Acupuncture

But your assertion isn't that people like accupuncture in the way that people like chocolate.
Your assertion is that accupuncture "works".
And that is a whole different thing.
You haven't pointed out a problem with my argument but merely failed to grasp what the gist of it is.
When we are working out what works medically the realm of "experience" is a very poor indicator. Because, as stated, experience of very unreliable.
You seem to give it a great deal of credence.
I give it virtually zero because if I used "experience" as a gauge as to what works I'd have to accept everything from witch doctoring, to faith healing, to homeopathy, to iridology and any number of other whack-a-loon ideas.
Because we can find people exactly like you pointing out the efficacy of such measures using exactly the same "I know loads of people it has worked for" logic.

 

research problems

It's difficult to know what to make of things when it comes to 'proving' non 'traditional' methods of treatment. You can get more than a 60% improvement from placebo and your expectations/beliefs factor in massively. I remember one study where they were giving a patient an opiate by an IV for pain relief and questioning pain levels. The patient was told that the drip had stopped when it hadn't and the pain levels sored... so your mind can creat huge levels of pain when there isn't a reason for the pain to be worse as well.

Here in the UK advertising standards will come after anyone who says that acupuncture will help with anything other than a few problems (nausea, some headaches, yadda yadda) . They don't allow speculation regarding effects on the back etc and say that the information is not sufficient to allow patients to be told something that isn't supported (to a level they approve of).

The research being carried out is often not of a good enough quality to make conclusions either way really but not simply because people are biased. There is often just too much variation in acupunture technique and thought to determine whether one is looking at like for like treatments. I can tell you that the guy I study with who is a PhD student working in a medical facility just cringes at how badly both traditional and medical research has been done. I think that there is an underlying problem with trying to evaluate acupunture much in the same way as evaluating whether 'drugs' help.. depends on which ones, in what dosage/combination, for how long, in combination with what other management etc...

Now I am pretty skeptical when it comes to lots of this stuff but I have had experiences that, at least to me, validate some of what is claimed. Some times I see things that are not explained away easily as 'placebo' but realistically it doesn't matter.. when we have a patient who is suffering from intractable pain ,and nothing pharmacologically is making a difference, who can all of a sudden get on with rehab after having some acupuncture then it's a 'win'! A cure all? Nah. Many CAM methods appear best suited for limited circumstances when they might well be safer to the patient than the drug equivalent or no drug treatment is available.

You know that for many years no one believed that there was a biological explanation why people developed ulcers. People always said it was stress or something. It took some pretty off the wall thinking to go against the tide and discover that H pylorus lived in people's guts and caused ulcers. Now we accept that ulcers come from a bug and over enthusiastic prescription of some medications. With any luck we will learn more from the evaluation of acupuncture even if it just confirms that it's an expensive way to make people feel 'well' temporarily.

Just some thoughts.

LFD

 

No it doesn't. I'm trying to make you recognize your extreme bias with pretty colors, because appealing to your common sense doesn't work. And I drink too much coffee.

This is an unscientific claim and belies a lack of critical thinking.

They don't have to be peer reviewed to be valid.

But how do you know they are valid? You ASSUMED because it was the #1 Google search hit.

By promoting Search Hit #1 only, you are promoting the extreme bias of a Professional Skeptic who happens to be a neurologist.

You are also throwing out all of the other DOCTORS who, through clinical research, have now produced positive results (albeit small) with good studies.

There you go again. "validly". How did you determine the SBM hit piece was valid?

The author himself uses his reasoning to advocate killing off a multi-billion dollar medical research industry.

Do I have to repeat that, or is his bias clear?

Why anyone touting "critical thinking" would use such an overtly biased piece of internet fluff is beyond me.

I am one of the only critical thinkers in this thread: the only one so far willing to not only point out his own (small) bias, AND the bias of past CAM studies, but also the HUGE bias of the anti-CAM lobby and the folks who use Google's #1 hit to support their anti-CAM bias, when the next 7 hits all include POSITIVE supporting EVIDENCE. Yes, EVIDENCE. From actual doctors. At hospitals and well respected universities. Yes, you've all but thrown out their results because it doesn't fits your bias.

There is a huge lobby that wants all that medical funding out of CAM's hands and into its own, and people like Dr. Steven are the spear head.

"Nonsense dressed as valid science", there you go again, Valid Science Warrior is calling thousands of doctors in the US alone frauds who don't understand statistics or how to apply blinding or how to be critical thinkers.

Where are Dr. Steven's supporters against CAM? Why are they a legion of internet names and not actual MDs willing to put their names down?

Because none of them, including Dr. Steven, has ever run a valid Acupuncture study of their own.

Yes, "Science Based Medicine" is the peanut gallery, and however qualified Steven is, he's done NO RESEARCH on the subject himself.

Now, are you going to continue to ignore all my excellent points and wait until I use some extra "!!!!!!" before you make snarky comments?

Here's some confidence boosting "!" for you, sir.

!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

 

No chocolate is me being flippant. The thread is full of folks who have solidly establish bias that prevents them from thinking rationally.

So, I am trying to appeal to their irrationality with a bit of chocolate, which has been known for centuries to lighten the mood.

Get it?

Really that is appears to work, and that medical studies exist that support that assertion in the positive, and that online opinion pieces by neurologists heavily biased in the negative (because being a Skeptic (big S) is more important to them than being objective) are not peer reviewed science.

You can agree with the SBM hit piece, but if you do, ask yourself why the author takes no steps to seem objective, and go read ALL Steven's other articles...he has been crusading against CAM for quite some time.

We call that an "agenda" boys and girls. So, why bother reading his article unless you A) don't believe in acupuncture and B) need a link to show someone "proof" acupuncture doesn't work.

Wrong. Experience is exactly how most people choose their doctors and what medical practices they attempt.

Experience is only poor if its data you use in a medical study. Who is using experience in a medical study? Nobody.

People don't rely on science, or even blogs like SBM, to figure out what doctors to go to or treatments to try. They use word of mouth and the experiences of their friends and family.

People go to acupuncture because others have told them it was effective. THOSE folks go to acupuncturists and if they get positive results, this cycle continues.

If medical science ever conclusively disproves the effectiveness of acupuncture, funding goes away, licensees go away. Acupuncture becomes something you can only get in a Chinatown alley. Let me know the day that comes, then I will kiss SBM's ring.

This is a very subjective claim. Experience is often very reliable for validating all sorts of things. Science can tell me the sky is blue and why, but cannot explain what blue is to me. I have to see it for it to "sink in".

How do you function in the world without using experience as a gauge?

Answer: you can't.

If you had a bee sting, and I came over with crushed plaintain leaves containing astringent compounds and said "this will help the pain", would you deny my attempt to heal your wound and say "WHERE'S THE SCIENCE!??!".

No, I would just make your boo boo better and you'd tell all your friends about how Rabbit made it all better by rubbing plant goo on you.

 

The collected works of mankind.

Somewhere between 1,000,000 and 1,500,000 servers worth of information available in hypertext format to allow for indexing.

As an information scientist and fuzzy logician, I deal in both "true" and "false" information, as well as "truthiness" values between true and false when decision making.

Fuzzy logic is the best way to make decisions based on incomplete data, and so I am using Google's simplest form of query "Is X True" to make a point that nearly everyone in the thread is basing their opinion on a single source, that is not in a peer reviewed periodical, attacking recent legitimate, well constructed, government funded research by OTHER DOCTORS, not "acupuncturists". There is a clear misunderstanding and belief that all these acupuncture studies are coming out poor sources. Sloan Kettering Cancer Center studies are a poor source? Crom laughs at the Four Winds!!!!!!!!!!!!!!!!!!!!!!!

Say that out loud and it helps stick: OTHER DOCTORS disagree with the SBM opinion.

So, why are those folks pushing the SBM link not seeing all the other sources that counter it?

Answer: they don't want to see those. They have made up their own minds, and have stopped thinking critically.

I saw Steven's article. I criticized it, and tracked it back and realized he has a clear agenda and advocates killing off "every cent" of research.

"Every cent"? What an absolutist. Of course, he also runs a Skeptics organization and has a great deal of investment in provoking controversy. Otherwise he'd have to just settle for being a neurologist. How boring is that..

!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

 

I can see where you're going Mitch. So, I want to perform an actual experiment for some of you to show you once and for all how Google is affecting your own bias on this issue. As John pointed out, the biases are so firmly rooted, even NEW, BETTER CONSTRUCTED research is getting dismissed by many. The only explanation I can think of has to be political influence, and if you research Dr. Steven Novella you'll start to see why he has a large vested interest in "not being wrong" about CAM. It would essentially make him look really, really, really stupid. Doctors have BIG EGOS!

I find it notable that although 75% of the top 8 hits for "Does Acupuncture Work" support the positive and link to peer reviewed sources, and only 2 of the links (both opinion pieces) support the negative...that ratio flips when looking at the opinions in this thread. What's the cause?

Yes, approx. 75% of you have expressed strongly in the negative, and gave us the #1 google hit as a source, which happens to not provide an objective review of CAM research, but in fact provides a political statement too: Defund All CAM Research

Yet, the #2 hit, http://www.womenshealthmag.com/health/acupuncture-to-relieve-pain, also includes the opinions of numerous MDs supporting the effectiveness of treatment.

Again, why does the weight of one neurologist advocating the elimination of CAM research globally, counter the weight of all the doctors in the second article?

Answer: it depends on how strongly you've made up your mind. Your mind will seek out whichever source fits your bias. If it's the first hit, BRAVO! Acupuncture "doesn't work", so says a Neurologist!! No need to proceed...

A deluded person will always find sources to support their bias.

A critical thinker acknowledges their bias as part of the decision making process, and attempts to minimize its impact.

A computer, though, has no such bias, it can be more fair. So, let's use digital logic and stop debating.

+++

I'm going to perform a fuzzy statistical inference analysis of the top 100 results for the logical assertion "Is X" where X = "Acupuncture effective", to try to determine an accurate, quantifiable truth value that could be used to make a simple binary decision "Should I use Acupuncture". Since this is fuzzy logic it will be impossible to reach a TRUE or FALSE value, instead the final truth value will be somewhere between 0 and 1, with results greater than 0.5 indicating TRUE.

Once I cull redundancies and questionable "true" sources like New Age markets selling stuff, TCM sites with no scientific references, and the like, as well questionable "false" sources like whatstheharm.com that are clearly unscientific, we'll see how an AI would approach the decision whether or not to take part in acupuncture. Keep in mind, this means I am including "Science Based Medicine" in my sample.

I am not eliminating bias results in either direction, just those without references that could be verified. That means I am including almost NO references to the ancient meridian models, antique TCM manuals like the "Yellow Emperor's Classic". Hopefully that will satisfy the "scientists" amongst you. My thought experiment AI will not take into account anecdotes, non-peer reviewed medical research, or any references to acupuncture older than the year 2000. I will only include medical opinions based on licensed medical practitioners in my study. Dr. Steven Novella makes the cut. I am so fair!

My hypothesis is that the 75/25 ratio will hold as peer reviewed studies are stacked. Let's see if I can falsify it.

Rabbit's Hypothesis: A logically generated survey sample of peer reviewed acupuncture research will show that approximately 75% of results appear to support a positive acupuncture healing effect (of any magnitude), which would appear to reject the Null Hypothesis and cause a computer with no decision tree for determining a boolean result for "Is X" where X = "Acupuncture effective", to return a truth value of t > 0.5.

In simpler words, if I asked a computer to make my acupuncture decision (and not my doctors or friends who could have bias), what would it choose?

Sorry guys, I don't have access to a more powerful computer than Google. Few do.

 

This argument made more sense a few years ago, when CAM studies suffered from a number of problems (many have been mentioned here) but the supporting research now includes positive studies that both adjust for and do not adjust for placebo.

So, whether I include them as positive or not, t's value only increases. It cannot decrease.

This is because positive studies whose results can be attributed to placebo do not prove the negative. They merely do a poor job of supporting their positive results.

Anyone using such a study to attempt to prove the negative is arguing from ignorance, and ignoring the positive, non-placebo effect studies.

Doctor Steven Novella of "Science Based Medicine" is really upset that studies are starting to show even minor results over placebo. He's REALLY worried because he's just spent decades advocating against it, making a lot of money along the way, and to be proven wrong would, well...upset anyone who had spent such an effort.

His bias is real big. My bias is....so small by comparison.

So small.

 

So I googled "Is creationism true" and these were my first 10 results:

http://www.icr.org/article/true-creation-science/

http://www.notsodeepthoughts.org/30-Reasons-Why-Creationism-Is-False.php

http://www.creationism.org/genesis.htm

http://answers.yahoo.com/question/index?qid=20080821153628AA6YVta

http://www.answersingenesis.org/articles/nab2/best-proof-of-creation

http://rr-bb.com/showthread.php?29037-101-Reasons-God-s-Creationism-is-True

http://creation.com/but-if-creation-is-true-why-dont-all-scientists-believe-it

http://www.genesis-creation-proof.com

http://www.remnantofgod.org/creation.htm

http://truecreation.info

Meatwad brings up a good argument.

 

"Meatwad"?

 

I had to ask

 

Opinions do not have to be peer-reviewed to be valid and I love your assumption that I just googled 'does acupuncture work?'

There are several other DOCTORS who have carried out their own research and done meta-analyses of the clinical research and found the results do not substantiate the view that acupuncture is any better than placebo.

You seem to be saying that no-one apart from Dr. Steven is willing to speak out against CAM and no-one has ever run any research that doesn't support it. Your google-fu is obviously lacking. Check out Google Scholar, there are several reviews and meta-analyses by actual DOCTORS, who - gasp - are willing to put their name on their research that doesn't support acupuncture over placebo.

Famously, Edzard Ernst has had lots (over 1000 peer-reviewed articles in fact) of studies published and is a Professor of Complementary Medicine. Here's his blog post on acuuncture, for example:

http://edzardernst.com/2013/02/acupuncture-placebo/

'Sir!' Your critical thinking skills may be lacking somewhat here, too.

 

This also applies to astrology and psychics. The idea that ineffective things will go away over time is demonstrably false.

I have had, statistically, more accurate diagnoses from iridology and reflexology than modern medicine. What should I extrapolate from that experience? (Before anyone asks, that's not hypothetical, it's true).

I was interested in this debate, but since Ms. Montgomery has weighed in, your posts have come to resemble some quack's popup ad.

I won't believe anything involving multiple consecutive punctuation, capitalized and/or coloured words, and especially "$$$" as an abbreviation. For that reason alone, I shall never believe in the efficacy of acupuncture

 

I've torn both rotator cuffs as well as had extensive back damage. The chiropractor that I've seen for all three injuries is also licensed as an acupuncturist. He asked if I wanted to try, I said sure why not what have I to lose. In all three cases although I noticed slight pain relief nothing helped more than a bit of physiotherapy and a few good adjustments.

 

I just wanted to add a couple more points. Although I can see times where acupuncture has been useful I also remember times where people have relayed horror stories. A small number of people have died (needled into the heart itself :' P ), others injured (scarring, a treatment that is part of acupuncture whether using needles or causing a burn using moxa). Sometimes problems occur because a better treatment is not provided (someone came into my office with a neck fracture that had been given a course of acupuncture and the fracture had not been discovered) or is refused because acupuncture is available. There are loss of potential problems.

Now in spite of this I still see some potential use for acupuncture. Although it's anecdotal I feel there are relevant experiences that still make me give it a chance. I mentioned the spinal cord patient. It involved pain so placebo etc could be an explanation. Another instance involved a non-painful phenomena where un-diagnosed parasites were expelled after acupuncture (and the doc telling me they weren't present). I really try not to be taken in by changes in symptoms alone because so many variables affect pain. Many things can change pain temporarily or displace a problem to a different area.

I'm still on the border about how much acupuncture should be offered as a treatment. :' P

LFD