Quackery at Yale

Post below excerpted from DC's Improbable Science. See the original for links and more

Remember that the terms `integrative' and `complementary' are euphemisms coined by quacks to make their wares sound more respectable, There is no point integrating treatments that don't work with treatments that do work.

`Integrative Medicine' at Yale says, like all the others on the roll of shame, says "we aim to improve awareness and access to the best in evidence-based, comprehensive medical care available worldwide". They all pay lip service to being "evidence based", but there is just one snag. It is untrue. In almost all cases, the evidence is either negative or absent. But this does not put them off for a moment. The whole process is simply dishonest.

The evidence

The evidence has been summarised in several books recently, The following books are particularly interesting because they are all `views from the inside. Edzard Ernst is the UK's first Professor of Complementary Medicine. Barker Bausell was research director of an NIH funded Complementary and Alternative Medicine Specialized Research Center at the University of Maryland.

The first two books go through the evidence fairly and carefully. They show no bias against alternative treatments (if anything, I'd say they are rather generous in cases of doubt).

For a first class US account try Barker Bausell's Snake Oil Science. Bausell's book gives an excellent account of how to test treatments properly, and of all the ways you can be fooled into thinking something works when it doesn't. Bausell concludes

"There is no compelling, credible scientific evidence to suggest that any CAM therapy benefits any medical condition or reduces any medical symptom (pain or otherwise) better than a placebo".

For an excellent account of how to find the truth, try also Testing Treatments (Evans. Thornton and Chalmers)

It can now be said with some certainty that the number of alternative treatments that have been shown to work better than placebo is very small, and quite possibly zero

With that settled, what's going on at Yale (and many others on the roll of shame)? David L. Katz, MD, MPH, FACPM, FACP, is founder and director of the Integrative Medicine Center (IMC) at Griffin Hospital in Derby, Connecticut. He is also an associate professor, adjunct, of Public Health and director of the Prevention Research Center (PRC) at the Yale University School of Medicine in New Haven, Connecticut.

That sounds pretty respectable. But he is into not just good nutrition, exercise, relaxation and massage, but also utterly barmy and disproved things like homeopathy and `therapeutic touch'.

Watch the movie

It so happens that Yale recently held an "Integrative Medicine Scientific Symposium". Can we find the much vaunted evidence base there? That is easy to answer because three hours of this symposium have appeared on YouTube. So this is the public face of Yale medical school.

Dr Katz goes through several different trials, all of which come out negative. And what is his conclusion? You guessed. His conclusion is not that the treatments don't work but that we need a "more fluid concept of evidence" .

It's equally bizarre to hear Richard Belitsky, Dean of Medical Education at Yale saying he is "very proud" of this betrayal of enlightenment values. If this is what Yale now considers to be education, it might be better to go somewhere else.

This is not science. It isn't even common sense. It is a retreat to the dark ages of medicine when a physician felt free to guess the answer. In fact it's worse. In the old days there was no evidence to assess. Now there is a fair amount of evidence, but Dr Katz feels free to ignore it and guess anyway. He refers to teaching about evidence as `indoctrination', a pretty graphic illustration of his deeply anti-scientific approach to knowledge. And he makes a joke about having diverted a $1m grant from CDC, for much needed systematic reviews, into something that fits his aims better.

Katz asks, as one must, what should we do if there is no treatment that is known to help a patient. That is only too frequent a problem. The reasonable thing to say is "there is no treatment that is known to help". But Dr Katz thinks it's better to guess an answer. There is nothing wrong with placebo effects but there is everything wrong with trying to pretend that you are doing more than give placebos. Perhaps he should consider the dilemmas of alternative medicine.





No surprise that it is the Left who are big on food nuttiness

Facts and evidence generally matter little to them. Looking good is all

Fried shrimp on a bed of jasmine rice and a side of mango salad, all served on a styrofoam plate. Bottled water to wash it all down. These trendy catering treats are unlikely to appear on the menu at parties sponsored by the Denver 2008 Host Committee during the Democratic National Convention this summer.

Fried foods are forbidden at the committee's 22 or so events, as is liquid served in individual plastic containers. Plates must be reusable, like china, recyclable or compostable. The food should be local, organic or both.

And caterers must provide foods in "at least three of the following five colors: red, green, yellow, blue/purple, and white," garnishes not included, according to a Request for Proposals, or RFP, distributed last week. The shrimp-and-mango ensemble? All it's got is white, brown and orange, so it may not have the nutritional balance that generally comes from a multihued menu. "Blue could be a challenge," joked Ed Janos, owner of Cook's Fresh Market in Denver. "All I can think of are blueberries."

The national nominating convention Aug. 25-28 will bring about 50,000 people to Denver, and many will scarf loads of chow served at catered parties. The prospect of that business windfall has tantalized caterers since Denver was named host city for the convention more than a year ago. Caterers praise the committee and the city for their green ambitions, but some say they're baffled by parts of the RFP.

"I think it's a great idea for our community and our environment. The question is, how practical is it?" asks Nick Agro, the owner of Whirled Peas Catering in Commerce City. "We all want to source locally, but we're in Colorado. The growing season is short. It's dry here. And I question the feasibility of that." Agro's biggest worry is price. Using organic and local products hikes the costs. "There is going to be sticker shock when those bids start coming in," he says. "I'll cook anything, but I've had clients who have approached me about all-organic menus, and then they see the organic stuff pretty much doubles your price."

The document, which applies only to the host committee's parties, came after months of work that involved discussions with caterers and event planners along the Front Range, says Parry Burnap, Denver's "greening" director. Burnap is attached to the host committee full time for now; the committee works closely with the city but is a separate, nonprofit entity.

Thousands of other parties hosted by corporations, lobbying groups, individuals, nonprofits and more will happen in Denver during the convention, Burnap says. None of them is subject to the committee's green agenda. The committee's effort to host eco-friendly events, she says, hinges on its determination not just to put on a smart convention but to transform Denver into a top-shelf green city. "We are hoping that everything we are doing for greening (the convention) has some legacy value," she says. The RFP, for example, will likely live on after the convention in a brochure the city will distribute widely to help guide local businesses interested in improving their green practices.

Burnap says taking the organic and local route may be more costly, but the committee thinks caterers will find ways to comply and still make a profit. "It takes some creativity because some of these things are more expensive," she says. "But we're at the front end of a market shift."

Joanne Katz, owner of Three Tomatoes Catering in Denver, cheers the committee's environmental aspirations and is eager to get involved with the convention, but she wonders if some of the choices the committee is making are really green. Compostable products, such as forks and knives made from corn starch, are often imported from Asia, delivered to the U.S. in fuel-consuming ships. But some U.S. products are made from recyclable pressed paper. Which decision is more environmentally sound? "Customers are beginning to demand these things, and we don't have all of the information," she says. "And we are doing the best we can, one project at a time."

Burnap acknowledged that figuring out what is most green can be difficult. "Maybe in 20 years, there will be better analysis for us to make better choices," she says. "One we are talking about now is, is it better to compost or to recycle? If you are using a cup for a beverage, is it better to be (plastic) and back in the materials stream, or compostable, biodegradable waste and go into the waste stream or compost? There are no definitive answers."

Composting for the convention hasn't been entirely figured out yet, she says. Colorado has commercial composting companies, such as A1 Organics in Eaton, but the link between the composters and caterers hasn't been made.

The committee is working with other groups to develop a carbon-footprint "calculator" that will measure the environmental impact of each event and suggest an "offset" - a fee - that will go toward a fund helping to match carbon losses with carbon gains. "That's a fun one," Burnap says. "If these event planners will calculate and offset, it will start to get the money flowing into the Colorado Carbon Fund, a fund that will reinvest in renewable energy here in Colorado."

Source