Fighting CAM Quackery at UCLA

[LostAngeles]

Last May, IIG West informed the Bruin Alliance of Skeptics and Secularists of a healing touch lecture being given at the UCLA Ronald Reagan Medical Center. While none of us in BASS were able to make it, IIG did and has provided us with a huge amount of data about the quackery being pushed on our campus. We've been trying to work with our school newspaper, the Daily Bruin, about getting this into the paper and our contact mused that he wished he'd had this in May. Since then, we've been trying to keep an eye out for something else that we can use as a wedge to push this issue.

The Daily Bruin hath provided.

These stories are both from today's copy and in the Health and Science section.

http://beta.dailybruin.com/articles/2009/10/21/wellness-remedies-can-work-best-tandem/

When a team of Japanese researchers approached Edwin Cooper seven years ago about becoming the editor in chief of a new journal on complementary and alternative medicine, he had his doubts.

“Afterward, I thought it was the most idiotic thing I had done and (that) it would be the end of my career,” said Cooper, an immunologist at UCLA for 47 years.

He nevertheless persisted, and the journal, Evidence-based Complementary and Alternative Medicine, has become the most highly regarded source of peer-reviewed research publication on alternative medicine, he said....

http://beta.dailybruin.com/articles/2009/10/21/ucla-center-east-west-medicine-fuses-integrates-al/

A gourmet dinner is to a chef as integrative medicine is to the UCLA Center for East-West Medicine, which strives to provide its patients with a variety of integrative medicine, said Dr. Ka-Kit Hui, founder and director of the UCLA Center for East-West Medicine.

The center was founded in 1993 with the intent of using Chinese medicine in a blended health model. It is founded on the pillars of low technology, patient interaction and low costs in order to solve problems in a financially viable and efficient manner, said Hui, who is also a Wallis Annenberg Professor in Integrative East-West Medicine.

“People are looking for alternative medicine (practices) because they want to avoid as much as possible medication, procedures, injections, surgery and long term (treatments),” said Dr. Malcolm Taw, an assistant clinical professor at the UCLA Center for East-West Medicine.

Alternative medicine is medicine that is not Western, while complementary medicine is used with Western medicine, Hui said....

I'm thinking the best plan right now is to start with a Letter to the Editor by the members of BASS. Since I've graduated, I'm not really the one to do this, but we've asked IIG-West for strategy advice and they also suggested we toss it out to the JREF forum.

 

[fourtoe]

Cooper is right.

This is the most idiotic thing he has ever done.

How come we haven't heard of this? I think we should try to get a North-South center too.

 

[JoeyDonuts]

I think we should try to get a North-South center too.

I like the way you think. Take the snake-venom-eating wackiness of some of the Northern fundie churches in the Appalachians and mix it in a tasty Mint Julep. That'll align your chakras!

ETA: Totally misconstrued the East-West reference into a worse joke. Whoops.

Good stuff, LostAngeles. Too much of this crap goes unchallenged on university campuses.

 

[pakeha]

From the link
"For the treatments that fall squarely within the realm of the alternative, such as acupuncture and hypnotherapy, insurance companies pay little and selectively, said Lonnie Zeltzer, director of the UCLA Pediatric Pain Program.

Alternative medicines can be effective against chronic pain, but patients are usually responsible for payment."

I'm in. How may I be useful?

 

[LostAngeles]

Cooper is right.

This is the most idiotic thing he has ever done.

How come we haven't heard of this? I think we should try to get a North-South center too.

I totally thought that was a North Campus-South Campus joke for a sec. (For the non-UCLA folks, South Campus is the hard sciences, North is the Humanities and Social Sciences)

From the link
"For the treatments that fall squarely within the realm of the alternative, such as acupuncture and hypnotherapy, insurance companies pay little and selectively, said Lonnie Zeltzer, director of the UCLA Pediatric Pain Program.

Alternative medicines can be effective against chronic pain, but patients are usually responsible for payment."

I'm in. How may I be useful?

That was a good grab there. (I skimmed the artices) I tossed that out as being used in our letter. Thanks!

 

[wardenclyffe]

"Evidence-based Complementary and Alternative Medicine"

Has anyone heard of that publication?

Does it really do double blind studies that show that CAM really works?

By whom is it highly regarded?

Who are the "peers" doing the review of the studies?

Ward

 

[drkitten]

"Evidence-based Complementary and Alternative Medicine"

Has anyone heard of that publication?

Does it really do double blind studies that show that CAM really works?

By whom is it highly regarded?

Who are the "peers" doing the review of the studies?

Ward

That's kind of my question, too.

I must admit that I'm not (yet) seeing a problem. An academic is studying a highly speculative and largely disreputable field. That's basically what they're supposed to be doing. I don't see any problem with an academic honestly and fairly studying homeopathy, any more than I see a problem with a physicist counting how many hyperbosons can dance on the head of a lepton.

I don't even see a problem with delivering a lecture on the subject.

The key words being "honestly" and "fairly." It's when they start to veer from accepted scientific practice, cheat, falsify data, and so forth, that there's a problem.

What are these guys at UCLA actually doing? If the they're restricting themselves, for example, to publishing papers that would pass the Cochrane criteria,.... more power to them. If they're looking to find cheaper ways to get people to eat better and exercise more (yes, yoga is actually a very good health practice; it combines relaxation and exercise, things Americans don't get enough of),.... great.

If they've never heard of a control group, there should be all the ammo you need in their publications....

 

[Wudang]

"Evidence-based Complementary and Alternative Medicine"

Has anyone heard of that publication?

It seems that pubmed accepts it FWIW.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1375242/

 

[LostAngeles]

That's kind of my question, too.

I must admit that I'm not (yet) seeing a problem. An academic is studying a highly speculative and largely disreputable field. That's basically what they're supposed to be doing. I don't see any problem with an academic honestly and fairly studying homeopathy, any more than I see a problem with a physicist counting how many hyperbosons can dance on the head of a lepton.

I don't even see a problem with delivering a lecture on the subject.

The key words being "honestly" and "fairly." It's when they start to veer from accepted scientific practice, cheat, falsify data, and so forth, that there's a problem.

What are these guys at UCLA actually doing? If the they're restricting themselves, for example, to publishing papers that would pass the Cochrane criteria,.... more power to them. If they're looking to find cheaper ways to get people to eat better and exercise more (yes, yoga is actually a very good health practice; it combines relaxation and exercise, things Americans don't get enough of),.... great.

If they've never heard of a control group, there should be all the ammo you need in their publications....

The way the Daily Bruin articles are written, it sounds, to me, like it's more than just that. Mind you, the Daily Bruin is not a well-written bit of journalism.

The problem isn't researching it, it's using unproven methods.

It seems that pubmed accepts it FWIW.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1375242/

I... can't see anything objectionable in that editorial. I'm going to advise that the team who's working on the TT nurse ***** and this try to get their hands on a copy of that journal and take it from there.

 

[drkitten]

The way the Daily Bruin articles are written, it sounds, to me, like it's more than just that. Mind you, the Daily Bruin is not a well-written bit of journalism.

The problem isn't researching it, it's using unproven methods.

Er, how do you "research" methods without "using" them? And why would you research "proven" methods?

That's the big question, and something you might look at. Is this primarily a research clinic (i.e. people are told going in that they're being guinea pigs and that the "treatment" might not work and might even make things work) or is it presented as a medical clinic where you come with the expectation that they'll make you feel better.

In particular, do they get the standard (Federally mandated) informed consent on their patients?

 

[LostAngeles]

Er, how do you "research" methods without "using" them? And why would you research "proven" methods?

That's the big question, and something you might look at. Is this primarily a research clinic (i.e. people are told going in that they're being guinea pigs and that the "treatment" might not work and might even make things work) or is it presented as a medical clinic where you come with the expectation that they'll make you feel better.

In particular, do they get the standard (Federally mandated) informed consent on their patients?

I'm referring to the use of TT as a treatment at Ronald Reagan UCLA Medical Center. The California Board of Registered Nurses allows these treatments to be taught to nurses to be used in a medical facility not necessarily the research facilities.

But, for example, while the UCLA Center for Integrative Oncology does participate in research as part of the UCLA Collaborative Centers for Integrated Medicine, it does apparently present primarily as a medical clinic and not a research clinic.

And I think "proven" methods still get re-researched from time to time. It's always good to go back and recheck work done earlier, especially when there's been new information.

 

[LostAngeles]

I have this thought festering in my brain and I think it's bearing fruit. What if we're approaching this the wrong way? The generally accepted explanation for any results of CAM tends to come from the placebo effect and that the appeal is the idea that CAM practitioners show and interest in the patient that doctors don't. Patients need reassurance and someone to talk to when they're in the hospital. I remember having my tonsils out and my hospital experience being incredibly lonely and miserable.

So what if a bunch of people volunteered themselves to the hospital to fulfill this role? I mean, I'm sure programs like this exist already, but why doesn't BASS volunteer itself to the hospital to do this or to any of the studies being done on TT and the like to be compared with?

If CAM practitioners are basically peddling comfort and hand-holding, why can't we (or someone else) take their place? Am I vastly underestimating the effect of saying, "And as I'm here, holding your hand, I'm sending you magical healing waves?"

 

[alleracsum]

Actually, some of the TT studies DO include a "control" person who simply visits with the patient. Some TT studies have (and I'm not making this up) "fake" TT practitioners who wave their hands around just like a "real" TT practitioner.

 

[wardenclyffe]

There have been studies which include hand-holding and fake TT. If I recall, all the patients showed improvement. The patients with hand-holders improved a little, with the fake TT practitionser, a little more; and with the "real" TT practitioners a, little more.

All this suggests that paying attention to a patient is helpful and paying attention with authority is more helpful. The placebo effect is not something with a simple on-off switch. It's a dimmer switch.

Sorry I don't have citations for the studies I'm talking about, but I seem to remember this. I could be 100% wrong, but I don't think so.

Ward