New antiquack blog

I don't think it's necessary to substantiate the claim that many alternative proponents claim special treatment, since Vaidya has just provided a typical example.

I think you misunderstand my points. I was talking about the blog articles. When trying to sway your audience, it is best to provide references, sources, show where the information comes from, why it is true. Just saying it is so will not sway the audience that might disagree with you.

Yes, herbalists do studies. Some of the studies they cite are from Asia, where 98% of the studies are positive; because of this bias, I hesitate to accept the results of any Asian study until it has been replicated in a good study elsewhere. I do not question the fact that herbs have medical effects: in fact, that was the whole point of Dr. Novella's article, which Vaidya seems not to have understood.

Again, if it is true that 98% of the studies are from Asia, then show how you know that, give the source of the information. Remember, you are trying to convince people who are hostile to your claims. Simply repeating something has little or no power to convince.

Yes, there are many studies supporting herbs, but the quality of those studies varies; some of them are right, but most of them are probably wrong. Bausell's book explains why. One of the main thrusts of the Science Based Medicine blog will distinguishing good science from not-so-good science.

Explaining WHY a study is of low quality, as well as why a study is wrong, would help educate people about the process.

The same is true for drug studies, especially drugs that have a huge profit potential. Pointing out how studies are skewed, or fraudulent, helps people gain faith in the process. Consumers are often well aware of the most blatant examples of fake science. Helping a skeptic learn to spot errors will increase their ability to know what is what.

Even one example of lies and fraud in science, does far more damage than a hundred good studies can repair. The recent study that found a huge amount of published studies are simply wrong, was an eye opener.

The lack of peer review, as well as repeating a study, is a huge problem with trust and drugs. As well as the recent examples of drug companies being found guilty of outright fraud and deception.
 
{snip} That is exactly the kind of testing that is done with both individual herbs, as well as formulas.
Okay, so cite some such tests. FLS acknowledges seven potentially useful herbs, so it would be most valuable if you confine yourself to the other thousands of claims made by herbalists.

{snip} Unless you are just seeking acclaim from like minded people, just saying something is not enough.
Agreed! Show your evidence for the efficacy of herbs.

{snip} I found many studies done on herbal formulas, double blind and everything, and none of them claimed any special exemptions, or tried to say testing could not be done.

They looked for both effectiveness as well as side effects.
We await the citations. One hopes you are more discriminating than Vaidaya. (Sorry if I spelled that incorrectly.)
 
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Again, is there any evidence to show that is true?

Yes, there is evidence that animals can respond to placebo.
The placebo effect is related to conditioning, and animals can be conditioned to respond to inert preparations. Bausell discusses this in his book. One example he gives is that dogs were given morphine injections, which caused salivation, and after they were conditioned, a saline injection produced the same response.
 
I think you misunderstand my points. I was talking about the blog articles. When trying to sway your audience, it is best to provide references, sources, show where the information comes from, why it is true. Just saying it is so will not sway the audience that might disagree with you.

I can assure you the blog will provide plenty of references. And the comments section will allow for dialog with those who disagree.
 
Again, if it is true that 98% of the studies are from Asia, then show how you know that, give the source of the information. Remember, you are trying to convince people who are hostile to your claims. Simply repeating something has little or no power to convince.

Please read more carefully. I did not say that 98% of the studies are from Asia. I said that 98% of studies from Asia are positive. The source of that statement is Bausell's summary of the data from a study by Vickers entitled "Do Certain Countries Only Produce Positive Results?: http://www.ncbi.nlm.nih.gov/pubmed/...ez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
 
Explaining WHY a study is of low quality, as well as why a study is wrong, would help educate people about the process.

The same is true for drug studies, especially drugs that have a huge profit potential. Pointing out how studies are skewed, or fraudulent, helps people gain faith in the process. Consumers are often well aware of the most blatant examples of fake science. Helping a skeptic learn to spot errors will increase their ability to know what is what.
.

Yes, absolutely! That is exactly what the SBM blog is all about. And the book I recommended, Snake Oil Science, by Bausell, offers a whole education on exactly that subject.
 
Just look at a simple herb such as garlic. Clinical and epidemiological research in China has shown that this herb dramatically reduces this risk of several types of cancer.(my bold)
I did wonder what you regarded was a "dramatic" reduction, and whether you would like to quantify it.

oh, and here are several studies on the efficacy of garlic (there were many more but i haven't the time to post them all)

The literature is clearly replete with poorly conducted, insufficiently powered studies carried out on small numbers of patients with numerous confounders.

The studies you cite fall into several distinct groups -

1. Studies that directly contradict your claims.
(Don't you bother checking your references? It is clear you have just cut and pasted everything your search terms have come up with, without bothering to read any of the articles).
#3: Arch Intern Med. 2007 Feb 26;167(4):346-53.
Comment in: Arch Intern Med. 2007 Feb 26;167(4):325-6.
Effect of raw garlic vs commercial garlic supplements on plasma lipid concentrations in adults with moderate hypercholesterolemia: a randomized clinical trial.
Gardner CD, Lawson LD, Block E, Chatterjee LM, Kiazand A, Balise RR, Kraemer HC.
/snip/
CONCLUSIONS: None of the forms of garlic used in this study, including raw garlic, when given at an approximate dose of a 4-g clove per day, 6 d/wk for 6 months, had statistically or clinically significant effects on LDL-C or other plasma lipid concentrations in adults with moderate hypercholesterolemia.

2. A series of studies of dubious quality considering therapeutic/clinical effects of garlic.

3. Studies showing a potential role for garlic in some conditions, but with no therapeutic or clinical evidence.

4. And then finally we have some cancer preventative studies......
#4: J Nutr. 2006 Mar;136(3 Suppl):821S-826S.
Aged garlic extract has potential suppressive effect on colorectal adenomas in humans.
AGE significantly suppressed both the size and number of colon adenomas in patients after 12 mo of high-dose treatment (P=0.04). The results suggest AGE suppresses progression of colorectal adenomas in humans.

#11: Hiroshima J Med Sci. 2004 Dec;53(3-4):39-45.
Effects of aged garlic extract (AGE) on colorectal adenomas: a double-blinded study.
The results of this study suggest the possibility of preventive and therapeutic effects of AGE on colorectal adenomas, though it is necessary to investigate these in larger-scale and longer-term trials.

#19: Am J Clin Nutr. 2000 Oct;72(4):1047-52.
Garlic consumption and cancer prevention: meta-analyses of colorectal and stomach cancers.
Fleischauer AT, Poole C, Arab L.
CONCLUSIONS: High intake of RC garlic may be associated with a protective effect against stomach and colorectal cancers. Heterogeneity of effect estimates, differences in dose estimation, publication bias, and possible alternative hypotheses (eg, confounding by total vegetable consumption) preclude sole reliance on summary effect estimates.

......and I thought you said garlic "dramatically reduced" cancer?

Rather than rely on your demonstrably error-prone attempts to extract something from Pubmed, perhaps a view from a Professor in Complementary and Alternative Medicine (who has conducted a rigorous meta-analysis of suitably high quality trials) might be a better source of information?

Here is what Prof Ernst had to say about garlic:
The evidence based on rigorous clinical trials of garlic is not convincing. For hypercholesterolemia, the reported effects are small and may therefore not be of clinical relevance. For reducing blood pressure, few studies are available and the reported effects are too small to be clinically meaningful. For all other conditions not enough data are available for clinical recommendations.
So that looks like a dud in my book. What effects garlic has are minor, and of no clinical relevance.

Next please.....
 
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Show your evidence for the efficacy of herbs.

Usually I would just ignore you, based on past interactions, in which it became obvious you are somehow immune to evidence based medicine, and logic and science. :D

But since I just finished actually doing what you are asking about, I will share.

http://www.internationalskeptics.com/forums/showthread.php?postid=3312310#post3312310
http://www.internationalskeptics.com/forums/showthread.php?postid=3311116#post3311116

I start off with a general statement, no evidence. My statements are challenged. So I do a little looking

http://www.internationalskeptics.com/forums/showthread.php?postid=3307447#post3307447
http://www.internationalskeptics.com/forums/showthread.php?postid=3307572#post3307572

After that, there is just a huge crapload of data and stuff posted. I skip most of it and look at PubMed for data.

http://www.internationalskeptics.com/forums/showthread.php?postid=3310195#post3310195

That isn't good enough so I dig some more, and post links.

http://www.internationalskeptics.com/forums/showthread.php?postid=3310495#post3310495

It seems to be ignored, so I repeat myself, with links. Some of it is challeneged, so I respond with
http://www.internationalskeptics.com/forums/showthread.php?postid=3311163#post3311163

Then when asked, sum up both my reasoning for my conclusion, as well as more links to evidence based medical studies.

See? Rather than just say something is so, it is best to provide evidence and explain your reasoning.

(edit) meh! Somehow those links got messed up. Just read the entire thread. :D
 
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The recent study that found a huge amount of published studies are simply wrong, was an eye opener.

Just to elaborate on this a little.

Ioannidis developed a model to demonstrate that particular fields of exploration can return many more false-positives than true-positives under the usual conditions. And he has confirmed this by investigating the true and false positive rate in some of those areas.

In particular (in order from most false-positives to least), discovery oriented exploratory research with massive testing (e.g. micro-array testing on genes), exploratory epidemiological testing (e.g. mining databases like NHANES), underpowered Phase I and II clinical trials, and meta-analysis of small, inconclusive trials will return more false-positives than true-positive. Well-performed RCT's and meta-analyses of well-performed RCT's will mostly return true positives.

This makes the basis for the standards in evidence-based medicine a bit more understandable (even though EBM arguably does not make good use of prior probabilities/plausibility, which is also an important part of Ioannidis' demonstration).

Linda
 
Please read more carefully. I did not say that 98% of the studies are from Asia. I said that 98% of studies from Asia are positive. The source of that statement is Bausell's summary of the data from a study by Vickers entitled "Do Certain Countries Only Produce Positive Results?: http://www.ncbi.nlm.nih.gov/pubmed/...ez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

Ah yes, my bad. And that is a good example of using a source. Except most of us can't read it. :hb:
 
Just to elaborate on this a little.

Ioannidis developed a model to demonstrate that particular fields of exploration can return many more false-positives than true-positives under the usual conditions. And he has confirmed this by investigating the true and false positive rate in some of those areas.

In particular (in order from most false-positives to least), discovery oriented exploratory research with massive testing (e.g. micro-array testing on genes), exploratory epidemiological testing (e.g. mining databases like NHANES), underpowered Phase I and II clinical trials, and meta-analysis of small, inconclusive trials will return more false-positives than true-positive. Well-performed RCT's and meta-analyses of well-performed RCT's will mostly return true positives.

This makes the basis for the standards in evidence-based medicine a bit more understandable (even though EBM arguably does not make good use of prior probabilities/plausibility, which is also an important part of Ioannidis' demonstration).

Linda
Thanks for a succinct summation.
Just to add that if one looks at Ioanidis' corollaries, one can also see they are much more readily applicable to studies in the alt-med field than in orthodox medicine.
 
Deetee said:
Thanks for a succinct summation.
Just to add that if one looks at Ioanidis' corollaries, one can also see they are much more readily applicable to studies in the alt-med field than in orthodox medicine.

I think they would be pretty applicable to the seemingly endless list of research which is reported in newspapers and on TV in the form of:

"eating/drinking/doing X is good for your heart/brain/other major organ, say scientists."

After not smoking, not being overweight/obese, having a balanced diet and taking regular exercise, most of these things have tiny impacts on an individual's health.

But hey, so long as there's a research grant available...
 
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False claim. A good example of bad science. Pet owners know without a doubt when their animal has diarrhea, when they refuse food, when they are passing foul gas, and many other obvious symptoms. They also can tell when such symptoms stop. Is it the herbal formula? Or would the problem have gone away on it's own?


Robinson, that is deeply dishonest. You did not say "pet owners know when their pets' condition has improved". You said (my bold)

one thing I know about pet owners, they know when something works on their pet.


That is an entirely different statement, and it was that statement which I was challenging. You have now changed this to "they know when the symptoms stop", commenting that who knows whether the remedy was responsible or whether it would have happened anyway. Where's the moving goalpost smilie when you need it?

However, you're still on completely shaky and indeed untenable ground. Pet owners are quite astonishingly subjective about their pets' clinical signs (not symptoms - pets cannot communicate symptoms, so it's a non-word in veterinary medicine). Frequently it is necessary to instruct owners to keep a diary of such things as amount of water drunk or even frequency ond consistancy of faeces, to get any idea at all of whether things are changing. Of course, for extremely obvious things, yes, and not everybody is wrong all the time. But it's quite astonishing how often they actually are.

If you have any actual "science" to refute this, fire away. But remember, anecdotes are worthless (especially so here - of course, owners get it right sometimes!).

Here's another little anecdote for you.

Either way, you missed the point, that the term "homeopathic" is being used on herbal formulas.


I did not miss the point. Interesting though it is, I chose to repond to the gross fallacy in your statement, as it is a common one used to prop up quack medicines of all sorts, and as such, ought to be addressed.

Do you have any evidence to show that to actually be true? Or is this just anecdotal evidence? Is there any science behind your claim?


Another study I like to quote in this context indeed concerns a herbal preparation, used in dogs with arthritis. In this case it was the vets who were fooled, rather more than the owners, but hey, we're all human. It's in the Veterinary Record, about 4 years ago, I can dig up the reference tomorrow if you're interested.

For reasons too complicated to go into, the blinding in this study was broken. And it was broken very much for the vets examining the dogs, but less so for the owners. They had three measures of lameness - vets' assessment, owner's assessment, and objective measurement by force plate (measures how much weight the dog is putting on each leg).

The vets' assessments showed statistically significant results for the herbal remedy.
The owners' assessments were not quite statistically significant, but there did seem to be quite a marked trend, and the authors' commented, oh, nearly!
The force plate measurements showed absolutely no difference at all between treated and placebo groups.

Why the bloody blue blazes do you think we need placebo control groups in veterinary studies, for pity's sake! Well, we do, they are mandatory.

All of them worthless when it comes to evidence based medicine.


Excuse me, what on earth are you talking about? You stated that pet owners "know when something works on their pet". So, no amount of single instances where the owner knew no such thing can refute this? Don't be ridiculous. Even a handful of such instances disproves your general assertion. If you're so into published studies, where is you citation to show that pet owners are invariably absolutely objective when recalling their pets' clinical condition, and always know when a treatment has "worked" on their animal. (Pointing out that you didn't say "always" is irrelevant here. Of course owners are right sometimes. The point is that they are also very very wrong sometimes, and quite often at that.)

Got any? Go on, surprise the entire veterinary profession!

Again, is there any evidence to show that is true? Panic attacks, which some dogs suffer from (triggered by thunderstorms, fireworks) are unmistakable, and no amount of attention will "cure" them. Drugs can alleviate the symptoms, but there is no doubt about pet owners knowing when it occurs, or when it subsides. If a "homeopathic" remedy stopped panic attacks, that would be remarkable.


Really? Funny you should pick that one.

[snip explanation that the writer was a sceptic who was persuaded against his better judgement to enrol in a course on veterinary homoeopathy]

....I went for four days in October 1991.

I arrived back at my practice armed with a free remedy kit given on the course, bursting with useless knowledge! Okay, I thought, let's put this junk to the test. We had been told about the 10 remedies in the box; the only things I could remember was that one of them was meant to be good for anticipatory anxiety, and one was for panic and shock. We were heading for bonfire night, and the annual drugging of anxious dogs which I was convinced made the anxiety worse, not better, and which I hated doing.

So I decided to run my own mini trial, and around 10 willing owners opted to give their dogs argentum nitricum 30c pre-5th November, and aconite 30c if they started to get into their expected state of panic during any fireworks. I waited to get my proof that these were nothing more than sugar pills, convinced that I would see no response. I felt sure I would never attend another homoeopathic course in my life and would, therefore, be able to continue to study for the Certificate in Small Animal Dermatology, for which I was registered, and which was my love at the time.

Improvement

When I saw the results, my heart sank. I cannot remember the exact figures, so excuse me for this, but around seven out of 10 dogs had shown improvement on previous years, some marked, and a couple had not even needed any of the panic remedy on the night as they seemed totally unconcerned.

This was not meant to happen! I did not want to have to learn any more about this stuff, but this was too unexpected to be ignored! I decided that I owed it to my curiosity to find out more, so enrolled for the first year of the course.

[snip rest of account of an educated professional slipping inexorably into homoeopathy]


Note the date of his conversion, and (probably) the firework trial. 1991. Funny that, people are still very concerned by the problem of dogs and fireworks, and yet this miracle breakthrough seems to have been entirely overlooked.

Note the remedies. Both 30C, and supplied by the London Homoeopathic Hospital. I suspect them of many things, but not of spiking their sugar pills with canine sedatives.

Any explanation? (I can think of several.)

But finding it is actually a potent herbal tincture, was quite a shock. It makes the whole homeopathic thing suspect, and possibly explains why some people swear by "homeopathy". It isn't really homeopathy, it is herbal medicine.


I'm sure that happens from time to time. The Zicam affair ("2X zincum gluconium", that is, appreciable amounts of zinc gluconate, used as a nasal spray, oh, look it up on Quackwatch) is perhaps the best documented occurrence.

It's actually more commonly reported for actual herbal preparations - "herbal impotence remedy" which actually contained viagra has been reported I believe, and a GP dermatologist friend of mine knows of a case where a Chinese herbal eczema cream which was apparently performing miracles for a group of children in Yorkshire was discovered on analysis to be repackaged (prescription-only, and quite unsuitable in such quantities for children that age) betamethasone. So don't discount the equivalent effect as possibly being behind some of the alleged miracle "herb" cures.

However, most of the studies the veterinary homoeopaths like to boast about incur no suspicion that the remedies have been adulterated. Sorry, but while this observation might explain a few of the alleged miracle cures from OTC preparations, it leaves most of the literature unscathed.

Rolfe.
 
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the term "drug" is a regulatory term, a kind "proprietary" term that denotes usage by a particular professional class, and so when you use it, you need to be aware of this

and in this context, herbs are not drugs


You are using a nonstandard definition of the word "drug". Using your definition, herbs are not drugs, and neither is marijuana. Novella is using the standard English meaning of the word "drug", which is any a chemical substance used in the treatment, cure, prevention, or diagnosis of disease.

Herbs contain chemicals. Are you trying to say ephedrine is not a drug? Quinine is not a drug?


You are also using a nonstandard definition of "nutritional value". Ginger adds little nutritional value to food - it adds flavor. Flavor is important to food, but it isn't nutritional.
 
Originally Posted by JJM
Show your evidence for the efficacy of herbs.
Usually I would just ignore you, based on past interactions, in which it became obvious you are somehow immune to evidence based medicine, and logic and science. :D

But since I just finished actually doing what you are asking about, I will share.

http://www.internationalskeptics.com/forums/showthread.php?postid=3312310#post3312310
http://www.internationalskeptics.com/forums/showthread.php?postid=3311116#post3311116

I start off with a general statement, no evidence. My statements are challenged. So I do a little looking

http://www.internationalskeptics.com/forums/showthread.php?postid=3307447#post3307447
http://www.internationalskeptics.com/forums/showthread.php?postid=3307572#post3307572

After that, there is just a huge crapload of data and stuff posted. I skip most of it and look at PubMed for data.

http://www.internationalskeptics.com/forums/showthread.php?postid=3310195#post3310195

That isn't good enough so I dig some more, and post links.

http://www.internationalskeptics.com/forums/showthread.php?postid=3310495#post3310495

It seems to be ignored, so I repeat myself, with links. Some of it is challeneged, so I respond with
http://www.internationalskeptics.com/forums/showthread.php?postid=3311163#post3311163

{snip}
An even larger data-dump than the first one offered by Vaidya. I was willing to pick-apart six, bogus citations; but not all you provide. I scanned a few did note suspect research locations (Asia) and dubious "journals."

Why not give us a hand and select the high-quality work. Note that high-quality papers on herbs are accepted in top journals, e.g.,
Conclusions: The results of this study indicate that extracts of E. angustifolia root, either alone or in combination, do not have clinically significant effects on infection with a rhinovirus or on the clinical illness that results from it.
N Engl J Med 2005; 353: 341-8.
 

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