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Tillabooks: Will's Book Blog

Sunday, December 16, 2007

Snake Oil Science by R. Barker Bausell

Snake Oil Science: The Truth About Complementary and Alternative Medicine by R. Barker Bausell. New York: Oxford University Press, 2007. ISBN: 978-0-19-531368-0

This is an incredibly illuminating book. An absolute must read for anyone involved in anything medical, whether mainline or alternative or complementary, or whatever. If you are an intellectually honest person involved in those fields, you really MUST read this book. If you don’t, then I question your intellectual honesty, flat out. If you are a person hunting for medical answers, if you have ever gone to any practitioner of any alternative medical treatments, again, you owe it to yourself to read this book. It is definitely an eye-opener.

My only complaint about the book is its title. I don’t know if the author himself suggested it, but I hope not. My guess would be that the title was imposed by some editor somewhere. It is really an unfortunate choice. If you’re a naturopath, or a chiropractor, or an acupuncturist, or anyone else involved in any of the areas typically defined as “complementary and alternative medicine” (CAM), how likely are you to read a book that by its very title, implies that you are a practitioner of snake oil medicine? The title is insulting, and I don’t think it’s fair to the author, or the book itself, which bends over backwards to be fair, objective, and quite the opposite of what the title implies.

So what does the book do? It lays out quite objectively, in relatively easy to read language, the bona fide, credible, scientific evidence related to complementary and alternative medicine. The author spends an entire chapter defining exactly what he means to cover under the label CAM, and eventually defines it as follows:

CAM therapies are physical, mental, chemical, or psychic interventions such as acupuncture, homeopathy, naturopathy, chelation, folk medicine, herbs, megavitamin therapy, nutraceuticals, chiropractic manipulation, massage, biofeedback, hypnosis, yoga, tai chi, qi gong, and any sort of energetic, psychic, or spiritual healing used for the treatment of specific medical conditions or disease symptoms.

He probably could have stopped there, but he continues his definition thusly:

They are practiced in the absence of both scientific evidence proving their effectiveness and a plausible biological explanation for why they should be effective, and their practice continues unabated even after (1) there is scientific evidence that they are ineffective and (2) their biological basis is discredited.

The author describes himself as a research methodologist, or a biostatistician, a rather tedious occupation which mostly involves examining the methodologies of scientific research studies, and crunching numbers for statistical validity. According to the author, this book could not have been written even as recently as 1999, because the scientific evidence on which it is based did not yet exist. In the author’s words,

Now, however, enough evidence has accumulated to permit the first scientific evaluation of complementary and alternative medicine. And that is what this book is about.

The book attempts to answer the following question:

Is any complementary and alternative medical therapy more effective than a placebo?

To answer that question, the author proposes to examine and attempt to answer four related questions:

  1. Is there such a thing as a placebo effect? In other words, can a completely bogus therapy work?
  2. Is there something that has been demonstrated to take place within the body that could explain how a placebo effect occurs? In other words, if there is evidence that a placebo effect exists, are these results consistent with findings from other scientific disciplines?
  3. Is there such a thing as a CAM effect over and above what can be attributed to the placebo effect?
  4. Is there something that has been demonstrated to take place within the body that could explain how one or more of these CAM effects occurs? Again, this addresses the issue of whether or not the existing evidence is consistent with what we know about the biology of the human body.

Now, to me, these are completely fascinating questions, questions to which I really want to know the answers. Are there definitive answers available, based on sound scientific studies? Yes, according to our author, and this book takes us through the process of understanding what makes a scientific study scientific, what makes it reliable, and more importantly, what more often makes it unreliable, and how to interpret the results of such studies. He then examines the evidence that is actually available, focusing, naturally, on those that are the most reliable, for the reasons he clearly explicates, and tells us what those studies say about the answers to the questions posed above.

So what is the answer? Is there any evidence of any CAM effect over and above the placebo effect? I’m not going to tell you. You’ll have to read the book. And believe me, it’s well worth reading. Highly recommended!

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