Testing whether magic works.

Steve,

Possibly you are not old enough to have been burned by mainstream medicine - I have - but fortunately not irreversibly!

Mainstream medicine is hopelessly skewed by big pharma's need for profits. It is also probably skewed by its adherence to materialistic explanations - even while it struggles with fact that people's minds seem capable of messing up all sorts of medical experiments (the placebo effect).

Even if you only accept the first part of that statement (the malign effect of big pharma), you can see that the science establishment is not a temple to rationality, it is driven by many forces.

David

However, that has nothing to do with the topic of this thread. Medicine could be as messed up as you claim and it still wouldn't mean that CAM therapies are any better than doing nothing.

Linda
 
I thought the main point was not that we shouldn't be doing the full scale studies of CAM hypotheses, but rather that they should only be getting the bigger dollars for the bigger studies if they have first gone through the preliminary, less expensive proof of concept type studies that other potential treatment have to go through.

The point he probably should have made more strongly (I only read it once so perhaps he did) is that CAM hypotheses should be approved for the resources to perform those preliminary type tests.
The expectation (based on the poor performance in the full scale studies) is that they would likely have failed the preliminary, less expensive, proof of concept type studies, and so never make it to full scale studies for that reason.

Linda
 
Novella's point is that we've tried this, and what we've found out is that a tremendous amount of time and money have been wasted on ideas which turned out not to be helpful. It sounds like a nice idea, but implementing it means that you have lost the opportunity to do something useful with your time and money instead.

Linda
No, it means you have resisted the temptation to give the science a veto over alternative medicine. Some would like to do that because people could no longer compare and contrast!

David
Medicine could be as messed up as you claim...
Is that something you agree, or disagree with? Try reading this:

http://healthinsightuk.org/2014/08/31/q-a-almost-totally-bogus-the-theory-behind-the-low-fat-diet/

...and it still wouldn't mean that CAM therapies are any better than doing nothing.

Linda

Well it would shed some light on the matter. If medical science can't be trusted to keep profit out of its own scientific methodology, why trust it to assess another system of medicine? The same profit motive probably distorts its attitude to alternative medicine!

David
 
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The expectation (based on the poor performance in the full scale studies) is that they would likely have failed the preliminary, less expensive, proof of concept type studies, and so never make it to full scale studies for that reason.

Linda

Right. But the policy going forward should be: do the preliminary ones first rather than skipping to the large scale.
 
However, that has nothing to do with the topic of this thread. Medicine could be as messed up as you claim and it still wouldn't mean that CAM therapies are any better than doing nothing.
Medicine, particularly mainstream allopathic medicine, is horribly messed up. CAM is also messed up, to a lower degree I dare say, given the mortality rate of the former. Supplement industry is messed up. Nothing is perfect.

Maybe when we fix mainstream medicine it will be so effective and side-effects free that CAM will disappear, maybe also thanks to integrating concepts taken from CAM. Labels are really not that important. It's the goal we want to achieve. These days CAM isn't likely to go away because people find solutions that are not available in mainstream medicine.

Unfortunately Novella's proposal for robotic medicine doesn't really look promising. We don't need that kind of fanatism.
 
Maybe when we fix mainstream medicine it will be so effective and side-effects free that CAM will disappear, maybe also thanks to integrating concepts taken from CAM. Labels are really not that important. It's the goal we want to achieve. These days CAM isn't likely to go away because people find solutions that are not available in mainstream medicine.

It's unlikely that medicine will ever be side effect free. The reason there are side effects is because medicines are actually doing something in the body. It is not easy to target an effect just to the issue we're trying to get at. The medications affect other parts of the body as well.

If a treatment has no side effect it should make one question whether or not it also has a primary effect. (please don't take this as my saying that its not possible to do so, I'm simply saying that no side effects in itself should cause us to strongly inspect whether the main effect is what we thought).

Unfortunately Novella's proposal for robotic medicine doesn't really look promising. We don't need that kind of fanatism.

But why do you think he's proposing robotic medicine? In what way do you think a CAM method can't be tested scientifically?
 
Accepting that there are abuses in mainstream medicine, I think we need to be cautious about throwing out the baby with the bathwater.
Nobody would suggest that we throw out conventional medicine - just that we should not let it throw out alternatives!
Abuses in medicine lower the reliability of some medical conclusions. Those abuses should certainly be a focus for improvement (by the way: only accepting studies that were pre-registered in support of approving medications should help - if its not already done - in combating the file drawer effect which is one major abuse of pharma companies who only publish the positive studies and not the negative ones).
Try reading the link that I gave to Linda!

But to point to the fact that medical science has abuses as a reason to adopt even less reliable conclusions doesn't seem to be wise to me.
It is if we rely on conventional medicine to assess its rivals! Would you really rely on Ford to assess the reliability of Citroen cars?

David
 
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It's unlikely that medicine will ever be side effect free. The reason there are side effects is because medicines are actually doing something in the body. It is not easy to target an effect just to the issue we're trying to get at. The medications affect other parts of the body as well.

Yes, but another reason can be that we expect the drug companies to run the trials on its own drugs!

David
 
No, it means you have resisted the temptation to give the science a veto over alternative medicine. Some would like to do that because people could no longer compare and contrast!

David

Is that something you agree, or disagree with? Try reading this:

http://healthinsightuk.org/2014/08/31/q-a-almost-totally-bogus-the-theory-behind-the-low-fat-diet/



Well it would shed some light on the matter. If medical science can't be trusted to keep profit out of its own scientific methodology, why trust it to assess another system of medicine? The same profit motive probably distorts its attitude to alternative medicine!

David
That sounds like a problem unique to the UK. It's not fair to condemn medical practice worldwide based upon your UK experiences.
Novella isn't saying science should automatically veto alternative
medicine. He's saying all medicine should be science based. If it's not it, should be discarded for being ineffective.
 
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No, it means you have resisted the temptation to give the science a veto over alternative medicine. Some would like to do that because people could no longer compare and contrast!

It's not a veto over alternative medicine. Novella is suggesting instead that they be treated like any other therapy, instead of giving them a free pass. As it is, CAM practitioners don't have any obligation to show that their claims are true, that their therapies are safe, or that their manufacturing processes are sound.

Is that something you agree, or disagree with?

Disagree. I am disturbed about the tactics of big PHARMA, but EBM provides a defense against this.


Don't know what the hell he's going on about. It's no secret that cholesterol levels are mostly determined genetically and low-fat diets have a minimal effect at best. And EBM recommends reporting effects as Absolute Risk Reductions, as he suggests, rather than Relative Risk Reductions.

Well it would shed some light on the matter. If medical science can't be trusted to keep profit out of its own scientific methodology, why trust it to assess another system of medicine? The same profit motive probably distorts its attitude to alternative medicine!

David

That's a good one, considering that having to show that it's better than doing nothing and is safe would cut considerably into CAM's profits, if one is going to compare profit motives.

Linda
 
It's unlikely that medicine will ever be side effect free. The reason there are side effects is because medicines are actually doing something in the body. It is not easy to target an effect just to the issue we're trying to get at. The medications affect other parts of the body as well.

If a treatment has no side effect it should make one question whether or not it also has a primary effect. (please don't take this as my saying that its not possible to do so, I'm simply saying that no side effects in itself should cause us to strongly inspect whether the main effect is what we thought).

I think you're drawing the conclusion based on a narrow-focus of what "medicine" should be. For example, advil is not side-effect free and it doesn't specifically target areas like you said. Neither does Tumeric, a common table spice that happens to have anti-inflammatory benefits too, but is veritably side-effect free and actually good for you.

Obviously, you can never get to 100% side effect free - even water can kill you if you drink too much - but many alternative therapies get pretty close.

My orthopedic dr recommened trying Tumeric to get me off the Advil I was getting somewhat dependent on for hiking/climbing. Glad he did - it works pretty good and has extra health benefits to boot.

All the vitamins, minerals, phytonutrients, etc do amazing things on the body without causing harm, in general. Just because something has a strong primary effect that is good for the body, doesn't mean it has to have harmful side effects.
 
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Nobody would suggest that we throw out conventional medicine - just that we should not let it throw out alternatives!

I'm not at all sure what you are saying. In what manner would you test a CAM proposed treatment differently? (forget about who is doing it for the moment, assume the tester is someone trustworther).
 
It is if we rely on conventional medicine to assess its rivals! Would you really rely on Ford to assess the reliability of Citroen cars?

David
I think you are misunderstanding something. Many of the trials Novella is referring to are being done by CAM proponents and practitioners, not by their rivals. What he is suggesting is that, if Ford has to agree to tests of the reliability of their cars, why not ask Citroen to agree to the same thing?

Linda
 
I think you're drawing the conclusion based on a narrow-focus of what "medicine" should be. For example, advil is not side-effect free and it doesn't specifically target areas like you said. Neither does Tumeric, a common table spice that happens to have anti-inflammatory benefits too, but is veritably side-effect free and actually good for you.

Obviously, you can never get to 100% side effect free - even water can kill you if you drink too much - but many alternative therapies get pretty close.

My orthopedic dr recommened trying Tumeric to get me off the Advil I was getting somewhat dependent on for hiking/climbing. Glad he did - it works pretty good and has extra health benefits to boot.

All the vitamins, minerals, phytonutrients, etc do amazing things on the body without causing harm, in general. Just because something has a strong primary effect that is good for the body, doesn't mean it has to have harmful side effects.

By side effect I'm not necessarily only looking at negative consequences, simply that if you're ingesting something in order to achieve a targeted goal, it is very difficult to ensure that it only targets that goal and doesn't affect the body in other ways as well.

Also, don't assume that there are no side effects to Tumeric. Take a look at cinnamon. It has been found to have several good effects. However, cassia cinnamon (the standard kind you find in the supermarket) has been found to cause liver damage if taken too much. Ceylon cinnamon (which I've just purchased from a speciality shop) has been found not to (basically because Cassia cinnamon has coumarin in it, and Ceylon does not).
 
By side effect I'm not necessarily only looking at negative consequences, simply that if you're ingesting something in order to achieve a targeted goal, it is very difficult to ensure that it only targets that goal and doesn't affect the body in other ways as well.

If it has positive consequences in addition to "healing" the original condition, isn't that a good thing? That was my whole point on the Advil vs Tumeric thing. The side effects found on allopathic medicine are usually harmful. Side effects are usually not listed on natural alternative therapies, but rather nutritional benefits are discussed.

Anyhow, this is a discussion that never goes anywhere on this forum ... I'm out.
 
I think you're drawing the conclusion based on a narrow-focus of what "medicine" should be. For example, advil is not side-effect free and it doesn't specifically target areas like you said. Neither does Tumeric, a common table spice that happens to have anti-inflammatory benefits too, but is veritably side-effect free and actually good for you.

Obviously, you can never get to 100% side effect free - even water can kill you if you drink too much - but many alternative therapies get pretty close.

My orthopedic dr recommened trying Tumeric to get me off the Advil I was getting somewhat dependent on for hiking/climbing. Glad he did - it works pretty good and has extra health benefits to boot.

All the vitamins, minerals, phytonutrients, etc do amazing things on the body without causing harm, in general. Just because something has a strong primary effect that is good for the body, doesn't mean it has to have harmful side effects.
The testing of therapies like tumeric isn't what Novella is referring to. The bulk of our medicines come from natural sources, so there isn't anything implausible about the idea that a substance may have therapeutic potential. And curcumin has gone through the kind of preliminary testing which Novella suggests - investigation into mechanisms of action, in vitro and animal studies, Phase I clinical trials, and a few targeted Phase 2+ trials. It's perfectly reasonable to subject tumeric to a clinical test of whether it does better than nothing (or other NSAIDs) with respect to pain.

Linda
 
If it has positive consequences in addition to "healing" the original condition, isn't that a good thing? That was my whole point on the Advil vs Tumeric thing. The side effects found on allopathic medicine are usually harmful. Side effects are usually not listed on natural alternative therapies, but rather nutritional benefits are discussed.
Just a point of legality. The reason you don't find side-effects listed on alternative therapies is because they are not obligated to do so, not because they don't have any, in therapeutic doses. If big PHARMA had a pass on listing side effects, I'm sure they would take advantage of it as well. :)

Linda
 
If it has positive consequences in addition to "healing" the original condition, isn't that a good thing? That was my whole point on the Advil vs Tumeric thing. The side effects found on allopathic medicine are usually harmful. Side effects are usually not listed on natural alternative therapies, but rather nutritional benefits are discussed.

I think you're missing my point which was that it is difficult to target the specific effect you want from a medication.

The other point was that if CAM has no side effects then it one might question whether it does anything at all (not that it must not do anything at all.)

Many of the foods we ingest have various effects on our bodies, some positive, some negative.

Be careful assuming that because some have good effects they don't also have negative ones. The cinnamon example was one. Don't assume tumeric has no side effects either: From WebMD: http://www.webmd.com/vitamins-suppl...ngredientid=662&activeingredientname=turmeric

Are there safety concerns? (update) Turmeric is LIKELY SAFE when used appropriately by adults.

Turmeric usually does not cause significant side effects; however, some people can experience stomach upset, nausea, dizziness, or diarrhea.

In one report, a person who took very high amounts of turmeric, over 1500 mg twice daily, experienced a dangerous abnormal heart rhythm. However, it is unclear if turmeric was the actual cause of this side effect. Until more is known, avoid taking excessively large doses of turmeric.

Special Precautions & Warnings:
Pregnancy and breast-feeding: Taking turmeric by mouth in medicinal amounts is LIKELY UNSAFE in pregnancy. It might promote a menstrual period or stimulate the uterus, putting the pregnancy at risk. Don’t take turmeric if you are pregnant.

There isn’t enough information to rate the safety of turmeric during breast-feeding. It’s best not to use it.

Gallbladder problems: Turmeric can make gallbladder problems worse. Don’t use turmeric if you have gallstones or a bile duct obstruction.

Gastroesophageal reflux disease (GERD): Turmeric can cause stomach upset in some people. It might make stomach problems such as GERD worse. Don’t take turmeric if it worsens symptoms of GERD.

Surgery: Turmeric might slow blood clotting. It might cause extra bleeding during and after surgery. Stop using turmeric at least 2 weeks before a scheduled surgery.

Anyhow, this is a discussion that never goes anywhere on this forum ... I'm out.

As you wish. Though I think with effort we can...
 
The testing of therapies like tumeric isn't what Novella is referring to. The bulk of our medicines come from natural sources, so there isn't anything implausible about the idea that a substance may have therapeutic potential. And curcumin has gone through the kind of preliminary testing which Novella suggests - investigation into mechanisms of action, in vitro and animal studies, Phase I clinical trials, and a few targeted Phase 2+ trials. It's perfectly reasonable to subject tumeric to a clinical test of whether it does better than nothing (or other NSAIDs) with respect to pain.
Linda

Well, I didn’t read the Novella thing, so I wasn't speaking to that.

But, anyhow, that's what people say about Turmeric NOW, because modern-day research finally ben done to confirm what Ayurvedic (sp?) "medicine" already knew for 1000's of years. But, of course, if you used Turmeric before modern-day research suggested it was useful, you were a quack. Now, it isn't even considered "alternative" by some. Funny how that works.

But, that's how it works with alternative therapies. They're disparaged until they get confirmed, if anybody even bothers to confirm in the first place.

Of course, I am speaking in general terms here.
 
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