3 ms·

I agree completely. Part of the problem remains however that so many treatments have been studied and proven wrong, however proponents of treatment by 'Insert

by robbiep 14y ago

I agree completely. Part of the problem remains however that so many treatments have been studied and proven wrong, however proponents of treatment by 'Insert CAM modality here' remain willfully blind to the evidence against their treatment, and still tell everyone that will listen that not only does it work, but modern medicine won't test it and the studies aren't done. as evidence I proffer the more than $1 Bn spent by the NCCAM for research into CAM that has largely come up bunk on the big issues. The research should be done, it is important to approach it with an open mind, but CAM proponents must live up to their end of the bargain and stop moving the goalposts whenever a study that debunks a modality is released. ps. I'm not too sure what your link has to do with the discussion exactly - I mean, artemisinin is not exactly part of the CAM stable anymore, it's a well accepted part of 'medicine proper' these days - joining a long list of other traditional therapies, asprin first and foremost amongst them, that have followed that route

ekianjo 14y ago
I would be interested to know what you think of Western Medicine in the light of what Ben Goldacre says about how clinical trials are conducted. There are many flaws even in the so-called "Evidence-based" system in Western drug development, which is what you guys are going to rely on when providing treatments. "better than placebo" being enough to register a drug, cherry-picking patients in the results, targetting very niche patient groups, not publishing any of the failed studies but being able to register on a SINGLE successful trial (which could be pure luck, statistically speaking)... and the fact that nobody ever repeats the trials for confirmation. Traditional Chinese Medicine may be bullshit, but I think we have a heavy luggage of bullshit in modern Western Medicine as well and we ought to recognize it. Disclaimer: I have a long track record in pharma industries.
- robbiep 14y ago
  I think the way some trials are conducted is worrying. Of course there is the points you bring up; I had also heard (but can't find any link from a bit of a cursory look around the net) that all subsequent trials of antidepressants show decreased treatment effect until you end up with meta-analyses that seem to show that they are no better than placebo, leading (jokingly) to Doctors, on the release of a new anti-depressant, saying 'Quick, let's use it before it stops working' Part of the problem I think is the model of the pharma industry (I have no suggestions on where to start to change this!), part is that students/researchers don't want to give up on publication and years of work with null results and so change the aims or methodology, or rig their study... Which is morally indefensible but understandable at the same time.. I think a lot of people involved with medicine are under no illusions as to the limitations of our current methods. However one of the beautiful things about the scientific method is that we are continually testing our preconceived ideas, and trying to tease out if the effects are real or some artefact of bias, statistics, population dynamics, etc. When I started Med School they tell us that 'Within 4 years, 50% of what you have learnt will be wrong and replaced. The difficulty is which 50%'. THAT is how quickly our knowledge is growing, and goes a long way to show that the people involved in the delivery of healthcare don't take this all for granted.
  - illuminate 14y ago
    And that 50% is entirely preferable to loyally sticking with long-disproved falsehoods and pretending that they are preferable to updating any knowledgebase.
- illuminate 14y ago
  "I would be interested to know what you think of Western Medicine in the light of what Ben Goldacre says about how clinical trials are conducted." The benefit of Western Medicine is that we know these terrible things and can work around them. They are not the system working as should be practiced. Using a fictional modality to treat patients is not a preferable alternative. Reform, not revolution.
  - ekianjo 14y ago
    I agree with you, but the current system shows no incentive to improve and to work around these issues. Regulators (because of the increased complexity) and Companies alike (because of the potential market losses) are unwilling to commit to do real science and to do the right thing. I do not think it is going to change anytime soon, even if we are all aware of the shortcomings.
    - illuminate 14y ago
      I agree with all of these problems. I believe that the solution is to root out these inefficiencies and corruptions, not to replace them with a new set of inefficiencies and corruption and a wholly pseudoscientific core.

by robbiep 14y ago

ekianjo 14y ago

I would be interested to know what you think of Western Medicine in the light of what Ben Goldacre says about how clinical trials are conducted. There are many flaws even in the so-called "Evidence-based" system in Western drug development, which is what you guys are going to rely on when providing treatments. "better than placebo" being enough to register a drug, cherry-picking patients in the results, targetting very niche patient groups, not publishing any of the failed studies but being able to register on a SINGLE successful trial (which could be pure luck, statistically speaking)... and the fact that nobody ever repeats the trials for confirmation. Traditional Chinese Medicine may be bullshit, but I think we have a heavy luggage of bullshit in modern Western Medicine as well and we ought to recognize it. Disclaimer: I have a long track record in pharma industries.

robbiep 14y ago
I think the way some trials are conducted is worrying. Of course there is the points you bring up; I had also heard (but can't find any link from a bit of a cursory look around the net) that all subsequent trials of antidepressants show decreased treatment effect until you end up with meta-analyses that seem to show that they are no better than placebo, leading (jokingly) to Doctors, on the release of a new anti-depressant, saying 'Quick, let's use it before it stops working' Part of the problem I think is the model of the pharma industry (I have no suggestions on where to start to change this!), part is that students/researchers don't want to give up on publication and years of work with null results and so change the aims or methodology, or rig their study... Which is morally indefensible but understandable at the same time.. I think a lot of people involved with medicine are under no illusions as to the limitations of our current methods. However one of the beautiful things about the scientific method is that we are continually testing our preconceived ideas, and trying to tease out if the effects are real or some artefact of bias, statistics, population dynamics, etc. When I started Med School they tell us that 'Within 4 years, 50% of what you have learnt will be wrong and replaced. The difficulty is which 50%'. THAT is how quickly our knowledge is growing, and goes a long way to show that the people involved in the delivery of healthcare don't take this all for granted.
- illuminate 14y ago
  And that 50% is entirely preferable to loyally sticking with long-disproved falsehoods and pretending that they are preferable to updating any knowledgebase.
illuminate 14y ago
"I would be interested to know what you think of Western Medicine in the light of what Ben Goldacre says about how clinical trials are conducted." The benefit of Western Medicine is that we know these terrible things and can work around them. They are not the system working as should be practiced. Using a fictional modality to treat patients is not a preferable alternative. Reform, not revolution.
- ekianjo 14y ago
  I agree with you, but the current system shows no incentive to improve and to work around these issues. Regulators (because of the increased complexity) and Companies alike (because of the potential market losses) are unwilling to commit to do real science and to do the right thing. I do not think it is going to change anytime soon, even if we are all aware of the shortcomings.
  - illuminate 14y ago
    I agree with all of these problems. I believe that the solution is to root out these inefficiencies and corruptions, not to replace them with a new set of inefficiencies and corruption and a wholly pseudoscientific core.