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Links With Your Coffee - Saturday

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In the interest of fostering rational arguments, I'm going to present a common fallacy with each day's links. Today's fallacy is: Appeal to Popularity


 

Comments

Interesting article on video games. I haven't enjoyed one in years so I can't judge what's on offer these days, but I would also add that in addition to the satisfaction of a challenge, the feeling of entering a new colorful world and taking on a virtual identity was the other main draw. The beeps and images (and blood) are just the most overt things to an observer, but that's never the point. I didn't care for the gory ones myself, though -- more of a Mario & Zelda person!

I have commented a couple of times about this and I will try one more time to address this latest post about it and then just let it go. I do not understand what the big problem here is about alternative treatments (I don't use "medicine" because I know people don't like that and I would think this is a preferable name anyway.) All of my experiences are related to me or people I know. Maybe others have had negative experiences?

Chiropracty - I've said this before - first you need a great one (and there are a whole lot of bad ones out there) but, my boss went only after his very well-respected orthosurgeon said he needed back surgery to stop his pain. After two month of chiropracty, no problems and it's been over five years ....

Homeopathy - I have two examples but I'll just give one. My mother uses a dilute arsinicum remedy that works for her. Placebo effect? I doubt it. To be crude, it helps her control her bowels which otherwise are erratic from surgery after colon cancer. She tried Imodium D but then ended up with incredible cramping. An MD who also offered some "Eastern" treatments gave her the arsinicum and she takes it when things are especially bad or she needs to be in long meetings.

Acupuncture - My friend's dog has epilepsy and it's seizures were increasing. Medicine wasn't helping. As a last resort, she took the dog to an acupuncturist and its seizures have gone from more than one a week to no more than once a month - even three months without. Maybe that's not what's doing it but she said her dog likes to go and the dog is very calm and relaxed while it's got all kinds of needles in its back. I don't get acupuncture at all but whatever it is, the dog's been doing much better the last year and a half.

Nutrition, positive visualization - my friend's mother got breast cancer, she decided against treating it (she was a widow, the doctors didn't think it would add much time). She was given six months on the outside so my friend went on a leave from work and she moved in to take care of her. She started cooking for her - steamed vegetables, no red meat - she got her mother started on meditating (to stop her panic attacks) and they went for walks, etc. Her mother ended up living six years (the last six months were very rough, though.) Personally, I think a lot of her improvement was just having her daughter around and not being alone but even that's got a hint of alternative treatment, doesn't it?

I would never tell someone what they should or shouldn't do - I would just say - with Western medicine or alternative treatments - caveat emptor.

All of the examples are anecdotal. Do you want our research dollars to go to restudy the efficacy of treatments that have failed to prove themselves in scientific studies. It's not a question of if people should be able to do whatever they want. The question is should we take money from promising research to support questionable methods.

I didn't know research dollars was at the root of all the alternative treatment postings.

I don't know if that's a place where money should be spent but do people think it would actually stop other promising research? I can't imagine pharmaceutical companies would stop their research so it would be governmental?

And, what were the breadth of previous tests, the methodology, how did other treatments compare, and what is the percentage of the placebo effect, anyway? I thought, at least sometimes, (I'm assuming it's not a constant) it was a fairly good showing but I don't specifically remember so I could be imagining that.

I have to admit to feeling like there are certain kinds of test results that seem nebulous to me. Linus Pauling's testing with Vitamin C had proven results (and I would consider Pauling testing credible), which were invalidated, then, supposedly the invalidating tests were conducted differently and I think I've even recently read that some tests show Vitamin C actually aids cancer cells.

And this gets into all kinds of tests. A polyunsaturated fat, by common wisdom would seem healthier than a mono-unsaturated but I've read there is actually a problem with polyunsaturates. Soy was good, soy is bad. Oh, but I did hear they did tests and yes, chicken soup does have anti-inflammatory qualities.

And, sometimes, the sources are dubious. Didn't the council on eggs tell us their cholesterol isn't a problem? I don't know if it is or isn't but I don't trust their answer.

Anyway - I didn't realize the overarching research question in play here and you see I don't have a good answer for it (no matter how much I write). Sorry - I'm a notorious multi-tasker and I think sometimes I really miss the point.

The problem is not so much with if people you know had a good experience with it. Like Norm said, it's anecdotal. But I'd like to add a bit to that. Placebo, by the way, is not the only possible explanation. It might be part of it, and/or there might be other factors at play.

For instance, how controlled were those observations? Did your friend stop giving the dog the medicine for its epilepsy? Was the observation long and detailed enough to discard regression to the mean, or the possibly delayed effects of the medicine (if the dog indeed stopped taking them)?

It's also very reasonable that a healthy diet and exercise, and generally a calm state of mind can make people healthier, and I don't think any doctor or scientist would say otherwise. That's no "alternative" to science-based medicine though. But still, even coincidence can skew our perceptions as well. What about confirmation bias, did you map how many people did not prolong their lives, or alternative methods did not work for them? I personally know many more people for which alternative methods did not work, than for which they apparently did.

Especially cancer patients, in their understandable desperation, are prone to try anything. My own mother passed away, even after trying shark fin stuff and going to healing mass (by the way, many different religions also claim very similar results as "alt-med" people, isn't that suspicious at the very least?"). It's just that some will actually heal, be it coincidence (cancer has a remission rate, albeit very small), or the actual medicine kicking in (some people will continue with medicine, and when it does start to show improvements, credit the "alternative" method because it just happened to happen right after doing it) while most will probably succumb to the odds.

The bottom line is that these controlled observations have been done, with many more patients than any anecdote can account for, and have failed miserably. It's also a matter of these treatments being run by scammers. Homeopathy and acupuncture in particular, have no known physical mechanism for them to work, and they both violate known laws of physics. They are utterly absurd (the qi thing with acupuncture). Extraordinary claims require extraordinary evidence. If you're gonna turn physics on its head, you better have a strikingly extraordinary scientific theory with evidence to match. You'll get a Nobel for sure as well.

Also, placebo is not to be underestimated. You'd be surprised. Colored placebo pills work better than white ones, injections work better than pills, etc. It's about the theatrics too.

Finally, there are practices that in themselves are healthy, but are wrapped around bogus BS, like yoga, for instance. It's just glorified stretching, but stretching is normally good.

I'll bite and chime in here. I could probably cite many more anecdotal incidents where "alternative" medicine works. To me, there are 2 requirements:

  1. self-education: you want to know what you're taking or undertaking AND you want to know that anyone from whom you're receiving advice/care is on top of it. There are charlatans in every branch of medicine (if someone will pay you for treatment, well, hell, that's the one to administer!).

  2. evaluation: does this course of action work? if yes, good; no, think again.

As for spending $ to research these methods, I'm not so hot on this. Acupuncture has a long history of helping people, and my Mom sees one who is also a licensed neurologist - to success. There's more but I'll leave it at if it works, go for it.

Those who are non-institutional care-givers often do not want the regulation that comes with government $ and oversight. Yes there are charlatans and yes there have been successes; I defer to my 2 requirements if you decide to go this route. The other reason is that government regulation of "alt" meds can dilute the very care that good folks give. The official label of "organic" for food products met with enough protests that the label should be met with skepticism at least. In buying groceries, I like to talk with/get to know my growers; in seeking treatment, I want to know all the whys and wherefores from my doctor, whether s/he is dispensing pills, herbs, needles, etc.

does this course of action work? if yes, good; no, think again.

There is unfortunately more to it than that. You may get better for a reason unrelated to the course of action you believe is working. That is why anecdotal evidence is always suspect.

You might want to read this on the topic of acupuncture.

First, I'll double back to my recent comment

And if they get better after a homeopathic remedy, why not go there? Placebo effect or just running its course, it beats taking unneeded drugs.

Course if someone continues homeopathy and nothing cures them...therein lies the rub.

This comment has to do with my occasional flip response "germs are good" (of course, some germs are not ever good to come in contact with; what doesn't kill you may may you weaker or at least more susceptible). I don't take a lot of institutional medicine, mainly because I don't need it, so I can go this route for at least the mean time.

Here's a great comment from your excellent link:

...the effects therefore seem not be due to the traditional acupuncture method, as was previously thought, but rather a result of the increased care the treatment entails. Patients could converse with the physiotherapists, they were touched, and they had extra time for rest and relaxation.

And that's why patients undergoing acupuncture think that it helped them. It's the placebo effect, combined with the human touch that is all too often missing in modern medicine.

Orac, you have hit on an important aspect that is overlooked here. Too often medicine can go the "wham bam thank you sir/ma'am" road, rather than taking full care of the patient. Here's your med/surgery/insert a favorite; call me if any thing else goes wrong...Next [patient].

The above scenario may be in part just bad bedside manner, but it usually has to do with Dr. : patient quotas, and with insurance coverage. Is it really better for the patient to be back at home soon after surgery, or is this really an expense-related discharge?

On the patient's side of the equation, the sick do not often allow themselves enough time to heal. Sore throat? Take something and go in to work. Kid got strep? Here's some pills. Ready for school? No matter that the worker or student might be in the contagious stage of an infection. In the age of perfect attendance and sick day allotments (for the truly ill, not shirkers; that's another matter), it's small wonder that health "care" takes this course.

This contributes to why I don't mind if someone receives a placebo treatment and feels better. It's easier to have a doctor's appointment sanctioned by your employer than the day of rest. OK, my Mom's of retirement age, BUT she needs to have some attention to her feet and respiratory conditions. Her particular doc has been successful in a way that other physicians weren't, and certainly my Mom wouldn't have a clue where to begin. (She lives geographically far away from all family save her husband, who has health issues of his own).

Next - expected - argument: the neurologist/acupuncturist is deluding herself in terms of the effectiveness of acupuncture. Well, OK, you have a point. Still, when the patient's health concerns improve - for less expense and better results from previous treatment - the cost-benefit [rather than meta-analysis ( :~) )] is my last submission.

I hate to go on

and on

but this reminds my of a french film, "La sorciere." It's been a while, but my recollection is of a medieval french village in which an inquisitor is sent to save the sinners, and the title character is one of his charges. Basically, she sways him to her side - not to believe in the hocus-pocus of her healing practices, but to see that what she does is heal. She administers a remedy, and so what if the sick/grieved hear an incantation in the mean time?

Fortunately we live in an age where folk remedies can be tested for scientific effectiveness (ethno-botanists have a role here). I hate to allow non-scientific possibilities cloud logic, but if someone's health improves, I'm for it. So sure me. I have a doctorate...but not in science!

so sue me.

sure....

I once asked a friend who is a physician, why not just cheat, because placebo does work. He said of course there are ethical questions there, should you lie to your patients for their own benefits? Don't they deserve you to be transparent with them? And such...

By the way, I don't wanna be misunderstood here. What I'm saying is that placebo does work, especially for psychosomatic stuff. Acupuncture and homeopathy (as probably Orac said in the link) do work, only that no better than placebo. It's a question of honesty and people being scammed, and of course, cost of opportunity, research money being wasted.

I just have a terribly inappropriate comment about "Respectful Insolence: An open letter to Seth Aronson about his movie project".

Seth refers to Audrey as his "soulmate". I wonder if that appellation was the result of their "often brutal arguments" or "her legendary 36DD breasts".

And, yes, I know I'll get letters. It just always amuses me when someone's "soulmate" turns out to have great big hooters. I mean, what are the odds?

In accordance with today's fallacy of Appeal to Popularity, scientists recently reveal the mental process which explains why we follow crowds.

Well sure, seeing dead people might be fun, but what to do with all those coffee grounds?

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