Product Description

Every year millions of people flock to complementary and alternative therapists offering a vast array of treatments ranging from acupuncture to biofeedback to urine injections. Millions more purchase over-the-counter alternative medications, such as glucosamine, herbs, and homeopathic remedies. While consumer motivations for turning to complementary and alternative medicine (CAM) vary, there is one common element among them all: a belief in their effectiveness. This belief appears to be prevalent among all elements of society, from scientists and physicians to celebrities such as Prince Charles and Oprah Winfrey to clerical workers and senior citizens. Do these therapies actually work? And if they work, how do they work? This book is about the science of complementary and alternative medicine, about how that science is conducted, how it is evaluated, and how it is synthesised to arrive at a conclusion about whether CAM therapies work. It is also about the phenomenon of the placebo effect, and the extent to which it is at play in a given CAM therapy's efficacy. Are CAM therapies in fact nothing more than creatively packaged placebos? In exploring this question, Barker Bausell provides an authoritative and engaging look at the nature of scientific evidence and at the logical, psychological, and physiological impediments that can confound such evidence in the world of CAM research. Ultimately, the book is not so much opposed to CAM as to the shoddy science upon which CAM claims are based, and in fact it closes with a chapter about how one might maximise the placebo effect that Bausell asserts is the main 'ingredient' of most CAM therapies. This book is a learned, witty examination not just of the scientific process as it is applied to CAM but also of the wonders of the human mind/body system.

Product Details

• Amazon Sales Rank: #130151 in Books
• Published on: 2007-11-15
• Original language: English
• Number of items: 1
• Binding: Hardcover
• 352 pages

Review
'Inside' Complementary and Alternative Medicine (CAM), we see embarrassingly little critical evaluation. Barker Bausell most certainly comes from the 'inside' and he is definitely critical about CAM; this makes his book unusual, ground-breaking and, I think, important...his book is highly informative, easy to read and full of entertaining wit and humour...aimed at the consumer...but too good a book to be read by the lay audience only. I warmly recommend it to healthcare professionals who work in CAM or have an interest in this area. Focus on Alternative and Complementary Therapies

Customer Reviews

Outstanding book that should be widely read, but won't be
Why?

Because Bausell's position on complementary and alternative medicine (CAM) is simply this: it's no more effective than a placebo. 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.

R. 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. To demonstrate a point, he recalls the work of famed research psychologist Joseph Banks Rhine at Duke University who seemed to establish statistically that people can indeed demonstrate clairvoyance by guessing face down cards, and telepathy by reading other people's minds. Rhine conducted so many experiments over so many years that the above average success of his subjects could not happen by chance. Unfortunately one day he innocently revealed that he had "a filing cabinet filled with results of experiments that had produced only chance results or lower." He explained that "these particular results were produced by people who were deliberately guessing incorrectly just to spite him." (p.270)

Bausell's point is that if studies are selected, then the statistical evaluation of the effectiveness of card guessing or some kind of treatment, is invalid. 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. He even demonstrates the probable mechanism for the placebo effect: endogenous opioids induced in the subject's brain by belief in the effectiveness of the treatment.

This brings me to the question, what's wrong with improvement that comes from the placebo effect? Nothing, is Bausell's answer, although placebo improvements usually are relatively short-lived and of moderate effectiveness. And there is nothing wrong with using CAM therapies if conventional methods are exhausted. If. 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? Wouldn't they then be without even the hope of a placebo benefit?

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. Personally I was surprised to learn that acupuncture really isn't effective beyond the placebo level. 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.

Cogent and fair-minded
I found this to be a splendidly well-written, comprehensive and fair-minded book. It is also witty. It's long enough to cover the ground, but not too long.
The publisher has done the author a disservice by using a hard-to-read sans-serif typeface and very light printing, which made the book hard to read. I hope they will go over to a conventional typeface for the paperback edition (and I'll buy a copy if they do).

The truth? Head in the sands reasoning disguised as scientific rigour
What we are seeing is a battle for dominance of healthcare by modern, chemically based medicine and Bausel is one of the footsoldiers in that battle. I believe it was Goebells who said that a lie told often enough becomes the truth and this book underlines that simple truth.

Contrary to what he tells us, many studies exist as to the efficacy of homoeopathy, way beyond placebo and whilst I cannot speak with confidence about acupuncture, I know of many who swear it has helped them with many different ailments. I also have the greatest regard for Tibetan medicne, a system that is one of the oldest in the world and which routinely cures conditions that are incurable by modern chemical based medicine. Chinese Traditional medicine, while not quite as effective as Tibetan Medicine, nevertheless can claim successes in areas where chemical based medicine must look on enviously

It doesn't take a genius to realise that something is very badly wrong with modern, chemically based medicine, with deaths from iatrogenic (doctor caused) disease massively on the increase, with fraudulent drug testing and contraindications covered up during the testing stage of many drugs, for the truth to come out when thousands have died. Many well documented cases exist of such cover-ups.

Medicine has been subverted to the profit motive and we all pay for this through massive drugs bills and by the payouts for damage done by many of these drugs.

In the case of homoeopathy, the AMA in the US waged a war to the death in the nineteenth and early twentieth centuries, not because homoeopathy was ineffective but because it was effective and because they saw it as a threat to be subverted and then destroyed.

In the UK now a similar war is being fought by those who wish to see NHS homoeopathic hospitals closed, despite high levels of public support and patient satisfaction. In India with its far more pragmatic approach, homoeopathy is a thriving, government sanctioned and supported medical system that routinely cures ailments that merely perplex drug based doctors.

But people are waking up. They realise that the drugs they receive for their conditions don't actually cure anything but merely keep them dependent as their conditions slowly deteriorate. Many are looking elsewhere and the drug companies are starting to worry seeing their massive profits under threat.

That is the true background to books like Bausel's but once people see the truth, they turn away. A final question. If homoeopathy's frequent successes are no better than placebo, why don't our western doctors with such lamentable treatment records actually resort to listening a little more to their patients? Sadly they haven't the time because like all drug pushers their rationale is merely to push product.