Lots of uncritical promotion of woo is to be found here in The UCSF Guide to Integrative Medicine. Although the fine print has the usual disclaimer that Inclusion of a therapy, resource, or practitioner in this guide does not imply endorsement by UCSF, the Integrative Medicine Network, or the Osher Center for Integrative Medicine and many chapters dutifully acknowledge the lack of randomized trials for a given modality, many sections contain uncritical descriptions or, worse, promotional comments about implausible claims. For example, the section on Ayurvedic medicine contains this testimonial from a fibromyalgia patient after undergoing Aruvedic “cleansing”: “By the third day I felt so much better physically I was able for the first time to walk down the stairs, then up the stairs, then I was able to cut my pain medication in half.”
6 comments:
RW: I'm somewhat surprised by your vitriol towards the weird alternate crap. As an advocate of evidence-based medicine, you know that a small fraction of what doctors do is proven in any truly scientific way (double blind randomized studies, etc.). Rather, they generally do what they've been trained to and what sort of works . . . isn't that what alternative medicine is based on?
In other words, there is no rational basis to chose between competing mythologies.
Wow, that is one retarded comment.
A small fraction of what we do is proven? Really? I take it you haven't been to medical school?
Evidence-based medicine is just that. The drugs we used have been studied, the methods we used have been studied, the screenings we perform have been studied, evidence based medicine is almost exclusively based on scientific study. The only stuff that isn't is the touchy-feely crap that always manages to insinuate itself into the curriculum.
There is no such thing as "alternative" medicine as you are trying to suggest with a pathetic, "all viewpoints are equivalent" crap statement that isn't based in reality. There is evidence-based medicing and then there are treatments that haven't been proven.
Prove your shit works, we use it.
"small fraction of what doctors do is proven in any truly scientific way"
That's a very vague statement, and you do not give any facts or statistics to back it up. Granted a lot of medicine started before EBM was formally recognised, but we have been catching up since.
In any case, the fact that some parts of modern medicine is not strictly EBM does not excuse alternative medicine from producing evidence to back their claims.
"there is no rational basis to chose between competing mythologies."
Really? If you wanted to launch a rocket to the moon, would you choose the one about it being made of cheese?
In any case, the fact that some parts of modern medicine is not strictly EBM does not excuse alternative medicine from producing evidence to back their claims.
Angry doc, just a quick question, we're on the same side here but what parts of modern medicine are these? For every drug licensed there are studies of efficacy. For every surgical procedure there is data. For the routine screening of patients we have massive trials backing these interventions up. When they refer to these non-EBM things used by doctors what are they referring to? I really can't think of them. Or do med students these days think what their professors teach them comes from the ether?
I apologise. I will rephrase:
While individual physician and community practices may not be strictly evidence-based, this does not excuse alternative medicine from producing evidence to back their claims.
rev.dr.,
In case you are still checking back on this discussion...
I believe I might have discovered the source of the belief that "a small fraction of what doctors do is proven in any truly scientific way"!
I believe the source is a 1978 report by the US Office of Technology Assessment titled "Assessing the Efficacy and Safety of Medical Technologies".
http://www.wws.princeton.edu/ota/disk3/1978/7805_n.html
A line on page 7 reads:
"It has been estimated that only 10 to 20 percent of all procedures currently used in medical practice have been shown to be efficacious by controlled trial"
but no source for this estimate is quoted.
As for how this statement became popularised, I have found two possible sources, being:
1. The book "Staying Well in a Toxic World" by Lynn Lawson, which quoted the line.
2. The article "If Oral Chelation Therapy is so Good, Why Is It Not More Widely Accepted?" by James P. Carter, MD, Dr PH, published in the Journal of Advancement in Medicine, Volume 2, Numbers 1/2, Spring/Summer 1989, pages 213-226.
This article is reprinted on a number of sites promoting oral chelation therapy.
It would be interesting to find out how the OTA report got its estimate though.
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