Tuesday, July 19, 2011

It is a Very Dangerous Thing to Believe in Nonsense

James Randi coined that phrase years ago...

When it comes to medicine skeptics have been trying to convince people of it ever since.  Asthma is scary and can be life-threatening.  Seems to me we would want to be sure to choose the very best treatment.

By way of Steven Novella here are the results of a study of asthma symptoms treated with three different methods - medical, placebo, and woo.  Above is the patients' subjective impression of the effectiveness of an albuterol inhaler, a placebo inhaler, acupuncture (technically "sham" acupuncture, but several studies have demonstrated that so-called sham works as well or better than real needles and with no negative side effects), and no treatment control.  Not much difference, except for the group that knew they had received no treatment.  If we stopped there we might guess that real medicine worked little better than placebo and acupuncture works about as well as either.  But wait, there's more...

David Gorksi's analysis of a study just published in NEJM goes on to demonstrate the actual measured effect of the different treatments, not just how the patient felt about them.  Bam!  Medicine works; placebo, acupuncture, and no treatment control come no where close.  Ain't science a wondrous thing?  Remember, if it's safe and effective it's not complimentary and alternative medicine, it's just medicine.

NOTE: This was a small study: 79 were screened, 46 randomized, 7 dropped out during the protocol, for a total of 39 patients.  Ideally, we'd want at least 100 participants, 100 in each group would be even better.  We'll have to wait on replication of the study elsewhere, which may be a challenge as negative studies are published much less often than those showing positive results (see "File Drawer Effect" or "Publication Bias").