Space City Skeptics

The Official Blog of the Houston Skeptic Society

Archive for December 2008

Another Side to Latest Survey on CAM Use…..

with 6 comments

Geek Goddess beat me to posting about the Washington Post article on the widespread use of so-called alternative medicine published today along with versions by several other news sources, and while I agree that the reporter handled the subject better than in the average fluff piece, it was by no means appropriate coverage.  The numbers, which have actually been out for over two months, actually paint a picture very different than that of the quoted CAM proponents, in particular Richard L. Nahin of the National Institutes of Health’s National Center for Complementary and Alternative Medicine.  As broken down in typical expert fashion by Steve Novella at Neurologica, the numbers reflect not an increase in usage of CAM, but no real change in the perecentage of Americans seeking out alternative medicine over the past twenty years. 

The most glaring lack of journalistic effort comes in the form of the apparent acceptance of a complete misrepresentation of what alternative medicine actually is. Novella nails it as usual in his post, revealing that,

“Also, the numbers reveal the hollowness of the CAM label – what does CAM really mean? The numbers are inflated by including items that are not necessarily out of the mainstream.”

Many of the modalities included in the survey do not necessarily deserve the title of alternative medicine. Entities like yoga, massage, and other techniques geared towards relaxation or treatment of some musculoskeletal complaints do not alternative medicine make. Potentially a very large percentage of the survey is made up of people using legitimate therapies. Novella reveals,

“If you factor out these modalities (and also legitimate use of nutrition), the numbers remaining are all quite low – in the single digits, and not significantly increasing. Only 1.8% of the population used homeopathy, 1.4 acupuncture, 0.3 naturopathy, and 0.5 energy healing. For these hard-core CAM modalities usage is still marginal and not really changing.”

One aspect of this issue that Dr. Novella did not address in his post, and not because he isn’t aware of it, is that of herbal therapies being included in the blanket category of alternative medicine, although not isolated specifically in this survey (ayurvedic and naturopathic medicine make generous use of herbs and supplements). Herbs and supplements are not alternative medicine, they are drugs. They are drugs which have either not been studied for safety and efficacy or have been studied and did not stand up to the scrutiny of proper scientific investigation. Many medications with true efficacy have been derived from plants but this is not evidence that alternative medicine in general is effective, despite what proponents may claim. The fact that digitalis came from foxglove in no way supports homeopathy, acupuncture, healing touch, or any other bogus therapy. Unfortunately, the current state of affairs is such that even the hallowed halls of many major academic medical centers are being infiltrated by such quackery in good part because of just that kind of flawed logic. The media interpretation of this survey, largely just regurgitation of NCCAM press releases, is another example of propaganda that will serve to elevate CAM to an undeserved legitimacy in the public eye.

Written by skepticpedi

December 11, 2008 at 10:13 pm

Reports Show Increasing Numbers of Americans Use Alternative “Therapies”

with 3 comments

I ran across this news article this morning:

38% of Adults Use Alternative Medicines: Study Prompts Critics to Warn of Therapies’ Risks”

One of the things I found interesting in the article was that it included chiropractic treatments in the list. Even though most skeptical people immediately agree homeopathy and weird food supplements are bogus, many often take a step back when it comes to chiropractics, siting personal experiences with pain relief. Even educated skeptics are susceptible to anecdotal evidence. I recently spent an hour trying to explain to my mother and aunt the history of chiropractic care, anecdotes, regression to the mean, and placebo effects. My aunt seemed interested, but my mom dismissed me out of hand, because her ‘doctor’ had helped her, many times. (I might add, this discussion took place while we were waiting for her pre-op examination for a cornea transplant. She’s not against real medicine.)

This story was refreshing because the writer didn’t pull any punches when quoting doctors and scientists’ strong language referring to alternative medicines as fraud, and calling the American public ‘gullible’. Usually, this is only found in scientific or skeptical journals, not in the mainstream media. It also discusses the current fad of antioxidants and how studies have shown no benefit. (Whatever happened to oat bran?)

Enjoy, and pass it along to those who are willing to listen.

Written by Geek Goddess

December 11, 2008 at 9:51 am

Sam Specious, Private Eye: Case #2 Analysis…..

with 8 comments

Once again, much thanks to Mike D for participating in my attempt at bringing critical thinking to the masses. Mike came close to what I had in mind regarding the detective’s mistake but didn’t quite hit the mark perfectly. Naturally there may be more than one way to approach this case, but, after all, this is my post so I get to call the shots. Regardless, Mike has won a beer on me at the next meeting of the GHSS.

My take on this case is that the detective and Dr. Van Helsing committed a common mistake made when facing a complex medical complaint, that of ordering a large battery of tests just to see what comes up abnormal. This “shotgun” or “rule-out” approach, especially when used without first establishing what the possible diagnoses might be and what the prior probability of each of those is, often leads to wasting time chasing red herrings. To understand why this is so, one must first know how normal lab values are typically derived.

The normal ranges of most laboratory tests are derived from taking the results of a large number of healthy volunteers. After determining the mean, usually a result is declared abnormal only if it falls outside of two standard deviations of that value. So, by definition, what is considered a normal test will only include 95% of healthy people, leaving 5% of folks to face the potential stigma of a false positive test such as increased anxiety, the unnecessary expense of further testing, and a potentially delayed accurate diagnosis.

Complicating the situation is the fact that with each additional test ordered, the likelihood that at least one of them will be falsely abnormal increases. For instance, when twenty different test results are obtained there is only a 36% chance that they will all be normal. So it is easy to see how, in the case of Vincent the vampire, his abnormal iron and magnesium resulsts might be spurious. This case is far from solved.

There are two logical fallacies that I believe may also apply to this case. One is that correlation, assuming these lab values did represent true deficiency, does not always equal causation. These deficiencies may be unrelated to Vincent’s condition or they may also be merely a symptom of whatever the true cause is. Thus simply replacing them with supplements might not do the trick. Additionally, this could be seen as a version of the Texas sharpshooter’s fallacy. In this instance, Sam and Van Helsing simply fired a number of shots into the side of a barn and then drew bullseyes around iron and magnesium after the fact.

Keep an eye out for the next installment: Sam Specious, Private Eye: The Case of Red-Faced Flyboy.

Written by skepticpedi

December 10, 2008 at 8:18 pm

Follow-Up on Bogus Mexican Stem Cell Clinic…..

with 3 comments

I recently posted on a Mexican clinic which is offering unproven and potentially dangerous treatments to credulous and desperate folks, many of which live in Houston. The clinic is taking advantage of a very powerful component of the general public’s current understanding of modern medical treatments: the perception that any therapy involving stem cells is cutting edge and effective for wide variety of ailments. The truth is that many people understand the science behind stem cells like they do the science behind quantum mechanics, which is to say that they don’t. Consequently, there are a growing number of quacks and charlatans employing stem cell centered pseudoscience just as many more have put the mystery and intrigue of quantum mechanics to use in fooling patients.

On December 4th, Reuters put out an article on this very topic. It describes the concern of the International Society for Stem Cell Research over so-called “Rogue” stem cell clinics. Check it out for yourself and let me know what you think.

Written by skepticpedi

December 8, 2008 at 10:41 pm

Children’s Hospital Bought by McDonald’s Corporation…..

leave a comment »

Houston, TX-Setting an unusual precedent, Texas Children’s Hospital was purchased today by the McDonald’s Corporation. Ronald McDonald himself was present at the press conference, along with employee liaison Grimace.

“This is sure to be only the beginning of a wonderful relationship between quality healthcare and the fast food industry,” TCH President and CEO Mark Wallace remarked. “This was by no means an easy decision however. Burger King put in a decent bid but McDonald’s just had more to offer. I like the Whopper better than the Big Mac but McDonald’s fries are better. That’s important to me and it’s important to my patients.”

Jarrod Knudson, pediatric resident at the Children’s Hospital, is excited about the transition. “There are going to be some bumps in the road, especially with the new drive through emergency department, but this is what’s best for the children. And I get free Happy Meals.”

Written by skepticpedi

December 7, 2008 at 10:49 pm

Posted in Satire

Sam Specious, Private Eye: The Case of the Curious Vampire*…..

with 2 comments

Detective Sam Specious is famous for using his brain to solve cases, or at least for attempting to solve them. What Sam doesn’t realize is just how easily the human brain assigns causation where none exists, finds patterns in random noise, and quickly jumps to conclusions that don’t add up. See if you can use your arsenal of critical thinking skills to take aim at Sam’s errors in thinking.

It was another long day here in Space City, and the seconds passed like flies swimming in blackstrap molasses. I was watching dust bunnies roll across the hardwood floors when the phone rang. A gentleman by the name of Vincent wanted answers to an unusual problem. Unusual or not, he had come to the right place.

I believed that the guy’s name was Vincent like I believe we landed on the moon. When a client uses an alias, I know that there is usually more to the story than meets the eye. Usually it’s a secret lover or an offshore bank account, but this time I was entering uncharted territory. I just hoped that I wouldn’t be taking a fall like some plane over the Bermuda Triangle.

I arrived at Vincent’s mansion just after sunset. The place was enormous, ancient, and in bad need of some feng shui. And though Vincent couldn’t have been a day over thirty-five, his dark and deep set eyes betrayed a far greater life experience. I suspected that Vincent was different when I noticed his pale skin and the way he kept looking at my neck. The jig was up when I noticed the exaggerated incisors and the blood smeared across both cheeks.

After reassuring me that he meant no harm, Vincent described in detail his desire to drink human blood, something which had begun in early childhood. He revealed how invigorated he became with each blood meal, and how he attributed frequent consumption to his seemingly preternatural good health. He even introduced me to his girlfriend, and willing supply of hemoglobin, Esmerelda. After the pleasantries, we got down to business.

Vincent believed himself to be a vampire, but he wanted to know for certain if a medical condition might be to blame for his lust for human blood, sensitivity to sunlight, and heightened senses of smell and hearing. He admitted that although he would never change who he was, even if a cure were to be found, his curiousity regarding a natural cause had gotten the better of him. Frankly, I thought that he was more than a few cards short of a full deck but I knew just who to call.

Arnold Van Helsing is a world renowned chemist with an interest in blood disorders, and he agreed to lend us his considerable expertise. The next morning Van Helsing arranged for as many blood tests as he could think of, and with his brain that’s more than you can shake a dowsing rod at. He checked Vincent’s complete metabolic profile, liver and kidney function, iron level, complete blood count, and red blood cell indices. He even looked at his bone marrow under a microscope. Imaging of Vincent’s brain, a urine analysis, and spinal fluid studies completed what was only the first round of tests. 

The next day, after a breathless Vincent called me with the exciting news, I celebrated with an ice cold glass of Noni juice. Van Helsing had discovered that Vincent wasn’t a true vampire after all, but was merely deficient in iron and magnesium, two components of human blood. A simple vitamin supplement would be all that was necessary to cure him of his vampiric cravings. Vincent said thanks but no thanks, but at least I still got paid for solving the case.

But did Sam and Van Helsing solve the case? Should they be so sure that iron deficiency and hypomagnesemia are really to blame for Vincent’s odd behavior? It sure sounds like a plausible etiology, and lab values don’t lie, right? What do you think? Where has Sam’s reasoning gone wrong?

*This case was inspired by an episode of the excellent National Geographic program Is It Real. I highly recommend the show to everyone.

Written by skepticpedi

December 4, 2008 at 7:37 pm