Thursday, October 20, 2005

Stephen Barrett takes courageous stand against Institute of Medicine Report

Stephen Barrett wrote this critical review (via Medscape) of the Institute of Medicine (IOM) book on complementary and alternative medicine (CAM). The National Center for Complementary and Alternative Medicine (NCCAM), a subsidiary of the NIH, commissioned the IOM to write the report. Barrett accuses both the NCCAM and the IOM of promoting unsound health claims. The report, Barrett says, uncritically accepts implausible health methods. In my opinion he nails the issue in stating “Methods that are plausible should be tested with well-designed clinical trials. The rest should be discarded” (Italics mine). I have previously argued that it is wasteful to study scientifically implausible treatments. He goes on: “Despite all the alleged experts involved in its preparation, the IOM report does not contain a single word of criticism against methods that are sufficiently irrational to be discarded now. Instead, it makes broad, sweeping generalizations and attempts to set an agenda for the widespread adoption of ‘CAM’ research and teaching.”

And, concerning CAM teaching, Barrett points out the increasing uncritical adoption of unscientific claims in medical school curricula. He cites this paper by Stanford professor of medicine Wallace Sampson, M.D. on medical school teaching of alternative medicine. Sampson’s survey indicates that medical schools often present baseless alternative medicine claims uncritically or, worse, actively promote them. This open access full text article is worth reading in its entirety. Sampson writes “With inadequate approaches that fail to uphold criteria for validity and plausibility, so called ‘evidence-based’ medicine remains fluid and loses its value to help physicians discern what is truly useful.” Bingo! Sampson makes valid suggestions for reform of the medical school curriculum.

2 comments:

Anonymous said...

Be careful about only endorsing plausible ideas. I am old enough to remember going to several meetings where the Australians who were saying that ulcers were caused by infectious disease were hooted off the conference stage. I believe they received the Nobel Prize last week.

R. W. Donnell said...

In response to anonymous---

Thanks for your comment. Perhaps I should clarify my statement about plausibility. The notion that an infectious agent could cause paptic ulcer was novel but not scientifically implausible. Contrast that, a novel but biologically plausible idea, with, e.g., the notion that one can diagnose and treat a variety of ailments by using ones hands to sense and manipulate magnetic fields (therapeutic touch)or that one can dilute a substance down until only a spirit like essence, but no molecules, remain, and achieve therapeutic effects (homeopathy).