How pseudoscience makes its case, Part 2
Nov/04/09 16:30 Filed in: Pseudoscience | Science | Vaccines | Alternative medicine | Evidence based medicine
A few days ago, I discussed how science works. It's not a belief. It's not a random set of rules. It is a rational and logical process to determine cause and effect in the natural world. Pseudoscience, by its very nature, ignores the scientific process; instead, it pretends to come to conclusions through science, although it does not.
Again, be very wary if you hear someone say, "it's proven." I've heard those words from both alternative medicine pushers and from well-trained physicians. I have previously discussed the ineffectiveness of almost every alternative medicine therapy. But what about your physician? They are, by far, devoted to your health and well-being. But they cannot know everything about medicine (thus, why we have specialists), so they may repeat information that is not valid.
So how can you tell the difference between science and pseudoscience in medicine? For me, I want to know if what I hear has been validated in one of two ways.
Almost any medical product, device, drug or procedure must, by law, must studied in a Randomized Controlled Trial, which is sometimes called a clinical trial. Essentially, it is a scientific experiment, designed to test the hypothesis of whether the safety and efficacy of a particular medical product is better than a placebo. That is, does the medical product produce results better than doing nothing at all. This is the "gold standard" of investigation, and if the study does confirm the hypothesis, you can be assured it has a benefit to your life (although the degree may be subject to argument). Alternative medicine just doesn't do this (most of their reasoning is that their beliefs just doesn't fit into the clinical trial model), so their is no proof that their products work. A clinical trial usually has thousands of participants, and is done in a manner that the patient and the physician do not know who is and who is not receiving the treatment. The results are analyzed statistically and published in peer-reviewed journals. Furthermore, the results are reviewed and investigated by the FDA (and legal bodies in other countries), before a drug or device can be used by a physician. This is an expensive and time-consuming process, in which alternative medicine hardly ever participates.
Now it's not ethical to test every medical hypothesis with a clinical trial. For example, we know that smoking is bad for your health. Yet, tobacco manufacturers love to insist that there has never been a clinical trial that makes this conclusion. The reason that is true is that it would be unethical to give one group of adults cigarettes for 20 years and another group nothing to see if one would die at a higher rate. So we use epidemiological studies to determine if we can see in a population whether a cause has an effect. We can review records of thousands of smokers to see what the effect will be. Once again, pushers of alternative medicine therapies have not published a study of all the patients who might have used their therapy and see the result. Epidemiology is a scientific process that is critical to preventative medicine–without it, we cannot know if some behavior or public health issue has a causal effect on health.
Remember, anecdote ("my mother's friend's cousin's daughter was cured by eating this leaf") is not a reason to accept alternative medicine. Even anecdotes that try to sound like science ("90 out of 100 people think this leaf does work") aren't a reason to "believe" in a pseudoscience.
You might have heard that taking lots of Vitamin C helps prevent colds. It doesn't. And that is shown by large clinical trials, so unless you are afflicted by scurvy, there's no reason to take large doses of the vitamin. And that's the difference between real science and pseudoscience.
By Michael W Simpson
Again, be very wary if you hear someone say, "it's proven." I've heard those words from both alternative medicine pushers and from well-trained physicians. I have previously discussed the ineffectiveness of almost every alternative medicine therapy. But what about your physician? They are, by far, devoted to your health and well-being. But they cannot know everything about medicine (thus, why we have specialists), so they may repeat information that is not valid.
So how can you tell the difference between science and pseudoscience in medicine? For me, I want to know if what I hear has been validated in one of two ways.
Almost any medical product, device, drug or procedure must, by law, must studied in a Randomized Controlled Trial, which is sometimes called a clinical trial. Essentially, it is a scientific experiment, designed to test the hypothesis of whether the safety and efficacy of a particular medical product is better than a placebo. That is, does the medical product produce results better than doing nothing at all. This is the "gold standard" of investigation, and if the study does confirm the hypothesis, you can be assured it has a benefit to your life (although the degree may be subject to argument). Alternative medicine just doesn't do this (most of their reasoning is that their beliefs just doesn't fit into the clinical trial model), so their is no proof that their products work. A clinical trial usually has thousands of participants, and is done in a manner that the patient and the physician do not know who is and who is not receiving the treatment. The results are analyzed statistically and published in peer-reviewed journals. Furthermore, the results are reviewed and investigated by the FDA (and legal bodies in other countries), before a drug or device can be used by a physician. This is an expensive and time-consuming process, in which alternative medicine hardly ever participates.
Now it's not ethical to test every medical hypothesis with a clinical trial. For example, we know that smoking is bad for your health. Yet, tobacco manufacturers love to insist that there has never been a clinical trial that makes this conclusion. The reason that is true is that it would be unethical to give one group of adults cigarettes for 20 years and another group nothing to see if one would die at a higher rate. So we use epidemiological studies to determine if we can see in a population whether a cause has an effect. We can review records of thousands of smokers to see what the effect will be. Once again, pushers of alternative medicine therapies have not published a study of all the patients who might have used their therapy and see the result. Epidemiology is a scientific process that is critical to preventative medicine–without it, we cannot know if some behavior or public health issue has a causal effect on health.
Remember, anecdote ("my mother's friend's cousin's daughter was cured by eating this leaf") is not a reason to accept alternative medicine. Even anecdotes that try to sound like science ("90 out of 100 people think this leaf does work") aren't a reason to "believe" in a pseudoscience.
You might have heard that taking lots of Vitamin C helps prevent colds. It doesn't. And that is shown by large clinical trials, so unless you are afflicted by scurvy, there's no reason to take large doses of the vitamin. And that's the difference between real science and pseudoscience.
By Michael W Simpson