Robert Imrie, David Ramey & AP in osteoarthritis of the knee

[Guest guest]

Hi All, & George,

 

Re the Berman article on AP in knee osteoarthritis [

http://tinyurl.com/6m62t ], George Mandler wrote:

> Here is another essay ripping apart the article from from another angle

> by Robert Imrie a DMV (heard of this guy Phil?) ... I think we can all

> agree on some of his comments, 'googling' him shows he takes vicarious

> pleasures in ripping acupuncture as fraud.)

 

Robert Imrie and David Ramey are veterinarians, who are very active

in Quackwatch / Quackbuster circles. In incisive and well researched

articles, they highlight the weaknesses of the entire CAM area, not

just acupuncture.

 

Drs. Imrie and Ramey are articulate and very able opponents of CAM.

Do not underestimate their abilities. IMO, anyone who tries to take

them on, attempting to cite scientific proof for most CAM therapies,

is on a hiding to nothing.

 

Many clever professionals oppose CAM. They adopt the concept of

" DIvide and Conquer " , which was so successful in the hands of the

generals of the ancient Roman armies.

 

For example, PubMed Medline has 17,518+ hits for the profile:

((acup* OR moxib* OR electro-acup* OR electroacup* OR su-jok OR koryo

OR acumoxa OR moxa OR dermojet) OR ((LLLT OR (LASER NEAR (cold OR

low)) AND (therapy OR treat* OR repair* OR heal OR health* OR

healing* OR rehab* OR regenerat* OR remodel* OR enhance* OR stimul*

OR biostim* OR efficac* OR success* OR inflamm*))) OR ((transcutan*

NEAR (electros* OR electric* OR neurostimulat*)) OR (stimulat* AND

(transcutaneous-electric* OR transcutaneous-electros*)) OR (((TENS

AND electric* OR electros*) AND stimulat*)) AND (therapy OR treat* OR

repair* OR heal OR health* OR healing* OR analges* OR rehab* OR

regenerat* OR remodel* OR enhance* OR stimul* OR biostim* OR efficac*

OR success* OR inflamm*)))

 

However, if one disalllows all keywords except (acup*), the number of

hits drops to 9802.

 

Of those, one can keep on subvividing. For example the profile (acup*

AND shoulder) has only 99 hits. One can further subdivide these into

pain, stiffness, paralysys, etc.

 

For example, (acup * AND shoulder AND paralysis) = 7 hits only

 

Then, if one uses the very high standards demanded by EBM-type

criteria to examine the individual papers in the highly fragmented

subsets, one can dismiss most of them on grounds of inadequate

design, numbers, lack of adequate controls, etc.

 

This approach leaves very few high-quality studies in any one subset

of the acup* data. Inevitably, most subsets are dismissed as not

proving the effect of acup* in THAT particular condition.

 

By eliminating each subset as " unproven " , one begins to see the

whole acup* set disappearing down the plughole.

 

Next, like the puff of smoke from the conjurer's hat, scientific

support for the efficacy of AP has disappeared. Ouch!

 

One can apply the same " divide-and-conquer principle " to any CAM

modality - herbal medicine, osteopathy, homeopathy, nutraceuticals,

etc.

is correct. We are atrociously weak as regards EBM-type

scientific validation of most of what we do as practitioners in AP /

TCM.

 

That is why CAM opponents are insisting that EBM standards be used as

the basis to assess CAM. They KNOW that we cannot defend ourselves on

that battlefield.

 

So, we have to make choices:

 

(a) Do we try to fight a battle on their (EBM) terms, KNOWING that we

MUST lose the main battle?

 

or

 

(b) Avoid THAT battle and focus instead on the political / PR battle,

in which clinical satisfaction of the PATIEBTS becomes the criterion

of success or failure of our methods?

 

Do you have other ideas on how the CAM-EBM war/battle can be fought?

 

IMO, it could take 50-100 years [assuming that research funding for

high-quality EBM studies could be found] to put EBM-type support

behind all of the the CAM cliniucal applications that we know are

useful.

 

Most of us will be dead by then.

 

Meanwhile, I expect that most of us will continue to use the methods

that work reasonably well for our patients.

 

Happy Christmas to you all,

PhilBest regards,

 

Email: <

 

WORK : Teagasc, c/o 1 Esker Lawns, Lucan, Dublin, Ireland

Mobile: 353-; [in the Republic: 0]

 

HOME : 1 Esker Lawns, Lucan, Dublin, Ireland

Tel : 353-; [in the Republic: 0]

WWW : http://homepage.eircom.net/~progers/searchap.htm

 

Chinese Proverb: " Man who says it can't be done, should not interrupt

man doing it "

[Guest guest]

Hi Phil and others,

 

IMO it does no good to try to debate or in any way " take on " the Quakbuster

types. They are to modern science what religious fundamentalists are to their

respective religions; They are fighting an all-important battle and they are

right - everybody else is wrong - end of story. They will be the very last to

see that they are losing their battle. I wrote a tongue-and-cheek article about

attending the Fourth World Skeptics conference, specifically their session on

CAM (and what to do to stop it). You might want to check it out at

www.acupuncturetoday.com Hit the " previous issues " tab and then the October 2002

issue and look for my article " A Quack Among Skeptics. " Holiday cheers to all -

Matthew Bauer

 

-

; pVA-L

Cc: vBMA ; pa-l ;

traditional_Chinese_Medicine

Thursday, December 23, 2004 6:24 AM

Robert Imrie, David Ramey & AP in osteoarthritis of the knee

 

 

Hi All, & George,

 

Re the Berman article on AP in knee osteoarthritis [

http://tinyurl.com/6m62t ], George Mandler wrote:

> Here is another essay ripping apart the article from from another angle

> by Robert Imrie a DMV (heard of this guy Phil?) ... I think we can all

> agree on some of his comments, 'googling' him shows he takes vicarious

> pleasures in ripping acupuncture as fraud.)

 

Robert Imrie and David Ramey are veterinarians, who are very active

in Quackwatch / Quackbuster circles. In incisive and well researched

articles, they highlight the weaknesses of the entire CAM area, not

just acupuncture.

 

Drs. Imrie and Ramey are articulate and very able opponents of CAM.

Do not underestimate their abilities. IMO, anyone who tries to take

them on, attempting to cite scientific proof for most CAM therapies,

is on a hiding to nothing.

 

Many clever professionals oppose CAM. They adopt the concept of

" DIvide and Conquer " , which was so successful in the hands of the

generals of the ancient Roman armies.

 

For example, PubMed Medline has 17,518+ hits for the profile:

((acup* OR moxib* OR electro-acup* OR electroacup* OR su-jok OR koryo

OR acumoxa OR moxa OR dermojet) OR ((LLLT OR (LASER NEAR (cold OR

low)) AND (therapy OR treat* OR repair* OR heal OR health* OR

healing* OR rehab* OR regenerat* OR remodel* OR enhance* OR stimul*

OR biostim* OR efficac* OR success* OR inflamm*))) OR ((transcutan*

NEAR (electros* OR electric* OR neurostimulat*)) OR (stimulat* AND

(transcutaneous-electric* OR transcutaneous-electros*)) OR (((TENS

AND electric* OR electros*) AND stimulat*)) AND (therapy OR treat* OR

repair* OR heal OR health* OR healing* OR analges* OR rehab* OR

regenerat* OR remodel* OR enhance* OR stimul* OR biostim* OR efficac*

OR success* OR inflamm*)))

 

However, if one disalllows all keywords except (acup*), the number of

hits drops to 9802.

 

Of those, one can keep on subvividing. For example the profile (acup*

AND shoulder) has only 99 hits. One can further subdivide these into

pain, stiffness, paralysys, etc.

 

For example, (acup * AND shoulder AND paralysis) = 7 hits only

 

Then, if one uses the very high standards demanded by EBM-type

criteria to examine the individual papers in the highly fragmented

subsets, one can dismiss most of them on grounds of inadequate

design, numbers, lack of adequate controls, etc.

 

This approach leaves very few high-quality studies in any one subset

of the acup* data. Inevitably, most subsets are dismissed as not

proving the effect of acup* in THAT particular condition.

 

By eliminating each subset as " unproven " , one begins to see the

whole acup* set disappearing down the plughole.

 

Next, like the puff of smoke from the conjurer's hat, scientific

support for the efficacy of AP has disappeared. Ouch!

 

One can apply the same " divide-and-conquer principle " to any CAM

modality - herbal medicine, osteopathy, homeopathy, nutraceuticals,

etc.

 

Todd is correct. We are atrociously weak as regards EBM-type

scientific validation of most of what we do as practitioners in AP /

TCM.

 

That is why CAM opponents are insisting that EBM standards be used as

the basis to assess CAM. They KNOW that we cannot defend ourselves on

that battlefield.

 

So, we have to make choices:

 

(a) Do we try to fight a battle on their (EBM) terms, KNOWING that we

MUST lose the main battle?

 

or

 

(b) Avoid THAT battle and focus instead on the political / PR battle,

in which clinical satisfaction of the PATIEBTS becomes the criterion

of success or failure of our methods?

 

Do you have other ideas on how the CAM-EBM war/battle can be fought?

 

IMO, it could take 50-100 years [assuming that research funding for

high-quality EBM studies could be found] to put EBM-type support

behind all of the the CAM cliniucal applications that we know are

useful.

 

Most of us will be dead by then.

 

Meanwhile, I expect that most of us will continue to use the methods

that work reasonably well for our patients.

 

Happy Christmas to you all,

PhilBest regards,

Email: <

 

WORK : Teagasc, c/o 1 Esker Lawns, Lucan, Dublin, Ireland

Mobile: 353-; [in the Republic: 0]

 

HOME : 1 Esker Lawns, Lucan, Dublin, Ireland

Tel : 353-; [in the Republic: 0]

WWW : http://homepage.eircom.net/~progers/searchap.htm

 

Chinese Proverb: " Man who says it can't be done, should not interrupt

man doing it "

 

 

 

http://babel.altavista.com/

 

and adjust

accordingly.

 

 

If you are a TCM academic and wish to discuss TCM with other academics, click

on this link

 

 

[Guest guest]

By the way, one has to be very cautious on taking them on. They were

able to put an alternative health magazine out of business a few years

back when they quoted one of their physicians in an article, as the

physician patented every work he spoke publically, and the magazine

violated the patent and lost in court.

 

 

On Dec 23, 2004, at 8:31 AM, Matt Bauer wrote:

 

>

> IMO it does no good to try to debate or in any way " take on " the

> Quakbuster types. They are to modern science what religious

> fundamentalists are to their respective religions; They are fighting

> an all-important battle and they are right - everybody else is wrong -

> end of story. They will be the very last to see that they are losing

> their battle. I wrote a tongue-and-cheek article about attending the

> Fourth World Skeptics conference, specifically their session on CAM

> (and what to do to stop it). You might want to check it out at

> www.acupuncturetoday.com Hit the " previous issues " tab and then the

> October 2002 issue and look for my article " A Quack Among Skeptics. "  

> Holiday cheers to all - Matthew Bauer

>

>

 

 

 

 

[Guest guest]

Hi Phil,

Interesting analysis of the situation.

 

My two-cents worth is this.

1. Demand EBM from WM, ie attack rather than defend. WM can't justify

itself on EBM, already the meta analysis shows WM via doctors, drugs,

surgery, hospital etc to be the greatest cause of death in USA. Promote

this reality to the public whenever asked to defend CAM, ie don't defend CAM

attack with stats WM. Ask WM to first show us the way to EBM.

2. Continue to treat with CAM and allow the commercial evidence to speak

for itself, ie people pay to have out of insurance treatment.

3. If legislation is required to be addressed then have the people who use

CAM demand access to CAM.

4. Have the best of the best CAM practitioners identify skills and

knowledge required to be a successful practitioner of each modality, this

should then be the basis of any training. Pretty it up with appropriate

studies in allied areas, and promote the best of the best.

5. Those qualified in both WM and CAM may wish to develop (a) model/s that

show how the two approaches can be used when individuals grow beyond the ego

of any single modality and philosophical approach.

 

Best wishes,

 

 

 

[]

Friday, 24 December 2004 12:24 AM

; pVA-L

Cc: vBMA; pa-l ;

traditional_Chinese_Medicine

Robert Imrie, David Ramey & AP in osteoarthritis of the

knee

 

 

Hi All, & George,

 

Re the Berman article on AP in knee osteoarthritis [

http://tinyurl.com/6m62t ], George Mandler wrote:

> Here is another essay ripping apart the article from from another angle

> by Robert Imrie a DMV (heard of this guy Phil?) ... I think we can all

> agree on some of his comments, 'googling' him shows he takes vicarious

> pleasures in ripping acupuncture as fraud.)

 

Robert Imrie and David Ramey are veterinarians, who are very active

in Quackwatch / Quackbuster circles. In incisive and well researched

articles, they highlight the weaknesses of the entire CAM area, not

just acupuncture.

 

Drs. Imrie and Ramey are articulate and very able opponents of CAM.

Do not underestimate their abilities. IMO, anyone who tries to take

them on, attempting to cite scientific proof for most CAM therapies,

is on a hiding to nothing.

 

Many clever professionals oppose CAM. They adopt the concept of

" DIvide and Conquer " , which was so successful in the hands of the

generals of the ancient Roman armies.

 

For example, PubMed Medline has 17,518+ hits for the profile:

((acup* OR moxib* OR electro-acup* OR electroacup* OR su-jok OR koryo

OR acumoxa OR moxa OR dermojet) OR ((LLLT OR (LASER NEAR (cold OR

low)) AND (therapy OR treat* OR repair* OR heal OR health* OR

healing* OR rehab* OR regenerat* OR remodel* OR enhance* OR stimul*

OR biostim* OR efficac* OR success* OR inflamm*))) OR ((transcutan*

NEAR (electros* OR electric* OR neurostimulat*)) OR (stimulat* AND

(transcutaneous-electric* OR transcutaneous-electros*)) OR (((TENS

AND electric* OR electros*) AND stimulat*)) AND (therapy OR treat* OR

repair* OR heal OR health* OR healing* OR analges* OR rehab* OR

regenerat* OR remodel* OR enhance* OR stimul* OR biostim* OR efficac*

OR success* OR inflamm*)))

 

However, if one disalllows all keywords except (acup*), the number of

hits drops to 9802.

 

Of those, one can keep on subvividing. For example the profile (acup*

AND shoulder) has only 99 hits. One can further subdivide these into

pain, stiffness, paralysys, etc.

 

For example, (acup * AND shoulder AND paralysis) = 7 hits only

 

Then, if one uses the very high standards demanded by EBM-type

criteria to examine the individual papers in the highly fragmented

subsets, one can dismiss most of them on grounds of inadequate

design, numbers, lack of adequate controls, etc.

 

This approach leaves very few high-quality studies in any one subset

of the acup* data. Inevitably, most subsets are dismissed as not

proving the effect of acup* in THAT particular condition.

 

By eliminating each subset as " unproven " , one begins to see the

whole acup* set disappearing down the plughole.

 

Next, like the puff of smoke from the conjurer's hat, scientific

support for the efficacy of AP has disappeared. Ouch!

 

One can apply the same " divide-and-conquer principle " to any CAM

modality - herbal medicine, osteopathy, homeopathy, nutraceuticals,

etc.

 

Todd is correct. We are atrociously weak as regards EBM-type

scientific validation of most of what we do as practitioners in AP /

TCM.

 

That is why CAM opponents are insisting that EBM standards be used as

the basis to assess CAM. They KNOW that we cannot defend ourselves on

that battlefield.

 

So, we have to make choices:

 

(a) Do we try to fight a battle on their (EBM) terms, KNOWING that we

MUST lose the main battle?

 

or

 

(b) Avoid THAT battle and focus instead on the political / PR battle,

in which clinical satisfaction of the PATIEBTS becomes the criterion

of success or failure of our methods?

 

Do you have other ideas on how the CAM-EBM war/battle can be fought?

 

IMO, it could take 50-100 years [assuming that research funding for

high-quality EBM studies could be found] to put EBM-type support

behind all of the the CAM cliniucal applications that we know are

useful.

 

Most of us will be dead by then.

 

Meanwhile, I expect that most of us will continue to use the methods

that work reasonably well for our patients.

 

Happy Christmas to you all,

PhilBest regards,

[Guest guest]

I would only add to this to attack WM lack of education in CAM as well.

Later

Mike W. Bowser, L Ac

 

> <>

>Chinese Medicine

><Chinese Medicine >

>RE: Robert Imrie, David Ramey & AP in osteoarthritis of

>the knee

>Fri, 24 Dec 2004 09:01:39 +1000

>

>

>Hi Phil,

>Interesting analysis of the situation.

>

>My two-cents worth is this.

>1. Demand EBM from WM, ie attack rather than defend. WM can't justify

>itself on EBM, already the meta analysis shows WM via doctors, drugs,

>surgery, hospital etc to be the greatest cause of death in USA. Promote

>this reality to the public whenever asked to defend CAM, ie don't defend

>CAM

>attack with stats WM. Ask WM to first show us the way to EBM.

>2. Continue to treat with CAM and allow the commercial evidence to speak

>for itself, ie people pay to have out of insurance treatment.

>3. If legislation is required to be addressed then have the people who use

>CAM demand access to CAM.

>4. Have the best of the best CAM practitioners identify skills and

>knowledge required to be a successful practitioner of each modality, this

>should then be the basis of any training. Pretty it up with appropriate

>studies in allied areas, and promote the best of the best.

>5. Those qualified in both WM and CAM may wish to develop (a) model/s that

>show how the two approaches can be used when individuals grow beyond the

>ego

>of any single modality and philosophical approach.

>

>Best wishes,

>

>

>

>

> []

> Friday, 24 December 2004 12:24 AM

> ; pVA-L

> Cc: vBMA; pa-l ;

>traditional_Chinese_Medicine

> Robert Imrie, David Ramey & AP in osteoarthritis of the

>knee

>

>

> Hi All, & George,

>

> Re the Berman article on AP in knee osteoarthritis [

> http://tinyurl.com/6m62t ], George Mandler wrote:

> > Here is another essay ripping apart the article from from another

>angle

> > by Robert Imrie a DMV (heard of this guy Phil?) ... I think we can

>all

> > agree on some of his comments, 'googling' him shows he takes

>vicarious

> > pleasures in ripping acupuncture as fraud.)

>

> Robert Imrie and David Ramey are veterinarians, who are very active

> in Quackwatch / Quackbuster circles. In incisive and well researched

> articles, they highlight the weaknesses of the entire CAM area, not

> just acupuncture.

>

> Drs. Imrie and Ramey are articulate and very able opponents of CAM.

> Do not underestimate their abilities. IMO, anyone who tries to take

> them on, attempting to cite scientific proof for most CAM therapies,

> is on a hiding to nothing.

>

> Many clever professionals oppose CAM. They adopt the concept of

> " DIvide and Conquer " , which was so successful in the hands of the

> generals of the ancient Roman armies.

>

> For example, PubMed Medline has 17,518+ hits for the profile:

> ((acup* OR moxib* OR electro-acup* OR electroacup* OR su-jok OR koryo

> OR acumoxa OR moxa OR dermojet) OR ((LLLT OR (LASER NEAR (cold OR

> low)) AND (therapy OR treat* OR repair* OR heal OR health* OR

> healing* OR rehab* OR regenerat* OR remodel* OR enhance* OR stimul*

> OR biostim* OR efficac* OR success* OR inflamm*))) OR ((transcutan*

> NEAR (electros* OR electric* OR neurostimulat*)) OR (stimulat* AND

> (transcutaneous-electric* OR transcutaneous-electros*)) OR (((TENS

> AND electric* OR electros*) AND stimulat*)) AND (therapy OR treat* OR

> repair* OR heal OR health* OR healing* OR analges* OR rehab* OR

> regenerat* OR remodel* OR enhance* OR stimul* OR biostim* OR efficac*

> OR success* OR inflamm*)))

>

> However, if one disalllows all keywords except (acup*), the number of

> hits drops to 9802.

>

> Of those, one can keep on subvividing. For example the profile (acup*

> AND shoulder) has only 99 hits. One can further subdivide these into

> pain, stiffness, paralysys, etc.

>

> For example, (acup * AND shoulder AND paralysis) = 7 hits only

>

> Then, if one uses the very high standards demanded by EBM-type

> criteria to examine the individual papers in the highly fragmented

> subsets, one can dismiss most of them on grounds of inadequate

> design, numbers, lack of adequate controls, etc.

>

> This approach leaves very few high-quality studies in any one subset

> of the acup* data. Inevitably, most subsets are dismissed as not

> proving the effect of acup* in THAT particular condition.

>

> By eliminating each subset as " unproven " , one begins to see the

> whole acup* set disappearing down the plughole.

>

> Next, like the puff of smoke from the conjurer's hat, scientific

> support for the efficacy of AP has disappeared. Ouch!

>

> One can apply the same " divide-and-conquer principle " to any CAM

> modality - herbal medicine, osteopathy, homeopathy, nutraceuticals,

> etc.

>

> Todd is correct. We are atrociously weak as regards EBM-type

> scientific validation of most of what we do as practitioners in AP /

> TCM.

>

> That is why CAM opponents are insisting that EBM standards be used as

> the basis to assess CAM. They KNOW that we cannot defend ourselves on

> that battlefield.

>

> So, we have to make choices:

>

> (a) Do we try to fight a battle on their (EBM) terms, KNOWING that we

> MUST lose the main battle?

>

> or

>

> (b) Avoid THAT battle and focus instead on the political / PR battle,

> in which clinical satisfaction of the PATIEBTS becomes the criterion

> of success or failure of our methods?

>

> Do you have other ideas on how the CAM-EBM war/battle can be fought?

>

> IMO, it could take 50-100 years [assuming that research funding for

> high-quality EBM studies could be found] to put EBM-type support

> behind all of the the CAM cliniucal applications that we know are

> useful.

>

> Most of us will be dead by then.

>

> Meanwhile, I expect that most of us will continue to use the methods

> that work reasonably well for our patients.

>

> Happy Christmas to you all,

> PhilBest regards,

>

>

>

>