Alternative Medicine, Psuedoscience, etc.

[qetzal]

The Ethos,

It sounds to me like you're conflating rather different situations.

If an MD prescribes antibiotics when he knows that valid clinical evidence says they won't help, I agree that's wrong. If he knowingly allows the patient to think the antibiotics will help, that's more wrong.

On the other hand, if an infection needs to be treated, and the MD is forced to guess which antibiotic might help, there's nothing wrong with playing the odds. That is most definitely science-based. We might wish we had enough evidence to pick a drug with 90% confidence, but if the evidence is only good enough to provide 60% confidence, you have to go with that. (At least until you can get a culture, or determine empirically that the chosen drug isn't working.)

I can understand being frustrated with how often you're forced to decide in the face of inadequate evidence, but I think that's an inevitable problem of our limited knowledge, not a fundamental problem in our approach.

[The Ethos]

But the infections do not need to be treated. Infection != disease.

EDIT: Sorry, I should explain. I gave cases where writing a script is 100% quicker then figuring out WHY the patient wants a script. I am by no means saying that empiric coverage followed by culture w/sensitivity is wrong. That's good medicine. We do know from evidence that treating these specific infections is more harmful than beneficial, but MANY doctors still do it anyways. Why is everyone happier when they stay on the side of non-science. Would explaining the science make Joe Q Public walk away happy? (Answer: depends HOW you explain it, but in most cases, yes.) I think this sort of question gets more to the root of why CAM exists than anything having to do with science.

We're one of the few countries that restricts access to antibiotics, interestingly enough.

[TheStranger]

And as I stated earlier, such research is almost uniformly of very poor quality, which I attribute at least in part to highly negative attitudes toward engaging in such research.

I'd suppose that it depends on what 'alternative medicine' you are testing. Those that have at least some basis in conventional science can be approached with an open mind, while those with no foundation in science (I'm looking at you homeopathy) have much more work to do to be accepted.

[qetzal]

But the infections do not need to be treated. Infection != disease.

Agreed. My second example was meant to refer to cases where an infection clearly does need to be treated. Sorry I was unclear.

EDIT: Sorry, I should explain. I gave cases where writing a script is 100% quicker then figuring out WHY the patient wants a script. I am by no means saying that empiric coverage followed by culture w/sensitivity is wrong. That's good medicine. We do know from evidence that treating these specific infections is more harmful than beneficial, but MANY doctors still do it anyways. Why is everyone happier when they stay on the side of non-science. Would explaining the science make Joe Q Public walk away happy? (Answer: depends HOW you explain it, but in most cases, yes.) I think this sort of question gets more to the root of why CAM exists than anything having to do with science.

If it's true that Joe Q will usually walk away without wanting a script if you just explain it to him properly, then that's indeed interesting.

Maybe those docs don't realize Joe Q can understand if they explain it well? Maybe they don't know how to explain it well? Maybe they think writing a script is easier than explaining it, and if it's harmless enough, they'll do it to save time?

Do you think many of those doctors think writing a script is actually beneficial for the patient, even when they've seen the evidence showing that it's not? If so, then I agree we're getting at the same things that help drive CAM. Otherwise, if most docs "know" they really shouldn't write the script, but do it anyway for convenience or whatever, that's probably a different thing.

[superglucose]

Other than the fact that this is a well-known phenomenon--enough so that my allergist kept saying it was likely throughout my childhood.

Now, this is the thing about quackery--if your allergies had not gotten better, you'd have gone away mildly frustrated, and thinking that guy was a quack. But if they do get better, even though no causal link has been conclusively established, they've created a die-hard follower.

Except, that's not at all relevant. Jalapeno's allergist said, "Allergies sometimes go away on their own, and it's fairly likely."

When you visit a quack, the quack gives you a REASON that he's right. "Your allergies went away because I pushed on your arm!" So then you naturally develop a causal link.

How the hell do you make a causal link if the statement is, "I haven't done anything, and there isn't anything I can do, but it might go away on its own."? What, is Jalapeno now supposed to be a die-hard follower of... nothing? Because that's where the only possible causal link is formed... the cause is nothing therefore Jalapeno is now a die-hard follower of absolutely nothing.

[janusx]

But the infections do not need to be treated. Infection != disease.

EDIT: Sorry, I should explain. I gave cases where writing a script is 100% quicker then figuring out WHY the patient wants a script. I am by no means saying that empiric coverage followed by culture w/sensitivity is wrong. That's good medicine. We do know from evidence that treating these specific infections is more harmful than beneficial, but MANY doctors still do it anyways. Why is everyone happier when they stay on the side of non-science. Would explaining the science make Joe Q Public walk away happy? (Answer: depends HOW you explain it, but in most cases, yes.) I think this sort of question gets more to the root of why CAM exists than anything having to do with science.

We're one of the few countries that restricts access to antibiotics, interestingly enough.

I'd just describe the situation to the patient and then not perscribe the drug. If the patient is very demanding perscribe a placebo, that way the patients psycological needs are treated and theres no harm done by perscribing a drug that statistically would only aggrivate the situation.

[qetzal]

I'm not generally in favor of prescribing placebos, but I agree with janusx. If the choice is between prescribing an antibiotic that you know won't help, and prescribing a placebo, I'd prefer the latter. Placebos don't have the risks of side effects to the patient and selection for antibiotic resistance.

[The Ethos]

So what's the difference between the placebo and the crystal or the homeopathic meds?

[qetzal]

In that specific situation, little or nothing. Just to be clear - I'm not saying the doc should prescribe placebo in that situation. I'm only saying that if the doc is determined to write a script, then placebo is better than a drug that he knows will be ineffective but could have negative side effects. (Naturally, this assumes we're sufficiently confident that the potential benefit from the antibiotic is less than the potential risk.)

I think the best course is for the doc to forget the script and explain to the patient why a script is a bad idea. Especially if most patients will understand and accept such an explanation, as you suggest.

(Edited to correct html code error.)

[TheStranger]

So what's the difference between the placebo and the crystal or the homeopathic meds?

In the given case? That a placebo is only given by a doctor to placate an irrational patient while the homeopathic 'med' is given to someone sick with the 'intention' of making them well.

[stony-p]

A few thoughts.

Acupuncture is considered to be one of the more-possible alternative medicines because if you stick a needle in someone then you can measure the response in the brain so it was thought that something might actually be happening. But someone pulling your ear will give a response in the brain, so will watching TV and we don't think that these are medicine.


A study was done comparing authentic, traditional acupuncture with "fake" acupuncture where the needles were not actually inserted [but they were good enough fakes to be indistinguishable from the real thing to the patient] or the needles were placed into the skin as usual but were not placed at the special meridians.

There was no difference between the sham and the real acupuncture. The evidence says that placing the needles is not important. The idea that there are special meridians that chi energy flows along and putting needles in them can help has no physical basis and this trial shows that there is evidence against acupuncture being specially effective.

Possibly more interesting than the conclusion that our bodies are not run on magical energy is that both the fake acupuncture and the real acupuncture were better than nothing. Sometimes an hour with a calm person speaking softly in a relaxing atmosphere can make you feel better. Perhaps a break from the stress of work, cooking tea, looking after the kids, cleaning the house and all the other pressures of life is beneficial to how people feel.


Herbal medicine has the potential to work, plants do contain chemicals that can have an effect but you do have to make sure you get a plant that does something useful for the problem you have. And the problem with plants is that they are not standardised; different locations, growing conditions, sub-species, storage conditions etc will change how much of the active ingredient there is per gram of plant, so how do you ensure you get the correct dose? Surely a standardised "synthetic" pill would be a better choice than the "natural" herbal remedy.

Homoeopathy is the Scientology of medicine. Ben Goldacre sums it up better than I could.

Recently in the UK a woman won £800,000 in a case against her 'nutritionist' who had advised her to drink lots of water and eat no salt at all. The patient complained of feeling bad a few days into treatment and was told that it was just her body 'detoxifying'. The woman later had a seizure and now has permanent brain damage. Terrible and dangerous health advice from someone whose only qualifications are taught by nutritionists, accredited by nutritionists, [un]regulated by nutritionists with none of the external watchdog or safeguards from conventional medicine.

Alternative medicine is different from medicine in that to be called medicine we [mostly] know a) how it works or b) that it does work. If alternative medicine were shown to work it would not be alternative, it would just be medicine.

[The Ethos]

Alternative medicine is different from medicine in that to be called medicine we [mostly] know a) how it works or b) that it does work. If alternative medicine were shown to work it would not be alternative, it would just be medicine.

I disagree. Alternative medicine is that which is not institutionalized as mainstream medicine. No more, no less. When something does work, it is brought into the fold (like foxglove herbals -> digitalis -> digoxin) and becomes "mainstream medicine".

There is plenty in medicine that we don't know how it works or that it works.

[TheStranger]

Alternative medicine is different from medicine in that to be called medicine we [mostly] know a) how it works or b) that it does work. If alternative medicine were shown to work it would not be alternative, it would just be medicine.

I disagree. Alternative medicine is that which is not institutionalized as mainstream medicine. No more, no less. When something does work, it is brought into the fold (like foxglove herbals -> digitalis -> digoxin) and becomes "mainstream medicine".

There is plenty in medicine that we don't know how it works or that it works.

Though we may not know the exact way in which some medications work we do have a general idea of the principles that drive their function (we know that the enzymes in a herb can interact with the bodies own chemistry). None of the 'alternative' treatments that have since become mainstream have involved re-writing our understanding of the physical universe (like say Crystals).

[HadouKen24]

This strikes me as too broad a claim to discuss productively. Are you willing to name a particular CAM modality that you think exemplifies these problems? Preferably something that's used by enough people to be of some importance. If you can also summarize how your concerns apply to that particular CAM, all the better.

Things are getting busy around here, so I don't know how much time I'll have to start going into detail. I don't want to get involved in a discussion requiring that kind of dedication if I can't follow through. I've already probably spent more time in this thread than I can really afford.

The biggest problem, it seems to me, is that the researchers frequently lack even a basic understanding of the subject as it is taught to practitioners--or at least, don't design their experiments to be consistent with it. As I mentioned earlier, there are serious problems with homeopathic research in that the homeopathic treatment used in the study is not one that would be simply prescribed straightforwardly for the problem being "treated" in the study. A homeopath looks at each individual and assigns treatment based on a more holistic view. Hence, any test of homeopathic medicine needs to have a homeopath on staff prescribing a treatment for each individual (including, of course, the control group--they just won't receive the treatment)

One sees similar problems in, e.g., acupuncture research.

A study was done comparing authentic, traditional acupuncture with "fake" acupuncture where the needles were not actually inserted [but they were good enough fakes to be indistinguishable from the real thing to the patient] or the needles were placed into the skin as usual but were not placed at the special meridians.

There was no difference between the sham and the real acupuncture. The evidence says that placing the needles is not important. The idea that there are special meridians that chi energy flows along and putting needles in them can help has no physical basis and this trial shows that there is evidence against acupuncture being specially effective.

This is the problem with acupuncture research. It's very difficult to create an effective sham procedure.

Simply not entirely inserting the needles shouldn't make a significant difference. This sham turns acupuncture into acupressure. Putting enough pressure on the point to make the patient feel as if the needle is penetrating would activate the chi meridians, even if not as effectively as actually using needles. Especially when considering how important mental focus is on chi flow, according to TCM, there may not be a reason to think that not inserting the needles would make acupuncture ineffective.

The fact that the meridians are unimportant, at least when dealing with pain, is very interesting. It does prove that acupuncture does not work by activating chi which runs along certain meridians. It does not, however, prove that it does not work by activating chi.

Beliefs similar to chi are not simply Eastern ideas. They have been around in the West for a very long time, though not usually given nearly the same level of importance. Mesmer's animal magnetism is a good example. Vitalist theories invoking some force or fluid as the source of life were considered quite respectable in biology until the end of the 19th century. I am unaware of any purely Western views of the vital force--or indeed, any view not arising from the Indo-Chinese view of prana/chi--which claims that there are meridians, or that they are important, though stagnation and low levels of flow are nonetheless important.

The best scientific response to claims about chi and other forms of vital energy is that there simply hasn't been any evidence found for them, despite an ever more sophisticated understanding of complex biological systems.

[Aaron123]

This is kind of an interesting issue for me. Maybe for the wrong reasons--listen to this:

So I've had acne like any other person would for about 6 years now. When I first got it, the dermatologists recommended me all sorts of antibiotics. Over the past 6 years, I've gone through tons of different treatments and medicines, all to no avail. A couple of a months ago, I said screw it, and just stopped using any medicines whatsoever for it. Right now, my face is the best its ever been in years. All acne is gone--my face is only fading red marks now. I should've left it alone a long, long time ago.

This got me to thinking: would this apply in other medicinal situations? Like if I had a cold, would it be healthier to just have bedrest and liquids rather than taking a bunch of pills? This dilemma is very intriguing to me.

[Iori_Yagami]

And sometimes religion and alternative medicine mix together...
If you'd only see those huge queues of people waiting to get their portion of 'holy' water from the priest after sunday sermon... "It helps very well against evil eye!"
Of course, it does! An imaginary illness cured by imaginary medicine!
Those things make me check the current year on my mobile. Still 21st century?

[TheStranger]

A homeopath looks at each individual and assigns treatment based on a more holistic view. Hence, any test of homeopathic medicine needs to have a homeopath on staff prescribing a treatment for each individual (including, of course, the control group--they just won't receive the treatment)

The quantities of medicine in a "good" homeopathic medicine are statistically insignificant (like finding a grain of sand in a body of water the size of the solar system, with a teaspoon). What use is a homeopath if we cannot distinguish the 'medicine' used from water?

This is the problem with acupuncture research. It's very difficult to create an effective sham procedure.

I think it would be quite easy to do so, just stick needles in random places on a person while telling a person that you are pushing one of their points. If the results are measurably similar to an actual acupuncture session then it would appear that the actual points are not important... so then why pay for a professional when you can just stick some needles in your own arm?

The fact that the meridians are unimportant, at least when dealing with pain, is very interesting. It does prove that acupuncture does not work by activating chi which runs along certain meridians. It does not, however, prove that it does not work by activating chi.

It also does demonstrate the presence of 'chi'.

The best scientific response to claims about chi and other forms of vital energy is that there simply hasn't been any evidence found for them, despite an ever more sophisticated understanding of complex biological systems.

Yes, that is the best science can do... it says the same thing about unicorns and genies.

[HadouKen24]

The quantities of medicine in a "good" homeopathic medicine are statistically insignificant (like finding a grain of sand in a body of water the size of the solar system, with a teaspoon). What use is a homeopath if we cannot distinguish the 'medicine' used from water?

This thread has already gone over this. It's one thing if you have a fresh perspective to bring to the table, but just repeating things is going to waste everyone's time.

I think it would be quite easy to do so, just stick needles in random places on a person while telling a person that you are pushing one of their points. If the results are measurably similar to an actual acupuncture session then it would appear that the actual points are not important... so then why pay for a professional when you can just stick some needles in your own arm?

There's an increased chance of infection if you don't know how to properly sterilize the needles, or use needles that are too big and don't have the knowledge or tools to properly deal with the wounds. There's also a significant chance, when dealing with untrained acupuncturists, that a needle will go too deep and pierce muscle (if you're lucky) or an organ (if you're not). If you yourself are doing it, it's more likely that you'll accidentally twist, pull on, or otherwise manipulate a needle that's already in your body, and thus do damage that could have been avoided. It's also possible that having a relaxed posture is important to the process, and that's going to be more difficult when you yourself are twisting needles into your skin. Finally, in your inexperience, you may pick places to stick the needles that just plain hurt more.

There are lots of reasons.

Yes, that is the best science can do... it says the same thing about unicorns and genies.

The distinction being that hardly anyone in America believes in unicorns and genies. Belief in chi is fairly common, and while vitalism is unpopular among scientists, many people find to be a useful metaphor in their daily lives. It's not entirely unreasonable for them to reify that metaphor, especially if they have not received an adequate education in biology.

[TheStranger]

This thread has already gone over this. It's one thing if you have a fresh perspective to bring to the table, but just repeating things is going to waste everyone's time.

All a 'good homeopath' will end up giving you is water (or a chalk pill). What more is there to test?

The distinction being that hardly anyone in America believes in unicorns and genies. Belief in chi is fairly common, and while vitalism is unpopular among scientists, many people find to be a useful metaphor in their daily lives. It's not entirely unreasonable for them to reify that metaphor, especially if they have not received an adequate education in biology.

It's unpopular among scientists because it has no basis IN science. Just because a large number of people believe in something does not mean that we need to keep testing it over and over again. It falls to those who believe in it to present the evidence that it's true.

[HadouKen24]

All a 'good homeopath' will end up giving you is water (or a chalk pill). What more is there to test?

If you'll scroll up, you'll see that I give reasons to test it aside from the possibility of finding positive results.

It's unpopular among scientists because it has no basis IN science. Just because a large number of people believe in something does not mean that we need to keep testing it over and over again. It falls to those who believe in it to present the evidence that it's true.

Were it not a public health issue, I'd be fairly comfortable leaving it there.

[The Great Hippo]

The biggest problem, it seems to me, is that the researchers frequently lack even a basic understanding of the subject as it is taught to practitioners--or at least, don't design their experiments to be consistent with it. As I mentioned earlier, there are serious problems with homeopathic research in that the homeopathic treatment used in the study is not one that would be simply prescribed straightforwardly for the problem being "treated" in the study. A homeopath looks at each individual and assigns treatment based on a more holistic view. Hence, any test of homeopathic medicine needs to have a homeopath on staff prescribing a treatment for each individual (including, of course, the control group--they just won't receive the treatment)

I understand what you're saying ("We have to play by the homeopath's rules to prove the homeopaths wrong"), but I don't think you're really looking at what the homeopath practitioners are claiming.

Go to your local pharmacy; check out the cold aisle. Pick up a box of Zicam. This is a homeopathic mixture which claims, directly on the box, to cure the common cold. That is their claim, and it's a claim that's been approved by whatever self-regulating governing body the homeopaths rely on (forget their name). This is a claim we can test outside of any homeopathic regulation--we need only follow the instructions on the box. We don't need a professional homeopath to administer this medicine effectively (they THEMSELVES have said this). And we've done this research, and we've found that products like it are no more effective than a placebo.

If you're talking about how we have to refute the idea that a hands-on homeopath can be more effective than a doctor of medicine--instead of just disproving the homeopathic claims, one by one--you're setting up what might be an unreasonable goal that science must meet to prove homeopathy bogus.

[Kendo_Bunny]

I use alternative herbal medicine for a lot of things myself. Why? Because it's inexpensive and usually pretty effective, plus, it doesn't have a lot of nasty side-effects. I cured most of my acne with stuff made in my kitchen- and I had really bad acne. I didn't have to use hormone therapy or continue using creams that burned my skin.

However, I think there is a difference between exploiting the natural disease-fighting properties of herbs in relatively minor cases (you can knock a cold right out with a nutrient-rich broth heavy in garlic and rosemary, and banish congestion with ginger tea mixed with honey and fresh lemon) and relying on them to fix something major. I did try a 'gallbladder flush' out of desperation once- it got rid of a few stones, but it was disgusting and painful. Surgery was a better solution. I'm very well versed in herbalism, but if anyone approached me about a serious problem, I would be responsible enough to tell them to seek help from an actual medical professional. I limit myself to hygiene/spa products (face masks, shampoos, rinses, massage oils), minor annoyances (like bug bites or cuts), and minor illnesses (like colds, mild flus, sore throats, and earaches). The only time I have ever used herbalism to try to help a serious problem was with someone who was too broke to afford medical care, and it was a serious skin condition. I was able to help, but I still did encourage a trip to a free clinic.

For how herbalism works despite growing differences, luckily, most plants won't hurt you, and the ones that can are strictly labeled in every reputable book on the subject. For example, I know that foxglove seeds can be made into a tea that can help with heart trouble. I also know that foxglove seeds are poisonous, so I would not use foxglove myself. Then again, if someone came to me with heart trouble and expected my knowledge of teas and poultices to fix it, I'd say they were crazy. If, say, I'm trying to help someone with a cold by giving them an herbal steam, I can add more rosemary or fennel to the water if it doesn't seem to be helping them. I can make ointments stronger by adding more herbs or weaker by adding more carrier oil.

Again- I believe strongly herbal medicine is for minor complaints, or for complementary action to a real doctor's treatment, never as a replacement for needed medical care. For example, if you're being treated for kidney disorders, acidic fruit juices like cranberry, apple, and blueberry can complement the medicine you're taking by dissolving uric acid crystals and also do help eliminate bacteria in the urinary tract. But if you are being treated for a problem, it would be silly to give up the doctor and just chug cranberry juice. Herbal medicine can't properly diagnose problems and can't keep an eye on potential complications.

For crystal therapy... someone once gave me a set of 'chakra' crystals. I find them beautiful, and rubbing a stone and admiring its color for a bit does help me focus. I think that's all they're good for. Feeling the cool, smooth surface of a stone and appreciating a deep, beautiful color is a form of meditation, which gives the mind a rest from outside influences- which in turn lets one focus on the task at hand. I don't think the orange one has any superiority in helping me write over the yellow one or the purple one or the blue one. It's just a moment of peaceful activity that doesn't introduce any more distracting thoughts.

[drunken]

I think many of the people on this forum (and in fact the world) cling to science like religious people cling to religion, out of fear of the unknown and the urge for control and understanding. I think this is dangerous and harmful and the first casualty of such an attitude is usually scientific progress, in the same way that blindly clinging to religion inhibits spiritual progress.

This post is about pseudoscience more than alternative medicine, although it will use alternative medecine in many cases in examples of pseudoscience.
Pseudoscience is a subject that is very close to my heart especially in such cases as when it is used by otherwise scientifically minded people and even memebers of the scientific community. I am not especially scientifically minded but I will try my best to put forward my ideas in a logical and precise manner.

In order to put forward a correctly argued point I would like to define a couple of terms, I hope no one objects to my using definitions from wikipedia.

Pseudoscience is defined as a body of knowledge, methodology, belief, or practice that is claimed to be scientific or made to appear scientific, but does not adhere to the scientific method, lacks supporting evidence or plausibility, or otherwise lacks scientific status.

The placebo effect or placebo response is a therapeutic or healing effect of an inert medicine or ineffective therapy, or more generally is the psychosocial aspect of every medical treatment. Sometimes known as a non-specific effect or subject-expectancy effect, the placebo effect (or its 'counterpart, the nocebo effect), occurs when a patient's symptoms are altered in some way (i.e., alleviated or exacerbated) by a treatment, due to the individual expecting or believing that it will work. The placebo effect occurs when a patient is treated in conjunction with the suggestion from an authority figure or from acquired information that the treatment will aid in healing and the patient’s condition improves. This effect has been observed since the early 20th century.

I would also like to note that I am making a strong distinction in this piece between 'science' and 'scientists', the first being an ideal of the pursuit of knowledge through unbiased imperical observation that in it's utmost perfection is unavailable to the human race but a close approximation of which we have used with massive success for some time. The second is a group of individual people who attempt to practise this approximation with varying degrees of success.

We know very little about anything, the human body is one of the most complex and unfathomable things we have ever attempted to understand. To say X medical treatment cannot possibly work is unscientific, or pesudoscientific. Many of the people who posted before me in this thread have maintained such a position, I urge you to reconsider this as in making these claims you are invoking a belief you have personally and making it appear scientific. But doing so without adhering to scientific method, and lacking supporting evidence.

I have a bad habit of taking the hardest examples to argue because I know my opponents in the debate will use them too. I know that after reading the last paragraph many people will refer to homeopathy (just for the record i think that homeopathy is probably bunk, but this is my opinion and I claim no scientific status for it) and the fact that at higher 'potencies' there is none of the active ingredient present at all. This is in fact scientific evidence but it does not imply that 'Homeopathy cannot work' it implies that 'homeopathy cannot work through the action of whole atoms of anything other than water in the body'. This is the true scientific conclusion from this evidence. To make the rest of the jump you need to also show that 'chemically is the only way that homeopathic remedies could possibly have an effect' perhaps someone might care to work this out but making such a claim implies in my mind a comprehensive perfect understanding of the human body, which we don't have. A comprehensive study of the effects gives a good statistical guide as to whether treatement X is effective but simply claiming that it is not because of a logical connection of various well known chemical properties does not.

I could list here some of the failures of scientists in the past and the many claims and answers they have sworn by that turned out to be complete bollocks but if I wanted to write a 1000 page history paper I wouldn't be doing it here. If I did however I would have to exclude medicine as that would take 1000 pages by itself. The point I am making here is that scientists have been wrong many many times. This is not because science is wrong, it is because science is not being done properly. This however leads me to suppose something of a gradient of pseudoscience, as failure to adhere to the scientific method and supply supporting evidence is not a black and white issue, there are degrees, a spectrum if you will. Newtonian physics for example is to me an example of the closest mankind is capable of coming to true scientific work, and is recognised by most people as such. The fact that relativity showed it to be lacking and eventually showed that most of the statements in it were not 'techically' correct does not mean that Newton was practising pseudoscience. But it shows that there is a gap between the work of Newton on the scale of scientificness (), and the end at which sits 'pure science' in all its glory upon a golden throne of true understanding (yes I am using religious imagery to describe science, Í really get a kick out of things like that). Homeopathy is very very far down near the bottom of the scale, claims that homeopathy cannot possibly work are a long way above it, but still below the point of 'minimal acceptable scientificness' in my opinion (I place the point higher than most though).

I am sick of scientists making pseudoscientific claims and I am basically writing this to plead with you, my beloved xkcd'ers who are so scientific and yet have a sense of humour and an openess to the absurd in the hope that the label 'pseudoscience' can start finally being applied to scientists as well as non scientists.

My favourite example of pseudoscience by the scientific community is the claim that 'we only use X percent of our brain' I don't remember which percentage they use but it is immaterial. The correct interpretation of the results of the experiments in question is that 'every type of scan we have so far developed to measure brain activity fails to show any activity in 100-X percent of our brain'. The two statements are not equivalent. Furthermore our brain uses a massive proportion of our bodies resources, especially if you factor in the length of time our young spend dependant on their parents which is mainly due to the size of our brain. If it were conclusively proven that we only use a small proportion of that brain capacity that would mean that the millions of years of evolution had got it wrong and that we were wasting a huge percentage of our bodies resources. This in turn sheds doubt on current evolutionary theory as such a gross misallocation of resources should not be possible in such a system. Maybe this is something the creationists should use in their arguments. (Just for the record I rate creationism lower than homeopathy on the scientificness scale)

The existence of the placebo effect is of special relevance when talking about pseudoscience in conjunction with medicine. If the human body can physically alleviate or exacerbate symptoms simply based on the action of your mind and psyche, the implications are rather large. We don't know why or how this works exactly in most cases. An interesting study that has probaly been done and if not should be done would be to give two control groups the same placebo but administered to one group by people in doctors coats and to the other group by regular clothes. Would this make a difference? Is the placebo effect of 'alternative' medicines heightened by the psudoscience that accompanies it? If the placebo effect is really based ont he belief of the patient then the pseudoscientific crap that new age healers always spout is likely to be integral to any healing that takes place. What if homeopathy sometimes works because the word homeopathy is printed on the packaging? I realise this is an absurd question but isn't it also absurd that we cannot conclusively answer it?

I personally have very little confidence in 'orthodox' medicine, the fact that I have even less confidence in 'alternative' medicine will never change that.

I would like to conclude by referring once more to the definition of pseudoscience: 'a body of knowledge, methodology, belief, or practice that is claimed to be scientific or made to appear scientific'. This means we can all be rid of pseudoscience for ever if we simply refrain from refferring to our own opinions and beliefs as scientific. I can claim for example that nothing I have said in this post is pseudoscience simply by putting a disclaimer at the bottom:

***This post is my own opinion and no claim is being made that it is in any way scientific nor intended to be construed as such by any reader***

tldr: Psedoscience happens all the time and it is more harmful when practised by recognised scientists. Please stop you are hurting us.

[The Great Hippo]

The point I am making here is that scientists have been wrong many many times. This is not because science is wrong, it is because science is not being done properly.

Scientists are sometimes wrong despite doing their science right. Science concerns an evolving understanding of the universe, and makes constant mistakes; the distinctive feature of science is that it acknowledges these mistakes and moves on.

A lot of your complaints do not boil down to what scientists believe, but what laypeople who have poor understandings of science (or ulterior motives) believe. The 'we only use some small percent of our brain' idea is an example of this. Also see What the Bleep Do We Know--a clear example of pseudoscience designed to misdirect and mislead.

To say X medical treatment cannot possibly work is unscientific, or pesudoscientific.

The thing is, good science never makes these claims. It will say things like--"in this clinical study, it was found that homeopathic compounds were indistinguishable in their benefits from placebos". Scientists might afterward draw the conclusion that because of this finding, homeopathy is bunk and only relies on the placebo effect; most scientists will not claim this statement is scientific, but they will claim (rightfully so) that the statement is supported by science.

I'm not sure where you're coming from or what you're criticizing. Making statements supported by science isn't pseudoscience; it's just making statements supported by science. Saying "Homeopathy is bunk" isn't scientific, but science certainly supports the idea.

[The Ethos]

blah blah blah

I think this quote most reflects the ideas that I've been trying to bring to the front. I am an American, educated in the American system, in American medical schools....and I mostly agree with him. Science has little to nothing to do with medicine. It is 'an art and a science'.

I think a MAJOR PROBLEM of what a lot of people on this forum somehow think is that SCIENCE=MEDICINE. This is strictly not true.

Science != medicine, in every sense of it. I will stand by that. We try to base it off of it, best we can, but if it disagrees with the art of med. in the slightest.....back to basics for all of us.

Seriously.

*sigh*

/Edit: Hippo: the problem with your statement is that medicine is != good science. We have far more than a few things that we do not have the "good science" to back up....

//double edit for clarity: We have no evidence that treating asymptomatic disease is helpful, but we do it anyways.
we have no evidence that spinal fusion surgery is helpful for back pain, but we do it anyways
we have no evidence that peptic ulcer prophylaxis is helpful in general hospital admissions...but we do it anyways.

I challenge anyone to prove that even 60% of medicine is based on "hard science". Every day my attendings ask, "Where's the evidence for that." We answer, "There isn't any..." And they nod.

I wish that medicine was as clear cut as XKCDers wanted it to be, but unfortunately, it isn't. I feel a lot of people are reluctant to this fact.

[seladore]

tldr: Psedoscience happens all the time and it is more harmful when practised by recognised scientists. Please stop you are hurting us.

I think the mistake you are making is confusing your opinion of science and the scientific method, with that of a practising scientist. I don't know what you do, how closely you work to a scientific field, but many of your criticisms attack popular misunderstandings of science, rather than science itself.

No real scientist would claim 'homeopathy is bunk, I am 100% certain'. What is said is that there is no known mechanism through which it would operate, it runs counter to much of what we do know about biology and chemistry, and that in double blind trial after double blind trial it is shown to be no better than a placebo. These facts strongly suggest that there is nothing going for it, but they do not prove there is nothing going for it. We are back to the old problem of scientific proof (you should read Popper about this).

Again, no scientist has ever made the claim that we only use 10% of our brains. This is frequently repeated, but has no basis in fact whatsoever - something which neuroscientists have been saying for years. It is repeated by non-scientists in the belief that it is a scientific fact, but it is not.

An interesting study that has probaly been done and if not should be done would be to give two control groups the same placebo but administered to one group by people in doctors coats and to the other group by regular clothes. Would this make a difference?

This has been done, and the doctor group was more successful. Equally amazing, among patents with chronic pain, four sugar pills are better than two for treating the pain. And the colour matters too - I think yellow is best (I don't remember exactly). This is why brand pain killers perform better than generic equivalents, even though they contain the same ingredients. The placebo effect is amazing.

I would like to conclude by referring once more to the definition of pseudoscience: 'a body of knowledge, methodology, belief, or practice that is claimed to be scientific or made to appear scientific'. This means we can all be rid of pseudoscience for ever if we simply refrain from refferring to our own opinions and beliefs as scientific.

This is an incomplete definition though, missing an important bit about lack of evidence. I have the belief that objects on Earth accelerate at 9.8ms^-2 towards the centre of the Earth. This is a belief that is claimed to be scientific - is it pseudoscience? No, because it is suppoerted by evidence. If I believed that objects actually fall at 5ms^-2, and that scientists are too closed minded to realise this, then this would be a pseudoscientific belief. Because the evidence suggests otherwise. Now, it is entirely possible that in every test ever done, we have measured the local gravity wrongly, and objects do actually fall at 5ms^-2. But this is so unlikely that it is possible, without being unscientific, to say that it isn't true. Homeopathy isn't as clear cut as this, but you get the idea.

[Charlie!]

I can often spoof the placebo effect for myself, which is awesome for headaches.

Also, I think the biggest things that can mark pseudoscience are as follows
Lack of testability (we don't know that acupuncture DOESN'T work by activating Chi, so you should pay us)
Lack of actual testing of beliefs (we can tell what job you do based on your handwriting, this is scientific even though I haven't tested this hypothesis, so you should pay us)
Ignoring contradictory evidence (Homeopathy comes to mind)
Committing grievous fallacies to try and make your argument (We could give you evidence of the aliens, but there's a conspiracy)

[cathrl]

I'd add to that "It's impossible for anyone other than one of us to test our method fairly. When someone who isn't one of us finds no benefit for our method in their research, this is proof that it wasn't tested fairly".

[Kaiyas]

Homeopathy debate.

http://mediasite.uchc.edu/Mediasite41/V ... e=WM64Lite

IMO, Novella (1st guy) sets up a pretty good list of what homeopathy needs to establish in order for it to gain acceptance.

[The Great Hippo]

I'd add to that "It's impossible for anyone other than one of us to test our method fairly. When someone who isn't one of us finds no benefit for our method in their research, this is proof that it wasn't tested fairly".

This is a good one. From what I've seen, the chief defense of pseudo-scientific scams like homeopathy boils down to creating unreasonable demands that science must meet to disprove them. If you make a claim ("X does Y"), we can prove the claim to be false by conducting a simple and no nonsense study ("Does X do Y any better than, say, plain drinking water?"). This has been done. People who claim the study is bogus because it didn't play by the pseudo-scientist's rules need to be pointed to the fact that those rules don't matter, only the claims they're making matter. As far as science is concerned, anyway.

[DubioserKerl]

To the Topic of homeopathy:

I just found some medicine whose package had the following text imprinted: "Registriertes homöopathisches Präparat, daher keine therapeutische Indikation"
In English, that would be something like "Registered homeopathic compound, therefore: no therapeutic indication".

You see, the package itself says "This does not help with anything", since the indication gives you the symptoms or illnesses that the medicine helps against.

And actually, that has to be right, because some of the ingredients are supposed to be in D12 delution, that is 1:10^12.

DK

[HadouKen24]

This is a good one. From what I've seen, the chief defense of pseudo-scientific scams like homeopathy boils down to creating unreasonable demands that science must meet to disprove them. If you make a claim ("X does Y"), we can prove the claim to be false by conducting a simple and no nonsense study ("Does X do Y any better than, say, plain drinking water?"). This has been done. People who claim the study is bogus because it didn't play by the pseudo-scientist's rules need to be pointed to the fact that those rules don't matter, only the claims they're making matter. As far as science is concerned, anyway.

The claims made by homeopaths cannot easily and straightforwardly be mapped onto traditional, "allopathic" diagnoses and treatments. One cannot simply say, "Traditional medicine says to treat this problem with this drug, and homeopathy says to treat it with this solution." The homepath treating the patient will look at a broader set of symptoms than the traditional doctor will, and will adjust his recommended treatment in response.

This is not some untestable claim. Nor is it an ad hoc response to research. Homeopaths have been working this way since before the professionalization of medicine. Any test of homeopathy which tries to test it as if it treats the same sets of symptoms as traditional medicine is not testing the claims which homeopathy makes.

[The Great Hippo]

The claims made by homeopaths cannot easily and straightforwardly be mapped onto traditional, "allopathic" diagnoses and treatments. One cannot simply say, "Traditional medicine says to treat this problem with this drug, and homeopathy says to treat it with this solution."

Except that the homeopaths themselves are saying precisely that. They put products on the shelves that make a claim--right on the front box--that this product will help you recover more quickly from a common cold, or successfully treat insomnia. This is very easy to test against a placebo.

All I see here are homeopaths fostering an illusionary impenetrability concerning their methodology while trying to reap in the benefits from making honest, solid claims--claims that don't stand up to good science. It's a clear attempt to have your cake and eat it.

[HadouKen24]

Except that the homeopaths themselves are saying precisely that. They put products on the shelves that make a claim--right on the front box--that this product will help you recover more quickly from a common cold, or successfully treat insomnia. This is very easy to test against a placebo.

Most homeopaths will tell you that, while those drugs may be effective for some of the people seeking treatment, it will not be effective for all. I'm aware that there are least three homeopathic remedies for the common cold. One would have to look up the symptoms in the Homeopathic Materia Medica--the encyclopedia of homeopathic remedies--to know which one is correct to take. Even then, knowing which one will be the most effective may take the expertise and experience of a trained homeopath.

Or at least, this is what homeopaths have been saying. For 200 years.

[roc314]

Or at least, this is what homeopaths have been saying. For 200 years.

If their methods have not changed for 200 years, despite the increases in biological and chemical knowledge, it is no wonder they are out of place. If their methods were developed in a time when we had much less understanding of science, it is hard to see how they would somehow manage to be accurate without any updates. I could say that, scientifically speaking, humans came to be because God created them from nothing. That would reflect the views of those a few hundred years ago, but would be contradicted by today's scientific knowledge. I would be wrong.

[The Ethos]

There have been a few studies that thought that they proved homeopathy, but between James Randi and his gorram RANDOMIZING AND DOUBLE BLINDING SHENANIGANS, the "memory of water" remains unproven.

I would love it if some evidence came forward that homeopathy's theories worked. Really, I would eat it up. Change the face of science. But until then...*shrug* It's just another big fat placebo.

[The Great Hippo]

Most homeopaths will tell you that, while those drugs may be effective for some of the people seeking treatment, it will not be effective for all. I'm aware that there are least three homeopathic remedies for the common cold. One would have to look up the symptoms in the Homeopathic Materia Medica--the encyclopedia of homeopathic remedies--to know which one is correct to take. Even then, knowing which one will be the most effective may take the expertise and experience of a trained homeopath.

Except, again, that isn't what the homeopaths are saying on the box. There's no reference to any requirements for additional or supplemental material; they aren't telling you that this is merely one part of a much larger regiment. The box says: "THIS PRODUCT CURES INSOMNIA". The box also says: "THIS PRODUCT IS APPROVED BY THE SOCIETY OF HOMEOPATHS". If the homeopaths are privately making claims that directly contradict their public claims, they're--at best--incompetent, and at worst, guilty of deception.

You can't blame science for taking the homeopaths at their word.

[seladore]

OK, but even allowing the fact that homeopaths take a holistic view to treating their patents, homeopathy still doesn't work better than placebo.

What you do:

Take some patents, say 200. A certified & trained homeopath works out a personal treatment, taking into account all the symptoms etc. Then, each patent is assigned a code, which decides if each patent is to be given the personalised, detailed homeopathic medicine, or a placebo (normally a sugar pill or a water injection) - 50% are given the placebo, and 50% are given the intended homeopathic remedy.
Here is the crucial bit - no one in the trial, not the doctors, not the homeopaths, not the patents, know who has the placebo and who has the personal homeopathic treatment.

Then, you monitor all the patents - this can be done by the homeopaths too - and decide which are getting better, and which are not. Then you cross-correlate the data relating to which drug has been given (up to now this has been secret), with the 'which patents are getting better' data.

The result? Every time this has been done, there is no statistical difference between the personalised homeopathic 'cure', and the placebo.

See here:
http://www.farmaciasfrancesco.it/Lancet_Omeopatia.pdf
for a good meta-analysis of homeopathic trials

Note that they say

there was weak evidence for a specific effect of homoeopathic remedies, but strong evidence for specific effects of conventional interventions. This finding is compatible with the notion that the clinical effects of homoeopathy are placebo effects.

[drunken]

Scientists are sometimes wrong despite doing their science right. Science concerns an evolving understanding of the universe, and makes constant mistakes; the distinctive feature of science is that it acknowledges these mistakes and moves on.

A lot of your complaints do not boil down to what scientists believe, but what laypeople who have poor understandings of science (or ulterior motives) believe.

A mathematician is a biological layperson, and a biologist is a mathematical layman. Not according to the official definition of the word but in the way it is often used to describe "someone who doesn't really know what they are talking about". The division of people into those who know and those who dont is very harmful because it implies that the people un the first group actually know something, whereas everyone is wrong for about the same percentage of time in their lives. The idea that "you don't understand and you should just listen to those people that do and do whatever they say" is the antithesis of what science is about. The word layperson used very often by scientists expresses exactly that idea. This is only a small part of the attitude in the scientific community that I have a problem with, but worse is the rightious indignation they have against anything they can't understand with the scientific knowledge that they have learned. You can be very well informed scientifically and then something can come along that you can't find any scientific explanation for it, but then you can explore it a bit, you may find an explanation. You may not find an explanantion but you might find it useful anyway in which case the explanation is immaterial.

People sometimes learn things as a group or society, over very long periods of time. The manifestiaion of this learning is in culture, stories, music, and language and the knowledge within it can not easily be denominated, extracted, translated, calculated, transcribed or even recognised but it is undeniably useful. It is knowledge that has enabled us to survive as a species. In my humble opinion this knowledge is the highest thing on the 'scientificness' scale I have encountered. It is always tested with thousands of control groups containing tens of thousands of participants and over immensely long periods of thousands or even millions of years, the kind of rigour conventional science can only dream of. The data is stored procedurally so you don't need to understand how it works to use it and with huge redundancy so that losing individuals in the process results in minimal loss of data. The main way I think it is superior to science is that it admits new ideas on a largely random and all inclusive basis This is one of the reasons scientists have no respect for traditional knowledge, if it allows something like homeopathy or christianity to happen then it must be bad. This misunderstanding is a result of the short term manner in which scientists (read all people) view the world. If homeopathy is as stupid as everyone here says it is then it will be gone in a couple of hundred more years, the blink of an eye as far as the species is concerned. Furthermore the origin of homeopathy is probably something along the lines of a 'placebo doctor', and in the distant past when it was conceived it was probably simply a situation that you went to the hoeopath and got a really good placebo. You can't deny that the fact that the entire process and construction of hoemopathy makes for a very convincing placebo unless you have some scientific knowledge. If your problem did't go away from the homeocebo then you would be sent to a surgeon. a few hundred years ago this meant you had a 70% chance of dying on the operating table or from a post-op infection anyway. Misunderstanding Christianity is another example of short term thinking, in the past religion has been incredibly useful to the human race. Religion is not so useful now and this is why so much of the devolped world is becoming secular, but it was not a mistake to start religion in the first place. I think science could stand to be much more open about what it will admit into the realm of science, or not so critical of the things it refuses to admit. There is value in random human ideas and if you want to keep science as a rigorous bastion fo provable demonstrable fact, then you should give up the right to criticise anything outside it for not being provable or demonstrable. The scientificness of a statement has no direct correlation to it's value except in evaluating other scientific statements.

As mentioned above, most traditional medical methods use a broader range of symptoms, in fact such methods are often simply referred to as holistic medicine. The favourite failure of orthodox medicine in this thread seems to be back pain. In my life I have gotten some back pain. In many cases the causes were recogniseable: sitting in front of a computer for hours with bad posture and an uncomfortable chair for example, Standing up for too long, lying down for too long... if you went to a holistic medical practitioner they might prescribe herbs or weird manipulation, or smoke and chanting, or they might simply prescribe that you buy a new chair, a new bed, a stand for your monitor, a change of job, movement flexibility and posture work (like dance), excercises to strengthen certain back muscles... But if you go to a hospital they do surgery which according to previous posts on this thread doesn't usually work and I would imagine aslo has a significant chance of complications.

I would love it if some evidence came forward that homeopathy's theories worked. Really, I would eat it up. Change the face of science. But until then...*shrug* It's just another big fat placebo.

It would change the face of scienctific knowledge because the only way that would happen is if scientists discovered the water memory thing and that would be a major scientific discovery. It would not change scientists attitudes towards such things though as many ideas that have been scorned and mocked by scientists and then shown to be correct and they still continue to do it.

Speaking of the water memory thing though the fact that water is a polar molecule and does in fact show patterns of a highly ordered hexagonal syymetry when frozen suggests that if a molecule of some other compound is in some water the molecules of water surrounding it will have a slightly different orientation and structure than otherwise. The question then is whether these patterns can a) persist for more than a moment after the molecule is removed and b) affect a human body in any way. This does not sound like and impossible hypothesis to me but I haven't tested it at all so I wouldn't know.

Can it please be noted that there are real money grubbing quacks out there who will say anything and stoop to the lowest depths to get your cash, and that there are also really stupid people who think they know everything and will tell you that all sorts of crap will cure your ills. It should be assumed that whenever a person refers to alternative medical practitioners in a complimentary way they are not talking about these people and any rebuttal to that point that mentions these types of people is meaningless.

[seladore]

A mathematician is a biological layperson, and a biologist is a mathematical layman. Not according to the official definition of the word but in the way it is often used to describe "someone who doesn't really know what they are talking about". The division of people into those who know and those who dont is very harmful because it implies that the people un the first group actually know something, whereas everyone is wrong for about the same percentage of time in their lives. The idea that "you don't understand and you should just listen to those people that do and do whatever they say" is the antithesis of what science is about. The word layperson used very often by scientists expresses exactly that idea. This is only a small part of the attitude in the scientific community that I have a problem with, but worse is the rightious indignation they have against anything they can't understand with the scientific knowledge that they have learned. You can be very well informed scientifically and then something can come along that you can't find any scientific explanation for it, but then you can explore it a bit, you may find an explanation. You may not find an explanantion but you might find it useful anyway in which case the explanation is immaterial.

People sometimes learn things as a group or society, over very long periods of time. The manifestiaion of this learning is in culture, stories, music, and language and the knowledge within it can not easily be denominated, extracted, translated, calculated, transcribed or even recognised but it is undeniably useful. It is knowledge that has enabled us to survive as a species. In my humble opinion this knowledge is the highest thing on the 'scientificness' scale I have encountered. It is always tested with thousands of control groups containing tens of thousands of participants and over immensely long periods of thousands or even millions of years, the kind of rigour conventional science can only dream of. The data is stored procedurally so you don't need to understand how it works to use it and with huge redundancy so that losing individuals in the process results in minimal loss of data. The main way I think it is superior to science is that it admits new ideas on a largely random and all inclusive basis This is one of the reasons scientists have no respect for traditional knowledge, if it allows something like homeopathy or christianity to happen then it must be bad. This misunderstanding is a result of the short term manner in which scientists (read all people) view the world.

I'm not sure you understand the terms you are using, particularly 'scientific method', 'rigour', and 'control group'.

It is true that traditional knowledge "admits new ideas on a largely random and all inclusive basis"; it lacks, however, a rigourous way of telling if these ideas are true or not. As someone has said before (I forget who), "The plural of 'anecdote' is not 'data' "

Folk wisdom, for thousands of years, held that disease is caused by evil spirits, which led to many ineffective cures, some of which are still in use today. The scientific method provided germ theory, with which we have eradicated many diseases, and can treat many more.

Another example: 'folk physics' is based on the intuitive model of physics we have in our heads. According to this model (which formed the basis of physics for thousands of years, allowing us to survive etc. etc.), the natural state for objects is at rest on the ground. Now, this is wrong, and it took Newton to show that it is wrong. Using Newton's findings, we went to the moon.
Try getting off the ground with intuitive folk physics.

There are thousands of other examples. The point is that

(1) Science is better because it provides a way of filtering these new ideas, to tell if they are valid or not. And it's not like science is incapable of testing folk wisdom - this happens all the time, sometimes vindicating the folk belief, sometimes not. The point is that folk beliefs don't have an effective filter - they don't get discarded if they don't work. This is because people see patterns everywhere, and it's easy to kid yourself into seeing an effect where there is just randomness.

(2) Science works*, in a way that folk beliefs don't. You cant build a plane using 'cultural understandings' of physics. You can't do medicine effectively with a 'folk wisdom' biology.


So when you say

...it is knowledge that has enabled us to survive as a species. In my humble opinion this knowledge is the highest thing on the 'scientificness' scale I have encountered.

You are wrong, I'm afraid. Just because it has enables us to survive, doesn't mean it's true, and doesn't mean it's useful in the 21st century for manipulating the physical world. People are imperfect, science is an attempt to overcome those imperfections.

EDIT

If homeopathy is as stupid as everyone here says it is then it will be gone in a couple of hundred more years, the blink of an eye as far as the species is concerned.

This is little consolation, I imagine, for the relatives of someone who dies after refusing effective treatment in favour of magic tap water. This is why it's important.



*bitches