How NOT to argue for Alternative Medicine 9
An anonymous reader's comment on this earlier post on acupuncture provides angry doc with the material for the next exercise in our series.
"Your link at the start of your comments takes you to information on trials on acupuncture for back pain. These mention the use of 'sham' points - given that Ashi points do not lie neccessarily on meridians, its questionable whether the 'sham' points are in fact sham points. The reserach design seems to have been developed without much undrestanding of the modality. Still, each to their own. Personally, I'm not angry about patients using any modality that works for them to get better or maintain health. But then again, I'm not that randomly angry.... Perhaps you should try some acupuncture for your stress and then you wouldn't be so generally angry ?! As a doctor you should know its not good for your health-long term!!"
Let's examine the arguments one by one then.
1. "given that Ashi points do not lie neccessarily on meridians, its questionable whether the 'sham' points are in fact sham points."
angry doc has read many defences for acupuncture, but this one is new to him.
Now leaving aside the fact that the study specified that sham acupuncture in this study consisted "of superficial needling at nonacupuncture points" (emphasis mine), this argument tries to renders the theory of acupuncture non-falsifiable.
If we are going to identify every point on the skin which shows an effect when needled to be an acupoint (or Ashi point) and then attribute the effect observed acupuncture, then it becomes impossible to prove that acupuncture doesn't work.
However, if we do not shift the goal-posts during our study (i.e. an identified acupoint is an acupoint, and a point not identified as an acupoint does not become an acupoint), then the evidence so far is that sham acupuncture often performs as well as 'true' acupuncture, which calls into question the theories behind acupuncture.
2. "The reserach design seems to have been developed without much undrestanding of the modality."
The study states that the authors are from the following institutions and departments (emphasis mine):
Orthopedic Department, University of Regensburg, Bad Abbach, Germany (Dr Haake); Institutes for Medical Biometry and Epidemiology (Drs Müller and Schäfer) and Medical Psychology (Dr Basler) and Centre for Clinical Trials (Ms Schade-Brittinger), Philipps-University Marburg, Marburg, Germany; Departments of Pain Management, BG-Kliniken Bergmannsheil (Dr Maier) and Medical Informatics, Statistics and Epidemiology, Ruhr-University Bochum, Bochum, Germany (Drs Endres and Trampisch); and Centre for Clinical Acupuncture and Research, Düsseldorf, Germany (Dr Molsberger).
Without trying to appeal to authority, angry doc would venture to say that it would be rather unwise for a Centre of Clinical Acupuncture and Research to set up a whole centre for studying acupuncture, go through the process of recruitment and intervention, and then finally publish the study, without having first gained some familiarity with the modality.
Unfortunately, our anonymous poster did not specify how he or she arrived at the conclusion that the "reserach design seems to have been developed without much undrestanding of the modality".
3. "Still, each to their own."
Acupuncture either works the way it is said to work, or it doesn't - that does not depend on whether you or I believe it, but on what the evidence show. To use phrases like "to each his own" or "we are all entitled to our own opinions" is to try to hide a lack of evidence or convincing argument behind freedom of choice.
4. "But then again, I'm not that randomly angry...."
Well, angry doc hopes his long-time readers will realise that while he may be angry, he is not *randomly* angry.
This statement is a form of ad hominem attack; angry doc does not think acupuncture doesn't work because he is 'angry at acupuncture', angry doc is 'angry at acupuncture' because it doesn't work.
5. "Perhaps you should try some acupuncture for your stress and then you wouldn't be so generally angry ?!"
angry doc is not sure whether this is another ad hominem attack, or an argument that subjective experience or anecdotes trump statistics and evidence.
In any case, if angry doc tried acupuncture and it didn't work for him, it does not prove that acupuncture doesn't work. Conversely, if angry doc tried acupuncture and it did work for him, it would not prove that acupuncture works - that's why we are conducting all these studies with blinding and controls.
(angry doc would like to thank his anonymous reader for providing the material for our discussion today.)
Labels: alternative medicine