We are not talking about patient records, we are talking about audits – individual and national. I would agree that all practitioners should learn to do simple auditing (many already do) and as the profession advances I’m sure this will become more universal.
3. With regard to rudeness, you – and some of your fellows on this blog – adopt the position (because you practise the culturally dominant form of medicine) that everyone else is a deluded fool. You place yourself in a position of rudeness whenever you so haughtily dismiss everyone else’s competence, knowledge and commitment to heal. You also betray a shocking and potentially racist stance by dismissing the millions of East Asian practitioners and their hundreds of millions of patients working throughout the world. You have never put yourself in a position of observing the real material help that these practitioners give to their patients – often the most difficult cases where orthodox medicine has either failed or made things worse.
If you have all this energy to spare trying to debunk things, why don’t you turn to where the real problem is … the fact that iatrogenic disease (almost exclusively from orthodox medicine) is the 3rd most common cause of disease killing nearly a quarter a million people in the USA a year, that psychiatric drugs kill over half a million over 65s in the western world every year, and that vested interests skew much of the research conducted into drug interventions.
you are talking tosh again, for instance:
1) “You have never put yourself in a position of observing the real material help that these practitioners give to their patients”. you know too little about me to make this assumption. as it happens, it is wrong.
2) “the real problem is … the fact that iatrogenic disease (almost exclusively from orthodox medicine) is the 3rd most common cause of disease …”
tu quoque fallacy + this blog is about alt med + my expertise is in alt med
3) BIG PHARMA conspiracy theory
1. How about laying off words like ‘tosh’?
2. My comment about observing practitioners of complementary medicine was addressed to Bjorn, not you.
3. Similarly my comment about iatrogenesis was addressed to Bjorn. It is entirely relevant since he constantly exalts the claimed proven effectiveness of orthodox medicine as a standard by which to judge complementary medicine.
4. You’re clearly not reading the literature if you think the effect of big pharma on clinical trials is a conspiracy.
yes! tosh is far too polite for the drivel you keep posting.
Edzard, I’ve learnt with you that the more insulting you get, the more challenged you are. I have also observed – I’m not holding back given your insulting use of the word drivel – that you’re not very bright.
I know! according to you I even have a personality disorder, or was it something else that you diagnosed with your clairvoyant skills?
no, sorry it was more subtle than that; I looked it up; this is what you posted about me: “…having read his blogs and communicated with him quite a bit I would say he’s on the margins of some kind of personality disorder…”
@Peter Deadman : Bjorn said ‘popularized’ by Mao, not an invention from him. Then, the fact that acunpuncture haven’t improved much from very ancient text is not really rassuring either…
Quark, if you know your history, you’ll know that post-revolutionary China faced one of the world’s greatest health crises with vastly inadequate numbers of orthodox doctors. Mao was no fan of traditional medicine (many Chinese turned on their own traditions after the humiliation of Western dominance of China in the 19th century) but the fact was, he couldn’t dispense with the service of all the traditional medicine doctors praising in China at the time. This was one of the wisest decisions of a man not noted for making them.
And of course it is wilful misreading of my words to suggest I supported the idea that acupuncture hasn’t improved from ancient times. What I said was that classical traditions inform the modern application of acupuncture, as do numerous developments of the past few decades.
Peter Deadman said:
How much would a database cost?
Well ket’s see – the database to centralise records of NHS patients failed after hundreds of millions of pounds were spent on it.
Quark
“Bjorn said ‘popularized’ by Mao, not an invention from him”
This time he did. Maybe he’s learning.
This is one way to see it… Most people says that he did it for pure political reasons. Then you can believe whatever you want.
Peter Deadman osaid:
That’s an answer to a question I did not ask and not an answer to one I did – unless you want to try to claim that acupuncturists treat as many people as there are NHS patients and that the data sets would be of similar size?
What to try again?
I was as stunned – or was I – as Edzard by Sasha’s declaration that he and others of his quality had no intention of allowing any scrutiny of how, and with what, they treat their ‘patients’.
I know that Sasha and Doc ‘If Only In His Own Mind’ Dale disagree, but surely that one simple statement delineates as much as anything that what we’re dealing with here are hermetically sealed cults, resentful of criticism and angry at requests for evidence.
Oh and by the way – I may be a dimwit, as Sasha believes, but I do speak the lingo quite well.
It’s ‘wreak’ havoc, not ‘wreck’.
Too busy doing it to notice, I expect.
I know that Sasha and Doc ‘If Only In His Own Mind’ Dale disagree, but surely that one simple statement delineates as much as anything that what we’re dealing with here are hermetically sealed cults, resentful of criticism and angry at requests for evidence.
That’s actually humorous considering how much time I spend discussing and debating other chiropractors claims as well as the thousands of research papers I’ve shared….all in an attempt to critically evaluate what we do and think. But whatever, eh?
‘Doc ‘Dale-
The critical phrase there would seem to be ‘debating other chiropractors’.
But nonsense -what Steve Martin called ‘Lies and made up facts’ – is still nonsense.
Wouldn’t matter how many pixie believers shared their ‘research’ with one another. Pixies have never been shown to exist. Which doesn’t mean they don’t. But in this, as I’ve said, I am with Asimov.
And I bet he’s glad.
All that comments such as yours do is to dig an even bigger ditch for that now much-abused term ‘research.
All that comments such as yours do is to dig an even bigger ditch for that now much-abused term ‘research.
That’s strange, because most of the research I share comes from the medical field and it’s allied professions. (You are looking foolish again).
A sample of what I’ve shared with my peers in just the last few days…I leave the pixie dust for others to chase.
http://link.springer.com/article/10.1007%2Fs00586-016-4503-7
http://www.hkmj.org/earlyrelease/hkmj154748.htm
http://link.springer.com/article/10.1007/s00586-016-4673-3
http://www.ncbi.nlm.nih.gov/pubmed/27342614
@Pete Attkins, those are some pretty wild, unsubstantiated and untrue accusations you’re making my friend. Can you or @Edzard please enlighten me as to why you’re making them and where you’re getting your information from?
which ‘accusations’ are you referring to?
I was referring to Pete’s obvious accusations, and wondering where you got your information from. Where on my website do I talk about treating smoking?
funny that I have to help you navigate your own website, isn’t it?
it’s here: http://www.thenaturalhealthclinic.com/stop-smoking-programme1
Not that funny, considering it’s not my website. Even a cursory glance would make it obvious that I’m just one of many practitioners that rents a room at that clinic, and I have no connection with the smoking program. For the record, when people approach me about smoking, I tell them the evidence isn’t positive, and that although acupuncture may help them relax and ‘take the edge off’, it’s unlikely to stop them smoking. I may lose some custom this way, but I’m always honest and up-front with people about expectations, which I base on my clinical experience as well as the available evidence. So your insinuations were completely unfounded.
I would expect someone who regularly preaches about the importance of rigor to be more careful when making public statements about another person’s professional integrity. But then, maybe you just did what you accuse many others of and jumped to a conclusion based on what you wanted and expected to see? Could it be that’s what you did with the NICE guidelines too?
your clinic, your website!
Oops, gotta make a correction – I looked back at comments and EE made his Ted’s website comments in response to a strange charge of Ted discrediting himself by saying “significantly better”. Sorry Edzard. That wasn’t ad hominem.
oops – have you just discovered that you are a moron?
Oh, very interesting… Let’s wait on the final verdict whether I am a moron or not until after I read your research.
Btw, remind me in what context were you referring to my website?
Also, could you tell us:
1. Why do you think that Cochrane’s review isn’t clinically significant?
2. What’s your explanation for 1.23 – 1.25 RR in verum vs sham?
3. How do you explain that acupuncture performs better than conventional care in migraines?
do I really need to explain what SIGNIFICANTLY BETTER means for anyone who understands English and clinical trials?
it means that, for the endpoint in question, the results showed a statistically significant difference between two groups suggesting a positive therapeutic effect for one treatment.
I am confused. The review he linked did show statistically significant difference. So, how did he discredit himself?
I know that you are confused!!!
‘your clinic, your website!’
Not even the decency to apologise or retract? It’s not ‘my clinic’, I just rent a room there as I said, and I have no control over the content of the site. So using your logic, presumably I can hold you to account for everything written in The Guardian because you sometimes write for them? Very weak.
not a very good comparison. I did write regularly for the Guardia and I did stop when I disagreed with some issue.
but I would never set a foot into a clinic that runs a website advertising treatments which are out of line with the evidence.
do you see the difference?
the lack of decency is not on my part, I think.
So you agreed with everything in The Guardian while you wrote for them?
The fact is you made untrue statements about me based on sloppy research, and rather than swallow your pride and admit it, you’d rather change your argument. Again, similar to the criticisms you regularly make of others.
no, the fact is that you are affiliated to a clinic that advertises treatments against the evidence of 2 Cochrane reviews, while you make a hoo-ha about a third Cochrane review.
‘Hot off the press, an updated Cochrane review on acupuncture for migraine. Still work to be done of course, but it seems in this case at least that the trend is not towards the conclusion espoused here so often that acupuncture is useless, and that verum is no better than placebo. Quite the opposite in fact.
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD001218.pub3/full‘
Is that really what you’d call ‘making a hoo-ha’? Surely I was raising new and significant scientific data to contribute to the supposed discussion? And what did I get for that? Untrue accusations that you refuse to retract or apologise for:
‘he had discredited himself long before; if you look at his website, you will find that he earns (some of) his money by treating smokers who want to quit with acupuncture and hypnotherapy’
These are your words and they are untrue. Changing the argument doesn’t make them any more true.
yes, I have changed my argument in view of new evidence. now you should deal with the new argument or shut up.
Edward, you know perfectly well that a significant proportion of all medical interventions do not have any evidence base and therefore you are clearly unable ever to set foot in a doctor’s surgery or hospital. More widely there are a vast number of human activities you are unable to participate in because of the shameful lack of evidence for their effects. I’m sure Channel 4 would love to make a programme about your severely constrained life.
“you know perfectly well that a significant proportion of all medical interventions do not have any evidence base”
GIVE US A FEW EXAMPLES, PLEASE
crucially, do you know the difference between using a therapy and advertising it on your website?
Well for starters: http://www.scientificamerican.com/article/demand-better-health-care-book/
strange ‘starters’!
I have asked:
“you know perfectly well that a significant proportion of all medical interventions do not have any evidence base”
GIVE US A FEW EXAMPLES, PLEASE
crucially, do you know the difference between using a therapy and advertising it on your website?
YOUR LINK IS NOT AN ANSWER TO EITHER OF MY QUESTIONS.
Dieter Petman here … my link is an absolute cast-iron, stainless steel answer to your question. It is an interesting overview of the state of the evidence base in orthodox medicine. If you can’t be bothered to read it, here are a few of its points:
“Only a fraction of what physicians do is based on solid evidence from Grade-A randomized, controlled trials; the rest is based instead on weak or no evidence and on subjective judgment. When scientific consensus exists on which clinical practices work effectively, physicians only sporadically follow that evidence correctly.”
“We could accurately say, “Half of what physicians do is wrong,” or “Less than 20 percent of what physicians do has solid research to support it.” Although these claims sound absurd, they are solidly supported by research that is largely agreed upon by experts.”
“The problem is that physicians don’t know what they’re doing.”
“The plain fact is that many clinical decisions made by physicians appear to be arbitrary, uncertain and variable. Reams of research point to the same finding: physicians looking at the same thing will disagree with each other, or even with themselves, from 10 percent to 50 percent of the time during virtually every aspect of the medical-care process—from taking a medical history to doing a physical examination, reading a laboratory test, performing a pathological diagnosis and recommending a treatment. ”
etc. etc.
I have asked for a few examples of treatments that have ANY ECIDENCE BASE.
and I have asked whether you know the difference between using a treatment and advertising it on your website.
Edzard, I am going to pay you the compliment of assuming that you are always in such a hurry that you don’t remember what you’ve just said. It was “but I would never set a foot into a clinic that runs a website advertising treatments which are out of line with the evidence.” Since numerous medical and surgical interventions have no or poor evidence base and since many hospitals (both private and NHS) have websites publicising a wide range of treatments it seems likely that some of those lack evidence.
PS: the mental arithmetic required to post on this site is doing my dementia no end of good
before your comments deteriorate any further, give me an example of a treatment for which you think this applies.
“Since numerous medical and surgical interventions have no or poor evidence base and since many hospitals (both private and NHS) have websites publicising a wide range of treatments it seems likely that some of those lack evidence.”
WHY DO YOU NOW ADD ‘POOR EVIDENCE’ TO YOUR ARGUMENT?
perhaps you should stop digging when you are in a hole?
Edzard, I really truly don’t know what to make of you. If it wasn’t for the fact that you have a public voice I simply wouldn’t bother debating with you because you betray the values you supposedly embrace. It’s sad as you could be an open-minded reasonable voice in this filed, but on these blogs you display such a hasty talent for nit-picking and avoiding the meat of the argument. “AHA” you say, “WHY DO YOU NOW ADD ‘POOR EVIDENCE’ TO YOUR ARGUMENT? perhaps you should stop digging when you are in a hole?”
I amplified ‘no evidence’ to ‘no or poor evidence’ as that encompasses even more of the orthodox medical treatments that are of unlikely or uncertain value. What advantage do you get for reacting like that, when the meat of my argument is clear and unchallenged (and widely accepted too)? Why would it be so difficult for you to acknowledge that all forms of medicine use methods that don’t have an evidence base and that it is therefore a weak argument to selectively attack those you don’t like on that basis alone. I would suggest that a slower, calmer reaction on your part, a greater attempt to live up to your responsibility as a mouthpiece, and an adherence to simple logical thinking, would garner you greater respect, beyond the misguided media that turn to you for comment and the tiny coterie of fanatics that seem to love your every utterance. I have read your blogs for a long time now and my observation is that you have never modified your point of view one iota on any issue – a de facto poor example of open scientific thinking.
I leave the last word to you but rather than getting a lot of obfuscating hot air back what I would really appreciate – and I’m willing to learn from you here – is an explanation of the purpose of sucking eggs.
“I amplified ‘no evidence’ to ‘no or poor evidence’” YOUR ARGUMENTS ARE UTTER TOSH!
there is a huge difference between ‘no’ and ‘poor’ evidence. the former is factual the second will always be a judgement call.
you may not know what to make of you, but I do know what to make of you.
as far as I am concerned, you can stop ‘debating’ with me – I fear, you don’t even know what a scientific or rational debate is.
Peter Deadman-
Originally, birds’ eggs were sucked-or blown- to remove the birdly contents for the benefit of egg collectors.
” I have read your blogs for a long time now and my observation is that you have never modified your point of view one iota on any issue – a de facto poor example of open scientific thinking.” AGAIN TOSH! I am blogging only since ~4 years! and I have been a researcher for almost 40 years.
and guess what: I have modified my point of view several times. not that this in itself is a merit, but I just needed to set the record straight.
and if you think I am abrupt with you, please re-read the insults you sent my way.
Tom Kennedy wrote: “I just rent a room there as I said, and I have no control over the content of the site.”
No, you do *not* “just rent a room” in a company (Natural Health Clinic) that lists *you* under “Our Acupuncturists”.
First, we had Sasha state “I am too lazy to maintain my own website!”, now we have Tom Kennedy reveal that he hasn’t read the company website of one of his places of work.
These appalling displays of irresponsibility and “I don’t care” attitudes are one of the hallmarks of sCAM. This is what “integrated medicine” is trying very hard to ‘integrate’ with medicine. Good grief!
“If you integrate fantasy with reality, you do not instantiate reality. If you mix cow pie with apple pie, it does not make the cow pie taste better; it makes the apple pie worse.” — Dr. Mark Crislip.
I ‘revealed’ no such thing. I work in a multi-disciplinary clinic, and whilst I don’t agree with everything on the website, I don’t write the content. However, I also respect the intelligence of the people that visit the clinic and the website and I’m content for them to make their own minds up about what interventions on offer.
You have revealed a whole lot more than you seem to think that you have.
If you say so Pete.
Tom Kennedy,
Q1: With which statements and/or claims made on the website of the Natural Health Clinic, 39 Cotham Hill, Bristol, BS6 6JY — in which you work — do you not agree?
Q2: Have you previously and directly informed said clinic — in which you work — as to the points on which you do not agree? Obviously, you have already, indirectly, informed both the said clinic and its past/current/potential clientele via your above statement of non-agreement made here on Professor Ernst’s website.
Q3: Do you intend to resolve your non-agreement with some of the statements/claims made by the Natural Health Clinic; or do you hope that you can continue to sweep your non-agreement under the carpet?
Pete
“These appalling displays of irresponsibility and “I don’t care” attitudes are one of the hallmarks of sCAM”
Bjorn and a few others have posted some straight up racist comments – others have skillfully toed the line. Many commenters will respond to all kinds of things – including spelling and grammer errors. But only a couple call out the racist comments.
If you think Tom has a responsibility to monitor the content of a place where he rents space…what must you think about unanswered racist comments…on a moderated blog? Would racism be a hallmark of EBM, or just Edzard, or all the commneters?
I honestly don’t know what you are going on about.
Please note that the allegations of racial slurs the deranged troll who calls herself/himself “jm” keeps accusing me of are completely unfounded and constitute part of his/her obsessive heckling at me here on this blog. They have been dealt with before.
What must I think about your accusations? I’ll tell you exactly what I think: You are a bitter and twisted, belligerent, condescending, obnoxious troll.
PS: That was the polite version.
Sorry to hear you think that, Pete. But terms like “chinamen”, “jaundiced emperor”, “wingwang”, etc are racist. That’s observation, not accusation.
@jm
Sometimes racism, like beauty, is in the eye of the beholder. ‘Chinamen’ is only very recently regarded as a pejorative description. Will ‘Englishmen’, ‘Frenchmen’, etc. go the same way. And ‘wingwang’ — racism?! — the word in my vocabulary has always been a euphemism for the male or female genitalia. I googled it to check; the top hits agree; one adds the anus to the litany. In other words, to call someone a wingwang is the equivalent of using something like ‘twat’ in its non-anatomical sense to denote idiocy.
and not all of us here have English as their first language; I, for instance, had no idea that chinaman could be understood as racist
EE-
Is it really possible that there are people so dim and so desperate to be offended that they genuinely consider the word ‘wingwang’ to be racist? If they’re THAT keen on their own sensitivity, I suggest they look up the origins of ‘berk’.
It reminds me of the case a few years ago when an incredibly stupid young black American woman-a College student no less – was taken seriously when she objected to the word ‘niggling’ as racist.Believing in magic healing is one thing. At least in that case most of the victims make a choice, however mad.
But attempting to impose your own- in this case linguistic- ignorance on others is a step too far.
No. That is ‘opinion’, not ‘observation’.
Frank
The recent use of “wingwang” showed up in relation to Chinese med terms. The commenter wasn’t referring to genitalia, but to the Chinese language. As you say, “Sometimes racism, like beauty, is in the eye of the beholder.”
I have no desire to debate this – those types of comments speak for themselves.
jm-
If I am correct in thinking myself to be the person under discussion here – a possibility, since I am certainly in the habit of using the term ‘wingwang’ – then I feel that I should know better than most why I use the term. I certainly do not need persons such as yourself to explain MY actions.
I use the term because it’s an American slang term I like the sound of. It’s a kind of poetry. The fact it was used in the context of a discussion about Chinese ‘medicine’ is irrelevant. Never even occurred to me. You’ll not believe this, but then given the nonsense you DO believe I could care less. There you go-another American construction.
I shall continue using ‘flimflam’ as well, even if somebody feverishly digs up a reason I shouldn’t.
I shall continue to use ‘berk’ even though its origins-long forgotten-would now be considered sexist.
I shall continue using ‘niggling’ or ‘niggardly’ in discussions- even those involving matters pertaining to black people- should I wish, despite the objections of people like the black College fool I mentioned a little while back.
Grow up. Have a rest. Stop looking to be insulted, even at one remove.
There’s plenty of real hateful stuff being said about people all the time, especially following Brexit.
Bjorn
Not sure what you mean by “dealt with”. You did say you didn’t know “chinamen” was a racist term. Glad you quit using that one. Other than the chinamen term, the rest of your quote (“Has it never occurred to your meridian-muddled mind that even if the chinamen were first with gunpowder and paper and whatnot…”) was amusing.
Folks I asked found your “jaundiced emperor” comment way more offensive, though.
And yes, I remember you explaining that you thought the “Yellow” in “Yellow Emperor” might be because he was jaundiced. Good grief. Your dedicated search for truth didn’t even extend to Wikipedia on that one.
Apologies – the auto spelling device keeps changing your name. Couldn’t you just change your name to Edward – much simpler
I will consider it once you changed yours to Dieter Petman
‘yes, I have changed my argument in view of new evidence. now you should deal with the new argument or shut up.’
If you acknowledge your errors and apologise for misrepresenting me, I’ll consider adjusting my aim to your newly shifted goalposts.
I cannot see why I should apologise!
for what?
for thinking your website is your website?
I have not insulted you, on the contrary, I have been very patient with you.
I didn’t say you insulted me, I said you misrepresented me (although saying I discredited myself based on that misrepresentation could also be construed as insulting). Anyway, you clearly have no intention of setting the record straight so let’s leave it there.
Has anybody, after all this time, asked ‘Don’t Trust Me, I’m A Doctor’ Dale if within his pretend Medicine he’s a ‘mixer’ or a ‘straight’? And does he still use a ‘neurocalometer’? And if so, what is it and how does it ‘work’?
Tune in next time when all these and more will not be answered.
Barrie: “…‘neurocalometer’? And if so, what is it and how does it ‘work’?”
A simple internet search will provide the answers…try using Google.
‘Doc’ Dale –
Yep. Found it. The neurocalometer, described by scientists as a ‘useless device’. Even some of Palmer’s own ‘students’ were cheesed off with his relentless advocacy of this toy.
Also called a ‘Nervo-Scope’ or ‘Tempo-O-Scope’. At which point it sounds so much like something out of the Beezer, or the 1930s Saturday pictures Flash Gordon serials that most of us decide to pop out for a strawberry Mivvi.
You couldn’t make it up.
Well, obviously you could. Somebody did.
And all the more ‘high-tech’ gadgets of more recent chiroquackery…
Alan Henness -I’m relatively new to this, as many will have discerned. I approach it all from the direction of ‘critical thinking’, a term which is in danger of slipping into comedic misuse-and which I hadn’t even encountered as such until a couple of years ago, though of course the concept was fairly evident and had been from when I was a child, even though such as Sasha like to throw around the ‘dimwit’ epithet.
There’s fun to be had though isn’t there!
Grim, but fun.
On balance though, I should prefer that gullibility and wilful foolishness were argued out of existence, and I were to get my fun from other directions. Like the Telegoons.
At least their insanity has a certain amount of sanity about it.
Anyway, ‘Trust Me I’m Not A Doctor’ Dale still hasn’t said if he’s an innie or an outie.
Perhaps these matters are best left to greater minds.
Barrie: Anyway, ‘Trust Me I’m Not A Doctor’ Dale still hasn’t said if he’s an innie or an outie.
I simply seek the truth in certain matters regardless of where leads. Others travel a different route due to different goals.
@ Barrie Lee ‘Wellness’Thorpe on Wednesday 06 July 2016 at 19:42
He is a straight, says so on his website. Yep, he is a SUBLUXATIONIST.
Frank Collins: links to physics.
These are not links or sources but a way to start thinking of mechanism of action in acupuncture. I would say look into electromagnetism and Earth’s magnetic field, dipole antennas and how it can correlate with human vascular system.
Disclosure: these are not ideas I got to myself, my understanding of physics doesn’t extend beyond college. But from reading up on it a bit, it is beginning to make sense to me.
@Sasha
You said
Not to anyone with an understanding of basic physics.
Correlate with what aspect of the human vascular system, exactly? You’re talking absolute drivel, man. Cue Dunning and Kruger.
@Frank Odds and Quark:
I will be the first one to say that my knowledge of physics is rudimentary. I am only now beginning to look into electromagnetism and its effects on physiology. You both are welcome to read books by Robert Becker, MD on the subject.
I never saw the need before as I don’t have difficulty correlating the ancient concepts of Qi and yinyang with what physics describes.
How can you said that you have ‘no difficulty correlating the ancient concepts of Qi and yinyang with what physics describes’ if your knowledge in physics is non-existent ? ? ? Full Dunning Krueger here : ‘hey, i’ve read a wikipedia page on physics, so it’s good, i get it’.
But in a way i understand… If you got any clue about physics, you would have a very hard time about correlating physics and imaginary things that doesn’t even exist following some hardcore physics concept.
So how are you ‘correlating’ both ? I’am very eager to heard this.
Well, since you are “very eager to heard this”, I am very eager to told you. I will just cut and paste what I said to Guy Chapman.
To understand Qi, please tell me:
Who said “Nothing happens until something moves”?
What’s that something that makes something move?
To start thinking about yinyang, please answer the following question:
What is the common mechanism underlying these phenomena:
Electricity
Cell membrane potential
Cell differentiation
Passive heat transfer
Wind
Ocean currents
and so on
Now, the eagerness is all mine…
Quark-
I’m guessing here, but is the answer to Daft Sasha’s question ‘Blancmange’?
Now I’M the eager one!
@Sacha This is not an anwser, this is more question… If you have no clue just admit it. Then don’t say thing like ‘I have no problem correlating both phenomena’, you are just embarassing yourself.
So here the question, again : So how are you ‘correlating’ both (Acupuncture and EM fields) ? (Last try)
Do you think I care what you find embarrassing? I said I have no problem correlating the ancient concepts of Qi and yinyang with physics and biology. Answer those questions and you will know why. Or don’t answer them, it’s not gonna change anything about how I see it.
Sasha wrote: “it’s not gonna change anything about how I see it.”
Thank you for highlighting *the core tenet* of all belief systems.
Nothing to do with beliefs. I asked the questions of two people and neither one answered. The reason is simple in my opinion: most of you bozos on this site know nothing about medicine and little about thinking for yourself. You repeat like parrots a few points by SBMers, EE, and whoever else you choose to be your authority. You have no thoughts, no experience, no nothing of your own when it comes to medicine. How could you possibly? Most of you never treated anyone for anything, even a common cold.
You get asked a few questions where you need to exercise your own brain cells and most of you are nowhere to be found. Just lots of silence. All you are capable of is useless bitching how no one is listening to your (borrowed) ideas on what medicine should be like. What a bunch of pathetic losers you are, truly!
http://edzardernst.com/2012/12/ad-hominem-attacks-are-signs-of-victories-of-reason-over-unreason/
thanks for admitting that you have no rational arguments.
Do you realize how childish you sound ? Can’t you just answer a straight question ? If you really have no problem with those concept you should be able to explain your idea. Here, here, i help you : define both, then show the link between them. Exemple :
Core concept of electromagnetism : …….
Core concept of accupuncture : …..
“So obviously, the link is …… because….. and ……”
But, again, if you don’t know, just admit it, no biggies, like a normal adult person.
I have no intention of spelling it out. As far as I am concerned, the answers are in the questions I asked. They are pretty simple questions, too. Try thinking, it’s good for you.
is that alt med speak for “sorry, I haven’t a clue”?
@Sasha
I know Medicine and Surgery and I have treated a lot of people for several decades for real diseases and trauma. I also know a lot about electricity, physics, EMF, RF etc. (out of hobby interests) I even have certificates to prove it 🙂
There are a number of subthreads here where “Sasha” has been answered, a few of them contain my answers to his speculations about electrophysiological forces, their actions in and on the body and their role in possible explanations of acupuncture efficacy (there is none). Each of these subthreads ends in either silence on his part or in an angry ad hominem ejaculation.
How pathetic is that?
Well I give up, I tried really hard and offered you to explain your idea two or three times. Now you reveal yourself as a simple mind that use big word. I’m no medic but I know quite well physics and biology, working between both fields in the physics of molecular interaction, you can even go full quantum I can follow. Bjorn is a medical surgeon and got extensive knowledge in electromagnetism, there is really nothing here to stop you from explaining your ‘theory’.
But no, you prefer to bite like a little angry dog in the corner. So be it, you are just ridiculous. Keep diggin’ =)))
Well, if you work in the physics of molecular interaction, then you should have no difficulty correlating the concept of yinyang and the fact that, say, you need a positively charged ion and a negatively charged ion to create a stable bond. Or what’s needed for creation of cell membrane potential and how yinyang concept fits into that.
And you really don’t need quantum physics to understand a concept from an ancient culture. High school level of biology and physics will suffice.
and you also just need common sense to realise that your argument is tosh !
You forgot to add: “in my opinion”.
@Sasha:
Yes, we readily appreciate the difference: the symmetry of charges is a conclusion based on the objectively testable findings of robust physics experiments, whereas “yin and yang” is mystical nonsense with no basis in empirical fact.
Put another way, the absence of negative gravity disproves yin-yang as much as the symmetry of charges proves it.
Ah, yes, Guy Chapman. The man who writes long posts full of bullshit but when asked pointed questions is nowhere to be found… Nice to hear from you again.
Yinyang isn’t about negative gravity, you dum dum. Yinyang is a concept describing the idea of forces that are both opposing and complementary.
“… you dum dum…”
will you some time learn how to write a comment without a personal insult?
Sure. When a commenter doesn’t deserve it. There aren’t many of those on your blog but here is to hoping!
@Sasha: Sorry, is there a service level agreement for this site that I failed to notice? Perhaps I was too busy working or building my extension to hang on your every word. Perhaps responding to your incoherent commentary has limited charm, especially given your tendency to fall back on childish insults while hypocritically accusing others of ad hominem.
If you want people to respond to your pertinent comments, you could start by making some, and further increase the chances of success buy leaving out the side order of delusion asserted as fact.
But if you need to go quantum, you can always ask Niels Bohr why he chose to engrave yinyang symbol on his grave.
and that proves what precisely?
Well, you can read about Bohr and his thoughts on yinyang and then you will know what it proves.
Guy
“…whereas “yin and yang” is mystical nonsense with no basis in empirical fact.”
Yin and Yang (from Wikipedia): “Many tangible dualities (such as light and dark, fire and water, expanding and contracting) are thought of as physical manifestations of the duality symbolized by yin and yang…Yin and yang can be thought of as complementary (rather than opposing) forces that interact to form a dynamic system in which the whole is greater than the assembled parts.[2] Everything has both yin and yang aspects, (for instance shadow cannot exist without light).”
Empirical: based on, concerned with, or verifiable by observation or experience rather than theory or pure logic.
Since I doubt you think a shadow is mystical nonsense, I hope that clears up the mystery for you.
jm, Wikipedia is only partially right. Yinyang forces are both opposing and complementary. Hence, Niels Bohr and his coat of arms which says: contraria sunt complementa. Opposites are complementary.
The curious thing is that you cite Wikipedia without realising that it support the fact that “yin-yang” is mystical nonsense. I suspect this is because you still have not understood the difference between belief and fact.
Perhaps Sasha can explain what he thinks Niels Bohr’s interest in China and Chinese philosophy is supposed to prove. The fact that Niels Bohr visited China in 1936 or thereabouts, had relations and cooperation with Chinese scientists (real ones) and was interested in Chinese culture has absolutely nothing to do with acupuncture or TCM or any of the fantasies (e.g. “Qi”) claimed to bee elemental in acupuncture function .
Many Nordic acupuncturists mention with reverence, as part of their marketing babble, the fact that Bohr used the YinYang symbol as a statement of philosophical ideology.
We are discussing the utility and efficacy of acupuncture here.
Niels Bohr never claimed or taught that the atom-physics, which he studied and brought forward, and for which he was awarded the Nobel prize and the order of the Elephant (Royal Danish order of merit), corroborate in any way ancient or recent medical qualities of acupuncture. I even doubt he was aware of the existence of modern acupuncture, which was at that time a quackery pursued by very few and not developed as a commercialised theatrical pseudotherapy until later.
If anyone can point to information that I am wrong then please do.
Insinuations about unreferenced and irretrievable information like this one
are not helpful because they lead to nowhere. If you want to make a point then please try to reference information that supports it so it can be checked and discussed.
The concept of yinyang establishes existence of polarity: two poles that are opposite but also complementary. That’s why Bohr’s coat of arms says: contraria sunt complementa. He knew that this principle underlies all phenomena on the physical level – the reason we have ocean currents or why your car needs two poles on its battery to start. Or, like it says in Dao De Jing: From Dao comes One, from One comes Two, from Two comes Three. From Three comes 10,000 things.
The reason understanding yinyang is important is because effective acupuncture is impossible without applying yinyang principles. This is not about: I am gonna design a verum arm with Large Intestine 4 in it because I have heard “it’s good for headaches”. And then I am gonna call myself a great explorer.
ACUPUNCTURE DOESN’T WORK LIKE THAT.
Your points about acupuncture being modern day quackery are a bunch of nonsense. Chinese texts from BCE talk about acupuncture. Stop repeating foolishness you read on some SBM site.
It’s true, to evaluate acupuncture efficacy, you don’t need to look to Niels Bohr. You can just read Cochrane reviews.
Sasha
That’s usually the case with Wikipedia. It’s a good starting point, to start deeper investigation.l
Guy
If you can’t understand that…mysterious nonsense is all you have left, I guess. I really don’t understand why or how you’re having a problem with this.
@Sasha
I promised myself I would refrain from further comment on this thread, because its length has become unsupportable. However, your recent comments here, here, and here
are so closely related to one I just made on another thread I’m breaking my promise.
Your comments contain a mixture of ‘courtier’s reply’ and one other feature I’ve noticed about proponents of one or other form of altmed: unwarranted affection for generalities over specifics. We all get that the yinyang concept is a duality of opposites that are complementary and that many examples are found in nature. (There are also counter-examples — Guy Chapman pointed out there is no opposite polarity to gravity but your response was just to bite his head off.)
So what? What use is the yinyang concept when the details of the examples are so exquisitely worked out scientifically? It’s just a broad, quasi-philosophical ‘gee-whiz!’. You wrote: “The reason understanding yinyang is important is because effective acupuncture is impossible without applying yinyang principles.” That’s pure ‘courtier’s reply’. You join Len Thomas in constantly complaining it’s given to only a few dedicated individuals to properly understand and practice the fine details of your woo. All the acupuncturists who have participated in the published clinical trials of acupuncture are not using true ‘verum’ [sic]. Clearly, there is no true acupuncturist in the same was as there is no true Scotsman.
Your special pleading is falling on stony ground here. The yinyang concept is an ancient attempt to understand the world that is utterly irrelevant in the light of progress of science. You’d do it a kindness to consign it to history instead of espousing it as though it is of serious practical importance.
The reason “there is no opposite polarity to gravity” is because GRAVITY ISN’T POLARITY. GRAVITY IS A FORCE.
There’s also no opposite polarity to electricity or osmosis. So what?
As far as verum, show me the verum designs you’re familiar with and I am fairly certain I will be able to prove how they are faulty. But even that doesn’t matter since Cochrane shows how even with these designs verum outperforms sham.
Acupuncture isn’t woo, it’s powerful medicine. Looking for “opposite polarity” to gravity is woo.
Many of you have no understanding of even high school level physics but yet you feel knowledgeable enough to make all sorts of pronouncements on matters of medicine and science. This is just way too funny!
Sasha is confusing the egg with the hen. Polarity is omnipresent in physics. It is not reliant on a philosophic concept for its established existence. It would be there even if YinYang or other philosophical ideas did not exist.
Niels Bohr was a smart man and knew physics. He even discovered a few principles of it himself. Of course he liked the concept of polarity, it was his job to like it and he enjoyed applying it philosophically to his vision and benevolence. Again nothing to do with sticking needles in the skin.
Sasha was asked where it says Niels Bohr knew about acupuncture or considered any part of Chinese medicine to be efficacious. We expect an answer to that, not irrelevant philosophical musings.
Yes they could count BCE. And even do arithmetic. We knew that already.
Non sequitur
And it does not work in any other way either. We have no credible evidence it works at all, beyond wishful thinking and conjecture. If anyone has information it does and how, then please provide it.
Please note that one needs to distinguish between what was called acupuncture before the reinvention and modern acupuncture involving filiform needles. The former was exactly parallel to “blood letting” rituals in other parts of the world. The latter was invented as a less traumatic version to fool the unknowing.
Yes, they describe “blood letting” rituals that were by some called ‘acupuncture’, a name that later has been used for the modern more benign version of the same ritual, based on philosophy, not science or rational observation.
there is no possibility that modern acupuncture was described in texts from BCE because the method of manufacturing the filiform, less traumatic needles is only a few centuries old.
If you want to read a first-hand description of the effects of acu-puncture, then I suggest you read Dougald Christie’s book published in New York in 1914. Therein he describes his observations of acupuncture and other Chinese medical ministrations of the ancient type. It is not a pleasant read.
I provide the link to the original source. Please take note of that when you want to make a supported point.
The book can be downloaded or read online. The relevant chapter is number V and starts on page 31.
https://archive.org/details/thirtyyearsinmo00chrigoog
(Let’s hope troll “jm” spares us from another round of irrelevant ramblings about this source.There is no need to fill yet another thread with obsessive, unsubstantiated rants about the truthfulness of Mr. Christie’s memoirs)
There is only one SBM site so I could not pick “some” of many. SBM-Science Based Medicine (http://www.sciencebasedmedicine.org/) is a blog where intelligent, rational and educated people write about facts and verifiable information. What is more, they largely support their writings with references so readers are able verify it.
We have read them and some of them only verify that institutions are fallible, not even the revered Cochrane collaboration. When you read scientific work, you have to understand the scientific process and be able to evaluate the quality and veracity of it. It is not enough to read the title and the author’s conclusions. You have to be able to verify for yourself that the conclusion is supported by the data. The latest Cochrane-published review of acupuncture for migraine we discussed recently, is grossly misinterpreted by its authors who obviously wish the clinically useless minor tendency in favour of acupuncture to be explained by an inherent effect. That such slight tendency towards the sought-after arm is to be expected in all research due to well known reasons and that even if researchers and reviewers find a numeric “significance” when ignoring multiple test correction and common sense, this is in no way proof of efficacy of the method even if the authors or Sasha would like it to be.
When I say that a concept “establishes existence” of something it’s not the same as saying that a concept “causes” something to exist. I am well aware that polarity would be there with or without yinyang concept, just like I am aware that gravity would be there with or without Newton. That, however, does nothing to the fact that development of yinyang concept was an early and successful attempt to describe the foundational process behind all natural phenomena. So successful, in fact, that Bohr was still fascinated by it centuries later. Actually, yinyang is more than just complementary opposites and the clues to more are contained in the symbol itself. You’re welcome to study it further. As a warning – you probably won’t find an answer from SBMers.
“Sasha was asked where it says Bohr considered acupuncture efficacious”??? What the hell? I can ask you where it says that crocodiles like peanut butter but it doesn’t mean my question deserves an answer. I brought up Bohr in relation to Quark mentioning quantum physics. I have no idea whether he knew about acupuncture or not.
About Dao De Jing: no, the phrase “from Two comes Three, from Three comes 10,000 things” has nothing to do with counting. To understand what it means you’ll have to go back to yinyang principle and THINK. Warning once again – you probably won’t be able to cut and paste an answer from SBM or Wiki but such is life, I suppose…
Early acupuncture had some bloodletting in it (and still does) but that is not all it did. For evidence, look at the set of early acupuncture needles. Also, bloodletting done in acupuncture isn’t like Western bloodletting.
You repeating that “acupuncture doesn’t work” doesn’t make it any more true. For evidence, go back to Cochrane. I highly doubt that Cochrane does not know how to interpret statistical data. What’s more likely is that you and SBMers simply don’t like their conclusions. Don’t matter much anyway since SBM site has no effect on the larger world of medicine.
In the last paragraph I see a trivial mistake:
To harmonize with the rest of the sentence “.. are fallible” should read “…are not infallible”
Bjorn
“There is no need to fill yet another thread with obsessive, unsubstantiated rants about the truthfulness of Mr. Christie’s memoirs”
I don’t think anyone (including myself) doubted Christie’s truthfulness. I pointed out that Christie’s book is anecdote. He says “This is not a History, still less is it an autobiography. It does not attempt to give a complete account of Manchuria, nor even of Moukden, nor to depict minutely its people and their customs.”
Could you cite your source(s) for:
“Please note that one needs to distinguish between what was called acupuncture before the reinvention and modern acupuncture involving filiform needles. The former was exactly parallel to “blood letting” rituals in other parts of the world. The latter was invented as a less traumatic version to fool the unknowing.
Yes, they describe “blood letting” rituals that were by some called ‘acupuncture’, a name that later has been used for the modern more benign version of the same ritual, based on philosophy, not science or rational observation.”
I’m still curious how you came to your conclusions. In particular, the “exactly parallel to “blood letting” rituals in other parts of the world” and that acupuncture wasn’t based on rational observation.
“jm” seems to keep a database of my comments. OC behaviour?
“Yin and yang can be thought of as complementary (rather than opposing) forces that interact to form a dynamic system in which the whole is greater than the assembled parts.[2] Everything has both yin and yang aspects, (for instance shadow cannot exist without light).” Bold words are my emphases. Quoted from Wikipedia entry on yin and yang by jm.
“GRAVITY ISN’T POLARITY. GRAVITY IS A FORCE. There’s also no opposite polarity to electricity or osmosis. So what?” From Sasha. So everything doesn’t have yin and/or yang.
Clearly there is no consistency about definitions of yin and yang. Qi blockage perhaps needling acupuncturists?
Dude, I give up…
Edzard Ernst, if you are reading this, are you still wondering why I call some of your followers dum dums? They have absolutely no capacity for rational thought like differentiating between the concept of polarity and the PHENOMENA that polarity underlies.
If dum dums like this are your legacy, this is one sad commentary on your work. In my opinion.
Bjorn
How about your sources? (“exactly parallel to “blood letting” rituals in other parts of the world” and that acupuncture wasn’t based on rational observation.)
? “jm” should know very well that we’ve been through this all before on this blog. It’s also easy to find for those who want to. Trolls like her/him only want to get into an argument. I’m sitting in a car writing on the iphone so if “jm” doesn’t want to dig this up in his/her archive of my comments, those of you who want to learn about the true nature of acupuncture can search for the keyword acupuncture on sciencebasedmedicine.com. Plenty of good compilations there, with many references.
Sure. Read SBM on acupuncture if you wanna learn a bunch of nonsense…
Bjorn
I checked my archive, and it seems that yes, we have been through this before. And you avoided those references by starting to call me a troll. Now apparently I’m heckling you.
We know the Su Wen has needling instructions for bloodletting, for not letting blood, for massage, etc. You don’t seem to think it’s possible to not let blood with needles of that time, and I’m not sure why. Surely you’re aware that you can use a modern hypodermic needle without letting blood.
I don’t want an argument – I’d like references. Really. I’m giving you the benefit of the doubt that you didn’t make this up, and actually have references comparing “bloodletting rituals” (as you call them) across cultures (Chinese, Greek, Tibetan, Cambodian, etc.) You can leave out the relatively recent European bloodletting…since it’s totally different. As you are aware.
And I’m really curious for your reference that acupuncture is not based on rational observation. I’m hoping you have something better than the sciencebasedmedicine site, Wikipedia, or YouTube.
Sasha who seems blind to sarcasm said among other ignorant comments:
Cochrane isn't a person.
Archie Cochrane, who was in effect its founder died in 1988. the organisation founded in 1993 was initially called the Cochrane collaboration after him, but is now simply called Cochrane.
It used to be considered the epitome of evidence based medicine and many people still believe that anything that comes out of there must be the waterproof truth. This semi-global organization encompasses almost 40 thousand volunteers and it would be strange if you couldn't find among them a good number of groups and individuals who are more led by their own agenda than scientific integrity. The review of acupuncture for migraine is a good example of this.
“Cochrane isn’t a person”. Wow, thanks for that.
Rather amusing how the troll thinks it can lecture a seasoned surgeon on the effects of sticking different instruments into the human body 🙂
“jm” has repeatedly been presented with references but refuses to acknowledge them. Among the stupidest is its attempts at explaining away the memoirs of Dougald Christie, a Scottish surgeon who spent thirty years in Manchuria and wrote about this in a book published in 1914.
In Chapter V he gives some terrible examples of the quackery that was ‘Chinese medicine’ at that time. He specifically talks about acupuncture after describing the ridiculous tongue and pulse diagnostics still practiced by many fools who sell “TCM-treatments”. He continues to relate grim examples of how the nine classical instruments of acupuncture were used. These were not the thin needles later invented for the more benign form of oriental quackery but crude needles, lances and knives.
Here’s an excerpt from Mr. Christie’s first hand observation of how these acupuncture instruments were used. This can be found on page 33 of his book:
How likely is it that the pious missionary surgeon is lying about all this as “jm” repeatedly has claimed?
Where Mr Christie says “cold needles” he means to differentiate from the very common use of the instruments red hot.
I highly recommend reading at least Chapter V of Christie’s book for all those interested in learning about the origins and nature of “Traditional Chinese Medicine”
Bjorn –
Perhaps jm, Sacha, Doc ‘Trust Me, I’m Not A Doctor’ Dale and other charlatans will use the savagery you quote as an example of how altmed has indeed ‘moved on’, as a response to those who say that whereas genuine medicine has progressed, and continues to do so, the made-up ‘treatments’ never have and are stuck in the past, in the original state in which they were invented.
Actually, now I recollect, I think homeopathy DID move on once.
In his later writings, didn’t Hahnemann modify his earlier instructions about the number of times a phial of ‘tincture’ needed to be struck upon a horsehair filled leather pad in order to ‘potentise’ it?
I imagine he must have modified his thinking in light of his continuing ‘research’.
Bjorn
“How likely is it that the pious missionary surgeon is lying about all this as “jm” repeatedly has claimed?”
Once again Bjorn, I never said Christie was lying. Why would he? So when you say that…it’s actually you who is lying. Again. If you really need me to, I can find the comments. But I think you know you’re making this up.
Yet again (it’s getting pretty tedious having to point this out), Christie said at the beginning it wasn’t a full and detailed account. Do you have a reference that isn’t admittedly an anecdote?
If you’re familiar with the nine needles, you know that some were used to let blood, others weren’t, some were used for massage. You seem to have issues understanding the “not letting blood” part. As a seasoned surgeon, you know that a needle as crude as a modern hypodermic needle can be used without letting blood. (That’s not a lecture, by the way.)
So once again, do you have references for “exactly parallel to “blood letting” rituals in other parts of the world” and that acupuncture wasn’t based on rational observation, or not? This isn’t a trick question.
@ Sasha on Thursday 07 July 2016 at 18:30
Do you mean Robert Otto Becker, the loony orthopedist who thought extrasensory perception was a thing and tried to explain it by ELF radio waves. (Extremely Low Frequency). He was also paranoid activist against power line radiation and other EMF scares, concepts that have been well researched and documented by real scientists and found to be harmless.
(see emfandhealth.com for links and information)
ROB also thought he was an expert who discovered electric potentials in living tissue, a well known fact.
The only good idea he seems to have had was that bone could have piezo-electric character and tried using electric potentials to promote fracture healing. This was later shown to be useless.
Why didn’t you check on the credibility of the author before you started reading his books as a source of knowledge?
perhaps he does not know what ‘credibility’ is?
@Bjorn. I think I will ask Guy Chapman to follow your posts. He has difficulties understanding ad hominems and every other word out of your mouth is one. Edzard can do it too, since he’s a bit logically challenged…
IT DOESN’T MATTER WHAT BECKER THOUGHT ABOUT EMF SCARES!
I brought him up because of EM conversation and Becker clearly knows more about EM than me. As well as EM effects on us. That’s what RELEVANT in the whole conversation unless, of course, you believe EM has no effect on human bodies!
And since you seem to be such a friend of Wikipedia, look up Logical Fallacies in there. If there’s a subsection on Logic, forward it to Edzard Ernst.
I see that I was right. Sasha has no idea what he is talking about, just waddles on about fancy technical terms he imagines will support his fantasies and then loses composure when confronted with facts.
I don’ know why he mentions Wikipedia? Seems like that is An object of many quacks nightmares. Probably too full of facts.
Sasha’s blurbs about earths magnetic field, dipole antennas and electromagnetism are something I happen to know a lot about. He must have this from reading Becker’s fantasies. Electrophysics happens to be something I studied at depth as a hobby interest. I even have an expert level Ham-license so I should know a bit about antennas and electromagnetism :). As a matter of fact this led on to studying all there is to find about such effects on the body and mind. Simply put there’s nothing to worry about and it certainly doesn’t explain acupuncture.
For those interrested I really recommend the site I mentioned before, emfandhealth.com. It contains massive, reliable information on the EMF issue.
This statement makes no sense… ‘Look at EM’ ? Really ? It’s like saying ‘Look at human body’ while talking about how any medicine work. I think you absolutely don’t know anything about this topic.
So to summarise, I made a post in good faith highlighting some new and relevant evidence for discussion. This was immediately dismissed in a matter of a few words, and instead I’ve been:
1) accused of making (some of) my money through treating smoking with acupuncture and hypnotherapy (this was untrue but not acknowledged as such);
2) told I’ve discredited myself on the basis of this false accusation
3) told that I’m responsible for everything on the website of the place I work (clearly unrealistic and an attempt to dodge being shown up for poor research)
4) told I blame my patients when they don’t get better and never accept any fallibility (a completely untrue assumption with no evidential basis)
5) asked to reveal my auditing strategies, and when I do, instead of being offered advice on how I might improve my methods by people who have the benefit of a fully funded system to help them, I’m patronised and ridiculed and told I have ‘no idea’, and that my note taking is inadequate (incidentally, although it is separate from auditing, I take careful notes for all my treatments including a record of how the patient is progressing, which is one way that I’ve gained a good sense of what works and what doesn’t over the years).
Is it unfair of me to say that this doesn’t represent a very productive or even an adult environment? I’ll continue to put my energy into making progress elsewhere, as this clearly isn’t the place.
Oh yes, and told I should address the a new line of interrogation – despite my original on-topic offering being dismissed – or ‘shut up’. Charming.
You need to book some Reiki treatments at the clinic to enable you to follow the Five Principles of Reiki:
http://www.thenaturalhealthclinic.com/reiki
Also try some hypnotherapy treatments:
“Hypnotherapy seeks to change repetitive negative thoughts or habits into positive outcomes, leaving you free to get on with your life.”
http://www.thenaturalhealthclinic.com/hypnotherapy
Doing both of the above would be much better than whingeing at us.
Bringing new evidence into the ‘debate’ in a polite way is apparently ‘making a hoo-har’ and ‘whingeing’ – says it all really.
You have certainly provided evidence that furthers our “insight into the acupuncturists’ mind-set”.
Unlike you, I have never worked in an environment that does not mandate: full accountability; independent inspections; and independent auditing. And I’ve never worked in health care so I’m horrified by some of the things that you’ve revealed in your comments.
Why has ‘Trust Me-I’m Not A Doctor’ Dale chosen this moment to throw a wobbler and retire from the field, complaining about name-calling when it’s mostly his side who are doing it?
As I pointed out a while ago, I’ve been called a ‘dimwit’ by a person whose critical faculties are so dulled that he believes in magic-and from whom Not-A-Doc has declined to distance himself- and EE has been called a ‘wanker’ by a similar cultist, in this case-shockingly- a trained proper doctor. And he’s had his mental stability questioned.
Why now? Has Cod-Doc finally tired of evading perfectly valid questions?
Are there new degree mills and magic machines for him to investigate?
I’ll miss him. And the way he used to copy great reams of philosophical stuff, word for word, off the Internet.
Still, there are others, as we know.
@Pete, I’m not sure why you’re so ‘horrified’ by my revelations. What horrifies me are some of the statistics about iatrogenic complications in conventional healthcare Peter shared. I’d love to see acupuncturists working under the conditions you describe, helping to reduce those iatrogenic figures, but unfortunately integration is resisted by authorities such as @Edzard and so we’re left to our own devices.
I won’t ask you as you clearly have no expertise in the area, but perhaps @edzard and @Bjorn would like to actually make a positive contribution and explain how they feel someone like me aught to be measuring outcomes, bearing in mind constraints of budget and time?
On a side note, apart from a couple of automated letters, I don’t think I’ve ever been asked for follow-up feedback by a GP. And they enjoy relatively large salaries and the benefits of a funded system. Any efforts I put into improving my workflow are self-funded and on my own time.
” …integration is resisted by authorities such as @Edzard… ”
too much honour!!!
but seriously: to anyone who can think rationally, integration first required the demonstration that the treatment in question does more good than harm. THE INTEGRATION OF NONSENSE MUST RESULT IN NONSENSE.
…and I refer you back to my original post, which demonstrates more good than harm for migraine. You complain that ‘quacks’ like me have no interest in being held to account and improving their working practices, and then stonewall attempts to do so. Wonderful.
no, no no, I did not stonewall; I said I am not impressed and doubt clinical relevance of the effect; but if it turns out that migraine specialists disagree with my view, I would change it and support integration of acupuncture for this specific indication.
do you see the difference?
What’s important is that Cochrane specialists disagree with your view. If you are planning to wait for migraine specialists (whatever that is), maybe you in the meantime should delete all your posts about acupuncture since acupuncture specialists disagree with you.
are you trying to surpass yourself?
I am not allowed to decide on which basis I change my mind whether a treatment is impressive or not?
all criticism of acupuncture should be stopped because acupuncturists disagree with it?
your arguments are completely bonkers!
“are you trying to surpass yourself?” – what does that mean?
“I am not allowed to decide on which basis I change my mind whether a treatment is impressive or not?” – you are allowed to do whatever you like, that wasn’t the point of my post.
“all criticism of acupuncture should be stopped because acupuncturists disagree with it?” – no, that’s not what I was saying at all. Let’s go back to it:
Cochrane said that:
1.AP works for migraines and results are both statistically and clinically significant.
2. Verum outperforms sham.
Cochrane results are reported by people TRAINED to analyze and interpret data. You, however, say that you disagree with them and will wait for “migraine specialists” to say whether they disagree with you before you decide on changing your recommendations.
You analyze and interpret data on acupuncture but we, acupuncture specialists, disagree with you. Should it not then logically follow that your recommendations on acupuncture should be dismissed?
Are my arguments “bonkers” or are you having difficulties with logic?
Btw, I didn’t forget about reading up on your earlier links. Just had a few busy days at the clinic, all those people who keep regressing to the mean… It’s an epidemic.
btw: there is no such a person as a ‘Cochrane specialist’; the review in question was written by a team of authors, many of them are acupuncturists, I presume.
Here are a few quick and random pointers hastily keyed in between breakfast and work…
If you want to be able to say: “My patients are happy with my treatments” or something to that effect, you will have to count all the patients, not only the happy one’s you happen to bump into or who return for more.
You might of course look into a commercial medical records system but they are usually rather costly. A simple index-card box is better than nothing. Micro$oft Excel can be used as a simple database in a one-man service of your kind. Just remember to keep backups.
Filemaker Pro is not expensive and is a very powerful, yet simple to use 2toolbox” that can be used to make both simple and complicated databases. It is ideal for those that are a little handy and want to learn. I have made many small and large research databases using Filemaker and even a comprehensive bariatric surgery database that is used extensively in our clinics.
Whether you use Filemaker, Excel or whatever, you have to be honest. You have to follow the “intention to treat” principle. You have to make sure you get the telephone number and e-mail of every patient and have them consent to be contacted for follow-up. You have to make sure both yourself and the patients understand the importance of being really honest with the evaluation of outcome.
By calling the patients and hearing how they are doing you get the added benefit of the patient being impressed by your care and consideration. The problem is that if you call yourself many patients will obligingly say they are better even if they do not really mean it. They just want to be nice and not dissappoint you. Therefore we have other staff contacting the patient for follow ups. Maybe your wife wants to help call the patients?
Remember, you only have patients who chose to come to you so they mostly believe in what you do. Your patient population is a “selected” part of the whole population. Therefore you are almost certain to have more satisfied patients than not. You have to allow for this selection bias when you evaluate your results.
That is why your outcome is not representative of whatever effect acupuncture might have if you used it on all all patients with, say, migraine headaches. Only for the population that for some reason or another walks in your door and wants you to help them.
That reminds me, by the way, that to have credible outcome results you have to define your diagnoses (indications) properly. When you say “migraine”, are you sure we are talking about real migraine or just another worried-well career seeker with stress-induced tension headaches that are easily relieved by whatever care and consideration you throw at the customer that helps temporarily with the stress? For that, a good massage, hike, yoga, reiki, or whatever “niceties” will help, especially if followed with a lot of reassuring claims of efficacy.
If you count migraine headache cases you will have to look into the criteria for “migraine” diagnosis and only count those that fulfil them . Or you might cooperate with a neurologist who makes the diagnosis for you.
Then there is the little matter of analysis of your data.
Most Universities offer courses in basic research methodology, epidemiology and statistics and, at least in my part of the world, they are not expensive.
Ah-well. This was, as I said, just a spontaneous and rather random collection of thoughts.
@Bjorn thank you for taking the time to give your thoughts. I’m rather relieved that although you sugegsted I have ‘no idea’ how to evaluate my success, I don’t feel too far off the mark after all. As I already acknowledged, I’m aware that completeness is desirable (and necessary if the full picture is to be claimed), and again, I’m working towards ways of doing this. In fact, the new booking system I use at one of my clinics automatically asks for feedback from all patients (including those that only come once), and so far my average rating is 4.9 out of 5 (with the admittedly small sample of 30 patients), so at least an indication that my woo woo nonsense is being received quite favourably. I already use various databases (including for the incomplete data I currently hold), and have studied statistics and differential diagnosis at university.
So, onwards and upwards.
Remember Tom, practically all those who walk in your door already have prior faith in your ministrations, and that may account for the satisfaction, along with the ardent help form regressions towards the mean, which can be illustrated in the conceptual diagram I lifted from SBM once. Let’s see if I can link the image here:
http://i.imgur.com/YkcXEtI.jpg?1
This is the best illustration I have seen of how regression towards the mean works. People tend to seek help where they expect it, like going to “Tom the acupuncturist” when they are at their worst. When they get better from their “migraine”, gout, arthritis… etc. which they would have anyway, they are led by coincidence and Tom’s reassuring attitude and awe-inspiring mystical, ancient chinese medical art, to believe it was Tom’s needles that worked the magic.
Simple.
What’s simple is the total idiocy of your post. Read the Cochrane review on migraines and acupuncture.
Is there a new one? The one I read was worthless.
Sure it was. Stick your head in the sand and pretend this isn’t happening.
There is a new one, and it’s unconvincing. The enthusiastic conclusion is not supported. http://www.cochrane.org/CD001218/SYMPT_acupuncture-preventing-migraine-attacks
It should be very obvious to you that, because your constraints on budget and time do not enable you to provide proper health care, you should stop providing your improper health care. Thanks again for the insight into your mind-set.
Yes, we know that acupuncture doesn’t cure any known disease — if it did, you would be practicing medicine without a licence. But, your clients are under the impression that acupuncture *does* cure diseases, otherwise they wouldn’t be spending their money on it.
quack [noun]: a person who dishonestly claims to have special knowledge and skill in some field, typically medicine.
If you can’t do a job properly, FFS STOP DOING IT.
Luckily, not everyone is deterred from striving to become better by financial and time constraints. And I’m sorry you consider me to be providing ‘improper healthcare’, but if one must personally follow up every single patient for statistical analysis, every GP in this country will have to join me in that category.
My NHS medical records are far better than anything you will ever produce for four main reasons:
1. Unlike quacks, GPs are authorised to *diagnose* and *treat* medical conditions.
2. Unlike quacks, GPs don’t charge for follow-up appointment, further treatment etc.
3. Unlike quacks, GPs have kept my medical records up-to-date over the decades.
4. Unlike quacks, all of the GPs I visit have access to my medical records.
That is health care. If you think that you are providing proper health care then you are dangerously deluded.
I’m afraid it’s you who is deluded if you think your NHS follow-up appointments are kindly donated to you by altruistic GPs!
That was possibly the most asinine reply that you have ever written on this website.
Edzard-
Just a slight -if you’ll forgive me, ‘niggling’- point, if that’s not a bit racist.
But calling somebody a ‘wingwang’ would be more like calling them a ‘knob’.
Much more innocuous than ‘twat’ which is equivalent to the ‘C’ word.
By the way – I just realised how deeply racist the Goons’ ‘Ying Tong Song’ is.
I shall never listen to it again. Not in the presence of a Chinese person anyway.
@Pete flattery will get you nowhere! But seriously, you’ll have to explain to me in what way GPs don’t charge for follow up appointments, or anything else for that matter.
Tom Kennedy,
MEDICINE
Under the NHS, how much does it cost me personally to see my GP. Specifically, what is the difference in the cost, to me, between making zero appointments per year and, say, ten appointments per year? Answer: zero. I’ve already paid for my NHS health care (via taxation), whether or not I need to use it. I’ve already paid towards yours as well, you ungrateful dipstick. The reason that *you* have access to NHS services is simply because everyone older than you has already paid to provide them to you. You are not paying for my visits to a GP, you are paying towards the future provisioning of NHS services.
It should be obvious to you, but sadly it isn’t, that GPs collect follow-up information whether or not they specifically ask the patient to book a follow-up appointment. Why? Because it’s an integral part of the system. Each time I visit a GP, the GP looks at my records and asks for feedback on my previous discussion/treatment, which is appended to my records. One core strength of this system is that it doesn’t make any difference whether I visit the same GP or a different GP on my next appointment. Another core strength is that the system will raise a warning flag when I’m due for, say, a blood test and I will be sent a reminder.
ALTERNATIVE-TO-MEDICINE (alt-med, sCAM, integrated medicine)
Alt-med is the complete opposite of 21st Century medicine. The alt-med empire is not ‘integrated’, unified; it is a hotchpotch of unconnected, disunited, diverse, and incompatible versions of absurdity.
I suffer migraine attacks — not a guess, it’s a medical diagnosis — of a type that cannot be cured by medicine. Suppose I visit the Natural Health Clinic, in which you work, and that I’m advised that there is evidence to show that acupuncture is effective in treating migraine. Great! Now let’s suppose that I book my first appointment with you.
I have no doubt whatsoever that you would exercise due diligence in carefully recording my health history, giving me your honest opinion based on your experience, and recommending a suitable number of treatment sessions to try. I also have no doubt whatsoever that you would try your very best to alleviate my health problem. Yes, of course you need to earn money, but I’ve gained the impression that we have something in common: the sense of reward (achievement) we gain from solving a difficult problem is far greater than the sense of reward we gain from the money we received while solving the problem.
Let’s suppose that I feel much better after the treatment sessions. This is extremely likely to occur for the reasons that Björn explained to you on Friday 08 July 2016 at 13:30, and Prof. Ernst has been explaining to the readers since he started his blog. You confirmed this with your statement “and so far my average rating is 4.9 out of 5 (with the admittedly small sample of 30 patients)”.
Let’s now suppose that after a few months or a year, the intensity of my migraine attacks increases. Again this is extremely likely to occur for the reasons already given.
What do you think I would do? Book and pay for another appointment to see you, at a cost of tens of pounds sterling, to inform you that the treatment hasn’t worked, then ask what you recommend I do next? How would you respond: by giving me a refund (I don’t think so!); that I need more acupuncture treatments; or that I should try a different alt-med modality available at the same clinic?
Very few people are daft enough to pay for an appointment to inform an alt-med practitioner that their treatment hasn’t been effective. You will very rarely, if ever, receive this information. Furthermore, no alt-med practitioner in their right mind enjoys receiving this negative feedback — it would burst their happy make-believe bubble of achieving a “4.9 out of 5” or similar success rate.
So, I go back to the clinic, inform them that I’m still having migraine attacks despite trying acupuncture. What will they do? Inform the acupuncturist who just rents a room — you — that your treatment hasn’t worked, and record this follow-up information in their patient recording and monitoring system? No, because they don’t have a patient recording and monitoring system. Each individual practitioner keeps their own private set of client records: private and secure as mandated by the Data Protection Act.
I ask the clinic to book an appointment for me to see a Reiki practitioner. Most of this first appointment is taken up by repeating what you did: recording my health history.
And so this cycle repeats, over and over again. Alt-med is the only perpetual motion machine I know of that has been running continuously for thousands of years. But that’s all it is. It is the opposite of medicine.
CONCLUSION
If you think that you are providing proper health care then you are dangerously deluded.
Pete, your GP is clearly working in a model practice. I have had personal and familial experience of the NHS (GP and hospital) recently and I would say that record-keeping, follow-ups and patient monitoring are absolutely and shockingly appalling. From my experience I would think that patients are even likely to die because of neglect unless they or their families ruthlessly chase up the NHS. This is not an attacks on the NHS – I passionately believe in a health service free at the point of use – but a realistic assessment of how it is currently operating. For that reason it is meaningless to compare the care given by practitioners working in the private sector (many of whom would love to work on the NHS but are unable to do so) to an imaginary perfect NHS.
To Peter Deadman
My GP’s practice is fully computerized, and offers exactly the care and follow-up described by Pete Attkins. So that’s two of us who, according to you, enjoy model practices.
I was recently admitted to an NHS hospital in an emergency. The hospital is one we keep reading locally is understaffed and under great pressure. Still, the medical and nursing staff spent colossal amounts of time recording every little thing they did to me on paper or computer. My hospital colleagues reckon they have to spend up to a third of their working days entering the tiniest details of patient care in a computer database. They do this mainly to cover the hospital’s backside in case of a complaint.
I’m sure they function well with acute complaints but my experience is with chronic ones … no follow-up, dropping off waiting lists, confusion about what has and what hasn’t been done, poor communication between GP and hospital etc.
Peter Deadman,
Whereas in the awesome domain of ‘integrated medicine’, there exists zero communication between each client’s various alt-med practitioners [as I’ve illustrated above], and zero communication between these practitioners and each of their client’s GP and hospital etc.
You wrote: “… For that reason it is meaningless to compare the care given by practitioners working in the private sector (many of whom would love to work on the NHS but are unable to do so) to an imaginary perfect NHS.”
That is utter bullshit. I’ve received excellent health care from private clinics. Why? Because every practitioner who ‘just rents a room’ in the clinic bothered to study medicine, and gain a license to practice medicine, BEFORE vending their health care services to patients. They spend some of their time working within the NHS: BECAUSE THEY ARE QUALIFIED TO DO SO!
I’m certain that many alt-med practitioners would love to work within the NHS, but are unable to do so. They are unable to do so because they love playing the role of a physician, but are too lazy and/or incompetent to undergo the required training.
If you think that you are providing proper health care then you are dangerously deluded.
Tom Kennedy said:
Bizarre. GPs do not charge for appointments, follow-up or otherwise. The NHS is free at the point if use. GPs are paid an annual sum per patient, regardless of the number of consultations, and (in 2013/14) amounted to an average of about £136 per annum – and considerably less for many GPs.
I see from your website you charge £55 for a first appointment then £45 for a follow-up so two follow-ups takes a customer over the total it costs their GP for a full year. I also see you provide a price for six follow-up appointments for £229.50.
@Pete, @Alan, @Bjorn, @Edzard and friends,
My wife saw this tab open on my browser and said ‘you’re not wasting your time with that lot again are you?’ (or words to that effect). So I’ve promised I’ll go back to the 12 step program and do something more productive instead after this post. I started writing what would have been a very long final post, but she’s quite right, it’s not worth it, so I’ll just summarise a few parting thoughts and leave it at that:
@Pete, your latest diatribe again contains false assumptions and misrepresentation (as well as ad hominem insults – ‘ungrateful dipstick’ is one of my favourites). For the record, I am extremely grateful to have access to the NHS, and I have great respect for conventional doctors (which doesn’t stop me from having grave misgivings about aspects of the system). My comment was intended to counter your apparent suggestion that GPs don’t charge for follow-up treatments. Yes, appointments are ‘free’ at the point of use, but the average tax payer contributes more than £1000 per annum towards the NHS, and GPs are paid good salaries for their efforts. I work in the private sector, so yes, I have no choice but to charge for follow-up treatments (I note @Alan chose only the most expensive option I offer in his illustration – selection bias?). I’d love to work for the NHS, and perhaps one day I will, but until then I’ll carry on trying to improve what I do for the benefit of my patients.
But why is it that people end up feeling they need to pay me (or others) in the first place, instead of using the NHS? Often because they’ve gone down the NHS route and come out the other end either without improvement, or worse off than they were before. The large number of people who do get what they are looking for from the NHS generally don’t come and see us. So why is it that this subset of people haven’t improved already? The way things are described here it should be easy with the ‘white coat effect’, confirmation bias, natural progression, regression to the mean etc. There are large gaps in what the NHS provides, particularly for chronic conditions, and I’d argue that CAM therapists in fact help to take the strain off the NHS in this way.
Finally, why is it that since posting the new Cochrane migraine review the vast majority of replies directed my way have been personal inquisition rather than addressing the review? Why wouldn’t EE be drawn on Mel’s reasonable questions about the NICE recommendations on back pain, and instead chose to write the above post examining her mind-set? If you want people to believe that your approach is any more rational than those you disparage, you need to properly discuss good evidence that contradicts your position instead of distracting attention.
All the very best.
P.S.
‘Am I making too much of all this? Perhaps – sorry, I am almost done.
But first I need to briefly address Edzard’s doubts about my integrity. He can, of course, question what he likes as often as he wants. My point is that repeating nonsensical arguments ad nauseam does not render then sensical.
Finally, there is Edzard’s public claim that I make (some of) my money using acupuncture and hypnotherapy to treat smokers who want to quit. To me, it suggests a degree of desperation, perhaps even fanaticism, that is only surpassed by his inability to apologize after the truth had become undeniable even to him.
I know that there are some people who would have sued for libel.
Not I!
For that I find all this far too hilarious.’
E E
Has Sasha finally cracked? He seems to have given up all pretence at civility, and is now just hurling abuse.
Being sarcastically patronised is bad enough, but he’s just not very good at it either. A child’s ‘wit” in the body of a man.n
more on Mel Koppelman here: https://sciencebasedmedicine.org/acupuncturist-complains-about-wikipedia/