What Piece Of Evidence Would Change Your Position On Altmed. Skeps And Alties?

1. Mathieu Says

   Like most skeptics I would accept AltMed if there was quality evidence showing a benefit, nothing else is required. I also apply the same standards to any drug, therapy, or other treatment.
   For example a new study came out that indicates up to 7% of children with ADHD respond to cognitive behavioral therapy (CBT) yet ten times more respond to any one stimulant medication (Adderall, Ritalin, Dexedrine, Focalin, Desoxyn). So when I see a study like that it reinforces the fact that ADHD is not typically responsive to therapy of any type, especially in severe cases. So I would not recommend a patient with ADHD to do CBT (unless other treatments failed) because the science shows it is be minimally effective. However I highly recommend CBT, sometimes in conjunction with hypnotics, for people with primary chronic insomnia because about 90% of people respond and often no longer need a hypnotic or only take it as needed.
   I don’t prescribe drugs like trazodone, the most commonly prescribed “sleeping medication” in North America, or other low dose sedating antidepressants which include 3 of the 5 most used sleeping drugs in North America as first line treatments because there is only a small amount of evidence they are at all effective for insomnia and none are approved for insomnia.
   New British guidelines, out today (02-09-2010) for treating insomnia recommend using therapeutic doses of antidepressants people with depression and there is evidence to support it but still, according to the science sedating antidepressants are only effective for a small group of people who often do not respond to traditional hypnotics. Also sedating antidepressants become less effective at larger doses and a large dose is required to produce antidepressant effects.
   The guidelines also recommend using melatonin in a number of situations. Yet most guidelines including those from The American Academy of Sleep Medicine indicate melatonin is not effective for insomnia but it may be useful for circadian sleep disorders.
   My point of this example is that it is true that evidence based medicine is open to interpretation and guides written by multiple organizations often contradict each other. Or why is it that Health Canada refused to approve melatonin for insomnia yet Australia, one of the only countries to have approved it, has approved it for use in the elderly with mild sleep onset insomnia (hard time falling asleep) for up to two weeks?
   Evidence based medicine certainly has flaws, some times studies are heavily bias, pharmaceutical drug reps have lied to doctors, they also provide useful information.
   Even in the traditional medical system things are far from perfect but there is actual science, something most AltMed simply does not have. Just because one (even a thousand) people say a homeopathic remedy helps them is not fact. Not to mention that the placebo effect is strong. Many people taking antidepressants for example really don’t need them and they reason the medication is actually helping is all placebo. But for other people they are literally life saving.
   It is also very powerful on a psychological level when you try a drug and it fails or causes a lot of side effects and then some AltMed treatment is tried and it works. People often talk about “knowing their body,” or they “just know” an AltMed treatment works. That is not science.

2. NA Says

   So in other words, the skeptics wont accept anything that isnt ‘reviewed’ by people who have the exact same training and programing, and who all sit around throughout the year masturbating each others egos, while the very things they try to make a claim to ‘work’ , are refuted within a short period of time by these same types of people, and this goes on and on with nothing changing.
   Then when they come out fighting , they claim ‘logic’ when it agrees with them, and ‘logical fallacy’ when it does not.
   Science is the ‘logical fallacy’ of the insane.
   It has nothing to do with healing.
   The facts are that there is plenty of documented evidence that other medicines work , and some far superior to ‘scientific logical fallacy’.
   If an alternative medical treatment that is documented to work , is then torn down from its method and modality of healing and placed in the skewed parameters of ‘scientific logical fallacy’ , then the logical fallacy is that it does not work , from this ilk of the ‘ scientific’ community.
   If they wanted the documented evidence, it is out here.
   If they want to tear it down and build something else with it and then claim it doesnt work,in its’ original form, why would anyone believe them?
   That is the ‘logical fallacies of the skeptics’, and madness.
   It isnt the alties that cant think right.
   Your own ‘logical fallacys’ are that one size fits all and that life is static , and that healing is static and nothing changes. Lets package it up in a pharmceutical to give to millions of people, all of whom are very different with many variables. ‘Scientific ‘ method is a logical fallacy when it comes to healing.
   There are not any pharmaceuticals that even meet the normal percentage of ‘placebo’ but fall far below that. They are , for the most part put out to be tested on the public .

3. evirusth Says

   properly controlled and blinded medical trials with results much greater than the statistical insignificance cut off(that is when the data appears to show a slight difference but the difference is so small that it’s more than likely to be the result of random luck rather than an actual positive result).
   the problem is that most alt med supporters rely on anecdotal results, which is in essence an uncontrolled trial, one in which you can’t compare the progression of an illness between those who have taken a treatment and those who haven’t, basically because the sample size is exactly 1, typically a good trial involves a sample size of at least 2,000. think of it like this, if you wanted to know the probability of getting a specific result on flipping a coin, would you only flip the count once? no you would flip the count several times.

4. dave Says

   I’m afraid the evidence I would accept would be the same as for any other medical treatment: double blind, extensive, peer reviewed trials. This has successfully changed any ‘alternative medicine’ into simply ‘medicine’ effectively enough to convince the finest brains on the face of the planet.
   That’s good enough for me.
   Edit: Lightning’s post is a brilliant example of why there’s no substitute for statistical analysis (either quantitative or qualitative) when it comes to the determination of treatment efficacy.

5. CrocoDuc Says

   It depends on which alt-med therapy you’re talking about. I’m not aware of any evidence for some alt med theories such as healing crystals, homepathy, etc., but you can’t just lump all alternative therapies in the same category.
   I can name many alternative therapies that have scientific support. Scientific studies have shown evidence that St Johns wort is effective for depression, for example:http://www.reuters.com/article/idUSTRE49…
   Chiropractic care is also well-studied with thousands of scientific studies having been done. There is plenty of proof that this works as well.
   It would be impractical to address every alternative therapy in this answer. But simply claiming that all alternative therapies are not supported by any evidence at all would be the ultimate logical fallacy. Just because some alternative therapies like healing crystals are lacking in evidence does not mean that all alternative therapies are lacking in evidence.

6. Mr E Says

   so-called scientific evidence manufactured along with the pills they sell, or results. tough choice? for some, but not most. sooner or later the consistent failure of allopathy leads most to try alternatives, regardless of their “doctor’s” advice. do you actually think someone who knows the truth in principle as well as sees it’s results in practice would turn their back on it because some know-nothing pill pushers who haven’t helped a sick person get well in their life say so? you need your head examined if you do.

7. Anonymous Says

   Well, as the others have stated, a well-done, double blind, peer-reviewed clinical trial would definitely convince me.
   However, when I proclaim this to the world, the alties accuse me of being “close-minded,” “dogma-bound,” or being paid by big pharma. WTF? I feel like I’m taking crazy pills when I read those.

8. Gary Y Says

   Its a trick question – if any alternative medicine is proved to work, its no longer alternative. Thats the point I’d change my mind.

9. Lightnin Says

   For my own brand, what would convince me to stop if if my results were poor.
   During questioning for follow ups I will ask these questions (among others):
   How are your symptoms?
   Any new symptoms?
   Any changes in the pattern of symptoms?
   Any changes in pain medication?
   For a few people nothing changes. Those cease to be my patients within 3 treatments as I’m not doing anything for them and I find it soul destroying to continue treating them.
   For most of the others I get a consistent change with reduced symptoms, reduced pain medication, no new symptoms.
   Often the symptom pattern changes because their mechanics alter slightly from the manual treatment. Sometimes because of this new symtoms occur.
   Occasionally they get severe treatment reactions which results in the symptoms temporarily worsening and then improving.
   I have seen this happen thousands of times. Because of the shear numbers I cannot beleive its all in their minds. Being a manual therapist you make direct changes to tissue function which you can see in their tissue tone and in their movements before and after. It stays changed too.
   I view myself as a facilitator. Manual treatment helps change tissue function. This optimises nature so the body has a better chance of repair. I give most of my patients exercises to do. If they do them they recover quicker. Again my job is a facilitator. I can’t make them do the exercises.
   Motivation is important. most of my patients are highly motivated to recover quickly because it costs them more money if they don’t.
   A patients desire to get well is important. If they don’t want to, nothing you do will help them so to some extent placebo is involved but this will be part of any system of medicine.
   What I’ve also observed over and over again is how peoples symptoms change with chronic musculoskeletal isues after a course of treatment. Some of these poeple have had symptoms for 5 years or more. After a course of treatment these symptoms have improved dramatically too often for me to feel its all placebo. These patients have all been well motivated, done the exercises I’ve given them and made chages to their lives as directed but the manual treatment I gave them helped too. Many of them will have tried other things to help before coming to me.
   If this stops I will cease to do my job.
   I’m a clever talented man. I can find other ways of making a living if I need too.
   I do my job because I love it and it makes a difference to a lot of people.
   Edit:
   Evirus, would a trail comparing medication use pre and post a corse of treatment for chronic conditions do?
   I’d be up for that.
   Edit:
   Angelhill, I have lots of returning patients. People injure themselves again especially in rural New Zealand.
   To answer you question if more than 1:10 people didn’t improve I’d seriously consider ceasing practice.
   What do you suggest I do with people who don’t improve then Angelhil? Keep treating them and relieving them of their cash?
   I have a few moral and ethical issues with that.
   I’ve treated enough people to know if there is no change after 3 treatments there will be no change after a dozen. So why keep doing it? How does that help them?
   How does it help me to have patients that don’t improve.
   You really should spend some time with us and see how we work before deciding we are all a bunch of shonks. An overwhelming majority of people aren’t fixed in 1 treatment so you do see them again and they do feed back whether or not they improved.
   Your friends wife should cease practice if no one came back. That just doesn’t happen if you are successful.
   Do I cure medical conditions?
   I have a patient with Marfans syndrome that I treat every few months. She gets a lot of relief from adjustments and work on her connective tissues. Have I cured her? No?
   When the sugeon replaces her Aorta before it dissects within the next 20 years will he have fixed herMarfans syndrome either?
   I’ve also got a 91 year old with low back pain. His vertebrae have changed shape dramatically from osteoarthritis. I can’t change that but I can help him manage to live his life in less pain. Hes changed from being unable to be in one position for 5 minutes, being in constant pain to doing his gardening and feeling pain free most of the time. I’m seeing him on a monthly basis and trying to push it out to 6 wks.Have I failed If I don’t change his osteophytic pattern? I’d have to be a magician to do that without surgery.
   ####I’ve just qouted Lightning’s entire answer as a winning blow for my side of an argument on facebook. Cheers mate.###
   I strongly suggest you delete it or risk looking extremely foolish.
   Edit:
   OK Dave, what would suffice?
   I have some stats from the ACC with statistics showing how many treatments on average for certain sprains and starins.
   Its a confidential document but I can anonymise it and have it sent to you by a third party if you like?
   You’ll see Osteopaths do quite favourably on the report.

10. Rhianna Says

    As stated many times with the exception of some herbals (which are at least plausible, and some have been demonstrated to have medicinal effects), the vast majority of AltMed has not only never been demonstrated to work, it violates every basic law of science. And, “extraordinary claims require extraordinary evidence”. For them to work, it would mean everything we know about everything would be wrong.
    In terms of what I would require to change my position. Basically peer-reviewed robust data (NOT personal anecdotes). In terms of demonstrated evidence, the activities would need to succeed in properly controlled blinded trials, and the results would have to be consistent and reproducible.

11. Tink Says

    Its kind of a load question, because “evidence” automatically implies empirical and thus, “statistical analysis”
    But…to answer the Q anyhow….
    Much to Dave’s Chagrin, I’m a big fan of Reiki – but only when done by certain folks. I used to share my office at work with the Nurse in charge of palliative care in the cancer dept*… and they used to offer Reiki to patients as an adjunct to conventional therapies…..and I never really gave it much thought. Figured who was I to tell the dying how they should do it….
    A little while later I’m working with another group of folks – and a couple of them kept insisting I needed Reiki (because they did it) – well after a while I figured it was down right rude to keep refusing…so I went along. And let me tell you, um…I’m not going to say I saw God or anything like that….but I do know that I’ve had it done a few times after that, and when I do I’m in a state of freaking bliss for days after…and considering that I’m not into mood altering substances anymore, I’ll take it….
    Sure, perhaps there is all kinds of placebo, and other psychological effects in it. Is that really bad? I mean really, I’ve seen too many cases of spontaeous remission of an assortment of serious illnesses to dismiss it…In some ways, and for some conditions, that might be the only “real medicine” that is available in the arsenal. And I’m well aware of all the ethical debates over the proper use of placebo….
    But for most mere mortals, who aren’t ill, who aren’t in clinical trials – who simply have a case of “restless, irritable and discontent” whats the harm? Most folks on any condition fall into the bell curve….
    So yes, I like the power of ‘p’, and ‘n’, and all that….I read journals on a regular basis, but you know what? Sometimes you have to let direct experience be the final judge. And I say that simply because I have seen too many cases where it couldn’t be dismissed.
    Now does it “cure” medical conditions. I surely think not. However, I don’t see any harm in people chosing to have it done as an adjunct. It reduces stress and stress reduction goes a long ways in any (physical) body…

12. Keiff Murray Says

    The only type of alternate med that works is herbs! Most of the drugs we take are derivatives of herbs so they can be patented. Ask any physician, herbs are powerful. I don’t believe in Reiki, crystal therapy or anything like that, but you cannot argue that herbs don’t work. If you don’t think so, I have some herbs that will change your chemistry.

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