For example one reason that SCAM (Supplimentary, Complementary and Alternative Medicine, a term I totally stole from Skeptico) folks shy away from evidence based medicine is because we often get our evidence of efficacy from animal testing. Its not that doctors are evil mad scientists who think its fun to hurt animals, but we require evidence that something works before we try it on humans. We breed animals for this purpose, we change their genetic make up to test various hypotheses, we probe and cut to understand various mechanisms of our biology.
As a meandering side note, here is my personal experience with animal testing. For my PhD we were developing an implant for the spine that would correct scoliosis slowly over time, rather the quick correction that is currently done. While scoliosis rates aren’t near the frequency of say autism, its not that low either, between 1 and 4% of children will get it, depending on how you set your threshold for having it (a measurement called the Cobb angle is used, a non-zero cobb angle is common, however choosing a threshold of 10 degrees is what leads to these rates).
Usually what happens is that during teenage years there is a growth spurt and kids with small scoliotic symptoms may get larger Cobb angles. Small angles are often treated with bracing (its been 10 years for me, perhaps things have changed), and more severe angles, like 50 degrees, get treated with surgery because large angles can lead to cardiovascular and other problems.
The surgery has gone through its own evolution. It was first thought that just straightening the spine would correct it. It used to be that they would slice open the back, inset screws into vertebrae and insert a rod, called a Harrington rod through the screw and use clamps to push the top and bottom vertebra away from each other, then the rod would be fastened to the screws and some of the vertebrae would be fused.
Later, some smart folks figured out that the problem with a scoliotic spine was not just a bend, but it was instead a 3-D deformity and what really needed to happen was a derotation. So a Cotrel Dubosset derotation maneuver was invented. There have been many many improvements and other variations, I don’t really want to go into it, there is a nice overview here among many other places where you can see the rods and screws and derotations.
Anyway, one of the things that is nerve racking about spinal surgery for scoliosis is that the derotation or even small adjustments may stretch the spinal cord. Patients are still, to this day, paralyzed from this procedure, some even killed because their spinal cord has been stretch to much and too fast.
So my group invented a treatment to implant a small actuator that can be energized from outside the body. When you energize the actuator, it moves one increment, its not like a motor. The increment was supposed to be like 10 or 100 microns. By implanting enough of these around the spine and ribcage the idea was that you could adjust the spine over months instead of seconds.
How do you test such a thing? Well goats. We stretched goats. We before we got started, we needed to understand what the spinal cord could take, and if making slow changes even helped at all. So we implanted a device into a goat two goat vertebrae similar to an external fixator used for limb lengthening, and every day we stretch the goat a little bit. We had to try this a number of times to understand what the range was on size of the increment and frequency of the adjustments.
Well, sadly this idea did not get off the ground. We could not get funding for the development of the device even though we had a lot of supporting data. Does that mean the now dead goats were a waste? Of course not, that spine stretching data is now available for other people to use for spine related treatments as was the other part of my research that came out of that including the forces imparted by the surgical tools and the geometric and dynamic computer spine models I came up with. All out there and being used. We stretched goats to help people with spinal disorders. People complain until it’s their spine.
Another well written on this subject comes from Orac.
OK, now lets wrap back around, what the hell does this have to do with SCAM? Evidence Based Medicine uses animal models to validate a procedure, to give evidence that it works. This reduces human suffering and casualties. We use a small controlled population of animals to help us in our quest to improve and lengthen our lives.
How about SCAM? I can’t say that I have any idea where all of the materials come for making those millions of “natural” products that pretend to cure everything, but I sure am familiar with the “Ancient Chinese Medicine” canard.
Lets look at some of that nice medicine…
Well here is a nice one. Asian black bears (Moon bears) are caught and caged, then bile is removed from gall bladders while they are alive. They are kept alive so that bile may be continually removed from them. This is in order to farm a material that supports some SCAM idea that this bile is in any way good for you. There is no evidence that it is good for anything. There are no studies. There is no controlled trials. Its just plain old wives tales handed down year after year making up the part of “Ancient Chinese Medicine”.
Here are some other wonderful reagents for Ancient Chinese Medicine. None of the uses of these endangered animals are for any purpose that have any evidence of their efficacy. None of them. There is no lasting information that transcends the death of the animals, no learning. Just unwarranted imprisonment and torture with no greater good to be found.
I have no doubt that PETA folks are as horrified by this as I am. But this is a result of continued embracing of so called ‘medicine’ without the evidence to back up its efficacy. One of the reasons to demand that the medicine that you use has been testing and found beneficial is to prevent suffering. Not only the animals are suffering, this crap doesnt work better than sugar pills. People are suffering also!
Now I could leave it there. But a thought occurred to me. What if Moon Bear bile actually did have some curative power? Would that justify imprisoning the bear to continually drain bile from an open, festering wound? Guess what? The action of evidence based medicine answers that also. The reason is that once efficacy has been determined, the next step is to find out the mechanism by which it works. We would certainly use a few bears to get some bile and test that it actually provides some curative power over sugar pills, but after that, we would try to understand how it works. We would then synthesis the material. No more moon bears would be required after that. This cycle of animal torture would stop.
Demand Evidence. Stop using SCAM.
