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	<title>Comments on: A Golden Age of Quackery and Antiscience</title>
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		<title>By: Science-Based Medicine &#187; Resistance is futile? Hell, no! (A call to arms)</title>
		<link>http://theness.com/neurologicablog/index.php/a-golden-age-of-quackery-and-antiscience/comment-page-1/#comment-4402</link>
		<dc:creator>Science-Based Medicine &#187; Resistance is futile? Hell, no! (A call to arms)</dc:creator>
		<pubDate>Mon, 21 Jul 2008 13:01:15 +0000</pubDate>
		<guid isPermaLink="false">http://www.theness.com/neurologicablog/?p=254#comment-4402</guid>
		<description>[...] agreed when Quackwatch webmaster Stephen Barrett characterized the era we live in as the &#8220;golden age of quackery and antiscience.&#8221; There&#8217;s nothing to be gained for us by pretending otherwise other than perhaps the [...]</description>
		<content:encoded><![CDATA[<p>[...] agreed when Quackwatch webmaster Stephen Barrett characterized the era we live in as the &#8220;golden age of quackery and antiscience.&#8221; There&#8217;s nothing to be gained for us by pretending otherwise other than perhaps the [...]</p>
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		<title>By: Science-Based Medicine &#187; Resistance is futile</title>
		<link>http://theness.com/neurologicablog/index.php/a-golden-age-of-quackery-and-antiscience/comment-page-1/#comment-3992</link>
		<dc:creator>Science-Based Medicine &#187; Resistance is futile</dc:creator>
		<pubDate>Mon, 30 Jun 2008 13:15:59 +0000</pubDate>
		<guid isPermaLink="false">http://www.theness.com/neurologicablog/?p=254#comment-3992</guid>
		<description>[...] If Dr. Weil succeeds, every new family practice physician will graduate from his or her residency program with a knowledge of CAM. This would not be a bad thing if it were truly a science- and evidence-based approach to CAM and a knowledge of what herbal remedies might interact with &#8220;conventional&#8221; pharmaceuticals. The optimist in me would like to believe that that&#8217;s what would happen, but the realist in me knows that it&#8217;s not. Given the history of CAM programs in medical schools and academic medical centers thus far, where credulous promotion of quackery&#8211;yes, I say quackery&#8211;such as reiki, therapeutic touch, and even that quackery of quackeries, homeopathy, somehow manage to be &#8220;integrated&#8221; into science-based offerings with nary a word of skepticism about the extreme (and I do mean extreme) lack of scientific plausibility and the preponderance of scientific studies demonstrating no greater efficacy for these modalities than placebo, I fear that when I visualize myself in the hospital 20 or 30 years being subjected to therapies parodied in this video, I may look back at it as prophetic, not funny. Steve Novella was right to wonder whether a golden age of quackery and antiscience is upon us. [...]</description>
		<content:encoded><![CDATA[<p>[...] If Dr. Weil succeeds, every new family practice physician will graduate from his or her residency program with a knowledge of CAM. This would not be a bad thing if it were truly a science- and evidence-based approach to CAM and a knowledge of what herbal remedies might interact with &#8220;conventional&#8221; pharmaceuticals. The optimist in me would like to believe that that&#8217;s what would happen, but the realist in me knows that it&#8217;s not. Given the history of CAM programs in medical schools and academic medical centers thus far, where credulous promotion of quackery&#8211;yes, I say quackery&#8211;such as reiki, therapeutic touch, and even that quackery of quackeries, homeopathy, somehow manage to be &#8220;integrated&#8221; into science-based offerings with nary a word of skepticism about the extreme (and I do mean extreme) lack of scientific plausibility and the preponderance of scientific studies demonstrating no greater efficacy for these modalities than placebo, I fear that when I visualize myself in the hospital 20 or 30 years being subjected to therapies parodied in this video, I may look back at it as prophetic, not funny. Steve Novella was right to wonder whether a golden age of quackery and antiscience is upon us. [...]</p>
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		<title>By: DanaUllman</title>
		<link>http://theness.com/neurologicablog/index.php/a-golden-age-of-quackery-and-antiscience/comment-page-1/#comment-2056</link>
		<dc:creator>DanaUllman</dc:creator>
		<pubDate>Thu, 27 Mar 2008 03:59:40 +0000</pubDate>
		<guid isPermaLink="false">http://www.theness.com/neurologicablog/?p=254#comment-2056</guid>
		<description>Yeah superdave, the silica hypothesis...and why do I have this sneaking suspicion that you know nothing about it.  Hmmm...but let&#039;s cure that.

Here&#039;s a link to an introduction to it by a Harvard doc and another respected scientist:

http://www.badscience.net//?p=498</description>
		<content:encoded><![CDATA[<p>Yeah superdave, the silica hypothesis&#8230;and why do I have this sneaking suspicion that you know nothing about it.  Hmmm&#8230;but let&#8217;s cure that.</p>
<p>Here&#8217;s a link to an introduction to it by a Harvard doc and another respected scientist:</p>
<p><a href="http://www.badscience.net//?p=498" rel="nofollow">http://www.badscience.net//?p=498</a></p>
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		<title>By: superdave</title>
		<link>http://theness.com/neurologicablog/index.php/a-golden-age-of-quackery-and-antiscience/comment-page-1/#comment-2044</link>
		<dc:creator>superdave</dc:creator>
		<pubDate>Wed, 26 Mar 2008 14:50:47 +0000</pubDate>
		<guid isPermaLink="false">http://www.theness.com/neurologicablog/?p=254#comment-2044</guid>
		<description>silica hypothesis?  are you kidding?</description>
		<content:encoded><![CDATA[<p>silica hypothesis?  are you kidding?</p>
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		<title>By: DanaUllman</title>
		<link>http://theness.com/neurologicablog/index.php/a-golden-age-of-quackery-and-antiscience/comment-page-1/#comment-2040</link>
		<dc:creator>DanaUllman</dc:creator>
		<pubDate>Wed, 26 Mar 2008 03:31:16 +0000</pubDate>
		<guid isPermaLink="false">http://www.theness.com/neurologicablog/?p=254#comment-2040</guid>
		<description>Yes, Steven, &quot;positive effects tend to go away under replication,&quot; but the evidence for replication of in vitro studies is impressive.  The Oscillo trials have now been replicated four times; childhood diarrhea trials three times; the Reilly trials on allergies have had four different but similar trials; and there&#039;s more.

What is additionally impressive is that there have been &quot;negative&quot; results from scientists who have shown positive results from other studies.  My point is that I do not know any &quot;homeopathic researchers&quot;; that is, these people are &quot;researchers&quot; who are doing all that they can to evaluate objective various phenomena.  These researchers are simply 

It is strange that French reseacher, Jacques Benveniste, and Irish biochemist, Madeleine Ennis, have been called  &quot;homeopathic researchers&quot; just because they found some positive results from homeopathic doses.  The bottomline is that these people have/had integrity and a backbone.     

Finally, one thing that I agree with you: extremely small doses of anything may not have any effect; however, there may indeed be something significantly different about how homeopathic medicines are made.  That is, the process of making serial dilution, with vigorous shaking, in a double-distilled water and in glass bottles, may create something other than &quot;small&quot; doses.  The &quot;silica hypothesis&quot;, that is, the &quot;silica fragments that fall off the glass walls of the bottle, may interact with the medicinal substance, thereby changing the structure of the water in unique ways for each substance that interacts with the silica chips.  Implausible becomes plausible.</description>
		<content:encoded><![CDATA[<p>Yes, Steven, &#8220;positive effects tend to go away under replication,&#8221; but the evidence for replication of in vitro studies is impressive.  The Oscillo trials have now been replicated four times; childhood diarrhea trials three times; the Reilly trials on allergies have had four different but similar trials; and there&#8217;s more.</p>
<p>What is additionally impressive is that there have been &#8220;negative&#8221; results from scientists who have shown positive results from other studies.  My point is that I do not know any &#8220;homeopathic researchers&#8221;; that is, these people are &#8220;researchers&#8221; who are doing all that they can to evaluate objective various phenomena.  These researchers are simply </p>
<p>It is strange that French reseacher, Jacques Benveniste, and Irish biochemist, Madeleine Ennis, have been called  &#8220;homeopathic researchers&#8221; just because they found some positive results from homeopathic doses.  The bottomline is that these people have/had integrity and a backbone.     </p>
<p>Finally, one thing that I agree with you: extremely small doses of anything may not have any effect; however, there may indeed be something significantly different about how homeopathic medicines are made.  That is, the process of making serial dilution, with vigorous shaking, in a double-distilled water and in glass bottles, may create something other than &#8220;small&#8221; doses.  The &#8220;silica hypothesis&#8221;, that is, the &#8220;silica fragments that fall off the glass walls of the bottle, may interact with the medicinal substance, thereby changing the structure of the water in unique ways for each substance that interacts with the silica chips.  Implausible becomes plausible.</p>
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		<title>By: Steven Novella</title>
		<link>http://theness.com/neurologicablog/index.php/a-golden-age-of-quackery-and-antiscience/comment-page-1/#comment-2038</link>
		<dc:creator>Steven Novella</dc:creator>
		<pubDate>Wed, 26 Mar 2008 00:58:10 +0000</pubDate>
		<guid isPermaLink="false">http://www.theness.com/neurologicablog/?p=254#comment-2038</guid>
		<description>Dana Ullman wrote: &quot;What would happen to science and medicine if researchers chose not to study things that were &quot;seemingly invalid&quot; or simply &quot;unlikely&quot;?&quot;

This is a common straw man. &quot;Implausible&quot; is a matter of degree. Science needs to push beyond the edge of current knowledge. There is a sweet spot where we are reaching far enough to discover new stuff about the world, but not so far that the probability of success becomes negligible. It&#039;s like making sound investments vs playing the lottery. 

Extreme scientific implausibility is a waste of time. In order to counter extreme implausibility there would have to be rock solid evidence, which is lacking in homeopathy. There is a great deal of bad research in homeopathy (there is a great deal of bad research in all of medicine) so we need plausibility to guide us through the complex maze of poor methodology, publication bias, placebo effect, etc. 

Also - medicine is an applied science. We have to make decisions that effect real people&#039;s lives. This is not just abstract knowledge.

What we have not had in homeopathy is a consensus trial - one designed and monitored by skeptics as well as believers, that is replicable by anyone. Positive effects tend to go away under replication.</description>
		<content:encoded><![CDATA[<p>Dana Ullman wrote: &#8220;What would happen to science and medicine if researchers chose not to study things that were &#8220;seemingly invalid&#8221; or simply &#8220;unlikely&#8221;?&#8221;</p>
<p>This is a common straw man. &#8220;Implausible&#8221; is a matter of degree. Science needs to push beyond the edge of current knowledge. There is a sweet spot where we are reaching far enough to discover new stuff about the world, but not so far that the probability of success becomes negligible. It&#8217;s like making sound investments vs playing the lottery. </p>
<p>Extreme scientific implausibility is a waste of time. In order to counter extreme implausibility there would have to be rock solid evidence, which is lacking in homeopathy. There is a great deal of bad research in homeopathy (there is a great deal of bad research in all of medicine) so we need plausibility to guide us through the complex maze of poor methodology, publication bias, placebo effect, etc. </p>
<p>Also &#8211; medicine is an applied science. We have to make decisions that effect real people&#8217;s lives. This is not just abstract knowledge.</p>
<p>What we have not had in homeopathy is a consensus trial &#8211; one designed and monitored by skeptics as well as believers, that is replicable by anyone. Positive effects tend to go away under replication.</p>
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		<title>By: DanaUllman</title>
		<link>http://theness.com/neurologicablog/index.php/a-golden-age-of-quackery-and-antiscience/comment-page-1/#comment-2025</link>
		<dc:creator>DanaUllman</dc:creator>
		<pubDate>Tue, 25 Mar 2008 14:59:06 +0000</pubDate>
		<guid isPermaLink="false">http://www.theness.com/neurologicablog/?p=254#comment-2025</guid>
		<description>According to dictionaries, &quot;implausible&quot; means &quot;unlikely&quot; or &quot;not plausible&quot; (which is defined &quot;seemingly valid&quot;).  

What would happen to science and medicine if researchers chose not to study things that were &quot;seemingly invalid&quot; or simply &quot;unlikely&quot;?  

In actual fact, there is a body of in vitro studies testing homeopathic medicines:  A group of German and Swiss physicians, scientists, and professors conducted a systematic review of the in vitro evidence of homeopathic high potencies (Witt, Bluth, Albrecht, et al, 2007).  From 75 publications, 67 experiments (1/3 of them replications) were evaluated. Nearly 3/4 of them found a high potency effect, and 2/3 of those 18 that scored 6 points or more and controlled contamination. Nearly 3/4 of all replications were positive. Design and experimental models of the reviewed experiments were inhomogenous, most were performed on basophiles.  These researchers concluded that even experiments with a high methodological standard could demonstrate an effect of high potencies.  [Witt, CM, Bluth, M, Albrecht, H, Weißhuhn, TER, Baumgartner, S, and Willich, SN, The in vitro evidence for an effect of high homeopathic potencies-A systematic review of the literature, Complementary Therapies in Medicine, 15,2, June 2007: 128-138]

The July 2007 issue of the journal HOMEOPATHY devoted itself to &quot;plausible&quot; mechanisms of action, including several researchers showing replicated data and some showing new data that awaits replication.

I have no serious problem with people questioning homeopathy, though I hope that we can agree that the case for homeopathy is not closed.  Those who do feel that way, IMO, are not good scientific thinkers.</description>
		<content:encoded><![CDATA[<p>According to dictionaries, &#8220;implausible&#8221; means &#8220;unlikely&#8221; or &#8220;not plausible&#8221; (which is defined &#8220;seemingly valid&#8221;).  </p>
<p>What would happen to science and medicine if researchers chose not to study things that were &#8220;seemingly invalid&#8221; or simply &#8220;unlikely&#8221;?  </p>
<p>In actual fact, there is a body of in vitro studies testing homeopathic medicines:  A group of German and Swiss physicians, scientists, and professors conducted a systematic review of the in vitro evidence of homeopathic high potencies (Witt, Bluth, Albrecht, et al, 2007).  From 75 publications, 67 experiments (1/3 of them replications) were evaluated. Nearly 3/4 of them found a high potency effect, and 2/3 of those 18 that scored 6 points or more and controlled contamination. Nearly 3/4 of all replications were positive. Design and experimental models of the reviewed experiments were inhomogenous, most were performed on basophiles.  These researchers concluded that even experiments with a high methodological standard could demonstrate an effect of high potencies.  [Witt, CM, Bluth, M, Albrecht, H, Weißhuhn, TER, Baumgartner, S, and Willich, SN, The in vitro evidence for an effect of high homeopathic potencies-A systematic review of the literature, Complementary Therapies in Medicine, 15,2, June 2007: 128-138]</p>
<p>The July 2007 issue of the journal HOMEOPATHY devoted itself to &#8220;plausible&#8221; mechanisms of action, including several researchers showing replicated data and some showing new data that awaits replication.</p>
<p>I have no serious problem with people questioning homeopathy, though I hope that we can agree that the case for homeopathy is not closed.  Those who do feel that way, IMO, are not good scientific thinkers.</p>
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		<title>By: Steven Novella</title>
		<link>http://theness.com/neurologicablog/index.php/a-golden-age-of-quackery-and-antiscience/comment-page-1/#comment-2022</link>
		<dc:creator>Steven Novella</dc:creator>
		<pubDate>Tue, 25 Mar 2008 14:32:53 +0000</pubDate>
		<guid isPermaLink="false">http://www.theness.com/neurologicablog/?p=254#comment-2022</guid>
		<description>Dana Ullman wrote: &quot;Sadly, conventional medicine tends to be extremely competitive and seeks to thwart research into modalities that are new and/or unconventional. Such is the continual and predictable history of medicine and science.&quot;

This is an unsubstantiated assertion. The whole point of scientific research is to find new and unconventional treatments. This is happening all the time in scientific medicine. In my opinion, this is just standard CAM apologist propaganda. 

You also stated that there are other legitimate ways (other than placebo-controlled trials) to scientifically investigate treatment. I agree, as I stated, and mainstream medicine uses a variety of scientific methods to assess new treatments and ideas. This is why I advocate for &quot;science-based medicine&quot; and not merely &quot;evidence-based medicine.&quot; 

But the part of science that the homeopaths (and CAM proponents in general) miss is the very critical one of scientific plausibility, which is a way of assessing prior probability. If you have a modality that is difficult to study, that has ambiguous clinical evidence, and a prior probability of essentially zero due to an utter lack of any scientific plausibility - this modality is probably not real. Simply appealing to ignorance is insufficient defense - we are not talking about uncertainty as to the precise physiological mechanism of a treatment, but a complete lack of physical plausibility. You cannot overlook this and claim to be science-based.</description>
		<content:encoded><![CDATA[<p>Dana Ullman wrote: &#8220;Sadly, conventional medicine tends to be extremely competitive and seeks to thwart research into modalities that are new and/or unconventional. Such is the continual and predictable history of medicine and science.&#8221;</p>
<p>This is an unsubstantiated assertion. The whole point of scientific research is to find new and unconventional treatments. This is happening all the time in scientific medicine. In my opinion, this is just standard CAM apologist propaganda. </p>
<p>You also stated that there are other legitimate ways (other than placebo-controlled trials) to scientifically investigate treatment. I agree, as I stated, and mainstream medicine uses a variety of scientific methods to assess new treatments and ideas. This is why I advocate for &#8220;science-based medicine&#8221; and not merely &#8220;evidence-based medicine.&#8221; </p>
<p>But the part of science that the homeopaths (and CAM proponents in general) miss is the very critical one of scientific plausibility, which is a way of assessing prior probability. If you have a modality that is difficult to study, that has ambiguous clinical evidence, and a prior probability of essentially zero due to an utter lack of any scientific plausibility &#8211; this modality is probably not real. Simply appealing to ignorance is insufficient defense &#8211; we are not talking about uncertainty as to the precise physiological mechanism of a treatment, but a complete lack of physical plausibility. You cannot overlook this and claim to be science-based.</p>
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		<title>By: Mojo</title>
		<link>http://theness.com/neurologicablog/index.php/a-golden-age-of-quackery-and-antiscience/comment-page-1/#comment-2020</link>
		<dc:creator>Mojo</dc:creator>
		<pubDate>Tue, 25 Mar 2008 13:33:50 +0000</pubDate>
		<guid isPermaLink="false">http://www.theness.com/neurologicablog/?p=254#comment-2020</guid>
		<description>Dana Ullman wrote, &quot;The &quot;team&quot; on which I play is the Hippocratic team, for I honor his &quot;First, do no harm&quot; dictum.&quot;

The trouble is that that&#039;s all homoeopathy does.</description>
		<content:encoded><![CDATA[<p>Dana Ullman wrote, &#8220;The &#8220;team&#8221; on which I play is the Hippocratic team, for I honor his &#8220;First, do no harm&#8221; dictum.&#8221;</p>
<p>The trouble is that that&#8217;s all homoeopathy does.</p>
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		<title>By: DanaUllman</title>
		<link>http://theness.com/neurologicablog/index.php/a-golden-age-of-quackery-and-antiscience/comment-page-1/#comment-2011</link>
		<dc:creator>DanaUllman</dc:creator>
		<pubDate>Tue, 25 Mar 2008 02:07:23 +0000</pubDate>
		<guid isPermaLink="false">http://www.theness.com/neurologicablog/?p=254#comment-2011</guid>
		<description>Steven,
     Like I said, I honor surgery, and I&#039;m glad that we both recognize there ARE other means to assessing &quot;scientifically&quot; whether a treatment is effective other than randomized placebo controlled trials.  Such are the challenges facing many CAM therapies:  how does one create a placebo mantra, a placebo massage, and even placebo acupuncture is quite challenging.   (Please don&#039;t get me wrong:  I do not disbelieve in the value of surgery just because there are few placebo-controlled trials.  My point is that even serious scientists respect various means to accumulating and confirming therapeutic value).  
      It is much easier to conduct placebo-controlled trials with homeopathy, but good trials must also be sensitive to the homeopathic method which requires individualization of treatment, except in a small number of medical situations where one medicine can routinely be given effectively (as has been seen in four large trials testing Oscillococcinum in the treatment of influenza, and recently, in the use of Kali bichromicum in treatment of COPD).  
      For those people who have any sense of medical history, we know that conventional medicine over the past 150 years or so has always insisted that their methods were &quot;scientifically confirmed,&quot; and yet, consistently, their treatments have been found to work only temporarily or not at all and that the side-effects are often worse than the benefits provided.  This is why I hope that we ALL become more HUMBLE.
     Sadly, conventional medicine tends to be extremely competitive and seeks to thwart research into modalities that are new and/or unconventional.  Such is the continual and predictable history of medicine and science.</description>
		<content:encoded><![CDATA[<p>Steven,<br />
     Like I said, I honor surgery, and I&#8217;m glad that we both recognize there ARE other means to assessing &#8220;scientifically&#8221; whether a treatment is effective other than randomized placebo controlled trials.  Such are the challenges facing many CAM therapies:  how does one create a placebo mantra, a placebo massage, and even placebo acupuncture is quite challenging.   (Please don&#8217;t get me wrong:  I do not disbelieve in the value of surgery just because there are few placebo-controlled trials.  My point is that even serious scientists respect various means to accumulating and confirming therapeutic value).<br />
      It is much easier to conduct placebo-controlled trials with homeopathy, but good trials must also be sensitive to the homeopathic method which requires individualization of treatment, except in a small number of medical situations where one medicine can routinely be given effectively (as has been seen in four large trials testing Oscillococcinum in the treatment of influenza, and recently, in the use of Kali bichromicum in treatment of COPD).<br />
      For those people who have any sense of medical history, we know that conventional medicine over the past 150 years or so has always insisted that their methods were &#8220;scientifically confirmed,&#8221; and yet, consistently, their treatments have been found to work only temporarily or not at all and that the side-effects are often worse than the benefits provided.  This is why I hope that we ALL become more HUMBLE.<br />
     Sadly, conventional medicine tends to be extremely competitive and seeks to thwart research into modalities that are new and/or unconventional.  Such is the continual and predictable history of medicine and science.</p>
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