The Power*

by apesara

How not to do a study on the efficacy of “alternative” medicine:
[Via Respectful Insolence]

If there’s one thing I’ve learned over the last four years of examining the various forms of woo out there, it’s to be very, very skeptical whenever an advocate of a highly dubious-sounding “therapy” points to a study as “proof” that the therapy, whatever it is, works. Usually, what I find is a small pilot study with inadequate controls or even a poorly designed study. For example, the acupuncture literature is rife with these sorts of studies. It’s also rife with larger studies for which the control was inadequate–or for which there was no real control at all. This phenomenon is generalizable to many, if not most, studies of so-called “complementary and alternative medicine” (CAM), as is another feature, namely that the larger and better designed the study, the less likely it is to find a treatment effect greater than placebo due to the treatment. Another principle is that at a statistical significance level of 95%, at least 5% of studies will appear to find a treatment effect through random chance alone. Guess which studies will be cherry picked and held up as “proof” while the preponderance of studies showing no effect are ignored?

There is at least one other form of studies pointed to by CAM advocates to “prove” that their woo “works.” Indeed, this form is perhaps their favorite crutch to fall back on. It’s what I like to call the “non sequitur” study. In other words, it’s a study that is, at best, only tangentially related to the question at hand, or, as I like to put it, a study that is related to the therapy being argued for only by coincidence. This sort of study is a favorite of homeopathy. Just think of studies about the molecular bonds of water homeopaths like to point to as “evidence” for the “memory of water.” It is this latter form of study that I’m going to deal with here.

Remember about three weeks ago, when I had a bit of fun with one of the most hilariously ludicrous bits of woo that I’ve ever seen, Tong Ren? If you’re really new to the blog and didn’t happen to read my post, I encourage you to go back and do so now. If you do, you’ll see, besides my own inimitably insolent prose, YouTube videos of a man named Tom Tam leading a bunch of people tapping on acupuncture dolls with small hammers and concentrating their “intent” to “heal” a person. I’ve seen a lot of woo before. A lot of woo. But Tong Ren was about the most ridiculous things I’ve ever seen. These people really believe that by taking what looks in essence to be a voodoo doll and tapping on it at the correct acupuncture points, they can direct some vague “energy” undetectable by science to cure cancer and all manner of other diseases. One thing you’ll also see is a news report that mentions a study of Tong Ren being done at the Dana Farber Cancer Institute, a very prestigious institution indeed. Naturally, at every opportunity, the connection to Harvard University is played up, so desperate is Tom Tam to wrap himself in the mantle of seeming legitimacy that the attention of Harvard University suggests. When I poked around various Tong Ren websites, I couldn’t find out anything about the study other than that it appeared to be some sort of survey and that the manuscript had been submitted.

It appears that the manuscript has been accepted and was published recently in a journal I’ve never heard of, namely Complementary Health Practice Review. The article, entitled The Tong Ren Healing Method: A Survey Study, by Amy M Sullivan, EdD (Virginia Commonwealth University School of Medicine), Susan Bauer-Wu, PhD, RN (Emory University), and Michael Miovic, MD (Dana Farber Cancer Institute). Of course, that this study appeared in a journal called Complementary Health Practice Review does not bode well for the quality of the study, and this is no exception. More importantly, the question studied by this study is related to the question of whether Tong Ren “heals” anything only by coincidence. Check out the abstract:

Read the rest of this post…

If this paper is typical of what gets published in the alternative medicine literature, then there are a lot of people in need of training in the Scientific Method. An anthropological poll based on what people report happen to them is not science. It is a poll.

The real telling thing for me is this:

Prior to the study, we determined that if 50% or more of participants reported improvements with symptoms of their disease or relief from side effects of treatment, we would consider this sufficient preliminary evidence to support future, more rigorous investigation of this healing method.

How was this figure arrived at? Why 50%? What is the percentage for any other sort of therapy? What placebo effects might alter this figure?

It looks to me that the 50% is just a gut reaction. I might argue that if even 30% of the people responded positively it was an important therapy? Or I could argue that over 70% was needed? The number is purely arbitrary and without any rigor to it at all.

And the journal wants $30 from me to read the paper myself!! Nice work if you can get it.

I wonder if insurance pays for this weird little therapy?

*taken from a great novel by Frank M. Robinson that had this little poem in it:

You remind me of a man.
What man?
The man with the power.
What power?
The power of hoodoo.
Hoodoo?
You do.
Do what?
Remind me of a man

and so on.

Technorati Tags: Health

White roofs for a green future

Geoengineering, adaptation and mitigation, Part 2: White roofs are the trillion-dollar solution:
[Via Climate Progress]

Part I introduced urban heat island mitigation (UHIM). It discussed how lighter colored (or reflective) roofs and pavement, plus urban trees, can save energy, cut CO2 emissions, cool a city, and reduce smog.
But a global “cool roofs” strategy can achieve far bigger benefits – the equivalent of several trillion dollars worth of CO2 reductions – since it can increase the albedo (reflectivity) of the planet, thereby directly reducing the absorption of incoming solar radiation and hence planetary warming. The strategy proposed below “is equivalent to taking the world’s approximately 600 million cars off the road for 18 years.“

[100 m2 (~1000 ft2) of a white roof, replacing a dark roof, offsets the emission of 10 tonnes of CO2.]
This is technically geoengineering, although I’d call it geoengineering light or geo-reverse-engineering, since we are mostly undoing the albedo decrease caused by all the dark roofs and dark pavement we have covered the planet with.
A forthcoming article in Climatic Change, “Global Cooling: Increasing World-wide Urban Albedos to Offset CO2,” provides the detailed calculations. A two-page non-technical summary, “White Roofs Cool the World, Directly Offset CO2 and
Delay Global Warming,” has been written by two of the country’s leading UHIM experts: Lawrence Berkeley National Laboratory’s Hashem Akbari and California Energy Commissioner Arthur Rosenfeld (coauthors with me on “Paint the Town White–and Green“). I reprint it below:

Kind of a cool idea. Ways to increase the albedo by painting things white could be helpful. I wonder if building large floating islands of styrofoam up in the Arctic would also help reflect more of the sun’s rays away, helping keep a larger icepack?

Technorati Tags: Environment, Science