Quackwatch, Alternative Medicine, and the Search for "Truth"
Today I'd like to step--respectfully, carefully--into the productive discussion taking place in this breast cancer forum in response to one of my earlier postings, about the value of the Web site Quackwatch.
I had recommended (and still do) patients considering alternative treatments for any condition to consult the Quackwatch site. I described its contents as "some of the most rigorously skeptical coverage of non-conventional therapies."
Quackwatch was founded by a psychiatrist who embraces the viewpoint that unconventional treatments should be held to the same standards of evidence as mainstream ones. The site includes reports on individual treatments written from that viewpoint. It also abides dialogue from those with opposing views. As such, it's a useful way to perform due diligence before pursuing an alternative treatment.
As its name suggests, however, the site is dedicated to the task of [what it sees as] protecting people from unscrupulous marketers of various unconventional therapies. From my perspective, Quackwatch provides a useful "con" to the frequent "pro" arguments for unconventional treatments.
But--therefore--Quackwatch is certainly not the only source one should consult. That would be as big of a mistake as basing a decision only on an Internet product sales site full of anonymous testimonials. Personal care decisions should be made with inputs from various sources, from recommendations by a trusted clinician or friend, to personal experience and beliefs, to gold-standard scientific studies untainted by commercial interest.
I believe it's useful for anybody considering treatments outside conventional standard of care at least to hear arguments to the contrary before deciding what to do. If they don't want to hear them at all. . .well, I'm not sure why anyone wouldn't want to know.
I personally flout Quackwatch advice. If on the site you look up "glucosamine"--a dietary supplement touted to treat, slow and maybe even reverse the course of arthritis--you'll find an [outdated] series of reports, many of which conclude the stuff has not been proven to work, and some of which suggest its safety is not verified.
I've read them.
I take glucosamine nonetheless. Hey, my knees hurt and nothing much seems to help. But at least I know what the research record is.
As for other useful sources of datapoints on alternative treatments, I'd recommend the following:
The National Library of Medicine's database of information on dietary supplements. Reports are authored by a group called The Natural Standard. They come to each supplement with no agenda. The reports fairly and accurately describe the quality and breadth of evidence available to support each claim that's made for a supplement's use.
Cochrane Reviews. These reports, published by an international team of researchers, evaluate scientific evidence in its totality, producing rigorous "meta-analyses" (studies of the studies) to document what the best research on a topic shows.
The National Center for Alternative and Complementary Medicine, a somewhat remote wing of the National Institutes of Health, has a series of even-handed fact sheets on some alternative treatments based on research.
I suspect this posting will extend the discussion, which is good. There are many good arguments why alternative treatments won't, and even can't, be subjected to gold-standard scientific trials:
- Lack of funding to study natural products
- The fact that they do not have to be approved by the FDA
- The fact that many treatments can't be regularized for study due to variability of herb and supplement formulations
- The wide variation in alt-med clinical skills
- The good possiblity that there are bodily mechanisms that Western medicine is willfully blind to
- The suspicion that Big Medicine and Big Media are in the pockets of Big Pharma [as I write this post an ad for a pharmaceutical company appears at the top of the page]. . .the list goes on.
The point is: More information is good. Gather it all and your choice, whatever it is, will be an informed one. That's never a bad thing.