SGU Episode 505
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| SGU Episode 505 |
|---|
| March 14th 2015 |
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| (brief caption for the episode icon) |
| Skeptical Rogues |
| S: Steven Novella |
B: Bob Novella |
J: Jay Novella |
E: Evan Bernstein |
| Guests |
K: Kevin Folta |
M: Marc Randazza |
| Quote of the Week |
All things must be examined, debated, investigated without exception and without regard for anyone's feelings... We must run roughshod over all these ancient puerilities, overturn the barriers that reason never erected, give back to the arts and sciences the liberty that is so precious to them. |
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| Show Notes |
| Forum Discussion |
Introduction
You're listening to the Skeptics' Guide to the Universe, your escape to reality.
Forgotten Superheroes of Science (5:47)
- Emmy Noether: Groundbreaking mathematician made significant contributions to Algebra and Theoretical Physics
News Items
Bright Spots on Ceres (9:37)
Clinical Science (14:25)
S: Alright, let's move on, the next item I want to talk about, this is an interesting one, this is about the essence of the disagreement about the nature of medical research between science based medicine and alternative medicine proponents. If you recall, about six months or so, David Gorski and I had an article published where we essentially argued that doing clinical research on therapies that are essentially magic, they're so impossible that you might as well think of them as magic, is a waste of resources.
E: How controversial.
S: Yeah, right, exactly. But obviously the alternative medicine proponents were not happy with our opinion because everything they do is essentially magic. If you accept the fact that you shouldn't research things like homoeopathy, the homoeopaths aren't going to like that. So there was a lot of push-back, a lot of criticism of our article, all nonsense, nothing that we hadn't heard before. Again, in my opinion, the alternative medicine community is intellectually bankrupt, they have nothing new or interesting to say, their ideas have been completely demolished long ago, they're on a par with the creationists, really. They're just recycling the same logical fallacies over and over again. As evidence for that, a recent article was published by Sunita Vohra and Heather Boon in an alternative medicine journal, once again criticising David Gorski's article, David Gorski's and my article, although they misspelled his name Gorki. Gorki and Novella. (laughs) David hates that.
E: Nice (laughs).
J: It's awesome, right?
S: In which they recycle the same tired, old arguments. But here it is. I just wanted to summarise, to use this as an opportunity to summaries the Science Based Medicine opinion and what they're saying. So fist they say that essentially you shouldn't use prior plausibility to determine what ideas in science should be researched.
B: Oh god.
E: How convenient.
B: Seriously?
J: What?
S: Essentially, their agument, this is their argument, this is their actual logical argument, although they're not as pithy as this, but it boils down to: we don't know everything, therefore we should behave as if we know nothing. That's their argument. Their argument is: we don't know everything. And then they erect a bunch of straw men about what our position is.
B: Logical fallacy.
S: Yeah, our position is not that we know everything. And they also, interestingly, flip one of our arguemnts, which again, they're not even following the basic logic of our argument. We would say that basic science, if a treatment looks promising from a basic science point of view, you still need to do high quality clinical studies because just looking promising in the test tube isn't enough and doesn't really predict what's going to work clinically, you still have to do the clinical research. They take from that the reverse argument that things which look impossible at the basic science level still may work.
E: Oh my gosh.
S: But you can't do that, I mean that doesn't make any sense.
E: So kabooki dances and voodoo are just as plausible as anything else out there.
S: Yeah, exactly. Yeah, why not spend money studying voodoo. Yeah, exactly. Which, homoeopathy is on that level, it's magic, it's complete magic. They actually pull the Galileo gambit, they mention Galileo by name.
E: Of course.
J: Oh, not again.
E: That old chestnut.
S: Yeah. So, that's number one, prior plausibility, scientific plausibility is right out, that's just bias and so we should act as if we know nothing, as if everything is a brand new question, it's a new day. Number two, and this is really, think about the combination of these two things. Their second big point is, it's like yeah, but we get, because our argument is, it's a waste of resources, we have limited research resources, we can't do definitive efficacy trials of every crank idea, we have to pick and choose which ones are likely to work out, you know?
E: Right, limited resources, hello?
S: So here's their solution.
J: Uh, oh.
S: You don't waste resources doing large, definitive efficacy trials, you could do smaller trials like n of 1 trials. N of 1. That's one person. Or you could do pragmatic studies. Pragmatic studies are designed for comparing the real world application of proven therapies, they're not placebo controlled, they're not efficacy trials. So get this: they want to simultaneously throw out prior plausibility and appeal to the weakest form of clinical evidence. So they want to support their treatments with low-grade clinical evidence without any appeal to scientific plausibility. That's their solution.
B: Well that's the only chance they have.
S: Of course.
B: Right?
J: Well they could change their freaking minds.
S: Yeah, or they could respond to the actual evidence. What we're saying is, you know. The other thing is, it's not as if these things haven't been studied, like for example, there was just yet another review of homoeopathy which I wrote about on science based medicine today. They looked at over 1800 studies. Of those, they found 225 that were worth look at. The rest were so bad they weren't even worth counting.
B: Oh my god.
S: The 225 studies they looked at, they did a systematic review, this was the Australian National Health and Medical Research Council. They concluded that homoeopathy doesn't work for anything. There's no clinical evidence to support homoeopathy's effectiveness, it's indistinguishable from placebo. So you have a treatment that makes absolutely no scientific sense, for whom we already have hundreds of studies showing it doesn't work for anything, but Vohra and Boon, they're the one who are studying homoeopathy. In fact, they're looking at homoeopathy for ADHD, they're involved in a controversial study in Canada looking at homoeopathy for ADHD. Why? Why should we ever do another homoeopathy study? It's impossible and it doesn't work. That is a complete waste of resources, it's unethical to subject subjects to that, it is complete malfeasance in terms of our responsibility to society, to civilisation. Nothing less than completely throwing homoeopathy on the trash heap of history is ethically or scientifically appropriate, and yet they're trying to say, wait a minute, we don't know everything, you don't know, we can't say that, just because it looks impossible doesn't mean it is, and by the way, we're going to do crappy studies and use that as our evidence so we don't have to waste time with these fancy-smancy double-blink placebo controlled trials. That's their position, that's what they've got. And that's what we get every time, that is their position. What I liked about their article was they so nicely summarised the alternative medicine position and they made their two points right after each other so it really put it into very clear focus.
J: So the summary here is they wanted to develop really shitty science to support their shitty ideas about how to make...
S: Exactly.
J: And it boils down to them making money, it's not even about science, it's just about them having the thing that they...
S: Well the thing is, they want their treatments to be studies because the fact that they're studied is a marketing point, the fact that they're being studied. And they want to do crappy studies because they're almost guaranteed to be false-positive.
E: They must not agree though that there's been no evidence that homoeopathy does anything. They have a totally different opinion of the research I suppose.
S: I depends who you mean by "they".
E: These two researchers for example.
S: I don't know about these two researchers. One of them actually doesn't believe homoeopathy works but thinks that we should study it. I think that's Boon.
E: Oh that's interesting.
S: Thinks that we should study it because it's popular. First of all, it's not that popular, it really isn't, it's single digits, it's not that popular. And second of all that's not a reason to do yet another crappy study when there's already been over 1800 studies in 200 years and they haven't been able to show it works. At some point you have to give up and just say. If you're worried about the public then you should just talk to the public and let them know that this is magical nonsense that doesn't work, that's what they need to know. We don't need another study, because another study's not going to change anything. It's the definition of wasted resources because to anyone who is scientific or skeptical we've already shown it doesn't work, and to anyone who hasn't been convinced by 1800 studies, 1801 is not going to convince them. It's a complete waste of resources. *sighs*
J: At this point Steve, just imagine that government institutions probably need to show some backbone here and say we're not going to spend any money on this garbage.
S: Well that's the thing, the UK did a report saying it's witchcraft, stop supporting it, now Australia has done it. The science is there, the consensus is there, it's amazing that we cannot summon the political will to get rid of this, to just get this monkey off our back. Civilization can comfortably ditch homoeopathy, again just relegate it to the trash heap of history, there's no excuse for anything else.
B: I mean this, homoeopathy, it's the poster child of this type of thing, and it just gives me so little hope that if we can't put this one to bed, the other ones, forget it, how are we ever going to put them to bed?
J: I know Bob, tell me about it.
B: It's really discouraging.
J: I mean homoeopathy is so disproven it's so obviously wrong, and if there's people that are never going to give it up alive today, what do you do at this point?
S: You've just got to marginalise it, got to win the political battles.
E: Can't eliminate it though, it'll never go away, ever.
J: We have to educate the next generation to know that it's stupid.
S: Yeah well this is why we need science based medicine because that's the line in the sand, right? Evidence based medicine doesn't quite get the job done, we need science based medicine.
E: Right.
Gravity Lensing (24:49)
Edison’s Plans to Record the Dead (31:14)
Who's That Noisy (36:17)
- Answer to last week:
Interview with Kevin Folta (40:23)
Interview with Marc Randazza (57:07)
Science or Fiction (1:06:27)
Item #1: A new analysis finds that the Milky Way is 50% larger than previous estimates, and has a rippled or corrugated shape. Item #2: Recent estimates indicate that the Milky Way contains more stars than the rest of the local group combined. Item #3: Astronomers have discovered nine new dwarf galaxies orbiting the Milky Way.
Skeptical Quote of the Week (1:22:08)
'All things must be examined, debated, investigated without exception and without regard for anyone's feelings... We must run roughshod over all these ancient puerilities, overturn the barriers that reason never erected, give back to the arts and sciences the liberty that is so precious to them.' - Denis Diderot
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