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R. Barker Bausell | 320 pages | 27 Aug 2009 | Oxford University Press Inc | 9780195383423 | English | New York, United States Snake Oil Science: The Truth about Complementary and Alternative Medicine by R. Barker Bausell Last year she wrote about the wonders of glucosamine and chondroitin sulfate supplements, a common CAM treatment for joint pain , and how both she and her dog are avid users of these substances. In a column , she wrote about her "arthritic spaniel's dramatic improvement" and her own "30 percent improvement," i. He walks two hours a day, goes up and down stairs easily and regularly climbs a mountain road with me. None of the studies would qualify as high quality, large scale, randomized, placebo controlled studies, however. Yet, when a high quality study involving 1, participants was published in the New England Journal of Medicine by Daniel Clegg et al. Yet, rather than reject the unbiased science in favor of her biased understanding of her personal experience, she offered this bit of rationalization and appeal to authority: "While not everyone who has tried this supplement has seen improvement, my sports medicine physician reports that at least a third of his patients have benefited. If cartilage has completely worn away, it cannot be rebuilt. On average, about half of those who try the supplements report reduced pain and stiffness. What is required of a high caliber study, the reader might wonder? According to Bausell, the most credible type of evidence available to us comes from "large [at least 25 in each group], double-blinded randomized, placebo-controlled clinical trials with low experimental attrition published in high-quality scientific journals that have been independently validated by other investigators" Unfortunately, that eliminates most CAM studies from consideration. Even so, for the period February to January , Bausell found twenty-two such studies involving such things as using to treat addiction, St. In every case but one, the results were negative Bausell wonders out loud if the one positive isn't the one-in-twenty false positive expected given the statistical standards used in these studies 0. Perhaps taking their cue from Dean Radin, many CAM supporters have turned to meta-analysis to try to make their case, although they seem to prefer the term systematic review. In any case, Bausell made his way through 98 systematic reviews of everything from using acupuncture to treat asthma to using to heal acute wounds pp. Bausell thinks he can reconcile the lack of high quality scientific studies supporting the efficacy of CAM with the fact that billions of people have been swearing by these remedies for thousands of years. The answer, he says, is in people's ignorance of the placebo effect and a few other artifacts that accompany most CAM studies and treatments. Placebo effects "are ultimately built upon human frailty and they depend upon ignorance or misconceptions for their continued effectiveness" Thus, we can probably count on CAM being around for a few more millennia. While many CAM researchers either "totally disregard" or are "totally ignorant of" methodological quality, according to Bausell, research establishing the reality and the mechanism of the placebo effect has been first class. One such study was published in the journal Pain. It was conducted by Antonella Pollo et al. Other researchers, such as Donald Price, have shown that placebos work to reduce pain only when the subject believes that the therapy is capable of reducing pain. Martina Amanzio et al. That is, we can be conditioned to release such chemical substances as endorphins, catecholamines, cortisol, and adrenaline. One reason, therefore, that people report pain relief from both acupuncture and sham acupuncture is that both are placebos that stimulate the opiod system, the body's natural pharmacy. According to Bausell, complementary and alternative medicine CAM practitioners' greatest asset is their nourishment of hope For billions of people everywhere, that seems to be enough. While it may be unethical to knowingly package, prescribe, or sell placebos as magical cures, the CAM folks seem to think they are ethical because they really believe in their chi , meridians , yin, yang, prana , vata, pitta, kapha, auras , chakras , energies , spirits , succussion , natural herbs , water with precise and selective memory , subluxations , cranial and vertebral manipulations , douches, body maps , divinities , and various unobservable processes that mysteriously carry out every sort of analgesic and curative function imaginable. Packaging placebos is big business and, for the reasons given by Bausell that have been outlined above, is likely to get even bigger. The only thing that could slow down CAM atavism would be the sudden appearance of horrible side effects issuing from toxic treatments like aura cleansings or homeopathic douches. I'd say that there's only about a one in twenty chance of that happening any time soon. And in this contradiction lies the genesis of R. All these departures from scientifically validated therapies tend to be accompanied by a disdain for the statistics supporting them, and Dr. But a stint directing research into alternative medicine has familiarized him with the thought patterns of those who use it, those who are inclined to prescribe it and those whose research seems to support it. He writes with a sense of humor and palpable compassion for all involved, and in the regrettably likely event that he winds up preaching exclusively to the choir, his book will be no less of a tour de force. Bausell starts out with the story of his late mother-in-law, Sarah, a concert pianist who developed painful arthritis in her old age and found her doctors to be generally useless when it came to satisfactory pain control. What ensued, according to Dr. Bausell, was a predictable pattern. Unfortunately, each cure was regularly replaced by a different one, in a cycle her son-in-law ruefully breaks down for detailed analysis. He makes it crystal clear exactly how the natural history of most painful conditions conspires with the immensely complex neurological and psychological phenomenon known as the placebo effect to make almost any treatment appear to work, so long as the recipient hopes and believes it will. Indeed, as Bausell reveals, it is the placebo effect that accounts for most of the positive results. He explores this remarkable phenomenon--the biological and chemical evidence for the placebo effect, how it works in the body, and why research on any therapy that does not factor in the placebo effect will inevitably produce false results. By contrast, as Bausell shows in an impressive survey of research from high-quality scientific journals and systematic reviews, studies employing credible placebo controls do not indicate positive effects for CAM therapies over and above those attributable to random chance. Here is not only an entertaining critique of the strangely zealous world of CAM belief and practice, but it also a first-rate introduction to how to correctly interpret scientific research of any sort. Readers will come away with a solid understanding of good vs. John's Wort for depression or acupuncture for chronic pain. The Rise of Complementary and Alternative Therapies 2. A Brief History of Placebos 3. Natural Impediments to Making Valid Inferences 4. Judging the Credibility and Plausibility of Scientific Evidence 8. Some Personal Research 9. Barker Bausell , Ph. He has also served as a consultant to Prevention and Discover magazines. Barker Bausell, a biostatistician, has stepped out of the shadows to give us an insider's look at how clinical evidence is manipulated to package and market the placebo effect. Labeled as "complementary and alternative medicine," the placebo effect is being sold not just to a gullible public, but to an increasing number of health professionals as well. Bausell knows every trick, and explains them in clear language. Park, Ph. It is big business with big claims and big demands on it to produce, but there is very little science behind most of it. Unfortunately, what has long been lacking is a well-written, clear, and concise analysis of its major claims to which we can direct our readers. That problem has now been remedied by R. Barker Bausell's authoritative and highly readable analysis Snake Oil Science, which should be read by anyone contemplating the use of any of the hundreds of alternative and complementary medical treatments out there that promise hope but usually deliver disappointment. Kassirer, M. So the consumer should and, I'm sure, will buy this book. Snake Oil Science: The Truth About Complementary and Alternative Medicine | JAMA | JAMA Network

CAM therapists, writes Bausell, "simply do not value and most, in my experience, do not understand the scientific process" p. Fortunately for the CAM healers, most of their clients don't understand the scientific process, either. Since the mids, when H. Beecher published a study that claimed that more than one-third of patients participating in clinical trials benefit without receiving any active treatment, medical researchers who understand what this means have designed their experiments to account for the placebo effect. New drugs or therapies might work, but if they don't work any better than a placebo then that's what they are: a placebo. This fact seems very difficult for many people to grasp. Acupuncture, for example, is currently enjoying a surge of popularity in the U. I'll return to this point later in a brief discussion of the scientific experiments described by Bausell that demonstrate this fact. Many CAM researchers seem oblivious to the requirement to rule out the placebo effect and not only don't use placebo groups, they don't use controls at all. Bausell explains the lack of placebo controls in CAM as partially due to the difficulty of devising adequate placebos. For example, it is easy to devise an adequate control for homeopathic remedies since one vial of water looks and tastes just like any other vial of water , but it would be very difficult to devise fake spinal manipulation. The placebo effect is just one of many confounding factors that make it difficult to assess properly the effectiveness of a treatment, i. The researcher must also consider "artifacts such as the natural history of a disease that is, the tendency for people to get better or worse during the course of an illness irrespective of any treatment at all , the fact that people behave differently when they are participating in an experiment than when they are not, a desire to please the experimental staff by providing socially desirable answers The scientific research has established beyond a reasonable doubt that a key factor in the placebo effect is belief. The main component of this belief is the expectation of some benefit from the treatment. Belief also seems to play a large part in the attrition rate of a study: controls often figure out they're controls and quit. Bausell does not consider all positive physiological effects that might result from reduction of stress or increase of exercise during CAM treatment to be part of the placebo effect. Even the practitioners of such voodoo as , , , , or auricular acupuncture don't attribute the wonders of their craft to relaxation. Another important factor in understanding the placebo effect is the role of suggestion and classical conditioning. Bausell speculates that we may be hardwired to be susceptible to suggestion and conditioning "because of their importance in facilitating learning" p. If you join together belief in a treatment, desire for it to bring relief, suggestion from authorities, anecdotes that it does work to relieve pain, classical conditioning, the natural history of a disorder, selective appeal to questionable studies, and the natural regression of most disorders involving chronic pain, then you have a recipe for magical thinking that will lead intelligent, highly educated persons down the path of no return from their favored CAM treatment. Last year she wrote about the wonders of glucosamine and chondroitin sulfate supplements, a common CAM treatment for joint pain , and how both she and her dog are avid users of these substances. In a column , she wrote about her "arthritic spaniel's dramatic improvement" and her own "30 percent improvement," i. He walks two hours a day, goes up and down stairs easily and regularly climbs a mountain road with me. None of the studies would qualify as high quality, large scale, randomized, placebo controlled studies, however. Yet, when a high quality study involving 1, participants was published in the New England Journal of Medicine by Daniel Clegg et al. Yet, rather than reject the unbiased science in favor of her biased understanding of her personal experience, she offered this bit of rationalization and appeal to authority: "While not everyone who has tried this supplement has seen improvement, my sports medicine physician reports that at least a third of his patients have benefited. If cartilage has completely worn away, it cannot be rebuilt. On average, about half of those who try the supplements report reduced pain and stiffness. What is required of a high caliber study, the reader might wonder? According to Bausell, the most credible type of evidence available to us comes from "large [at least 25 in each group], double- blinded randomized, placebo-controlled clinical trials with low experimental attrition published in high-quality scientific journals that have been independently validated by other investigators" Unfortunately, that eliminates most CAM studies from consideration. Even so, for the period February to January , Bausell found twenty-two such studies involving such things as using acupuncture to treat cocaine addiction, St. It is, of course, not only research into alternative therapies that is compromised by the pitfalls Dr. Bausell describes. Exactly the same subtle problems bedevil orthodox research, and they are often the source of the contradictory studies and here-today-gone-tomorrow treatment vogues that drive patients crazy. Nor are patients who are using alternative treatments the only ones to become all wrapped up in the soothing folds of the placebo effect. In fact, though, placebos have as venerable and honorable a history as just about any medication, and are better studied than most. Bausell explores the science behind placebos in detail: the pain relief they afford is reliable and reproducible, and for some reason tends to linger in memory as even stronger than it really is. But is that placebo-generated pain relief real or imaginary? Patients generally roll their eyes when the argument gets to this stage, for as Dr. But it turns out that the issue is more than just scientific nitpicking. Along the way, he provides an excellent education into such issues as what differentiates high-quality scientific research from poor quality research, publication bias, the natural history of pain, and the psychological and physiological mechanisms behind the placebo effect. Bausell's conclusion is that there is effectively no high-quality scientific research proving that any alternative medical therapy is more effective than a placebo. Many of these therapies do seem to provide temporary placebo relief, however, ensuring ongoing devotion by their adherents. Bausell's conclusion is likely to be disputed by adherents who point to anecdotal evidence or poor quality studies that affirm their treatment's efficacy, yet my own extensive experience of these treatments all of which were undertaken as a true believer leads me to agree with Bausell's findings. Though I found the subject matter of this book to be fascinating, Bausell may be a bit too detailed in laying out his arguments for the less patient reader. I found the writing easy enough for a non-scientist to understand, however, and he does punctuate the text with the occasional biostatistician joke. Having spent years of my life and money I couldn't afford pursuing these kinds of treatments, I closed this book with some rather mixed emotions. On the one hand, I am relieved to think of the money I shall save by not running after the latest treatment-du-jour. In addition, I feel I am much more capable of understanding what does and doesn't qualify as good research. On the other hand, I am disappointed to realize that there are certain annoying health issues I may just have to live with. As Bausell points out, " View all 11 comments. May 09, Carrie Poppy rated it really liked it. Very useful. Jan 23, Scott rated it really liked it. For the attention-deprived, Bausell succinctly summarizes his thesis and conclusion at the end of Chapter "CAM therapies are nothing more than cleverly packaged placebos. After all, other reviews have noted aptly that Bausell is likely preaching to choir. Those who disagree likely did not get past the front cover. Bausell starts by disc For the attention-deprived, Bausell succinctly summarizes his thesis and conclusion at the end of Chapter "CAM therapies are nothing more than cleverly packaged placebos. Bausell starts by discussing the rise in the use of CAM therapies. Conventional medicine has not always had a great track record in curing illness or alleviating pain. Can one be blamed for wanting to try alterntives remedies for chronic pain or anincurable illness - even if most have been proven complete bunk? Most positive CAM studies tend suffer from one of several flaws including publication bias and poor research practices such as low participation and high dropout rates. But, there are some items that are naturally open to criticism just by the nature of the debate. His sometimes sarcastic, albeit amusing, demeanor is not likely to win friends and influence people. Snake Oil Science is most helpful for those who want to learn about research methodologies — or lack thereof — behind CAM therapies. Bausell provides numerous citations for those who want to learn more about individual specific types of treatments. Aug 09, Ken rated it it was amazing. The author wanted to see if alternative medical treatments are any better than placebos. In any test of medicine, the placebo effect has to be taken into account, but in most research done on things like accupuncture, herbal medicines, chiropracty and others, they fail to do this. The author leads us through the history of the placebo effect, how to test for it, the difficuties of testing for it so that we are well prepared to think about what might be a properly controlled test. Few actually s The author wanted to see if alternative medical treatments are any better than placebos. Few actually seem to be, but the author is able to find some 22 that were properly controlled and were accepted by the JAMA or the New England AJournal of medicine. You can guess from the title what his results were. I haven't gone in for alternative medicines too much and I am glad I haven't because it probably saved me some cash. I tried glocosamine for my aching knees a few years back and it seemed to work for awhile The placebo effect? Peter Ryan recommended it and it seemed to have worked for him The placebo effect? I read some negative stuff on the Internet about it and stopped. The best thing for my knees turns out to be not playing basketball. My wife blows a lot of money on this stuff and has no desire to read this book. I guess I have a hard time convincing her that black goats are not that beneficial for osteoporosis. She also likes "bo-yak" which is a traditional Chinese medicine. May 23, Pam Reeder rated it liked it. Kind of dry writing. And, heck, I kind of like the placebo effect of a number of therapies -- why knock 'em if people feel better. Sep 04, Bob Colwick rated it really liked it Shelves: investigative. When my older son was diagnosed with autism, the first thing I latched on to was a cure When none of these methods worked, I found myself wanting to learn why they didn't work They never worked for my son because they would have required for HIM to believe that they would work Highly recommended for others who are going through or who have loved ones going through chronic health conditions and need to better understand the machinations behind CAM therapy. Dec 27, Kenneth Sherman rated it it was amazing. Few actually se The author wanted to see if alternative medical treatments are any better than placebos. Feb 04, Alexander Miles rated it it was amazing. When I first heard about this book, I figured it would be an all-out one-sided argument against alternative medicine, but the narrative wasn't quite as aggressive as I would have suspected. While the conclusion reached is indeed that all presently tested CAM complementary and alternative medicine therapies are no more effective then placebo, it doesn't feel like a foregone conclusion. Indeed the final chapters even encourage the reader to find a CAM therapy that works for them, with the caveat When I first heard about this book, I figured it would be an all-out one-sided argument against alternative medicine, but the narrative wasn't quite as aggressive as I would have suspected. Indeed the final chapters even encourage the reader to find a CAM therapy that works for them, with the caveats that we know they work for a limit range of applications e. The entire CAM debate is actually a shell for this book, as the substantive meat of it, at least for me, was the idea that good medical studies are really really hard to do. Bausell goes through the common confounding factors, and what it actually means for a study to be done well. Coming from the hard sciences side, where physical quantitative measurements are easy and essentially always repeatable, there were a lot of ideas that I had simply never wrestled with before. The writing style is a lot drier than the other pop-science books I've been reading lately, and that is perhaps because this isn't actually for general audiences. I'd recommend this book primarily to scientists, but if anyone has ever asked, "How do we know X doesn't work?! Jul 04, Jon Allen rated it really liked it Shelves: skepticism , science , medicine. I really enjoyed this book, because it provided a different viewpoint on Complementary and Alternative Medicine than what I've read in other books. The majority of the book is focused not on how effective any particular CAM practice, but on experimental artifacts that create false impressions of its effectiveness, e. A great deal is centered on a in-depth look at the Placebo effect and how its effects compare to the various CAM schools and criticism o I really enjoyed this book, because it provided a different viewpoint on Complementary and Alternative Medicine than what I've read in other books. A great deal is centered on a in-depth look at the Placebo effect and how its effects compare to the various CAM schools and criticism of many studies about CAM, i. While the conclusion is that CAM is probably no more effective than placebos, the author does not universally dismiss CAM, attesting that such an act would be an over-statement of the science and some people might be helped by the practices. He advises that CAM is best begun only after a frank discussion with a doctor about severity and duration of symptoms and should not be used in place of conventional medicine, e. All it was a fresh and illuminating new outlook on an area of medicine that I had never given great thought to. Jul 12, Dennis Littrell rated it it was amazing. This is not something that millions of people want to hear. Regardless, he puts together a compelling case to support this contention. In fact I would call his conclusion inescapable. Barker Bausell is a research methodologist or biostatistician, a professor at the University of Maryland, and has had many years experience in evaluating research studies. It knows the ways researchers can fool themselves, leading to biased results, and he spells them out in elaborate detail. Rhine conducted so many experiments over so many years that the above average success of his subjects could not happen by chance. Bausell notes that this selective process occurs not just from decisions made by researchers but by peer review journals and by the results that research sponsors may suppress as not helping the sales of their product or treatment. All studies done in China for example on the effectiveness of acupuncture are positive! Studies sponsored by CAM companies are also almost universally positive, and those that are not, are typically not published. Bausell has analyzed thousands of studies and finds that most do not fall within what he considers good research guidelines. The most frequent fault is the lack of a placebo control group. Without such a group it is impossible to say whether the results of the study exceed what would be expected from the placebo effect. Bausell goes into a lot detail on this and other research methodological points and makes what seems to me to be an air-tight case for rejecting the results of studies that do not meet good research guidelines. And there is nothing wrong with using CAM therapies if conventional methods are exhausted. The problem is that people shell out a lot of money for very little benefit, and in some cases neglect using conventional medicine or treatments that would work. A curious conundrum arose in my mind as I read this book. What if everybody were as sophisticated as Professor Bausell and knew that CAM therapies were no more effective than placebos? This book will be read by few true believers or practitioners of such CAM therapies as homeopathy, acupuncture, distant healing, therapeutic touch, etc. And those trained in Ayurvedic or traditional Chinese medicine will be appalled at how blithely Bausell dismisses the efficacy of their ancient traditions. Certainly the theoretical basis of the Ayurvedic and Chinese healing arts is in conflict with the way modern science understands the human body. Still I wonder if these venerable bodies of knowledge can be completely discounted as Bausell seems to discount them. The people who will read this book, and should, are practitioners of medical research who want to be sure that they understand how such research should be conducted, and others who want the unvarnished truth about CAM. From this point of view—and I think it is the proper one—this is an outstanding book, probably destined to become the recognized work on the effectiveness of CAM research methods and results for some time to come. Jul 30, Stephanie rated it liked it Shelves: I read this book to challenge myself as a Chemistry graduate and a person who uses different CAM therapies. Early in the book, Bausell states "None of this will be relevant to people whose beliefs are more important to them than whether or not those beliefs are correct. Discussions such as this are relevant only for those individuals who are willing to consider the possibility that science represents a reasonable path toward providing specific answers to exceedingly specific questions - people, i I read this book to challenge myself as a Chemistry graduate and a person who uses different CAM therapies. Discussions such as this are relevant only for those individuals who are willing to consider the possibility that science represents a reasonable path toward providing specific answers to exceedingly specific questions - people, in other words, who believe that science has its place in the world of thought and that one of those places is in the protection, restoration, and maintenance of our health. Things I appreciated from this book: Bausell states what quality research should include and not include when being performed when examining different CAM therapies providing framework to account for the placebo effect. He discusses the reality of research bias - he doesn't limit this to CAM therapies and explains how even conventional medicine research has it's faults Adam Ruins Everything has a great episode on research integrity. Bausell mentions early in the book that even conventional practitioners prescribe different drugs to act as a placebo which, while this is very true and needs to be recognized by the public - he does not explain that the drugs are active enough to affect the human bodies in different ways due to side effects. Snake Oil Science - Hardcover - R. Barker Bausell - Oxford University Press

Does it matter if my brain is actually prompting my body to heal, with no side effects, versus possibly pumping my body full of drugs? To that I answer - No. Number one reason I believe in Medical Freedom mind you I still have to pay for Medical Insurance that does not cover my therapy of choice. Things that are missing from this book: From all of the examined research cases, the length of the cases are never discussed. Does anyone really believe that certain herbs that are used to treat different conditions really just instantly relieve pain? To me, certain studies should be conducted over a longer period of time to examine long term effects and see if there are any changes. I also think, although Bausell is knowledgeable on different times of CAM, he might not know exactly the complexities of the medicine and does not seem to understand that some CAM Chinese Medicine and Homeopathy come to mind quickly do not have just one-size-fits all medicine for each person; the body is treated as a whole. For example, you cannot just give everyone in a trial one medicine that is supposed to treat one symptom. It's amazing that our species survived for hundreds of thousands of years using primarily herbal medicines and other ancient therapies now classified as CAM! Oct 15, Kat Grant rated it liked it. I must admit, this book was a little bit above my reading level but I very much enjoyed it. Snake Oil Science is valuable reading if you wish to better understand how to read scientific studies and judge their quality. This book is not an attack but a soft invitation to better understand how things work. Absolutely recommend. Feb 07, Andrea Berardi rated it really liked it. I found the foundation of this book to be fascinating. Aug 29, Mehmet rated it liked it. This book's content is so important, especially in the first couple of chapters, but its quality of argument deteriorates so thoroughly near the end, that I cannot fully endorse it. Read the arguments in the later parts with full skepticism not that one should ever drop that guard , and use this book in conjunction with others such as Trick or Treatment. Jan 07, Temnospondyli rated it liked it. A bit of a slog in places. Bausell really digs deep into the methods of a proper scientific study, which isn't necessarily good reading, while being absolutely invaluable in evaluating Complementary and Alternative "medicine". The book spends much of its time focused on how the placebo effect works, what it is, and how it can make a mess of poorly controlled studies. Trust me, if you want to know about the placebo effect, this book is for you how odd that it wasn't mentioned in the title or sub A bit of a slog in places. Trust me, if you want to know about the placebo effect, this book is for you how odd that it wasn't mentioned in the title or subtitle of the book I wish more time had been spent going in-depth with several of the CAM's mentioned in the book, taking apart specific studies 98 studies were mentioned in one chapter, but given only a cursory sentence or two , although that would have made a much longer book by far. Some of the book seems a bit repetitive as Bausell really hammers home the important aspects of scientific evaluations but it is worth the effort. Overall, this is a good book, if not always an easy read and is well worth the effort for anyone who is interested in the placebo effect and learning the weaknesses of so many highly-touted CAM studies. Oct 30, Ariadna73 rated it it was ok Shelves: health-and-health-care , drugs. This book discusses a set of different techniques called "complementary medicine", and then goes on to give advice on how to lead better lives by eating smart, breathing well and getting some exercise. This is the jacket of the book I read. This is the editorial page. Bausell published it 10 years ago, in I found it interesting even today. So, it has passed a little bit of the test of time. This is the table of contents This book discusses a set of different techniques called "complementary medicine", and then goes on to give advice on how to lead better lives by eating smart, breathing well and getting some exercise. This is the table of contents; as you can see, the discussion in the book focuses with great rigour in the validity of the science behind the CAM Complementary Alternative Medicine. This is part of the prologue, when this doctor says that his book will prove that there is no evidence behind CAM, and that people are just under some kind of spell related to the placebo effect. For some reason this reasoning does not apply to . Here is part of the introduction: And some statistics: In conclusion, I found this book interesting, but obviously very biased towards the author's own beliefs. Which is not bad at all. Well, I hope you liked this review. Did you know that I also have a blog? Jan 10, Margot rated it it was amazing Shelves: non-fiction. I thoroughly enjoyed this book. I would highly recommend it to anyone interested in the methods of scientific research it makes science exciting! Although the topic is specifically complementary and alternative medicine, biostatician Bausell takes the reader on a comprehensive and comprehensible tour of the scientific process, explaining what goes into good research, and the possible confounding factors. The biggest factor in this type of research is the placebo effect, and the section in whi I thoroughly enjoyed this book. The biggest factor in this type of research is the placebo effect, and the section in which Bausell cites evidence for the biological existence of the placebo effect was incredibly enlightening. My friend send me a link for an infographic on the same topic after I raved to her about this book. Here are a few samples: "Even as late as the s and early s it was not uncommon for hospital pharmacies to stock both placebo pills sugar and injections saline --conveniently available in selected colors. For at some point in our history we, as humans, began adapting our environment to our own needs rather than the other way around, to the extent that it is now against our nature to accept our fate without a struggle--which in turn means that we as a species have become inveterate experimenters. In other words, we are all scientists. We have to be. If a serious problem arises, it is written in our genes that we must try to solve it. If you'll bear with me for just a page or two longer, however, I'll make you even more jealous. These reviews provide a judgment regarding whether or not the paper should be published as well as extensive revisions and comments. This is sometimes called the peer review process in science, and while imperfect, it is the best we've come up with yet. Jan 21, Marshall rated it really liked it Shelves: non-fiction , science , health. This book explores the scientific research on alternative medicine. The best part is at the beginning. It has the best explanation I've seen so far of the placebo effect. He explains what it is, how it works physiologically, and how to control for it. He also explains the many other confounding variables and biases good research must control for if they want to claim to have scientific results supporting their treatments. The verdict is pretty bad. He goes through dozens of the best research that This book explores the scientific research on alternative medicine. He goes through dozens of the best research that exists on the subject. The only ones that showed positive results failed to control sufficiently for all of the variables and biases. The biggest culprit was always that pesky placebo effect. The placebo is so powerful and so pervasive and so hard to control for that it always rears its head in research of this kind. It's not that the placebo is a bad thing. It's an amazing gift our brains have given us-- just by believing a treatment will work, it so often does, even when it doesn't. But alternative medicine practitioners claim that their treatments are more than just fancy placebos. This is an empirical claim, so it should be explored empirically. The author tends to pick on acupuncture. He never explained why, whether is was because it was the worst culprit it seemed to be , or whether he has a personal grudge against it. Feb 01, Dave rated it really liked it. More than just a scientific look at alternative medicine. Bausell explains the placebo effect and several related factors that you may not have heard of. Taking these effects into account in a clinical trial is tough. He discusses in depth what it takes to run a rigorous clinical trial, the kind you should base your medical decisions on. The last section of the book explores studies on alternative medicine. How nearly all of them fail to meet the criteria for a good clinical trial and the few th More than just a scientific look at alternative medicine. How nearly all of them fail to meet the criteria for a good clinical trial and the few that do show no benefit from alternative therapy. When I picked up this book I was hoping to read some specifics on debunking clinical trials of alternative medicine. It definitely has that in abundance. However, I was more intrigued by material on placebos and designing clinical trials. The way your mind can affect your body and vice versa is amazing. Dec 31, Lauren rated it really liked it Shelves: recommended-nonfiction , science-skepticality-smarts. A bit technical and dense, but still highly readable. Lots of information on why exactly it is that peer-reviewed research and science-based medicine do not support the claims of CAM. Anyone who has been paying any attention to the science and the studies as opposed to the hype and the rhetoric can probably already guess the conclusion of this book. CAM, for the most part, is not supported by the e A bit technical and dense, but still highly readable. Please talk to your doctor before trying ANY alternative therapy or supplement or herbal or treatment. Your doctor went to medical school for a reason: to be able to help you sort the wheat from the chaff. Jul 05, Kirsten rated it it was amazing Shelves: favorites. I loved this book. It was such an enlightening read. Bausell definitely has a bit of a snarky and sarcastic way of writing which I thoroughly enjoyed. It made the material much more entertaining to read and his small jokes helped get me through some of the more boring parts of the book. I will say that this book is really more for those who are sort of the fence regarding CAM therapies as opposed to those who believe in them. Bausell, as mentioned above, comes off as very snarky and sarcastic an I loved this book. Bausell, as mentioned above, comes off as very snarky and sarcastic and this may not go over well with those who firmly believe in these therapies. This is definitely a book I will keep and reference often and I already have referenced it multiple times for use in my grad courses. Apr 20, Melanie Meyer rated it really liked it. Although this wasn't the most interesting thing I have ever read,research methodology can be a little "dry", the information contained in this book is incredibly valuable. This is a thorough, systematic review of the high-quality, empirical scientific evidence for complimentary and alternative medicine, and comparison of how CAM therapies stack up against the placebo effect. The conclusion after reviewing years of research from around the world into a variety of alternative medicines: Go see you Although this wasn't the most interesting thing I have ever read,research methodology can be a little "dry", the information contained in this book is incredibly valuable. The conclusion after reviewing years of research from around the world into a variety of alternative medicines: Go see your M. Nov 30, David rated it really liked it Shelves: science. A research methodologist's view of complementary and alternative medicine. Strict, rigorous, and utterly devastating to those who still hold hope for these kinds of methods. The final section is a little patronizing, however, giving advice on how to choose the right placebo for you. Those placebos would only work if you didn't believe anything you read in the book beforehand, so few people will find that useful. Shelves: nonfiction-misc. He also investigates some of the science behind the placebo effect itself. Apr 17, Holly rated it liked it Shelves: reads. This is an exploration of the placebo effect and trials of medical therapies. Emphases on publication bias, the natural history of pain, and the psychological and physiological mechanisms behind the placebo effect. Very interesting; not a takedown so much as an effort to clear the miasma of popular confusion. Punctuated by biostatistics jokes. Feb 18, Rosalinda rated it it was amazing. I really enjoyed this book. It was written by a bio statistician so I new it was right up my ally and sure enough, I loved his presentation of data analysis and research design. The context is equally important given that people spend so much money on alternative medicine these days. In the end, I have a better understanding and appreciation for the placebo effect. Aug 09, Isil Arican rated it it was amazing. Very organized book with lots of scientific evidence. Provides a great overview for the Placebo effect, and comparison of placebo with various CAM therapies. Also includes a complete section on "how to evaluate a scientific study" and comparison on various research methods. Strongly recommended for critical thinkers, clinical researchers. Also a good eye-opener for CAM supporters. Apr 02, Chris Pederson rated it it was amazing Shelves: non- fiction. It asks the question 'Is any complementary or alternative medical therapy more effective than a placebo? It discusses the placebo effect, statistics, the up and down nature of illness, the research process, and a brief meta-analysis of hundreds of 'altmed' studies. May 22, Doc added it. Excellent book by a biostatistician about why all alternative medical techniques work - for two weeks! Becomes an exploration of the placebo effect. Hence, a good book. View 1 comment. Dec 24, Kate rated it did not like it. He has such little respect for someone that makes his living off of the CAM field that it's hard to take even his legitimate points seriously. And putting comments in parentheses doesn't make them any less bitchy. There are no discussion topics on this book yet. Readers also enjoyed. About R. Books by R. Escape the Present with These 24 Historical Romances. You know the saying: There's no time like the present In that case, we can't Read more Trivia About Snake Oil Science No trivia or quizzes yet. The best science involves randomized placebo control groups, but these are not always easy to implement: placebo treatments for manipulation therapies or drugs with side effects are difficult to implement and, compounded by the need to obtain informed consent, can result in incomplete blinding and differential attrition. So Bausell considers some general rules for judging the credibility and plausibility of scientific evidence. After this background, and a brief account of his own experience researching acupuncture, Bausell begins his argument proper. He begins by "proving the obvious", with tests of the placebo effect and of the role of conditioning. From these he concludes: "The placebo effect is real and is capable of exerting at least a temporary pain reduction effect. It occurs only in the presence of the belief than an intervention or therapy is capable of exerting this effect. This belief can be instilled through classical conditioning, or simply by the suggestion of a respected individual that this intervention or therapy can reduce pain. Out of twenty one such trials, there was only one positive result, which is about what you'd expect by chance, testing at a 0. An alternative approach is that taken by the Cochrane Collaboration, to systematically review all the trials of a therapy and to analyze them together. In addition to general trial quality concerns, the biggest problem with such reviews is publication bias: positive results are vastly more likely to get published than negative ones. Surveying nearly one hundred of the best quality reviews of CAM therapies reveals some notionally positive results, but these are always qualified by extremely weak support or poor quality evidence. 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. Bausell finishes with some tips on how to make best use of the placebo effect in selecting a CAM treatment and therapist.

Snake Oil Science (R. Barker Bausell) - book review

Privacy Policy Terms of Use. Sign in to access your subscriptions Sign in to your personal account. Institutional sign in: OpenAthens Shibboleth. Create a free personal account to download free article PDFs, sign up for alerts, and more. Purchase access Subscribe to the journal. Sign in to download free article PDFs Sign in to access your subscriptions Sign in to your personal account. Get free access to newly published articles Create a personal account or sign in to: Register for email alerts with links to free full-text articles Access PDFs of free articles Manage your interests Save searches and receive search alerts. Get free access to newly published articles. Create a personal account to register for email alerts with links to free full-text articles. Sign in to save your search Sign in to your personal account. Create a free personal account to access your subscriptions, sign up for alerts, and more. Purchase access Subscribe now. Purchase access Subscribe to JN Learning for one year. Sign in to customize your interests Sign in to your personal account. Create a free personal account to download free article PDFs, sign up for alerts, customize your interests, and more. With equal dexterity Dr. Bausell introduces us to Dr. Smith, a fictional physician who becomes interested in acupuncture and convinced that it helps his patients. Enthusiastically organizing a series of research studies to confirm his conviction, Dr. Smith falls victim to an even more complicated set of scientific, psychological and emotional confounders than did Sarah, all of which invalidate his science and make his treatment appear far more effective than it actually is. It is, of course, not only research into alternative therapies that is compromised by the pitfalls Dr. Bausell describes. Exactly the same subtle problems bedevil orthodox research, and they are often the source of the contradictory studies and here-today-gone-tomorrow treatment vogues that drive patients crazy. Nor are patients who are using alternative treatments the only ones to become all wrapped up in the soothing folds of the placebo effect. In fact, though, placebos have as venerable and honorable a history as just about any medication, and are better studied than most. Bausell explores the science behind placebos in detail: the pain relief they afford is reliable and reproducible, and for some reason tends to linger in memory as even stronger than it really is. But is that placebo-generated pain relief real or imaginary? Patients generally roll their eyes when the argument gets to this stage, for as Dr. But it turns out that the issue is more than just scientific nitpicking.

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