[recycled post, with a few text edits; original here]
Hmm. Was I wrong in concluding that St. John’s Wort was little more than placebo? (Mind you, I have been wrong before and will be wrong again.) I had come to that conclusion after encountering and reading a well-designed and controlled study conducted in the good ole U.S. of A.
So I was a bit surprised when my eyes hit upon this headline: St. John’s Wort Relieves Symptoms Of Major Depression, Study Shows. The article states:
New research provides support for the use of St. John’s wort extracts in treating major depression. A Cochrane Systematic Review backs up previous research that showed the plant extract is effective in treating mild to moderate depressive disorders.
“Overall, we found that the St. John’s wort extracts tested in the trials were superior to placebos and as effective as standard antidepressants, with fewer side effects,” says lead researcher, Klaus Linde of the Centre for Complementary Medicine in Munich, Germany.
Hmm. The “new research,” was a systematic review of previously conducted research. In other words, the new research wasn’t a meta-analysis, which itself would necessitate a grain of salt to accept. It was a “Chochrane Systematic Review.” What, pray tell, is that? As far as I can tell it is a methodological review of research findings contained in the Chochrane database. The method employed depends upon the author. Interestingly, nearly all of the positive studies were conducted in Germany. Why is that?
Alright, so maybe I’ll refine my conclusion. St. John’s Wort may be effective, but the jury is still out.
Here are a couple questions I have.
1) Does it matter that the reviewer is from the “Centre for Complementary Medicine in Munich, Germany”? (Maybe?)
2) How is this complimentary medicine? Rename St. John’s Wort as, say, hyperizoft (i.e. tag the extract of the active ingredient — Hypericum perforatum — with a pharma-sounding name, and would one continue to believe this type of medicine belongs in a distinct category?
Acupuncture works. Kindof. Multiple studies have determined it is as effective as “sham acupuncture.” But no more. Sham acupuncture is basically false acupuncture — it ignores the supposed energy meridians and there is no actual puncturing of the skin. Envision toothpicks pressed on random spots.
A new study on acupuncture sheds light on both how it doesn’t work and how it succeeds in eliciting a placebo-like response.
In the ScienceDaily post, Acupuncture Not Superior to Sham Acupuncture in Knee Osteoarthritis, Study Finds, I learned -
Researchers from MD Anderson Cancer Center determined patients with osteoarthritis (OA) of the knee who are treated with traditional Chinese acupuncture (TCA) do not experience any more benefit than those receiving sham acupuncture (placebo). The team did find that the communication style of the acupuncturist could have a significant effect on pain reduction and satisfaction in patients….
A total of 455 knee OA patients received either TCA or sham acupuncture treatments and 72 healthy controls were included. Acupuncturists were trained to interact in 1 of 2 communication styles — high (“I’ve had a lot of success with treating knee pain”) or neutral (“It may or may not work for you”) expectations. Patients were then randomized and nested within 1 of 3 style groups — waiting list, high, or neutral….
The team found significant differences in J-MAP pain reduction (0.25) and satisfaction (0.22) for those patients in the high expectations group compared with the neutral group.[emphases added]
In other words, it is looking like that when acupuncture does work, it is not the voodoo of sticking pins in magic chi-releasing, yin-and-yang balancing points — as the dogma asserts — but upon the expectations of the patient and how these may be influenced by the “bedside manner” of the practitioner of this pseudo-scientific modality.
The most interesting part of the study, for me, was the effect of “communication styles.” I wonder, does a doctor provide better treatment — in the short term it should be noted — by engaging in behavior that borders on salesmanship? Is it the better salesmanship of the practitioners of alternative medicines that people are drawn to?
I’ve had a lot of success with this. Statements like that are a lot more conducive to hopeful feelings than, say, Studies have determined that for people in your condition this treatment is 38% effective of a five year period.
Hmm. Should this type of soft salesmanship be part of a doctor’s modus operandi? I wonder.
[recycled post - first appeared here]
That sound you just heard was millions of dollars of future vitamin revenues being flushed down the toilet. Well, if people bother to read the science news, that is.
Antioxidants Are Unlikely To Prevent Aging, Study Suggests
You mean I can’t just buy some friendly sounding pills at my local health food store or supermarket and effectively treat what ails me and even cheat death? A little background:
In 1956, Denham Harman proposed the theory that aging is caused by an accumulation of molecular damage caused by “oxidative stress”, the action of reactive forms of oxygen, such as superoxide, on cells. This theory has dominated the field of aging research for over fifty years. But now, a study published online today in the journal Genes & Development suggests that this theory is probably incorrect and that superoxide is not a major cause of aging.
In the developmental psychology text I use they still mention this theory. I wonder if it will be erased from future editions.
Here is my favorite passage from the article:
“The fact is that we don’t understand much about the fundamental mechanisms of aging,” says Dr David Gems from UCL. “The free radical theory of aging has filled a knowledge vacuum for over fifty years now, but it just doesn’t stand up to the evidence.”
If nature abhors a vacuum, the human mind seems downright repulsed by one. And thus we rush to fill gaps in our knowledge with supernatural mechanisms and neat and tidy yet half-baked theories.
Patience. The scientific attitude is one of patience.
[Recycled-post, I'm in traveling mode. First appeared here.]
Do herbal remedies work? Some may. But we don’t know until we test them. And in Little Or No Evidence That Herbal Remedies Relieve Menopausal Symptoms I read about tests conducted, and the lack thereof, on a few.
The lead string of words, however, momentarily perplexed me.
There is no strong evidence either way for several herbal remedies . . .
To me, the idea that evidence can go “either way” is fundamentally mistaken. It can also perpetuate a misunderstanding of science and what we call the burden of proof.
In a very important sense, when conducting scientific research the possible results are not either 1) evidence pointing one way — in the affirmative, or 2) evidence pointing the other way — in the negative.
Research results, verses evidence, may be used to argue the negative. “Herbal remedy X doesn’t work.” But in the strict sense, the evidence itself will always be some degree of affirmative down to null.
For herbal remedies, either there is evidence a particular one works or no evidence it works. “No evidence it works” is not the same as “evidence it doesn’t work.”
Evidence doesn’t go both ways. Sure, results can lead to opposite conclusions. But evidence isn’t bi-sensational.
As for the herbal remedies in question (black cohosh, evening primrose oil, red clover) for treating menopause, I would have worded summarizing thoughts this way: There is little convincing evidence x, y & z work.
It may seem like splitting hairs, but that is what scientific minds do. Again, you cannot test if a herbal remedy doesn’t work. You can only test if it does work. With null results, you can then conclude it doesn’t. The more null results, and the more unequivocal the results, the more confidently you can conclude it doesn’t work.
On the other hand, the default position of whether a herbal remedy works should not be “probably” or even “possibly.” The default position is “don’t know.” And it stays “don’t know” until tests are performed. From there we go to degrees of certainty in our conclusion of “works” or “doesn’t.”
—
Update: I forgot to come back to the “burden of proof” point. To those unfamiliar with the concept, it is a logical principle that for any claim it is up to the claimant to provide evidence for their belief. The burden is not on others to disprove it. We don’t assume something is true because no one has bothered to attempt to disprove it or succeeded at disproving. Strictly speaking, we believe something is likely to be true because affirming evidence has been provided.
Just in case you haven’t seen this brilliant cartoon from xkcd.
This science-news article-title caught my eye:
Multivitamins Can Add Sparkle for Healthy Young People
No, the vitamins do not have glitter in them, with the instructions to grind up the pills and sprinkle them on yourself after showering.
How I wonder, was the variable “sparkle” measured? And do I personally have enough of this attribute? Am a sparkle-deficient?
Here’s some of the dope:
In a randomized, double-blind and placebo-controlled study, 215 men in full-time employment aged between 30 and 55 were given either a proprietary multivitamin or a placebo for a period of 33 days. [bolds mine]
Um. Those healthy young people were males between the ages of 30 and 55. Man! You really got to read the not-so-fine print.
The two groups were tested at the beginning of the study and at the end with a battery of mood, stress and health questionnaires and with physical and mental tasks that included mental arithmetic (counting backwards in 3s or 7s from a random number).
And what happened?
. . . after 33 days supplementation the multivitamin/minerals group reported significantly improved ratings of general mental health, reduced subjective stress and increased ratings of ‘vigour’, with a strong trend towards an overall improvement in mood . . . . The placebo group showed no significant changes.
Wow. That’s something, isn’t it? All from a multi-vitamin? Well, yes and no. It wasn’t just any old vitamin.
The multivitamin was a B complex, vitamin C and minerals product known as Berocca® which is manufactured by Bayer Consumer Care, the sponsors of the study.
While the results of this study may be legit, I’m a bit skeptical. Which isn’t the same as sparkly. Is there a multivitamin to increase skepticism?
