Time to Stop Testing Magic in Medicine
Why waste time and money testing medical treatments that defy the laws of physics and chemistry?
That's the pointed question posed by Drs. David Gorski and Steven Novella in a new op-ed published in the journal Trends in Molecular Medicine. To most, the answer is obvious: we shouldn't. But in the past decade, alternative medicines without any basis in science, like acupuncture, homeopathy, and chiropractic, have received hundreds of millions of dollars from the U.S. government, which, in turn, has been used to fund hundreds of randomized clinical trials.
Alternative medicine supporters insist that these trials are necessary to find out what does and does not work. That seems reasonable. But unlike proper scientists, they don't cast off that which evidence shows to be worthless. When a study's result is negative -- and almost all of them are -- they ignore it. And on the rare occasion when a study's result is positive -- however miniscule the effect may be -- they cling to it like there's no tomorrow. In the eyes of the alternative medicine proponent, more research will always be needed.
So what we're left with is a medical community endlessly analyzing treatments that amount to nothing more than a placebo, thus lending credibility to the practices themselves.
Evidence is the lifeblood of science and rational thought. But should we analyze hocus-pocus? Take homeopathy, for example.
"Homeopathy violates multiple laws of physics with its claims that dilution can make a homeopathic remedy stronger and that water can retain the ‘memory’ of substances with which it has been in contact before," Gorski and Novella write.
In other words, it's based on magic.
"Thus, treatments like homeopathy should be dismissed as ineffective on basic scientific grounds alone."
In evidence-based medicine, a treatment must first be shown to be plausible with basic science, then further studied in vitro on cell cultures and in vivo on animals. Only then is it allowed to continue to clinical trials in humans. But alternative medicine consistently seems to get a pass on the first three steps, proceeding straight to human trials, Gorski and Novella say. It is in these clinical trials, where confounding variables seep in, and occasionally produce false-positives. Moreover, it's ethically dubious to test implausible alternative treatments on patients with serious medical conditions. The $30 million TACT study analyzed unsubstantiated chelation therapy on patients with heart disease, who -- unsurprisingly -- received no benefit. Another trial examined an alternative treatment strategy for pancreatic cancer in which patients drank juices, used coffee enemas, and took large quantities of supplements. The results of this disturbing trial were tragically unsurprising.
"One year survival of subjects undergoing this protocol was nearly fourfold worse than subjects receiving standard-of-care chemotherapy," Novella and Gorski describe.
Terrible research like that can be avoided with a simple rule.
"All clinical trials should be based on scientifically well-supported preclinical observations that justify them," the duo says.
Until alternative medical practices pass the basic science test, we shouldn't waste time or money testing them on humans.
Source: David H. Gorski, Steven P. Novella. "Clinical trials of integrative medicine: testing whether magic works?" Trends in Molecular Medicine. August 2014. DOI: http://dx.doi.org/10.1016/j.molmed.2014.06.007