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Quack medicine: Real harm vs. possibly useful silliness

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A friend kindly linked us to a Reason feature on the alternative medicine “racket:”

Behind the dubious medical claims of Dr. Mehmet Oz and Deepak Chopra is a decades-long strategy to promote alternative medicine to the American public. Twenty-three years ago, the National Institutes of Health (NIH) began to investigate a wide variety of unconventional medical practices from around the world. Five-and-a-half billion dollars later, the NIH has found no cures for disease. But it has succeeded in bringing every kind of quackery—from faith healing to homeopathy—out of the shadows and into the heart of the American medical establishment. … The OAM’s stated mission was to investigate the medical value of alternative therapies. Despite its minuscule budget, its mandate was massive. Almost any kind of unusual therapy could be considered “alternative”, spanning dozens of widely differing cultural traditions and historical eras. Everything from homeopathic remedies for arthritis to acupuncture for back pain to remote prayer for HIV/AIDS to coffee enemas for fighting cancer was in its purview.

We wish everyone well who disputes paying taxes for nonsense.

Here is one caution, however, in interpreting data: The “placebo effect” (the perception that relief is at hand) is not equivalent to a null effect. It is a very powerful influence in human survival, marshalling the body’s defenses. That is the true reason that drugs are expected to perform 5% better than placebo.

The “help is at hand” (placebo) effect may well contribute to humans’ unusual longevity. After all, with reason, we can know if help might be at hand.

Drugs are not expected to perform 5% better than nothing at all.

The placebo effect is a nuisance in family doctors’ offices because symptoms tend to dissipate just when they would be useful indicators. That said, if all else fails, the patient could end up in the ER, where more radical problems prompt more radical measures. Placebo does not match defibrillation, surgery, etc.. But that is not its role.

Which is the true reason that drugs must be tested at 5% against placebo, not 5% against nothing.

It’s right to ask what taxpayers are required to fund. But we mustn’t lose sight of the fact that how a human being feels is an inextricable part of health.

So the question is, what’s the evidence?

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2 Replies to “Quack medicine: Real harm vs. possibly useful silliness

  1. 1
    wd400 says:

    That is the true reason that drugs are expected to perform 5% better than placebo.

    Who expects this? I’ve never heard of a specific effect-size requirement from the FDA or anyone else.

    EDIT Oh, hold on. I think you are conflating effect-size (the estimate of who good a drug is) with a p-value (the probability of observing such an effect even if the drug was no more effective than the comparison)?

  2. 2
    anthropic says:

    The placebo effect, and its evil cousin nocebo effect (told that a drug may cause nausea, we begin feeling twinges even before taking it), are quite real and quite potent. Not just in perception of pain, as used to be thought, but in actual pain, as the brain’s expectation of relief causes a release of opiods that actually reduce it.

    Further, placebo/nocebo effects include heart rate and respiration.

    Our beliefs cause the brain and body to change, which ought not to be the case if the mind is a mere epiphenomenon of the material brain.

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