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 Communicating science, we can learn from Karl Rove
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beskeptigal
SFN Die Hard

USA
3834 Posts

Posted - 06/11/2006 :  13:09:02  Show Profile Send beskeptigal a Private Message
(Posting on 3 forums, here, BAUT & JREF in case you reply on one of the others.)

Communicating science, we can learn from Karl Rove, except I am not advocating by any means that we adopt lies and "Newspeak" terminology. (War is not peace and lies eventually backfire.)

I brought this up before discussing "ID, we're arguing the wrong question" but now I want to expand on the idea. It dawned on me when reading Eos' latest thread in the JREF forum describing the adoption of worthless therapies by the universal health plan of Alberta, Canada. When we refer to unproven remedies and therapies if we adopted some more marketing savvy terminology, we could be a lot more effective in ridding humanity of these time and dollar wasting endeavors.

Keep the term, alternative medicine. But let's not be using it for anything and everything people want to believe in. We need to have three categories.
    1) Alternative medicine for which there is evidence of some benefit.
    2) Alternative medicine for which there may be evidence of some benefit or there hasn't been research ruling it out. (There may be leeway here for arguing when is something sufficiently ruled out.)
    3) Everything else referred to as therapeutic but which has no basis whatsoever like homeopathy.
For #1 we can still call things in this group alternative medicine. By doing so we don't get the automatic tuning out of the message by people already convinced that modern medicine advocates conspire against their magical ideas.

For #2 we might refer to this group as untested alternative medicine. I'm looking for ideas from forum members here if you have any.

But for the things in category #3 it's time to drop the term 'alternative medicine' period. These things are not alternatives, they are nonsensical.

Modern medicine has adopted the terminology, 'evidence based medicine'. I believe that is an incredibly useful term and I use it all the time when discussing alternative medicine with people. It changes the argument from alternative medicine vs Western medicine to "they both need supporting evidence to convince me of their value.

'Junk science' is a good term and much more effective than 'paranormal' which has become synonymous with unexplained events. Paranormal events have explanations. Even when they don't, the possibilities are still not in the range of paranormal, the possibilities are merely in the range of normal but not enough evidence to determine. I argue there is no such thing as paranormal except maybe in fantasy (literature, film or thought).

So for thing in group #3, I suggest people quit referring to these as alternatives and start using the term, 'junk medicine'. It might require explaining at first that junk medicine doesn't include alternative medicine that has supporting evidence of its effectiveness. But if used consistently with 'evidence based medicine', when challenged about bias against alternative medicine, one need merely ask for supporting evidence. Again, I'm wondering what other terms might be used if anyone has suggestions.

In addition it is useful to communicate the amount of profit in junk medicine and the amount of political clout such profit brings to counter the nonsense that big pharmaceutical companies stifle alternative medicine research. Junk medicine peddlers have been increasingly influencing government to stifle the powers of the FDA to regulate them and the FTC to regulate their false advertising. The conspiracy theorists should be able to grasp that message.

One would think all we need to do is educate the masses. And hopefully in the long run that will be the end result. But marketing research and marketing successes show us that it isn't just simple imparting knowledge which results in educating people. The language you choose when imparting that knowledge has a large influence on how the knowledge is interpreted and categorized by the learner. Shouldn't we be using the science of marketing and communication while trying to spread the science of evidence?

Dave W.
Info Junkie

USA
26001 Posts

Posted - 06/11/2006 :  14:16:37   [Permalink]  Show Profile  Visit Dave W.'s Homepage Send Dave W. a Private Message
I think the term "alternative medicine" needs to go. It implies that "therapy X" is a viable "alternative" to some other form of treatment for some condition or other. But few of the things labeled "alternative medicine" are so well-supported with evidence of efficacy to be actual alternatives to the standards of care for any disease. By way of analogy, a paperback book is not a viable alternative to a hammer with regard to driving nails into two-by-fours, even though with enough work you can drive a nail with a book.

I also think your three categories aren't sufficiently delineated to make for good talking points. In other words, the lines separating one from the others are blurry. You're really talking about a continuum of evidenciary support, with category one being "some support," two being "little or no support" and three being "little or no support and no logical basis" (at least, that's the way it reads to me). But how much evidence would move something from category two into one (and how does one measure "evidence")? Or, if something which works without dispute is promoted by folks who present a totally false therapeutic model for it, would it go into category one or three?

Another thing to consider is that the "alternative" label implies "natural" treatment, so surely bed rest as a therapy for groin pulls falls into category one, even though it's the "Western medicine" standard of care (I think). In other words, doctors prescribe "natural" treatments all the damn time, which led to one researcher, years ago, stating that there aren't two kinds of medicine, "mainstream" and "alternative," there's only evidence-based medicine and everything else (paraphrased from memory).

And so the framing of the argument has already shifted. More than ten years ago, it seems to me. The "alternative" producers know it, too, and so we see "natural" medicines like "Enzyte" are being slickly packaged to look like "Big Pharma" products, even though they lack FDA review. The most-important thing which needs to be done to "educate the masses" is to show 'em that "these statements have not been reviewed by the FDA" likely means that the statements are utterly bogus, but then "the masses" have to actually pay attention to the tiny type which vanishes in half a second at the bottom of TV ads.

Perhaps what's really needed is more grass-roots lobbying efforts to counter the power that the $20-billion-a-year "alternative medicine" market has already, get the DSHEA repealed, and dump a lot more money into the FTC's policing efforts. Then, when we're back to having a legal requirement to "put up or shut up" regarding medical therapy evidence, maybe educational efforts to teach the value of science and scientific testing will be likely to succeed.

- Dave W. (Private Msg, EMail)
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HalfMooner
Dingaling

Philippines
15831 Posts

Posted - 06/11/2006 :  14:55:23   [Permalink]  Show Profile Send HalfMooner a Private Message
Controlling the definitions is right on the mark, B. It's very important that scientific medicine should control its own terms -- or else its opponents will.

About the only term I'm a bit uncomfortable with, is "junk medicine," because cedes the word "medicine" to the quacks. (How about, say, "junk nostrums"?) Whatever words are adopted, they are very important. You have recognized that these words are the very hills and dales across which the battle with quackery is fought. The words should be crafted, debated and considered very carefully before the proposed offensive is launched

Some ideas: How about "emerging alternatives" for your group 1, alternative treatments that are showing some actual scientific evidence of effectiveness? (As any techniques in this first group became proven, they would be called, simply, "medicine.") "Unproven alternatives" would describe your group 2, and "disproven alternatives" your group 3. I'm a layman, and it ain't my party, but I'll keep trying to think of ideas, grasping at straws, etc.

Edited to add: I partially agree with Dave. Except I'd leave the word "medicine" out of anything that's not proven, while ceding the generally accepted term "alternative," but only with the above type qualifiers.


Biology is just physics that has begun to smell bad.” —HalfMooner
Here's a link to Moonscape News, and one to its Archive.
Edited by - HalfMooner on 06/11/2006 14:59:20
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beskeptigal
SFN Die Hard

USA
3834 Posts

Posted - 06/12/2006 :  01:19:16   [Permalink]  Show Profile Send beskeptigal a Private Message
Those are some very good points Dave. We still need to keep in mind that this is marketing as much as technically correct. I made the three categories for that reason but I'm well aware of the continuum for evidence based medicine. However, I think you are on the right track with dropping the term alternative medicine. That was similar to my argument about dropping the term paranormal in as much as there is no such thing except in fiction.

"There is some [sufficient/pretty good/etc.] evidence for that treatment [drug/herb/etc.]."
"[X] may be a credible treatment option but there isn't enough research yet to be sure."
"[Y] hasn't panned out to be a credible treatment [drug/herb/etc.]."

I'm using credible instead of proven and disproven, HM, because proven may not be exactly correct. But it could be a viable choice depending on how concrete of a thinker one's target audience was.

Using the term junk medicine again has a marketing goal, not a technical goal. While one could get rid of the term alternative medicine most of the time, there's still a need for a term to use with these whole systems of treatment like homeopathy. Junk science is already in use. That's why I thought junk medicine would be a useful term to convey a message. I don't understand your objection here, HM. Do you see using the term as elevating junk medical providers in some way?
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HalfMooner
Dingaling

Philippines
15831 Posts

Posted - 06/12/2006 :  03:03:00   [Permalink]  Show Profile Send HalfMooner a Private Message
quote:
Originally posted by beskeptigal
Using the term junk medicine again has a marketing goal, not a technical goal. While one could get rid of the term alternative medicine most of the time, there's still a need for a term to use with these whole systems of treatment like homeopathy. Junk science is already in use. That's why I thought junk medicine would be a useful term to convey a message. I don't understand your objection here, HM. Do you see using the term as elevating junk medical providers in some way?

Not a biggie to me, but are the established quacks really "medical providers" at all? Is using the terms, "medical" and "medicine" in relationship with them letting them get away with controlling the language? Because aren't those the very key words in any fight over terminology? To use military analogy again, take the high ground.


Biology is just physics that has begun to smell bad.” —HalfMooner
Here's a link to Moonscape News, and one to its Archive.
Edited by - HalfMooner on 06/12/2006 03:06:59
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dv82matt
SFN Regular

760 Posts

Posted - 06/12/2006 :  04:23:01   [Permalink]  Show Profile Send dv82matt a Private Message
I couldn't agree more B'gal. As far as terminology goes I'd suggest 'pseudo-medicine' rather than 'junk medicine'. Junk suggests low value to me which still gives it too much credit IMO.
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filthy
SFN Die Hard

USA
14408 Posts

Posted - 06/12/2006 :  05:00:15   [Permalink]  Show Profile Send filthy a Private Message
quote:
Originally posted by dv82matt

I couldn't agree more B'gal. As far as terminology goes I'd suggest 'pseudo-medicine' rather than 'junk medicine'. Junk suggests low value to me which still gives it too much credit IMO.

On the contrary, Matt. "Junk" means that it needs to be sent off to the medical version of a knacker's yard and replaced with something that actually has a good chance of working.

The problem, of course, is to show that like a bright paint job on a car with blown transmission and a busted carrier bearing, these "cures" might look good and sound better, but will take you exactly nowhere. And the guy who sold you the car is a thief, as is the purveyor of so-called "alternative medicine." The difference is that the car the guy ripped you off with won't have the potential to kill you.

I am perfectly comfortable with "junk medicine."




"What luck for rulers that men do not think." -- Adolf Hitler (1889 - 1945)

"If only we could impeach on the basis of criminal stupidity, 90% of the Rethuglicans and half of the Democrats would be thrown out of office." ~~ P.Z. Myres


"The default position of human nature is to punch the other guy in the face and take his stuff." ~~ Dude

Brother Boot Knife of Warm Humanitarianism,

and Crypto-Communist!

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Dave W.
Info Junkie

USA
26001 Posts

Posted - 06/12/2006 :  06:48:17   [Permalink]  Show Profile  Visit Dave W.'s Homepage Send Dave W. a Private Message
You know what term has been in use far longer than "junk science," and everyone knows - to some extent - what it means?

Quackery.

Congress even defined the word for use in Federal law, as the promotion of untested or known-to-be-false therapies. The only real education work which needs to be done is to get people to realize that calling something quackery doesn't mean it doesn't work, just that we don't know that it works as "advertised." (I got that a lot in the psoriasis newsgroup: "it worked for me, how can it be quackery?!?")

So, call homeopathy quackery. Forget about calling anyone a "junk doctor" or "junk scientist," call 'em quacks, like they are. It's a perfectly good frame for these discussions. Sure, some folk will take offense to the term, seeing as how the popular conception of a quack is someone who is purposefully conning the unsuspecting out of their cash (while Congress' definition doesn't speak to intent), but I can't imagine that calling someone's pet therapy "junk" will be seen as less of an personal affront.

'Cause people get very defensive about "alternative medicine" which seems to be doing them some good.

- Dave W. (Private Msg, EMail)
Evidently, I rock!
Why not question something for a change?
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HalfMooner
Dingaling

Philippines
15831 Posts

Posted - 06/12/2006 :  10:34:41   [Permalink]  Show Profile Send HalfMooner a Private Message
Dave, you've convinced me. Quackery it should be, especially since you have shown it to be a term with "official" status and a legal definition. Just supply the definition as required. And it certainly addresses my personal objection to describing what quacks do as any kind of "medicine."

However, if we are to use B.'s suggestion of three classes of "treatment," that still leaves the problem of naming the class between quackery and established scientific medicine. What do we call this middle-ground, the gray area of practices that are neither fully accepted, nor fully rejected, by medical science? Some of these practices may fall into the pit of quackery as we learn more, while others may rise to become established medical practice. What term is neither too positive, nor too negative, to describe them as a group?



Biology is just physics that has begun to smell bad.” —HalfMooner
Here's a link to Moonscape News, and one to its Archive.
Edited by - HalfMooner on 06/12/2006 10:40:56
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Dave W.
Info Junkie

USA
26001 Posts

Posted - 06/12/2006 :  12:51:31   [Permalink]  Show Profile  Visit Dave W.'s Homepage Send Dave W. a Private Message
Well, HalfMooner, I can tell you're not quite grokking the definition of quackery. Those therapies which are neither fully accepted nor rejected are whatever they are. If someone promotes them (through advertisements or interviews or popular articles or whatever) as being medically sound treatments for some disease or other, that promotion is what's quackery.

If the definition applied to the therapies themselves, then one would have to say that (for example) Lipitor was (at the start of the R&D) "quackery" simply because it hadn't been through any testing. But nobody, back then, was actually saying, "people should use this right now." Instead, it went through the scientific "gauntlet" successfully prior to being marketed, so it wasn't ever quackish. (And when I said, "call homeopathy quackery," I was referring to the acts and statements of homeopaths, not to the water they sell.)

Now, if you want a one- or two-word descriptor for all the stuff in the gray area, I would suggest "emerging medicine," since that implies an on-going process which may not be successful. Of course, this will immediately be shot down by medical people on the grounds that "emergent medicine" means something rather different, and the near-homonyms will just sew confusion.

- Dave W. (Private Msg, EMail)
Evidently, I rock!
Why not question something for a change?
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HalfMooner
Dingaling

Philippines
15831 Posts

Posted - 06/12/2006 :  13:13:35   [Permalink]  Show Profile Send HalfMooner a Private Message
Dave W. corrected:
quote:
If someone promotes them (through advertisements or interviews or popular articles or whatever) as being medically sound treatments for some disease or other, that promotion is what's quackery.
I understand your meaning, right now. But I'm not sure I will remember it in the future. To employ poorly-used words, it's easy for me to confuse the "verb" quackery, with the "noun" quackery. I mean the practice, which you explain is quackery, vs. the discredited "treatments," such as homeopathy. I suspect a lot of sometimes sloppy thinkers like myself may confuse the two.


Biology is just physics that has begun to smell bad.” —HalfMooner
Here's a link to Moonscape News, and one to its Archive.
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Dave W.
Info Junkie

USA
26001 Posts

Posted - 06/12/2006 :  13:47:16   [Permalink]  Show Profile  Visit Dave W.'s Homepage Send Dave W. a Private Message
No, see, the discredited treatments won't do anything by themselves except slowly turn to dust over time. It takes people - specifically quacks - to promote the discredited treatments as viable alternatives to mainstream medicine.

Adjectives like "useless," "therapeutically bankrupt" or "dangerous" should be applied to fully-discredited treatments themselves.

- Dave W. (Private Msg, EMail)
Evidently, I rock!
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Zebra
Skeptic Friend

USA
354 Posts

Posted - 06/12/2006 :  20:11:12   [Permalink]  Show Profile Send Zebra a Private Message
quote:
Originally posted by beskeptigal

...We need to have three categories.
    1) Alternative medicine for which there is evidence of some benefit.
    2) Alternative medicine for which there may be evidence of some benefit or there hasn't been research ruling it out. (There may be leeway here for arguing when is something sufficiently ruled out.)
    3) Everything else referred to as therapeutic but which has no basis whatsoever like homeopathy.

...But for the things in category #3 it's time to drop the term 'alternative medicine' period. These things are not alternatives, they are nonsensical.


...One would think all we need to do is educate the masses. And hopefully in the long run that will be the end result. But marketing research and marketing successes show us that it isn't just simple imparting knowledge which results in educating people. The language you choose when imparting that knowledge has a large influence on how the knowledge is interpreted and categorized by the learner. Shouldn't we be using the science of marketing and communication while trying to spread the science of evidence?

First, you seem to be talking about therapeutic measures, not diagnostic measures (though there are some bogus moves there, too). In that case, maybe it's easier to take out the term "medicine" & substitute "treatments" - seems like a term that's less loaded with the hope that sometimes gets linked to "medicine".

And then, just to complicate things, #3 could be divided into "useless treatments" and "harmful treatments". Homeopathy is an example of useless treatment, bloodletting an example of harmful treatment. I'll let you each decide where "high colonics" belong.

The "useless treatments" could be called just that, or could be called "placebo treatments". (People just hate thinking they're getting a placebo - especially when they're paying for it!)

Educating the masses to be more skeptical would be great...but hard. Not only is the language important, but there needs to be something that grabs people's attention, personalizes the issue. Here, it seems like quackery is a good route - telling people they might be cheated out of their hard-earned money if they pay quacks for useless or even harmful treatments.

I think, you know, freedom means freedom for everyone* -Dick Cheney

*some restrictions may apply
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Dave W.
Info Junkie

USA
26001 Posts

Posted - 06/12/2006 :  20:51:13   [Permalink]  Show Profile  Visit Dave W.'s Homepage Send Dave W. a Private Message
quote:
Originally posted by Zebra

...bloodletting an example of harmful treatment.
Don't speak too fast, Zebra. Bloodletting is the standard of care for hemochromatosis.

This is, of course, exactly why the FDA approves drugs and therapies for specific diseases, and never gives blanket approval to a drug for all possible uses. For example, zinc pyrithione (ZP) is approved for the treatment of dandruff. The makers of an old product for psoriasis containing ZP as its active ingredient marketed it by saying that its main ingredient was "FDA approved." However, since it was not approved by the FDA for the treatment of psoriasis, the manufacturer got its hand slapped by the FTC for misleading consumers. Later, the FDA released a list of commonly misbranded drugs, and specifically said that ZP has never been shown to be effective for psoriasis, so any product making such claims is "misbranded" and illegal.

Similarly, blanket statements about any treatment being "harmful" must be carefully qualified. Bloodletting certainly lets hemochromatosis patients live a better life, and the benefits far outweigh the risks. Suggesting bloodletting for a hangnail, on the other hand, would be quackery of the first order.

- Dave W. (Private Msg, EMail)
Evidently, I rock!
Why not question something for a change?
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beskeptigal
SFN Die Hard

USA
3834 Posts

Posted - 06/13/2006 :  00:46:58   [Permalink]  Show Profile Send beskeptigal a Private Message
We take a little blood out when people with lung disease have very high red blood cell counts as well if they have heart failure. It's rare, but has been done.

I like the term quack medicine. I'm with HM though in that to me it means the disproven or total woo stuff, not the apparently true definition of promoting an unproven claim. I didn't know that was part of the definition.

For the stuff in the middle category, trying to better define it, it really is something akin to medical practices that have been in use but aren't supported by today's standard of evidence. These practices are generally outside of the modern medical system. But we don't want them to stay out there. We want them to be tested and either added to evidence based medicine or tossed into the quack pile.

In the meantime though, these medicines are being used and people want to use them. If the treatments/meds are not harmful, a better alternative isn't being forgone, and they aren't too expensive, then it's hard to justify calling them quackery. Even though technically they would be when the unproved claims are made. We have to keep in mind that people believe there is evidence for these things in the fact that they've been in use so long.

So, I am going with evidence based medicine and refraining from using the term alternative medicine.

Quack or junk medicine, I think quack might be better. I want to give it more thought and discussion if anyone has more to say.

But I'm still pondering ancient medicine/folk medicine/Eastern medicine, all those seem about the same as alternative medicine. I need something that conveys medicine that is currently being used, and is being used because it was established outside of the evidence based medicine system, but hasn't yet been tested adequately.
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beskeptigal
SFN Die Hard

USA
3834 Posts

Posted - 06/13/2006 :  00:50:54   [Permalink]  Show Profile Send beskeptigal a Private Message
Treatment doesn't cut it Zebra because it includes treatments and medicines. I'm not sure complicating this by throwing in therapeutic measures vs diagnostic measures is helpful. Though I do see where you are coming from there. Therapeutic measures would be the term I'd use instead of medicine but then you are getting into vocabulary that isn't going to make a good talking point.

The word useless has the right connotation.

Better than placebo for what I'm looking for. Placebo has meaning to some people that it works and one is discounting the effects.
Edited by - beskeptigal on 06/13/2006 00:53:57
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