Guest droid Posted October 5, 2009 Report Share Posted October 5, 2009 I agree, but evidence-based medicine is fantastic as it gives us the tools to evaluate if these treatments work, even if we don't understand the mechanism why.Absolutely,the evidence for TCM is thousands of years old,funny how when you tell a doctor or consultant about TCM they look at you with a raised eyebrow. Quote Link to comment Share on other sites More sharing options...
nullmouse Posted October 5, 2009 Report Share Posted October 5, 2009 Absolutely,the evidence for TCM is thousands of years old,funny how when you tell a doctor or consultant about TCM they look at you with a raised eyebrow.Well, you have to look at the quality of the evidence: When I talk about evidence-based medicine I'm pretty much referring to the way in which current clinical data is gathered via carefully controlled trials. The thousands of years evidence for TCM is pretty much all anecdotal evidence, testimonials and such. This isn't to say that there can't be truth in these testimonials, but they're not scientific evidence.If any TCM treatments work, then they can be tested used the principles of evidence-based medicine (proper controls, randomised groups, 'blinding' so patients and doctors don't know what treatment they're giving etc) and solid evidence gained without needing to understand the mechanism behind the effect. Quote Link to comment Share on other sites More sharing options...
TheTickingTime-Bomb Posted October 5, 2009 Report Share Posted October 5, 2009 Absolutely,the evidence for TCM is thousands of years old,funny how when you tell a doctor or consultant about TCM they look at you with a raised eyebrow.If it's evidence is thousands of years old, then it isn't good evidence. The more recent the study the better it is. Quote Link to comment Share on other sites More sharing options...
Guest droid Posted October 5, 2009 Report Share Posted October 5, 2009 If it's evidence is thousands of years old, then it isn't good evidence. The more recent the study the better it is. I really don't get your logic or how you arrived to that conclusion,but it it is your opinion,which i respect!Totally agree Nullmouse,it's a pity Western medecine and TCM couldn't work as complementary treatments eh? Quote Link to comment Share on other sites More sharing options...
nullmouse Posted October 5, 2009 Report Share Posted October 5, 2009 I really don't get your logic or how you arrived to that conclusion,but it it is your opinion,which i respect!Totally agree Nullmouse,it's a pity Western medecine and TCM couldn't work as complementary treatments eh?I agree with The TickingTime-Bomb as the more recent the evidence the more likely it is to be carried out to the highest scientific standards. For example, our understanding of the placebo effect and how it can impact poorly controlled trials is relatively recent to medicine - Older trials will most likely be subject to inappropriate controls that make it hard to work out what is a true effect and what is placebo.Just to be clear, I don't think we should recommend any treatment without evidence. That evidence should be gathered in the strongest, most robust way - But the ways in which we gather this evidence does not rely on the need to know the mechanism why a treatment works. For example, acupuncture is claimed to work due to insertion of needles into certain regions (meridians) that are specific to the ailments presented. We don't need to know how (or indeed, if) meridians work to understand that a good control would be to insert needles in to regions that weren't specific. We could then compare how well the two groups did, and make some observation on how effective the treatment was. Quote Link to comment Share on other sites More sharing options...
Guest droid Posted October 5, 2009 Report Share Posted October 5, 2009 Yes but surely the evidence of it being accurate from a diagnostic sense,then the treatment speaks for its self.TCM has evolved to what it is now,acupuncture is available on the NHS.My physio uses it to stimulate blood flow.I get what you are saying,but it has worked for me and my wife so i can only comment from a personal point of view. Quote Link to comment Share on other sites More sharing options...
Le Stu Posted October 5, 2009 Report Share Posted October 5, 2009 I think it goes like this:Medical Establishment: This is a load of hooey as there is no hard evidence to back up the claims of TCM practioners.TCM Practitioners: Wanna do some studies?Medical Establishment: No.Well, not many anyway. Sceptics who never play devil's advocate are more accurately described as cynics. Quote Link to comment Share on other sites More sharing options...
nullmouse Posted October 5, 2009 Report Share Posted October 5, 2009 Yes but surely the evidence of it being accurate from a diagnostic sense,then the treatment speaks for its self.TCM has evolved to what it is now,acupuncture is available on the NHS.My physio uses it to stimulate blood flow.I get what you are saying,but it has worked for me and my wife so i can only comment from a personal point of view.I think the important thing is that every treatment (alternative or not) is properly evaluated for how effective it is, otherwise anyone could claim anything and no-one would be able to refute it. The availability of acupuncture on the NHS is limited to specific treatments and is part based on successful political lobbying (hello, Prince Charles), part based on the available data suggesting it may be more effective than simply doing nothing. The jury is still out whether acupuncture works as claimed, or is just a special version of the placebo effect: In either case, doing something is better than doing nothing, but the latter calls in to question the method by which acupuncture supposedly works. One argument would be that as long as it's better doing something rather than nothing, then it doesn't matter if acupuncture works due to meridians and qi flow or if it works as nothing but a placebo. A counter-argument to this would be that if acupuncture is just a placebo, then it is not a treatment with any efficacy and to claim it is would be deceitful. Quote Link to comment Share on other sites More sharing options...
nullmouse Posted October 5, 2009 Report Share Posted October 5, 2009 Medical Establishment: This is a load of hooey as there is no hard evidence to back up the claims of TCM practioners.TCM Practitioners: Wanna do some studies?Medical Establishment: No.I'd disagree, as many, many studies have been done upon a wide range of alternative therapies. As an example, here's the summary of the Cochrane report on the use of acupuncture as a means of helping people quit smoking (Spoiler: It doesn't):We identified 24 reports of studies. The only comparison for which there were sufficient studies to combine meaningfully was acupuncture compared with sham acupuncture. The fixed-effect odds ratio (OR) for the short-term effect was 1.36 (95% confidence interval 1.07 to 1.72), but the studies are heterogeneous and the result is strongly influenced by one individual positive study. The significant short-term effect was lost with the random-effects model for pooling, or by removing the outlying study that led to heterogeneity. The long-term result shows no effect of acupuncture compared with sham acupuncture. There was no consistent evidence that acupuncture is superior to no treatment, and no evidence that the effect of acupuncture was different from that of other anti-smoking interventions, or that any particular acupuncture technique is superior to other techniques.For that particular, specialised application of acupuncture they found 24 studies that have attempted to answer this particular question. Note, not all of the studies found were performed properly (which is a big problem), but this illustrates that studies are prevelent, are being performed by researchers and are also being analysed in some detail: It's not just a case of dismissively waving it away with a hand, and nor should it be. Again, these claims can and are being evaluated. Quote Link to comment Share on other sites More sharing options...
Graeme Posted October 5, 2009 Report Share Posted October 5, 2009 I'd disagree, as many, many studies have been done upon a wide range of alternative therapies. As an example, here's the summary of the Cochrane report on the use of acupuncture as a means of helping people quit smoking (Spoiler: It doesn't):For that particular, specialised application of acupuncture they found 24 studies that have attempted to answer this particular question. Note, not all of the studies found were performed properly (which is a big problem), but this illustrates that studies are prevelent, are being performed by researchers and are also being analysed in some detail: It's not just a case of dismissively waving it away with a hand, and nor should it be. Again, these claims can and are being evaluated.Are you like some sort of doctor or something! Quote Link to comment Share on other sites More sharing options...
nullmouse Posted October 5, 2009 Report Share Posted October 5, 2009 Are you like some sort of doctor or something!Luckily not the kind that gets let loose anywhere near patients Quote Link to comment Share on other sites More sharing options...
Le Stu Posted October 5, 2009 Report Share Posted October 5, 2009 I'd disagree, as many, many studies have been done upon a wide range of alternative therapies. As an example, here's the summary of the Cochrane report on the use of acupuncture as a means of helping people quit smoking (Spoiler: It doesn't):For that particular, specialised application of acupuncture they found 24 studies that have attempted to answer this particular question. Note, not all of the studies found were performed properly (which is a big problem), but this illustrates that studies are prevelent, are being performed by researchers and are also being analysed in some detail: It's not just a case of dismissively waving it away with a hand, and nor should it be. Again, these claims can and are being evaluated.Would these trials be on anything like the scale of the trials for the various NRT treatments though? I somehow doubt it. Personally, I believe that acupuncture for addiction issues brings a largely psychological benefit, a true placebo effect, so these results don't surprise me. I'd be more interested in trials concerning ME if you've got any info on that.Anyway, I'm not really arguing with anything you've posted in this thread as you've obviously got a balanced view. Quote Link to comment Share on other sites More sharing options...
Guest droid Posted October 5, 2009 Report Share Posted October 5, 2009 If the NHS are practicing acupuncture then it must have some scientific value!TCM is not just about acupuncture.My practitioner has a degree in physics and is a very intelligent man,if he can't help you,he won't take money off you for the sake of it. Quote Link to comment Share on other sites More sharing options...
nullmouse Posted October 5, 2009 Report Share Posted October 5, 2009 Would these trials be on anything like the scale of the trials for the various NRT treatments though? I somehow doubt it. Personally, I believe that acupuncture for addiction issues brings a largely psychological benefit, a true placebo effect, so these results don't surprise me. I'd be more interested in trials concerning ME if you've got any info on that.Anyway, I'm not really arguing with anything you've posted in this thread as you've obviously got a balanced view.A lot of these trials do fall short of having the same numbers as you'd expect from a properly controlled trial, which is why organisations like the Cochrane Library give them less weight when reviewing the available evidence. The more robustly designed trials (of which numerous do exist), are given more weight. Given the breadth of conditions acupuncture is suggested to treat it's not surprising that some of the evidence may get spread a little thin, but it's certainly not non-existent. I'm all for big, carefully controlled experiments for every treatment whatever the outcome, but they're not always practical to perform for a wide range of reasons (cost often being the major one, to be honest).With regards ME, there's currently a report being compiled by the Cochrane library (the font of all evidence-based medicine fun) on the effectiveness of acupuncture for the alleviation of chronic fatigue syndrome. Unfortunately, that means there's no conclusion to share just now, but here's something I did find from a recent journal review:Studies on the treatment of chronic fatigue syndrome (CFS) with acupuncture and moxibustion in China were reviewed. All studies concluded the treatments were effective, with response rates ranging from 78.95% to 100%. However, the qualities of the studies were generally poor, and none of them used a RCT design. The common acupoints/sites used in the treatment of CFS, which may reflect the collective experience of acupuncturists in China based on Traditional Chinese Medicine theories can be used to evaluate the effectiveness of acupuncture for the treatment of CFS in future studies using more scientifically rigorous study designs.Note that this review only looks at studies from China (who may have a national pride stake in acupuncture working) and none adhered to an RCT design (meaning patients were neither randomly assigned into groups or controlled appropriately). The authors reflect this in their conclusions. Note though, that the reported success rate in these studies is "78.95% to 100%". The old rule of thumb about "if something sounds too good to be true, it probably is" springs to mind - But keeping an objective mind, this would appear superficially promising. To be 100% sure, proper studies would need to be performed that both randomised the patients in to groups and made sure half of them received fake treatment. If, under those conditions, they still got such high success then everyone would be on to a winner. At the moment, all the studies they review are just comparing doing something to doing nothing, which can't tell us if the treatment is anything more than placebo... Quote Link to comment Share on other sites More sharing options...
nullmouse Posted October 5, 2009 Report Share Posted October 5, 2009 If the NHS are practicing acupuncture then it must have some scientific value!TCM is not just about acupuncture.My practitioner has a degree in physics and is a very intelligent man,if he can't help you,he won't take money off you for the sake of it.TCM isn't just about acupuncture, true - But it's a good example that fits in with the rest of the thread. Irregardless, any TCM should be subject to the same scrutiny as any medical treatment in order to ascertain its effectiveness.The NHS stance on acupunture is a controversial one, and is based on evidence that doesn't necessarily show that acupuncture is any better than a fake needling session. What the evidence does show is that doing acupuncture is better than doing nothing for some conditions. The key question is if acupuncture actually does anything that random needle placing wouldn't. For the treatments that the NHS prescribe acupuncture for, that it is not yet known.I can't really comment on your practitioner, from what you say he sounds like a nice guy though. Quote Link to comment Share on other sites More sharing options...
Guest droid Posted October 5, 2009 Report Share Posted October 5, 2009 The NHS uses it for acute pain,i don't think sticking needles randomly into your body would have the same effect,might be wrong though.My physio calls the points trigger points,nothing to do with TCM but works on the same principle...i.e.blood flow. Quote Link to comment Share on other sites More sharing options...
Le Stu Posted October 5, 2009 Report Share Posted October 5, 2009 Note that this review only looks at studies from China (who may have a national pride stake in acupuncture working) and none adhered to an RCT design (meaning patients were neither randomly assigned into groups or controlled appropriately). The authors reflect this in their conclusions. Note though, that the reported success rate in these studies is "78.95% to 100%". The old rule of thumb about "if something sounds too good to be true, it probably is" springs to mind - But keeping an objective mind, this would appear superficially promising. To be 100% sure, proper studies would need to be performed that both randomised the patients in to groups and made sure half of them received fake treatment. If, under those conditions, they still got such high success then everyone would be on to a winner. At the moment, all the studies they review are just comparing doing something to doing nothing, which can't tell us if the treatment is anything more than placebo...Yeah that does sound a little bit too good to be true and you're right about TCM being a newly installed national treasure in China so politics may be a factor. Anyway, cheers for the info and I've found the site now so I'll quit being so lazy:up: Quote Link to comment Share on other sites More sharing options...
TheTickingTime-Bomb Posted October 5, 2009 Report Share Posted October 5, 2009 If the NHS are practicing acupuncture then it must have some scientific value!TCM is not just about acupuncture.My practitioner has a degree in physics and is a very intelligent man,if he can't help you,he won't take money off you for the sake of it.The NHS is not infallible. Acupuncture does have scientific value,but only as a placebo.Also I know many people who have a degree and yet believe in utter nonsense.There is no shame in ignorance though. Quote Link to comment Share on other sites More sharing options...
TheTickingTime-Bomb Posted October 5, 2009 Report Share Posted October 5, 2009 If I may be slighty tangential: EUS - Homeopathy ProjectThis is the one that gets me fumin'. Quote Link to comment Share on other sites More sharing options...
Scootray Posted October 5, 2009 Report Share Posted October 5, 2009 The NHS uses it for acute pain,i don't think sticking needles randomly into your body would have the same effect,might be wrong though.My physio calls the points trigger points,nothing to do with TCM but works on the same principle...i.e.blood flow.Give me 50 per session and we'll test it out. Quote Link to comment Share on other sites More sharing options...
Alkaline Posted October 5, 2009 Report Share Posted October 5, 2009 Who's up for a good, old fashioned blood-letting. The leeches are ready! Quote Link to comment Share on other sites More sharing options...
Le Stu Posted October 5, 2009 Report Share Posted October 5, 2009 The NHS is not infallible. Acupuncture does have scientific value,but only as a placebo.Also I know many people who have a degree and yet believe in utter nonsense.There is no shame in ignorance though.Oh come on, you can't claim acupuncture is purely down to the placebo effect. An absence of hard data to support the efficacy of acupuncture treatments hardly constitutes proof that it is merely a placebo.I blame that Richard Dawkins, I really do... Quote Link to comment Share on other sites More sharing options...
TheTickingTime-Bomb Posted October 5, 2009 Report Share Posted October 5, 2009 Oh come on, you can't claim acupuncture is purely down to the placebo effect. An absence of hard data to support the efficacy of acupuncture treatments hardly constitutes proof that it is merely a placebo.I blame that Richard Dawkins, I really do... The absence of hard data simply proves that it should not be assimilated into our medical system. Also, the five phases theory of acupuncture along with the idea of "Qi" simply don't fit in to the crossword puzzle of evidence that constitute our current biomedical understanding of the human body.If there is some desirable effect in the practice, then it certainly isn't in these antiquated concepts. However I have not seen any evidence at all to prove beyond reasonable doubt that it achieves anything more than the placebo effect. Quite how Dicky Dawk comes into this I'm not at all sure. Quote Link to comment Share on other sites More sharing options...
Le Stu Posted October 5, 2009 Report Share Posted October 5, 2009 The absence of hard data simply proves that it should not be assimilated into our medical system. Also, the five phases theory of acupuncture along with the idea of "Qi" simply don't fit in to the crossword puzzle of evidence that constitute our current biomedical understanding of the human body.If there is some desirable effect in the practice, then it certainly isn't in these antiquated concepts. However I have not seen any evidence at all to prove beyond reasonable doubt that it achieves anything more than the placebo effect. Quite how Dicky Dawk comes into this I'm not at all sure.He uses the same arguments, that an absence of proof is a proof of absence. It's an infantile argument.I suggest you look at the video I posted of the young Buddhist fellow getting repeatedly kicked in the nuts. Not because it proves Qi exists but because it's fucking awesome:up: Quote Link to comment Share on other sites More sharing options...
Guest droid Posted October 5, 2009 Report Share Posted October 5, 2009 The absence of hard data simply proves that it should not be assimilated into our medical system. Also, the five phases theory of acupuncture along with the idea of "Qi" simply don't fit in to the crossword puzzle of evidence that constitute our current biomedical understanding of the human body.If there is some desirable effect in the practice, then it certainly isn't in these antiquated concepts. However I have not seen any evidence at all to prove beyond reasonable doubt that it achieves anything more than the placebo effect. Quite how Dicky Dawk comes into this I'm not at all sure.So what you are saying is the NHS are wasting money and resources on an "antiquated concept" that clearly works for some people..Conventional medicine only works for some people,but is this justified because it has been clinically tested to produce hard data?I have seen TCM work first hand,what is your experience of it?Furthermore is UCLH wasting millions on alternative therapies..http://www.uclh.nhs.uk/Our+hospitals/Royal+London+Homoeopathic+Hospital.htm and The Gerson Institute - Alternative Cancer Treatment Quote Link to comment Share on other sites More sharing options...
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