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Kil
Evil Skeptic

USA
13458 Posts

Posted - 08/04/2010 :  07:49:44   [Permalink]  Show Profile  Visit Kil's Homepage  Send Kil an AOL message  Send Kil a Yahoo! Message Send Kil a Private Message  Reply with Quote
Farseeker:
How do I put the above quote from an earlier post into a little blue box?


At the beginning of a quote, put the word quote in the same brackets you used to create blue text. End quote by writing /quote in a bracket. You can also quote a whole post by hitting the reply with quote icon above each post. That's the one with the back arrow. You might want to do that to this post just to see how the quote brackets work. Just don't bother posting it...

Uncertainty may make you uncomfortable. Certainty makes you ridiculous.

Why not question something for a change?

Genetic Literacy Project
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Farseeker
Skeptic Friend

Canada
76 Posts

Posted - 08/04/2010 :  10:52:05   [Permalink]  Show Profile Send Farseeker a Private Message  Reply with Quote
Originally posted by Farseeker

"If the patient believes something will work, then the placebo effect is present. If the doctor believes it will work, then the placebo effect is present. Why else do double blind studies?"

Double-blind studies actually measure the amount of placebo effect going on, even though they're double-blind. The patient is being treated, and the doctor is treating, so they're not blind in the sense that neither party thinks anything is happening. The control groups do not experience zero effects, but instead experience normal placebo effects. If it were otherwise, no control group would be needed.



Yes, thank you, that is my point. Since both the control and the treatment group experience placebo, they balance each other out, more or less. So, if P+treatment = P+result, we can remove P and determine result.(Obviously with only statistical confidence, not absolute confidence)

Then you're arguing against a straw man. Most "clinical results" from alt-med are due to errors in methods or analysis.

Most is not all. Take for example the book "the Cholesterol Myth". It lists reliable studies, points out alternative mechanisms (inflammation, homocystein levels, etc.) and is supported by reputable doctors and researchers. Reasonable people can differ.

So, what I just said was that if some, or even most of a group are wrong, that does not mean every member of a group is wrong. Especially if the "opposition" gets to define who is in a specific group.


Laypeople might suggest placebo or remission first simply because they can't mount a proper critique of an article, but laypeople aren't an appropriate group to decide the value of a study.

I am not sure if you are supporting my point or not. It depends on what you call the medical doctor that is deciding what therapies I need. I would not call him (generally speaking) an expert in biology, biochemistry, nutrition, toxicology, etc. To me, he is a layperson in these fields.

Another point is that ultimately, laypeople have to take the consequences of any decision made. Again, let's take the Cholesterol example. My doctor told me to eat margarine, not butter. Yet today we know the margarine of that time contained trans fats, many times more harmful than the butter. I got the consequences. As such, I need to be a skeptic and balance any authoritarian "expert" medical opinion with a request for proof, preferably based on biochemistry.

Where are the studies which show that to be true? It's quite a bold claim for you to just plop it out there without supporting evidence.

That is a good question. I take your point. I got carried away, as I wanted to discuss removal of a double standard. Change the word "Mexican" to Japanese, Swiss, British, German, Russian, and then I am more comfortable. Perhaps I was overly influenced by celebrity endorsements.

That said, American insurance companies do pay for out of country medical care in Mexico. Have they submitted their data for analysis? I do not know, but I used to work in an insurance company, and I know they do gather data and do analysis.

The point of my discussion is not to favor any specific alternative approach, but to be skeptical of current methods as applied, and to ask for the removal of a double standard.

Wow, that's just insane. Want to try to rephrase that into something more rational?


Ok, lets take it a step at a time.

Radiation therapy saves a life sometimes.
Radiation therapy does not save a life at other times, for whatever reason.
We know that some of the time the results for a therapy are due to placebo.
Clear?

The point is, blind faith in a treatment often (not always) leads to it being applied at inappropriate times. Does the reason matter?

Again, let me point to the prior reference to radiation therapy that had "No statistically significant or important difference in overall, cancer-specific survival".
.
Here is a quote, followed by the supporting studies: Remember, I am not suggesting anything other than skepticism of unquestioningly accepting the orthodox approach, and radiation is just a "for instance".

The studies quoted are fairly old, but the principles are valid. Namely, that intervention can promote metastasis while at the same time stress the immune system, thus affecting outcomes. They even show therapy VS doing nothing statistics. (I do not support doing nothing, but that is just a personal opinion).

from http://www.whale.to/a/last.html
"German comparison found that untreated post-menopausal women with breast cancer live longer than treated women, and the recommendation was not to treat postmenopausal women for breast cancer.6
This conclusion confirms a finding by Ernst Krokowski, a German professor of radiology. He demonstrated conclusively that metastasis is commonly triggered by medical inter­vention, including sometimes even by a biopsy or surgery unrelated to the cancer.7

6. Oregl, A., "Die Lebenserwartung des unbehandelten Mammakarzinoms" ("The life expectancy of the untreated mamma carcinoma [breast cancer]"), Klin. Wschr. 41:676 (1963)

7. Krokowski,EJl,"IstheCurrentTreatrnentofCancer Self-Limiting in the Extent of its Success?", /. Int. Acad. Preventive Medicine 6(1) 23-39 (1979)


No, it works differently on different cancers. Haven't you been paying attention?


Read my earlier post, with studies mentioned, that SOME radiation treatments DOES NOT WORK AT ALL for a whole group of patients. So yes, radiation (which is also a catch all term) works differently or not at all. You have made my point that blind acceptance of what your doctor says is not appropriate, at least for those who got the non-performing treatment. What are you trying to say, beyond the rude tone?

There's generally no refund if alt-med woo doesn't work. In the alt-med world, most failures of treatment are blamed on the patients instead of on the treatment not working. That's the only sure way to keep the money patients coming in.

Alt-med woo is not part of my discussion.
Unless you define everything, everywhere in the world that is not part of the American standard of practice with the pejorative term "alt-med woo".

Actually, there are lots of supplement formulas that promise money back if not satisfied. This is not to imply that their formulas work, but to show that there are people who back their product.

I am concerned about the fact that those receiving financial benefit from a treatment are the ones proposing it. No, I do not have a better idea about how to minimize the bias from this, beyond be obvious of being skeptical of the claims, asking for disclosure of financial ties to the recommended therapy and using the whole world as a resource.

Because you have a completely unreasonable definition of "working."
To keep it simple, lets again, reference the study I mentioned earlier.
"Literature review. 243 articles,
185 single-institution retrospective,
9 non-randomized trials,
8 randomized trials


o Outcome: No statistically significant or important difference in overall, cancer-specific survival or total serious adverse events"
my bold

I do not understand why you are attacking me. Am I really unreasonable to ask that a treatment has a better than No statistically significant or important difference in overall, cancer-specific survival?

Of course, you seem to know my definition of "working", whereas, to be frank, I would actually have to think about how I would define that. I just no that "no significant effect" is not good enough.

Yeah, and every level of radiation they used was enough to kill an adult human, but the flour beetles survived very well. Different biology, different results. What's your point here?
My point here is that "same biology, different result." Some flour beetles died, some lived.

Yes, you're stating the obvious. What's your point?
What's obvious to you may not have been obvious to others. It was part of my response to another person, but since it is obvious to you, no more need be said.

That's mistakes in practice, not mistakes in theory.
Now who is making bold statements.
Also, I did not state that all the doctor/hospital/drug related deaths were faulty theory, though I will say some of them are. Again, it depends on how you define "death due to faulty theory".

If I die of an operation that was only performed because of a faulty theory, can I attribute at least part of the blame to the theory?

Again, let's take "the Cholesterol Myth". If my arteries got clogged up due to the trans fats recommended by the medical professionals (margarine) and then I died for whatever reason on the operating table, who or what do I blame?
Is the faulty theory not at least partly to blame?

Another straw man. Drugs are withdrawn every year because they kill too many people. Nobody is arguing that drugs are free from risk. The recent highly publicized drug withdrawals were all because the risk of death was higher on the market than what was reported to the FDA during trials (for a variety of reasons, some unethical), and not because some drug was "death-free" during trials and only killed people once it got out into the public.

I was making the point that one had to be skeptical of the recommended treatment one is given. Obviously, the approved drugs, despite being recommended by one's doctor, killed more people than expected. To simplify, they had originally gotten the risk / reward ratio wrong.

Yes, both "safe" and "effective" are relative terms, and there is no set standard for every drug and every disease. A drug is "safe" if it kills fewer people than who would die of their disease(s) anyway, not because it doesn't kill at all.
Just not true. For example one company's Cox2 inhibitors (a pain med) where withdrawn because it killed. It is a pain med, no one died from arthritis because they did not take this med. There are other pain meds.

A drug is "effective" if it causes more-frequent remission of disease to a statistically significant extent than leaving that disease untreated, not because it works on everyone.
Are you saying pain meds cure disease? No one argues that the drug reduced pain, so it is effective in that sense.

In fact, many, many drugs are just symptom relievers and cure nothing. Do I really need to point out examples?

But when these "symptom relievers" kill people, what is the cost/benefit, especially if there are alternatives from a different drug company?

We must first be skeptical of our own understandings of medical science, and not leap to attack straw men that bear little resemblance to the real world.

Is that stating the obvious? Or is it saying that I should just be quiet?

What level of medical science understanding must I have before I question one small part of it? Why can I not be a skeptic and demand proof before you perform an intervention on my person?

History is full of "medical experts" being wrong, fundamentally wrong. Recently, the homocystein theory of cardiovascular disease is a good case in point where the latest research supports an idea that is decades old and was previously "discredited".

...though, on second thought, on another level, does not the act of reasonable questioning have some value, even if only to inform an audience?
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Dr. Mabuse
Septic Fiend

Sweden
9666 Posts

Posted - 08/04/2010 :  11:19:13   [Permalink]  Show Profile  Send Dr. Mabuse an ICQ Message Send Dr. Mabuse a Private Message  Reply with Quote
Originally posted by Farseeker

Again you pretend that a double blind test is the only way to provide evidence that a certain treatment works. Perhaps you'll actually acknowledge it this time.

How do I put the above quote from an earlier post into a little blue box?

Exactly the same way you made the text blue, except use the icon that looks like instead of the "color" drop-down list.

Or simply replace blue with quote.

Dr. Mabuse - "When the going gets tough, the tough get Duct-tape..."
Dr. Mabuse whisper.mp3

"Equivocation is not just a job, for a creationist it's a way of life..." Dr. Mabuse

Support American Troops in Iraq:
Send them unarmed civilians for target practice..
Collateralmurder.
Edited by - Dr. Mabuse on 08/04/2010 11:22:46
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Farseeker
Skeptic Friend

Canada
76 Posts

Posted - 08/04/2010 :  11:58:39   [Permalink]  Show Profile Send Farseeker a Private Message  Reply with Quote
When it comes to medicine, I see a deplorable lack of flexibility and way too much reliance on "authority". Call me skeptical...

I'd call you skeptical if you didn't trot out the authority of studies which allegedly demonstrate things which you want to be true. Why is it okay for you to rely on such things, and not doctors?


Wow, what a shot! harsh.

I believe I said "way too much reliance", not "do not rely on".

Yes, I select studies to prove my point in a discussion. If I don't, I would guess you would berate me with making bold statements without "proof".

I am quite happy to have my doctor rely on studies. But I would wish he/she would also employ a little skepticism rather than blind faith. I am personally lucky, as my doctor does explain her reasoning for every treatment she recommends for me.


Yeah, just ignore the "for example" and try to turn it into something I didn't mean, why don't you? If you're going to argue against straw men often, perhaps you should avoid preaching about proper skepticism.


I take offense to your term "preaching". It is just my opinion.

If I misinterpreted the intent of your reply, I apologize. However, let me explain why I interpreted like I did.

Retrospective correlational studies combined with a solid biological mechanism can provide the evidence needed for a cause-and-effect relationship lacking any direct experimentation. For example, once all other variables are accounted for, patients undergoing radiation therapy live longer than patients who don't get it.


I took the "for example" to be a statement of fact supporting the earlier statement about
Retrospective correlational studies combined with a solid biological mechanism can provide the evidence needed for a cause-and-effect relationship lacking any direct experimentation.


I did not agree with that statement of fact as a blanket truth in all cases, hence my reply. But if you meant that good things CAN happen sometimes from such studies even in the absence of experimental proof, then of course, you are right.

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Dave W.
Info Junkie

USA
25976 Posts

Posted - 08/04/2010 :  14:00:58   [Permalink]  Show Profile  Visit Dave W.'s Homepage Send Dave W. a Private Message  Reply with Quote
Originally posted by Farseeker

Then you're arguing against a straw man. Most "clinical results" from alt-med are due to errors in methods or analysis.

Most is not all.
You used the word "often." I'm suggesting that more often than not, alt-med studies are criticized correctly, and not just hand-waved away by claiming "remission" or "placebo," as you suggested they "often" are.
Take for example the book "the Cholesterol Myth". It lists reliable studies, points out alternative mechanisms (inflammation, homocystein levels, etc.) and is supported by reputable doctors and researchers. Reasonable people can differ.
And how has it been dismissed? Is anyone ignoring the book by saying "placebo" or "remission" and letting it go at that?
So, what I just said was that if some, or even most of a group are wrong, that does not mean every member of a group is wrong. Especially if the "opposition" gets to define who is in a specific group.
That's actually irrelevant to what you were saying and what I was criticizing.
Laypeople might suggest placebo or remission first simply because they can't mount a proper critique of an article, but laypeople aren't an appropriate group to decide the value of a study.

I am not sure if you are supporting my point or not. It depends on what you call the medical doctor that is deciding what therapies I need. I would not call him (generally speaking) an expert in biology, biochemistry, nutrition, toxicology, etc. To me, he is a layperson in these fields.
I guess I have to remind you about what you were saying: you said, "I am just arguing against a double standard, as so often any clinical result done by alternative doctors is dismissed as either placebo or remission." I was suggesting that laypeople often don't have the skills to be able to properly critique a study. Most family doctors don't, either.
Another point is that ultimately, laypeople have to take the consequences of any decision made. Again, let's take the Cholesterol example. My doctor told me to eat margarine, not butter. Yet today we know the margarine of that time contained trans fats, many times more harmful than the butter. I got the consequences. As such, I need to be a skeptic and balance any authoritarian "expert" medical opinion with a request for proof, preferably based on biochemistry.
Then you're going to be waiting a long time, since even double-blind studies are correlational, and not "proof" of anything.
Where are the studies which show that to be true? It's quite a bold claim for you to just plop it out there without supporting evidence.

That is a good question. I take your point. I got carried away, as I wanted to discuss removal of a double standard. Change the word "Mexican" to Japanese, Swiss, British, German, Russian, and then I am more comfortable. Perhaps I was overly influenced by celebrity endorsements.
Still, where is the evidence that alt-med clinics are being successful in treating disease in any of those countries?
The point of my discussion is not to favor any specific alternative approach, but to be skeptical of current methods as applied, and to ask for the removal of a double standard.
As far as alt-med is concerned, the double standard exists thanks to alt-med people often refusing to submit their therapies to appropriate scientific testing, yet marketing them and using them on people anyway. If we were to mandate that all medical procedures go through the highest ethical amount of testing possible, then that would be a single standard, and many of the alt-med folks would get busted. Which is what you seemed to be criticizing in your first post here, other people's reasonable demands that alt-med go through proper testing. You implied that that's just an attempt to shut them out using the law instead of science. It's quite the opposite.

Wow, that's just insane. Want to try to rephrase that into something more rational?

Ok, lets take it a step at a time.

Radiation therapy saves a life sometimes.
Radiation therapy does not save a life at other times, for whatever reason.
We know that some of the time the results for a therapy are due to placebo.
Clear?
Clear as mud.
The point is, blind faith in a treatment often (not always) leads to it being applied at inappropriate times.
Please provide evidence that anyone has "blind faith" in any mainstream medical treatment. Note that "blind faith" criticisms cannot fairly include things about which we had zero evidence at the time (trans fats in margarine, for example).
Again, let me point to the prior reference to radiation therapy that had "No statistically significant or important difference in overall, cancer-specific survival".
You should really do what Ricky suggested, and read that article. It was comparing one form of radiation therapy to other forms of radiation therapy, and found no difference. It's not saying that radiation therapy doesn't work, it's saying that there's no evidence that charged-particle radiation therapy works better (or worse) than regular photon radiation therapy. And it's only saying that because people haven't done the comparative studies needed, while it's obvious that charged-particle radiation therapy has some advantages in certain cases over other forms of irradiation.
Here is a quote, followed by the supporting studies: Remember, I am not suggesting anything other than skepticism of unquestioningly accepting the orthodox approach, and radiation is just a "for instance".
And I'm saying that nobody involved in medical research unquestionably accepts anything.
The studies quoted are fairly old, but the principles are valid. Namely, that intervention can promote metastasis while at the same time stress the immune system, thus affecting outcomes. They even show therapy VS doing nothing statistics. (I do not support doing nothing, but that is just a personal opinion).

from http://www.whale.to/a/last.html
Okay, this is a joke, right? You have to be able to come up with a better source than whale.to There's no reason to go to that crank. Find the studies (and the quotes) elsewhere, please.
"German comparison found that untreated post-menopausal women with breast cancer live longer than treated women, and the recommendation was not to treat postmenopausal women for breast cancer.6
This conclusion confirms a finding by Ernst Krokowski, a German professor of radiology. He demonstrated conclusively that metastasis is commonly triggered by medical inter­vention, including sometimes even by a biopsy or surgery unrelated to the cancer.7

6. Oregl, A., "Die Lebenserwartung des unbehandelten Mammakarzinoms" ("The life expectancy of the untreated mamma carcinoma [breast cancer]"), Klin. Wschr. 41:676 (1963)

7. Krokowski,EJl,"IstheCurrentTreatrnentofCancer Self-Limiting in the Extent of its Success?", /. Int. Acad. Preventive Medicine 6(1) 23-39 (1979)
The age of the sources is, indeed, highly relevant because we've learned so much. "Untreated" means much different things then than it does now. Can you find anything more recent?
Read my earlier post, with studies mentioned, that SOME radiation treatments DOES NOT WORK AT ALL for a whole group of patients.
No, it doesn't say that at all. That review says that one particular type of radiation doesn't necessarily work better than others. Not that it "DOES NOT WORK AT ALL." That's just a completely false description of the review in question.
You have made my point that blind acceptance of what your doctor says is not appropriate, at least for those who got the non-performing treatment.
I'm all for patient empowerment, but the average patient doesn't have the time or inclination to do the studying necessary to really understand the sorts of evidence that doctors have available to them, and they certainly won't be delaying their treatment to get up-to-speed on the latest in molecular biology, genetics and all those other sub-sub-disciplines. That doesn't mean that a patient is left with "blind acceptance" of what their doctor says, since the schooling and licensing requirements for doctors exist in order to help patients to not have to be their own doctors. Standards of care exist for a reason, and it's to ensure that doctors act with the best current knowledge that we have in hand. That's not "blind acceptance," but is instead "trust but verify."
What are you trying to say, beyond the rude tone?
Rude tone? Are you kidding me? You've been here lecturing us on skepticism with smugness and an air of superiority while attacking straw men and mischaracterizing medical studies and you have the gall to accuse me of having a rude tone?
Alt-med woo is not part of my discussion.
It's what this thread is about, and it's what was talked about as perhaps amenable to a legislative solution when you commented about not using the law to silence our opponents. Alt-med woo is all this thread was about before now.
Unless you define everything, everywhere in the world that is not part of the American standard of practice with the pejorative term "alt-med woo".
Nope. Not interested in that.
Actually, there are lots of supplement formulas that promise money back if not satisfied. This is not to imply that their formulas work, but to show that there are people who back their product.
I said "generally." I know there are some who offer money back, but that certainly isn't the norm. And supplements are hardly the bell-weather of the alt-med industry as a whole.
I am concerned about the fact that those receiving financial benefit from a treatment are the ones proposing it.
You'll never escape that.
No, I do not have a better idea about how to minimize the bias from this, beyond be obvious of being skeptical of the claims, asking for disclosure of financial ties to the recommended therapy and using the whole world as a resource.
Since any family doctor with no ties at all to any manufacturer still makes money from his patients for the mere act of treating, the two cannot be divorced.
Because you have a completely unreasonable definition of "working."
To keep it simple, lets again, reference the study I mentioned earlier.
"Literature review. 243 articles,
185 single-institution retrospective,
9 non-randomized trials,
8 randomized trials

o Outcome: No statistically significant or important difference in overall, cancer-specific survival or total serious adverse events"
my bold

I do not understand why you are attacking me. Am I really unreasonable to ask that a treatment has a better than No statistically significant or important difference in overall, cancer-specific survival?
Apparently, yes you are being unreasonable, because you think that that review says that radiation doesn't work. That review doesn't say that at all. It says something quite different.

What you're saying is analogous to saying that because there's no statistical difference in headache reduction times or serious adverse events between aspirin and acetominophen, that must mean that acetominophen doesn't work. It's ridiculous.
Of course, you seem to know my definition of "working", whereas, to be frank, I would actually have to think about how I would define that. I just no that "no significant effect" is not good enough.
Except that it's "no significant difference in effect."
My point here is that "same biology, different result." Some flour beetles died, some lived.
Wow, you really think that those flour bettles were all genetic clones with the same pre-experiment exposures to the environment? You're going to have to come up with some hard evidence that they actually all had the "same biology."
If I die of an operation that was only performed because of a faulty theory, can I attribute at least part of the blame to the theory?
Sure.
Again, let's take "the Cholesterol Myth". If my arteries got clogged up due to the trans fats recommended by the medical professionals (margarine) and then I died for whatever reason on the operating table, who or what do I blame?
Is the faulty theory not at least partly to blame?
The theory was faulty. But at the time, you couldn't have known it. The next time you have a serious condition, will you delay all treatment until you have "proof" that the treatment being suggested will work on you and not have any drastic side-effects? If so, you'll be waiting until you die, because it's unreasonable to ask for such "proof."
I was making the point that one had to be skeptical of the recommended treatment one is given.
And I don't disagree with that in principle. Practically, there has to be a limit to skepticism because not everyone can get a PhD in cardiology before accepting treatment for the heart attack they just had.
Obviously, the approved drugs, despite being recommended by one's doctor, killed more people than expected. To simplify, they had originally gotten the risk / reward ratio wrong.
Which isn't to say that there was allegedly no risk at all, which is what you were suggesting before.
Just not true. For example one company's Cox2 inhibitors (a pain med) where withdrawn because it killed. It is a pain med, no one died from arthritis because they did not take this med. There are other pain meds.
Okay, you're probably talking about Vioxx, here, which kills people through heart attacks and strokes. People with arthritis tend to be older, and so tend to have more heart attacks and strokes. If a patient in a trial has a heart attack or a stroke, do you attribute it to the drug? What Merck found was that people were almost twice as likely to die will taking Vioxx than people taking placebos. But people on the placebo died during the trials for the drug, too. From heart attacks and strokes, not from arthritis. The drug was thought to be safe, at first, because the earlier trials were too short to see these effects (the risk is only so greatly increased after 18 months of being on the drug).
Are you saying pain meds cure disease?
Oh, forcryingoutloud. I was speaking in general terms, I couldn't read your mind to know that you were specifically interested in Vioxx. Don't act like I should have known.
No one argues that the drug reduced pain, so it is effective in that sense.
Again, you were arguing something quite different. Do I need to re-quote you again?
In fact, many, many drugs are just symptom relievers and cure nothing. Do I really need to point out examples?
Now who's got the rude tone?
But when these "symptom relievers" kill people, what is the cost/benefit...
Let's see... commit suicide because of all the pain, or reduce the pain and take a chance of dying because of the drug. Hmm...

Sure, Vioxx wasn't that great, but the cost/benefit analysis for any drug has to be left up to the patient and doctor to work out together, within reasonable limits. If I sprain my ankle, nobody in their right medical mind would offer me morphine for the pain. If I've got end-stage metastatic small-cell lung cancer, it's likely that anything less powerful than morphine will be ineffective.
...especially if there are alternatives from a different drug company?
Now I'm back to not understanding your complaints. Every drug has side effects.
We must first be skeptical of our own understandings of medical science, and not leap to attack straw men that bear little resemblance to the real world.

Is that stating the obvious? Or is it saying that I should just be quiet?
It's stating that you need to go back and look critically at your own ideas.
What level of medical science understanding must I have before I question one small part of it?
Um, you should understand it before criticizing it, that's for sure. If you don't understand it, how can you mount a valid criticism?
Why can I not be a skeptic and demand proof before you perform an intervention on my person?
There is no "proof" in science so you're demand is unreasonable.
History is full of "medical experts" being wrong, fundamentally wrong.
Yup. And the future will be full of medical experts who are wrong, too. The quest for omniscience is folly. Refusing to be satisfied while the possibility of error exists is to refuse to be satisfied, forever.
...though, on second thought, on another level, does not the act of reasonable questioning have some value, even if only to inform an audience?
So long as the questioning is relevant and doesn't misrepresent the truth. Unlike, for example, questioning the use of radiation therapy by pointing to a comparative study which found no difference between therapies and claiming that it "DOES NOT WORK AT ALL." That's not skepticism, it's ignorance.

- Dave W. (Private Msg, EMail)
Evidently, I rock!
Why not question something for a change?
Visit Dave's Psoriasis Info, too.
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Dave W.
Info Junkie

USA
25976 Posts

Posted - 08/04/2010 :  14:03:10   [Permalink]  Show Profile  Visit Dave W.'s Homepage Send Dave W. a Private Message  Reply with Quote
Originally posted by Farseeker

But if you meant that good things CAN happen sometimes from such studies even in the absence of experimental proof, then of course, you are right.
That'd be why I used the word "can." It was right there in what you quoted.

- Dave W. (Private Msg, EMail)
Evidently, I rock!
Why not question something for a change?
Visit Dave's Psoriasis Info, too.
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H. Humbert
SFN Die Hard

USA
4574 Posts

Posted - 08/04/2010 :  14:17:24   [Permalink]  Show Profile Send H. Humbert a Private Message  Reply with Quote
Originally posted by Dave W.
Okay, this is a joke, right? You have to be able to come up with a better source than whale.to There's no reason to go to that crank.
I somehow stumbled onto that site last night (maybe through following a link). Holy shit, is there some crazy stuff there! I clicked on an article titled God as Allopathy and was greeted with this opening line:
The lie of atheism is promoted by the Cartel though the media and State, to cut off our Higher Self connection (called soul murder carried to extreme) so our inbuilt need to believe in God can be transferred onto covert pseudo-Gods (false idols) such as political parties, with the main one being Allopathy (disguised under terms such as "Modern", "Conventional," "Orthodox, and "Evidence based," Medicine) which becomes a secular religion and explains why some people have such problems giving up belief in vaccination, and modern medicine.

That's some weapons grade insanity right there.


"A man is his own easiest dupe, for what he wishes to be true he generally believes to be true." --Demosthenes

"The first principle is that you must not fool yourself - and you are the easiest person to fool." --Richard P. Feynman

"Face facts with dignity." --found inside a fortune cookie
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Dave W.
Info Junkie

USA
25976 Posts

Posted - 08/04/2010 :  14:50:34   [Permalink]  Show Profile  Visit Dave W.'s Homepage Send Dave W. a Private Message  Reply with Quote
Originally posted by H. Humbert

That's some weapons grade insanity right there.
And the guy's been going at it for years, too. I got his crap thrown at me in psoriasis discussions back in the late 90s, I think.

- Dave W. (Private Msg, EMail)
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Why not question something for a change?
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Farseeker
Skeptic Friend

Canada
76 Posts

Posted - 08/04/2010 :  14:59:49   [Permalink]  Show Profile Send Farseeker a Private Message  Reply with Quote
Thank you for the attention you have given my, obviously not optimally expressed, ideas. Either you intentionally misrepresent my points, or we view life differently. I will assume the latter.

I got into this discussion because of personal experience with the medical system. Yes, you are right, I can not become an expert on every aspect, or even a significant portion, of medical science.

But my doctor has to know how to help all her patients, I just have to learn enough to make informed decisions about my case (or my mother-in-law's case, who was diagnosed with pancreatic cancer, or my mother who was diagnosed with skin cancer, or my father, who was diagnosed with Parkinsons, or my close friend who was diagnosed with high blood pressure and high cholesterol, etc.

I do not need to take everything down to the point of the actual study right away. I can use the popular press (I do not mean newspapers, but Readers Digest, Popular Science, Scientific American, etc) as signposts to point the way to where further research is warranted.

And then what do I have left other than to use my "life skills" to make sense of it all?

You are right, I misread the foundation for the "radiation treatment" issue, as that is not what I wanted to talk about, and foolishly did a quick internet look up of failed radiation treatments. Mea culpa. I should known better than to be hasty.

I still believe radiation therapy has a less than stellar success rate, but I do not want to spend any more time discussing it. I have admitted my error.

In both my mother-in-law's case, and my mother's case, the attending doctor did not recommend it, so I did not specifically study it.

As an aside, in some countries doctors are on salary, thus having no direct profit from recommending any particular therapy. I am not judging whether this is better or worse, just pointing out... this model does exist. Even in America, are the doctors in the army not paid like that?

When I had my heart attack in the early 90's, Dr. Dean Ornish was publishing results showing he could reverse heart disease. My Canadian Cardiologist would not even discuss Ornish's findings with me and insisted I would need a bypass, or die. The Framingham study was under way by then, yet when I suggested vitamin E and aspirin as a blood thinner, I was dismissed out-of-hand.

They loaded me up with statins, beta blockers (which they forgot to mention would also slow my brain and make me stupid) and tried to give me diuretics and blood thinners. I increased potassium and took vitamin E and aspirin instead.

Still, I lived daily with near debilitatiing chest pain(angina).
Finally, I discovered that CoQ10 is depleted with statin medication, and that starves the heart of needed nutrients, causing pain. It is now accepted by mainstream practice, but it wasn't 15 years ago. CoQ10 takes my pain away. I can function again.

So you see, some facts are obvious.
1. I am not dead yet
2. I learned a lot via Google
3. Some (not all) supplements are definitely of theraputic value.
4. My doctors were typically 5 to 10 years behind the current research.

You are quite right that I can not expect to wait for total proof. But I want to look at the biochemical foundation behind the recommendations. Give me a web site, or give me a pamphlet, or a suupport group.

As a system's analyst, responsible for multiple multi-mllion dollar computerization projects, it was often my job to go in and tell and "old-timer" that a computer algorithm was about to significanly change his department's life. Oh, and then I had to ask "please help me implement this and possibly make you obsolete".

My projects always worked. On time, on budget is what got me promoted. I like to think it was my ability to grasp the essentials of whatever discipline I was "computerizing", as they called it. I like to think it was because I respected the prior people's expertise. I like to think, it was because I followed a logical thread through the miasma of human interactions.

I like to think, it was because I was a skeptic, and questioned relevant items while not wasting time questioning the irrelevant.

Which brings me to the point I was trying to make. North American "standard" medical care is not perfect. I will quote a fictitional character from TV show called House to illustrate a point. "I may not save as many patients as you do, but I will kill less".

That is what I want from my doctor, to not kill me. If my prognosis is bad, tell me, let me draw on other resources. Just maybe, someone in Japan found something that works.

Ted
Ted
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Farseeker
Skeptic Friend

Canada
76 Posts

Posted - 08/04/2010 :  15:22:52   [Permalink]  Show Profile Send Farseeker a Private Message  Reply with Quote

Again, let's take "the Cholesterol Myth". If my arteries got clogged up due to the trans fats recommended by the medical professionals (margarine) and then I died for whatever reason on the operating table, who or what do I blame?
Is the faulty theory not at least partly to blame?

The theory was faulty. But at the time, you couldn't have known it.


There were suggestions in the scientific literature as early as 1988 that trans fats could be a cause of the large increase in coronary artery disease.[13][14]
13.
# ^ a b Ascherio A, Stampfer MJ, Willett WC. "Trans fatty acids and coronary heart disease". http://www.hsph.harvard.edu/reviews/transfats.html. Retrieved 2006-09-14.
14.
# ^ Booyens J, Louwrens CC, Katzeff IE (1988). "The role of unnatural dietary trans and cis unsaturated fatty acids in the epidemiology of coronary artery disease". Medical Hypotheses 25 (3): 175–182. doi:10.1016/0306-9877(88)90055-2. PMID 3367809.

Certainly, by 1992 I had read enough to convince myself. Sorry, I do not remember the specifics, but I was convinced trans fats were junk.

Also, I read about the homocysteine theoryy of heart disease proposed as early as 1969. I took massive amounts of folic acid. In retrospect, this may explain... well, why go on. This is just anecdotal.

I guess my point is, the research had been done, some people saw the relevance. When my life was at stake, I chose biochemistry over "belief".

Sometimes, it pays to be a skeptic.




























































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Ricky
SFN Die Hard

USA
4907 Posts

Posted - 08/04/2010 :  15:58:06   [Permalink]  Show Profile  Send Ricky an AOL message Send Ricky a Private Message  Reply with Quote
Which brings me to the point I was trying to make. North American "standard" medical care is not perfect.


You may claim that was your intention, but from your posts here it would seem as this is a deception. Your previous thesis at least appeared to be that doctors, nationally, were not using evidence to decide upon which treatments to use, and instead knowledgeably or ignorantly tried to tow the party line. You have since seemed to fall back to the statement: medical professionals have made mistakes.

Of course, if that was your original point, then the most you would have gotten out of any of us was, "Duh."

My doctors were typically 5 to 10 years behind the current research.


Sounds like a reasonable amount of time to take a plausible idea and turn it into a practical treatment.

Why continue? Because we must. Because we have the call. Because it is nobler to fight for rationality without winning than to give up in the face of continued defeats. Because whatever true progress humanity makes is through the rationality of the occasional individual and because any one individual we may win for the cause may do more for humanity than a hundred thousand who hug their superstitions to their breast.
- Isaac Asimov
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Dave W.
Info Junkie

USA
25976 Posts

Posted - 08/04/2010 :  16:56:11   [Permalink]  Show Profile  Visit Dave W.'s Homepage Send Dave W. a Private Message  Reply with Quote
Originally posted by Farseeker

Again, let's take "the Cholesterol Myth". If my arteries got clogged up due to the trans fats recommended by the medical professionals (margarine) and then I died for whatever reason on the operating table, who or what do I blame?
Is the faulty theory not at least partly to blame?

The theory was faulty. But at the time, you couldn't have known it.
There were suggestions in the scientific literature as early as 1988 that trans fats could be a cause of the large increase in coronary artery disease.
But the time at which medical professionals started to recommend switching from butter to margarine was long before 1988. I remember thinking I was eating healthier by pouring squeeze margarine over stuff instead of slathering it in butter, back when I was just becoming a teenager in the late 1970s.
I guess my point is, the research had been done, some people saw the relevance. When my life was at stake, I chose biochemistry over "belief".
But that's not the choice you're talking about. You're choosing to ride closer to the cutting edge than doctors who are more conservative. They're often 5-10 years behind the research because such conservatism is protective against fads and/or poor research.

Yes, not using cutting-edge research as a basis for treatment will lead to some people dying who didn't have to, but so will using cutting-edge medicine that hasn't been fully fleshed-out.

The latter part is the lesson of Vioxx. Doctors who were 20 years behind never gave any of their patients Vioxx, and so didn't kill anyone accidentally with it. On the other hand, hypothetical doctors who are 80 years behind the research are still trying to control infection with sulfa drugs instead of the much more effective and safe penicillin.

And it's somewhat ironic that current research suggests that vitamin E is not heart protective, so your doctor was being appropriately conservative in hindsight. But you're apparently using (at least) five-year-old research that says otherwise. Aspirin, on the other hand, had been demonstrated to be heart-protective in the late 1980s, so your doctor was being inappropriately conservative in the 1990s.

- Dave W. (Private Msg, EMail)
Evidently, I rock!
Why not question something for a change?
Visit Dave's Psoriasis Info, too.
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Farseeker
Skeptic Friend

Canada
76 Posts

Posted - 08/04/2010 :  18:46:34   [Permalink]  Show Profile Send Farseeker a Private Message  Reply with Quote

Yes, not using cutting-edge research as a basis for treatment will lead to some people dying who didn't have to, but so will using cutting-edge medicine that hasn't been fully fleshed-out.

The latter part is the lesson of Vioxx. Doctors who were 20 years behind never gave any of their patients Vioxx, and so didn't kill anyone accidentally with it. On the other hand, hypothetical doctors who are 80 years behind the research are still trying to control infection with sulfa drugs instead of the much more effective and safe penicillin.

And it's somewhat ironic that current research suggests that vitamin E is not heart protective, so your doctor was being appropriately conservative in hindsight. But you're apparently using (at least) five-year-old research that says otherwise. Aspirin, on the other hand, had been demonstrated to be heart-protective in the late 1980s, so your doctor was being inappropriately conservative in the 1990s.


Sorry, I seem to be unable to get my point across. Cultural differences, maybe? Let me try again.

For me, it is not about any specific policy, such as being on the trailing, middle or leading edge of the bell curve of innovation.

It's about employing critical thinking, going to the basis of why some things are recommended and evaluating every major point on its merits. Of course, only to the limit of my ability and that of my friends and such.

BTW, the research seeming to show vitamin E is not effective, seems to be with an artificial form of vitamin E, not the mixed tocopherols with or without toctrianols that some studies find effective. You see, vitamin E is a catch all phrase for several different chemicals. This is where your earlier point, that one should read the actual study, hit home. You were so right!

The Framingham study I relied on was not about the effects of vitamin E directly, but the combination of vitamin E and aspirin as a blood thinner. Believe me, when I cut myself I bled freely until I backed off on the dosage.

Again, thank you for your input.

Ted
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Dave W.
Info Junkie

USA
25976 Posts

Posted - 08/04/2010 :  19:30:07   [Permalink]  Show Profile  Visit Dave W.'s Homepage Send Dave W. a Private Message  Reply with Quote
Originally posted by Farseeker

It's about employing critical thinking, going to the basis of why some things are recommended and evaluating every major point on its merits. Of course, only to the limit of my ability and that of my friends and such.
But you seem to be faulting doctors for not knowing things that they couldn't have known. For not being omniscient. I mean if, five years from now, it's discovered that taking vitamin E and aspirin orally (but not via IV) causes cancer, are you going to be complaining about your doctor not telling you that now?
BTW, the research seeming to show vitamin E is not effective, seems to be with an artificial form of vitamin E, not the mixed tocopherols with or without toctrianols that some studies find effective. You see, vitamin E is a catch all phrase for several different chemicals.
Oh, I know. The things I'd read about it being ineffective were from some rare, honest alt-med people who wouldn't bother with anything "artificial" in the first place.

- Dave W. (Private Msg, EMail)
Evidently, I rock!
Why not question something for a change?
Visit Dave's Psoriasis Info, too.
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Farseeker
Skeptic Friend

Canada
76 Posts

Posted - 08/04/2010 :  23:05:34   [Permalink]  Show Profile Send Farseeker a Private Message  Reply with Quote
But you seem to be faulting doctors for not knowing things that they couldn't have known. For not being omniscient. I mean if, five years from now, it's discovered that taking vitamin E and aspirin orally (but not via IV) causes cancer, are you going to be complaining about your doctor not telling you that now?


Your experience of doctors may be different than mine, as we live under different medical systems.

I feel frustrated in that I seem to lack the talent to make my point.

I fault only those doctors who pretend expertise they do not have. We both agree that doctors are laypeople when it comes to many aspects of medical science, such as biochemistry, orthomolecular medicine, statistical analysis, perhaps even knowing how to properly read a research paper.

An example may illustrate my frustration with our medical practitioners.
My mother-in-law was dying in the hospital because she could not eat. I asked the doctors to provide IV feeding. They refused. I offered to pay the cost. They said it was not allowed. I then took research papers to the department head (a medical doctor too), who read them and then authorized the procedure.

So, see my point? The oncologist who stood in the way of saving her life, did not seem to understand that the chemo he had given caused her inability to eat. I was not asking for alternative anything, just simple, standard TPN (nutrition via iv). Yet when I presented studies I got off the internet in one night's research, his boss saw my point. Since the hospital was paying (under our medical system), it was not a reversal of policy they undertook lightly.

Does the example better illustrate what I am trying to say? I do not expect doctors to know everything. But I also do not want them to block me based on nothing but their lack of current knowledge. I suppose I want more freedom over my own body.

I also resent the doctors who have plainly told me they do not respect work done in other countries. That is an insult to England, France, Germany, etc. and their medical researchers. And some of our doctors feel American doctors are overly controlled by drug companies. I have no personal knowledge that Canadian doctors are any better, though our prescription medication costs are substantially lower. Still, see my point about the attitudes of too many doctors?

In short, I do not expect anyone to be omniscient, but then, neither should they pretend to be.

If my accountant does not keep up with the latest tax changes and gives me bad advice, he is liable. If my doctor does not keep up with the latest research, then he should not give out old advice. I know, there is that bell curve issue, as to when should he change his position.
This is where thinking about a problem properly seems to be of help.

If your only tool is a hammer, then every problem looks like a nail. So, get more tools.

Oh, I know. The things I'd read about it being ineffective were from some rare, honest alt-med people who wouldn't bother with anything "artificial" in the first place.

If you would seriously like the truth of the matter, the official government fact sheet on Vitamin E is here.
http://ods.od.nih.gov/factsheets/vitamine.asp

Please note two things.
1. The studies with the highest number of participants, 90,000 nurses re:CVD and 1 million people re: bladder cancer showed positive results.
2. Many of the studies did not differentiate among the different forms of vitamin E, including synthetic (different molecular structure) vs natural.




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