Wednesday, December 2, 2009

Jus' Sayin'

When medicine -in this day & age- has to deal with a pile of "medical" garbage magically transmuted into "real" medicine in the mind of a political hack...

it's no wonder that real scientists and researchers who spend endless hours, blood, sweat and tears at work...that are hit again and again with the cold whip of comunal criticism, sometimes dispair...

Especially, when all you need to "educate" the masses is to claim to see the "answer"...and if your bullshit is good enough, fanning the flames of madness can be had with but the conjured image of an idea...

Noble reflection of reality and inner intimate connection to THE answer for us all?...

Wednesday, July 15, 2009

Types of Truth...

In a strange way, the truth or "Truth" can have a degree of fuzziness depending on ones perspective. It comes in and out of focus based on the lens one chooses to view it through. In other words, some things are truer than others.

The evolving mind has come up with an intriguing description of this phenomenon and -if nothing else- helps structure this concept so that certain beliefs and philosophies can be categorized more clearly. For example reagrding reality, some points of view concentrate on a tree, others embrace the forest, while others don't even look at trees and concetrate on the "idea" of a tree and still others distill their observations to the worship of scratches and scribbles with no trees in sight.

1. personal truth
A personal truth is what is true for an individual. Personal truths reflect physiological attributes, psychological tendencies and the learning and experiences of an individual.

2. social truth
A social truth is what a distinct group perceives to “be so.” Social truths reflect group history, customs, and values.

3. human truth
A human truth reflects and pertains to the universal dispositions and abilities of our species, Homo sapiens.

Many things that we consider to be inherently true probably reflect distinctive features of human psychology. For instance, because human beings are primates that readily establish and acknowledge dominance hierarchies, the human individual may be predisposed to feeling that there is or could be some entity “greater than me,” whether or not that happens to be true.

4. universal truth
A universal truth is one that all sufficiently intelligent and educated observers, from this planet or any other (should they exist), would conclude to “be so.” For instance, the proportion of a circle’s circumference to its diameter is 3.141592 ( . . . ). This is a universal truth. Any capable, unbiased individual could verify that truth.

A universal truth is the only type of truth that is not relative to the person or group making the claim. Science, by and large, provides us with universal truths. Or it at least aspires to.
Religion, no doubt, reflects social truths, and perhaps, in some regards, human truths as well.

So, this doesn't validate in and of themselves the "new age" philosophies, religions nor postmodernism for example as reality. These edifices are mostly human constructs:

What believers in a religion frequently fail to do is to place possible human truths and their own social truths into a wider perspective.

Good or bad, they are chained and bound well within the subjective bounds of humanity whereas reality expands beyond this realm. Obviously, there may be utility in some of these perspectives, but always if their limitations are acknowledged.

These perspectives or tools work better -if they work at all- at a different level and may or may not reflect reality in a hit or miss sort of way. On the other hand, from a humanistic perspective many of these constructs can serve as useful bridges between us and reality -but again with the caveat that they need to be kept in check.

Reality itself -to an extent- may always be beyond our reach, but there are ways to embrace its essence and approximate an understanding of how things truly are. Here is where the self effacing and correcting community based methodology -science- has proven its worth. It has proven to date to be the most objective human tool available to consistently touch "her" true face.

Acknowledging our humanity in the light of whatever wonders we discover keeps us humbly grounded to ourselves and who we are - just highly social primates on a tiny pale blue dot.

Tuesday, July 14, 2009

That Mitchell and Webb Look: Homeopathic A&E

Just wanted to add a link to this hilarious sketch.
Sadly, it does have a morbid side to it as the last post demonstrates.

Monday, July 13, 2009

Homeopathy: What's the harm?

So, inert placebo based ritualistic practices are harmless and should be tolerated as innocent and benign ?

In context, belief based medicine does a lot more harm than one would guess - but you know that. In a modern, fairly stable society these practices may cause less obvious impacts but -even here- if they hold more sway on every day reality than Bugs Bunny, the Simpsons and flying tea kettles we've got problems.

Imagine then, the consternation of those doctors in the trenches working in parts of the world where anarchy, lawlessness, illiteracy and corruption drip from every pore of society when homeopathy is promulgated as a reality.

Here's hoping the WHO will support their very reasonable and humanitarian plea for support.

"Many people in developing countries urgently need access to evidence-based medical information and to the most effective means of treating these dangerous diseases. The promotion of homeopathy as effective or cheaper makes this difficult task even harder. It puts lives at risk, undermines conventional medicine and spreads misinformation.

We are sure that you will recognise these dangers and ask that you issue a clear international communication condemning the promotion of homeopathy for treating TB, infant diarrhoea, influenza, malaria and HIV. We are sure, too, that you will recognise the urgency of our request, and look forward to your response."

Thursday, June 11, 2009

Spreading the word...

New science based veterinary blog promoting critical thinking!

Though I've been temporarily distracted from my little blog posting hobby, I continue to enjoy the wonderful and thoughtful writings of so many excellent thinkers.

As the scourges of psuedoscience, dogma and crankery continue their assault on reason and so many seem to trod a stuporous mindless path, it's very gratifying to note that there are many knowledgeable folks out there willing to take the time and energy to be "candles in the dark"...beacons of intellectual honesty and authentic reason.

In that vein, I am pleased to bring to your attention a new veterinary medicine site and its associated blog of note chalk full of critical thinking and reasoned posts. Please add The and The Skepvet blog to your links and enjoy some great reading!

Keep up the great work, we need it... !!

Thursday, January 29, 2009

Acupuncture: forget the qi & meridians...AND any strong placebo effect

...even more dead in the water than thought.
There is an interesting research study published January 2009 regarding acupuncture treatment for pain. The most interesting thing about it is that it seems acupuncture isn't even much of a placebo, let alone anything else related to real healng. The second most interesting development as a result of this study is the almost comical cognitive dissonance from several media players as well as acupuncture apologists.

DC's improbable science has the goods and excellent discussion regarding the study and some of the sadly predictable -albeit quite athletic- false positive mental "spin" on the obviously negative implications for the institution that is acupuncture itself.

Dr Colquhoun notes in the comments section that even "modern" acupuncture denuded of the archaic and imaginative sophistry of "qi", points or meridians is dealt what could be a fatal blow:

"It’s true that the Medical acupuncture people, Adrian White et al. have abandoned the hocus pocus, and seem happy to admit that it doesn’t matter where the needles go. But that was already well-established before these last lot of reviews.

It was also quite well established already that in a non-blind comparison of acupuncture versus no acupuncture, the acupuncture wins.

The really new thing in the Madsen paper is that although acupuncture still beats no acupuncture, the advantage is too small to be much use to patients. So it may be a theatrical placebo, but the placebo effect isn’t big enough to matter in real life.

If this conclusion is confirmed by others, then acupuncture is dead. You can’t even make the (morally-dubious) argument that it’s a good placebo."
(my bold)

It's important to note that non-blind studies severely limit the quality of interpretations, especially for elucidating any effects beyond a placebo. Other superior studies clearly reveal no putative acupuncture effects beyond chance or placebo. In essence, as the study design improves acupuncture effects disappear.

Remember, this particular study relates to the very nebulous, variable and personal concept of pain- a realm fraught with confounding factors. Many studies regarding acupuncture effects deal with these rather subjective areas because that's pretty much what is left as the search for bigger effects has proven fruitless. If it is this hard to tease out any real acupuncture effect here from the a back ground noise of probability, acupuncture -as a legitimate medical modality- has a big, big problem.

Yet some people just don't get it...and the credulous will likely still drink deep from the twisted rhetorical kool aid and "feel" good.

Trusting the medical literature

really nothing always... just take it with a grain of salt
Dr RW has an interesting post where he responds to Dr Marcia Angells JAMA commentary where she questions the ability to practice evidence based medicine noting that "Physicians can no longer rely on the medical literature for valid and reliable information".

Though, as pointed out by Dr RW, there are prescient challenges and significant problems reagrding industry and non-industry supported research, Dr Angells assertion -reminiscent of the "pharma is all evil" canard- indeed seems far too simplistic.

Unfortunately, her opinion -though important and worth measured consideration- may be taken as fact and used by the ideological or the less scientifically literate to distract from a more balanced approach to considering a litany of real problems. Indeed, the research landscape is far from the useless state Dr Angell seems to claim.

As Dr RW notes:
"What then are practicing doctors to do? Angell’s statement above suggests that in the current environment the practice of evidence based medicine and science based medicine are impossible. Nonsense. EBM is premised on the fact that all research reports have weaknesses and are to be viewed with skepticism. SBM, recognizing that EBM lacks the tools to examine all claims, goes a step further by evaluating reports in light of prior research and scientific plausibility. In short, doctors have the tools to critically appraise the medical literature. It’s hard to believe Dr. Angell wants to abandon EBM altogether."
(My bold)

Hopefully that is not her intent. Dr Angell does seem to favor an "independent body" to serve as overseer and provider of clinical option fraught with many of the same problems beguiling the present research environment.

In the end, as these issues are -hopefully- objectively and pragmatically addressed, Dr RWs' call to using evidence and science based approaches and tools when evaluating data will continue to serve practitioners and their patients well.