Sunday, January 11, 2009

My first sheaf of notes!

I fell asleep last night to the sounds of the giant oscar cichlid eating the weakest of the other fish - the telescope eye goldfish. I can't understand why anyone would purposely breed an animal that is half-blind, so deformed that it can barely move about, and susceptible to injury through its own actions.
` Unless it was meant to be a feeder fish, which it was in this case. That is, until the cichlid realized it couldn't swallow it whole.
` That is why, this morning, I woke up to the sounds of Lou Ryan and B-Gangsta trying to flush the poor monstrosity's mangled remains down the toilet.

They got stuck halfway.

Well, this is a great excuse to work on making one of the other two bathrooms in the house usable!

Just thought that might be of some amusement to you all. Now, down to business: In the Corrigendopedia, my main format will be two columns, rather than one.

The left-hand column will have a general, brief overview of a broader topic, while the right-hand column will have more details, including links to specific examples of the same topic.

In other words, it's very non-linear and, by displaying all manner of things, is intended to prompt the reader to ask questions and gain curiosity.

Now, these notes are extremely incomplete and contain no references, precisely because I've heard all of this information from many reputable sources and don't precisely remember where it is I've heard all this from.
` References will be added as I go over the material I got it all from, but that comes later on as I double-check, triple-check and fill in the details of the notes, turning them finally into a proper article.

Does this make sense to you?

The first notes I just happen to have decided to start with are about Evidence-Based Medicine versus Non-Evidence-Based Medicine. The point of this exercise is for me to physically type in all this stuff, in a linear fashion, and show any folks watching out there that I am indeed working on the Corrigendopedia.
` I figure, if I keep doing this every four days, I'll have it 'filled in' by no time.

No wonder I've had so much trouble starting this website - this is the most backwards method possible! Read this and see if you don't agree:

Non-Evidence-Based Medicine (left column)

Is the preferred term for Alternative or Complementary Medicine. Let's compare the definitions of Evidence-Based Medicineand Non-Evidence-Based Medicine. ...

For short I'll call them EBM, and Non-EBM.

Sometimes, Non-EBM is recommended alongside EBM. To paraphrase snarky skepchick Rebecca Watson, "First, bathe in crystals, then have the tumor removed. It works!"

What are some differences?

Why call it Non-Evidence-Based Medicine? The only conclusive studies in 'alternative' medicine are conclusively negative.
` There is at least some degree of certainty in Evidence-Based Medicine.

Biomedical research is extremely expensive and time-consuming, and doing this on the free market results in a lose-lose situation.
` First of all, on the free market, Non-EBM products are attached to health claims before any research is done.
If they were to do actual research, the manufacturer must provide its own millions or even billions in research money, and if the product is found to be unsafe or not able to meet the company's claims, then they risk a possible decrease in sales, thus sabotaging themselves.
` On the other hand, if the research does happen to show that your product really does work, it won't help your sales because you've already said that it works before even bothering to see if it really works or not!
` Since just saying that something works is what people respond to the most, sales probably will not increase and you've just wasted millions of dollars of your own money.
` This is why free-market companies would rather spend their millions of advertising - that's the only sure way to improve sales.

Offshoot: Herbal Supplements

What is a drug? It is a substance that affects the body in a way other than providing nutrients. In other words, it does something to you other than what food does (of course, some foods contain drugs, such as coffee beans).

Herbs are taken for their pharmacological effects, which therefore makes them drugs. In America, these drugs do not need to be proven effective, or even safe, because they are labeled as 'dietary supplements'.
` Thanks to the Dietary Supplement Education Act, herbs are not allowed to be labeled with claims that they can cure any disease, only that they 'may improve' bodily functioning. A quick perusal through an aisle full of such 'supplements' will reveal a multitude of examples.

Drugs take massive amounts of time and money to establish because they must be regulated.

If mainstream medicine were not regulated, it would be like... alternative medicine! The free market would explode with unproven pharmaceuticals!
` There is very little chance that untested drugs are safe or effective; regulation is what ensures that drugs on the market are probably both safe and effective.
` However, consumers don't usually choose their supplements after carefully reviewing the literature, they choose based on what they perceive as quality. Personal evidence is not acceptable in medicine because there are always people who swear by products that 'work' even though this is highly unlikely for a variety of reasons.
` Scientists know how much individual situations differ, and they see how what seems to work for one person can easily not work for others. If they can't find something that has consistent effects for more than just one person, then there isn't much point in pretending that it does.

It's your health on the line. Would you trust someone who does not think basic medical standards are very important? A consumer typically has no tools to test out whether a product works. They mostly go by what the ads claim to sell, or by what they are told.
` Interestingly, many quacks do believe in what they're doing, even some who have medical training.

Testing methods (Detail?)

Pilot studies are tiny and usually have no placebo group. The point of them is to see whether or not it's even safe to have studies with more people, over a longer time, with a higher dose of the drug.
` In other words, pilot studies are not designed to determine the effectiveness of the drug, only the safety of it as tested on a small handful of people.
` Because the placebo effect is not measured, every drug will seem to show somewhat positive results, whether or not it later turns out to be effective. On top of that, negative studies tend to be published less often.
` In Phase II trials, there is enough exposure to the drug, and a placebo group so that the outcomes with the real drug can be compared with the positive effects from a fake drug.
` It isn't until Phase III trials that one can gain definitive evidence: That is, it's a prospective study, which means that experiment is designed before the data is collected. In Phase III trials, controls like double-blinding are the norm.
` Though Phase III gives the least promising results, they show what's passed all the tests and what doesn't measure up. Echinacea, Gingko, St John's Wort, etc, have all failed.
` If an effect is determined after two or three Phase III trials, and side-effects are relatively mild, then the drug is taken to Phase IV trials, which are the facilitation of common use.
` This process takes about a decade and many millions of dollars.

Supplements, magnets and the like do not need to be regulated, so marketers can use pilot studies, which, remember, are relatively cheap but worthless for determining the effectiveness of a drug, to claim that they've been scientifically tested with positive results.
` Another method is to refer to studies that show positive results for something completely irrelevant and pretend as though they support what the marketer is selling.

The people at drug companies, however, do not have this liberty.

Pilot studies of echinacea affecting affecting the natural course of the common cold were aggressively marketed at the public as if they were significant.
` By the time echinacea got to Phase III trials, no effect was found, though the marketing effects have lived on. In other words, enough people were told, and believed, that it worked, earlier on, and that's all that was needed to get a market going.

When Phase III trials are done on 'alternative' products and are shown not to work, it generally has no effect on the market because commerce is separate from scientific research. No change has been found in sales of Echinacea, Gingko, St John's Wort, etc. when they were shown not to live up to the manufacturers' claims.
` Selling products is all about marketing and advertising. Even Consumer Report, a skeptical publication, does not sway the established customer base.

Some say, "We know it works because people have used these herbs for thousands of years."
` The truth is that most of them are simply new gimmicks for a changing market.
` Even so, a thousand years ago, people had a 50-50 shot at surviving to 18 years of age, and had an average lifespan of 35. Why would anyone believe that they had superior medical knowledge?

Interestingly, many pharmaceutical companies sell herbal supplements because they do not require millions of dollars in scientific research and possible rejection. Instead, the herbs are ready to sell, no impediments.
` The fact that some drugs, like Vioxx, have been found to be dangerous is a good example of how science corrects itself. If some herb made people more likely to have heart attacks, we would have no way of knowing because they would probably never be scrutinized.

Scientists know full well just how much people can fool themselves into thinking that treatments work, via a placebo effect, and that's what science is for.
` Well-designed trials are meant to eliminate one's expectations. That is why scientists routinely find things that surprise them.

Scientific viability is not required when it comes to patents or licenses for 'Alternative' medicine. Take the wide world of 19th century 'Patent Medicine'. ...
` In other words, your invention doesn't have to work - a patent is merely evidence that you came up with a unique idea that no one else has.

Non-EBM practitioners don't have to pass any kind of inspection of qualifications to have a state-issued license. Like psychics, they merely have to decide for themselves what they think makes them qualified, no objective tests administered.

In evidence-based medicine, you can get in trouble for giving substandard care. Non-EBM takes care of this problem by not having any standards to begin with.
` If you're administering some type of treatment that's not even based on scientific research, you can protect yourself from malpractice suits by labeling it 'alternative medicine'.
` Unlike a doctor, your patients are not protected if you behave irresponsibly, even if it's intentional.

How was Vioxx discovered to be dangerous? Scientific scrutiny and research! Since 'alternative' medicine isn't part of the medical community, there is no one there to screen for things that are harmful or don't work.

Examples of Non-EBMs (Offshoot)

Sam Chuchua claims to cure cancer, as do Hulda Clarke and (Adolph?) Brazinski. Each of them has a different explanation for how cancer works - Clark claims it's because of bodily pollutants while another says it has to do with a certain protein, and the other says the key is nutrition. Yet, despite these contradictions, they support one another.
` Why? If they criticized one another's claims, they'd encourage other people to shoot down the others claims with scientific research, and they don't want potential followers looking into that.

Since stem cells have been all the buzz, some Non-EBM practicioners like to profess that they're into that.
` Dr. Hwang implants olfactory stem cells into patients with ALS, MS, spinal cord injuries, etc. He says the reason he's done zero research is because he's too busy healing people.
` So, some neurosurgeons found the time to study his technique and found no benefit, as well as a side-effect rate of 80%, meningitis among them.

Toxins, of course, are routinely used as medicine. For example, scientific studies show that Botulinum toxin actually works in treatment of nervous disorders.
` Dr. Coley discovered tumor necrosis factor, which our body produces when we are infected with bacteria. It's been shown to kill only part of tumors, and can kill other tissues, so it's potentially dangerous and doesn't work well enough to meet modern medical standards.
` However, some people sell products purported to contain 'Coley's Toxins'. The good news is that they don't.


According to one survey, 1/3 of women taking herbal supplements for menopause don't tell their doctors, and 2/3 also say these supplements work.
` It may be telling that 70% of former users say that it did not help them.

Laetrile is naturally found in crops like maize and cassava. When cows eat too much laetrile, they stagger and fall down, showing symptoms similar to 'mad cow' disease (bovine spongiform encephalitis).
` Laetrile contains very well-known poisons like cyanide, and the only clinical effects known are toxic rather than beneficial.

Conspiracy? (Offshoot)

Many Non-EBM practitioners diagnose their patients with cancer, without first having any medical evidence of cancer, and then administer a treatment that costs the patients money.
` Since the patient almost certainly has no cancer to begin with, they are grateful to find that they still don't have cancer by the end of treatment.

Many people who are utterly immersed in Non-Evidence-Based Medicine and/or conspiracy theories have told me that the people working for 'Big Pharma' have a cure for cancer but won't share it.
` My answer is: A cure for cancer would tell us a lot about the nature of cancer itself, because for all those medical researchers know, different types of cancers have different causes, and currently cannot all be treated in the same way.
` If any research hinted at a cure-all for cancer, various pharmaceutical companies would be in a race for the sloagan; 'First to Cure Cancer'. Such a title would amount to the winning company's financial security for the next hundred years.

Upon hearing that, most of these people say; "That's total bullshit!" Then, they usually say one of three things;

1.) "If they did that, people would stop getting sick and the company would stop making money."

And I say to that; "If that was so, then why did pharmaceutical companies bother to completely wipe out other diseases (at least in industrialized nations) such as smallpox or polio, which used to kill and disable people on a regular basis?
` Besides, I would think that saving people's lives is more effective at keeping a patient base than letting them all die, since they may later on need other drugs from your company.

2.) "Their cancer cure patent would only last twenty years, and after that, they wouldn't be able to make any more money off it."

And I say; "If your company actually cured cancer, it wouldn't ever lose its recognition. As I've mentioned, it's the ultimate advertising campaign."

3.) "The cures from cancer can be found in our backyards, and they can't make money off that."

And I say, "Au contraire! Some pharmaceutical companies also make money off of selling herbs that you can grow yourself. Why? They don't require all that complicated and expensive scientific testing.
` The truth is, most people would rather buy their herbs than grow them, just as most people buy fruits and vegetables (or even cannabis!) at the store even though they can grow their own."

Besides, if they really did have a cure, then why do pharmaceutical companies spend billions of dollars a year on cancer research?

Also, why would researchers and physicians alike let their own friends, spouses and children die of cancer?
` Of course I've gotten responses like, "Those doctors very well-educated, they just don't realize they're not being taught the right things." ...

Most articles about the safety of microwave ovens are sober and scientific. According to them, the radiation levels of microwave ovens are far below the recognized 'safe' levels. If you stand a foot away from a microwave oven, there's virtually no radiation because the levels fall off at, well, the rate at which microwave radiation falls off. Which is fast.
` Still, it's not safe to stand too close to the microwave and look in, because that can give you cataracts.
` On the other hand, there are some really incoherent articles that claim microwave ovens kill people. It is important to note that these are usually written by naturopaths and the like.


People have always asked; "How does disease come about?" Before things like harmful bacteria were discovered, there were many ideas. Some had to do with an irregular flow of life-giving energy.
` One such idea was that a life force from God comes down through the top of our heads and through our nerves, keeping us healthy. When the nerves are crooked, we get sick.
` That idea was called 'chiropractic', though only about 30% of today's chircopractors still make these claims.

It is interesting to note that people with severed nerves do not have diseases aplenty - their organs would be getting no 'life force', so why are they still healthy?
` Also, the neurological symptoms of a pinched nerve are not usually present when a chiropractor makes this diagnosis.

While some chiropractors do have some medical education, they are not required to have basic medical knowledge to get their doctorate, and don't even need to pass any kind of test.

Most of what chiropractors do has nothing to do with disease, but rather it's about manipulating one's spine to relieve back pain. It's about as good as physical therapy and other EBM treatments.
` However, neck manipulation can tear arteries and increases the risk of stroke by five times. If neck manipulation were a drug, it would not survive FDA inspections because it is too much of a health hazard.


In Hahneman's time, medical doctors relied on the four humors, which later evolved into the 'hot' and 'cold' energy in modern Non-EBM practices. Methods of treatment based on this view involved experimenting with bloodletting and having patients ingest toxic minerals, treatments which did kill some of them.
` The best treatment a patient could get was to stay out of a hospital, and since homeopathy did not hurt patients, they had a better chance of surviving their illnesses. Apparently, Hahneman saved lives by keeping them away from doctors.
` In a very real way, by not killing people, homeopathy was superior to 19th century medicine!

Proving a substance generally involves telling people what to expect, so it's no surprise that they can develop matching symptoms. ...

As James Randi has quipped; "The First Law is that you take something that gives you symptoms; the Second Law is that you don't."

In modern times, Dr. Strauss rigorously tests homeopathy, using up lots of money despite the fact that he hasn't found anything yet.

I hope this jumble of assorted notes was not as exhausting to read as it was for me to type! Now, to put everything into its own place and, well, continue on with assemblage!

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