Btw, are there scientific and clinical evidence to prove that GOD or any other Deities exist? I hate to have innocent happy good people pray to ducks. Quack! Perhaps, to protect the ignorant, all places of worship must bear an ISO certification to prove something is there for worship before being allowed to open, unless of course all donations is patented and goes directly into the coffers of ..ahem…u know who.

I really do not know why there is all this “fighting” (or online debate) over this topic. If something works for you, be it anecdotal whatever, it works, period. It doesn’t work for someone else, there could be so many reasons why. Sorry, I am not schooled in all this cheem things so I don’t see it at such a “high level” as the opponents to CAM.

It is interesting for me to read all these comments anyway!

I’d just like to deal with this thing that Darren quoted me on:
“However I also believe that just because something has been around for a long time, it should be respected. Unless Ed, you suggest that only ‘Doc’s’ are people with brains and the rest of us are fools? Surely not!”

For what reason, Darren, do you base your respect on? Shouldn’t respect be earned and not just be a function of time? We respect the elderly because of their accumulated wisdom and respect other people because of the things they have done and the roles they have played. In what way does archaic methodologies with no proven efficacy earn our respect? Do you respect the idea of the sun revolving around the earth just because it is old?

As what Angrydoc has said, the main motivation of Clearthought bloggers and many other like-minded skeptic blogs, we are here to encourage people to think critically and objectively. Anybody can learn to assess evidence and to come to a logical, well informed decision. In this case, our vociferious opposition to this article stems from our desire to help in public education on such matters.

I would also like to reinterate Angrydoc’s point that a doctor’s role is to provide the best evidence of efficacy and safety to his/her patients and not to play the role of being the “middle-man” between two opposing sides. A responsible physician should give sound, clinical advice based on the best clinical evidence supported by good science, as Angrydoc has detailed above. It is frightening to believe that a physician should choose to do otherwise.

My assessment of the central issue here however differs from yours.

The issue here is more basic than that of FDA approval or phase I – IV trials – it is about what the best way to know if and to what degree a particular intervention improves a certain condition.

Let’s look at ‘mom of 2s’ account again. Her children suffered from a condition that “impedes their growth and they are delayed where the usual milestones are concerned”. They underwent “Biomedical Science, TCM, CST and GFCF” and now they are “healthy and alive, and high functioning”.

While that may be all that matters to ‘mom of 2′, I think there are other questions we should ask.

- Which of the modalities of treatment contributed to the improvement observed? How much of the improvement can be attributed to each of the modalities?

- How much improvement is due to the treatment, and how much is due to natural progression? (After all, the condition is supposed to *delay* milestones.)

- Are the improvements, in fact, due to the various treatment, and not just the natural history of the condition?

How do we know, at the end of the day, whether and what to offer to children with the same condition as ‘mon of 2s’ children?

You and I both know that the best way to answer those questions is through a properly designed study that includes the following features:

0. A plausible physiological basis for the treatment being tested.
1. A large enough study group.
2. A treatment arm (or arms) and a credible-placebo arm.
3. Proper randomisation into each arm, with a large enough population in each arm.
4. Adequate blinding of the subjects and researchers.
5. Low drop-out rate.
6. Proper collection and analysis of the data.

(The reason why I numbered the first feature 0 is because I think it can be waived if casual observation suggests a high probability of efficacy – if efficacy is proven the physiological basis of the mechanism can be worked out later. Others may disagree.)

I think you will agree, Darren, that this is a fair way to assess a ‘conventional’ mode of treatment. The question then is why are we willing to waive that for CAM and accept anecdotes as proof of efficacy instead?

Why, if the proponents of CAM are so sure of the efficacy of their modality of treatment for conditions which conventional medicine has no answer to, if they are so sure of their safety, if they are so supportive of research into CAM, and if they are (as mentioned by Energetic Believer) making good money out of CAM, are there so few high quality studies on CAM that show evidence of efficacy?

Do the PubMed search, Darren, and look at the studies. Look at the studies from the high Impact Factor journals and not the dedicated CAM ones with known publication bias (search PubMed on the subject of publication bias in CAM journals while you are at it too, in fact). Look at how many of them fulfill the criteria I laid out above. Count how many there are, and see what they say about the efficacy of CAM for the variety of conditions which their practitioners claim they are good for.

Now tell me: am I doing more harm by ‘dashing hopes’, and are CAM practitioners doing more harm by giving false hopes?

I agree with your classification of people into ‘Docs’ and ‘Everyday’. However, a person doesn’t have to be a doctor or scientist to be a ‘doc’; ‘Everyday people’ can also learn to look at issues with a critical mind if they are willing to question the way we take things from granted. That is the main reason why people like myself, Leng Hiong and Ed blog.

Finally, as one doctor to another, I would like to say this to you, Darren: you do not have the luxury of being an ‘Everyday person’. As a doctor, your role is that of an advocate for your patients. Your duty is to advise them on what their options are and to give them sound advice on what the efficacy, risks, and benefits of each are, based on the best evidence available. It is not playing peacemaker and trying to “bring the 2 camps just a little bit closer together” with no regard for facts and evidence.

My name is Darren and I am a doctor. This is just in case ‘angry doc’ has any issue and gets too angry with me being anonymous, just like you did on August 30th, 2008 4.11am. In fact, what pushed me to contribute to the thread was chiefly because of ‘angry doc’’s reply to ‘Just a mom of 2’ that day.

I believe it is clear there are 2 camps right now, and neither appears to be giving in. In my humble effort, I wish to bring the 2 camps just a little bit closer together. I will call the two camps ‘Doc’s’ and ‘Everyday people’. I will attempt to synthesize the current situation and perhaps, the best way forward.

Doc’s: Having been taught evidence-based medicine for what it seems to be our whole life, it is difficult for us to accept any drug or treatment without the so-called scientific methodology which included but not limited to the pre-clinical trials and the clinical trials (Phase I-IV). At this point, I will like to remind everyone that these methods are mainly to make sure that drugs are safe. Even if the drugs perform marginally better, even in optimal conditions (ie Phase III), as long as they are safe, there usually get approval and have patent rights. Which means patients sometimes pay for a so-called ‘better’ with no better response. Doctors will say that ,”Well, there are other cheaper drugs in the market, so why don’t you try those? There produce the same response. Maybe just a higher risk of diarrhoea.”. Honestly ‘Doc’s’, if the patient was your next-of-kin, and you have the financial capability, will you offer this option to them? I guess not.

Everyday people: And perhaps this is where sometimes we find ourselves trapped. I use ‘we’ because I was a patient. Again, you can be cynical and think that I am cooking this story up, like I said I think it is much better if we come together than to remain apart. Even if ‘Just a mom of 2’ is a fake (and I doubt it), can any of the doctors claim that her story is impossible and that it only happens in fairy tales? ‘First, do no harm. Perhaps ‘Doc’s’ do the most harm by actually dashing away any glimmer of hope. As long as we are not recommending treatment with harm is there any harm?

CAM is something that is coming on us whether ‘Doc’s’ like it or not. Most, if not all, public hospitals have a TCM unit in them now. Rather than adopting a ‘holier-than-thou’ attitude, ‘Doc’s’ should treat the patient and not do a ‘do this because I know best’. Ed wrote, “Just because something has been around for a long time does not mean that it is tried and tested”. I agree. However I also believe that just because something has been around for a long time, it should be respected. Unless Ed, you suggest that only ‘Doc’s’ are people with brains and the rest of us are fools? Surely not!

The goal is the same. Better health for all. The methods are different. And therein lies the problem. ‘Doc’s’ are running the 100m dash while the ‘Everyday people’ are running the marathon. (If the analogy is poor, I apologize). But essentially that is the problem. However, things are changing. Go to PubMed search engine and search for ‘complementary alternative medicine’ and you will see many hits. But almost none for ‘complementary alternative medicine phase III’.

There is in fact a lot of research on CAM, especially acupuncture and homeopathy. The problem however, besides what Ed mentioned about spending time and money on claims which lack scientific plausibility to begin with, is that despite the large number of studies showing the lack of efficacy, proponents do not abandon their claims, but always call for “one more study”. It’s sort of like playing ‘scissors-paper-stone’ with someone who loses a round and then insists on “two wins out of three”, and when he loses the next round insists on “three out of five”, and so on.

If you interested in learning more about how we use science and statistics to evaluate the efficacy of treatments, as well as what the existing studies tell us about the various CAM therapies, you may want to read the books “Snake Oil Science” and “Trick or Treatment” (both of which are available from Amazon).

Thank you.

MRI Machines costs millions of dollars a piece and so do many other expensive yet scientifically proven diagnostic or medical therapeutic devices. Price has not deterred the manufacturers from doing extensive testing as the potential profits are huge and well worth the investment in detailed, extensive scientific research. This of course, is a calculated risk as they feel that there is indeed real scientific merit to doing such research as they are grounded in good science. CAM however, generally floats in the realm of airy pseudoscience and hence hardly worth the purchase of a single piece of “vibratory device” to research into. Moreover most prices of CAM devices are inflated versions of simple electronic devices, as often pointed out by many skeptic blogs like Ben Goodacre’s.

There is a good reason support here is scant as we are unable to afford frivolous research into areas in which there is no scientific merit. I would advise you to focus your hunger towards reading articles and papers of real scientific merit, such as those we have quoted above.

Investment in CAM in products and continued treatment can be expensive. Vibratory devices can cost several thousand dollars apiece.
Anti-aging treatments claiming neuron cell communication can cost a bomb.

Unfortunately there is not much support for research in CAM here; I was in Australia last month and read their Government’s funding of more than a $A 1 B for several aspects of CAM researchs in tie ups with 4 Australian universities.
As a consumer, I welcome more open discussion, and education in the CAM field. I am hungry for learning.

“CAM has been around since biblical times and after physical medicine and chemical medicine, what choice does one have but to seek out CAM for cures which are not found in the mainstream.”

Some CAM therapies which are particularly dangerous, for example Mr. Seah’s chelation therapies are definitely new while drinking water, aka homeopathy has indeed a long history. I do not understand what Energetic Believer means by physical and chemical medicine but I would assume he refers to modern medicine. Whilst not claiming to have a cure for all diseases, modern medicine has indeed developed a system of rigourous testing to prove or disprove proposed therapies. CAM has never been conclusively or scientifically shown to provide a cure for a disease. Just because something has been around for a long time does not mean that it is tried and tested. I wouldn’t try trepenation for a headache, would you?

“There is always the subjectivity but there is also the merging trend, and from my own experience, the closest “cure all ” so to speak in prevention can be found in the strict following of Nutritional Therapy , and Vibratory Medicine for a total holistic healing.”

This issue of subjectivity is precisely why there is a need for randomised blinded trials to erase this subjectivity to provide a more objective and scientific method of assessing one’s claims about therapies. I would kindly request all future CAM supporters to refrain from anecdotal claims and provide us with information in the form of good research. It is never enough to base one’s belief on your own experience as the above comments have explained. Whatever fancy words you use to describe CAM (I would rather dispute even the use of “complementary” and “alternative” as there are quite a few modalities that are quite the opposite), be it Nutritional Therapy or imagining being healed by “vibrational energies”, they must all be backed up with sound evidence to be accepted as a treatment option.

Would the authors of the article or supporters kindly stop shifting the argument around, be sincere in your request to have a space to air your views and answer the questions we have posed in the above comments? If not, it would be blatantly apparent that you are just simply airing unjustifiable “grieviances” without being sincere in wanting to have an opportunity for free speech and to take responsibility for the materials that you have uploaded here.

Leng Hiong, Hansolo, Angrydoc, Hopeful Oncologist and myself hail from many different scientific and medical disciplines and are sincere about engaging you, the authors on the issues that you have raised. It is about time you stop prevaricating and basking in the occasional anecdotal evidence by random anonymous posters and bring on good, sound evidence to justify your claims.

But what is it going to be, Mr Seah? Are anecdotes to be “appreciated”? Or are they unreliable? How many negative anecdotes cancel out one positive anecdotes?

Fact is the plural of anecdote is not data, and it is certainly not evidence, so let’s stop arguing with anecdotes and start produing evidence, shall we?

An excellent example of this selection bias is when doctors inform a patient that he has a median prognosis of 6 months. The vast majority will probably have an eventual survival between 3-9 months, some 70-80% of them trying complementary medicine as well. A small and limited number, by the very nature of biology and random variation, will have a far longer survival. It’s called ‘median’ because 50% will live less than 6 months, and 50% will live longer. Some of these patients who do survive will attribute their survival to complementary medicine, a miracle etc.

When one reads letters to the press on anecdotal cases of patients who ‘did well on complementary medicine’, one sees these phenomena of selection at work. The question is what is the denominator of patients who tried the therapy. Unfortunately for those who prefer anecdotal medicine, this is only available in the setting of a trial.

Now if alternative medicine was as cheap and free of adverse effects as water, there would be much less fuss from all around, and most physicians would probably turn a blind eye. Unfortunately, alternative medicine and much of the naturopathic industry makes expensive products with little documented benefit and most with little studied adverse effects.

Has anyone noticed that the so-called proponents of scientific evidence never take issue with anecdotes about negative effects of alternative medicine, such as those reported in ST, but only with anecdotes about positive effects such as the one shared here by Just a mom of 2 ?

I’m sorry, Just a mom of 2 – you may choose to hold a *belief* that the therapies work, but if you come onto a public forum with a *claim* that they do, I think readers may expect more details and a means to verify your story. After all, if your beliefs are correct, parents of children with the same disease as yours may stand to benefit from the knowledge.

(Yes, I am an anonymous blogger, but I do not make my arguments with unverifiable personal ancedotes but refer to (and link to) published studies in my entries where relevant.)

CAM has been around since biblical times and after physical medicine and chemical medicine, what choice does one have but to seek out CAM for cures which are not found in the mainstream. There is always the subjectivity but there is also the merging trend, and from my own experience, the closest “cure all ” so to speak in prevention can be found in the strict following of Nutritional Therapy , and Vibratory Medicine for a total holistic healing.

Both my children were born with a genetic condition caused by an abnormal protein that affects their ligaments and connective tissues. This condition impedes their growth and they are delayed where the usual milestones are concerned.

The geneticist declared there is “no cure” and we would just have to live with it.

I did not accept that. I tried Complementary and Alternative Medicines and Therapies to help them and just wanted to share that the very same therapies that the ST reporters and some of TOC commenters seem to be very against are the very same therapies that helped my two children achieve what they are capable of today.

The same therapies that get a bad name and are labelled “quack” are the ones my children benefitted from.

I guess it’s a case of one man’s meat is another’s poison. It is entirely all right if you don’t believe the therapy works. But please don’t belittle those who have actually tried and benefitted from it. We are grateful and thankful for these therapies!

I am just a mother, so I don’t have any evidence in numbers or control tests to show except my two children, who are healthy and alive, and high functioning, thanks to Biomedical Science, TCM, CST and GFCF.

First of all, any non-mainstream therapy will always face an uphill task and it is no surprise that the media and even several comments in this thread smack of disdain – this is to be expected.

Second, the ST (and its sisters, cronies and goons) operates under a different model – which many of us fail to recognise. As in any magazine, it only concerns itself with its own POV – just like how a pro-religious magazine is likely to dismiss science as the work of teh devil. I understand that due to its layout and design, many of us might mistake it for a daily newspaper and here is where we fall into the wrong understanding. No, no, it is a daily magazine, that’s all. And we can’t be taking what magazines say seriously at all, as simple as that.

Also, only those who are hopelessly dependent on the Singapore system (ie. like those plugged into the ‘Matrix’ – as in the movie) rely on ST as the gospel of truth. And such people would hardly care what the other side has to say anyway. As for the rest, we are interested in debate and hearing both sides of he argument. And for this, we have many wonderful resources online to get the information and get our burning questions answered as well.

So, I say, why worry what ST has to say in the first place? If our forum letters deliberately get unpublished, it just means we must have a damn good point to have scared them isn’t it? We certainly have better platforms…