So I finally made it to the Society of Surgical Oncology Annual Symposium. Thanks to the snowstorm that apparently wasn’t (at least, I don’t see any snow around), my arrival was delayed by a day, as all flights to the Washington, DC area were canceled on Wednesday. But I did finally get here, and, although I missed most of the first day, I did at least get to see a talk given by a friend of mine late in the day and I had a chance to hang out for a while with an old friend.
I also got the chance after I got back to my hotel room to be highly amused by a “response” to criticism from the author of an acupuncture meta-analysis last year. Part of my amusement came from the whininess demonstrated by the author of the article. More importantly because it is always about me, what really amused me is that Orac got a whole paragraph worth of mention in the article. I kid you not. These acupuncture apologists were so upset at criticism of their meta-analysis in the skeptical blogosphere that they actually wrote a response to it and that response was actually published in the “peer-reviewed” literature! I use scare quotes because the journal in which the response was published isn’t exactly what I’d call a decent journal. That’s true by definition because it’s an acupuncture journal. Specifically, it’s Acupuncture in Medicine, which is published by BMJ. Now what BMJ is doing publishing an acupuncture journal, I don’t know. When puzzled about a company’s motivation, look for the profit potential, I guess. Be that as it may the journal exists, and it appears to exist for the amusement of Orac.
The article, by Andrew J. Vickers of the Department of Epidemiology and Biostatistics at Memorial Sloan-Kettering Cancer Center, is fresh off the press in the March 2012 issue and entitled Responses to the Acupuncture Trialists’ Collaboration individual patient data meta-analysis. Right from the abstract, you can tell that Dr. Vickers is pissed. Real pissed. In fact, I can’t say that I’ve ever seen an abstract that reads quite like it, and, because the journal is behind a paywall and you can’t read it all for yourself other than what I quote of it, I think the abstract is worth quoting in its entirety:
In September 2012 the Acupuncture Trialists’ Collaboration published the results of an individual patient data meta-analysis of almost 18,000 patients in high quality randomised trials. The results favoured acupuncture. Although there was little argument about the findings in the scientific press, a controversy played out in blog posts and the lay press. This controversy was characterised by ad hominem remarks, anonymous criticism, phony expertise and the use of opinion to contradict data, predominantly by self-proclaimed sceptics. There was a near complete absence of substantive scientific critique. The lack of any reasoned debate about the main findings of the Acupuncture Trialists’ Collaboration paper underlines the fact that mainstream science has moved on from the intellectual sterility and ad hominem attacks that characterise the sceptics’ movement.
Methinks Dr. Vickers doth protest too much. “Little argument about the findings in the scientific press”? That’s probably because the scientific press didn’t pay much attention to the meta-analysis, not because it agreed with the results. Also, at only six months after the publication, it’s rather hard to see how much the scientific press agrees or disagrees; you can’t tell that until there has been time for some citations of Vickers’ work to see how it is used by other scientists. The lay press, however, ate it up, which, of course, it always does whenever there is a study that purports to find that some form of “alternative medicine” allegedly works. I’m also amused by the annoyance Dr. Vickers has at “anonymous criticism.” I’m amused because my identity is one of the worst-kept secrets in the medical blogosphere, so much so that if he had just clicked on a certain link on this blog he would have found out who I am. Even more amusing, so concerned about my anonymity am I that I published almost exactly the same post under my real name on my other blog under a very similar title. In fact, if you Google the title, both versions of the post will pop up. Sadly, so will a bunch of stolen versions of the post, in which link dumps basically steal content wholesale. Very annoying, but a side issue to Dr. Vicker’s apparent laziness or lack of Google skills (take your pick). Mad Google skillz, he haz dem not, as an LOL Cat might say.
In particular, he was annoyed at my asking “Can we finally just say that acupuncture is nothing more than an elaborate placebo? Can we?” and by a post by askeptic entitled Acupuncture study reveals new desperation on the part of NCCAM. Oddly enough, he was also annoyed by a post on the study by Steve Novella, which just goes to show that being a nice guy will still get you lumped in with us “militant” skeptics if the “victim” of one of your deconstructions is annoyed enough. I mean, seriously. How can you compare Steve’s nearly always calm deconstruction of such papers to a work of Orac-style Insolence. The dude must have some seriously thin skin. One wonders how he reacts when someone asks him a critical question at a scientific conference after he presents his work.
The other thing that people like Dr. Vickers seem not to understand is just what an ad hominem attack is. It’s not simply being critical. It’s arguing against an argument based on the person making the argument rather than the argument itself. Were I to say that Dr. Vickers was wrong because he’s an acupuncturist, that would be an ad hominem. I didn’t do that. I deconstructed why I thought he was wrong based on the way the meta-analysis was done, how it was written, and the methodological “issues” I found. Let’s just put it this way. Calling someone stupid (which I did not do) is not an ad hominem attack. Saying that someone is wrong because he is stupid is an ad hominem attack.
Let’s see what else is bothering Dr. Vickers. Here’s a hint. These are not ad hominems:
In a typical blog post, the study authors were accused of displaying ‘considerable pro-acupuncture bias’;3 a comment on another blog described senior author Klaus Linde as a ‘homeopath’.4 One poster, who claims that the study shows that the ‘desperation of NCCAM’ and the ‘gullibility’ of the media, opined that ‘Dr Vickers … needs to go back and take an introductory course on statistics’ and warned ‘like loaded guns, some people shouldn’t be left alone with a statistical software program’.5
Oh. My. God! A commenter actually had the temerity to mention that Klaus Linde is a homeopath! Note that I didn’t mention a thing about the study’s connection to homeopathy in the post itself. At this point it would appear useful to mention another thing. Not all ad hominems are inappropriate. If a study author is a homeopath, that tells you something right there about the source. It tells you that at least one of the authors embraces pseudoscience with a big, enthusiastic bear hug. It’s a piece of the puzzle that is entirely worth mentioning. If it’s the “meat” of your argument, then your argument is basically a logical fallacy, an ad hominem, but it is not inappropriate to mention information that reflects on the reliability of the source in the context of a broader criticism of a meta-analysis like this.
Here’s another hint. Reading a paper and finding that it shows “considerable pro-acupuncture bias” is not an ad hominem attack either. It’s a statement of Steve’s opinion, a conclusion based upon reading the article. Here’s the full quote in more context:
I took a close look at the study and find that the authors display considerable pro-acupuncture bias in their analysis and discussion. They clearly want acupuncture to work. That aside, the data are simply not compelling, and the authors, in my opinion, grossly overcall the results, which are compatible with the conclusion that there are no specific effects to acupuncture beyond placebo.
Sorry, Dr. Vickers. That’s just not an ad hominem attack. It’s a statement of opinion based on analysis. Steve says he thinks the study shows pro-acupuncture bias, and then he describes why, both in the rest of the paragraph and the rest of the article. You, sir, are a whiny baby whose spine could use a bit of stiffening. No, that’s not an ad hominem attack either. It’s a statement of my opinion based on your commentary.
Even the seemingly vicious bit about needing remedial statistics education is not an ad hominem attack. It’s sarcastic and insulting, yes, but the order is wrong for an ad hominem attack. It would be an ad hominem attack if askeptic had said that Vickers was wrong because “he needs to go back and take an introductory course on statistics,” instead of concluding that Vickers “he needs to go back and take an introductory course on statistics” because of the content of his meta-analysis. Thus endeth the lesson for Dr. Vickers. I hope he takes it to heart. In the meantime, what else is eating at Dr. Vickers?
A lot, it turns out:
One post made a direct accusation of statistical misconduct: ‘The whole thing looks like a number the authors pulled out of their nether regions and then plugged into their meta-analysis software in order to see if it would affect anything.’4
Yes, that was me. And it did look as though that’s what the authors did. But let’s put the whole thing in context. I hate quoting extensively from my own work when I can just link to it, but I think it’s appropriate here:
Finally, there’s the issue of publication bias. Publication bias, as most of my readers probably know, is the tendency for published studies to be more likely to be positive than studies that remain unpublished. That’s because scientists don’t like publishing negative studies (they seem like “failures”) and journals don’t like publishing them either (because editors don’t consider them very interesting). That’s why, it’s essential that a meta-analysis include an analysis looking for publication bias. One very common way of doing this is a funnel plot. Yet there is no funnel plot included that I could find (I couldn’t get access to the supplemental material because I had to have someone e-mail the study to me and forgot to ask). Instead, they talk about looking at effect sizes in small studies and large studies and then calculate that “only if there were 47 unpublished RCTs with n = 100 patients showing an advantage to sham of 0.25SD would the difference between acupuncture and sham lose significance.” How they calculated this number is not described. I must say, I’ve never seen this sort of analysis in a meta-analysis before, which is why it stuck out like the proverbial sore thumb, as did the lack of a description of how this estimate was calculated. Modeling? Why 47 unpublished RCTs of 100 subjects and not a smaller number of larger RCTs? The whole thing looks like a number the authors pulled out of their nether regions and then plugged into their meta-analysis software in order to see if it would affect anything. In fact, I have a sneaking suspicion that they probably tried a lot of combinations in order to find the one that would make it look as though it would take a whole boatload of studies going the other way to eliminate the statistical significance of their results. Is that unfair to say so? Well, the authors have no one to blame but themselves, and if I missed the description of how that was calculated I’ll take my lumps.
You’ll see that there is a lot more there than Dr. Vickers acknowledges. One notes that Dr. Vickers accuses me of not having read the paper. Here and now I say to Dr. Vickers: I read the paper. Oh, did I read the paper! I suffered mightily reading the paper! What I didn’t read was the supplemental material because I didn’t have access to it then. I do now and have read it over. It doesn’t change my conclusions. The authors do have no one to blame but themselves if they gave the impression that they fiddled around with the statistics software. Because they didn’t describe in detail how they calculated that statistic, it came across as the statistical equivalent of hand waving.
One of the big criticisms that many of us made was that the trials used in the analysis were not blinded. Vickers’ response to that criticism is—shall we say—less than convincing. He argues that Ernst is wrong to criticize the meta-analysis for including unblinded studies because many of the studies that were blinded found that the blinding was adequate because post-study assessments showed that the blinding was adequate. That’s all well and good, but it doesn’t mean that the studies that were unblinded weren’t prone to the bias that results from inadequate blinding. Basically, Vickers seems to think that lack of blinding works only at the patient level to insert bias, when in fact it also works at the researcher level to insert observation bias. That this is true is so well-accepted in general that it is rather shocking that Vickers would even argue against it. His evidence? A single study comparing a laser acupuncture with “real” acupuncture.
Among critics, Orac gets a full paragraph, plus the previous unhappiness:
In an extensive critique published anonymously online, ‘Orac’ makes several points.4 The collaboration was accused of ‘comparing apples and oranges’ due to our ‘mixing studies that compare acupuncture to no treatment [with those that compare acupuncture] to sham treatment’. This is false: comparisons between acupuncture versus sham and acupuncture versus no acupuncture were kept entirely separate. With respect to our analysis for publication bias, Orac asks ‘Why 47 unpublished RCTs of 100 subjects and not a smaller number of larger RCTs?’ and then accuses us of pulling numbers out of our ‘nether regions’. The answer to the question ‘why … RCTs of 100 subjects?’ is that it was prespecified in the protocol which was previously published and referenced in the paper.10 Orac claims that our failure to report I2 was ‘sloppy’ (in fact, we chose not to cite this statistic because we believe it to be invalid) and criticises the lack of a funnel plot (highly underpowered for the number of trials in our analysis). Orac also complains about our characterisation of the study results, stating that ‘it’s uncommon to have a 50% reduction in pain scores’. But in fact we chose 50% precisely because it was close to what was reported in the trials.11
One notes that Vickers concentrates on what are actually rather minor parts of my original criticism. For instance, what did Vickers do if not mixing studies that had different methodologies? Sure, they did separate comparisons of the two different types but that doesn’t change the problematic nature of using studies with different controls. As for the issue of the “47 trials,” as I said, I’d take my lumps if I missed something. I didn’t miss anything. If Vickers had simply said what he said above in the paper, I probably would have still complained about the equivalent of statistical handwaving, but I would probably not have wondered about whether they fiddled with the software to find just the right number. I’m not a mind reader. If something that clarifies a point, particularly for a calculation as unusual as the one above, is not in the part of the paper in which that calculation is reported, it’s the authors’ fault if readers wonder. Finally, one notes that Dr. Vickers is trying to have it both ways. He says that the paper followed PRISMA methodology for high quality meta-analyses, but then he dismisses a key statistic that PRISMA suggests.
Overall, Dr. Vickers sidesteps what is the key criticism of his analysis, one that every single critic he lambastes makes note of, namely that the effect size is so small that it’s almost certainly not clinically significant. Let’s briefly revisit that argument. Vickers et al try to argue that a change of 5 on a 0-100 pain scale, a subjective scale, is noticeable by patients. As I pointed out, it’s probably not. In fact, in light of Vickers’ “response,” it is probably worth revisiting the concept of “minimally clinically important difference” (MCID), which is defined as “the smallest difference in score in the domain of interest which patients perceive as beneficial and which would mandate…a change in the patient’s management.” A recent review looking at minimal detectable and clinically relevant changes in pain scores in arthritis found a range in absolute terms between 6.8 and 19.9. Tubach et al assessed only the improvement aspect of the MCID and defined the minimal clinically important improvement (MCII) as the minimum improvement in the pain score reported by 75% of osteoarthritis patients ranking their response as “good” and reported that the MCII was -15.3 for hip osteoarthritis and -19.9 for knee osteoarthritis. A difference of -5 (the difference between sham acupuncture and “real” acupuncture found in the Vickers meta-analysis) is not clinically significant.
As I pointed out, too, Vickers et al labored mightily to try to convince readers that this tiny effect, if it exists apart from bias, is not just statistically significant, but clinically significant. They failed, and it’s no surprise that Vickers doesn’t even address this issue, except obliquely, in his “response.” Instead, he concentrated on Edzard Ernst’s assessment and claimed that Ernst was trying to dismiss the effect by saying that bias would eliminate it. This is a bit of a straw man argument. The argument based on the low change in pain score is not primarily that any bias could easily make it disappear; the argument is that the difference, if it actually exists, is so small as to be clinically insignificant by Vickers own results and arguments. It is well below the MCID.
Having failed to make substantive rebuttals to this criticism, which would still be a valid criticism even if Vickers’ responses to all the other more peripheral criticisms were absolutely valid, Vickers is left with vitriol, which I quote extensively because I know most of you don’t have access to the paper:
The Acupuncture Trialists’ Collaboration meta-analysis was published during the presidential campaigns of 2012 and it is remarkable how closely the debate about our paper mirrored the election. Contemporary politics now seems characterised by anonymous blog posts, press releases, phony expertise (how many political commentators really understand how health insurance works?), ad hominem attacks and the attempt to fight data with opinion, something that culminated in the bizarre spectacle of a leading Republican denying live on TV that Obama had won.
After a paragraph on what Vickers thinks would be appropriate debates in acupuncture, he finishes with a flourish:
However, these are not debates that many self appointed ‘acupuncture sceptics’ want to have, appearing to prefer instead the comfort of nay-saying and the thrill of adversarial campaigning. It is far less work to make a comment about a researcher’s ‘nether regions’ than to spend the time getting to grips with a complex paper, and it is clearly more fun to make a cutting remark about another scientist’s supposed statistical cluelessness than, say, to write a thoughtful critique of different approaches to handling the problem of publication bias. The lack of any reasoned debate about the main findings of the Acupuncture Trialists’ Collaboration paper underlines that mainstream science has moved on from the intellectual sterility and ad hominem attacks that characterise the sceptics’ movement.
I do so love being compared to FOX News analysts and political flacks like Karl Rove. Notice, also, how Vickers tries to dismiss criticism by claiming that his critics didn’t spend enough time trying to understand him. I can’t speak for Steve Novella or askeptic, but I’ve spent probably far more time than I should trying to come to grips with papers like that of Vickers et al, hours and hours, all for my own education and the ability to educate and entertain my readers. I suppose it’s easier to dismiss criticism than it is to spend the time coming to grips with the actual criticisms. I still don’t think that our friend Dr. Vickers knows what MCID is, why it’s relevant to his meta-analysis, and how obvious it was that he was doing contortions of language, logic, and science to try to convince you that what might be a statistically significant difference in pain scores so ephemeral that if there was even a little bias unaccounted for it would disappear into placebo is not a clinically significant difference. Dr. Vickers should take a long look in the mirror, as he appears to be projecting his own shortcomings onto the “sceptics’ movement.”
96 replies on “The author of the acupuncture meta-analysis lambastes the “sceptics’ movement” in a “peer-reviewed” paper”
It always irks me when I get in contact with an author and ask them, “How did you get “X” as a result for your calculations?”
To which you get a reply, “Oh, we used software X,Y,Z in the manner of (Some other researcher), but excluded (or included), A, B and C to the mix”
Why the hell couldn’t you put that in your paper? You know – so people can tell what you did to pull that result out of your posterior?
Dang, I can’t even read this whole thing without getting pissed off. Reading their accusations makes me angry in thinking about acupuncturists in general.
Where should I start? Should I start with discussing the largest acupuncture clinic in our town that is committing large-scale healthcare and insurance fraud? They file false billing statements so as to get a higher rate of reimbursement. They perform services that for some reason don’t appear on their bill. Such a bogus practice. They know it, and yet they continue to mislead and exploit desperate patients.
Maybe you & Steve should write a rebuttal letter – pointing out your key complaint, and submit it to the journal…
…not too sure you’d want to list that as a publication on your CV though…
Degredation of meaning is a common process but one that ought to be resisted at least in academic contexts – the reduction of ‘ad hominem [fallacy]’ to mean merely ‘an insult’ seems motivated mostly by a wish to sound important while actually saying “they’ve been horrible to me”.
To be a touch pedandic, Orac is awry when he writes ” It’s arguing against an argument based on the person making the argument rather than the argument itself” – in the sense that the ad hominem fallacy can equally apply to the support of an argument on the basis of who is making the argument.
IVI
‘To say he was wrong because he was an acupuncturist would be an ad hominem’
Interesting point, but it would be quite correct in most cases.
So, we have an acupuncture researcher using the phrase “phony expertise” to damn critics _in an abstract of a purported scientific article_, accompanied by complaints of ad hominem attacks.
I’m not sure if that’s “intellectual sterility”, but it’s irony meter-shattering cluelessness reminiscent of a certain antivaccine pediatrician, who used to gripe here about his critics being pharma shills and then moan about how mean they were to him.
Another vote for a rebuttal letter to Dr. Vickers, addressing the real issues he’s avoiding.
Good explanations of what an ad hominem is, and what it is not. It’s nice to see someone else doing that kind of thing.
I’m disappointed in Dr. Vickers as he is the author of a paper I have often found useful when addressing true believers in alternative treatments for cancer: Alternative cancer cures: “unproven” or “disproven”?.
You do your blogging reputation no favors by using “an” in front of lol cat. It is supposed to be pronounced as words (and can even be spelled as a single word), not el-oh-el, and therefore should be preceded by “a”.
Man, he really is stuck on that “nether regions” comment, mentioning it so many times.
Dr. Vickers, if you happen to read this, would you mind responding to the actual criticisms of your paper, rather than just whinging about the tone?
@carl
I don’t care. Now take your pedantry elsewhere. 🙂
@ carl:
*An* is always correct when one pronounces the letters phonetically BUT is exquisitely appropo when one pronounces the word whilst being sarcastic.
Plus, it’s his blog.
Good news for cranks: can’t get your work published? Got fired because you make a fool of yourself espousing crankery? Call the Center for Peer Review Justice.
http://www.peerreview.org/
BTW, generally one can spot a crackpot website because all its content is on the first page.
Ooh, I get to put on the editorial squid hat again. “LOL” is a barbarous neologism that, as I recall, originated with the initial Usenet infiltration of AOL cretins. You may pronounce “LOLCats” with two syllables, but this is not the etymological fallacy. The underlying term is is an initialism, not an acronym.
A personal anecdote about acupuncture, if I may. I recently saw a surgeon for a second opinion regarding upcoming neck surgery. Having suffered from chronic pain for a long time, I’ve tried all legitimate options: previous surgery (unsuccessful): NSAIDs; PT on at least 5 different occasions; opiates; steroid injection many times; – and probably other modalities that I can’t recall at the moment. A few have afforded temporary relief but that’s simply not enough.
A number of the MDs I’ve seen have asked if I’ve tried acupuncture, to which I’ve invariably responded that if they can refer me to some compelling evidence that the procedure works better than a placebo, I’ll be willing to try it. They’ve all backed down except for the second opinion surgeon who claimed that, although there’s no good evidence re neck pain, there are good studies indicating its efficacy for back pain. There wasn’t enough time for me to press him about the discrepancy but, somehow, it doesn’t seem logical that it can work for one but not the other.
Bottom line: I’m still waiting for proof.
(I will make the further note that, when referring to supernovae, “a SN” flies. However, “a SN Ia” does not.)
Another to carl: given that the lolcat meme is typified by faulty grammar and spelling, the choice of “a” or “an” is really less of a grammar question and more of a style question, is it not? 😛
Dr Vickers response is honestly quite hilarious. 😀 Irony is lost on so many….
Ever step back and ask, WTF are we doing here? I mean, holy crap, we’ve been funding this NCCAM agency for like a decade now, and what do they have to show for it? Maybe prodding people with needles (or just pretending to) helps people a little bit with pain – a notoriously placebo-sensitive metric.
Big whup. How much money has been wasted on this? Whole labs dedicated to actual science are folding in the midst of the idiotic management of our nations scientific enterprise, and we’re spending millions to find out what exactly? Research in to diabetes, cancer, cardiovascular disease, infectious disease, all are suffering, and yet we continue to fund this do-nothing agency which improves our knowledge how exactly?
Now more than ever the NCCAM seems like a pointless waste of money, the result of a time of plenty that should have been cut the second our ability to real science was threatened by shrinking budgets. Their ability to improve our knowledge of biology or medicine is virtually nill. Their findings, even when statistically significant, are clinically-meaningless. Can’t we sac this agency already and divide its funds among real scientific research projects? (and the office of the director’s budget too?)
MESSAGE BEGINS——————–
Unfamiliar Human “Carl”
You are clearly not informed on RI protocol. Rule 1: Relieving oneself on the metaphorical Aubusson is not acceptable here, despite the best of utterly selfless intentions. If there is grammatical error, there is grammatical error. It is not your job to “save” our Fearless Leader™. Grammatical errors simply do not need commenting on. But there is good news on the pedantic incontinence front my monkeys!
At Glaxxon PharmaCOM we have a lovely new product in the pipeline, SIWOTaway™ (Exivividitacuix Sulfate, 20mg). The ladies on Level 7 tell me it will help with the excess of pedantry that plagues the internets here on your little blue backwater. Just one SIWOTaway™ in the morning and the complusion to correct just vanishes on a sea of bliss. Of course, there will be side effects, but they’re too numerous to list here. Trials are underway.
In any case Human Carl, so very many loyal Minions and Shills have made this mistake at least once in their time here. And, of course, you’re only human.
Just don’t do it again.
Pleasantly,
Lord Draconis Zeneca, VH7ihL
Forward Mavoon of the Great Fleet, Pharmaca Magna of Terra, Grand Vitara of Albakerkee . . . don’t you dare.
PharmaCOM Terrabase DIA
010101111110101011101011101010101
—————————–MESSAGE ENDS
Vickers sneer at “intellectual sterility” may have something to it.
I’m tired of basing my pathology diagnoses on the barren wasteland of evidence. It’s time to blaze a new trail – Placebo Pathology!
In this paradigm, if I give you a benign diagnosis (regardless of what I see under the microscope), your disease will be benign if you believe hard enough.
Calling for volunteers…
From the OP:
Maybe, in the context of acupuncture “research”, Dr Vickers is not used to receiving critical feedback at the sorts of conferences he would attend?
The implication that an argument is inherently of less worth if its coming from an “anonymous” blogger – if only there were some handy latin phrase for that.
Lord Draconis Zeneca,
I consider your description of me as “human” to be an ad hominem.
I always thought an “ad homynym” attack was when you use words that sound like other words.
@ Mark
@ Mark
(Sorry for the blank post.)
The reason this is still being funded is because idiot politicians (is that redundant?) believe in it and use taxpayers money to fund their personal biases.
“If a study author is a homeopath, that tells you something right there about the source. It tells you that at least one of the authors embraces pseudoscience with a big, enthusiastic bear hug”
Yeah, like pointing out that the author of a homeopathy paper is also a accupunturist.
As in, which is worse? “Dang–they pointed out he’s a homeopath”. THAT’s what makes an accupucture paper a waste?
What does a homeopathic accupuncturist do, anyway? Press the memory of needles into patient’s skin?
“Ever step back and ask, WTF are we doing here?”
Well, “we” as in taxpayers are throwing money down a hole.
Can we stop it? Hard to say. Should we stop it? Absolutely.
a comment on another blog described senior author Klaus Linde as a ‘homeopath’.
Clearly a homeopath would approach acupuncture with heightened skepticism, the underlying principles and assumptions of the two modalities being so radically contradictory and incompatible. All the more reason to trust the paper!
To reject an argument because it is coming from an educated donkey is an example of the Ad Houyhnhnm fallacy.
Face it, you are jealous.
They did a blog response, but they get to put it on their CV. Perhaps it will cited as a ridiculous paper many times, driving their h-index up.
@IVI –
You may wish to enrol on a trial for SIWOTaway PR*.
It’s clear that your terrible case of SIWOTI is so severe that it’s inducing paradoxical-WOTIism. Howlers such as “degredation” and “pedandry” are clear evidence of this.
*Not for oral use.
A silly question from a relative newbie: if so much time and money has been spent on NCCAM, why don’t people know about the results? Could it be that they don’t want to know?
And I always thought the “ad homyInn” fallacy referred to an argument made from the bar of a HongKong hotel.
agree with I. Rony Meter – this guy just banged out a comment and got a pub out of it. I don’t have access to the letter – did he attribute the “work” to a particular grant?
Dingo199,
That’s true, but some hotel in Japan called the TokyoKwee also makes a lot of logical fallacies so it must be ok for the Homyinn to do it.
@ physicsmum:
If you just use the “search box” on the upper right corner of this blog and search for “NCCAM”, you will see the many times Orac has blogged about NCCAM, its funding and the support it receives from Congress.
NCCAM also has a blog where you can comment and where you can register for email notifications, every time a new topic or a new study is discussed.
Sometimes you will see some of the “RI Regulars” who comment on the NCCAM blog…
https://nccam.nih.gov/research/blog/quirkyideas
AAAAAAAAAAAAAAAARRRRRGGGGHHHH!!!
I read the comments on the “quirky ideas” NCCAM blog. Why would I torture myself like that? The bullshit flows with such endless gratuity that it could be used as a renewable biofuel.
And did I really not previously notice Briggs’ attempt to claim BREAST FEEDING on behalf of altmed? Does she think boobs were just there for no reason (well, no SECOND reason) until the 1950s when someone came up with the wacky idea that they can be used to feed babies?
I thought an ad homonym was a commercial announcement that resembles another.
Ad hominy, though, is accepting or rejecting the argument based on the presence of processed corn.
Guys, guys guys, be careful, I got a short sentence at the nearest FEMA facility for mispronouncing the fallacy in its original Draconian language front of one of my glorious overlords. But it’s so hard to say “Ad Hjjjkkhomyyych’hnhaamgh” with just human vocal chords.
Now back to my dissident corpse hauling work, if I finish quickly I’ll be back at my usual work post at the NWO HQ before Monday.
It’s not all bad
” the Houyhnhnms have an orderly and peaceful society. They possess philosophy and have a language that is entirely pure of political and ethical nonsense. They possess, for example, no word for a lie”
Just saying, not entirely sure what, but anyway….
@C Currah: That can work both ways. There’s a proverb about fish not having a word for water…
I’m thinking maybe an “ad Houyhnhnm” would be an argument without fallacy based on pure reason and critical thinking…or am I just flogging a dead horse (geddit).
Apologies for my discursion!
@physicsmum
I’d say that’s the real “What THEY don’t want you to know”
Ad harmonem arguments are always off-key, but they can be a major distraction.
Loving these comments!
@lilady — thank you for the link, I fear I had a similar reaction to carl there. Also really meaning most of the people I know, plus most of those who vote, get interviewed by journalists, etc., all rather depressing…..
I guess the lack of results just doesn’t make a compelling story 😛
oops, that was NOT meant to be a smiley face!!!!
Melissa G, wasn’t that supposed to be “ad harmonium” arguments? Oh, wait, “ad harmonium” might actually be on-key!
Physicsmium, do check out the “fun and exciting” stories about NCCAM on the ScienceBasedMedicine blog. Though another way to understand it all is to read Natural Causes: Death, Lies and Politics in America’s Vitamin and Herbal Supplement Industry.
It is really not a fun read, it kind of makes one quite angry.
I tend to use pieces like this goofy “research” article as teaching pieces, since my graduate students have to present a “bonehead research” article to their peers as they work towards their literature review (I’m in the social sciences). Perhaps the BEST use for crappy research–examples of how NOT to do it, and what CRAP really looks like. I will say every student who has engaged with the “bonehead project” becomes MUCH sharper at tearing research apart–and quickly discover how much scary crappola is out there. So, ironically, this article may find a permanent home in academe, but not one they wanted.
Chris– better than an “ad harmonicam” argument, but then, isn’t everything? 😉
Brat, that is an excellent point. I had a research seminar class which engaged in exactly that– carefully reading papers, some of which described well-conducted experiments and analysis, and others of which were crap, and we learned to tease out the crap. It was one of the best classes I ever had– wish there were a way to teach it in elementary school!
Btw, on vaccine safety, a case example + one comment. feel free to argument objectively.
my son recieved the rotovirus vaccine and a day later he went into kidney failure and cardiac arrest. My son was born completely healthy and happy and perfect and who would have thouht that the one thing that was supposed to help protect him almost killed him… for years I blamed his father and his family and just recently I was going through my babys medical records and put two and two together and now because its over the “three year” mark we can not do anything about it. I think it is complete bullshit considering I have the medical records dating back to when I was pregnant. No body will understand what we go through on a day to day basis because he now has permanate brain damage. My son will be 4 in march and it kills me to see him not being able to play with children his own age bc he cant walk, he has very little speech, and now we have to go through all of this extensive theropy, go to all these specialists, and different doctors to hope and try to get him as independant as possible. This vaccine changed our lives and because of it we will have to suffer for the rest of our life bc we’re over the ” three year mark”. All I can say, is bc of this shot, when and if I decide to have more children no doctor better come close to child or children with any type of vaccine untill I feel, they are ready for it. They say this RV shot doesn’t induce the diarhhia, tell tht to my baby who almost died bc of the little bit he was having that made him so dehydrated to where it put him in kidney failure and cardiac arrest twice.. tell tht to me, who had to watch my child breath from a machine for two weeks and had to watch the doctors perform cpr on him. Nobody can take tht pain away and nobody can help with the everyday struggle were going through not because they cant but bc they wont bc were over the 3 yr mark… to me thts some bull and bc of tht I will nvr trust another doc or have any faith in them.. bc when we called they kept saying it was a normal reaction… guess it wasnt was it?
it really did happen and were ok but its an everyday struggle to care for a child with special needs ecspecially being a young single parent… but all we can do is take it day by day.
===
It is not only specific ingredients which may have a deleterious effect. The way in which substances influence and interact with each other must also be taken into consideration.
Emulgents such as polysorbates lower surface tension and may increase permeability of the blood-brain barrier, thus facilitating passage of substances through the barrier and into the brain tissue where they may accumulate.
This property is used in the case of brain targeting. Polysorbates are present in injections where it is desired that for example psychiatric and chemo drugs may gain closer contact with brain tissue.
Emulgents are present in many vaccines to increase miscibility and to render the fluids more homogeneous. The fact that they may also facilitate passage of toxic substances to the brain tissue is obviously undesirable.
Examples of many are:
The H1N1 pandemic influensa vaccine PANDEMRIX which contains polysorbates and mercury. It is especially worrying that this vaccine was also advised for small children and pregnant women. These groups are exceedingly vulnerable as the blood-brain barriers of infants and fetus’ are not fully developed and may therefore be more permeable.
Another example is the HPV vaccine GARDASIL where polysorbate 80/Tween 80 may facilitate passage of substances including neurotoxic aluminium into the brain tissue. This may be one reason why many young girls who have been injured by Gardasil show symptoms of brain damage.
Pharma:
Memory is a funny thing. We can attribute much of happened to us in the past if we think about it. I perhaps can could have just “put two and two together” and blame the seizures that sent my kid to the hospital on the MMR vaccine he had had two weeks before. But the most logical reason was dehydration from the intestinal virus that had been causing rivers of poo diarrhea during the previous week.
Perhaps I can also blame my kid’s heart disorder on going skiing the week or so before I knew I was pregnant.
Oh, that bit about memory. You forgot to switch to the article about vaccines, instead you posted on the acupuncture thread.
@ Pharma: I don’t know why you are blaming your child’s serious diarrhea illness/kidney failure on your child’s father or on the rotavirus vaccine he received.
My sense is that you are omitting some/most of the facts surrounding his admission to the hospital as well as the results of the tests during his hospitalization. If you have his hospital records, why not peruse them and provide some additional information?
BTW, your blaming of ingredients in vaccines, for kidney failure, diarrhea, cardiac problems and developmental delays have no basis in science.
I am sorry for your child’s problems.
Bit puzzled as to how you forgot that your child had been vaccinated the day before becoming ill? Even with no correlation it would be something I would have remembered.
Pharma:
Funny how the rotavirus vaccine is oral, not injected…
This person has been posting that comment for over a year, about 200 times.
This person has been posting that comment for over a year, about 200 times.
Note that those are not genuine comments, though. All of those occurrences are in comment threads at the spam website of an ambulance-chasing “vaccine injury” lawyer. In each thread the initial post is slightly different but the site proprietor tacks on the same list of comments.
Did “Pharma” steal the comment from one of these spam threads for trolling purposes? Who knows? Who cares?
Bye-Bye “Pharma”.
The second part of “Pharma”‘s tirade is stolen from another spurious comment from the 199 occurrences of the same identical comment threads set as spam by the vaccine-chasing lawyer (someone else also posted it under a different name at ‘Vactruth.com’).
feel free to argument objectively.
Feel free to comment honestly.
Thanks. I thought it was very weird.
The original comment, quoted by “pharma” does appear to be a genuine one though hijacked and cut and pasted everywhere. On the site mentioned by Herr Dr you can link back to the mother’s facebook page and get her whole life story, including a good example of why you shouldn’t leave your facebook security settings open. Late night drink fueled rants are never a good idea.
As Herr Dr says, doesn’t really matter, it’s now spam.
Thank you for the comments and suggestions. Chris, I have not seen that book, not sure I have the stomach for it but will consider having a look.
I have read a few books on related topics. My favourite so far is “Trick or Treatment”, which I found very well-written and informative. I did lend it to a friend, who alas found it cynical, hateful and impossible to read. Sigh……. well, no one said this would be easy 🙁
Thank you for the basics of ad hominem. I get accused of it when I make comments at the NYTimes–usually on “health” pieces. I don’t rebut because I wasn’t sure. Now I will.
I use copy/paste of testimonies. here is the source of the last one (i am doing in order to gather objective arguments to these claims )
http://www.vaccineinjuryhelpcenter.com/national-vaccine-injury-compensation-program/
Any objective arguments to this opinion ?
It is not only specific ingredients which may have a deleterious effect. The way in which substances influence and interact with each other must also be taken into consideration.
Emulgents such as polysorbates lower surface tension and may increase permeability of the blood-brain barrier, thus facilitating passage of substances through the barrier and into the brain tissue where they may accumulate.
This property is used in the case of brain targeting. Polysorbates are present in injections where it is desired that for example psychiatric and chemo drugs may gain closer contact with brain tissue.
Emulgents are present in many vaccines to increase miscibility and to render the fluids more homogeneous. The fact that they may also facilitate passage of toxic substances to the brain tissue is obviously undesirable.
Examples of many are:
The H1N1 pandemic influensa vaccine PANDEMRIX which contains polysorbates and mercury. It is especially worrying that this vaccine was also advised for small children and pregnant women. These groups are exceedingly vulnerable as the blood-brain barriers of infants and fetus’ are not fully developed and may therefore be more permeable.
Another example is the HPV vaccine GARDASIL where polysorbate 80/Tween 80 may facilitate passage of substances including neurotoxic aluminium into the brain tissue. This may be one reason why many young girls who have been injured by Gardasil show symptoms of brain damage. ( author Sandy Lunoe, source: fb comments above http://www.vaccineinjuryhelpcenter.com/national-vaccine-injury-compensation-program/ )
This claim needs to be investigated:
It is not only specific ingredients which may have a deleterious effect. The way in which substances influence and interact with each other must also be taken into consideration.
Emulgents such as polysorbates lower surface tension and may increase permeability of the blood-brain barrier
Pharma, take your copypasta spam somewhere else. We’re not interested.
Oh goody, it is an ambulance chasing lawyer! Who cannot figure out he/she is posting off topic!
So, do defend acupuncturists when they puncture a lung?
@ Pharma: How about answering some of the questions I posed to you about your child’s *”vaccine injury”…that I posed at # 54 above? Specifically…
-Your child’s tentative hospital admitting diagnosis.
-The tests performed/results of laboratory tests, during your child’s hospitalization.
-Your child’s hospitalization’s discharge diagnosis.
Why do you blame your child’s father for his *problems*?
lilady, “Pharma” is not the parent of the child in question. He/she is bottom dwelling ambulance chasing lawyer who cuts and pastes other people’s stories in order to pull in new clients.
Finding an ambulance-chaser in our comments section is like finding a Christmas plum in our troll pie! 😀
Or Laraine Abbey.
^ Actually, the “vactruth” comment that led me to that conclusion may have been from “Mindanoiha,” who is on about surface tension; the page renders very poorly for me.
@Pharma – I note a lot of “may” in that post. It is generally up to the person making a claim to collect the data required to prove the claim. Have any studies been done that show something more definite than idle speculation?
I use copy/paste of testimonies. here is the source of the last one
As the saying goes, I would prefer to argue with the organ grinder rather than with the monkey.
So, the bottom-feeding lawyer is using comments on the blog at his website, eh?
I see he’s attracted Edwin Alber and Viktor Pavlovic from AoA.
I remember the days when lawyers practicing in New York State were not permitted to advertise their services…anywhere.
Actually, the “vactruth” comment that led me to that conclusion may have been from “Mindanoiha,”
The comment is purportedly scraped from Sandy Lunoe’s FB page when it appears on the scumlawyer’s site. When it appears on Vactruth, it’s supposedly from ‘Mindanoiha’.
However, ‘Sandy Lunoe’ is evidently a contributor to VacTruth, and has identical views to Mindanoiha (and a habit of sending similar comments to all the same websites), so sockpuppetry is the most charitable interpretation.
the page renders very poorly for me
I had to search through the HTML source to make any sense of it and stop it telescoping / expanding at random.
the bottom-feeding lawyer is using comments on the blog at his website?
The comments are all scraped from people’s FB pages and thrown together to create the impression of a groundswell of interest in the ambulance merchant.
The comments are all scraped from people’s FB pages
In retrospect, that might have been a rash statement. It may be that the ambulance merchant does have a real FB page on which people have vented their idiocy, and the website is set up so that every post links to it, presenting it as if it’s a comment thread.
But where else can one make rash statements, if not in the context of vaccinations?
@herr doktor bimler: I wouldn’t call him an ambulance chaser…those lawyers work on a contingency fees, mainly on motor vehicle personal injury cases or medical malpractice resulting in injury or death. You win your case in court, the lawyer gets his contingency fee. You lose in court, the lawyer gets zilch.
“Pharma” has got a thriving law practice because win or lose in Vaccine Court, the master/judge will award him legal fees.
http://www.peoples-law.org/node/718
Oh, dear, one gets Patricia Finn as a bonus prize.
Oh noes… there’s tween80 in my gardasil.
It’s an emulsifier. Look up what an emulsifier is and does.
Ms. Lunoe does hit it out of the park with not just caterpillars, but “DOGS, GENETICALLY MODIFIED YEAST, RABBITS, COW HEARTS, CALF SERUM, CHICK EMBRYOS, DUCK EGGS, PIG, SHEEP AND HORSE BLOOD, GUINEA PIGS AND RABBIT BRAINS” as a section hed.
One might think Scotsmen really are behind it after all.
@Narad
But are those Scotsmen true?
Not baby ducks?!
This claim needs to be investigated:
So investigate it.
No-one here seems inclined to do your homework for you.
I propose a neologism:
Tweenophobia n. an irrational fear of minuscule quantities of
surfactants in vaccines.
Krebiozen,
Tweenophobia would double as fear of young adolescents 😛
Grant,
Tweenotweenophobia could be a fear of surfactants in vaccines when it manifests in young adolescents. Maybe brijophobia? But that could also be misinterpreted as a fear of trolls. This neologism business isn’t as easy as it looks 😉 (and I do wish WordPress didn’t term emoticons into cartoon smiley faces like that)
That was a strange brain-finger miscommunication. I meant “turn” not “term”.
It’s preventable. You typed ; – ), which WP’s turned into the smiley. (I see that in the ‘view selection source’ and in the copypasta for the blockquote.)
I was able to defeat WP by inserting an HTML non-breaking space entity into the emoticon: ; - ).
At least, that’s how it’s supposed to work. WordPress has a really nasty practice of corrupting HTML in many screwy ways, so my demo might not come out correctly.
And, you can also use (subject to WP’s html-corruption rules) the html ‘zero-width joiner’ or ‘zero-width non-joiner’, ‍ or ‌. The ‍ should prevent the characters or the emoticon from getting separated by a line-break.
Let’s try it using the zwj: ;‍-‍) to produce ;-) and using the zwnj ;‌-‌) gives ;-).
Given WP’s perverse lack of preview and my own speeling difficutlies, I can only hope I’ve typd what I intended.
[…] https://www.respectfulinsolence.com/2013/03/08/author-of-the-acupuncture-metaanalysis-lambastes-scepti… […]
Polysorbate 80 in Vaccines – A Potentially Toxic Vaccine Stabilizer
FaceBook Post by Dr. Palevsky
http://www.associatedcontent.com/article/907819/polysorbate_80_in_vaccines_a_potentially.html?cat=70
DR PALEVSKY’S COMMENTS: Several years ago when I was investigating the damaging side effects of Polysorbate 80, and found out about its relationship to allergy and infertility, I came across some other interesting information about the use of Polysorbate 80 that isn’t talked about very much, although I don’t hesitate to present this information to parents in the office and in the talks that I give.
Polysorbate 80 is used as an emulsifier by the pharmaceutical industry to enhance the delivery of chemicals/drugs from the blood into the brain across the blood brain barrier (BBB). Being that the BBB is impermeable to many things in the bloodstream, researchers needed to find a way to deliver chemicals/drugs into the brain from the bloodstream in order to treat hard-to-reach brain infections/lesions/tumors, etc. Polysorbate 80 is one such chemical that helps in this delivery.
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6TWB-4B28VMF-2&_user=10&_rdoc=1&_fmt&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=190781550545bd0220d6ac4415f7a08e
Since vaccines contain polysorbate 80, we can ask the following questions;
1) What vaccine materials get across the BBB, with the help of polysorbate 80, into the brain of children? and
2) What effect do they have once they get into the brain? Do they contribute to inflammation, toxicity, encephalitis?
Since polysorbate 80 works as an emulsifier, and will also enhance the delivery of vaccine materials into the rest of the cells of the body,
3) What vaccine materials enter the cells of our bodies?
4) Do they remain in the cells once they get in there?
5) Do they impair any parts of the cells, i.e, mitochondrial DNA, nuclear DNA, or other cellular apparatuses – endoplasmic reticulum, golgi apparatus?
6) Do they become part of the DNA of the cells since there are whole DNA strands from live viruses in the vaccines, along with foreign animal DNA and bacterial/viral/yeast protein antigens?
7) If they do become part of the DNA, how does this change the function and/or regulatory systems in the cells?
8) Do the materials from vaccines (e.g. aluminum, mercury, formaldehyde) entering through the cell membranes at the hands of polysorbate 80 do anything to impair the electrical charge of the cell membrane, or impair/alter the way materials enter or exit the cell through the cell membrane (nutrients, cellular wastes, manufactured proteins, or enzymes?
Since babies have a poorly developed BBB, which may not solidify for at least the first 6 months, or maybe longer if they have a brewing inflammatory condition yet to be determined that has delayed the full development of the BBB, then questions 3-8 apply to their brains as well.
We don’t know the answers to most/all of these questions because studies have never been done to evaluate them.
We use vaccines all for the sake of producing an antibody to bacteria and viruses that might not give us protection against getting the diseases anyway.
Of note, we are already protected against getting diseases from trillions of bacteria and viruses that live along the linings of our bodies and within the DNA of our cells, for which we don’t have antibodies, so antibodies are not the be-all and end-all of protection from disease. Even the textbooks, the literature, and the CDC admit to this.
With ever-increasing cases of significant neuro-inflammatory conditions in this country, and the fact that the US has one of the highest rates of chronic inflammatory conditions in the world, (http://health.usnews.com/health-news/family-health/boomer-health/articles/2011/03/09/americans-have-worse-health-than-english-peers-study-finds?PageNr=1), shouldn’t we know the answers to these questions?
Ask questions first, then shoot.
http://www.drpalevsky.com/articles_pages/81_Polysorbate_80_in_Vaccines.asp
@pharma
Do you have any point besides necroing old threads?
And, have you ever heard “the poison is the dose?”
This displays a profound misunderstanding of microbiology. There is a difference between commensal organisms and infectious organisms. Our microbiome, the “trillions of bacteria and viruses that live along the linings of our bodies” of which you speak, are in general not disease-causing. In fact, current research shows that these commensal organisms are in fact part of our own antiviral defense:
http://www.ncbi.nlm.nih.gov/pubmed?term=22705104
For someone so offended by a purported ad hominem argument, Dr. Vickers appears to be perilously close to saying “you can’t trust the critique of an acupuncture article coming from someone in the SCEPTICS MOVEMENT” (cue ominous music).